Using evidence to improve Psychological Therapies Services

Psychological therapy services offer help to clients with many different sorts of mental health problems using a variety of therapies provided by a range of different professional groups and are supported by a large amount of research evidence. However, applying evidence-based practice in routine clinical settings presents particular challenges. This paper outlines some of the difficulties applying research findings to routine settings and argues for a more inclusive approach to linking evidence with practice. It describes a systematic approach to service evaluation and practice based evidence within a large psychological therapies service. This approach is integrated into the service delivery. It enables clinicians to become engaged in the process of reflecting on evidence in a non-threatening way and allows innovative ways of enhancing reflective practice by linking evidence with practice in routine settings

The Effects of School Board Consolidation and Financing on Student Performance

Over the last 20 years, states and provinces have become increasingly involved in the financing and administration of elementary and secondary education. Local school boards, however, still retain control over key aspects of the provision of education. Historically, these boards were organized at the community level so as to meet the wants of the local community. Today, states and provinces have become more interested in consolidating school boards and moving to a more centralized funding scheme. Do these changes result in improved student achievement? This paper attempts to answer these questions by examining the school board consolidation and funding changes instituted by the province of Ontario. We differentiate the effects of the policy changes based on observed differences in the school boards prior to consolidation. We show that students in previously high wealth school boards perform worse after the policy change compared to students in previously low wealth school boards.school district consolidation; student achievement

Factors that influence treatment seeking expectations in response to infectious intestinal disease: original survey and multinomial regression

Background: Infectious intestinal disease affects 25% of the UK population annually; 1 in 50 affected people consult health professionals about their illness. Aims: We tested if anticipated treatment-seeking decisions for suspected infectious intestinal disease could be related to emotional response, tolerance of symptoms, or beliefs about the consequential benefits and harms of seeking treatment (or not). Methods: Questionnaire survey of adults living in the UK with statistical analysis of responses. A vignette was presented about a hypothetical gastrointestinal illness. People stated their emotional reactions, expected actions in response and beliefs about possible benefits or harms from seeking treatment (or not getting treatment). Multinomial regression looked for predictors of anticipated behaviour. Results: People were inclined to consult a GP when they believed that seeking treatment would be beneficial and that its absence would be harmful. Seeking treatment was less anticipated if the condition was expected to improve quickly. Respondents were also more likely to consult if they strongly disliked fever or headache, and/or if the illness made them feel anxious or angry. Treatment-seeking (or lack of it) was not linked to harms from treatment-seeking, other specific symptoms and emotional responses. Conclusion: It was possible to link anticipated treatment-seeking behaviour to specific factors: expected prognosis, perceived benefits of seeking treatment, some emotions and some specific symptoms. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences

PyGOM - A Python Package for Simplifying Modelling with Systems of Ordinary Differential Equations

Ordinary Differential Equations (ODE) are used throughout science where the capture of rates of change in states is sought. While both pieces of commercial and open software exist to study such systems, their efficient and accurate usage frequently requires deep understanding of mathematics and programming. The package we present here, PyGOM, seeks to remove these obstacles for models based on ODE systems. We provide a simple interface for the construction of such systems backed by a comprehensive and easy to use tool--box. This tool--box implements functions to easily perform common operations for ODE systems such as solving, parameter estimation, and stochastic simulation. The package source is freely available and organized in a way that permits easy extension. With both the algebraic and numeric calculations performed automatically (but still accessible), the end user is freed to focus on model development.Comment: 23 pages, 6 figure

Potential Impact of Antiviral Drug Use during Influenza Pandemic

Impact of different antiviral treatment strategies on hospitalizations during an influenza pandemic is evaluated

Suitability of European climate for the Asian tiger mosquito Aedes albopictus: recent trends and future scenarios

The Asian tiger mosquito (Aedes albopictus) is an invasive species that has the potential to transmit infectious diseases such as dengue and chikungunya fever. Using high-resolution observations and regional climate model scenarios for the future, we investigated the suitability of Europe for A. albopictus using both recent climate and future climate conditions. The results show that southern France, northern Italy, the northern coast of Spain, the eastern coast of the Adriatic Sea and western Turkey were climatically suitable areas for the establishment of the mosquito during the 1960–1980s. Over the last two decades, climate conditions have become more suitable for the mosquito over central northwestern Europe (Benelux, western Germany) and the Balkans, while they have become less suitable over southern Spain. Similar trends are likely in the future, with an increased risk simulated over northern Europe and slightly decreased risk over southern Europe. These distribution shifts are related to wetter and warmer conditions favouring the overwintering of A. albopictus in the north, and drier and warmer summers that might limit its southward expansion

Population preference values for treatment outcomes in chronic lymphocytic leukaemia: a cross-sectional utility study

<p>Abstract</p> <p>Background</p> <p>Given that treatments for chronic lymphocytic leukaemia (CLL) are palliative rather than curative, evaluating the patient-perceived impacts of therapy is critical. To date, no utility (preference) studies from the general public or patient perspective have been conducted in CLL. The objective of this study was to measure preferences for health states associated with CLL treatment.</p> <p>Methods</p> <p>This was a cross-sectional study of 89 members of the general population in the UK (England and Scotland). Using standard gamble, each participant valued four health states describing response status, six describing treatment-related toxicities based on Common Toxicity Criteria, and two describing line of treatment. The health states incorporated standardized descriptions of treatment response (symptoms have "improved," "stabilized," or "gotten worse"), swollen glands, impact on daily activities, fatigue, appetite, and night sweats. Utility estimates ranged from 0.0, reflecting dead, to 1.0, reflecting full health.</p> <p>Results</p> <p>Complete response (CR) was the most preferred health state (mean utility, 0.91), followed by partial response (PR), 0.84; no change (NC), 0.78; and progressive disease (PD), 0.68. Among the toxicity states, grade I/II nausea and nausea/vomiting had the smallest utility decrements (both were -0.05), and grade III/IV pneumonia had the greatest decrement (-0.20). The utility decrements obtained for toxicity states can be subtracted from utilities for CR, PR, NC, and PD, as appropriate. The utilities for second- and third-line treatments, which are attempted when symptoms worsen, were 0.71 and 0.65, respectively. No significant differences in utilities were observed by age, sex, or knowledge/experience with leukaemia.</p> <p>Conclusions</p> <p>This study reports UK population utilities for a universal set of CLL health states that incorporate intended treatment response and unintended toxicities. These utilities can be applied in future cost-effectiveness analyses of CLL treatment.</p

Eye Colour, Aging, and Decoy Trap Bias in Lesser Scaup, Aythya affinis

Researchers routinely assume that samples of trapped or captured animals are representative of the overall population, though these assumptions are not always evaluated. We used decoy-trapped Lesser Scaup (Aythya affinis) to assess the reliability of classifying females as yearlings or adults from a distance, based on documented age-related eye-colour changes, and also to evaluate the presence of sex, condition and age biases in decoy trapping. We compared eye colour of trapped females to photographs of known-age females following a published procedure while females were (1) in traps (by using spotting scopes or binoculars) and (2) in-hand. Assuming in-hand age assessments were correct, we found that adults aged from a distance were frequently misclassified as yearlings, but yearlings were never misclassified as adults. Distance between observer and female, overall observation quality, and cloud cover did not influence age assignment success. A larger proportion of males was captured than observed during a survey of the local breeding population. We also found that decoy-trapped females had lower body mass and were more likely to be yearlings compared to pass- and jump-shot females from the same area. We conclude that female Lesser Scaup cannot be accurately aged from a distance using eye colour and concur with other researchers that possible sex, age and condition biases should be evaluated when using decoy traps

Assessing the capability of in-situ nondestructive analysis during layer based additive manufacture

Unlike more established subtractive or constant volume manufacturing technologies, additive manufacturing methods suffer from a lack of in-situ monitoring methodologies which can provide informationrelating to process performance and the formation of defects. In-process evaluation for additive manufacturing is becoming increasingly important in order to assure the integrity of parts produced in this way. This paper addresses the generic performance of inspection methods suitable for additive manufacturing. Key process and measurement parameters are explored and the impacts these have upon production rates are defined. Essential working parameters are highlighted, within which the spatial opportunity and temporal penalty for measurement allow for comparison of the suitability of different nondestructive evaluation techniques. A new method of benchmarking in-situ inspection instruments and characterising their suitability for additive manufacturing processes is presented to act as a design tool to accommodate end user requirements. Two inspection examples are presented: spatially resolved acoustic spectroscopy and optical coherence tomography for scanning selective laser melting and selective laser sintering parts, respectively. Observations made from the analyses presented show that the spatial capability arising from scanning parameters affects the temporal penalty and hence impact upon production rates. A case study, created from simulated data, has been used to outline the spatial performance of a generic nondestructive evaluation method and to show how a decrease in data capture resolution reduces the accuracy of measurement