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Geochemical and related studies have been made of near-surface sediments from the River Clyde estuary and adjoining areas, extending from Glasgow to the N, and W as far as the Holy Loch on the W coast of Scotland, UK. Multibeam echosounder, sidescan sonar and shallow seismic data, taken with core information, indicate that a shallow layer of modern sediment, often less than a metre thick, rests on earlier glacial and post-glacial sediments. The offshore Quaternary history can be aligned with onshore sequences, with the recognition of buried drumlins, settlement of muds from quieter water, probably behind an ice dam, and later tidal delta deposits. The geochemistry of contaminants within the cores also indicates shallow contaminated sediments, often resting on pristine pre-industrial deposits at depths less than 1m. The distribution of different contaminants with depth in the sediment, such as Pb (and Pb isotopes), organics and radionuclides, allow chronologies of contamination from different sources to be suggested. Dating was also attempted using microfossils, radiocarbon and 210Pb, but with limited success. Some of the spatial distribution of contaminants in the surface sediments can be related to grain-size variations. Contaminants are highest, both in absolute terms and in enrichment relative to the natural background, in the urban and inner estuary and in the Holy Loch, reflecting the concentration of industrial activity.
Potassium titanyl phosphate crystals in both x-cut and z-cut were irradiated with 185 MeV Au ions. The morphology of the resulting ion tracks was investigated using small angle x-ray scattering (SAXS), transmission electron microscopy (TEM), and atomic force microscopy (AFM). SAXS measurements indicate the presence of cylindrical ion tracks with abrupt boundaries and a density contrast of 1 ± 0.5% compared to the surrounding matrix, consistent with amorphous tracks. The track radius depends on the crystalline orientation, with 6.0 ± 0.1 nm measured for ion tracks along the x-axis and 6.3 ± 0.1 nm for those along the z-axis. TEM images in both cross-section and plan-view show amorphous ion tracks with radii comparable to those determined from SAXS analysis. The protruding hillocks covering the sample surface detected by AFM are consistent with a lower density of the amorphous material within the ion tracks compared to the surrounding matrix. Simulations using an inelastic thermal-spike model indicate that differences in the thermal conductivity along the z- and x-axis can partially explain the different track radii along these directions.
Depression is expensive to treat, but providing ineffective treatment is more expensive. Such is the case for many patients who do not respond to antidepressant medication.
Aims
To assess the cost-effectiveness of cognitive–behavioural therapy (CBT) plus usual care for primary care patients with treatment-resistant depression compared with usual care alone.
Method
Economic evaluation at 12 months alongside a randomised controlled trial. Cost-effectiveness assessed using a cost-consequences framework comparing cost to the health and social care provider, patients and society, with a range of outcomes. Cost-utility analysis comparing health and social care costs with quality-adjusted life-years (QALYs).
Results
The mean cost of CBT per participant was £910. The difference in QALY gain between the groups was 0.057, equivalent to 21 days a year of good health. The incremental cost-effectiveness ratio was £14 911 (representing a 74% probability of the intervention being cost-effective at the National Institute of Health and Care Excellence threshold of £20 000 per QALY). Loss of earnings and productivity costs were substantial but there was no evidence of a difference between intervention and control groups.
Conclusions
The addition of CBT to usual care is cost-effective in patients who have not responded to antidepressants. Primary care physicians should therefore be encouraged to refer such individuals for CBT.
Division IX provides a forum for astronomers engaged in the planning, development, construction, and calibration of optical and infrared telescopes and instrumentation, as well as observational procedures including data processing. A few years ago, discussions were started about changes in the structure of Division IX, with the aim of bringing it more in line with today's world of large coordinated projects and multi-national observatories. The course of this process, and further steps to be taken in the period from 2009 to 2012, were at the focus of the deliberations at the business meeting of Division IX at the IAU General Assembly in Rio de Janeiro.