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

Infrared images of merging galaxies

Infrared imaging of interacting galaxies is especially interesting because their optical appearance is often so chaotic due to extinction by dust and emission from star formation regions, that it is impossible to locate the nuclei or determine the true stellar distribution. However, at near-infrared wavelengths extinction is considerably reduced, and most of the flux from galaxies originates from red giant stars that comprise the dominant stellar component by mass. Thus near infrared images offer the opportunity to study directly components of galactic structure which are otherwise inaccessible. Such images may ultimately provide the framework in which to understand the activity taking place in many of the mergers with high Infrared Astronomy Satellite (IRAS) luminosities. Infrared images have been useful in identifying double structures in the nuclei of interacting galaxies which have not even been hinted at by optical observations. A striking example of this is given by the K images of Arp 220. Graham et al. (1990) have used high resolution imaging to show that it has a double nucleus coincident with the radio sources in the middle of the dust lane. The results suggest that caution should be applied in the identification of optical bright spots as multiple nuclei in the absence of other evidence. They also illustrate the advantages of using infrared imaging to study the underlying structure in merging galaxies. The authors have begun a program to take near infrared images of galaxies which are believed to be mergers of disk galaxies because they have tidal tails and filaments. In many of these the merger is thought to have induced exceptionally luminous infrared emission (cf. Joseph and Wright 1985, Sanders et al. 1988). Although the optical images of the galaxies show spectacular dust lanes and filaments, the K images all have a very smooth distribution of light with an apparently single nucleus

Herding cats: observing live coding in the wild

After a momentous decade of live coding activities, this paper seeks to explore the practice with the aim of situating it in the history of contemporary arts and music. The article introduces several key points of investigation in live coding research and discusses some examples of how live coding practitioners engage with these points in their system design and performances. In the light of the extremely diverse manifestations of live coding activities, the problem of defining the practice is discussed, and the question raised whether live coding will actually be necessary as an independent category

Using Multi-method Assessment to Evaluate a Media Enhanced Classroom

This paper looks at the process of assessment of a media-enhanced classroom experience. It utilizes an assessment model based on Rathbun and Goodrum (8) that suggests multi-methods of data collection. The use of triangulation (3) to answer a research question fits into the proposed multi-method design. The Living Textbook was developed to support a senior level management class in a Recreation and Park Administration program. The instructor identified four instructional goals of the multi-media program: Triangulation techniques included group observations, individual student observations, data based and open ended surveys, and debriefing of instructors. The results suggested that usability/accessibility were essential precursors to students developing receptivity to the multimedia program. When receptivity was achieved students valued the program as a contributor to their base of knowledge about the real work world. The use of student workbooks where opportunities for learning by doing occurred and in-class discussions in small groups were strongly linked to valuing the Living Textbook

ZAMJENA RIBLJEG BRAŠNA S ORGANSKIM PROTEINOM NA BAZI KVASCA U HRANI ZA PACIFIČKE BIJELE RAČIĆE (Litopenaeus vannamei): LABORATORIJSKI I PRIRODNI UVJETI

The feasibility of totally replacing the fishmeal component of marine shrimp (Litopenaeus vannamei) diets was examined both in the laboratory setting and during a full–scale commercial trial. Animals were fed either a traditional fishmeal–based diet or one in which complete replacement of fishmeal, on a per protein basis, was manufactured using a yeast–based product, NuPro®. Laboratory studies determined that irrespective of diet fed, no difference in shrimp performance (weight gain, survival and SGR) occurred. A field trial was thus activated to determine whether lab–scale studies were transferable to the commercial setting. Trials were conducted in earthen ponds from mid–June to early November 2005. Ponds were initially stocked with PL12–16 shrimp at a rate of 100,000 per hectare. At trial end, ponds receiving the NuPro®–based feed had equivalent growth to that of shrimp fed the traditional, fishmeal–based diet. Percent increase in weight from initial values and survival for the NuPro® ponds was 296, 269 and 275%, and 78, 76 and 85% respectively, whereas that for the fishmeal–based diet was 305% and 80% respectively. Noteworthy was that within pond size variation of L. vannamei was lower in NuPro® fed animals (±2.3 g) when compared against animals receiving the traditional feed (±4.1 g). Overall observations from the field trial indicate the importance of the »bioreactor« pond with respect to the supply of energy to sustain shrimp growth potential.Mogućnost potpune zamjene ribljega brašna u prehrani morskih račića (Litopenaeus vannamei) istraživana je u laboratorijskim i komercijalnim uvjetima. Životinje su bile hranjene uobičajenom hranom s ribljim brašnom i hranom u kojoj je riblje brašno u potpunosti zamijenjeno proteinom na bazi kvasca NuPro®. U laboratorijskim uvjetima nije zapažena razlika kod račića glede prirasta, preživljenja i dnevnoga prirasta. Pokusi u prirodnim uvjetima provedeni su da bi se rezultati dobiveni u pokusnim uvjetima mogli potvrditi u komercijalnom uzgoju. Pokus je postavljen u zemljanim ribnjacima od sredine lipnja do ranoga studenoga godine 2005. Ribnjaci su nasađeni s PL12–16 račića u gustoći od 100 000 komada/hektaru. Na kraju pokusa rast račića hranjenih objema hranama bio je jednak. Postotak povećanja te‘ine od početnih vrijednosti i preživljenje račića hranjenih s NuPro® bio je 296, 269 i 275%, odnosno 78, 76 i 85%, dok je u onih hranjenih ribljim brašnom bio 305%, odnosno 80%

Analysis of direct segregated boundary-domain integral equations for variable-coefficient mixed bvps in exterior domains

This is the post-print version of the Article. The official published version can be accessed from the link below - Copyright @ 2013 World Scientific Publishing.Direct segregated systems of boundary-domain integral equations are formulated for the mixed (Dirichlet–Neumann) boundary value problems for a scalar second-order divergent elliptic partial differential equation with a variable coefficient in an exterior three-dimensional domain. The boundary-domain integral equation system equivalence to the original boundary value problems and the Fredholm properties and invertibility of the corresponding boundary-domain integral operators are analyzed in weighted Sobolev spaces suitable for infinite domains. This analysis is based on the corresponding properties of the BVPs in weighted Sobolev spaces that are proved as well.The work was supported by the grant EP/H020497/1 \Mathematical analysis of localised boundary-domain integral equations for BVPs with variable coefficients" of the EPSRC, UK

Interpolation of Hilbert and Sobolev Spaces: Quantitative Estimates and Counterexamples

This paper provides an overview of interpolation of Banach and Hilbert spaces, with a focus on establishing when equivalence of norms is in fact equality of norms in the key results of the theory. (In brief, our conclusion for the Hilbert space case is that, with the right normalisations, all the key results hold with equality of norms.) In the final section we apply the Hilbert space results to the Sobolev spaces $H^s(\Omega)$ and $\widetilde{H}^s(\Omega)$, for $s\in \mathbb{R}$ and an open $\Omega\subset \mathbb{R}^n$. We exhibit examples in one and two dimensions of sets $\Omega$ for which these scales of Sobolev spaces are not interpolation scales. In the cases when they are interpolation scales (in particular, if $\Omega$ is Lipschitz) we exhibit examples that show that, in general, the interpolation norm does not coincide with the intrinsic Sobolev norm and, in fact, the ratio of these two norms can be arbitrarily large