A systematic review of the validity and responsiveness of EQ-5D and SF-6D for depression and anxiety

Background: Generic preference based measures (PBM) such as the SF-6D and EQ-5D are increasingly used to inform health care resource allocation decisions. They aim to be generic in the sense of being applicable to all physical and mental health conditions. However, their applicability has not been demonstrated for all mental health conditions. Aims: To assess the construct validity and responsiveness of EQ-5D and SF-6D measures in depression and anxiety. Method: A systematic review of the literature was undertaken. Eleven databases were searched in December 2010 and reference lists scrutinised to identify relevant studies. Studies were appraised and data extracted. A narrative synthesis was performed of the evidence on construct validity including known groups validity (detecting a difference in PBM scores between different groups such as different levels of severity of depression), convergent validity (strength of association between generic PBM and other outcome measures) and responsiveness (the ability to detect relevant health changes in health status and the absence of change where there is none). Results: 26 studies were identified that provided data on the validity and/or responsiveness of the EQ-5D and SF-6D. Both measures demonstrate good construct validity and responsiveness for depression. One study, however, suggests EQ-5D may lack responsiveness in the elderly. These measures are more highly correlated with depression scales in patients with anxiety than they are clinical anxiety scales suggesting known group validity in patients with anxiety may be driven by aspects of depression within anxiety disorder and the presence of co-morbid depression. Direct comparisons between the measures find that the EQ-5D gives lower utility levels for severe depression hence greater health improvement for this group and SF-6D shows more sensitivity to mild depression and performs better in terms of ES and SRM. The comparison between EQ-5D and SF-6D is similar to that found in other conditions. Conclusion: The evidence base supports the use of EQ-5D and SF-6D in patients with depression and anxiety. More work is needed on the true utility level for severe depression

Measuring Uncertainty in Games: Design and Preliminary Validation

Uncertainty is an important element of game play, which is widely believed to act as a precondition for player experience (PX). To investigate the concept and examine its relation to other PX concepts, we should be able to measure it. We present the design and preliminary results of the validation of the Player Uncertainty in Games (PUG) questionnaire. Based on various sources from games user research and work done with regards to searching digital archives, we designed a questionnaire that measures the experience of uncertainty in games. The scale was refined down to 66 items via interviews with players and expert reviews, which was then validated and further refined based on data gathered from gamers in an online survey. The Principal Component Analysis showed high level of internal consistency for the scale and each of its four factors: Disorientation, Exploration, Prospect, and Randomness. This work demonstrates the initial findings towards a validated tool for measuring uncertainty of players in digital games

"Transit Data"-based MST Computation

In this work, we present an innovative image recognition technique which is based on the exploitation of transit-data in images or simple photographs of sites of interest. Our objective is to automatically transform real-world images to graphs and, then, compute Minimum Spanning Trees (MST) in them.We apply this framework and present an application which automatically computes efficient construction plans (for escalator or low-emission hot spots) for connecting all points of interest in cultural sites, i.e., archaeological sites, museums, galleries, etc, aiming to to facilitate global physical access to cultural heritage and artistic work and make it accessible to all groups of population

Oxidative stress dependent microRNA-34a activation via PI3Kα reduces the expression of sirtuin-1 and sirtuin-6 in epithelial cells

Sirtuin-1 (SIRT1) and SIRT6, NAD(+)-dependent Class III protein deacetylases, are putative anti-aging enzymes, down-regulated in patients with chronic obstructive pulmonary disease (COPD), which is characterized by the accelerated ageing of the lung and associated with increased oxidative stress. Here, we show that oxidative stress (hydrogen peroxide) selectively elevates microRNA-34a (miR-34a) but not the related miR-34b/c, with concomitant reduction of SIRT1/-6 in bronchial epithelial cells (BEAS2B), which was also observed in peripheral lung samples from patients with COPD. Over-expression of a miR-34a mimic caused a significant reduction in both mRNA and protein of SIRT1/-6, whereas inhibition of miR-34a (antagomir) increased these sirtuins. Induction of miR-34a expression with H2O2 was phosphoinositide-3-kinase (PI3K) dependent as it was associated with PI3Kα activation as well as phosphatase and tensin homolog (PTEN) reduction. Importantly, miR-34a antagomirs increased SIRT1/-6 mRNA levels, whilst decreasing markers of cellular senescence in airway epithelial cells from COPD patients, suggesting that this process is reversible. Other sirtuin isoforms were not affected by miR-34a. Our data indicate that miR-34a is induced by oxidative stress via PI3K signaling, and orchestrates ageing responses under oxidative stress, therefore highlighting miR-34a as a new therapeutic target and biomarker in COPD and other oxidative stress-driven aging diseases

Politics of innovation and development: The role of industry associations in integrating political, bureaucratic, industrial and health systems in India and South Africa

Integrating political, bureaucratic, industrial and healthcare systems has been a major challenge for politics of innovation and development policy in low- and middle-income countries. This challenge has so far been understood in terms of separate industrial and health-related innovation policies without paying adequate attention to the institutional roles of biopharmaceutical and other umbrella associations. This article seeks to examine such roles in the developmental contexts of South Africa and India. The argument put forward is that, in both countries, biopharmaceutical and umbrella associations have evolved from lobbying organizations to institutional partners who influence the politics of innovation and development—and therefore the degree of integration and fragmentation—of political, bureaucratic, industrial innovation and health systems

The tale of the two Greeces: some management practice lessons

Based on an original double‐blind survey on randomly drawn samples of over 10,000 manufacturing firms across a range of different industries and countries, the World Management Survey is one of the first large and internationally comparable management practices data sets. In this paper, I describe and compare the performance of Greek firms to those from other countries around the world with the aim of identifying some lessons for both managers and policy makers in Greece on how to increase management quality, and hence, firms' productivity

Fiber Optic-Based Pressure Sensing Surface for Skin Health Management in Prosthetic and Rehabilitation Interventions

Applied physic

Probabilistic flood inundation mapping at ungauged streams due to roughness coefficient uncertainty in hydraulic modelling

Abstract. Probabilistic flood inundation mapping is performed and analysed at the ungauged Xerias stream reach, Volos, Greece. The study evaluates the uncertainty introduced by the roughness coefficient values on hydraulic models in flood inundation modelling and mapping. The well-established one-dimensional (1-D) hydraulic model, HEC-RAS is selected and linked to Monte-Carlo simulations of hydraulic roughness. Terrestrial Laser Scanner data have been used to produce a high quality DEM for input data uncertainty minimisation and to improve determination accuracy on stream channel topography required by the hydraulic model. Initial Manning's n roughness coefficient values are based on pebble count field surveys and empirical formulas. Various theoretical probability distributions are fitted and evaluated on their accuracy to represent the estimated roughness values. Finally, Latin Hypercube Sampling has been used for generation of different sets of Manning roughness values and flood inundation probability maps have been created with the use of Monte Carlo simulations. Historical flood extent data, from an extreme historical flash flood event, are used for validation of the method. The calibration process is based on a binary wet-dry reasoning with the use of Median Absolute Percentage Error evaluation metric. The results show that the proposed procedure supports probabilistic flood hazard mapping at ungauged rivers and provides water resources managers with valuable information for planning and implementing flood risk mitigation strategies

Lost at the Edge of Uncertainty: Measuring Player Uncertainty in Digital Games

Uncertainty has previously been identified as an important ingredient of engaging games. Design in games can create different levels of uncertainty in players that they can recognize and describe as being either attributable to external forces, such as chance or hidden information, or internal to their own understanding of what to do in relation to their own goals. While it appears that uncertainty can contribute both positive and negative play experiences, there is little work in trying to operationalize and measure this concept as a component of player experience. Reported in this article is an analysis of data from over 700 players using modern bi-factor analysis techniques resulting in a five factor psychometric scale which captures the broad feelings of players about uncertainty in games. Three of these specific factors appear to point toward a single generic factor of uncertainty that is internal to the players, one captures experiences relating to external uncertainty, with the final factor relating to player’s experience of exploring the game to resolve uncertainty. In order to further validate the scale, we conducted an experiment with a commercial puzzle game manipulating the duration of play with predicted outcomes on the different specific factors of the scale. Overall the scale shows promise with good statistical reliability and construct validity of the separate factors and so will be a useful tool for further investigating player experiences in digital games

Sonic Hedgehog signalling in the regulation of barrier tissue homeostasis and inflammation

Epithelial barrier tissues such as the skin and airway form an essential interface between the mammalian host and its external environment. These physical barriers are crucial to prevent damage and disease from environmental insults and allergens. Failure to maintain barrier function against such risks can lead to severe inflammatory disorders, including atopic dermatitis and asthma. Here, we discuss the role of the morphogen Sonic Hedgehog in postnatal skin and lung and the impact of Shh signalling on repair, inflammation and atopic disease in these tissues