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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.
In the study of approximate methods for solving ordinary differential equations, an interesting question arises. To state it roughly for a single first order expression, let y0(t) be the solution of the equation
which satisfies the initial condition y(a) = na. Let nb be an approximation to the value of y0 at a later time, t = b.
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.
Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.
We describe a versatile array controller developed at RAL and SAAO. The original concept was due to Waltham, van Breda and Newton (1990). A Transputer-based microcomputer forms the heart of the device.
Very-long-baseline Interferometry (VLBI) has opened for study a broad new spectrum of geophysical phenomena including: direct observation of the tectonic motions and deformations of the Earth's crustal plates, observations of unprecedented detail of the variations in the rotation of the Earth, and direct measurement of the elastic deformations of the Earth in response to tidal forces. These new measurements have placed significant constraints on models of the interior structure of the Earth; for example, measurements of the variations in the Earth's nutation have been shown to be particularly sensitive to the shape of the core-mantle boundary. The VLBI measurements will allow us to construct a global reference frame accurate at the centimeter level. Such a frame will be essential to studying long-term global changes, especially those changes related to sea-level variations as recorded by tide gauge measurements.
We have observed 3 moderate redshift clusters using a combination of 7 intermediate band filters and 2 CCDs in order to derive photometric information for cluster galaxies from 400 nm to 900 nm. Preliminary results are presented for 2 clusters: Abell 1942 (z=0.224) and Abell 1525 (z=0.259) from 580 nm to 860 nm. The CCD photometry reaches a limit equivalent to RF=21 mag with a precision of better than 0.1 mag. The galaxy colours derived from the intermediate band measurements are generally consistent with those expected at the appropriate redshift. However, in Abell 1525, and to a lesser extent in Abell 1942, a large proportion of cluster members have far red (720–860 nm) colours redder than expected. Many of these galaxies have blue photographic BJ-RF colours. A possible explanation for the anomalous CCD colours is that these galaxies possess a strong emission line component which enters the far red filter at z=0.25.
Project IRIS (International Radio Interferometric Surveying) was set up under the IAG and COSPAR to provide an operational system that would employ Very-Long-Baseline Interferometry (VLBI) techniques to monitor variations in the rotation of the Earth. Currently the IRIS-A network, with stations at Westford, MA, Ft. Davis, TX, Richmond, FL, and Wettzell, FRG, conducts 24-hour observing sessions every five days to produce determinations of pole position, UT1, and nutation in addition to other parameters of geophysical and astrometric interest. The resulting Earth orientation parameters (EOP) have been shown to have an accuracy of 1 to 2 milliseconds of arc in pole position, and 0.05 to 0.1 milliseconds of time in UT1. In order to observe the relatively large higher frequency variations in UT1, daily 45-minute observing sessions are conducted using the single baseline between Westford and Wettzell. Intercomparison of the UT1 values from the daily and the 5-day series indicates that the accuracy of the daily values is better than 0.1 millisecond of time.
The longer term objectives of the IRIS project include improving the monitoring of Earth orientation by increasing the sampling rate and accuracy of the observations. In April, 1987, the IRIS-P network, with stations in Kashima, Japan, Fairbanks, AK, Ft, Davis, TX, and Richmond, FL began monthly 24-hour observing sessions, and a second series of daily UT1 observing sessions was begun using the stations in Richmond and Bologna, Italy. The additional networks will provide redundancy that will improve the reliability of the system and allow the accuracy of the EOP values to be estimated.
The IRIS UT1 time series provides, for the first time, sufficient accuracy and temporal resolution to look for the few percent increase in k/C caused by the anelastic response of the mantle. Initial results presented here suggest that improved methods of accounting for the dynamics of the oceans and atmosphere may be required before the intertwined variations in UT1 can be fully separated.
The combined POLARIS-IRIS Earth orientation time series now span nearly a full cycle of the Chandler-annual beat period, beginning in late 1980. Since April 1985 there is also a nearly continuous coverage of UT1 at daily intervals. We have fit a simple model, consisting of circular 14-month and annual components and a linear drift to the polar motion series, then computed the “along-track” and “cross-track” residuals. Both sets of residuals display structure with amplitudes of tens of milliseconds of arc on time scales of months, but Fourier analysis reveals no significant peaks at shorter periods, including the 40-60 day period found in the UT1 time series.
During September, 1986, we introduced a new “quick-look” UT1 time series. The values are typically available within 7 days. The accuracy, which depends strongly on the accuracy of the X and Y pole coordinates used in the computations, ranged from 0.3 to 0.7 milliseconds during the first two weeks, but improved to about 0.1 milliseconds during the latter two weeks of the month. We plan to continue the quick-look UT1 series as a standard product of the IRIS Earth orientation monitoring service.
We observed three 0.44 square degree fields centered on the Coma cluster center (Coma-1), about 1 degree SW of the Coma center (Coma-3), and on a control field in SA57 with the mosaic CCD camera at the prime focus of the 4.2-m William Herschel Telescope. We detected 5628, 5020, and 4323 galaxies down to R = 22 mag in Coma-1, Coma-3, and SA57 fields, respectively. We measure the magnitude and color within the variable aperture r90 in which about 90% of the total flux is included. The histograms of (B–R) colors of galaxies are made for four magnitude bins of width ΔR = 2 mag covering 13 < R < 21 mag for each of the three fields. The mean colors and the 1σ scatters of the Coma galaxies are obtained by a histogram subtraction technique (Coma-1/3 minus SA57). We find a very shallow slope of the color-magnitude relation (CMR), Δ(B–R)/ΔR=−0.0037, which indicates nearly a constant (B–R) color over 6 magnitude in 15 < R < 21 mag (−19.5 < MR < −13.5 at Coma cluster). Dwarf galaxies are dominant in this magnitude range, and we conclude that the mean color of dwarf galaxies in the Coma clusters is nearly constant at (B–R) ∼ 1.6–1.7, which is similar to the color of the faint end of giant elliptical galaxies.
Introduction: This study provides an estimate of the number of EMS calls related to police use of force events that involve struggling, intoxicated and/or emotionally distressed patients. We hypothesized there would be under-reporting of EMS risk by paramedic agencies due to lack of standardized reporting of police events by EMS services and lack of a common linked case number between prehospital agencies in Canada. Methods: Data were collected during a multi-site, prospective, consecutive cohort study of police use of force in 4 Canadian cities using standardized data forms. Use of force was defined a priori and the application of handcuffs was not considered a force modality. Inclusion criteria: all subjects ≥ 18 years of age involved in a use of force police-public encounter. We defined risk to EMS as the presence of police- and/or paramedic- assessments of violent or struggling subjects on the scene. Three separate data forms (police-report of use of force, EMS encounter, and Emergency Department (ED) visit) were linked in the study by unique ID. When police-reported EMS was activated, investigators hand searched the EMS service reports at the relevant agencies for matching call sheets. Results: From Jan 2010 to Dec 2012, we studied 3310 consecutive public-police interactions involving use of force above simple joint lock application. Subjects were male (86%) with a mean age of 33 yrs; 85% were assessed by police as emotionally disturbed, intoxicated with drugs and/or alcohol or a combination of those. 45% were violent at the scene. Police-reported EMS attendance in 24% (809/3310) of use of force events, of which only 43% (349/809) of EMS run sheets were available. In events with violent subjects, EMS transported 51% to ED compared to 35% by police transport (chi=79.7, p=0.00). Conclusion: We identified periods of professional and physical risk to paramedics attending police use of force events and found that risk significantly underrepresented in EMS data. Paramedical training would benefit from policy and procedures for response to police calls and the violent patient, the majority of whom are struggling. A common linked case number in prehospital care would enable more specific quantification of the risk for EMS providers involved in police events.
During the period, there have been several major events which have effected the scope and interest of Commission 19. The most significant of these has been the dissolution of the BIH and IPMS and their replacement by the International Earth Rotation Service (IERS). The correlation of higher frequency fluctuations in the Earth’s rotation rate with changes in the Earth’s Atmospheric Angular Momentum is also significant. Many investigators now seem to believe that the “decade variations„ in the Earth’s rotation rate are caused by torques between the core and mantle caused by the uneven motions at the core-mantle boundary. These events and discoveries have made this an exciting period. It seems that the future holds more in the way of discovery due to the utilization of the more accurate and precise Earth rotation data coming from the modern observing techniques.
Our knowledge of the universe comes from recording the photon and particle fluxes incident on the Earth from space. We thus require sensitive measurement across the entire energy spectrum, using large telescopes with efficient instrumentation located on superb sites. Technological advances and engineering constraints are nearing the point where we are recording as many photons arriving at a site as is possible. Major advances in the future will come from improving the quality of the site. The ultimate site is, of course, beyond the Earth’s atmosphere, such as on the Moon, but economic limitations prevent our exploiting this avenue to the degree that the scientific community desires. Here we describe an alternative, which offers many of the advantages of space for a fraction of the cost: the Antarctic Plateau.
The Figaro data reduction system was originally written for DEC VAXes running VMS, and little attention was paid to making it portable. Recently, however, a cooperative effort between the AAO, MSSSO, UNSW, the UK Starlink network and Caltech has resulted in a version for UNIX. This new version has been run under VMS and three different versions of UNIX. The files produced by any version may be read directly by any other version, although Figaro has a particularly complex file format which contains an extensible, self-defining, hierarchical structure of data items. This complexity has allowed the addition of error and quality data, as well as specific structures used, for example, for echelle data. Figaro is written mainly in Fortran (with numerous DEC extensions) but there is also a significant use of C. While C and Fortran are reasonably portable, the way one is called from the other is less portable and needs careful handling. Ports to other systems are possible, with effort; a Macintosh version is being considered.
The University of NSW’s Automated Patrol Telescope is a modified Baker-Nunn satellite tracking camera, now used for CCD imaging of astronomical objects. The f/1 Baker-Nunn optical design gives a 30° field of view with an approximately spherical focal surface of radius ≈500 mm. While the focal plane curvature is tolerable across the 1.4° × 1.0° field of the present CCD, it becomes unacceptable when a larger CCD is used. In addition, the use of glass filters in the highly convergent beam produces intolerable spherical aberration. We present a design modification to the original Baker-Nunn which enables a 5° diameter flat field to be produced when using B, V, R or I filters. By making this modification, we plan to perform multicolour imaging, using a new large-format CCD with a 2.9° × 1.9° field of view.
3C75 consists of a pair of twin-jetted radio galaxies near the centre of the cluster Abell 400 which is a strong extended X-ray source. Fibre spectroscopy from the AAT, combined with number counts of the galaxies in Abell 400 give the gravitational potential of the cluster which is used to model the X-ray source. The inferred pressure of the X-ray gas suggests that the lobes of the radio source are probably confined. Evidence of excess X-ray emission near the centre of the cluster is also found.
A review of the MOA (Microlensing Observations in Astrophysics) project is presented. MOA is a collaboration of approximately 30 astronomers from New Zealand and Japan established with the aim of finding and detecting microlensing events towards the Magellanic Clouds and the Galactic bulge, which may be indicative of either dark matter or of planetary companions. The observing program commenced in 1995, using very wide band blue and red filters and a nine-chip mosaic CCD camera.
As a by-product of these observations a large database of CCD photometry for 1.4 million stars towards both LMC and SMC has been established. In one preliminary analysis 576 bright variable stars were confirmed, nearly half of them being Cepheids. Another analysis has identified large numbers of blue variables, and 205 eclipsing binaries are included in this sample. In addition 351 red variables (AGB stars) have been found. Light curves have been obtained for all these stars. The observations are carried out on a 61-cm f/6.25 telescope at Mt John University Observatory where a new larger CCD camera was installed in 1998 July. From this latitude (44° S) the Magellanic Clouds can be monitored throughout the year.
The Automated Patrol Telescope (APT) is a wide-field CCD imaging telescope operated by the University of New South Wales at Siding Spring Observatory in Australia. The optical design employed resembles that of a Schmidt, but uses a 3-element lens to achieve a wide, corrected field of view. The APT was developed by extensively modifying the optical, mechanical and electronic systems of a Baker-Nunn satellite tracking camera. Telescope motion and operation of the CCD have been placed under computer control, allowing automated observations for longterm survey and monitoring projects. The APT has 0.5 m aperture f/1 optics which produce a 5° flat field, of which a 2°×3° field is covered by the CCD currently installed. The telescope is being used for studies of stellar activity in open clusters and regions of star formation, and comet and minor planet investigations. A number of other projects for the APT are being considered, including searches for novae, supernovae in clusters of galaxies, and brown dwarfs.