Are Antidepressants Overprescribed? Patients’ Experiences of the Prescribing Process

An online survey was completed by 1829 New Zealand adults prescribed antidepressants. Only 43% were experiencing self-reported “severe” depression when first prescribed antidepressants. Thus, most prescriptions were for depression that was self-reported as mild or moderate, despite studies suggesting that antidepressants are no more effective than placebo at these levels. General practitioners (GPs) prescribed at lower depression levels than psychiatrists and spent less time with patients. 35% of GPs and 42% of psychiatrists reportedly gave no information about adverse effects. Almost no prescribers gave information about adverse effects in the personal and interpersonal domains, or about withdrawal effects. Closer adherence to evidence-based prescribing and to the principle of informed consent may lead to a reduction in unnecessary, ineffective, and potentially harmful prescribing

The effects of investigating homicide on police investigators

This paper presents the initial findings of an exploratory study comparing the cognitive and emotional stressors experienced by police when investigating suspicious child and adult deaths (e.g. homicides). The results of an online survey questionnaire with 99 experienced UK police investigators are presented, with key differences found in the cognitive and emotional stress experienced depending on whether the victim was a child or an adult, and key differences and similarities identified in the ways investigators deal and cope with adult and child victim cases. A brief discussion of the implications for the well-being and training of police homicide investigators is also provided

Polarization Observations with the Cosmic Background Imager

We describe polarization observations of the CMBR with the Cosmic Background Imager, a 13 element interferometer which operates in the 26-36 GHz band from Llano de Chajnantour in northern Chile. The array consists of 90-cm Cassegrain antennas mounted on a steerable platform which can be rotated about the optical axis to facilitate polarization observations. The CBI employs single mode circularly polarized receivers which sample multipoles from ℓ~400 to ℓ~4250. The instrumental polarization of the CBI was calibrated with 3C279, a bright polarized point source which was monitored with the VLA

Substitution, delegation or addition? Implications of workforce skill mix on efficiency and interruptions in computed tomography

Objectives: This study evaluated multiple computed tomography (CT) workforce models to identify any implications on efficiency (length of stay, scan frequency and workforce cost) and scanning radiographer interruptions through substituting or supplementing with a trained CT assistant. Methods: The study was conducted in a CT unit of a tertiary Queensland hospital and prospectively compared four workforce models, including usual practice: Model 1 used an administrative assistant (AA) and one radiographer Model 2 substituted a medical imaging assistant (MIA) for the AA Model 3 was usual practice, consisting of two radiographers and Model 4 included two radiographers, with a supplemented MIA. Observational data were collected over 7 days per model and were cross-checked against electronic records. Data for interruption type and frequency, as well as scan type and duration, were collected. Annual workforce costs were calculated as measures of efficiency. Results: Similar scan frequency and parameters (complexity) occurred across all models, averaging 164 scans (interquartile range 160-172 scans) each. The median times from patient arrival to examination completion in Models 1-4 were 47, 35, 46 and 33 min respectively. There were between 34 and 104 interruptions per day across all models, with the 'assistant role' fielding the largest proportion. Model 4 demonstrated the highest workforce cost, and Model 2 the lowest. Conclusion: This study demonstrated that assistant models offer similar patient throughput to usual practice at a reduced cost. Model 2 was the most efficient of all two-staff models (Models 1-3), offering the cheapest workforce, slightly higher throughput and faster examination times. Not surprisingly, the additional staff model (Model 4) offered greater overall examination times and throughput, with fewer interruptions, although workforce cost and possible role ambiguity were both limitations of this model. These findings may assist decision makers in selecting the optimal workforce design for their own individual contexts. What is known about the topic?: Innovative solutions are required to address ongoing health workforce sustainability concerns. Workforce substitution models using trained assistants have demonstrated numerous benefits internationally, with translation to the Australian allied health setting showing promise. What does this paper add?: Building on existing research, this study provides clinical workforce alternatives that maintain patient throughput while offering cost efficiencies. This study also quantified the many daily interruptions that occur within the CT setting, highlighting a potential clinical risk. To the best of our knowledge, this study is the first to empirically test the use of allied health assistants within CT. What are the implications for practitioners?: Role substitution in CT may offer solutions to skills shortages, increasing expenditure and service demand. Incorporating appropriate assistant workforce models can maintain throughput while demonstrating implications for efficiency and interruptions, potentially affecting staff stress and burnout. In addition, the assistant's scope and accepted level of interruptions should be considerations when choosing the most appropriate model

The cuttlefish Sepia officinalis (Sepiidae, Cephalopoda) constructs cuttlebone from a liquid-crystal precursor

Cuttlebone, the sophisticated buoyancy device of cuttlefish, is made of extensive superposed chambers that have a complex internal arrangement of calcified pillars and organic membranes. It has not been clear how this structure is assembled. We find that the membranes result from a myriad of minor membranes initially filling the whole chamber, made of nanofibres evenly oriented within each membrane and slightly rotated with respect to those of adjacent membranes, producing a helical arrangement. We propose that the organism secretes a chitin-protein complex, which self-organizes layer-by-layer as a cholesteric liquid crystal, whereas the pillars are made by viscous fingering. The liquid crystallization mechanism permits us to homologize the elements of the cuttlebone with those of other coleoids and with the nacreous septa and the shells of nautiloids. These results challenge our view of this ultra-light natural material possessing desirable mechanical, structural and biological properties, suggesting that two self-organizing physical principles suffice to understand its formation.Spanish Ministerio de Ciencia e Innovacion [CGL2010-20748-CO2-01, CGL2013-48247-P, FIS2013-48444-C2-2-P]; Andalusian Consejeria de Innovacion Ciencia y Tecnologia [RNM6433]; (Sepiatech, PROMAR program) of the Portuguese Ministerio da Agricultura e do Mar, Portugal [31.03.05.FEP.002]; Junta de Andalucia [RNM363]; FP7 COST Action of the European Community. [TD0903]info:eu-repo/semantics/publishedVersio

Genic Variation in White-tailed Deer from Arkansas

Liver and kidney samples of 33 white-tailed deer (Odocoileus virginianus) representing three populations in Arkansas were examined with horizontal starch gel electrophoresis. Of 17 loci examined, only PGM-1 and ES-2 exhibited polymorphism. Average individual heterozygosity, ranging from 2.3% to 4.7% with a mean of 3.1 %, was much lower than that reported for white-tailed deer in other parts of its range. The three populations examined in this study were highly similar based on Rogers\u27 genetic similarity coefficient

Monthly average daily global and diffuse solar radiation based on sunshine duration and clearness index for Brasov, Romania

The main objective of this study is to develop single location appropriate models for the estimation of the monthly average daily global and diffuse horizontal solar radiation for Brasov, Romania. The study focuses particularly on models based on the sunshine duration and clearness index. The data used for the calibration of the models were collected during a period of 4 yr, between November 2008 and October 2012, at the Transilvania University of Brasov. The testing and validation of the models was carried out using data from the online SoDa database for Brasov for the year 2005. Different statistical error tests were applied to evaluate the accuracy of the models. The predicted values are also compared with values from three other known models concerning the global and diffuse solar radiation. A new mixed model was developed for the estimation of monthly average daily global horizontal solar radiation. The data processing was performed by means of a real-time interface developed with LabVIEW graphical programming language. The parameters taken into account were the relative sunshine, the clearness index, the extraterrestrial radiation, the latitude and the longitude. The methodology is simple and effective and may be applied for any region. Its effectiveness was proven through comparison with global models

Impact History on Vesta: Petrographic, Compositional and Future Chronological Studies of Melt Clasts in Howardites

Howardite meteorites are polymict breccias composed mainly of eucritic and diogenitic material that likely originate from the surface of the Asteroid 4 Vesta. They can be separated into two subtypes: Regolithic, which represent the lithified remains of the active vestan regolith; Fragmental, which represent simpler polymict breccias. Amongst the regolithic features observed in the former, melt clasts are particularly striking for their appearance and compositional variability. They range from glassy spherules to finely crystalline (i.e., devitrified) clasts, and clasts containing only relict mineral grains to those containing only phenocrysts. Glasses can be separated into compositional sub-types including those with low FeO/MgO ratios (less than 5) -low alkali glasses, K-rich (K2O greater than 0.2 wt.%), Na-rich (Na2O greater than 0.6 wt.%) and CaO-rich, and those with high FeO/MgO ratios (greater than 10). There is also a distinction to be made between primary volcanic melt clasts and those produced by impacts. While suggested that a lack of chemical homogeneity among their studied melt clasts ruled out a primary volcanic origin, the low siderophile element contents observed in such clasts suggest less compositional influence from impactors than commonly assumed. Studying the chronology of the impact melt clasts in howardites can help us to better determine the timing of impact events on Vesta and the asteroid belt. In this research, we are launching an investigation into the petrology, composition (major/trace element and noble gas) and chronology of melt clasts in howardites. We have selected a set of howardites known to contain large quantities of melt clasts, and have begun the petrological and compositional studies of these materials. Once the melt clasts have been fully classified, we aim to perform chronological studies of individual clasts using both the Ar-40/Ar-39 and Pb-Pb chronometers, as well as determine the noble gas components present. Of particular note, the study will take advantage of the laser ablation techniques associated with the noble gas facilities at ASU, which will allow high-resolution, in-situ analysis of individual clasts. The broader aim of this work is to ascertain whether the impact flux in the region of the asteroid belt was similar to that on the Moon. Our understanding of impact events in the inner Solar System relies heavily on our analyses of lunar meteorites and returned samples, and there is currently some debate regarding whether there was a "Lunar Cataclysm" event around approx. 3.9 Ga, or the end of an epoch of "Late Heavy Bombardment" (LHB) at this time. New and more comprehensive constraints on howardite melt clast ages may help determine whether the asteroid belt experienced such a cataclysm or LHB