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.
Depression is a major public health problem in European countries, and health systems need to ensure access to effective psychological and pharmacological treatments. Research suggests that improvements in depression care require “complex interventions” that implement change in several areas simultaneously.
We describe an observational study of the implementation of a “stepped care” model to provide care for all adults presenting with a new case of depression in a mixed urban-rural area of Scotland with a population of 76,000 people.
A team of 5.2 clinicians provided care for about 1,000 new cases of depression each year. “Guided Self-Help” was the baseline intervention for all patients, supplemented where necessary with pharmacological treatment and Cognitive Behavioural or Interpersonal Therapy.
Service delivery systems were reformed to provide: specialist treatment in primary care settings using primarily non-medical clinicians, comprehensive electronic clinical records, continuous outcome monitoring and intensive investment in staff training and support.
Clinical outcomes (measured by the Personal Health Questionnaire, Social and Work Adjustment Scale and EQ-5D) showed significant improvement despite relatively brief clinician contact (2.5 hours over 4.6 contacts). Savings of more than 50% were made on the antidepressant drug budget. Service user satisfaction ratings were high.
Population needs for depression care can be met using “stepped care” models such as that described above. A randomised controlled study of this approach would be required to fully test the model.
The striking and unusual personality of Socrates attracted much attention among the Athenians of the later fifth century, and brought him many admirers. But his influence was exerted by his conversation, not by any writing, so that posterity knew him only through the literature that sprang up, as enemies attacked him and friends attempted, often using dialogue form, to present the man they had known. Of this literature the work of Plato and Xenophon is all that survives, apart from some fragments of Aeschines of Sphettus. Plato, it is certain, made Socrates express philosophic views he never held; at times he became Plato's mouthpiece. Xenophon's Socrates, on the other hand, is hardly a philosopher at all; he gives good practical advice and sets an inspiring example of personal conduct. Plato and Xenophon may have developed different sides of their hero; but, unlike Plato, Xenophon was unable to paint a portrait that could explain the fascination which he had undoubtedly exerted.
There is nothing to show that the young Xenophon knew Socrates well before he joined the expedition of Cyrus in 401. Nor can it be said when he began to write of him; presumably this was not before returning to Greece in 394. His first contribution to Socratic literature was Socrates' defence (Apology). Earlier writers, he says, agreed that at his trial (399 B.C.) Socrates took a high or haughty line, but they failed to explain that he did this to secure his own conviction, knowing that death was better than the deterioration that age must bring.
It is often repeated that at the unsuccessful productions of Terence's Hecyra the audience left the theatre in order to see, on the first occasion, boxers and a tight-rope walker, on the second, a gladiatorial contest.1 The other view, that the spectators remained but demanded other entertainment, is to my mind clearly correct and deserves restatement since the mistaken one is so widespread.
In the two speeches with which the play opens the paedagogus has asked Orestes and Pylades to determine the course of action (15-16, 20-21), while Orestes has informed him of the oracle of Apollo and given him instructions about what is required of him (39ff.). In the lines reproduced above the roles are reversed: the paedagogus is asked whether it is his wish that they should stay, a question which goes back upon the words with which Orestes had just concluded his speech at 73-5: σοὶ δ᾿ἤδη, γερον, | τὸ σὸν μελέσθω βαντί φρουρῆσαι χρέος, | νὼ δ᾿ ἔξιμεν· καιρὸς γάρ. He replies decisively that Apollo's orders must come first.