Objective: This study analyzes effectiveness of screening, referrals, and treatment uptake of a collaborative care for depression intervention across 10 primary care clinics in Chicago.Methods: Patients were screened with the PHQ-2/9 based on an eligibility algorithm. Electronic health record data were analyzed for sample characteristics, screening rates, referrals, and treatment pathways. To identify disparities, a test of proportions was conducted between eligible and screened patients and referred and treated patients.Results: From November 2016 -December 2017, 25,369 patients were eligible for screening, and rates rose to 79%, versus 7% in the prior year. Screenings, referrals, and uptake occurred proportionately across subgroups except for patients ages 12-17. Adolescent age was associated with disproportionate PHQ-9 screenings and with treatment disengagement. Conclusion:The intervention shows promise in expanding access to care and reducing disparities. Greater access to psychotherapies and innovative treatment modalities, particularly for adolescents, may improve overall treatment uptake.

Engagement is a multifaceted construct and a likely mechanism by which digital interventions achieve clinical improvements. To date, clinical research on digital mental health interventions (DMHIs) has overwhelmingly defined engagement and assessed its association with clinical outcomes through the objective/behavioral metrics of use of or interactions with a DMHI, such as number of log-ins or time spent using the technology. However, engagement also entails users' subjective experience. Research is largely lacking that tests the relationship between subjective metrics of engagement and clinical outcomes. The purpose of this study is to present a proof-of-concept exploratory evaluation of the association between subjective engagement measures of a mobile DMHI with changes in depression and anxiety. Adult primary care patients ( N = 146) who screened positive for depression or anxiety were randomized to receive a DMHI, IntelliCare, immediately or following an 8-week waitlist. Subjective engagement was measured via the Usefulness, Satisfaction, and Ease of Use (USE) Questionnaire. Across both conditions, results showed that individuals who perceived a mobile intervention as more useful, easy to use and learn, and satisfying had greater improvements in depression and anxiety over eight weeks. Findings support our proposed experimental therapeutics framework that hypothesizes objective/behavioral and subjective engagement metrics as mechanisms that lead to changes in clinical outcomes, as well as support directing intervention design efforts for DMHIs to target the user experience.

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Background: Urinary problems are common in female population of India which adversely affect their quality of life. Urinary problems add to chronic suffering of Indian females. The objective of this study was to find psychosocial correlation of common urinary problems in Indian females. Methods: This is an epidemiological study which includes all adult female patients coming to surgery and

Globalization of society is connected to remarkable developments in Information Technology (IT), and global networking has given birth to the e-learning phenomena, which broadens our horizons of traditional learning and creates opportunities for all stakeholders in the teaching and learning process. Education is no longer about teachers and teaching. Societal forces now demand that the focus be on learners and learning. In parallel, e-learning is opening up a varied supply of new and powerful possibilities for learners and learning. The 'sage on the stage' is giving way to the guide on the side. Significantly, e-learning is turning out to be evolutionary, not revolutionary. Institutions with strategies based on quality learning outcomes are well placed to benefit from this e-learning evolution. The single most dramatic effect of this paradigm shift is learner sovereignty. The teacher's role, at least as defined by the instructivists, now belongs to a bygone era. Students have much greater autonomy over their learning, in terms NEHA GUPTA** By of when, where and how they learn. Interaction with fellow students and faculty is literally (and metaphorically) at their fingertips. With asynchronous discussion boards as the modus operandi, learner interaction is heightened. Elearning is very inclusive and democratic in this sense, in that everyone has an equally loud voice. No one talks over you or interrupts before you have time to make your point. Meanwhile, course materials are varied in format, media rich and constructivist in instructional design. Harnessing the power of e-learning, assessment tasks can be real world, authentic and engaging. Since content is developed in advance, faculty have more time to devote to individual students, permitting shorter turnaround times on feedback. Importantly, as less time is spent in didactic content transmission, there is more time for reflection and critical analysis. Finally, learning online provides students with an opportunity to be part of a strong learning community (Kassop, 2003). Some of the advantages of elearning are as follows: E-Learning offers huge potential for economies of scale. It