Includes bibliographies. ; Dual exchange rate regimes are not a phenomenon peculiar only to South Africa. In the past they have been implemented by the BLEU, France, Italy and the Netherlands in one form or another. More recently, multiple exchange regimes have been adopted by other developing countries such as Mexico, Brazil, Venezuela and Argentina. The rationale for imposing a two- or multi-tier exchange regime is to protect the balance of payments from volatile short-term capital flows due to political and economic uncertainty inherent in developing economies. The focus of this paper is on the insulation properties of dual market systems against foreign shocks. These shocks may take the form of foreign interest rate increases or increases in foreign perceptions of risk. An implication of these insulation properties is that the monetary authorities are able to pursue a monetary policy independent of external constraints.
Background The UK Government's implementation in 2008 of the Improving Access to Psychological Therapies (IAPT) initiative in England has hugely increased the availability of cognitive behavioural therapy (CBT) for the treatment of depression and anxiety in primary care. Counselling for depression—a form of person-centred experiential therapy (PCET)—has since been included as an IAPT-approved therapy, but there is no evidence of its efficacy from randomised controlled trials (RCTs), as required for recommendations by the National Institute for Health and Care Excellence. Therefore, we aimed to examine whether PCET is cost effective and non-inferior to CBT in the treatment of moderate and severe depression within the IAPT service. Methods This pragmatic, randomised, non-inferiority trial was done in the Sheffield IAPT service in England and recruited participants aged 18 years or older with moderate or severe depression on the Clinical Interview Schedule-Revised. We excluded participants presenting with an organic condition, a previous diagnosis of personality disorder, bipolar disorder, or schizophrenia, drug or alcohol dependency, an elevated clinical risk of suicide, or a long-term physical condition. Eligible participants were randomly assigned (1:1), independently of the research team, and stratified by site with permuted block sizes of two, four, or six, to receive either PCET or CBT by use of a remote, web-based system that revealed therapy after patient details were entered. Those assessing outcomes were masked to treatment allocation. Participants were seen by appropriately trained PCET counsellors and CBT therapists in accordance with the IAPT service delivery model. Depression severity and symptomatology measured by the Patient Health Questionnaire-9 (PHQ-9) at 6 months post-randomisation was the primary outcome, with the PHQ-9 score at 12 months post-randomisation being a key secondary outcome. These outcomes were analysed in the modified intention-to-treat population, which comprised all randomly assigned patients with complete data, and the per-protocol population, which comprised all participants who did not switch from their randomised treatment and received between four and 20 sessions. Safety was analysed in all randomly assigned patients. The non-inferiority margin was set a priori at 2 PHQ-9 points. Patient safety was monitored throughout the course of therapy, adhering to service risk procedures for monitoring serious adverse events. This trial is registered at the ISRCTN Registry, ISRCTN06461651, and is complete. Findings From Nov 11, 2014, to Aug 3, 2018, 9898 patients were referred to step three treatments in the Sheffield IAPT service for common mental health problems, of whom 761 (7·7%) were referred to the trial. Of these, we recruited and randomly assigned 510 participants to receive either PCET (n=254) or CBT (n=256). In the PCET group, 138 (54%) participants were female and 116 (46%) were male, and 225 (89%) were White, 16 (6%) were non-White, and 13 (5%) had missing ethnicity data. In the CBT group, 155 (61%) participants were female and 101 (39%) were male, and 226 (88%) were White, 17 (7%) were non-White, and 13 (5%) had missing ethnicity data. The 6-month modified intention-to-treat analysis comprised 401 (79%) of the enrolled participants (201 in the PCET group; 200 in the CBT group) and the 12-month modified intention-to-treat analysis comprised 319 participants (167 in the PCET group; 152 in the CBT group). The 6-month per-protocol analysis comprised 298 participants (154 in the PCET group; 144 in the CBT group). At 6 months post-randomisation, PCET was non-inferior to CBT in the intention-to-treat population (mean PHQ-9 score 12·74 [SD 6·54] in the PCET group and 13·25 [6·35] in the CBT group; adjusted mean difference −0·35 [95% CI −1·53 to 0·84]) and in the per-protocol population (12·73 [SD 6·57] in the PCET group and 12·71 [6·33] in the CBT group; 0·27 [95% CI −1·08 to 1·62]). At 12 months post-randomisation, there was a significant adjusted between-group difference in mean PHQ-9 score in favour of CBT (1·73 [95% CI 0·26–3·19]), with a 95% CI exceeding the 2-point non-inferiority margin. There were two deaths, one death by suicide in the PCET group and one due to chronic obstructive pulmonary disease in the CBT group. Both were assessed by the responsible clinician to be unrelated to the trial. In terms of using emergency departments for depression-related events, four people (three in the PCET group; one in the CBT group) made more than a single use and six people (three in the PCET group; three in the CBT group) made a single use. One patient in the PCET group had inpatient treatment for a depression-related event. Interpretation This trial is the first to examine the two most frequently administered psychological therapies in the IAPT service. The finding of non-inferiority of PCET to CBT at 6 months supports the results from large, routine, non-randomised datasets from the IAPT programme. Given the high demand for psychological therapies and the need for patient choice, our findings suggest the need for continued investment in the training and delivery of PCET for improving short-term outcomes, but suggest that PCET might be inferior to CBT at 12 months.
United States National Science Foundation (NSF) ; Science and Technology Facilities Council (STFC) of the United Kingdom ; Max-Planck Society ; State of Niedersachsen/Germany ; Australian Research Council ; Netherlands Organisation for Scientific Research ; EGO consortium ; Council of Scientific and Industrial Research of India ; Department of Science and Technology, India ; Science & Engineering Research Board (SERB), India ; Ministry of Human Resource Development, India ; Spanish Ministerio de Economia y Competitividad ; Conselleria d'Economia i Competitivitat and Conselleria d'Educacio Cultura i Universitats of the Govern de les Illes Balears ; National Science Centre of Poland ; European Commission ; Royal Society ; Scottish Funding Council ; Scottish Universities Physics Alliance ; Hungarian Scientific Research Fund (OTKA) ; Lyon Institute of Origins (LIO) ; National Research Foundation of Korea ; Industry Canada ; Province of Ontario through Ministry of Economic Development and Innovation ; National Science and Engineering Research Council Canada ; Canadian Institute for Advanced Research ; Brazilian Ministry of Science, Technology, and Innovation ; Russian Foundation for Basic Research ; Leverhulme Trust ; Research Corporation ; Ministry of Science and Technology (MOST), Taiwan ; Kavli Foundation ; Australian Government ; National Collaborative Research Infrastructure Strategy ; Government of Western Australia ; United States Department of Energy ; United States National Science Foundation ; Ministry of Science and Education of Spain ; Science and Technology Facilities Council of the United Kingdom ; Higher Education Funding Council for England ; National Center for Supercomputing Applications at the University of Illinois at Urbana-Champaign ; Kavli Institute of Cosmological Physics at the University of Chicago ; Center for Cosmology and Astro-Particle Physics at the Ohio State University ; Mitchell Institute for Fundamental Physics and Astronomy at Texas AM University ; Financiadora de Estudos e Projetos ; Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) ; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) ; Ministerio da Ciencia, Tecnologia e Inovacao ; Deutsche Forschungsgemeinschaft ; Collaborating Institutions in the Dark Energy Survey ; National Science Foundation ; MINECO ; Centro de Excelencia Severo Ochoa ; European Research Council under European Union's Seventh Framework Programme ; ERC ; NASA (United States) ; DOE (United States) ; IN2P3/CNRS (France) ; CEA/Irfu (France) ; ASI (Italy) ; INFN (Italy) ; MEXT (Japan) ; KEK (Japan) ; JAXA (Japan) ; Wallenberg Foundation ; Swedish Research Council ; National Space Board (Sweden) ; NASA in the United States ; DRL in Germany ; INAF for the project Gravitational Wave Astronomy with the first detections of adLIGO and adVIRGO experiments ; ESA (Denmark) ; ESA (France) ; ESA (Germany) ; ESA (Italy) ; ESA (Switzerland) ; ESA (Spain) ; German INTEGRAL through DLR grant ; US under NASA Grant ; National Science Foundation PIRE program grant ; Hubble Fellowship ; KAKENHI of MEXT Japan ; JSPS ; Optical and Near-Infrared Astronomy Inter-University Cooperation Program - MEXT ; UK Science and Technology Facilities Council ; ERC Advanced Investigator Grant ; Lomonosov Moscow State University Development programm ; Moscow Union OPTICA ; Russian Science Foundation ; National Research Foundation of South Africa ; Australian Government Department of Industry and Science and Department of Education (National Collaborative Research Infrastructure Strategy: NCRIS) ; NVIDIA at Harvard University ; University of Hawaii ; National Aeronautics and Space Administration's Planetary Defense Office ; Queen's University Belfast ; National Aeronautics and Space Administration through Planetary Science Division of the NASA Science Mission Directorate ; European Research Council under European Union's Seventh Framework Programme/ERC ; STFC grants ; European Union FP7 programme through ERC ; STFC through an Ernest Rutherford Fellowship ; FONDECYT ; Australian Research Council Centre of Excellence for All-sky Astrophysics (CAASTRO) ; NASA in the US ; UK Space Agency in the UK ; Agenzia Spaziale Italiana (ASI) in Italy ; Ministerio de Ciencia y Tecnologia (MinCyT) ; Consejo Nacional de Investigaciones Cientificas y Tecnologicas (CONICET) from Argentina ; USA NSF PHYS ; NSF ; ICREA ; Science and Technology Facilities Council ; UK Space Agency ; National Science Foundation: AST-1138766 ; National Science Foundation: AST-1238877 ; MINECO: AYA2012-39559 ; MINECO: ESP2013-48274 ; MINECO: FPA2013-47986 ; Centro de Excelencia Severo Ochoa: SEV-2012-0234 ; ERC: 240672 ; ERC: 291329 ; ERC: 306478 ; German INTEGRAL through DLR grant: 50 OG 1101 ; US under NASA Grant: NNX15AU74G ; National Science Foundation PIRE program grant: 1545949 ; Hubble Fellowship: HST-HF-51325.01 ; KAKENHI of MEXT Japan: 24103003 ; KAKENHI of MEXT Japan: 15H00774 ; KAKENHI of MEXT Japan: 15H00788 ; JSPS: 15H02069 ; JSPS: 15H02075 ; ERC Advanced Investigator Grant: 267697 ; Russian Science Foundation: 16-12-00085 ; Russian Science Foundation: RFBR15-02-07875 ; National Aeronautics and Space Administration's Planetary Defense Office: NNX14AM74G ; National Aeronautics and Space Administration through Planetary Science Division of the NASA Science Mission Directorate: NNX08AR22G ; European Research Council under European Union's Seventh Framework Programme/ERC: 291222 ; STFC grants: ST/I001123/1 ; STFC grants: ST/L000709/1 ; European Union FP7 programme through ERC: 320360 ; FONDECYT: 3140326 ; Australian Research Council Centre of Excellence for All-sky Astrophysics (CAASTRO): CE110001020 ; USA NSF PHYS: 1156600 ; NSF: 1242090 ; Science and Technology Facilities Council: Gravitational Waves ; Science and Technology Facilities Council: ST/L000946/1 ; Science and Technology Facilities Council: ST/K005014/1 ; Science and Technology Facilities Council: ST/N000668/1 ; Science and Technology Facilities Council: ST/M000966/1 ; Science and Technology Facilities Council: ST/I006269/1 ; Science and Technology Facilities Council: ST/L000709/1 ; Science and Technology Facilities Council: ST/J00166X/1 ; Science and Technology Facilities Council: ST/K000845/1 ; Science and Technology Facilities Council: ST/K00090X/1 ; Science and Technology Facilities Council: ST/N000633/1 ; Science and Technology Facilities Council: ST/H001972/1 ; Science and Technology Facilities Council: ST/L000733/1 ; Science and Technology Facilities Council: ST/N000757/1 ; Science and Technology Facilities Council: ST/M001334/1 ; Science and Technology Facilities Council: ST/J000019/1 ; Science and Technology Facilities Council: ST/M003035/1 ; Science and Technology Facilities Council: ST/I001123/1 ; Science and Technology Facilities Council: ST/N00003X/1 ; Science and Technology Facilities Council: ST/I006269/1 Gravitational Waves ; Science and Technology Facilities Council: ST/N000072/1 ; Science and Technology Facilities Council: ST/L003465/1 ; UK Space Agency: ST/P002196/1 ; This Supplement provides supporting material for Abbott et al. (2016a). We briefly summarize past electromagnetic (EM) follow-up efforts as well as the organization and policy of the current EM follow-up program. We compare the four probability sky maps produced for the gravitational-wave transient GW150914, and provide additional details of the EM follow-up observations that were performed in the different bands.