111 research outputs found

    Personalised Search Time Prediction using Markov Chains

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    For improving the effectiveness of Interactive Information Retrieval (IIR), a system should minimise the search time by guiding the user appropriately. As a prerequisite, in any search situation, the system must be able to estimate the time the user will need for finding the next relevant document. In this paper, we show how Markov models derived from search logs can be used for predicting search times, and describe a method for evaluating these predictions. For personalising the predictions based upon a few user events observed, we devise appropriate parameter estimation methods. Our experimental results show that by observing users for only 100 seconds, the personalised predictions are already significantly better than global predictions

    Use of chromium picolinate and biotin in the management of type 2 diabetes: an economic analysis

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    This paper addresses the potential economic benefits of chromium picolinate plus biotin (Diachrome ®) use in people with Type 2 diabetes (T2DM). The economic model was developed to estimate the impact on health care systems’ costs by improved HbA1C levels with chromium picolinate plus biotin (Diachrome). Lifetimes cost savings were estimated by adjusting a benchmark from the literature, using a price index to adjust for inflation. The cost of diabetes is highly dependent on the HbA1C level with higher initial levels and higher annual increments increasing the cost. Improvement in glycemic control has proven to be cost-effective in delaying the onset and progression of T2DM, reducing the risk for diabetes-associated complications and lowering utilization and cost of care. Chromium picolinate plus biotin (Diachrome) showed greater improvement of glycemic control in poorly controlled T2DM patients (HbA1C \u3e=10%) compared to their better controlled counterparts (HbA1C \u3c 10%). This improvement was additive to that achieved by oral hypoglycemic medications and correlates to calculated levels of cost savings. Average 3-year cost savings for chromium picolinate plus biotin (Diachrome) use could range from 1,636forapoorlycontrolledpatientwithdiabeteswithoutheartdiseasesorhypertension,to1,636 for a poorly controlled patient with diabetes without heart diseases or hypertension, to 5,435 for a poorly controlled patient with diabetes, heart disease, and hypertension. Average 3-year cost savings was estimated to be between 3.9billionand3.9 billion and 52.9 billion for the 16.3 million existing patients with diabetes. Chromium picolinate plus biotin (Diachrome) use among the 1.17 million newly diagnosed patients with T2DM each year could deliver lifetime cost savings of 42billion,or42 billion, or 36,000 per T2DM patient. Affordable, safe, and convenient, chromium picolinate plus biotin (Diachrome) could prove to be a cost-effective complement to existing pharmacological therapies for controlling T2DM. (Disease Management 2005;8:265–275

    A qualitative study on the impacts of COVID-19 on the delivery of randomised controlled trials evaluating lay-delivered psychological interventions in five countries

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    COVID-19 is having substantial impacts on research conduct, including clinical trials. However, there is limited research investigating the impact of the pandemic on the conduct of clinical trials and barriers to the delivery of interventions. The current study contributes to filling this gap by investigating the impacts of COVID-19 and related mitigation strategies in the context of five randomised controlled trials (RCTs) of lay-delivered psychological interventions for Syrian refugees in Jordan, Lebanon, the Netherlands, Switzerland, and Turkey. We conducted semi-structured interviews with purposively selected researchers (N = 14) across all five countries. Data were analysed using codebook thematic analysis. The trial researchers highlighted how COVID-19 has had pervasive impacts across different components of the trial including recruitment, assessment, intervention delivery, and supervision. These impacts were considered to influence the external and internal scientific validity of these trials, as well as some aspects of trial administration such as budgeting and the workforce. Various mitigation strategies to adapt to constraints imposed by pandemic responses were described by researchers, such as shifting to a remote intervention delivery and evaluation or adding COVID-19 measures to better understand the impacts of COVID-19 on outcome data. The current piece provides an account of the impacts of COVID-19 on the conduct of trials of lay-delivered psychological interventions for refugees in five countries. Our findings will be valuable for researchers testing similar interventions during COVID-19 and other public health emergencies

    Peer-provided Problem Management plus (PM+) for adult Syrian refugees: a pilot randomised controlled trial on effectiveness and cost-effectiveness

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    Aims Common mental disorders are highly prevalent among Syrian refugees. Problem Management Plus (PM+) is a brief, transdiagnostic, non-specialist helper delivered, psychological intervention targeting psychological distress. This single-blind pilot randomised controlled trial (RCT) on PM+ delivered by peer-refugees examined trial procedures in advance of a definitive RCT, evaluated PM+ 's acceptability and feasibility, and investigated its likely effectiveness and cost-effectiveness among Syrian refugees in the Netherlands.Methods Adult Syrian refugees (N = 60) with elevated psychological distress (Kessler Psychological Distress Scale (K10) score >15) and reduced pychosocial functioning (WHO Disability Assessment Schedule 2.0 (WHODAS) score >16) were randomised into PM+ in addition to care as usual (CAU) (PM+/CAU; n = 30) or CAU alone (n = 30). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes were pychosocial functioning (WHO Disability Assessment Schedule; WHODAS 2.0), symptoms of posttraumatic stress disorder (PTSD) (PTSD Checklist for DSM 5; PCL-5) and self-identified problems (Psychological Outcomes Profiles; PSYCHLOPS). Changes in service utilisation and time out of employment and/or adult education were estimated (adapted version of the Client Service Receipt Inventory; CSRI). Semi-structured interviews on the implementation of PM+ were conducted with stakeholders (i.e. six PM+ participants, five non-specialist helpers and five key informants).Results Recruitment, randomization and blinding procedures were successful. PM+ was generally perceived positively by stakeholders, especially regarding the intervention strategies, accommodation of the intervention and the helpers. Two serious adverse events not attributable to the trial were reported. At 3-month follow-up, the HSCL-25 total score was significantly lower for the PM+/CAU group (n = 30) than CAU group (n = 30) (p = 0.004; d = 0.58). Significant differences in favour of PM+/CAU were also found for WHODAS psychosocial functioning (p = 0.009, d = 0.73), PCL-5 symptoms of PTSD (p = 0.006, d = 0.66) and PSYCHLOPS self-identified problems (p = 0.005, d = 0.81). There were no significant differences in mean health service costs (p = 0.191) and the mean costs of lost productive time (p = 0.141). This suggests PM+ may potentially be cost-effective with an incremental cost from a health system perspective of €5047 (95% CI €0–€19 773) per additional recovery achieved.Conclusions Trial procedures and PM+ delivered by non-specialist peer-refugee helpers seemed acceptable, feasible and safe. Analyses indicate that PM+ may be effective in improving mental health outcomes and psychosocial functioning, and potentially cost-effective. These results support the development of a definitive RCT with a larger sample of refugees and a longer follow-up period

    Magnetic interplay between two different lanthanides in a tris-phthalocyaninato complex: a viable synthetic route and detailed investigation in the bulk and on the surface

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    Future applications of molecular units in quantum information technologies require a fine control at the single molecule level. This includes the choice of each functional element, the intramolecular interaction and the robustness of molecules when dispersed on a substrate. Keeping these goals in mind, we designed and synthesized a heterometallic phthalocyaninato-complex including two different lanthanides in each moiety, namely [PcDyPcTbPc*] (Pc being phthalocyanines; and Pc* being 2,3,9,10,16,17,23,24- octahexyl-substituted phthalocyanines). Full magnetic characterization was performed down to the mK temperature range on bulk microcrystals by means of AC susceptibility, DC magnetization (including microSQUID) and specific heat measurements. A weak, yet sizeable, interaction between the two lanthanides is clearly detected by different techniques, altering the magnetic behavior of the single lanthanide as observed in the parent [LnPc2] complexes. Isolated [PcDyPcTbPc*] molecules dispersed on HOPG and the Au surface by liquid phase deposition are proven to maintain their main chemical and magnetic features by combined XPS, XAS and XMCD analysis and to lie with one Pc ligand flat to the surface. Opening of a small but sizable hysteresis loop at 1.8 K is directly observed on both Tb and Dy sites proving the retention of magnetization at the single molecule level

    Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial

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    BACKGROUND: Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention. METHODS: Refugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n = 24) or E-CAU only (n = 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses. RESULTS: There were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found. CONCLUSIONS: gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT03567083 ; date: 25/06/2018
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