Clinical effectiveness of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial

BACKGROUND: Computerised cognitive-behavioural therapy (CCBT) might offer a solution to the current undertreatment of depression. AIMS: To determine the clinical effectiveness of online, unsupported CCBT for depression in primary care. METHOD: Three hundred and three people with depression were randomly allocated to one of three groups: Colour Your Life; treatment as usual (TAU) by a general practitioner; or Colour Your Life and TAU combined. Colour Your Life is an online, multimedia, interactive CCBT programme. No assistance was offered. We had a 6-month follow-up period. RESULTS: No significant differences in outcome between the three interventions were found in the intention-to-treat and per protocol analyses. CONCLUSIONS: Online, unsupported CCBT did not outperform usual care, and the combination of both did not have additional effects. Decrease in depressive symptoms in people with moderate to severe depression was moderate in all three interventions. Online CCBT without support is not beneficial for all individuals with depressio

PND44 Eliciting Patients’ Preferences for Epilepsy Diagnostics: A Discrete Choice Experiment

Background: Diagnosing epilepsy is a lengthy and burdensome process for patients and their family. Although the need for a more patient-centered approach in clinical practice is widely acknowledged, empirical evidence regarding patient preferences for diagnostic modalities in epilepsy is missing. The objectives of this study were 1) to identify to what extent important attributes of diagnostic procedures in epilepsy affect preferences for a procedure, 2) to determine the relative importance of these attributes, and 3) to calculate overall utility scores for routine electroencephalography (EEG) and magnetoencephalography (MEG) recordings. Methods: A discrete choice experiment was performed to determine patients' preferences, which involved presentation of pairwise choice tasks regarding hypothetical scenarios. Scenarios varied along six attributes: "way of measuring brain activity", "duration", "freedom of movement", "travel time", "type of additional examination", and "chance of additional examination". Choice tasks were constructed using a statistically efficient design, and the questionnaire contained 15 unique unlabeled choice tasks. Mixed multinomial logistic regression was used to estimate patients' preferences. Results: A total of 289 questionnaires were included in the analysis. McFadden's pseudo R-2 showed a model fit of 0.28, and all attributes were statistically significant. Heterogeneity in preferences was present for all attributes. "Freedom of movement" and "Chance of additional examination" were perceived as the most important attributes. Overall utility scores did not substantially differ between routine EEG and MEG. Conclusion: This study suggests that the identified attributes are important in determining patients' preference for epilepsy diagnostics. It can be concluded that MEG is not necessarily more patient-friendly than a routine EEG in primary diagnostics and, regarding additional diagnostics, patients have a strong preference for long-term 24-h EEG over EEG after sleep deprivation. Furthermore, barring substantial heterogeneity within the parameters in mind, our study suggests that it is important to take individual preferences into account in medical decision-making. (C) 2013 Elsevier Inc. All rights reserved

Critical statistics in a power-law random banded matrix ensemble

We investigate the statistical properties of the eigenvalues and eigenvectors in a random matrix ensemble with $H_{ij}\sim |i-j|^{-\mu}$. It is known that this model shows a localization-delocalization transition (LDT) as a function of the parameter $\mu$. The model is critical at $\mu=1$ and the eigenstates are multifractals. Based on numerical simulations we demonstrate that the spectral statistics at criticality differs from semi-Poisson statistics which is expected to be a general feature of systems exhibiting a LDT or `weak chaos'.Comment: 4 pages in PS including 5 figure

Alternative Technique for "Complex" Spectra Analysis

. The choice of a suitable random matrix model of a complex system is very sensitive to the nature of its complexity. The statistical spectral analysis of various complex systems requires, therefore, a thorough probing of a wide range of random matrix ensembles which is not an easy task. It is highly desirable, if possible, to identify a common mathematcal structure among all the ensembles and analyze it to gain information about the ensemble- properties. Our successful search in this direction leads to Calogero Hamiltonian, a one-dimensional quantum hamiltonian with inverse-square interaction, as the common base. This is because both, the eigenvalues of the ensembles, and, a general state of Calogero Hamiltonian, evolve in an analogous way for arbitrary initial conditions. The varying nature of the complexity is reflected in the different form of the evolution parameter in each case. A complete investigation of Calogero Hamiltonian can then help us in the spectral analysis of complex systems.Comment: 20 pages, No figures, Revised Version (Minor Changes

Experimental evidence for 56Ni-core breaking from the low-spin structure of the N=Z nucleus 58Cu

Low-spin states in the odd-odd N=Z nucleus 58Cu were investigated with the 58Ni(p,n gamma)58Cu fusion evaporation reaction at the FN-tandem accelerator in Cologne. Seventeen low spin states below 3.6 MeV and 17 new transitions were observed. Ten multipole mixing ratios and 17 gamma-branching ratios were determined for the first time. New detailed spectroscopic information on the 2+,2 state, the Isobaric Analogue State (IAS) of the 2+,1,T=1 state of 58Ni, makes 58Cu the heaviest odd-odd N=Z nucleus with known B(E2;2+,T=1 --> 0+,T=1) value. The 4^+ state at 2.751 MeV, observed here for the first time, is identified as the IAS of the 4+,1,T=1 state in 58Ni. The new data are compared to full pf-shell model calculations with the novel GXPF1 residual interaction and to calculations within a pf5/2 configurational space with a residual surface delta interaction. The role of the 56Ni core excitations for the low-spin structure in 58Cu is discussed.Comment: 15 pages, 7 figures, submitted to Phys. Rev.

Reducing conflict-related employee strain: The benefits of an internal locus of control and a problem-solving conflict management strategy

Workplace conflict is a potent stressor, but most previous research has focused on its effect on productivity and performance rather than on individual well-being. This paper examines the moderating roles of an individual's internal locus of control and a problem-solving conflict management strategy. In the cross-sectional study, among 774 health care workers in the Netherlands, employees' internal locus of control did moderate the relationship between experienced conflict at work and psychological strain, which was measured using a 13-item Dutch adaptation of the Occupational Stress Indicator. In addition, this moderation was mediated by the active conflict management strategy of problem solving; people with a more internal locus of control use a problem-solving conflict management strategy more often and, as a result, experience less psychological strain in cases of workplace conflict. Implications for conflict theory, for future research, and for practice are discussed

Transcriptional profiling and biomarker identification reveal tissue specific effects of expanded ataxin-3 in a spinocerebellar ataxia type 3 mouse model

Molecular Epidemiolog