Challenges and implications of routine depression screening for depression in chronic disease and multimorbidity: a cross sectional study

<b>Background</b> Depression screening in chronic disease is advocated but its impact on routine practice is uncertain. We examine the effects of a programme of incentivised depression screening in chronic disease within a UK primary care setting.<p></p> <b>Methods and Findings</b> Cross sectional analysis of anonymised, routinely collected data (for 2008-9) from family practices in Scotland serving a population of circa 1.8 million. Patients registered in primary care with at least one of three chronic diseases, coronary heart disease, diabetes and stroke, underwent incentivised depression screening using the Hospital Anxiety and Depression Score (HADS). <p></p> 125143 patients were identified with at least one chronic disease. 10670 (8.5%) were under treatment for depression and exempt from screening. Of the remaining, HADS were recorded for 35537 (31.1%) patients. 7080 (19.9% of screened) had raised HADS (≥8); the majority had indications of mild depression with a HADS between 8 and 10. Over 6 months, 572 (8%) of those with a raised HADS (≥8) were initiated on antidepressants, while 696 (2.4%) patients with a normal HADS (<8) were also initiated on antidepressants (relative risk of antidepressant initiation with raised HADS 3.3 (CI 2.97-3.67), p value <0.0001). Of those with multimorbidity who were screened, 24.3% had a raised HADS (≥8). A raised HADS was more likely in females, socioeconomically deprived, multimorbid or younger (18-44) individuals. Females and 45-64 years old were more likely to receive antidepressants.<p></p> <b>Limitations</b> – retrospective study of routinely collected data.<p></p> <b>Conclusions </b> Despite incentivisation, only minority of patients underwent depression screening, suggesting that systematic depression screening in chronic disease can be difficult to achieve in routine practice. Targeting those at greatest risk such as the multimorbid or using simpler screening methods may be more effective. Raised HADS was associated with a higher number of new antidepressant prescriptions which has significant resource implications. The clinical benefits of such screening remain uncertain and merit investigation

Laser radiation pressure slowing of a molecular beam

There is substantial interest in producing samples of ultracold molecules for possible applications in quantum computation, quantum simulation of condensed matter systems, precision measurements, controlled chemistry, and high precision spectroscopy. A crucial step to obtaining large samples of ultracold, trapped molecules is developing a means to bridge the gap between typical molecular source velocities (~150-600 m/s) and velocities for which trap loading or confinement is possible (~5-20 m/s). Here we show deceleration of a beam of neutral strontium monofluoride (SrF) molecules using radiative force. Under certain conditions, the deceleration results in a substantial flux of molecules with velocities <50 m/s. The observed slowing, from ~140 m/s, corresponds to scattering ~10000 photons. We also observe longitudinal velocity compression under different conditions. Combined with molecular laser cooling techniques, this lays the groundwork to create slow and cold molecular beams suitable for trap loading.Comment: 7 pages, 7 figures. Supplementary material updated

An integrative review of attention biases and their contribution to treatment for anxiety disorders

Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians.published_or_final_versio

Injection seeded, diode pumped regenerative ring Nd:YAG amplifier for spaceborne laser ranging technology development

A small, all solid state, regenerative ring amplifier designed as a prototype for space application is discussed. Novel features include dual side pumping of the Nd:YAG crystal and a triangular ring cavity design which minimizes the number of optical components and losses. The amplifier is relatively small (3 ns round trip time) even though standard optical elements are employed. The ring regeneratively amplifies a 100 ps single pulse by approximately 10(exp 5) at a repetition rate of 10 to 100 Hz. The amplifier is designed to be injection seeded with a pulsed, 100 ps laser diode at 1.06 microns, but another Nd:YAG laser system supplying higher pulse energies was employed for laboratory experiment. This system is a prototype laser oscillator for the Geoscience Laser Ranging System (GLRS) platform. Results on measurements of beam quality, astigmatism, and gain are given

Influence of Introduced Peregrine Falcons on the Distribution of Red Knots within a Spring Staging Site

Predator recovery driven by single-species management approaches may lead to conservation conflicts between recovered predators and prey species of conservation concern. As part of an aggressive recovery plan, the Eastern Peregrine Falcon Recovery Team released (1975–1985) 307 captive-reared peregrine falcons (Falco peregrinus) and successfully established a breeding population within the mid-Atlantic Coastal Plain, a physiographic region with no historic breeding population and a critical spring staging area for migratory shorebirds. We examined the influence of resident falcons on the distribution of foraging red knots during spring migration. We conducted weekly aerial surveys (2006–2009) along the Virginia barrier islands during the spring staging period (25 April– 6 June) to map foraging red knots (Calidris canutus) and evaluated the influence of proximity (0–3, 3–6, \u3e6 km) of beaches to active peregrine falcon nests on knot density (birds/km). Accumulated use of beaches throughout the season by red knots was significantly influenced by proximity of beaches to active falcon nests such that mean density was more than 6 fold higher on beaches that were \u3e6 km compared to beaches that were only 0–3 km from active eyries. Whether or not an eyrie was used in a given year had a significant influence on the use of associated close (0–3 km) beaches. From 6.5 to 64 fold more knots used beaches when associated eyries were not active compared to when they were active depending on the specific site. Historically, red knots and other migratory shorebirds would have enjoyed a peregrine-free zone within this critical staging site. The establishment of a dense breeding population of falcons within the area represents a new hazard for the knot population

Quantum secret sharing with qudit graph states

We present a unified formalism for threshold quantum secret sharing using graph states of systems with prime dimension. We construct protocols for three varieties of secret sharing: with classical and quantum secrets shared between parties over both classical and quantum channels.Comment: 13 pages, 12 figures. v2: Corrected to reflect imperfections of (n,n) QQ protocol. Also changed notation from $(n,m)$ to $(k,n)$, corrected typos, updated references, shortened introduction. v3: Updated acknowledgement