BACKGROUND/AIMS The stepped-wedge cluster randomised trial design has received substantial attention in recent years. Although various extensions to the original design have been proposed, no guidance is available on the design of stepped-wedge cluster randomised trials with interim analyses. In an individually randomised trial setting, group sequential methods can provide notable efficiency ga...

BACKGROUND In stepped care models patients typically start with a low-intensity evidence-based treatment. Progress is monitored systematically and those patients who do not respond adequately step up to a subsequent treatment of higher intensity. Despite the fact that many guidelines have endorsed this stepped care principle it is not clear if stepped care really delivers similar or better pati...

INTRODUCTION Stepped care strategies are potentially effective to organise integrated care but unknown is whether they function well in practice. This paper evaluates the implementation of a stepped care programme for depression in primary care and secondary care. THEORY AND METHODS We developed a stepped care algorithm for diagnostics and treatment of depression, supported by a liaison-consu...

BACKGROUND Screening for alcohol use disorders identifies a wide range of needs, varying from hazardous and harmful drinking to alcohol dependence. Stepped care offers a potentially resource-efficient way of meeting these needs, but requires evaluation in a randomised controlled trial. AIMS To evaluate the feasibility, effectiveness and cost-effectiveness of opportunistic screening and a step...

We describe a method to make even insulation layers for high-pressure laser-heated diamond-anvil cell samples using stepped anvils. The method works for both single-sided and double-sided laser heating using solid or fluid insulation. The stepped anvils are used as matched pairs or paired with a flat culet anvil to make gasket insulation layers and not actually used at high pressures; thus, the...

A bandpass filter is designed using two end-connected quarter-wavelength stepped impedance resonators. The quarter-wavelength stepped impedance resonators are implemented by a half-wavelength stepped impedance resonator with its middle shorting to ground. Hence, the modes that the λ/4 stepped impedance resonator supports are the (1+2n)/4 which also occur on the branches of a combline. An enhanc...

Stepped-care approaches may offer a solution to delivering accessible, effective and efficient services for individuals with depression. In stepped care, all patients commence with a low-intensity, low-cost treatment. Treatment results are monitored systematically, and patients move to a higher-intensity treatment only if necessary. We deliver a stepped-care model targeting patients with depres...

BACKGROUND Since 2004, 'stepped-care models' have been adopted in several international evidence-based clinical guidelines to guide clinicians in the organisation of depression care. To enhance the adoption of this new treatment approach, a Quality Improvement Collaborative (QIC) was initiated in the Netherlands. METHODS Alongside the QIC, an intervention study using a controlled before-and-a...

Nowadays, application of high speed crafts with large tonnage is of our country's essences. In order to gain high speed, new multi hull crafts are traditional. A hull form having been used recently in frigates is the Trimaran. Trimaran hull form and motion have been extensively studied due to the development of numerical and analytical methods as well as the exploitation of experimental setup. ...