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After retrieving the tea towels from the wreck, they continued searching for survivors. Ballard and his friend spent hundreds of hours inside the decomposing remains, living through the results of oxygen poisoning, infection, and starvation. They were able to rescue several men from lifeboats but most of them died of pneumonia and dysentery. In the end, they succeeded in rescuing only 20 of the 2200 people on board, and they were able to recover some personal belongings of the passengers. They did find a whole lot of junk, including kitchenware, fishing equipment, and massive amounts of clothing. This included such oddities as money belts, fur coats, and a woman’s tailors case filled with frocks which her servants had to quickly discard because they wouldnt fit even the thin old bodies of the water victims. The bodies were nearly all decomposed, many of them with bloated forms, and some had been completely eaten by fish or birds. A few were still relatively fresh, but a lot of them were too long in the ground.

From the time of randomization to the end of the 1 year treatment period, the percentage of patients in the DCP who completed the 26-week trial was 94%. With regard to comparisons between the DCP and SFP patients, the average (mean) group MADRS scores at 26 weeks were similar and clinically significant. It is important to recognize, however, that the mean change from randomization in scores for patients in both groups did not achieve statistical significance. Despite these similarities, two key differences emerge from these analyses: (1) the percentage of patients in the DCP group who completed treatment was higher than in the SFP group, and (2) the dropout rate for the DCP group was lower than in the SFP group. The reasons for these differences are unknown. This study was powered for the primary outcome (the patient’s MADRS score at 26 weeks) and not for the secondary outcome of costs associated with the care management program. As noted above, the significance of the change in MADRS scores between groups was found not to be significant. A trend towards improved MADRS scores for patients in the DCP was evident, but with a similarly wide confidence interval.

Assessments included data on demographic and other characteristics of patients who were screened for depression. The study took place at three primary care outpatient clinics of the Geneva University hospital and included an additional observational study of real-life adherence that took place at the Swiss Paraplegia center. Visit to the participating patients was defined as the initial contact with the drug treatment by the GP, in response to a confirmed diagnosis of depression. The initial visit involved an initial assessment by the study nurse. The nurse reported patients’ self-assessed depression symptoms, made a diagnosis of depression, and gave the patient an appointment with their GP. The GP was offered to participate in the study with a brief training session in order to provide an initial assessment of depression and adherence, and completed a brief adherence assessment with the patient before and after the visit, or as part of the initial visit. This adherence assessment included the 5-question Morisky Adherence Scale (MEMS), which was administered before the visit to the GP to assess patients’ baseline medication adherence. Patients were defined as adherent when the score was 0 or 1. For patients who were not adherent at baseline, an additional MEMS assessment was conducted at the initial visit with the GP, prior to the patients’ drug treatment start date. Patients were defined as non-adherent if the score was 2 or 3. Patients with missing data at baseline and followup were not included in the analyses. Patient characteristics were compared using t-tests for continuous variables and chi-squared tests for categorical variables. The primary endpoint was treatment completion at 1 year and was analyzed as a dichotomous variable. The proportion of patients who were adherent at 1 year and the number of deaths were compared between groups using chi-squared tests and Fisher’s exact test, as appropriate. Medication adherence, patient satisfaction with the intervention, and reliability of the MEMS adherence assessment were measured using selfreported survey data collected immediately following the initial visit with the GP. The questionnaire asked patients about their perception of satisfaction with the interventions and with the quality of the initial and subsequent interactions with their GPs, their faith in the value of the interventions, and their estimated trust in the GPs. In addition, patients were asked if they felt pressure from the GPs to take their medications as prescribed, if they had experienced any side effects, and if they were sure that they would definitely do as the GP had advised. The attitudes and experiences of healthcare workers with the interventions were also assessed. Results: Primary Outcomes 5ec8ef588b

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