To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
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.
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.
Depression and obesity are highly prevalent, and major impacts on public health frequently co-occur. Recently, we reported that having depression moderates the effect of the FTO gene, suggesting its implication in the association between depression and obesity.
To confirm these findings by investigating the FTO polymorphism rs9939609 in new cohorts, and subsequently in a meta-analysis.
The sample consists of 6902 individuals with depression and 6799 controls from three replication cohorts and two original discovery cohorts. Linear regression models were performed to test for association between rs9939609 and body mass index (BMI), and for the interaction between rs9939609 and depression status for an effect on BMI. Fixed and random effects meta-analyses were performed using METASOFT.
In the replication cohorts, we observed a significant interaction between FTO, BMI and depression with fixed effects meta-analysis (β=0.12, P = 2.7 × 10−4) and with the Han/Eskin random effects method (P = 1.4 × 10−7) but not with traditional random effects (β = 0.1, P = 0.35). When combined with the discovery cohorts, random effects meta-analysis also supports the interaction (β = 0.12, P = 0.027) being highly significant based on the Han/Eskin model (P = 6.9 × 10−8). On average, carriers of the risk allele who have depression have a 2.2% higher BMI for each risk allele, over and above the main effect of FTO.
This meta-analysis provides additional support for a significant interaction between FTO, depression and BMI, indicating that depression increases the effect of FTO on BMI. The findings provide a useful starting point in understanding the biological mechanism involved in the association between obesity and depression.
The Protoplanetary Discussions conference—held in Edinburgh, UK, from 2016 March 7th–11th—included several open sessions led by participants. This paper reports on the discussions collectively concerned with the multi-physics modelling of protoplanetary discs, including the self-consistent calculation of gas and dust dynamics, radiative transfer, and chemistry. After a short introduction to each of these disciplines in isolation, we identify a series of burning questions and grand challenges associated with their continuing development and integration. We then discuss potential pathways towards solving these challenges, grouped by strategical, technical, and collaborative developments. This paper is not intended to be a review, but rather to motivate and direct future research and collaboration across typically distinct fields based on community-driven input, to encourage further progress in our understanding of circumstellar and protoplanetary discs.
The confusion concerning the theoretical roots of the dynamic capabilities view and the fact that it was often being positioned as an extension to the resource-based view in strategic management, prompted a paper by Galvin, Rice, and Liao (2014) that suggested that the dynamic capabilities view would benefit from adopting a more explicit Darwinian approach. In response to this paper, Arndt and Bach (2015) highlighted that the seminal papers in the field do indeed take an evolutionary perspective and that in operationalizing the variation–selection–retention cycle in an empirical setting it is necessary to move away from firm performance as a dependent variable and instead use survival, which more closely aligns with the concept of natural selection. In this paper, we respond to this recent critique to articulate the benefits of a Darwinian nomenclature and how this will assist in positioning the dynamic capabilities view as an independent, though complementary, theory to the resource-based view. However, we do clearly recognize that until the key terms of variation, selection and retention can be operationalized at the routine, firm and industry level, such an approach may not in itself bring the field towards a common understanding of how dynamic capabilities operate in different environments.
The UK's Driver Vehicle Licensing Authority (DVLA) requires individuals to report if they have a medical condition such as alcohol dependence. General Medical Council guidance indicates that medical practitioners should ensure patients are aware of their impairment and requirement to notify the DVLA.
In a survey of 246 people with known alcohol dependence, none were aware of advice on driving given by medical practitioners and none had self-reported. In addition, 362 doctors, either attending a college symposium or visiting a college website, were asked about their knowledge of DVLA regulations regarding alcohol dependence: 73% of those attending the symposium and 63% of those visiting the website answered incorrectly. In Scotland, over 20000 people have alcohol dependence (over 1 million people with alcohol abuse), yet only 2548 people with alcohol problems self-reported to the DVLA in 2011.
If the DVLA regulations were implemented, it could make an enormous difference to the behaviours of the driving public.
Obesity has been shown to be associated with depression and it has been suggested that higher body mass index (BMI) increases the risk of depression and other common mental disorders. However, the causal relationship remains unclear and Mendelian randomisation, a form of instrumental variable analysis, has recently been employed to attempt to resolve this issue.
To investigate whether higher BMI increases the risk of major depression.
Two instrumental variable analyses were conducted to test the causal relationship between obesity and major depression in RADIANT, a large case–control study of major depression. We used a single nucleotide polymorphism (SNP) in FTO and a genetic risk score (GRS) based on 32 SNPs with well-established associations with BMI.
Linear regression analysis, as expected, showed that individuals carrying more risk alleles of FTO or having higher score of GRS had a higher BMI. Probit regression suggested that higher BMI is associated with increased risk of major depression. However, our two instrumental variable analyses did not support a causal relationship between higher BMI and major depression (FTO genotype: coefficient −0.03, 95% CI −0.18 to 0.13, P = 0.73; GRS: coefficient −0.02, 95% CI −0.11 to 0.07, P = 0.62).
Our instrumental variable analyses did not support a causal relationship between higher BMI and major depression. The positive associations of higher BMI with major depression in probit regression analyses might be explained by reverse causality and/or residual confounding.
The Darwinian logic of evolution occurring via the mechanisms of variation, selection and retention provides a possible theoretical framework from which to further develop the dynamic capabilities view. Presently, criticized for lacking a theoretical foundation and featuring a degree of confusion concerning how it aligns with the resource-based view, the dynamic capabilities view would benefit from greater clarity concerning its assumptions, theoretical base and the development of a series of testable predictions. We test elements of a potential Darwinian style framework through variation-focused hypotheses using panel data for 190 Australian service firms. Our results highlight the importance of market development as a basis for variation, however, the impact of dynamic capabilities upon a likely antecedent of selection was not clear and highlighted a nuanced relationship between capability development, market development and sales growth in an small-and-medium-sized enterprise environment. We conclude that applying a Darwinian lens to the dynamic capabilities view is challenging without longer time series data and additional measures, but such an approach remains theoretically attractive and further investigation may help clarify how we conceptualize the relationship between the dynamic capabilities view and resource-based view.
Downy brome is a problematic invasive annual grass throughout western rangeland and has been increasing its abundance, spread, and impacts across Montana during the past several years. In an effort to develop effective management recommendations for control of downy brome on Montana rangeland, we compiled data from 24 trials across the state that investigated efficacy of imazapic (Plateau®, BASF Corporation, Research Triangle Park, NC) applied at various rates and timings and with methylated seed oil (MSO) or a nonionic surfactant (NIS). We ran a mixed-model ANOVA to test for main effects and interactions across application rate (70, 105, 141, 176, and 211 g ai ha−1), application timing (preemergent [PRE], early postemergent [EPOST, one- to two-leaf growth stage], and postemergent [POST, three- to four-leaf growth stage]), and adjuvant (MSO, NIS). Application timing and rate interacted to affect downy brome control (P = 0.0033). PRE imazapic application resulted in the lowest downy brome control (5 to 19%), followed by POST application (25 to 77%) and EPOST application (70 to 95%). Downy brome control remained fairly consistent across rates within application timing. Adjuvant (MSO or NIS) did not affect downy brome control (P = 0.2789). Our data indicate that POST application at 105 to 141 g ai ha−1 provides the most-consistent, short-term control of downy brome. Furthermore, applying imazapic to downy brome seedlings shortly after emergence (one- to two-leaf growth stage) provided better control than applying it to older downy brome seedlings (three- to four-leaf growth stage).
Strategic alliance research emerged to explain alliance formation based upon transaction cost minimisation and opportunism reduction. Later research, and early research from Japan, emphasised the role of alliances in facilitating the transfer of knowledge between organisations. Most recently, alliance research has focussed on the development of shared, potentially idiosyncratic, resource stocks. This paper builds on this recent research, testing the proposition that alliances are important vehicles allowing firms to access or acquire external resources, hence shoring up capability gaps and building new capabilities as required during firm, product and industry life cycles. Using a sample from Australian manufacturing small-and-medium-sized enterprises, the paper reveals that alliances employed by firms can be viewed as initiatives to either fill a gap in the firm's resource stock or to exploit a perceived opportunity in its operational and strategic environment.
The UK has seen a dramatic increase in alcohol consumption and
alcohol-related harm over the past 30 years. Alcohol taxation has long been
considered a key method of controlling alcohol-related harm but a
combination of factors has recently led to consideration of methods which
affect the price of the cheapest alcohol as a means of improved targeting of
alcohol control measures to curb the consumption of the heaviest drinkers.
Although much of the evidence in favour of setting a minimum price of a unit
of alcohol is based on complex econometric models rather than empirical
data, all jurisdictions within the UK now intend to make selling alcohol
below a set price illegal, which will provide a naturalistic experiment
allowing assessment of the impact of minimum pricing.
Software development and maintenance under EMBOSS is made easy. EMBOSS has powerful inbuilt functionality which any native application can make use of with little or no additional coding, saving you a great deal of effort. It includes extensive C programming libraries for extending the core functionality and developing new applications. Well-defined processes are in place for key aspects such as quality assurance testing, installation, maintenance and support. General aspects are handled by the EMBOSS developers, leaving you to support the parts specific to your own software.