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Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
A high vacuum soft x-ray source has been coupled to a large volume experimental chamber to provide a versatile facility for x-ray investigations in the energy range of 0.1 to 10 kev. The source chamber presently contains a modified Herike tube, but can employ any of a variety of source designs. The large experimental chamber is equipped with a kinematic mount to position a number of x-ray optical instruments. The source and experimental chambers are connected through a high vacuum valve/shutter, and are pumped separately with provision for a thin window to isolate one from the other, single and double crystal spectrometers have been used in the experimental chamber. A variable chord diffractometer/reflectometer using double crystal monnotiromatization has been designed, in addition, the facility has been used to expose photoresists in x-ray lithography tests.
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interest
Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
If the subject of my paper derives from the desire to talk about the king whom Warren Hollister knew so well, its title derives from R.W. Southern's famous British Academy Raleigh Lecture, ‘The Place of Henry I in English History'. The lecture reappeared in his collection Medieval Humanism and Other Studies under the title ‘King Henry I’. The original title is the more appropriate, using the word ‘history’ to mean both the past and writings about the past; the lecture situates aspects of Henry's reign both within long-term historical developments and within a broad range of historiography. Here, I hope to share some of this dual aspect but concentrate on legal history, a subject upon which Southern touched but briefly. In particular, I reflect upon periodization and upon the ways in which different historians and different types of legal historiography attribute different degrees of significance to Henry's reign.
Writers in Henry I's reign and its aftermath state their opinions clearly. The author of the Leges Henrici Primi referred to the ‘formidable power [tremendum … imperium] of the royal majesty’ and to ‘the pleas of the king's court, which stand above everything'. The Anglo-Saxon Chronicle stated that ‘no one dared injure another in his time. He made peace for man and beast.’ Geoffrey of Monmouth's Prophecies of Merlin referred to the ‘Lion of Justice’, who was identified with Henry. According to William of Malmesbury, By the rigour of inflexible justice he restrained his countrymen peacefully, his nobles with appropriate dignity. He showed the greatest diligence in seeking out thieves and forgers in their dens, and punishing them when found. Nor did he neglect details; having heard that broken coins, although made of good silver, were not being accepted by those making sales, he ordered that all coins should be broken or cut. He punished the false ell in use among merchants, introducing his own forearm as a standard measure for all throughout England. … At the beginning of his reign, so that by fearful example he might make a lasting impression on evildoers, he was more inclined to mutilation of limbs, later to require monetary payments.
The focus of writers was thus on Henry's power throughout his realm, his maintenance of peace, and his dealing with offences such as theft and false moneying.
The Lower Oxford Clay, a marine formation of Middle Jurassic (Callovian) age exposed in central and southern England, merits the attention of paleontologists and geochemists for several reasons. It was the subject of a classic of biostratigraphic and evolutionary paleontology by Brinkmann on the ammonites; sexual dimorphism and bioprovinciality in the same group has since been intensively studied by Callomon and others. Its exploitation by the brick industry has enabled the assembly of one of the most extensive collections of marine vertebrates by the Leeds brothers and later workers; these include the world's largest ever fish, and superbly preserved ichthyosaurs, plesiosaurs and crocodiles now dispersed to museums throughout Europe and beyond. Dinosaurs, while rare, are also diverse. The benthic fauna is dominated by abundant but not diverse molluscs, believed tolerant of soupy bottom conditions and periodic dysoxia. Coccoliths and dinoflagellates represent the phytoplankton. Aragonite, calcite and phosphate biominerals are excellently preserved. In our main study area burial did not exceed 500m.; organic matter is immature. Early diagenesis resulted in the formation of carbonate concretions that preserve original sediment fabrics elsewhere destroyed by compaction; later diagenesis brought about further mineralogical changes.
Work since the 1970's has resulted in much improved understanding of the Lower Oxford Clay biota and its trophic relationships. It is useful to compare it to the more calcareous Middle and Upper Oxford Clay. The biostratigraphy is extremely well-known. The well-preserved fossils invite microstructural and geochemical studies. Economic concerns add impetus to the study of actual or potential hydrocarbon source rocks. Yet the Lower Oxford Clay is full of enigmas and questions still. It looks quiet-water but has many diastems, not all recognizable by classic criteria like shell beds. The fossil preservation might imply a high sediment delivery rate, but the sediment accumulation rate is low. It is organic-rich, but not anoxic. Where did the enigmatic ‘pendent’ bivalves live? Whence the nutrients to support the rich biota? To what extent do organic compounds survive from the primary producers, or does heterotrophic reworking dominate? Can we refine or quantify trophic relationships? We should also be able to use our ‘laboratory’ for experiments of wider significance for paleotemperatures or paleo-CO2 levels.
In the Oxford Clay group of papers we attempt to summarize where traditional paleoecological analysis has led us to so far, and to show how the new approaches made possible by advances in isotopic and biomolecular paleontology can revise and refine our ideas, solve old problems and, no doubt, raise new ones. We believe our collaborative approach has much to offer for paleontologists and geochemists, as also exemplified by the other contributions to the symposium.
The Middle Jurassic is a poorly sampled time interval for non-pelagic neosuchian crocodyliforms, which obscures our understanding of the origin and early evolution of major clades. Here we report a lower jaw from the Middle Jurassic (Bathonian) Duntulm Formation of the Isle of Skye, Scotland, UK, which consists of an isolated and incomplete left dentary and part of the splenial. Morphologically, the Skye specimen closely resembles the Cretaceous neosuchians Pachycheilosuchus and Pietraroiasuchus, in having a proportionally short mandibular symphysis, shallow dentary alveoli and inferred weakly heterodont dentition. It differs from other crocodyliforms in that the Meckelian canal is dorsoventrally expanded posterior to the mandibular symphysis and drastically constricted at the 7th alveolus. The new specimen, together with the presence of Theriosuchus sp. from the Valtos Formation and indeterminate neosuchians from the Kilmaluag Formation, indicates the presence of a previously unrecognised, diverse crocodyliform fauna in the Middle Jurassic of Skye, and Europe more generally. Small-bodied neosuchians were present, and ecologically and taxonomically diverse, in nearshore environments in the Middle Jurassic of the UK.
The Asian Monsoon, which brings ~80% of annual precipitation to much of the Tibetan Plateau, provides runoff to major rivers across the Asian continent. Paleoclimate records indicate summer insolation and North Atlantic paleotemperature changes forced variations in monsoon rainfall through the Holocene, resulting in hydrologic and ecologic changes in plateau watersheds. We present a record of Holocene hydrologic variability in the Yarlung Tsangpo (YT) valley of the southern Tibetan Plateau, based on sedimentology and 14C dating of organic-rich black mats’ in paleowetlands deposits, that shows changes in wetlands extent in response to changing monsoon intensity. Four sedimentary units indicate decreasing monsoon intensity since 10.4 ka BP. Wet conditions occurred at ~10.4 ka BP, ~9.6 ka BP and ~7.9–4.8 ka BP, with similar-to-modern conditions from ~4.6–2.0 ka BP, and drier-than-modern conditions from ~2.0 ka BP to present. Wetland changes correlate with monsoon intensity changes identified in nearby records, with weak monsoon intervals corresponding to desiccation and erosion of wetlands. Dating of in situ ceramic and microlithic artifacts within the wetlands indicates Epipaleolithic human occupation of the YT valley after 6.6 ka BP, supporting evidence for widespread colonization of the Tibetan Plateau in the early and mid-Holocene during warm, wet post-glacial conditions.
The Articles of the Barons record royal concessions to baronial demands in 1215 and form the basis for Magna Carta. They reveal at least some of the aims of the first English baronial rebellion with a clear programme of governmental reform. Their survival also for the first time allows analysis of the development of a major English legal document from draft to final version.
This essay begins by examining the drafting of the Articles, and suggests who may lie behind their composition. It then compares the form and contents of Magna Carta with the Articles. Finally it makes suggestions as to how the redrafting may have been carried out, and who influenced it. Comparison of the Articles and Magna Carta is not new. The contribution of the present paper reflects its origins: its starting point with the Articles rather than Magna Carta; its underlying interest in the drafting of legislation as much as in the politics of 1215; and its analysis of both the minutiae of the texts and the broader ideas that examination of those minutiae reveals.
The Articles of the Barons are written on a single sheet of parchment, under the heading ‘These are the articles that the barons seek and the lord king grants.’ They probably owe their survival to Archbishop Stephen Langton (1207–28), into whose hands they seem to have passed in 1215. The form of the document is unusual, in that it is set out article by article, each introduced with the paragraphus symbol, making it much easier to consult than the solid block of text that characterizes charters, including Magna Carta. The form was presumably intended to facilitate further discussion, which would lead to the already-envisaged Charter [i.e. Magna Carta]. Particularly in the earlier part of the document there is some logic to the ordering of the clauses into groups, although also elements of apparent disorder.
The Articles are in the handwriting typical of, although not exclusive to, clerks of the royal chancery.
The SMAC cluster sample (Hudson et al. 1999), with a depth of ˜ 12000km s-1, has a bulk velocity of ˜ 600 km s-1, with respect to the Cosmic Microwave Background (CMB) frame. Other surveys (Willick 1999, hereafter LP10k; Lauer & Postman 1994, hereafter ACIF) have also yielded large bulk motions on similarly large scales. Taken at face value, these results appear to be in conflict with bulk flows expected from favoured cosmological models. However, at the same time, other surveys (notably Dale et al. 1999, hereafter SC) have found rather small bulk motions on large scales. We have measured bulk flows from the above mentioned surveys plus SNIa (Riess et al. 1995) in a consistent way. The results are given in Table 1. The measurement errors are due to peculiar velocity errors. Note that these are the errors typically quoted. Based on these errors alone, there appears to be conflict between some of the surveys (e.g. SC vs SMAC).
Maria had been with her homestay family for 10 days when she found out that her host mother and brother were HIV positive. She asked to be moved, and the program directors complied. Another student, on another program, declared his HIV-positive status on his application form. Under American law, AIDS is not a reportable disease, and confidentiality policy obligated the director to place the student without informing his host family of the risk or educating them about precautions. What messages are we sending? Are the lives and legal principles of international students superior to those of the host nationals?
Our study examines the effect of water utilization together with the effect of water quality on economic growth across countries. We constructed a panel of 177 countries covering the period of 1960–2009. We analyse two dependent variables, gross domestic product per capita and the average of five years of growth. The analysis is conducted using a fixed effects model and fixed effects with instrumental variables. We find that although water utilization affects growth, water quality also proves to be highly significant and affects growth in both the short and long run to a greater degree than water quantity.
(1) Agreement between King John and Robert fitz Walter, Marshal of the Army of God, and others concerning the custody of London (P.R.O. Chancery Miscellanea, 34/1/1)(see pl. 10).
Hec est conventio facta inter dominum Johannem regem Anglie, ex una parte, et Robertum filium Walteri, marescallum exercitus Dei et sancte ecclesie in Anglia, et Ricardum comitem de Clara, Gaufridum comitem Essex' [et] Glouc', Rogerum Bigot comitem Northfolc' et Suthfolc', Saherum comitem Wint', Robertum comitem Oxon', Henricum comitem Hereford', et barones subscriptos, scilicet Willielmum Mariscallum juniorem, Eustachium de Vescy, Willielmum de Mobray, Johannem filium Roberti, Rogerum de Monte Begonis, Willielmum de Lanvalai, et alios comites et barones et liberos homines totius regni, ex altera parte, videlicet quod ipsi comites et barones et alii prescripti tenebunt civitatem London' de ballio domini regis, salvis interim domino regi firmis, redditibus et claris debitis suis, usque ad assumptionem beate Marie anno regni ipsius regis xviimo, et dominus Cantuar' tenebit similiter de ballio domini regis turrim London' usque ad predictum terminum, salvis civitati London' libertatibus suis et liberis consuetudinibus suis, et salvo cuilibet jure suo in custodia turris London', et ita quod interim non ponat dominus rex munitionem vel vires alias in civitate predicta vel in turri London'. Fiant etiam infra predictum terminum sacramenta per totam Angliam viginti quinque baronibus sicut continetur in carta de libertatibus et securitate regno concessis vel attornatis viginti quinque baronum sicut continetur in literis de duodecim militibus eligendis ad delendum malas consuetudines de forestis et aliis. Et preterea infra eundem terminum omnia que comites et barones et alii liberi hominess petunt a domino rege que ipse dixerit esse reddenda vel que per xxv barones aut per majorem partem eorum judicata fuerint esse reddenda reddantur secundum formam predicte carte. Et si hec facta fuerint vel per dominum regem non steterit quo minus ista facta fuerint infra predictum terminum tunc civitas et turris London' ad eundem terminum statim reddantur domino regi salvis predicte civitati libertatibus suis et liberis consuetudinibus suis sicut prescriptum est. Et si hec facta non fuerint et per dominum regem steterit quod ista non fiant infra predictum terminum barones tenebunt civitatem predictam et dominus archiepiscopus turrim London' donec predicta compleantur. Et interim omnes ex utraque parte recuperabunt castra, terras et villas quas habuerunt in initio guerre orte inter dominum regem et barones.
Dr Antonia Gransden and Dr R. M. Thomson are more inclined than I am to accept the evidence of Roger of Wendover that a great baronial gathering occurred at Bury St Edmunds late in 1214 at which the barons swore on the high altar that they would fight, if necessary, in order to compel the king to confirm the charter of liberties of Henry I. We are all agreed that the difficulty arises from the abrupt termination of the Annales S. Edmundi in 1212; but it seems to me to carry speculation too far to suppose that the story of the meeting appeared in the lost continuation of the Annales or its source. Indeed Dr Thomson provides strong grounds for thinking that this was not the case, for the author of the later Cronica Buriensis used John of Wallingford, not the Bury annals, as the source for his account of the meeting. In Bury histories the story first appears in a condensed form in a chronicle of Bury composed by Bury monks at St Benet of Hulme in or after 1327.
The matter therefore depends on the evidence or lack of it, in the Electio Hugonis. Now the Electio mentions no such meeting, and, given its subjectmatter, it may reasonably be asked – why should it? Dr Gransden relies in some degree on this argument. However, both she and Dr Thomson go further by maintaining that the Electio does, in fact, contain veiled references to incipient rebellion which are consistent with Wendover's story.
Before examining these it is well to bear some dates in mind. First, John was at La Rochelle on 2 October and at Dartmouth on 15 October. He probably arrived in England about 7 October. Secondly, he visited Bury on 4 November, when he attempted to settle the disputed election. Thirdly, the most likely date for a baronial meeting would be 20 November, the feast of St Edmund, when there was a good excuse for an assembly at Bury; and indeed Wendover states that the barons gathered ‘as if for prayer’.
The conventional numbering of the clauses in the 1225 text has been followed. The main variants of the 1216 and 1217 versions have been noted, but no attempt has been made to collate minor variations (Bámont, 1892, pp. 45–60, Statutes of the Realm, i, 14–19, 22–5).
Henricus Dei gratia rex Anglie, dominus Hybernie, dux Normannie, Aquitanie et comes Andegavie, archiepiscopis, episcopis, abbatibus, prioribus, comitibus, baronibus, vicecomitibus, prepositis, ministris et omnibus ballivis et fidelibus suis presentem cartam inspecturis salutem. Sciatis quod nos, intuitu Dei et pro salute anime nostre et animarum antecessorum et successorum nostrorum, ad exaltationem sancte ecclesie et emendationem regni nostri, spontanea et bona voluntate nostra, dedimus et concessimus archiepiscopis, episcopis, abbatibus, prioribus, comitibus, baronibus et omnibus de regno nostro has libertates subscriptas tenendas in regno nostro Anglie in perpetuum.
In primis concessimus Deo et hac presenti carta nostra confirmavimus pro nobis et heredibus nostris in perpetuum quod Anglicana ecclesia libera sit, et habeat omnia jura sua integra et libertates suas illesas. Concessimus etiam omnibus liberis hominibus regni nostri pro nobis et heredibus nostris in perpetuum omnes libertates subscriptas, habendas et tenendas eis et heredibus suis de nobis et heredibus nostris in perpetuum. [1215, c. 1.]
Si quis comitum vel baronum nostrorum sive aliorum tenencium de nobis in capite per servicium militare mortuus fuerit, et, cum decesserit, heres ejus plene etatis fuerit et relevium debeat, habeat hereditatem suam per antiquum relevium, scilicet heres vel heredes comitis de baronia comitis integra per centum libras, heres vel heredes baronis de baronia integra per centum libras, heres vel heredes militis de feodo militis integro per centum solidos ad plus; et qui minus debuerit minus det secundum antiquam consuetudinem feodorum. [1215, c. 2.]
Si autem heres alicujus talium fuerit infra etatem, dominus ejus non habeat custodiam ejus nec terre sue antequam homagium ejus ceperit; et, postquam talis heres fuerit in custodia, cum ad etatem pervenerit, scilicet viginti et unius anni, habeat hereditatem suam sine relevio et sine fine, ita tamen quod, si ipse, dum infra etatem fuerit, fiat miles, nichilominus terra remaneat in custodia dominorum suorum usque ad terminum predictum.