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The Association Between Parent Engagement and Child Outcomes in Social Skills Training Programs: Discovering the Secret Agent Society in Partnership
- Debra Costley, Susanna Baldwin, Trevor Clark, Patricia Howlin, John R. Taffe, Renae Beaumont, Kylie M. Gray, Stewart L. Einfeld, Jennifer Smith-Merry, Jacqueline Roberts, Kate Sofronoff
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- Journal:
- Australasian Journal of Special and Inclusive Education / Volume 44 / Issue 1 / July 2020
- Published online by Cambridge University Press:
- 31 March 2020, pp. 46-59
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Previous research in clinical, community, and school settings has demonstrated positive outcomes for the Secret Agent Society (SAS) social skills training program. This is designed to help children on the autism spectrum become more aware of emotions in themselves and others and to ‘problem-solve’ complex social scenarios. Parents play a key role in the implementation of the SAS program, attending information and support sessions with other parents and providing supervision, rewards, and feedback as their children complete weekly ‘home mission’ assignments. Drawing on data from a school-based evaluation of the SAS program, we examined whether parents’ engagement with these elements of the intervention was linked to the quality of their children’s participation and performance. Sixty-eight 8–14-year-olds (M age = 10.7) with a diagnosis of autism participated in the program. The findings indicated that ratings of parental engagement were positively correlated with children’s competence in completing home missions and with the quality of their contribution during group teaching sessions. However, there was a less consistent relationship between parental engagement and measures of children’s social and emotional skill gains over the course of the program.
The Northwest Participant and Clinical Interactions Network: Increasing opportunities for patients to participate in research across the Northwestern United States
- Laura-Mae Baldwin, Laurie Hassell, Cindi Laukes, Michelle Doyle, Anne Reedy, Brenda Mollis, Sandra Albritton, Elizabeth Ciemins, Robert Coker, Jeannine Brant, Katherine R. Tuttle, Laura Baker, Bonnie Ramsey
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- Journal:
- Journal of Clinical and Translational Science / Volume 1 / Issue 2 / April 2017
- Published online by Cambridge University Press:
- 19 April 2017, pp. 94-100
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Introduction
The Institute of Translational Health Sciences (ITHS) promotes and supports translational research collaboration between clinicians, communities, and investigators across the five-state Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region. The ITHS has developed a collaborative regional clinical research network, the Northwest Participant & Clinical Interactions Network (NW PCI), involving 12 diverse clinical health systems and academic institutions.
MethodsThis descriptive article details NW PCI’s development, infrastructure and governance, tools, characteristics, and initial outcomes.
ResultsRegional NW PCI sites are conducting largely industry-sponsored studies; they are interested in including more grant-funded research. Regional NW PCI sites had over 1,240 open studies involving over 6700 patients in 2016. NW PCI trials are largely industry-sponsored; NW PCI sites are interested in including more grant-funded research. In its first three years, the NW PCI Coordinating Center facilitated regional sites’ participation in 34 new grant and contract applications across diverse topics.
ConclusionThe NW PCI model supports the goals of the developing CTSA Trial Innovation Network by increasing access to cutting-edge research across the Northwestern U.S., by supporting investigators seeking diverse populations, including those with rare diseases, for their research studies, and by providing settings to test implementation and dissemination of effective interventions.
The separation of adult separation anxiety disorder
- David S. Baldwin, Robert Gordon, Marianna Abelli, Stefano Pini
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- Journal:
- CNS Spectrums / Volume 21 / Issue 4 / August 2016
- Published online by Cambridge University Press:
- 09 August 2016, pp. 289-294
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The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorization of mental disorders places “separation anxiety disorder” within the broad group of anxiety disorders, and its diagnosis no longer rests on establishing an onset during childhood or adolescence. In previous editions of DSM, it was included within the disorders usually first diagnosed in infancy, childhood, or adolescence, with the requirement for an onset of symptoms before the age of 18 years: symptomatic adults could only receive a retrospective diagnosis, based on establishing this early onset. The new position of separation anxiety disorder is based upon the findings of epidemiological studies that revealed the unexpectedly high prevalence of the condition in adults, often in individuals with an onset of symptoms after the teenage years; its prominent place within the DSM-5 group of anxiety disorders should encourage further research into its epidemiology, etiology, and treatment. This review examines the clinical features and boundaries of the condition, and offers guidance on how it can be distinguished from other anxiety disorders and other mental disorders in which “separation anxiety” may be apparent.
Chapter 20 - Anxiety and depression in women in old age
- from Section 4 - Depression, anxiety and related disorders
- Edited by David J. Castle, University of Melbourne, Kathryn M. Abel, University of Manchester
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- Book:
- Comprehensive Women's Mental Health
- Published online:
- 05 March 2016
- Print publication:
- 07 March 2016, pp 247-268
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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- By Brittany L. Anderson-Montoya, Heather R. Bailey, Carryl L. Baldwin, Daphne Bavelier, Jameson D. Beach, Jeffrey S. Bedwell, Kevin B. Bennett, Richard A. Block, Deborah A. Boehm-Davis, Corey J. Bohil, David B. Boles, Avinoam Borowsky, Jessica Bramlett, Allison A. Brennan, J. Christopher Brill, Matthew S. Cain, Meredith Carroll, Roberto Champney, Kait Clark, Nancy J. Cooke, Lori M. Curtindale, Clare Davies, Patricia R. DeLucia, Andrew E. Deptula, Michael B. Dillard, Colin D. Drury, Christopher Edman, James T. Enns, Sara Irina Fabrikant, Victor S. Finomore, Arthur D. Fisk, John M. Flach, Matthew E. Funke, Andre Garcia, Adam Gazzaley, Douglas J. Gillan, Rebecca A. Grier, Simen Hagen, Kelly Hale, Diane F. Halpern, Peter A. Hancock, Deborah L. Harm, Mary Hegarty, Laurie M. Heller, Nicole D. Helton, William S. Helton, Robert R. Hoffman, Jerred Holt, Xiaogang Hu, Richard J. Jagacinski, Keith S. Jones, Astrid M. L. Kappers, Simon Kemp, Robert C. Kennedy, Robert S. Kennedy, Alan Kingstone, Ioana Koglbauer, Norman E. Lane, Robert D. Latzman, Cynthia Laurie-Rose, Patricia Lee, Richard Lowe, Valerie Lugo, Poornima Madhavan, Leonard S. Mark, Gerald Matthews, Jyoti Mishra, Stephen R. Mitroff, Tracy L. Mitzner, Alexander M. Morison, Taylor Murphy, Takamichi Nakamoto, John G. Neuhoff, Karl M. Newell, Tal Oron-Gilad, Raja Parasuraman, Tiffany A. Pempek, Robert W. Proctor, Katie A. Ragsdale, Anil K. Raj, Millard F. Reschke, Evan F. Risko, Matthew Rizzo, Wendy A. Rogers, Jesse Q. Sargent, Mark W. Scerbo, Natasha B. Schwartz, F. Jacob Seagull, Cory-Ann Smarr, L. James Smart, Kay Stanney, James Staszewski, Clayton L. Stephenson, Mary E. Stuart, Breanna E. Studenka, Joel Suss, Leedjia Svec, James L. Szalma, James Tanaka, James Thompson, Wouter M. Bergmann Tiest, Lauren A. Vassiliades, Michael A. Vidulich, Paul Ward, Joel S. Warm, David A. Washburn, Christopher D. Wickens, Scott J. Wood, David D. Woods, Motonori Yamaguchi, Lin Ye, Jeffrey M. Zacks
- Edited by Robert R. Hoffman, Peter A. Hancock, University of Central Florida, Mark W. Scerbo, Old Dominion University, Virginia, Raja Parasuraman, George Mason University, Virginia, James L. Szalma, University of Central Florida
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- Book:
- The Cambridge Handbook of Applied Perception Research
- Published online:
- 05 July 2015
- Print publication:
- 26 January 2015, pp xi-xiv
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Risk Regulation and Transnationality: Institutional Accountability as a Driver of Innovation
- Robert Baldwin, Julia Black, Gerard O’Leary
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- Journal:
- Transnational Environmental Law / Volume 3 / Issue 2 / October 2014
- Published online by Cambridge University Press:
- 26 June 2014, pp. 373-390
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This article describes the processes that led the Irish Environmental Protection Agency (EPA) to develop a National Inspection Plan for domestic waste water treatment systems, following intervention from European Union institutions. The discussion focuses on two issues: the role of transnational institutional settings in galvanizing innovation and regulatory reform, and the practical challenges of dealing with lower risks. It is argued that multi-level transnational regimes have considerable potential to stimulate high-level reviews of regulatory strategy. As a result, lower risks present challenges that cannot be ignored in favour of policies that focus on the most severe risks. Traditional risk regulation theories, it is contended, do not provide much assistance in selecting intervention strategies in the face of such pressures, but the example of the Irish EPA shows how regulators can address these issues.
Contributors
- Edited by Carla Bagnoli, Università degli Studi di Modena, Italy
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- Book:
- Constructivism in Ethics
- Published online:
- 05 July 2013
- Print publication:
- 18 July 2013, pp vii-x
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Cost-effectiveness analyses for mirtazapine and sertraline in dementia: randomised controlled trial
- Renee Romeo, Martin Knapp, Jennifer Hellier, Michael Dewey, Clive Ballard, Robert Baldwin, Peter Bentham, Alistair Burns, Chris Fox, Clive Holmes, Cornelius Katona, Claire Lawton, James Lindesay, Gill Livingston, Niall McCrae, Esme Moniz-Cook, Joanna Murray, Shirley Nurock, John O'Brien, Michaela Poppe, Alan Thomas, Rebecca Walwyn, Kenneth Wilson, Sube Banerjee
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- Journal:
- The British Journal of Psychiatry / Volume 202 / Issue 2 / February 2013
- Published online by Cambridge University Press:
- 02 January 2018, pp. 121-128
- Print publication:
- February 2013
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Background
Depression is a common and costly comorbidity in dementia. There are very few data on the cost-effectiveness of antidepressants for depression in dementia and their effects on carer outcomes.
AimsTo evaluate the cost-effectiveness of sertraline and mirtazapine compared with placebo for depression in dementia.
MethodA pragmatic, multicentre, randomised placebo-controlled trial with a parallel cost-effectiveness analysis (trial registration: ISRCTN88882979 and EudraCT 2006-000105-38). The primary cost-effectiveness analysis compared differences in treatment costs for patients receiving sertraline, mirtazapine or placebo with differences in effectiveness measured by the primary outcome, total Cornell Scale for Depression in Dementia (CSDD) score, over two time periods: 0–13 weeks and 0–39 weeks. The secondary evaluation was a cost-utility analysis using quality-adjusted life years (QALYs) computed from the Euro-Qual (EQ-5D) and societal weights over those same periods.
ResultsThere were 339 participants randomised and 326 with costs data (111 placebo, 107 sertraline, 108 mirtazapine). For the primary outcome, decrease in depression, mirtazapine and sertraline were not cost-effective compared with placebo. However, examining secondary outcomes, the time spent by unpaid carers caring for participants in the mirtazapine group was almost half that for patients receiving placebo (6.74 v. 12.27 hours per week) or sertraline (6.74 v. 12.32 hours per week). Informal care costs over 39 weeks were £1510 and £1522 less for the mirtazapine group compared with placebo and sertraline respectively.
ConclusionsIn terms of reducing depression, mirtazapine and sertraline were not cost-effective for treating depression in dementia. However, mirtazapine does appear likely to have been cost-effective if costing includes the impact on unpaid carers and with quality of life included in the outcome. Unpaid (family) carer costs were lower with mirtazapine than sertraline or placebo. This may have been mediated via the putative ability of mirtazapine to ameliorate sleep disturbances and anxiety. Given the priority and the potential value of supporting family carers of people with dementia, further research is warranted to investigate the potential of mirtazapine to help with behavioural and psychological symptoms in dementia and in supporting carers.
Stomach contents of small cetaceans stranded along the Sea of Oman and Arabian Sea coasts of the Sultanate of Oman
- Louisa S. Ponnampalam, Tim J.Q. Collins, Gianna Minton, Isabelle Schulz, Howard Gray, Rupert F. G. Ormond, Robert M. Baldwin
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 92 / Issue 8 / December 2012
- Published online by Cambridge University Press:
- 06 February 2012, pp. 1699-1710
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This study examined the stomach contents of 11 bottlenose dolphins (Tursiops sp.), five Indo-Pacific humpback dolphins (Sousa chinensis) and two spinner dolphins (Stenella longirostris) that were found stranded along the Omani coastline. Across the three species examined, a total of 4796 fish otoliths and 214 cephalopod beaks were found, representing at least 33 species in 22 families. Prey item importance was calculated using the percentage by number and percentage by frequency of occurrence methods, and a modified index of relative importance. The fish families Apogonidae, Carangidae and Scombridae were the most numerically important prey of the bottlenose dolphins. Sciaenidae was the most numerically important fish family for the Indo-Pacific humpback dolphins. The myctophid Benthosema pterotum formed the majority of the prey items of spinner dolphins. Cephalopod remains found in the stomach samples were represented by the families Sepiidae, Loliginidae and Onychoteuthidae. The known depth distribution of prey items of bottlenose dolphins indicated that the animals fed in a wide variety of habitats. Indo-Pacific humpback dolphin prey items indicated feeding in shallow coastal areas. Spinner dolphins appear to have exploited the upper 200 m of the water column for food, where their vertically migrating mesopelagic prey are found at night. Most prey species found in the stomach contents do not appear to be of current commercial importance in Oman. However, the findings here indicated that all three species of dolphins were feeding in areas where artisanal and/or commercial fishing occurs and has conservation implications.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Preventing late-life depression: a clinical update
- Robert C. Baldwin
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- Journal:
- International Psychogeriatrics / Volume 22 / Issue 8 / December 2010
- Published online by Cambridge University Press:
- 01 July 2010, pp. 1216-1224
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Background: Achieving remission in late-life depressive disorder is difficult; it is far better to prevent depression. In the last ten years there have been a number of clinical studies of the feasibility of prevention.
Methods: A limited literature review was undertaken of studies from 2000 specifically concerning the primary prevention of late-life depressive disorder or where primary prevention is a relevant secondary outcome.
Results: Selective primary prevention (targeting individuals at risk but not expressing depression) has been shown to be effective for stroke and macular degeneration but not hip fracture. It may also prove effective for the depression associated with caregiving in dementia. Emerging evidence finds effectiveness for indicated prevention (in those identified with subthreshold depression often with other risk factors such as functional limitation). Despite a number of promising risk factors (for example, diet, exercise, vascular risk factors, homocysteine and insomnia), universal prevention of late-life depression (acting to reduce the impact of risk factors at the population level) has no current evidence base, although a population approach might mitigate suicide.
Conclusion: Interventions which work in preventing late-life depression include antidepressant medication in standard doses and Problem-Solving Treatment. When integrated into a care model, such as collaborative care, prevention is feasible but more economic studies are needed.
12 - Mental health problems in older people
- from Part II - Clinical issues
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- By Carolyn Chew-Graham, Professor of Primary Care in the School of Community Based Medicine, University of Manchester, Robert Baldwin, Consultant in Old Age Psychiatry at Manchester Royal Infirmary and Honorary Professor of Old Age Psychiatry at the University of Manchester
- Edited by Linda Gask, Helen Lester, Tony Kendrick, Robert Peveler
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- Primary Care Mental Health
- Published online:
- 02 January 2018
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- 01 October 2009, pp 174-197
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Summary
This chapter is divided into four main sections, presenting, in turn, the primary care management of the commonest mental health problems in older people: delirium, depression, dementia and delusions (the first three of these are compared in Table 12.1). The presentation and management of a typical case are illustrated for each. Although the discussion largely refers to the UK context and the general practitioner (GP), the majority of it will apply internationally and to primary care physicians (and indeed other professionals) more generally.
Delirium
Clinical presentation
Delirium is a syndrome comprising disturbance of consciousness (often manifest as impaired attention or concentration), cognitive deficits (such as memory, orientation or language problems), disturbed sleep–wake cycle, associated features such as delusions or hallucinations (especially visual) and behavioural disturbances (such as agitation or apathy) and alterations in affect, notably fear (Table 12.1).
The onset is often sudden (hours or days) and fluctuation is a hallmark. A useful mnemonic is the four ‘I's (Crausman, 2004):
intermittent impairment of cognition
inattention
incoherent thought
impaired consciousness.
Delirium is synonymous with ‘acute confusional state’ (see Chapter 16).
Case 1. Delirium: Marjorie
The GP is called to see an 83-year-old lady, Marjorie, who lives in a residential home and who has quickly become confused, withdrawn and irritable. She has wandered out of her room, awake, for the past three nights.
She has a history of diabetes, ischaemic heart disease, peptic ulcer and recurrent urinary tract infections.
Her medication comprises gliclazide, digoxin, aspirin, ramipril, atorvastatin, thyroxine, omeprazole and paracetamol.
The nurse in charge has asked the GP to see her because Marjorie is being disruptive.
What does the GP need to consider in relation to assessment, diagnosis and management?
Two main presentations are recognised:
• hyperactive delirium (hallucinations, delusions, agitation and disorientation)
• hypoactive delirium (cognitive impairment with apathy or withdrawal, less often accompanied by hallucinations and delusions).
The latter form can easily be overlooked in older patients.
One Economics, Many Recipes: Globalization, Institutions, and Economic Growth by Dani Rodrik Princeton, NJ: Princeton University Press, 2007
- Robert E. Baldwin
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- Journal:
- World Trade Review / Volume 7 / Issue 3 / July 2008
- Published online by Cambridge University Press:
- 27 June 2008, pp. 573-575
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- July 2008
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Comparison of older people with psychosis living in the community and in care homes
- Emily Clancy, Robert C. Baldwin
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- Journal:
- Psychiatric Bulletin / Volume 32 / Issue 5 / May 2008
- Published online by Cambridge University Press:
- 02 January 2018, pp. 177-179
- Print publication:
- May 2008
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Aims and Method
To compare two groups of older people with chronic schizophrenia or delusional disorder living in the community and in care homes, along the domains of morbidity suggested by prior research. From the case-load of one old age psychiatrist, 22 individuals with chronic psychosis residing in care homes were compared to 23 living in their own homes. The measures used were: the Positive and Negative Symptom Score (PANSS; Kay et al, 1987); the Mini Mental State Examination (MMSE; Folstein et al, 1975); the Burvill Physical Illness Scale (Burvill et al, 1990); and an Activities of Daily Living Scale (IADL; Lawton et al, 1969).
ResultsThose in care homes had significantly higher PANSS scores (38.9 v. 21.0, P<0.01), largely accounted for by significantly more deficit symptoms (14.2 v. 5.6, P<0.01). They also had poorer cognition and significantly greater impairment in daily-life activities but their medical condition was not significantly worse. Most were seen only by a psychiatrist.
Clinical ImplicationsThe greater morbidity and disablement of older people with chronic schizophrenia or delusional disorder living in care homes is likely to be intrinsic to the disorder but does not appear to be taken into account in current service planning or delivery.
Index
- Carolyn A. Chew-Graham, University of Manchester, Robert Baldwin, Alistair Burns, University of Manchester
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- Book:
- Integrated Management of Depression in the Elderly
- Published online:
- 18 December 2009
- Print publication:
- 03 April 2008, pp 178-184
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2 - Management of late-life depression
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- By Carolyn Chew-Graham, University of Manchester, Robert Baldwin, Manchester Mental Health and Social Care NHS Trust, Karina Lovell, Professor of Mental Health Nursing School of Nursing Midwifery and Social Work, University of Manchester
- Carolyn A. Chew-Graham, University of Manchester, Robert Baldwin, Alistair Burns, University of Manchester
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- Integrated Management of Depression in the Elderly
- Published online:
- 18 December 2009
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- 03 April 2008, pp 17-32
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Summary
Introduction
Most patients with depression are managed in primary care settings; however, a substantial number of patients are not recognized, and those who are diagnosed often do not receive effective treatment (Kessler et al. 1999). There is, however, a good evidence base for the management of depression in older people. Treatments that have been shown to work are the same as for younger adults: antidepressants, psychosocial and psychological interventions, or combinations of these and electroconvulsive treatment (ECT) for severe life-threatening or therapy-resistant cases. There is evidence to show that there are effective pharmacological (Wilson et al. 2001), psychological (Karel and Hinrichsen 2000) and psychosocial (Scogin and McElreath 1994) interventions for late-life depression, but these have yet to be adopted in primary care (Unützer 2002), in part because although cost-effective, they may involve added resource and investment to begin with. Only one in four depressed people receives effective pharmacological treatment and fewer than one in ten a talking therapy (Singleton et al. 2001). However, this is despite the fact that many people want and prefer ‘talking treatments’ (Rogers et al. 1993).
General principles of treatment
Goals of treatment
Table 2.1 provides a framework and summary of the goals for depression management (Baldwin et al. 2002).
Resolving all the symptoms of depression is the goal rather than getting the patient a bit better, as partial recovery is a predictor of future relapse.
Contents
- Carolyn A. Chew-Graham, University of Manchester, Robert Baldwin, Alistair Burns, University of Manchester
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- Book:
- Integrated Management of Depression in the Elderly
- Published online:
- 18 December 2009
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- 03 April 2008, pp v-v
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7 - Resources
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- By Robert Baldwin, Manchester Mental Health and Social Care Trust, Carolyn Chew-Graham, University of Manchester, Alistair Burns, University of Manchester
- Carolyn A. Chew-Graham, University of Manchester, Robert Baldwin, Alistair Burns, University of Manchester
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- Book:
- Integrated Management of Depression in the Elderly
- Published online:
- 18 December 2009
- Print publication:
- 03 April 2008, pp 114-139
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Summary
The aim of this chapter is bring together the variety of information found in the preceding chapters and commentaries into a practical resource for practitioners.
Screening for depression in older people
The usefulness of screening for depression depends on the baseline prevalence in the population screened; the higher the baseline prevalence the more likely is the screening to be cost-effective. Thus, targeted screening is more effective than screening an entire population. Examples include screening residents of a nursing home or the list of older patients on a general practice with physical conditions known to have strong links with depression, such as diabetes, chronic obstructive pulmonary disease or chronic heart disease (Krishnan et al. 2002). Iliffe and colleagues (page 95) add that screening should be linked to patients' perceptions of what is important and their SPICE acronym suggests five priority areas: senses, physical activity, incontinence, cognition and emotional distress.
The Geriatric Depression Scale (GDS) has been advocated as a screening instrument. It comprises 30 questions and takes about 10 minutes to complete (Table 7.1). The GDS avoids questions which rely on physical symptoms, and uses a simple yes/no format. Although designed to be self-administered, rater-assistance is acceptable. There are shorter versions, including a four-item (questions 1, 3, 8 and 9) and a 15-item version (Table 7.1) which may be more appropriate for use in primary care.
Integrated Management of Depression in the Elderly
- Carolyn A. Chew-Graham, Robert Baldwin, Alistair Burns
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- Published online:
- 18 December 2009
- Print publication:
- 03 April 2008
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Depression is one of the most common mental health problems facing older people, and it is often unrecognised and usually under-treated. Integrated Management of Depression in the Elderly provides an entirely new approach to understanding late-life depression, by using a series of case studies with commentaries from practitioners internationally. The book covers the epidemiology, presentation and diagnosis of depression in older people and outlines current evidence for effective management drawing on recently published work. The substantive part of the book presents ten case studies of increasing complexity, each case has a commentary from a primary care clinician and a health or social care professional, to outline how professionals should work together to manage the patient within their community. Contributions from world experts give the book an international appeal. It will appeal to a wide audience of health and social care professionals together with psychiatrists-in-training.