Alcohol use disorders and the course of depressive and anxiety disorders

BACKGROUND: Inconsistent findings have been reported on the role of comorbid alcohol use disorders as risk factors for a persistent course of depressive and anxiety disorders. AIMS: To determine whether the course of depressive and/or anxiety disorders is conditional on the type (abuse or dependence) or severity of comorbid alcohol use disorders. METHOD: In a large sample of participants with current depression and/or anxiety (n = 1369) we examined whether the presence and severity of DSM-IV alcohol abuse or alcohol dependence predicted the 2-year course of depressive and/or anxiety disorders. RESULTS: The persistence of depressive and/or anxiety disorders at the 2-year follow-up was significantly higher in those with remitted or current alcohol dependence (persistence 62% and 67% respectively), but not in those with remitted or current alcohol abuse (persistence 51% and 46% respectively), compared with no lifetime alcohol use disorder (persistence 53%). Severe (meeting six or seven diagnostic criteria) but not moderate (meeting three to five criteria) current dependence was a significant predictor as 95% of those in the former group still had a depressive and/or anxiety disorder at follow-up. This association remained significant after adjustment for severity of depression and anxiety, psychosocial factors and treatment factors. CONCLUSIONS: Alcohol dependence, especially severe current dependence, is a risk factor for an unfavourable course of depressive and/or anxiety disorders, whereas alcohol abuse is not

New Forms of Development: Branding Innovative Ideas and Bidding for Foreign Aid in the Maternal and Child Health Service in Nepal

Nepal has been receiving foreign aid since the early 1950s. Currently, the country’s health care systemis heavily dependent on aid, even for the provision of basic health services to its people. Globally, the mechanismfor the dispersal of foreign aid is becoming increasingly complex. Numerous stakeholders are involved at variouslevels: donors, intermediary organisations, project-implementing partners and the beneficiaries, engaging not onlyin Nepal but also globally. To illustrate how branding and bidding occurs, and to discuss how this process hasbecome increasingly vital in securing foreign aid to run MCH activities in Nepal

Affordances, constraints and information flows as ‘leverage points’ in design for sustainable behaviour

Copyright @ 2012 Social Science Electronic PublishingTwo of Donella Meadows' 'leverage points' for intervening in systems (1999) seem particularly pertinent to design for sustainable behaviour, in the sense that designers may have the scope to implement them in (re-)designing everyday products and services. The 'rules of the system' -- interpreted here to refer to affordances and constraints -- and the structure of information flows both offer a range of opportunities for design interventions to in fluence behaviour change, and in this paper, some of the implications and possibilities are discussed with reference to parallel concepts from within design, HCI and relevant areas of psychology

Remaking Africa's informal economies: youth, entrepreneurship and the promise of inclusion at the bottom of the pyramid

In recent years, the quest for 'inclusive markets' that incorporate Africa's youth has become a key focus of national and international development efforts, with so-called bottom of the pyramid (BoP) initiatives increasingly seen as a way to draw the continent's poor into new networks of global capitalism. SSA has become a fertile frontier for such systems, as capital sets its sights on the continents vast 'under-served' informal economies, harnessing the entrepreneurial mettle of youth to create new markets for a range of products, from solar lanterns and shampoo to cook stoves and sanitary pads. Drawing on ethnographic research with youth entrepreneurs, we trace the prcesses of individual and collective 'transformation' that the mission of (self-) empowerment through entrepreneurship seeks to bring about. We argue that, while such systems are meant to bring those below the poverty line above it, the 'line' is reified and reinforced through a range of discursive and strategic practices that actively construct and embed distinctions between the past and the future, valuable and valueless, and the idle and productive in Africa's informal economies

Contralateral routing of signals disrupts monaural level and spectral cues to sound localisation on the horizontal plane

Objectives: Contra-lateral routing of signals (CROS) devices re-route sound between the deaf and hearing ears of unilaterally-deaf individuals. This rerouting would be expected to disrupt access to monaural level cues that can support monaural localisation in the horizontal plane. However, such a detrimental effect has not been confirmed by clinical studies of CROS use. The present study aimed to exercise strict experimental control over the availability of monaural cues to localisation in the horizontal plane and the fitting of the CROS device to assess whether signal routing can impair the ability to locate sources of sound and, if so, whether CROS selectively disrupts monaural level or spectral cues to horizontal location, or both. Design: Unilateral deafness and CROS device use were simulated in twelve normal hearing participants. Monaural recordings of broadband white noise presented from three spatial locations (-60°, 0°, and +60°) were made in the ear canal of a model listener using a probe microphone with and without a CROS device. The recordings were presented to participants via an insert earphone placed in their right ear. The recordings were processed to disrupt either monaural level or spectral cues to horizontal sound location by roving presentation level or the energy across adjacent frequency bands, respectively. Localisation ability was assessed using a three-alternative forced-choice spatial discrimination task. Results: Participants localised above chance levels in all conditions. Spatial discrimination accuracy was poorer when participants only had access to monaural spectral cues compared to when monaural level cues were available. CROS use impaired localisation significantly regardless of whether level or spectral cues were available. For both cues, signal re-routing had a detrimental effect on the ability to localise sounds originating from the side of the deaf ear (-60°). CROS use also impaired the ability to use level cues to localise sounds originating from straight ahead (0°). Conclusions: The re-routing of sounds can restrict access to the monaural cues that provide a basis for determining sound location in the horizontal plane. Perhaps encouragingly, the results suggest that both monaural level and spectral cues may not be disrupted entirely by signal re-routing and that it may still be possible to reliably identify sounds originating on the hearing side

Truth or precision? Some reflections on the economists’ failure to predict the financial crisis

The failure of professional economic forecasters to predict the financial crises has led many to question the credibility of modern economics as a reliable foundation for economic policy. If economists were unable to foresee so big a crisis, how can they be trusted to cure or prevent it? Several accounts of this failure exist. The paper offers a tentative answer based on the lessons that may be drawn from the wisdom of a short list of past and present economists: Hayek, Neville Keynes, Mankiw, Tinbergen, Maynard Keynes and Lucas. The glue to keep such an odd bunch together is the distinction between truth and precision provided by science historian Ted Porter