Healthcare resource utilization

Background: Treatment resistant depression (TRD) is diagnosed when patients experiencing a major depressive episode fail to respond to ≥2 treatments. Along with substantial indirect costs, patients with TRD have higher healthcare resource utilization (HCRU) than other patients with depression. However, research on the economic impact of this HCRU, and differences according to response to treatment, is lacking. Methods: This multicenter, observational study documented HCRU among patients with TRD in European clinical practice initiating new antidepressant treatments. Data regarding access to outpatient consultations and other healthcare resources for the first 6 months, collected using a questionnaire, were analyzed qualitatively according to response and remission status. The economic impact of HCRU, estimated using European costing data, was analyzed quantitatively. Results: Among 411 patients, average HCRU was higher in non-responders, attending five times more general practitioner (GP) consultations and spending longer in hospital (1.7 versus 1.1 days) than responders. Greater differences were observed according to remission status, with non-remitters attending seven times more GP consultations and spending approximately three times longer in hospital (1.7 versus 0.6 days) than remitters. Consequently, the estimated economic impacts of non-responders and non-remitters were significantly greater than those of responders and remitters, respectively. Limitations: Key limitations are small cohort size, absence of control groups and generalizability to different healthcare systems. Conclusion: Patients with TRD, particularly those not achieving remission, have considerable HCRU, with associated economic impact. The costs of unmet TRD treatment needs are thus substantial, and treatment success is fundamental to reduce individual needs and societal costs.publishersversionpublishe

Rhetoric and reality: Critical perspective on education in a 3D virtual world

The emergence of any new educational technology is often accompanied by inflated expectations about its potential for transforming pedagogical practice and improving student learning outcomes. A critique of the rhetoric accompanying the evolution of 3D virtual world education reveals a similar pattern, with the initial hype based more on rhetoric than research demonstrating the extent to which rhetoric matches reality. Addressed are the perceived gaps in the literature through a critique of the rhetoric evident throughout the evolution of the application of virtual worlds in education and the reality based on the reported experiences of experts in the field of educational technology, who are all members of the Australian and New Zealand Virtual Worlds Working Group. The experiences reported highlight a range of effective virtual world collaborative and communicative teaching experiences conducted in members’ institutions. Perspectives vary from those whose reality is the actuation of the initial rhetoric in the early years of virtual world education, to those whose reality is fraught with challenges that belie the rhetoric. Although there are concerns over institutional resistance, restrictions, and outdated processes on the one-hand, and excitement over the rapid emergence of innovation on the other, the prevailing reality seems to be that virtual world education is both persistent and sustainable. Explored are critical perspectives on the rhetoric and reality on the educational uptake and use of virtual worlds in higher education, providing an overview of the current and future directions for learning in virtual worlds

Rhetoric and reality: Critical perspective on education in a 3D virtual world

The emergence of any new educational technology is often accompanied by inflated expectations about its potential for transforming pedagogical practice and improving student learning outcomes. A critique of the rhetoric accompanying the evolution of 3D virtual world education reveals a similar pattern, with the initial hype based more on rhetoric than research demonstrating the extent to which rhetoric matches reality. Addressed are the perceived gaps in the literature through a critique of the rhetoric evident throughout the evolution of the application of virtual worlds in education and the reality based on the reported experiences of experts in the field of educational technology, who are all members of the Australian and New Zealand Virtual Worlds Working Group. The experiences reported highlight a range of effective virtual world collaborative and communicative teaching experiences conducted in members’ institutions. Perspectives vary from those whose reality is the actuation of the initial rhetoric in the early years of virtual world education, to those whose reality is fraught with challenges that belie the rhetoric. Although there are concerns over institutional resistance, restrictions, and outdated processes on the one-hand, and excitement over the rapid emergence of innovation on the other, the prevailing reality seems to be that virtual world education is both persistent and sustainable. Explored are critical perspectives on the rhetoric and reality on the educational uptake and use of virtual worlds in higher education, providing an overview of the current and future directions for learning in virtual worlds

The Role of the Clean Development Mechanism in Achieving China’s Goal of a Resource Efficient and Environmentally Friendly Society

This paper examines the impact of the clean development mechanism (CDM) on China’s progress in building a resource-efficient and environmentally friendly society, referred to as a dual-goal society. It presents China’s CDM activities from the perspective of policy directions, administrative arrangements and capacity building as well as outlines the regional trends and distribution of CDM projects across China’s 30 provinces. Based on regression analysis of 2006–2009 panel data, the research was able to provide estimates at provincial level of the impacts of CDM activities on China’s CO2 emission intensity, SO2 emission intensity and industrial dust emission intensity. The study concludes that the active CDM projects are mainly located in the less-developed central and west China where they have provided increased opportunities for sustainable development. Furthermore, the successful implementation of CDM projects across the country has significantly decreased the emission intensity of CO2, SO2 and industrial dust, which means that these activities have enhanced China’s ability to build the desired dual-goal society

Tracking uncertainties in the causal chain from human activities to climate

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95537/1/grl25489.pd