Probability Distributions.- Linear Models for Regression.- Linear Models for Classification.- Neural Networks.- Kernel Methods.- Sparse Kernel Machines.- Graphical Models.- Mixture Models and EM.- Approximate Inference.- Sampling Methods.- Continuous Latent Variables.- Sequential Data.- Combining Models.

Pattern Recognition and Machine Learning

XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Data Mining Practical Machine Learning Tools and Techniques

In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress— explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications. The study of mental health of lesbian, gay, and bisexual (LGB) populations has been complicated by the debate on the classification of homosexuality as a mental disorder during the 1960s and early 1970s. That debate posited a gay-affirmative perspective, which sought to declassify homosexuality, against a conservative perspective, which sought to retain the classification of homosexuality as a mental disorder (Bayer, 1981). Although the debate on classification ended in 1973 with the removal of homosexuality from the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1973), its heritage has lasted. This heritage has tainted discussion on mental health of lesbians and gay men by associating— even equating— claims that LGB people have higher prevalences of mental disorders than heterosexual people with the historical antigay stance and the stigmatization of LGB persons (Bailey, 1999). However, a fresh look at the issues should make it clear that whether LGB populations have higher prevalences of mental disorders is unrelated to the classification of homosexuality as a mental disorder. A retrospective analysis would suggest that the attempt to find a scientific answer in that debate rested on flawed logic. The debated scientific question was, Is homosexuality a mental disorder? The operationalized research question that pervaded the debate was, Do homosexuals have high prevalences of mental disorders? But the research did not accurately operationalize the scientific question. The question of whether homosexuality should be considered a mental disorder is a question about classification. It can be answered by debating which behaviors, cognitions, or emotions should be considered indicators of a mental

/pdf/prejudice-social-stress-and-mental-health-in-lesbian-gay-and-2eymy1qdt5.pdf

Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence

ABI
: ankle–brachial index
ACCORD
: Action to Control Cardiovascular Risk in Diabetes
ADVANCE
: Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation
AGREE
: Appraisal of Guidelines Research and Evaluation
AHA
: American Heart Association
apoA1
: apolipoprotein A1
apoB
: apolipoprotein B
CABG
: coronary artery bypass graft surgery
CARDS
: Collaborative AtoRvastatin Diabetes Study
CCNAP
: Council on Cardiovascular Nursing and Allied Professions
CHARISMA
: Clopidogrel for High Athero-thrombotic Risk and Ischemic Stabilisation, Management, and Avoidance
CHD
: coronary heart disease
CKD
: chronic kidney disease
COMMIT
: Clopidogrel and Metoprolol in Myocardial Infarction Trial
CRP
: C-reactive protein
CURE
: Clopidogrel in Unstable Angina to Prevent Recurrent Events
CVD
: cardiovascular disease
DALYs
: disability-adjusted life years
DBP
: diastolic blood pressure
DCCT
: Diabetes Control and Complications Trial
ED
: erectile dysfunction
eGFR
: estimated glomerular filtration rate
EHN
: European Heart Network
EPIC
: European Prospective Investigation into Cancer and Nutrition
EUROASPIRE
: European Action on Secondary and Primary Prevention through Intervention to Reduce Events
GFR
: glomerular filtration rate
GOSPEL
: Global Secondary Prevention Strategies to Limit Event Recurrence After MI
GRADE
: Grading of Recommendations Assessment, Development and Evaluation
HbA1c
: glycated haemoglobin
HDL
: high-density lipoprotein
HF-ACTION
: Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing
HOT
: Hypertension Optimal Treatment Study
HPS
: Heart Protection Study
HR
: hazard ratio
hsCRP
: high-sensitivity C-reactive protein
HYVET
: Hypertension in the Very Elderly Trial
ICD
: International Classification of Diseases
IMT
: intima-media thickness
INVEST
: International Verapamil SR/Trandolapril
JTF
: Joint Task Force
LDL
: low-density lipoprotein
Lp(a)
: lipoprotein(a)
LpPLA2
: lipoprotein-associated phospholipase 2
LVH
: left ventricular hypertrophy
MATCH
: Management of Atherothrombosis with Clopidogrel in High-risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke
MDRD
: Modification of Diet in Renal Disease
MET
: metabolic equivalent
MONICA
: Multinational MONItoring of trends and determinants in CArdiovascular disease
NICE
: National Institute of Health and Clinical Excellence
NRT
: nicotine replacement therapy
NSTEMI
: non-ST elevation myocardial infarction
ONTARGET
: Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial
OSA
: obstructive sleep apnoea
PAD
: peripheral artery disease
PCI
: percutaneous coronary intervention
PROactive
: Prospective Pioglitazone Clinical Trial in Macrovascular Events
PWV
: pulse wave velocity
QOF
: Quality and Outcomes Framework
RCT
: randomized clinical trial
RR
: relative risk
SBP
: systolic blood pressure
SCORE
: Systematic Coronary Risk Evaluation Project
SEARCH
: Study of the Effectiveness of Additional Reductions in Cholesterol and
SHEP
: Systolic Hypertension in the Elderly Program
STEMI
: ST-elevation myocardial infarction
SU.FOL.OM3
: SUpplementation with FOlate, vitamin B6 and B12 and/or OMega-3 fatty acids
Syst-Eur
: Systolic Hypertension in Europe
TNT
: Treating to New Targets
UKPDS
: United Kingdom Prospective Diabetes Study
VADT
: Veterans Affairs Diabetes Trial
VALUE
: Valsartan Antihypertensive Long-term Use
VITATOPS
: VITAmins TO Prevent Stroke
VLDL
: very low-density lipoprotein
WHO
: World Health Organization

### 1.1 Introduction

Atherosclerotic cardiovascular disease (CVD) is a chronic disorder developing insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur. It remains the major cause of premature death in Europe, even though CVD mortality has …

/pdf/european-guidelines-on-cardiovascular-disease-prevention-in-4z4nw4311i.pdf

European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012)

TO THE EDITOR: Hillman and colleagues give an excellent overview of rapid response systems (RRSs).1 There is no doubt that this system of care that matches “the right people — with the right skills and knowledge — with the right patients at the right time” is a vast improvement on the usual traditional hierarchical referral model of care, particularly for patients in acute care hospitals whose condition is deteriorating.

The gap remains: NHMRC research funding for suicide and self-harm, 2000-2014.

Australian & New Zealand Journal of Psychiatry, 47(9) The WHO predicts that by the year 2030 unipolar depressive disorders will rank as the principal cause of disease burden among high-income countries (Mathers and Loncar, 2006). In Australia, 10% of the total burden of disease in 2003 was accounted for by depression and anxiety in women; double that of men (4.8%). Between 1990 and 2010, depression has jumped from 15th to 11th as a cause of global disability-adjusted life years (DALYs) (Murray et al., 2013). It is highly prevalent, with 6% of the population meeting criteria for depression or dysthymia at any time and 20% of those with major depressive disorder having a prolonged illness course, with symptoms persisting for more than 2 years (Reavley et al., 2011). It is equally highly recurrent, with 30% of individuals experiencing a relapse within 3 months of recovery and 50% experiencing a further episode within 2 years, in the absence of continuation or maintenance treatment (Gordon et al., 2011). Bipolar disorder is frequently under-diagnosed, and is also highly recurrent, costly and disabling; it is one of the most important causes of disability at ages 15 to 44, with 35% of the total cost attributable to hospital care. Suicide rates in bipolar I disorder is elevated to 30 times the general population rate (Malhi and Berk, 2011; Page et al., 2011). Germane to primary care, both depression and bipolar disorders are additionally highly comorbid with a range of mental and medical disorders (Magalhães et al., 2012). Critically, a significant component of the burden of disability of mood disorders is avertable with optimal care, although a large component is not avertable (Andrews et al., 2004). Depression is a predominant cause of work-related disability (both absenteeism and presenteeism), and even sub-threshold depression is a major driver of disability pension awards (Knudsen et al., 2010; McKeith and Scott, 2008). Additionally, the most efficient interventions for depression are highly cost-effective, with each averted DALY costing less than a year of average per capita income (Chisholm, 2005). It has been suggested that the clinical focus on the management of discrete episodes of major depressive disorder and other mood disorders is outdated and that there is a need to treat depression as a ‘life course’ disorder using models of chronic disease management, as promoted for medical problems such as diabetes (Scott, 2006; Wagner et al., 1998). Services oriented to chronic disease management for depression are, however, marked by their paucity. While there are pockets of high-quality care, there are clinically significant obstacles to the delivery of a more uniform highquality model of care for mood disorders. The current funding model, which sees the care of those with a ‘serious mental illness’ as being primarily a state responsibility, leaving the highprevalence disorders in the federal domain has significant and well recognised sequelae for effective continuity of care. It does not support intensive or long-term interventions for those with anxiety or depression by specialised experts in the public system. The additional preoccupation with risk assessment in the triage process, and the reliance on risk assessment within the public services to determine access to care, filters individuals with expressed aggression or suicide into the system, and leaves many with potentially treatable mood disorders outside of the public system unless critical safety issues are present. Most academics are in the public (state) system, which has a primary focus on psychotic disorders rather than mood and anxiety disorders. Indeed, the paucity of expertise in mood and particular anxiety disorders leaves Australia in divergence to most major Western countries. The counterpoint of this anomaly, which is that the ‘high prevalence’ disorders are amongst the greatest contributors to burden of disease in adults, is stark. The federal model of care for mood disorders, with the emphasis on primary care, is appropriate given their frequency; however this leads to a number of service consequences. Funding is focused on primary care, with the GP as the centre of the system. The better access system has clearly had a substantial beneficial The need for specialist services for serious and recurrent mood disorders

The need for specialist services for serious and recurrent mood disorders.

Why Suicide?: Reasons for Suicide Attempts as Self-Reported by Youth: A Systematic Evaluation of Qualitative Studies

Public institutions in Australia are subject to increasing statutory requirements to engage their communities, and consequently the number of practitioners has increased. These participatory and deliberative practitioners design, deliver, and evaluate democratic processes on behalf of public institutions. This article argues that the practitioner body has broadened, where different types of practitioners can now be identified in Australia. This broadening is the result of three main variables: (1) whether practitioners are employed by or contracted to public institutions; (2) whether they are engaged to work on projects with limited or considerable scope; and (3) whether they are focused on limited time frame processes or entire programs. Drawing on the results of a mixed method study, including survey and semi-structured interviews, this article explores the work contexts that shape the contemporary Australian practitioner, drawing lessons that can inform their practice in other contexts.

https://delibdemjournal.org/article/615/galley/4452/download/

Participatory and Deliberative Practitioners in Australia: How Work Context Creates Different Types of Practitioners

In a recent investigation [K. Roberts et al., J. Chem. Phys. 136, 074104 (2012)], we have shown that, for a sufficiently complex potential, the Diffusion Monte Carlo (DMC) random walk can become quasiergodic, and we have introduced smart darting-like moves to improve the sampling. In this article, we systematically characterize the bias that smart darting moves introduce in the estimate of the ground state energy of a bosonic system. We then test a simple approach to eliminate completely such bias from the results. The approach is applied for the determination of the ground state of lithium ion-n–dipoles clusters in the n = 8–20 range. For these, the smart darting diffusion Monte Carlo simulations find the same ground state energy and mixed-distribution as the traditional approach for n < 14. In larger systems we find that while the ground state energies agree quantitatively with or without smart darting moves, the mixed-distributions can be significantly different. Some evidence is offered to conclude th...

Helen Christensen

Papers

The gap remains: NHMRC research funding for suicide and self-harm, 2000-2014.

The need for specialist services for serious and recurrent mood disorders.

Why Suicide?: Reasons for Suicide Attempts as Self-Reported by Youth: A Systematic Evaluation of Qualitative Studies

Participatory and Deliberative Practitioners in Australia: How Work Context Creates Different Types of Practitioners

Smart darting diffusion Monte Carlo: Applications to lithium ion-Stockmayer clusters