Sensitivity and Specificity of Empiric Treatment for Sexually Transmitted Infections in a Pediatric Emergency Department.

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Breslin, Kristen; Tuchman, Lisa; Hayes, Katie L; Badolato, Gia; Goyal, Monika K

2017-10-01

To determine test characteristics of provider judgment for empiric antibiotic provision to patients undergoing testing for a sexually transmitted infection. We conducted a retrospective cross-sectional electronic health record review of all patients aged 13-19 years who had Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) testing sent from an urban, academic pediatric emergency department in 2012. We abstracted data, including patient demographics, chief complaint, sexually transmitted infection test results, and treatment. We calculated test characteristics comparing clinician judgment for presumptive treatment for a sexually transmitted infection with the reference standard of the actual results of testing for a sexually transmitted infection. Of 1223 patient visits meeting inclusion criteria, 284 (23.2%) had a positive GC and/or CT test result. Empiric treatment was provided in 615 encounters (50.3%). Provider judgment for presumptive treatment had an overall sensitivity of 67.6% (95% CI, 61.8-73.0) and a specificity of 55% (95% CI, 51.7-58.2) for accurate GC and/or CT detection. Many adolescents tested for GC and CT receive empiric treatment at the initial emergency department visit. Provider judgment may lack sufficient sensitivity and specificity for identifying infected patients, resulting in the potential for undertreatment of true disease, overtreatment of uninfected patients, or both. Copyright © 2017 Elsevier Inc. All rights reserved.

Substance Abuse Counselors' Recovery Status and Self-Schemas: Preliminary Implications for Empirically Supported Treatment Implementation.

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Nielson, Elizabeth M

2016-01-01

The purpose of this paper is to better understand the relationship between substance abuse counselors' personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients' struggles. Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors' recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments.

Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence.

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Palsson, Olafur S

2015-10-01

Hypnotherapy has been investigated for 30 years as a treatment for gastrointestinal (GI) disorders. There are presently 35 studies in the published empirical literature, including 17 randomized controlled trials (RCTs) that have assessed clinical outcomes of such treatment. This body of research is reviewed comprehensively in this article. Twenty-four of the studies have tested hypnotherapy for adult irritable bowel syndrome (IBS) and 5 have focused on IBS or abdominal pain in children. All IBS hypnotherapy studies have reported significant improvement in gastrointestinal symptoms, and 7 out of 10 RCTs in adults and all 3 RCTs in pediatric patient samples found superior outcomes for hypnosis compared to control groups. Collectively this body of research shows unequivocally that for both adults and children with IBS, hypnosis treatment is highly efficacious in reducing bowel symptoms and can offer lasting and substantial symptom relief for a large proportion of patients who do not respond adequately to usual medical treatment approaches. For other GI disorders the evidence is more limited, but preliminary indications of therapeutic potential can be seen in the single randomized controlled trials published to date on hypnotherapy for functional dyspepsia, functional chest pain, and ulcerative colitis. Further controlled hypnotherapy trials in those three disorders should be a high priority. The mechanisms underlying the impact of hypnosis on GI problems are still unclear, but findings from a number of studies suggest that they involve both modulation of gut functioning and changes in the brain's handling of sensory signals from the GI tract.

Perspectives on empirical approaches for ocean color remote sensing of chlorophyll in a changing climate.

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Dierssen, Heidi M

2010-10-05

Phytoplankton biomass and productivity have been continuously monitored from ocean color satellites for over a decade. Yet, the most widely used empirical approach for estimating chlorophyll a (Chl) from satellites can be in error by a factor of 5 or more. Such variability is due to differences in absorption and backscattering properties of phytoplankton and related concentrations of colored-dissolved organic matter (CDOM) and minerals. The empirical algorithms have built-in assumptions that follow the basic precept of biological oceanography--namely, oligotrophic regions with low phytoplankton biomass are populated with small phytoplankton, whereas more productive regions contain larger bloom-forming phytoplankton. With a changing world ocean, phytoplankton composition may shift in response to altered environmental forcing, and CDOM and mineral concentrations may become uncoupled from phytoplankton stocks, creating further uncertainty and error in the empirical approaches. Hence, caution is warranted when using empirically derived Chl to infer climate-related changes in ocean biology. The Southern Ocean is already experiencing climatic shifts and shows substantial errors in satellite-derived Chl for different phytoplankton assemblages. Accurate global assessments of phytoplankton will require improved technology and modeling, enhanced field observations, and ongoing validation of our "eyes in space."

Estimating the effect of treatment rate changes when treatment benefits are heterogeneous: antibiotics and otitis media.

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Park, Tae-Ryong; Brooks, John M; Chrischilles, Elizabeth A; Bergus, George

2008-01-01

Contrast methods to assess the health effects of a treatment rate change when treatment benefits are heterogeneous across patients. Antibiotic prescribing for children with otitis media (OM) in Iowa Medicaid is the empirical example. Instrumental variable (IV) and linear probability model (LPM) are used to estimate the effect of antibiotic treatments on cure probabilities for children with OM in Iowa Medicaid. Local area physician supply per capita is the instrument in the IV models. Estimates are contrasted in terms of their ability to make inferences for patients whose treatment choices may be affected by a change in population treatment rates. The instrument was positively related to the probability of being prescribed an antibiotic. LPM estimates showed a positive effect of antibiotics on OM patient cure probability while IV estimates showed no relationship between antibiotics and patient cure probability. Linear probability model estimation yields the average effects of the treatment on patients that were treated. IV estimation yields the average effects for patients whose treatment choices were affected by the instrument. As antibiotic treatment effects are heterogeneous across OM patients, our estimates from these approaches are aligned with clinical evidence and theory. The average estimate for treated patients (higher severity) from the LPM model is greater than estimates for patients whose treatment choices are affected by the instrument (lower severity) from the IV models. Based on our IV estimates it appears that lowering antibiotic use in OM patients in Iowa Medicaid did not result in lost cures.

Dispelling myths about dissociative identity disorder treatment: an empirically based approach.

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Brand, Bethany L; Loewenstein, Richard J; Spiegel, David

2014-01-01

Some claim that treatment for dissociative identity disorder (DID) is harmful. Others maintain that the available data support the view that psychotherapy is helpful. We review the empirical support for both arguments. Current evidence supports the conclusion that phasic treatment consistent with expert consensus guidelines is associated with improvements in a wide range of DID patients' symptoms and functioning, decreased rates of hospitalization, and reduced costs of treatment. Research indicates that poor outcome is associated with treatment that does not specifically involve direct engagement with DID self-states to repair identity fragmentation and to decrease dissociative amnesia. The evidence demonstrates that carefully staged trauma-focused psychotherapy for DID results in improvement, whereas dissociative symptoms persist when not specifically targeted in treatment. The claims that DID treatment is harmful are based on anecdotal cases, opinion pieces, reports of damage that are not substantiated in the scientific literature, misrepresentations of the data, and misunderstandings about DID treatment and the phenomenology of DID. Given the severe symptomatology and disability associated with DID, iatrogenic harm is far more likely to come from depriving DID patients of treatment that is consistent with expert consensus, treatment guidelines, and current research.

Substance Abuse Counselors’ Recovery Status and Self-Schemas: Preliminary Implications for Empirically Supported Treatment Implementation

Science.gov (United States)

Nielson, Elizabeth M.

2016-01-01

Purpose The purpose of this paper is to better understand the relationship between substance abuse counselors’ personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. Methods A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Results Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients’ struggles. Discussion Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors’ recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments. PMID:28626597

Rape treatment outcome research: empirical findings and state of the literature.

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Vickerman, Katrina A; Margolin, Gayla

2009-07-01

This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery.

Rape Treatment Outcome Research: Empirical Findings and State of the Literature

Science.gov (United States)

Vickerman, Katrina A.; Margolin, Gayla

2009-01-01

This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery. PMID:19442425

Reasons for Choice of Antibiotic for the Empirical Treatment of CAP by Canadian Infectious Disease Physicians

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Jacob Pendergrast

1999-01-01

Full Text Available BACKGROUND: Previous studies have documented substantial variation in physician prescribing practices for the treatment of community-acquired pneumonia. Much of this variation is the result of empirical treatment, in which physicians must choose antibiotics in the a8bsence of culture and sensitivity data.

Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections.

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Linsenmeyer, Katherine; Strymish, Judith; Gupta, Kalpana

2015-12-01

The emergence of multidrug-resistant (MDR) uropathogens is making the treatment of urinary tract infections (UTIs) more challenging. We sought to evaluate the accuracy of empiric therapy for MDR UTIs and the utility of prior culture data in improving the accuracy of the therapy chosen. The electronic health records from three U.S. Department of Veterans Affairs facilities were retrospectively reviewed for the treatments used for MDR UTIs over 4 years. An MDR UTI was defined as an infection caused by a uropathogen resistant to three or more classes of drugs and identified by a clinician to require therapy. Previous data on culture results, antimicrobial use, and outcomes were captured from records from inpatient and outpatient settings. Among 126 patient episodes of MDR UTIs, the choices of empiric therapy against the index pathogen were accurate in 66 (52%) episodes. For the 95 patient episodes for which prior microbiologic data were available, when empiric therapy was concordant with the prior microbiologic data, the rate of accuracy of the treatment against the uropathogen improved from 32% to 76% (odds ratio, 6.9; 95% confidence interval, 2.7 to 17.1; P tract (GU)-directed agents (nitrofurantoin or sulfa agents) were equally as likely as broad-spectrum agents to be accurate (P = 0.3). Choosing an agent concordant with previous microbiologic data significantly increased the chance of accuracy of therapy for MDR UTIs, even if the previous uropathogen was a different species. Also, GU-directed or broad-spectrum therapy choices were equally likely to be accurate. The accuracy of empiric therapy could be improved by the use of these simple rules. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Treatments for Autism: Parental Choices and Perceptions of Change

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Bowker, Anne; D'Angelo, Nadia M.; Hicks, Robin; Wells, Kerry

2011-01-01

Empirically conducted studies of the efficacy of various treatments for autism are limited, which leaves parents with little evidence on which to base their treatment decisions (Kasari, "Journal of Autism and Developmental Disorders," 32: 447-461, 2002). The purpose of this study was to examine the types of treatments in current use by families of…

Training addiction professionals in empirically supported treatments: perspectives from the treatment community.

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Hartzler, Bryan; Rabun, Carl

2014-01-01

Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, "Seeking Safety," and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge

Treatments for Sleep Changes

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... Contributing medical factors Non-drug strategies Medications Common sleep changes Many people with Alzheimer’s experience changes in ... at night. Subscribe now Non-drug treatments for sleep changes Non-drug treatments aim to improve sleep ...

ADAPTATION PROCESS TO CLIMATE CHANGE IN AGRICULTURE- AN EMPIRICAL STUDY

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Ghulam Mustafa

2017-10-01

Full Text Available Climatic variations affect agriculture in a process with no known end means. Adaptations help to reduce the adverse impacts of climate change. Unfortunately, adaptation has never been considered as a process. Current study empirically identified the adaptation process and its different stages. Moreover, little is known about the farm level adaptation strategies and their determinants. The study in hand found farm level adaptation strategies and determinants of these strategies. The study identified three stages of adaptation i.e. perception, intention and adaptation. It was found that 71.4% farmers perceived about climate change, 58.5% intended to adapt while 40.2% actually adapted. The study further explored that farmers do adaptations through changing crop variety (56.3%, changing planting dates (44.6%, tree plantation (37.5%, increase/conserve irrigation (39.3% and crop diversification (49.2%. The adaptation strategies used by farmers were autonomous and mostly determined perception to climate change. It was also noted that the adaptation strategies move in a circular process and once they are adapted they remained adapted for a longer period of time. Some constraints slow the adaptation process so; we recommend farmers should be given price incentives to speed-up this process.

Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions

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Mitchell, John T.; Zylowska, Lidia; Kollins, Scott H.

2015-01-01

Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided. PMID:25908900

Empirical Validation of a Thermal Model of a Complex Roof Including Phase Change Materials

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Stéphane Guichard

2015-12-01

Full Text Available This paper deals with the empirical validation of a building thermal model of a complex roof including a phase change material (PCM. A mathematical model dedicated to PCMs based on the heat apparent capacity method was implemented in a multi-zone building simulation code, the aim being to increase the understanding of the thermal behavior of the whole building with PCM technologies. In order to empirically validate the model, the methodology is based both on numerical and experimental studies. A parametric sensitivity analysis was performed and a set of parameters of the thermal model has been identified for optimization. The use of the generic optimization program called GenOpt® coupled to the building simulation code enabled to determine the set of adequate parameters. We first present the empirical validation methodology and main results of previous work. We then give an overview of GenOpt® and its coupling with the building simulation code. Finally, once the optimization results are obtained, comparisons of the thermal predictions with measurements are found to be acceptable and are presented.

Recommendations for the empirical treatment of complicated urinary tract infections using surveillance data on antimicrobial resistance in the Netherlands

NARCIS (Netherlands)

Koningstein, Maike; van der Bij, Akke K.; de Kraker, Marlieke E. A.; Monen, Jos C.; Muilwijk, Jan; de Greeff, Sabine C.; Geerlings, Suzanne E.; van Hall, Maurine A. Leverstein-; Vlaspolder, F.; Cohen Stuart, J. W. T.; van Hees, B. C.; Wintermans, R. G. F.; Altorf-van der Kuil, W.; Alblas, J.; van der Bij, A. K.; Frentz, D.; Leenstra, T.; Monen, J. C.; Muilwijk, J.; Notermans, D. W.; de Greeff, S. C.; van Keulen, P. H. J.; Kluytmans, J. A. J. W.; Mattsson, E. E.; Sebens, F. W.; Frenay, H. M. E.; Maraha, B.; Heilmann, F. G. C.; Halaby, T.; Versteeg, D.; Hendrix, R.; Schellekens, J. F. P.; Diederen, B. M. W.; de Brauwer, E. I. G. B.; Stals, F. S.; Bakker, L. J.; Dorigo-Zetsma, J. W.; van Zeijl, J. H.; Bernards, A. T.; de Jongh, B. M.; Vlaminckx, B. J. M.; Horrevorts, A.; Kuipers, S.; Moffie, B.; Brimicombe, R. W.; Jansen, C. L.; Renders, N. H. M.; Hendrickx, B. G. A.; Buiting, A. G. M.; Kaan, J. A.

2014-01-01

Complicated urinary tract infections (c-UTIs) are among the most common nosocomial infections and a substantial part of the antimicrobial agents used in hospitals is for the treatment of c-UTIs. Data from surveillance can be used to guide the empirical treatment choices of clinicians when treating

Empirical Philosophy of Science

DEFF Research Database (Denmark)

Mansnerus, Erika; Wagenknecht, Susann

2015-01-01

knowledge takes place through the integration of the empirical or historical research into the philosophical studies, as Chang, Nersessian, Thagard and Schickore argue in their work. Building upon their contributions we will develop a blueprint for an Empirical Philosophy of Science that draws upon...... qualitative methods from the social sciences in order to advance our philosophical understanding of science in practice. We will regard the relationship between philosophical conceptualization and empirical data as an iterative dialogue between theory and data, which is guided by a particular ‘feeling with......Empirical insights are proven fruitful for the advancement of Philosophy of Science, but the integration of philosophical concepts and empirical data poses considerable methodological challenges. Debates in Integrated History and Philosophy of Science suggest that the advancement of philosophical...

Antibiotic stewardship and empirical antibiotic treatment: How can they get along?

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Zuccaro, Valentina; Columpsi, Paola; Sacchi, Paolo; Lucà, Maria Grazia; Fagiuoli, Stefano; Bruno, Raffaele

2017-06-01

The aim of this review is to focus on the recent knowledge on antibiotic stewardship and empiric antibiotic treatment in cirrhotic patients. The application of antimicrobial stewardship (AMS) rules appears to be the most appropriate strategy to globally manage cirrhotic patients with infectious complications: indeed they represent a unique way to provide both early diagnosis and appropriate therapy in order to avoid not only antibiotic over-prescription but, more importantly, selection and spread of antimicrobial resistance. Moreover, cirrhotic patients must be considered "frail" and susceptible to healthcare associated infections: applying AMS policies would assure a cost reduction and thus contribute to the improvement of public health strategies. Copyright © 2017. Published by Elsevier Ltd.

An empirical perspective for understanding climate change impacts in Switzerland

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Henne, Paul; Bigalke, Moritz; Büntgen, Ulf; Colombaroli, Daniele; Conedera, Marco; Feller, Urs; Frank, David; Fuhrer, Jürg; Grosjean, Martin; Heiri, Oliver; Luterbacher, Jürg; Mestrot, Adrien; Rigling, Andreas; Rössler, Ole; Rohr, Christian; Rutishauser, This; Schwikowski, Margit; Stampfli, Andreas; Szidat, Sönke; Theurillat, Jean-Paul; Weingartner, Rolf; Wilcke, Wolfgan; Tinner, Willy

2018-01-01

Planning for the future requires a detailed understanding of how climate change affects a wide range of systems at spatial scales that are relevant to humans. Understanding of climate change impacts can be gained from observational and reconstruction approaches and from numerical models that apply existing knowledge to climate change scenarios. Although modeling approaches are prominent in climate change assessments, observations and reconstructions provide insights that cannot be derived from simulations alone, especially at local to regional scales where climate adaptation policies are implemented. Here, we review the wealth of understanding that emerged from observations and reconstructions of ongoing and past climate change impacts in Switzerland, with wider applicability in Europe. We draw examples from hydrological, alpine, forest, and agricultural systems, which are of paramount societal importance, and are projected to undergo important changes by the end of this century. For each system, we review existing model-based projections, present what is known from observations, and discuss how empirical evidence may help improve future projections. A particular focus is given to better understanding thresholds, tipping points and feedbacks that may operate on different time scales. Observational approaches provide the grounding in evidence that is needed to develop local to regional climate adaptation strategies. Our review demonstrates that observational approaches should ideally have a synergistic relationship with modeling in identifying inconsistencies in projections as well as avenues for improvement. They are critical for uncovering unexpected relationships between climate and agricultural, natural, and hydrological systems that will be important to society in the future.

Organizational change in its context. A theoretical and empirical study of the linkages between organizational change projects and their administrative, strategic and institutional environment

NARCIS (Netherlands)

Man, Huibert de

1988-01-01

This dissertation deals with the multi-level analysis of organizational change projects. Empirical examples are taken from the COB-SER participation experiments which took place in the Netherlands between 1977 and 1983. ... Zie: Summary

Empirical likelihood

CERN Document Server

Owen, Art B

2001-01-01

Empirical likelihood provides inferences whose validity does not depend on specifying a parametric model for the data. Because it uses a likelihood, the method has certain inherent advantages over resampling methods: it uses the data to determine the shape of the confidence regions, and it makes it easy to combined data from multiple sources. It also facilitates incorporating side information, and it simplifies accounting for censored, truncated, or biased sampling.One of the first books published on the subject, Empirical Likelihood offers an in-depth treatment of this method for constructing confidence regions and testing hypotheses. The author applies empirical likelihood to a range of problems, from those as simple as setting a confidence region for a univariate mean under IID sampling, to problems defined through smooth functions of means, regression models, generalized linear models, estimating equations, or kernel smooths, and to sampling with non-identically distributed data. Abundant figures offer vi...

Life Writing After Empire

DEFF Research Database (Denmark)

A watershed moment of the twentieth century, the end of empire saw upheavals to global power structures and national identities. However, decolonisation profoundly affected individual subjectivities too. Life Writing After Empire examines how people around the globe have made sense of the post...... in order to understand how individual life writing reflects broader societal changes. From far-flung corners of the former British Empire, people have turned to life writing to manage painful or nostalgic memories, as well as to think about the past and future of the nation anew through the personal...

Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study

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Peralta Galo

2012-10-01

Full Text Available Abstract Background The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL - producing Escherichia coli and Klebsiella spp. bacteremia. Methods Cases of ESBL producing Enterobacteriaceae (ESBL-E bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression. Results We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%, biliary tract (12.7%, intra-abdominal (8.8% and unknown origin (9.6%. Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI: 0.39 (0.31-0.97; P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients. Conclusion ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited.

Should the patients colonized with extended-spectrum beta-lactamase-producing Gram-negative bacilli (E-GNB) coming to hospital from the community with pneumonia get anti-E-GNB active empirical treatment?

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Peterlin, Lara; Žagar, Mateja; Lejko Zupanc, Tatjana; Paladin, Marija; Beović, Bojana

2017-10-01

Extended-spectrum beta-lactamases are responsible for resistance of Gram-negative bacilli to several beta-lactam antibiotics, including those prescribed for treatment pneumonia. To evaluate the importance of colonization with E-GNB for the choice of empirical treatment we performed a retrospective case-control study including 156 patients, hospitalized for treatment of pneumonia from 2009 through 2013. Empirical treatment success and in-hospital survival were significantly lower in patients colonized with E-GNB compared to non-colonized (p = 0.002, p = 0.035). When comparing subgroups of colonized patients, treatment success was significantly lower in patients who were colonized with E-GNB resistant to empirical antibiotic (p = 0.010), but not in those colonized by E-GNB susceptible to empirically given antibiotic (p = 0.104). Difference in in-hospital mortality was insignificant in both subgroups (p = 0.056, p = 0.331). The results of study suggest that an anti-E-GNB active antibiotic should be used for empirical treatment of pneumonia in E-GNB colonized patients.

Psychodynamic therapy from the perspective of self-organization. a concept of change and a methodological approach for empirical examination.

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Gumz, Antje; Geyer, Michael; Brähler, Elmar

2014-01-01

Observations from therapeutic practice and a series of empirical findings, for example, those on discontinuous change in psychotherapeutic processes, suggest modelling the therapeutic process as a self-organizing system with stable and critical instable phases and abrupt transitions. Here, a concept of psychotherapeutic change is presented that applies self-organization theory to psychodynamic principles. The authors explain the observations and considerations that form the basis of the concept and present some connections with existing findings and concepts. On the basis of this model, they generated two hypotheses regarding the co-occurrence of instability and discontinuous change and the degree of synchrony between the therapist and patient. A study design to test these hypotheses was developed and applied to a single case (psychodynamic therapy). After each session, patient and therapist rated their interaction. A measure of instability was calculated across the resulting time series. Sequences of destabilization were observed. On the basis of points of extreme instability, the process was divided into phases. Local instability maxima were accompanied by significant discontinuous change. Destabilization was highly synchronous in therapist and patient ratings. The authors discussed the concept and the methodological procedure. The approach enables the operationalization of crises and to empirically assess the significance of critical phases and developments within the therapeutic relationship. We present a concept of change that applies self-organization theory to psychodynamic therapy. We empirically tested the hypotheses formulated in the concept based on an extract of 125 long-term psychodynamic therapy sessions. We continuously monitored the therapeutic interaction and calculated a measure of the instability of the assessments. We identified several sequences of stable and unstable episodes. Episodes of high instability were accompanied by discontinuous

Moving Clinical Deliberations on Administrative Discharge in Drug Addiction Treatment Beyond Moral Rhetoric to Empirical Ethics.

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Williams, Izaak L

2016-01-01

Patients' admission to modern substance use disorder treatment comes with the attendant risk of being discharged from treatment-a widespread practice. This article describes the three mainstream theories of addiction that operate as a reference point for clinicians in reasoning about a decision to discharge a patient from treatment. The extant literature is reviewed to highlight the pathways that patients follow after administrative discharge. Little scientific research has been done to investigate claims and hypotheses about the therapeutic function of AD, which points to the need for empirical ethics to inform clinical addictions practice. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Stability of an empirical psychosocial taxonomy across type of diabetes and treatment.

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Nouwen, A; Breton, M-C; Urquhart Law, G; Descôteaux, J

2007-01-01

The aims of the study were (i) to examine whether an empirical psychosocial taxonomy, based on key diabetes-related variables, is independent of type of diabetes and treatment, and (ii) to further establish the external validation of the taxonomy. In a cross-sectional study, 82 patients with Type 1 and 86 patients with Type 2 diabetes mellitus were assigned to one of three psychosocial patient profiles based on their Multidimensional Diabetes Questionnaire (MDQ) scores. General psychological and diabetes-specific measures were obtained through self-report and HbA(1c) was measured. Equal proportions of Type 1 and Type 2 patients, and of patients using insulin and oral medication/diet only were classified within each of the three psychosocial profiles. External validation confirmed the validity and distinctiveness of the patients' profiles. The patient profiles were independent of demographic variables, body mass index, duration of diabetes, complexity of treatment, number of complications, social desirability, and major stress levels. The Psychosocial Taxonomy for Patients with Diabetes provides a new way to categorize individuals who may have more in common than just their type of diabetes and/or its treatment and can help target interventions to individual patients' needs.

Evaluating Process Quality Based on Change Request Data - An Empirical Study of the Eclipse Project

Science.gov (United States)

Schackmann, Holger; Schaefer, Henning; Lichter, Horst

The information routinely collected in change request management systems contains valuable information for monitoring of the process quality. However this data is currently utilized in a very limited way. This paper presents an empirical study of the process quality in the product portfolio of the Eclipse project. It is based on a systematic approach for the evaluation of process quality characteristics using change request data. Results of the study offer insights into the development process of Eclipse. Moreover the study allows assessing applicability and limitations of the proposed approach for the evaluation of process quality.

Climate change and the collapse of the Akkadian empire: Evidence from the deep sea

Energy Technology Data Exchange (ETDEWEB)

Cullen, H.M.; Menocal, P.B. de; Hemming, S.; Hemming, G.; Brown, F.H.; Guilderson, T.; Sirocko, F.

2000-04-01

The Akkadian empire ruled Mesopotamia from the headwaters of the Tigris-Euphrates Rivers to the Persian Gulf during the late third millennium B.C. Archeological evidence has shown that this highly developed civilization collapsed abruptly near 4,170 {+-} 150 calendar yr B.P., perhaps related to a shift to more arid conditions. Detailed paleoclimate records to test this assertion from Mesopotamia are rare, but changes in regional aridity are preserved in adjacent ocean basins. The authors document Holocene changes in regional aridity using mineralogic and geochemical analyses of a marine sediment core from the Gulf of Oman, which is directly downwind of Mesopotamian dust source areas and archeological sites. Results document a very abrupt increase in eolian dust and Mesopotamian aridity, accelerator mass spectrometer radiocarbon dates to 4,025 {+-} 125 calendar yr B.P., which persisted for {approximately} 300 yr. Radiogenic (Nd and Sr) isotope analyses confirm that the observed increase in mineral dust was derived from Mesopotamian source areas. Geochemical correlation of volcanic ash shards between the archeological site and marine sediment record establishes a direct temporal link between Mesopotamian aridification and social collapse, implicating a sudden shift to more arid conditions as a key factor contributing to the collapse of the Akkadian empire.

Dropout among patients in qualified detoxification treatment : the effect of treatment motivation is moderated by trauma load

OpenAIRE

Odenwald, Michael; Semrau, Peter

2013-01-01

Background: Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, butthis has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change andbehavioral change.Methods: Over the course of two months in 20...

Cost Effectiveness of Candida Polymerase Chain Reaction Detection and Empirical Antifungal Treatment among Patients with Suspected Fungal Peritonitis in the Intensive Care Unit.

Science.gov (United States)

Pagès, Arnaud; Iriart, Xavier; Molinier, Laurent; Georges, Bernard; Berry, Antoine; Massip, Patrice; Juillard-Condat, Blandine

2017-12-01

Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs. We constructed a decision tree model to evaluate the cost effectiveness. Cost and effectiveness were taken into account in a 1-year time horizon and from the French National Health Insurance perspective. Six strategies were compared: fluconazole or echinocandin as an empirical therapy, plus diagnosis by fungal culture or detection by PCR of all Candida species, or use of PCR to detect most fluconazole-resistant Candida species (i.e., Candida krusei and Candida glabrata). The use of fluconazole empirical treatment and PCR to detect all Candida species is more cost effective than using fluconazole empirical treatment without PCR (incremental cost-effectiveness ratio of €40,055/quality-adjusted life-year). Empirical treatment with echinocandin plus PCR to detect C. krusei and C. glabrata is the most effective strategy, but has an incremental cost-effectiveness ratio of €93,776/quality-adjusted life-year. If the cost of echinocandin decreases, then strategies involving PCR plus empirical echinocandin become more cost-effective. Detection by PCR of all Candida species and of most fluconazole-resistant Candida species could improve the cost-effectiveness of fluconazole and echinocandin given to non-neutropenic patients with suspected peritoneal candidiasis in ICUs. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Empiric 131I treatment of high thyroglobulin levels in differentiated thyroid carcinoma after remnant ablation

International Nuclear Information System (INIS)

Kalender, E.; Elboga, U.; Celen, Y.; Demir, H.; Yilmaz, M.; Sahin, E.

2015-01-01

Full text of publication follows. Objective: serum thyroglobulin (Tg) measurements are usually the best marker of residual or metastatic disease after the treatment of differentiated thyroid carcinoma (DTC). It is not rare to find patients with detectable serum Tg levels after ablative 131 I treatment (AIT). The objective of this study is to establish the efficacy of empiric 131 I treatment (EIT) given for patients whose Tg levels remained high after AIT. Materials and methods: 28 patients (23 women, 5 men; mean age 47.4 ± 16.8) without distant metastasis, who were treated empirically for high Tg levels after AIT in our clinic were studied retrospectively. In all patients stimulated Tg levels before AIT (Tg I) and 6 months after AIT (Tg II) were measured. The Tg cutoff level for EIT was accepted 10 ng/ml. After EIT, post-therapeutic whole-body scintigraphy (PWBS) was performed to all patients. 18 F-FDG PET CT was performed to patients who had negative PWBS but continued high Tg II levels. Results: PWBS was positive in 14 patients (50%) and negative in 14 patients (50%). 14 patients did not respond to EIT (50%), and 14 patients (50%) responded to EIT at different rates. Eight patients (28.6%) responded to EIT completely, and 6 patients (21.4%) responded to EIT partially. Tg I was 60.7 ± 40 ng/ml and Tg II was 31 ± 20.4 ng/ml in responded patients. Tg I was 87.6 ± 96 ng/ml and Tg II was 114.3 ± 106 ng/ml in non-responding patients. 18 F-FDG PET CT was performed to 14 patients who had negative PWBS. 18 F-FDG PET CT was positive in 11 patients and negative in 3 patients. 18 F-FDG PET CT positive patients were referred to surgery. Conclusion: Our findings, suggested that the EIT is not beneficial in patients who have higher Tg II than Tg I and the cure rate is low in increasing Tg levels. The patients who have high Tg II but lower than Tg I can be treated empirically with 131 I. In these patients EIT may be beneficial. (authors)

Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe

DEFF Research Database (Denmark)

McQuiston Haslund, Josephine; Rosborg Dinesen, Marianne; Nielsen, Anni Brit Sternhagen

2013-01-01

OBJECTIVE: Uncomplicated urinary tract infection (uUTI) is a common reason for antibiotic treatment in primary health care. Due to the increasing prevalence of antibiotic-resistant uropathogens it is crucial to use the most appropriate antibiotics for first-choice empiric treatment of uUTI....... Particularly, it is important to avoid antibiotics associated with a high rate of antimicrobial resistance. This study compares national recommendations from six European countries, investigating recommendations for first-choice antibiotic therapy of uUTI. SETTING: General practice in six European countries...... at least one antibiotic associated with a low (UTI could not be explained by differences in local bacterial aetiology or by different patterns of antimicrobial resistance. Despite resistance rates exceeding 10...

Empiric treatment based on Helicobacter Pylori serology cannont ...

African Journals Online (AJOL)

Background: Evidence that chronic gastric Helicobacter pylori (HP) infection is an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and lymphoma has led to the suggestion that all serologically positive dyspeptic patients should be treated empirically with antibiotics to eradicate the infection, without ...

New GRACE-Derived Storage Change Estimates Using Empirical Mode Extraction

Science.gov (United States)

Aierken, A.; Lee, H.; Yu, H.; Ate, P.; Hossain, F.; Basnayake, S. B.; Jayasinghe, S.; Saah, D. S.; Shum, C. K.

2017-12-01

Estimated mass change from GRACE spherical harmonic solutions have north/south stripes and east/west banded errors due to random noise and modeling errors. Low pass filters like decorrelation and Gaussian smoothing are typically applied to reduce noise and errors. However, these filters introduce leakage errors that need to be addressed. GRACE mascon estimates (JPL and CSR mascon solutions) do not need decorrelation or Gaussian smoothing and offer larger signal magnitudes compared to the GRACE spherical harmonics (SH) filtered results. However, a recent study [Chen et al., JGR, 2017] demonstrated that both JPL and CSR mascon solutions also have leakage errors. We developed a new postprocessing method based on empirical mode decomposition to estimate mass change from GRACE SH solutions without decorrelation and Gaussian smoothing, the two main sources of leakage errors. We found that, without any post processing, the noise and errors in spherical harmonic solutions introduced very clear high frequency components in the spatial domain. By removing these high frequency components and reserve the overall pattern of the signal, we obtained better mass estimates with minimum leakage errors. The new global mass change estimates captured all the signals observed by GRACE without the stripe errors. Results were compared with traditional methods over the Tonle Sap Basin in Cambodia, Northwestern India, Central Valley in California, and the Caspian Sea. Our results provide larger signal magnitudes which are in good agreement with the leakage corrected (forward modeled) SH results.

Future Scenarios of Land Change Based on Empirical Data and Demographic Trends

Science.gov (United States)

Sleeter, Benjamin M.; Wilson, Tamara S.; Sharygin, Ethan; Sherba, Jason T.

2017-11-01

Changes in land use and land cover (LULC) have important and fundamental interactions with the global climate system. Top-down global scale projections of land use change have been an important component of climate change research; however, their utility at local to regional scales is often limited. The goal of this study was to develop an approach for projecting changes in LULC based on land use histories and demographic trends. We developed a set of stochastic, empirical-based projections of LULC change for the state of California, for the period 2001-2100. Land use histories and demographic trends were used to project a "business-as-usual" (BAU) scenario and three population growth scenarios. For the BAU scenario, we projected developed lands would more than double by 2100. When combined with cultivated areas, we projected a 28% increase in anthropogenic land use by 2100. As a result, natural lands were projected to decline at a rate of 139 km2 yr-1; grasslands experienced the largest net decline, followed by shrublands and forests. The amount of cultivated land was projected to decline by approximately 10%; however, the relatively modest change masked large shifts between annual and perennial crop types. Under the three population scenarios, developed lands were projected to increase 40-90% by 2100. Our results suggest that when compared to the BAU projection, scenarios based on demographic trends may underestimate future changes in LULC. Furthermore, regardless of scenario, the spatial pattern of LULC change was likely to have the greatest negative impacts on rangeland ecosystems.

Future scenarios of land change based on empirical data and demographic trends

Science.gov (United States)

Sleeter, Benjamin M.; Wilson, Tamara; Sharygin, Ethan; Sherba, Jason

2017-01-01

Changes in land use and land cover (LULC) have important and fundamental interactions with the global climate system. Top-down global scale projections of land use change have been an important component of climate change research; however, their utility at local to regional scales is often limited. The goal of this study was to develop an approach for projecting changes in LULC based on land use histories and demographic trends. We developed a set of stochastic, empirical-based projections of LULC change for the state of California, for the period 2001–2100. Land use histories and demographic trends were used to project a “business-as-usual” (BAU) scenario and three population growth scenarios. For the BAU scenario, we projected developed lands would more than double by 2100. When combined with cultivated areas, we projected a 28% increase in anthropogenic land use by 2100. As a result, natural lands were projected to decline at a rate of 139 km2 yr−1; grasslands experienced the largest net decline, followed by shrublands and forests. The amount of cultivated land was projected to decline by approximately 10%; however, the relatively modest change masked large shifts between annual and perennial crop types. Under the three population scenarios, developed lands were projected to increase 40–90% by 2100. Our results suggest that when compared to the BAU projection, scenarios based on demographic trends may underestimate future changes in LULC. Furthermore, regardless of scenario, the spatial pattern of LULC change was likely to have the greatest negative impacts on rangeland ecosystems.

Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice

Directory of Open Access Journals (Sweden)

Glenn D. Shean

2013-01-01

Full Text Available Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009. The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized.

Impact of climate change on human infectious diseases: Empirical evidence and human adaptation.

Science.gov (United States)

Wu, Xiaoxu; Lu, Yongmei; Zhou, Sen; Chen, Lifan; Xu, Bing

2016-01-01

Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects--the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial-temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Use of Evidence-Based Practice Resources and Empirically Supported Treatments for Posttraumatic Stress Disorder among University Counseling Center Psychologists

Science.gov (United States)

Juel, Morgen Joray

2012-01-01

In the present study, an attempt was made to determine the degree to which psychologists at college and university counseling centers (UCCs) utilized empirically supported treatments with their posttraumatic stress disorder (PTSD) clients. In addition, an attempt was made to determine how frequently UCC psychologists utilized a number of…

Empirically derived pain-patient MMPI subgroups: prediction of treatment outcome.

Science.gov (United States)

Moore, J E; Armentrout, D P; Parker, J C; Kivlahan, D R

1986-02-01

Fifty-seven male chronic pain patients admitted to an inpatient multimodal pain treatment program at a Midwestern Veterans Administration hospital completed the MMPI, Profile of Mood States (POMS), Tennessee Self-Concept Scale (TSCS), Rathus Assertiveness Schedule (RAS), activity diaries, and an extensive pain questionnaire. All patients were assessed both before and after treatment, and most also were assessed 2-5 months prior to treatment. No significant changes occurred during the baseline period, but significant improvements were evident at posttreatment on most variables: MMPI, POMS, TSCS, RAS, pain severity, sexual functioning, and activity diaries. MMPI subgroup membership, based on a hierarchical cluster analysis in a larger sample, was not predictive of differential treatment outcome. Possible reasons for comparable treatment gains among these subgroups, which previously have been shown to differ on many psychological and behavioral factors, are discussed.

Colonialism, Education and Social Change in the British Empire: The Cases of Australia, Papua New Guinea and Ireland

Science.gov (United States)

O'Donoghue, Tom

2009-01-01

This paper focuses on the history of relations between colonialism, schooling and social change in Australia, Papua New Guinea and Ireland, countries that were once part of the British Empire. It indicates that responses to schooling ranged from acceptance and tolerance, to modification and rejection, depending on the country, the issue, and the…

The Role of Empirical Research in Bioethics

Science.gov (United States)

Kon, Alexander A.

2010-01-01

There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. PMID:19998120

Promoting Behavioral Change in Psychoanalytic Treatments.

Science.gov (United States)

Busch, Fredric N

2017-01-01

One of the shibboleths of psychoanalysis is that treatment should not target behavioral change, focusing instead on gaining insight and the therapeutic relationship (Freud, 1917; 1923; Gabbard, 2014; Greenson, 1967). Such an approach is believed to be accompanied by disruptions of exploration or problematic distortions of the transference (Freud, 1917; 1923; Gabbard, 2014; Greenson, 1967). However, ignoring behavioral change can put patients at increased risk for stalemates in treatment and persistent problematic behaviors that interfere with improvement and impair relationships. This article suggests that rather than being at odds or disruptive, efforts at behavioral change can be part of the development and employment of a psychodynamic formulation, and can be used to enhance self-understanding and exploration of the transference. Psychoanalytic approaches provide strategies for behavioral change not included in other psychotherapeutic treatments. This article describes a variety of ways in which efforts at behavioral change can be integrated with and enhanced by psychodynamic exploration.

SPACE AND MEANING CHANGE IN URBANIZATION AND MODERNIZATION PROCESS: An Urban Park in the First Capital of the Ottoman Empire

Directory of Open Access Journals (Sweden)

Gul ATANUR

2015-03-01

Full Text Available The foundations of Westernization Movement in Turkey were laid in late Ottoman Empire. Following the fall of the Ottoman Empire and the proclamation of the republic, urban space became highly important and modernist architects from the west planned a large number of Turkish cities. The concept of urban park was introduced and parks became significant components of modern life in this period. Bursa, too, was influenced by this movement; it was planned by western planners and an urban park was built. However, the meaning of urban parks within the ideal of modern life in Turkey and in Bursa has changed over time.  This study is based on urban development periods in Turkey and it presents the change Bursa Kültürpark in Bursa, the early modern city of Turkey, underwent during the process from modernization to globalization.

The regulatory treatment of adverse outcomes: Empirical evidence from the electric utility industry

International Nuclear Information System (INIS)

Ryan, N.E.

1991-01-01

This dissertation consists of two essays, both of them empirical studies using data from the US electric utility industry. Part I focuses on utilities' investment behavior, while Part II examines regulatory policy toward the industry. The first paper presents an analysis of utilities' decisions about whether to continue or cancel nuclear construction projects. During the seventies and eighties, changes in economic conditions and regulatory policy radically altered the costs and benefits of nuclear power. This study seeks to determine whether regulators pursued policies which induced utilities to employ socially efficient criteria in re-evaluating ongoing projects. The analysis also yields insights into regulators' distributional goals. Results based on data for 1978-84 are consistent with the capture theory hypothesis, which holds that regulators weigh industry interests more heavily than consumer interests. A test for structural change provides no support for the contention that the relative importance of consumer interests increased over this period. These empirical findings are inconsistent with a standard (and essential) assumption of theoretical principal-agent models of rate-of-return regulation, that regulators value consumers' payoffs more than utility profits. The second paper examines regulatory policy toward generating facilities that entered commercial service during the years 1983-88. In a significant departure from past practice, state public utility commissions often denied utilities full recovery of their investments in new plants. Although such ex post disallowances have an important efficiency rationale, they also provide a means for opportunistic regulators to effect transfers between utilities' ratepayers and shareholders. A probit model was used to assess the impact on the probability of a disallowance of firm and project characteristics as well as attributes of a state's political and institutional environment

A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders

Science.gov (United States)

Sburlati, Elizabeth S.; Schniering, Carolyn A.; Lyneham, Heidi J.; Rapee, Ronald M.

2011-01-01

While a plethora of cognitive behavioral empirically supported treatments (ESTs) are available for treating child and adolescent anxiety and depressive disorders, research has shown that these are not as effective when implemented in routine practice settings. Research is now indicating that is partly due to ineffective EST training methods,…

Linezolid Versus Vancomycin in the Empiric Treatment of Nosocomial Pneumonia: A Cost-Utility Analysis Incorporating Results from the ZEPHyR Trial.

Science.gov (United States)

Collins, Curtis D; Schwemm, Ann K

2015-07-01

To examine the cost-effectiveness of vancomycin versus linezolid in the empiric treatment of nosocomial pneumonias incorporating results from a recent prospective, double-blind, multicenter, controlled trial in adults with suspected methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. A decision-analytic model examining the cost-effectiveness of linezolid versus vancomycin for the empiric treatment of nosocomial pneumonia was created. Publicly available cost, efficacy, and utility data populated relevant model variables. A probabilistic sensitivity analysis varied parameters in 10,000 Monte-Carlo simulations, and univariate sensitivity analyses assessed the impact of model uncertainties and the robustness of our conclusions. Results indicated that the cost per quality-adjusted life-year (QALY) increased 6% ($22,594 vs. $23,860) by using linezolid versus vancomycin for nosocomial pneumonia. The incremental cost per QALY gained by using linezolid over vancomycin was $6,089, and the incremental cost per life saved was $68,615 with the use of linezolid. Vancomycin dominated linezolid in the subset of patients with documented MRSA. The incremental cost per QALY gained using linezolid if no mortality benefit exists between agents or a 60-day time horizon was analyzed was $19,608,688 and $443,662, respectively. Linezolid may be a cost-effective alternative to vancomycin in the empiric treatment of patients with suspected MRSA nosocomial pneumonia; however, results of our model were highly variable on a number of important variables and assumptions including mortality differences and time frame analyzed. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Fluconazole for empiric antifungal therapy in cancer patients with fever and neutropenia

Directory of Open Access Journals (Sweden)

Peterson Josh F

2006-12-01

Full Text Available Abstract Background Several clinical trials have demonstrated the efficacy of fluconazole as empiric antifungal therapy in cancer patients with fever and neutropenia. Our objective was to assess the frequency and resource utilization associated with treatment failure in cancer patients given empiric fluconazole antifungal therapy in routine inpatient care. Methods We performed a retrospective cohort study of cancer patients treated with oral or intravenous fluconazole between 7/97 and 6/01 in a tertiary care hospital. The final study cohort included cancer patients with neutropenia (an absolute neutrophil count below 500 cells/mm3 and fever (a temperature above 38°C or 100.4°F, who were receiving at least 96 hours of parenteral antibacterial therapy prior to initiating fluconazole. Patients' responses to empiric therapy were assessed by reviewing patient charts. Results Among 103 cancer admissions with fever and neutropenia, treatment failure after initiating empiric fluconazole antifungal therapy occurred in 41% (95% confidence interval (CI 31% – 50% of admissions. Patients with a diagnosis of hematological malignancy had increased risk of treatment failure (OR = 4.6, 95% CI 1.5 – 14.8. When treatment failure occurred the mean adjusted increases in length of stay and total costs were 7.4 days (95% CI 3.3 – 11.5 and $18,925 (95% CI 3,289 – 34,563, respectively. Conclusion Treatment failure occurred in more than one-third of neutropenic cancer patients on fluconazole as empiric antifungal treatment for fever in routine clinical treatment. The increase in costs when treatment failure occurs is substantial.

Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer.

Science.gov (United States)

Amodeo, Maryann; Storti, Susan A; Larson, Mary Jo

2010-05-01

Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001 ; Roman and Johnson, 2002 ; Willenbring et al., 2004 ). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported practice (ESP) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors' perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors was also difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified.

An empirical test of the relative and combined effects of land-cover and climate change on local colonization and extinction.

Science.gov (United States)

Yalcin, Semra; Leroux, Shawn James

2018-04-14

Land-cover and climate change are two main drivers of changes in species ranges. Yet, the majority of studies investigating the impacts of global change on biodiversity focus on one global change driver and usually use simulations to project biodiversity responses to future conditions. We conduct an empirical test of the relative and combined effects of land-cover and climate change on species occurrence changes. Specifically, we examine whether observed local colonization and extinctions of North American birds between 1981-85 and 2001-05 are correlated with land-cover and climate change and whether bird life history and ecological traits explain interspecific variation in observed occurrence changes. We fit logistic regression models to test the impact of physical land-cover change, changes in net primary productivity, winter precipitation, mean summer temperature, and mean winter temperature on the probability of Ontario breeding bird local colonization and extinction. Models with climate change, land-cover change, and the combination of these two drivers were the top ranked models of local colonization for 30%, 27%, and 29% of species, respectively. Conversely, models with climate change, land-cover change, and the combination of these two drivers were the top ranked models of local extinction for 61%, 7%, and 9% of species, respectively. The quantitative impacts of land-cover and climate change variables also vary among bird species. We then fit linear regression models to test whether the variation in regional colonization and extinction rate could be explained by mean body mass, migratory strategy, and habitat preference of birds. Overall, species traits were weakly correlated to heterogeneity in species occurrence changes. We provide empirical evidence showing that land-cover change, climate change, and the combination of multiple global change drivers can differentially explain observed species local colonization and extinction. This article is protected

An update on the "empirical turn" in bioethics: analysis of empirical research in nine bioethics journals.

Science.gov (United States)

Wangmo, Tenzin; Hauri, Sirin; Gennet, Eloise; Anane-Sarpong, Evelyn; Provoost, Veerle; Elger, Bernice S

2018-02-07

A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is changing, that is, what are the characteristics of the empirical works published in these nine bioethics journals. A review of the same nine journals (Bioethics; Journal of Medical Ethics; Journal of Clinical Ethics; Nursing Ethics; Cambridge Quarterly of Healthcare Ethics; Hastings Center Report; Theoretical Medicine and Bioethics; Christian Bioethics; and Kennedy Institute of Ethics Journal) was conducted for a 12-year period from 2004 to 2015. Data obtained was analysed descriptively and using a non-parametric Chi-square test. Of the total number of original papers (N = 5567) published in the nine bioethics journals, 18.1% (n = 1007) collected and analysed empirical data. Journal of Medical Ethics and Nursing Ethics led the empirical publications, accounting for 89.4% of all empirical papers. The former published significantly more quantitative papers than qualitative, whereas the latter published more qualitative papers. Our analysis reveals no significant difference (χ2 = 2.857; p = 0.091) between the proportion of empirical papers published in 2004-2009 and 2010-2015. However, the increasing empirical trend has continued in these journals with the proportion of empirical papers increasing from 14.9% in 2004 to 17.8% in 2015. This study presents the current state of affairs regarding empirical research published nine bioethics journals. In the quarter century of data that is available about the nine bioethics journals studied in two reviews, the proportion of empirical publications continues to increase, signifying a trend towards empirical research in bioethics. The growing volume is mainly attributable to two

Testing the robustness of the anthropogenic climate change detection statements using different empirical models

KAUST Repository

Imbers, J.; Lopez, A.; Huntingford, C.; Allen, M. R.

2013-01-01

This paper aims to test the robustness of the detection and attribution of anthropogenic climate change using four different empirical models that were previously developed to explain the observed global mean temperature changes over the last few decades. These studies postulated that the main drivers of these changes included not only the usual natural forcings, such as solar and volcanic, and anthropogenic forcings, such as greenhouse gases and sulfates, but also other known Earth system oscillations such as El Niño Southern Oscillation (ENSO) or the Atlantic Multidecadal Oscillation (AMO). In this paper, we consider these signals, or forced responses, and test whether or not the anthropogenic signal can be robustly detected under different assumptions for the internal variability of the climate system. We assume that the internal variability of the global mean surface temperature can be described by simple stochastic models that explore a wide range of plausible temporal autocorrelations, ranging from short memory processes exemplified by an AR(1) model to long memory processes, represented by a fractional differenced model. In all instances, we conclude that human-induced changes to atmospheric gas composition is affecting global mean surface temperature changes. ©2013. American Geophysical Union. All Rights Reserved.

Testing the robustness of the anthropogenic climate change detection statements using different empirical models

KAUST Repository

Imbers, J.

2013-04-27

This paper aims to test the robustness of the detection and attribution of anthropogenic climate change using four different empirical models that were previously developed to explain the observed global mean temperature changes over the last few decades. These studies postulated that the main drivers of these changes included not only the usual natural forcings, such as solar and volcanic, and anthropogenic forcings, such as greenhouse gases and sulfates, but also other known Earth system oscillations such as El Niño Southern Oscillation (ENSO) or the Atlantic Multidecadal Oscillation (AMO). In this paper, we consider these signals, or forced responses, and test whether or not the anthropogenic signal can be robustly detected under different assumptions for the internal variability of the climate system. We assume that the internal variability of the global mean surface temperature can be described by simple stochastic models that explore a wide range of plausible temporal autocorrelations, ranging from short memory processes exemplified by an AR(1) model to long memory processes, represented by a fractional differenced model. In all instances, we conclude that human-induced changes to atmospheric gas composition is affecting global mean surface temperature changes. ©2013. American Geophysical Union. All Rights Reserved.

Salmonella typhi time to change empiric treatment

DEFF Research Database (Denmark)

Gade, C.; Engberg, J.; Weis, N.

2008-01-01

In the present case series report we describe seven recent cases of typhoid fever. All the patients were travellers returning from Pakistan, where typhoid is endemic. Salmonella typhi isolated from the patients by blood culture were reported as intermediary susceptible to fluoroquinolones in six...

Appropriability, Technological Opportunity, Market Demand, and Technical Change - Empirical Evidence from Switzerland

OpenAIRE

Harabi, Najib

1992-01-01

The purpose of this paper is to analyze both theoretically and empirically those factors which underlay the - empirically observable - inter-industry differences in technical progress. At the theoretical level economists agree more and more that technical progress can be explained at the industry level by the following three factors: (1) the technological opportunities, (2) the appropriability conditions, meaning the ability to capture and protect the results of technical innovations and (3) ...

Empirical methods for estimating future climatic conditions

International Nuclear Information System (INIS)

Anon.

1990-01-01

Applying the empirical approach permits the derivation of estimates of the future climate that are nearly independent of conclusions based on theoretical (model) estimates. This creates an opportunity to compare these results with those derived from the model simulations of the forthcoming changes in climate, thus increasing confidence in areas of agreement and focusing research attention on areas of disagreements. The premise underlying this approach for predicting anthropogenic climate change is based on associating the conditions of the climatic optimums of the Holocene, Eemian, and Pliocene with corresponding stages of the projected increase of mean global surface air temperature. Provided that certain assumptions are fulfilled in matching the value of the increased mean temperature for a certain epoch with the model-projected change in global mean temperature in the future, the empirical approach suggests that relationships leading to the regional variations in air temperature and other meteorological elements could be deduced and interpreted based on use of empirical data describing climatic conditions for past warm epochs. Considerable care must be taken, of course, in making use of these spatial relationships, especially in accounting for possible large-scale differences that might, in some cases, result from different factors contributing to past climate changes than future changes and, in other cases, might result from the possible influences of changes in orography and geography on regional climatic conditions over time

Comparative Case Study of Diffusion of Eye Movement Desensitization and Reprocessing in Two Clinical Settings: Empirically Supported Treatment Status Is Not Enough

NARCIS (Netherlands)

Cook, Joan M.; Biyanova, Tatyana; Coyne, James C.

2009-01-01

An in-depth comparative case study was conducted of two attempts at diffusion of an empirically supported, but controversial, psychotherapy: eye movement desensitization and reprocessing (EMDR). One Department of Veterans Affairs (VA) treatment setting in which there was substantial uptake was

Environmental policy instruments and technological change in the energy sector: findings from comparative empirical research

International Nuclear Information System (INIS)

Skjaerseth, J.B.; Christiansen, A.C.

2006-01-01

This article explores the extent to which and in what ways environmental policy instruments may affect patterns of environmental friendly technological change in the energy sector. Our argument is based on the assumption, however, that technological change is also affected by the political context in which the instruments are applied and by the nature of the problem itself. Comparative empirical research involving different European countries, sectors and policy fields were examined, including climate change, air pollution and wind power. The relationship between environmental policy instruments and technological change is extremely complex, not least due to the impact of other factors that may be more decisive than environmental ones. Against this backdrop, it was concluded that: 1) a portfolio of policy instruments works to the extent that different types of policy instruments affect the different drivers and stages behind technological change needed to solve specific problems. The need for a portfolio of policy instruments depends on the technological challenge being faced; 2) voluntary approaches facilitated constructive corporate strategies, but mandatory approaches tended to be more effective in stimulating short term major technological change; 3) voluntary approaches work well in the short term when the problem to be solved is characterized by lack of information and coordination. (author)

Empirical likelihood based detection procedure for change point in mean residual life functions under random censorship.

Science.gov (United States)

Chen, Ying-Ju; Ning, Wei; Gupta, Arjun K

2016-05-01

The mean residual life (MRL) function is one of the basic parameters of interest in survival analysis that describes the expected remaining time of an individual after a certain age. The study of changes in the MRL function is practical and interesting because it may help us to identify some factors such as age and gender that may influence the remaining lifetimes of patients after receiving a certain surgery. In this paper, we propose a detection procedure based on the empirical likelihood for the changes in MRL functions with right censored data. Two real examples are also given: Veterans' administration lung cancer study and Stanford heart transplant to illustrate the detecting procedure. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Autobiography After Empire

DEFF Research Database (Denmark)

Rasch, Astrid

of the collective, but insufficient attention has been paid to how individuals respond to such narrative changes. This dissertation examines the relationship between individual and collective memory at the end of empire through analysis of 13 end of empire autobiographies by public intellectuals from Australia......Decolonisation was a major event of the twentieth century, redrawing maps and impacting on identity narratives around the globe. As new nations defined their place in the world, the national and imperial past was retold in new cultural memories. These developments have been studied at the level......, the Anglophone Caribbean and Zimbabwe. I conceive of memory as reconstructive and social, with individual memory striving to make sense of the past in the present in dialogue with surrounding narratives. By examining recurring tropes in the autobiographies, like colonial education, journeys to the imperial...

An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities.

Science.gov (United States)

Kurtz, Patricia F; Boelter, Eric W; Jarmolowicz, David P; Chin, Michelle D; Hagopian, Louis P

2011-01-01

This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults. Copyright © 2011 Elsevier Ltd. All rights reserved.

Empirically derived personality subtyping for predicting clinical symptoms and treatment response in bulimia nervosa.

Science.gov (United States)

Haynos, Ann F; Pearson, Carolyn M; Utzinger, Linsey M; Wonderlich, Stephen A; Crosby, Ross D; Mitchell, James E; Crow, Scott J; Peterson, Carol B

2017-05-01

Evidence suggests that eating disorder subtypes reflecting under-controlled, over-controlled, and low psychopathology personality traits constitute reliable phenotypes that differentiate treatment response. This study is the first to use statistical analyses to identify these subtypes within treatment-seeking individuals with bulimia nervosa (BN) and to use these statistically derived clusters to predict clinical outcomes. Using variables from the Dimensional Assessment of Personality Pathology-Basic Questionnaire, K-means cluster analyses identified under-controlled, over-controlled, and low psychopathology subtypes within BN patients (n = 80) enrolled in a treatment trial. Generalized linear models examined the impact of personality subtypes on Eating Disorder Examination global score, binge eating frequency, and purging frequency cross-sectionally at baseline and longitudinally at end of treatment (EOT) and follow-up. In the longitudinal models, secondary analyses were conducted to examine personality subtype as a potential moderator of response to Cognitive Behavioral Therapy-Enhanced (CBT-E) or Integrative Cognitive-Affective Therapy for BN (ICAT-BN). There were no baseline clinical differences between groups. In the longitudinal models, personality subtype predicted binge eating (p = 0.03) and purging (p = 0.01) frequency at EOT and binge eating frequency at follow-up (p = 0.045). The over-controlled group demonstrated the best outcomes on these variables. In secondary analyses, there was a treatment by subtype interaction for purging at follow-up (p = 0.04), which indicated a superiority of CBT-E over ICAT-BN for reducing purging among the over-controlled group. Empirically derived personality subtyping appears to be a valid classification system with potential to guide eating disorder treatment decisions. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:506-514). © 2016 Wiley Periodicals, Inc.

Climate change and associated spatial heterogeneity of Pakistan: Empirical evidence using multidisciplinary approach.

Science.gov (United States)

Ali, Ghaffar

2018-09-01

Climate change is a multidimensional phenomenon, which has various implications for the environment and socio-economic conditions of the people. Its effects are deeper in an agrarian economy which is susceptible to the vagaries of nature. Therefore, climate change directly impacts the society in different ways, and society must pay the cost. Focusing on this truth, the main objective of this research was to investigate the empirical changes and spatial heterogeneity in the climate of Pakistan in real terms using time series data. Climate change and variability in Pakistan, over time, were estimated from 1961 to 2014 using all the climate variables for the very first time. Several studies were available on climate change impacts, mitigation, and adaptation; however, it was difficult to observe exactly how much change occurred in which province and when. A multidisciplinary approach was utilized to estimate the absolute change through a combination of environmental, econometric, and remote sensing methods. Moreover, the Autoregressive Distributed Lag (ARDL) model was used to ascertain the extent of variability in climate change and information was digitalized through ground truthing. Results showed that the average temperature of Pakistan increased by 2°C between 1960 and 1987 and 4°C between 1988 and 2014, and R 2 was 0.978. The rate of temperature increased 0.09°C between 1960 and 2014. The mean annual precipitation of Pakistan increased by 478mm, and its R 2 were 0.34-0.64. The mean annual humidity of Pakistan increased by 2.94%, and the rate of humidity has been increased by 0.97% from 1988 to 2014. Notably, Sindh and Balochistan provinces have shown a significant spatial heterogeneity regarding the increase in precipitation. Statistically all variables are significant. This would serve as a baseline information for climate change-related studies in Pakistan and its application in different sectors. This would also serve the plant breeders and policymakers of

Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia

DEFF Research Database (Denmark)

Arendrup, M C; Dzajic, Esad; Jensen, R H

2013-01-01

Significant changes in the management of fungaemia have occurred over the last decade with increased use of fluconazole prophylaxis, of empirical treatment and of echinocandins as first-line agents for documented disease. These changes may impact the epidemiology of fungaemia. We present nationwide...

Reasons for Treatment Changes in Patients With Moderate to Severe Psoriasis.

Science.gov (United States)

Anderson, Kathryn L; Feldman, Steven R

2015-01-01

Psoriasis treatment involves multiple treatment arms. Treatment choice depends on many factors and may change, due to the chronicity of psoriasis. The purpose of our study is to explore reasons for treatment changes in patients with moderate to severe psoriasis. Ten charts of patients with moderate to severe psoriasis were reviewed. The medication changes and reasons for change were extracted. A "treatment change" was defined as switching between medication classes, adding or removing a medication class, or switching medications within the oral or biologic medication class. Seventy-seven treatment changes were identified. On average, 1 treatment change occurred per year of follow-up. The most common reason for treatment change was inadequate disease control. Inadequate disease control with current therapy is the most common reason a physician changes treatment for moderate to severe psoriasis. More efficacious treatments or ways to improve efficacy may help improve the long-term outcomes of psoriasis. © The Author(s) 2015.

Empirical Productivity Indices and Indicators

NARCIS (Netherlands)

B.M. Balk (Bert)

2016-01-01

textabstractThe empirical measurement of productivity change (or difference) by means of indices and indicators starts with the ex post profit/loss accounts of a production unit. Key concepts are profit, leading to indicators, and profitability, leading to indices. The main task for the productivity

Empirical antimicrobial therapy of acute dentoalveolar abscess

Directory of Open Access Journals (Sweden)

Matijević Stevo

2009-01-01

Full Text Available Background/Aim. The most common cause of acute dental infections are oral streptococci and anaerobe bacteria. Acute dentoalveolar infections are usually treated surgically in combination with antibiotics. Empirical therapy in such infections usually requires the use of penicillin-based antibiotics. The aim of this study was to investigate the clinical efficiency of amoxicillin and cefalexin in the empirical treatment of acute odontogenic abscess and to assess the antimicrobial susceptibility of the isolated bacteria in early phases of its development. Methods. This study included 90 patients with acute odontogenic abscess who received surgical treatment (extraction of a teeth and/or abscess incision and were divided into three groups: two surgicalantibiotic groups (amoxicillin, cefalexin and the surgical group. In order to evaluate the effects of the applied therapy following clinical symptoms were monitored: inflammatory swelling, trismus, regional lymphadentytis and febrility. In all the patients before the beginning of antibiotic treatment suppuration was suched out of the abscess and antibiotic susceptibility of isolated bacteria was tested by using the disk diffusion method. Results. The infection signs and symptoms lasted on the average 4.47 days, 4.67 days, and 6.17 days in the amoxicillin, cefalexin, and surgically only treated group, respectively. A total of 111 bacterial strains were isolated from 90 patients. Mostly, the bacteria were Gram-positive facultative anaerobs (81.1%. The most common bacteria isolated were Viridans streptococci (68/111. Antibiotic susceptibility of isolated bacteria to amoxicillin was 76.6% and cefalexin 89.2%. Conclusion. Empirical, peroral use of amoxicillin or cefalexin after surgical treatment in early phase of development of dentoalveolar abscess significantly reduced the time of clinical symptoms duration in the acute odontogenic infections in comparison to surgical treatment only. Bacterial strains

Identification of sudden stiffness changes in the acceleration response of a bridge to moving loads using ensemble empirical mode decomposition

Science.gov (United States)

Aied, H.; González, A.; Cantero, D.

2016-01-01

The growth of heavy traffic together with aggressive environmental loads poses a threat to the safety of an aging bridge stock. Often, damage is only detected via visual inspection at a point when repairing costs can be quite significant. Ideally, bridge managers would want to identify a stiffness change as soon as possible, i.e., as it is occurring, to plan for prompt measures before reaching a prohibitive cost. Recent developments in signal processing techniques such as wavelet analysis and empirical mode decomposition (EMD) have aimed to address this need by identifying a stiffness change from a localised feature in the structural response to traffic. However, the effectiveness of these techniques is limited by the roughness of the road profile, the vehicle speed and the noise level. In this paper, ensemble empirical mode decomposition (EEMD) is applied by the first time to the acceleration response of a bridge model to a moving load with the purpose of capturing sudden stiffness changes. EEMD is more adaptive and appears to be better suited to non-linear signals than wavelets, and it reduces the mode mixing problem present in EMD. EEMD is tested in a variety of theoretical 3D vehicle-bridge interaction scenarios. Stiffness changes are successfully identified, even for small affected regions, relatively poor profiles, high vehicle speeds and significant noise. The latter is due to the ability of EEMD to separate high frequency components associated to sudden stiffness changes from other frequency components associated to the vehicle-bridge interaction system.

A sensitivity analysis of centrifugal compressors' empirical models

International Nuclear Information System (INIS)

Yoon, Sung Ho; Baek, Je Hyun

2001-01-01

The mean-line method using empirical models is the most practical method of predicting off-design performance. To gain insight into the empirical models, the influence of empirical models on the performance prediction results is investigated. We found that, in the two-zone model, the secondary flow mass fraction has a considerable effect at high mass flow-rates on the performance prediction curves. In the TEIS model, the first element changes the slope of the performance curves as well as the stable operating range. The second element makes the performance curves move up and down as it increases or decreases. It is also discovered that the slip factor affects pressure ratio, but it has little effect on efficiency. Finally, this study reveals that the skin friction coefficient has significant effect on both the pressure ratio curve and the efficiency curve. These results show the limitations of the present empirical models, and more reasonable empirical models are reeded

Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder

Science.gov (United States)

Schreibman, Laura; Dawson, Geraldine; Stahmer, Aubyn C.; Landa, Rebecca; Rogers, Sally J.; McGee, Gail G.; Kasari, Connie; Ingersoll, Brooke; Kaiser, Ann P.; Bruinsma, Yvonne; McNerney, Erin; Wetherby, Amy; Halladay, Alycia

2015-01-01

Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. "Naturalistic Developmental Behavioral Interventions…

Neuroimaging mechanisms of change in psychotherapy for addictive behaviors: emerging translational approaches that bridge biology and behavior.

Science.gov (United States)

Feldstein Ewing, Sarah W; Chung, Tammy

2013-06-01

Research on mechanisms of behavior change provides an innovative method to improve treatment for addictive behaviors. An important extension of mechanisms of change research involves the use of translational approaches, which examine how basic biological (i.e., brain-based mechanisms) and behavioral factors interact in initiating and sustaining positive behavior change as a result of psychotherapy. Articles in this special issue include integrative conceptual reviews and innovative empirical research on brain-based mechanisms that may underlie risk for addictive behaviors and response to psychotherapy from adolescence through adulthood. Review articles discuss hypothesized mechanisms of change for cognitive and behavioral therapies, mindfulness-based interventions, and neuroeconomic approaches. Empirical articles cover a range of addictive behaviors, including use of alcohol, cigarettes, marijuana, cocaine, and pathological gambling and represent a variety of imaging approaches including fMRI, magneto-encephalography, real-time fMRI, and diffusion tensor imaging. Additionally, a few empirical studies directly examine brain-based mechanisms of change, whereas others examine brain-based indicators as predictors of treatment outcome. Finally, two commentaries discuss craving as a core feature of addiction, and the importance of a developmental approach to examining mechanisms of change. Ultimately, translational research on mechanisms of behavior change holds promise for increasing understanding of how psychotherapy may modify brain structure and functioning and facilitate the initiation and maintenance of positive treatment outcomes for addictive behaviors. 2013 APA, all rights reserved

Mindfulness for the treatment of stress disorders

DEFF Research Database (Denmark)

Pallesen, Karen Johanne; Dahlgaard, Jesper; Fjorback, Lone

2015-01-01

expression to pathological changes. We finally discuss the effects of mindfulness-based interventions on these changes. Can the damage be reversed? Stress-induced modulation of physiological processes may account for a group of poorly understood “functional” disorders, commonly labeled as “Medically...... Unexplained Symptoms”, “Functional Somatic Syndromes”, or “Bodily Distress Syndrome”. In our research clinic, we use Mindfulness Based Stress Reduction to treat patients with these disorders. The beneficial effects of the treatment have received increasing support from empirical studies, which indicate...... that mindfulness-based therapies mediate neuroplastic changes and changes in physiological stress mechanisms. We describe some of the experiences gained and results obtained using Mindfulness Based Stress Reduction in clinical treatment....

Predicting treatment noncompliance among criminal justice-mandated clients: a theoretical and empirical exploration.

Science.gov (United States)

Sung, Hung-En; Belenko, Steven; Feng, Li; Tabachnick, Carrie

2004-01-01

Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.

Evaluating guideline adherence regarding empirical vancomycin use in patients with neutropenic fever.

Science.gov (United States)

Chastain, Daniel B; Wheeler, Sarah; Franco-Paredes, Carlos; Olubajo, Babatunde; Hawkins, W Anthony

2018-04-01

The purpose of this study was to evaluate the use of empirical vancomycin for patients with neutropenic fever (NF) with regard to adherence to treatment guidelines. Adult patients with a diagnosis of neutropenia, who met the definition of NF as per treatment guidelines, were identified. Use of vancomycin was evaluated as part of empirical therapy and again after 72h. Outcomes were assessed using descriptive statistics, the Chi-square or Fisher's exact test, and univariate exact logistic regression analyses. Sixty-four patients were included. Overall, inappropriate empirical vancomycin use was observed in more than 30% of patients. Of 35 patients with indications for empirical vancomycin, only 68% received it. At 72h, appropriate vancomycin continuation, de-escalation, or discontinuation occurred in 21 of 33 patients. On univariate regression, hematological malignancy was associated with appropriate empirical vancomycin prescribing, whether initiating or withholding (odds ratio 4.0, 95% confidence interval 1.31-12.1). No variable was independently associated with inappropriate continuation at 72h. There is poor guideline adherence to vancomycin prescribing as empirical therapy and at 72-h reassessment in patients with NF. Further efforts are needed to foster a more rational use of vancomycin in patients with NF. Copyright © 2018. Published by Elsevier Ltd.

Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes.

Science.gov (United States)

Doessel, D P; Scheurer, Roman W; Chant, David C; Whiteford, Harvey

2007-01-01

Australia has a national, compulsory and universal health insurance scheme, called Medicare. In 1996 the Government changed the Medicare Benefit Schedule Book in such a way as to create different financial incentives for consumers or producers of out-of-hospital private psychiatric services, once an individual consumer had received 50 such services in a 12-month period. The Australian Government introduced a new Item (319) to cover some special cases that were affected by the policy change. At the same time, the Commonwealth introduced a 'fee-freeze' for all medical services. The purpose of this study is two-fold. First, it is necessary to describe the three policy interventions (the constraints on utilization, the operation of the new Item and the general 'fee-freeze'.) The new Item policy was essentially a mechanism to 'dampen' the effect of the 'constraint' policy, and these two policy changes will be consequently analysed as a single intervention. The second objective is to evaluate the policy intervention in terms of the (stated) Australian purpose of reducing utilization of psychiatric services, and thus reducing financial outlays. Thus, it is important to separate out the different effects of the three policies that were introduced at much the same time in November 1996 and January 1997. The econometric results indicate that the composite policy change (constraining services and the new 319 Item) had a statistically significant effect. The analysis of the Medicare Benefit (in constant prices) indicates that the 'fee-freeze' policy also had a statistically significant effect. This enables separate determination of the several policy changes. In fact, the empirical results indicate that the Commonwealth Government underestimated the 'savings' that would arise from the 'constraint' policy.

Empirical data and moral theory. A plea for integrated empirical ethics.

Science.gov (United States)

Molewijk, Bert; Stiggelbout, Anne M; Otten, Wilma; Dupuis, Heleen M; Kievit, Job

2004-01-01

Ethicists differ considerably in their reasons for using empirical data. This paper presents a brief overview of four traditional approaches to the use of empirical data: "the prescriptive applied ethicists," "the theorists," "the critical applied ethicists," and "the particularists." The main aim of this paper is to introduce a fifth approach of more recent date (i.e. "integrated empirical ethics") and to offer some methodological directives for research in integrated empirical ethics. All five approaches are presented in a table for heuristic purposes. The table consists of eight columns: "view on distinction descriptive-prescriptive sciences," "location of moral authority," "central goal(s)," "types of normativity," "use of empirical data," "method," "interaction empirical data and moral theory," and "cooperation with descriptive sciences." Ethicists can use the table in order to identify their own approach. Reflection on these issues prior to starting research in empirical ethics should lead to harmonization of the different scientific disciplines and effective planning of the final research design. Integrated empirical ethics (IEE) refers to studies in which ethicists and descriptive scientists cooperate together continuously and intensively. Both disciplines try to integrate moral theory and empirical data in order to reach a normative conclusion with respect to a specific social practice. IEE is not wholly prescriptive or wholly descriptive since IEE assumes an interdepence between facts and values and between the empirical and the normative. The paper ends with three suggestions for consideration on some of the future challenges of integrated empirical ethics.

Paclitaxel/carboplatin with or without belinostat as empiric first-line treatment for patients with carcinoma of unknown primary site

DEFF Research Database (Denmark)

Hainsworth, John D; Daugaard, Gedske; Lesimple, Thierry

2015-01-01

: The addition of belinostat to paclitaxel/carboplatin did not improve the PFS of patients with CUP who were receiving first-line therapy, although the patients who received belinostat had a higher investigator-assessed response rate. Future trials in CUP should focus on specific subsets, defined either......BACKGROUND: The objective of this study was to evaluate the efficacy of belinostat, a histone deacetylase inhibitor, when added to paclitaxel/carboplatin in the empiric first-line treatment of patients with carcinoma of unknown primary site (CUP). METHODS: In this randomized phase 2 trial......, previously untreated patients with CUP were randomized to receive belinostat plus paclitaxel/carboplatin (group A) or paclitaxel/carboplatin alone (group B) repeated every 21 days. Patients were re-evaluated every 2 cycles, and those without disease progression continued treatment for 6 cycles. Patients...

Meta-Analysis and Cost Comparison of Empirical versus Pre-Emptive Antifungal Strategies in Hematologic Malignancy Patients with High-Risk Febrile Neutropenia.

Directory of Open Access Journals (Sweden)

Monica Fung

Full Text Available Invasive fungal disease (IFD causes significant morbidity and mortality in hematologic malignancy patients with high-risk febrile neutropenia (FN. These patients therefore often receive empirical antifungal therapy. Diagnostic test-guided pre-emptive antifungal therapy has been evaluated as an alternative treatment strategy in these patients.We conducted an electronic search for literature comparing empirical versus pre-emptive antifungal strategies in FN among adult hematologic malignancy patients. We systematically reviewed 9 studies, including randomized-controlled trials, cohort studies, and feasibility studies. Random and fixed-effect models were used to generate pooled relative risk estimates of IFD detection, IFD-related mortality, overall mortality, and rates and duration of antifungal therapy. Heterogeneity was measured via Cochran's Q test, I2 statistic, and between study τ2. Incorporating these parameters and direct costs of drugs and diagnostic testing, we constructed a comparative costing model for the two strategies. We conducted probabilistic sensitivity analysis on pooled estimates and one-way sensitivity analyses on other key parameters with uncertain estimates.Nine published studies met inclusion criteria. Compared to empirical antifungal therapy, pre-emptive strategies were associated with significantly lower antifungal exposure (RR 0.48, 95% CI 0.27-0.85 and duration without an increase in IFD-related mortality (RR 0.82, 95% CI 0.36-1.87 or overall mortality (RR 0.95, 95% CI 0.46-1.99. The pre-emptive strategy cost $324 less (95% credible interval -$291.88 to $418.65 pre-emptive compared to empirical than the empirical approach per FN episode. However, the cost difference was influenced by relatively small changes in costs of antifungal therapy and diagnostic testing.Compared to empirical antifungal therapy, pre-emptive antifungal therapy in patients with high-risk FN may decrease antifungal use without increasing mortality

Meta-Analysis and Cost Comparison of Empirical versus Pre-Emptive Antifungal Strategies in Hematologic Malignancy Patients with High-Risk Febrile Neutropenia.

Science.gov (United States)

Fung, Monica; Kim, Jane; Marty, Francisco M; Schwarzinger, Michaël; Koo, Sophia

2015-01-01

Invasive fungal disease (IFD) causes significant morbidity and mortality in hematologic malignancy patients with high-risk febrile neutropenia (FN). These patients therefore often receive empirical antifungal therapy. Diagnostic test-guided pre-emptive antifungal therapy has been evaluated as an alternative treatment strategy in these patients. We conducted an electronic search for literature comparing empirical versus pre-emptive antifungal strategies in FN among adult hematologic malignancy patients. We systematically reviewed 9 studies, including randomized-controlled trials, cohort studies, and feasibility studies. Random and fixed-effect models were used to generate pooled relative risk estimates of IFD detection, IFD-related mortality, overall mortality, and rates and duration of antifungal therapy. Heterogeneity was measured via Cochran's Q test, I2 statistic, and between study τ2. Incorporating these parameters and direct costs of drugs and diagnostic testing, we constructed a comparative costing model for the two strategies. We conducted probabilistic sensitivity analysis on pooled estimates and one-way sensitivity analyses on other key parameters with uncertain estimates. Nine published studies met inclusion criteria. Compared to empirical antifungal therapy, pre-emptive strategies were associated with significantly lower antifungal exposure (RR 0.48, 95% CI 0.27-0.85) and duration without an increase in IFD-related mortality (RR 0.82, 95% CI 0.36-1.87) or overall mortality (RR 0.95, 95% CI 0.46-1.99). The pre-emptive strategy cost $324 less (95% credible interval -$291.88 to $418.65 pre-emptive compared to empirical) than the empirical approach per FN episode. However, the cost difference was influenced by relatively small changes in costs of antifungal therapy and diagnostic testing. Compared to empirical antifungal therapy, pre-emptive antifungal therapy in patients with high-risk FN may decrease antifungal use without increasing mortality. We

Electricity markets evolution with the changing generation mix: An empirical analysis based on China 2050 High Renewable Energy Penetration Roadmap

International Nuclear Information System (INIS)

Zou, Peng; Chen, Qixin; Yu, Yang; Xia, Qing; Kang, Chongqing

2017-01-01

Highlights: • How electricity markets are evolving with the changing generation mix is studied. • China 2050 High Renewable Energy Penetration Roadmap are empirically analysed. • A multi-period Nash-Cournot model is established to study the market equilibrium. • Energy storages are analysed and compared to reveal their impacts on the equilibrium. - Abstract: The power generation mix are significantly changing due to the growth of stricter energy policies. The renewables are increasingly penetrating the power systems and leading to more clean energy and lower energy prices. However, they also require much more flexibilities and ancillary services to handle their uncertainties and variabilities. Thus, the requirements for regulation and reserve services may dramatically increase while the supplies of these services, which are mainly from the traditional thermal plants, remain almost invariant. This changing situation will cause higher regulation and reserve prices and impact the profit models and revenue structures of the traditional plants. How electricity markets are actually evolving with the changing generation mix? Can enough backup power plants be given adequate economic incentives and thus remained with the increasing renewables and the decreasing energy prices and productions? Can de-carbonization be fully performed in power systems? To explicitly answer the question, this paper uses a multi-period Nash-Cournot equilibrium model to formulate the evolution of power markets incorporating different types of generators, including thermal units, hydro units, wind farms, solar stations and energy storage systems. The price changes in the co-optimized energy, regulation and reserve markets, and the profit changes of various generators are studied. And the variabilities and uncertainties of renewable generation sources are considered in dynamically determining the requirements of regulation and reserve services. Based on the China 2050 High Renewable Energy

Empirically Based Myths: Astrology, Biorhythms, and ATIs.

Science.gov (United States)

Ragsdale, Ronald G.

1980-01-01

A myth may have an empirical basis through chance occurrence; perhaps Aptitude Treatment Interactions (ATIs) are in this category. While ATIs have great utility in describing, planning, and implementing instruction, few disordinal interactions have been found. Article suggests narrowing of ATI research with replications and estimates of effect…

Evaluating guideline adherence regarding empirical vancomycin use in patients with neutropenic fever

Directory of Open Access Journals (Sweden)

Daniel B. Chastain

2018-04-01

Full Text Available Objective: The purpose of this study was to evaluate the use of empirical vancomycin for patients with neutropenic fever (NF with regard to adherence to treatment guidelines. Methods: Adult patients with a diagnosis of neutropenia, who met the definition of NF as per treatment guidelines, were identified. Use of vancomycin was evaluated as part of empirical therapy and again after 72 h. Outcomes were assessed using descriptive statistics, the Chi-square or Fisher’s exact test, and univariate exact logistic regression analyses. Results: Sixty-four patients were included. Overall, inappropriate empirical vancomycin use was observed in more than 30% of patients. Of 35 patients with indications for empirical vancomycin, only 68% received it. At 72 h, appropriate vancomycin continuation, de-escalation, or discontinuation occurred in 21 of 33 patients. On univariate regression, hematological malignancy was associated with appropriate empirical vancomycin prescribing, whether initiating or withholding (odds ratio 4.0, 95% confidence interval 1.31–12.1. No variable was independently associated with inappropriate continuation at 72 h. Conclusions: There is poor guideline adherence to vancomycin prescribing as empirical therapy and at 72-h reassessment in patients with NF. Further efforts are needed to foster a more rational use of vancomycin in patients with NF. Keywords: Antibiotics, Neutropenia, Neutropenic fever, Vancomycin

The Role of Empirical Evidence for Transferring a New Technology to Industry

Science.gov (United States)

Baldassarre, Maria Teresa; Bruno, Giovanni; Caivano, Danilo; Visaggio, Giuseppe

Technology transfer and innovation diffusion are key success factors for an enterprise. The shift to a new software technology involves, on one hand, inevitable changes to ingrained and familiar processes and, on the other, requires training, changes in practices and commitment on behalf of technical staff and management. Nevertheless, industry is often reluctant to innovation due to the changes it determines. The process of innovation diffusion is easier if the new technology is supported by empirical evidence. In this sense our conjecture is that Empirical Software Engineering (ESE) serves as means for validating and transferring a new technology within production processes. In this paper, the authors report their experience of a method, Multiview Framework, defined in the SERLAB research laboratory as support for designing and managing a goal oriented measurement program that has been validated through various empirical studies before being transferred to an Italian SME. Our discussion points out the important role of empirical evidence for obtaining management commitment and buy-in on behalf of technical staff, and for making technological transfer possible.

Mindfulness for the treatment of stress disorders

DEFF Research Database (Denmark)

Pallesen, Karen Johanne; Dahlgaard, Jesper Ovesen; Fjorback, Lone Overby

2016-01-01

track from epigenetic influences via altered gene expression to pathological changes. We finally discuss the effects of mindfulness-based interventions on these changes. Can the damage be reversed? Stress-induced modulation of physiological processes may account for a group of poorly understood...... “functional” disorders, commonly labeled as “Medically Unexplained Symptoms”, “Functional Somatic Syndromes”, or “Bodily Distress Syndrome”. In our research clinic, we use Mindfulness Based Stress Reduction to treat patients with these disorders. The beneficial effects of the treatment have received...... increasing support from empirical studies, which indicate that mindfulness-based therapies mediate neuroplastic changes and changes in physiological stress mechanisms. We describe some of the experiences gained and results obtained using Mindfulness Based Stress Reduction in clinical treatment. Keywords...

Stories of change in drug treatment

DEFF Research Database (Denmark)

Andersen, Ditte

2015-01-01

’ (story content) and ‘the hows’ (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug...... treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both ‘the whats...... treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged...

Empiric outpatient therapy with trimethoprim-sulfamethoxazole, cephalexin, or clindamycin for cellulitis.

Science.gov (United States)

Khawcharoenporn, Thana; Tice, Alan

2010-10-01

Limited data exist on optimal empiric oral antibiotic treatment for outpatients with cellulitis in areas with a high prevalence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) infections. We conducted a 3-year retrospective cohort study of outpatients with cellulitis empirically treated at a teaching clinic of a tertiary-care medical center in Hawaii. Patients who received more than 1 oral antibiotic, were hospitalized, or had no follow-up information were excluded. Treatment success rates for empiric therapy were compared among commonly prescribed antibiotics in our clinic: cephalexin, trimethoprim-sulfamethoxazole, and clindamycin. Risk factors for treatment failure were evaluated using multivariate logistic regression analysis. Of 544 patients with cellulitis, 405 met the inclusion criteria. The overall treatment success rate of trimethoprim-sulfamethoxazole was significantly higher than the rate of cephalexin (91% vs 74%; P<.001), whereas clindamycin success rates were higher than those of cephalexin in patients who had subsequently culture-confirmed MRSA infections (P=.01), had moderately severe cellulitis (P=.03), and were obese (P=.04). Methicillin-resistant S. aureus was recovered in 72 of 117 positive culture specimens (62%). Compliance and adverse drug reaction rates were not significantly different among patients who received these 3 antibiotics. Factors associated with treatment failure included therapy with an antibiotic that was not active against community-associated MRSA (adjusted odds ratio 4.22; 95% confidence interval, 2.25-7.92; P<.001) and severity of cellulitis (adjusted odds ratio 3.74; 95% confidence interval, 2.06-6.79; P<.001). Antibiotics with activity against community-associated MRSA, such as trimethoprim-sulfamethoxazole and clindamycin, are preferred empiric therapy for outpatients with cellulitis in the community-associated MRSA-prevalent setting. Copyright © 2010 Elsevier Inc. All rights reserved.

Empirical psychology, common sense, and Kant's empirical markers for moral responsibility.

Science.gov (United States)

Frierson, Patrick

2008-12-01

This paper explains the empirical markers by which Kant thinks that one can identify moral responsibility. After explaining the problem of discerning such markers within a Kantian framework I briefly explain Kant's empirical psychology. I then argue that Kant's empirical markers for moral responsibility--linked to higher faculties of cognition--are not sufficient conditions for moral responsibility, primarily because they are empirical characteristics subject to natural laws. Next. I argue that these markers are not necessary conditions of moral responsibility. Given Kant's transcendental idealism, even an entity that lacks these markers could be free and morally responsible, although as a matter of fact Kant thinks that none are. Given that they are neither necessary nor sufficient conditions, I discuss the status of Kant's claim that higher faculties are empirical markers of moral responsibility. Drawing on connections between Kant's ethical theory and 'common rational cognition' (4:393), I suggest that Kant's theory of empirical markers can be traced to ordinary common sense beliefs about responsibility. This suggestion helps explain both why empirical markers are important and what the limits of empirical psychology are within Kant's account of moral responsibility.

The effect of loss functions on empirical Bayes reliability analysis

Directory of Open Access Journals (Sweden)

Camara Vincent A. R.

1998-01-01

Full Text Available The aim of the present study is to investigate the sensitivity of empirical Bayes estimates of the reliability function with respect to changing of the loss function. In addition to applying some of the basic analytical results on empirical Bayes reliability obtained with the use of the “popular” squared error loss function, we shall derive some expressions corresponding to empirical Bayes reliability estimates obtained with the Higgins–Tsokos, the Harris and our proposed logarithmic loss functions. The concept of efficiency, along with the notion of integrated mean square error, will be used as a criterion to numerically compare our results. It is shown that empirical Bayes reliability functions are in general sensitive to the choice of the loss function, and that the squared error loss does not always yield the best empirical Bayes reliability estimate.

Theoretical and Empirical Descriptions of Thermospheric Density

Science.gov (United States)

Solomon, S. C.; Qian, L.

2004-12-01

The longest-term and most accurate overall description the density of the upper thermosphere is provided by analysis of change in the ephemeris of Earth-orbiting satellites. Empirical models of the thermosphere developed in part from these measurements can do a reasonable job of describing thermospheric properties on a climatological basis, but the promise of first-principles global general circulation models of the coupled thermosphere/ionosphere system is that a true high-resolution, predictive capability may ultimately be developed for thermospheric density. However, several issues are encountered when attempting to tune such models so that they accurately represent absolute densities as a function of altitude, and their changes on solar-rotational and solar-cycle time scales. Among these are the crucial ones of getting the heating rates (from both solar and auroral sources) right, getting the cooling rates right, and establishing the appropriate boundary conditions. However, there are several ancillary issues as well, such as the problem of registering a pressure-coordinate model onto an altitude scale, and dealing with possible departures from hydrostatic equilibrium in empirical models. Thus, tuning a theoretical model to match empirical climatology may be difficult, even in the absence of high temporal or spatial variation of the energy sources. We will discuss some of the challenges involved, and show comparisons of simulations using the NCAR Thermosphere-Ionosphere-Electrodynamics General Circulation Model (TIE-GCM) to empirical model estimates of neutral thermosphere density and temperature. We will also show some recent simulations using measured solar irradiance from the TIMED/SEE instrument as input to the TIE-GCM.

Darwinism and cultural change.

Science.gov (United States)

Godfrey-Smith, Peter

2012-08-05

Evolutionary models of cultural change have acquired an important role in attempts to explain the course of human evolution, especially our specialization in knowledge-gathering and intelligent control of environments. In both biological and cultural change, different patterns of explanation become relevant at different 'grains' of analysis and in contexts associated with different explanatory targets. Existing treatments of the evolutionary approach to culture, both positive and negative, underestimate the importance of these distinctions. Close attention to grain of analysis motivates distinctions between three possible modes of cultural evolution, each associated with different empirical assumptions and explanatory roles.

Treatment Changes in Patients With Moderate to Severe Psoriasis: A Retrospective Chart Review.

Science.gov (United States)

Smith, Jaclyn A; Wehausen, Brooke; Richardson, Irma; Zhao, Yang; Li, Yunfeng; Herrera, Vivian; Feldman, Steven R

Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians' justifications for those changes. 'Treatment change' was defined as switching between, adding, or removing medication classes or switching within the oral or biologic class. There were 221 visits with treatment changes identified, and a change occurred every 4.1 visits. On average, there were 1.2 treatment changes per year. Patients treated for at least 1 year averaged 1 treatment change every 16 months. The most common type of change was from one biologic to another biologic (24.9%), followed by adding a nonbiologic to a biologic (18.6%). The most common reason for switching was poor control or flare of psoriasis. Affordability was a more common problem for biologics than for nonbiologic treatments. Biologic treatment options provide a major improvement over older systemic treatments, but patients still undergo frequent treatment changes to help control their disease.

Unveiling the checkered fortunes of the Ottoman Empire

OpenAIRE

Dimitrova-Grajzl, Valentina

2013-01-01

The Ottoman Empire has been predominantly viewed as the ćSick Man of Europe.ć The question arises, however, how this perceived inefficiency can be reconciled with the long existence and prosperity of the Empire. I argue that the Ottoman system could have been efficient subject to constraints. More specifically, I explore the role of the technology of predation and the adherence to the law in determining relative changes in the social order and the power of the Sultan, which in turn led to the...

Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Changing the Conversation.

Science.gov (United States)

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

This report is the result of five expert panels and six regional public hearings around the country that focused on key persistent issues that have characterized discussions of substance abuse over the years: closing the treatment gap; reducing stigma and changing attitudes; improving and strengthening treatment systems; connecting services and…

Empirical estimation of present-day Antarctic glacial isostatic adjustment and ice mass change

Science.gov (United States)

Gunter, B. C.; Didova, O.; Riva, R. E. M.; Ligtenberg, S. R. M.; Lenaerts, J. T. M.; King, M. A.; van den Broeke, M. R.; Urban, T.

2014-04-01

This study explores an approach that simultaneously estimates Antarctic mass balance and glacial isostatic adjustment (GIA) through the combination of satellite gravity and altimetry data sets. The results improve upon previous efforts by incorporating a firn densification model to account for firn compaction and surface processes as well as reprocessed data sets over a slightly longer period of time. A range of different Gravity Recovery and Climate Experiment (GRACE) gravity models were evaluated and a new Ice, Cloud, and Land Elevation Satellite (ICESat) surface height trend map computed using an overlapping footprint approach. When the GIA models created from the combination approach were compared to in situ GPS ground station displacements, the vertical rates estimated showed consistently better agreement than recent conventional GIA models. The new empirically derived GIA rates suggest the presence of strong uplift in the Amundsen Sea sector in West Antarctica (WA) and the Philippi/Denman sectors, as well as subsidence in large parts of East Antarctica (EA). The total GIA-related mass change estimates for the entire Antarctic ice sheet ranged from 53 to 103 Gt yr-1, depending on the GRACE solution used, with an estimated uncertainty of ±40 Gt yr-1. Over the time frame February 2003-October 2009, the corresponding ice mass change showed an average value of -100 ± 44 Gt yr-1 (EA: 5 ± 38, WA: -105 ± 22), consistent with other recent estimates in the literature, with regional mass loss mostly concentrated in WA. The refined approach presented in this study shows the contribution that such data combinations can make towards improving estimates of present-day GIA and ice mass change, particularly with respect to determining more reliable uncertainties.

Inglorious Empire

DEFF Research Database (Denmark)

Khair, Tabish

2017-01-01

Review of 'Inglorious Empire: What the British did to India' by Shashi Tharoor, London, Hurst Publishers, 2017, 296 pp., £20.00......Review of 'Inglorious Empire: What the British did to India' by Shashi Tharoor, London, Hurst Publishers, 2017, 296 pp., £20.00...

Dropout among patients in qualified alcohol detoxification treatment: the effect of treatment motivation is moderated by Trauma Load.

Science.gov (United States)

Odenwald, Michael; Semrau, Peter

2013-03-21

Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, but this has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change and behavioral change. Over the course of two months in 2009, 55 patients admitted to an alcohol detoxification unit of a psychiatric hospital were enrolled in this study. At treatment entry, we assessed lifetime Trauma Load and motivation to change. Mode of discharge was taken from patient files following therapy. We tested whether Trauma Load moderates the effect of motivation to change on dropout from alcohol detoxification using multivariate methods. 55.4% dropped out of detoxification treatment, while 44.6% completed the treatment. Age, gender and days in treatment did not differ between completers and dropouts. Patients who dropped out reported more traumatic event types on average than completers. Treatment completers had higher scores in the URICA subscale Maintenance. Multivariate methods confirmed the moderator effect of Trauma Load: among participants with high Trauma Load, treatment completion was related to higher Maintenance scores at treatment entry; this was not true among patients with low Trauma Load. We found evidence that the effect of motivation to change on detoxification treatment completion is moderated by Trauma Load: among patients with low Trauma Load, motivation to change is not relevant for treatment completion; among highly burdened patients, however, who a priori have a greater risk of dropping out, a high motivation to change might make the difference. This finding justifies targeted and specific interventions for highly burdened alcohol patients to increase their motivation to change.

The effect of loss functions on empirical Bayes reliability analysis

Directory of Open Access Journals (Sweden)

Vincent A. R. Camara

1999-01-01

Full Text Available The aim of the present study is to investigate the sensitivity of empirical Bayes estimates of the reliability function with respect to changing of the loss function. In addition to applying some of the basic analytical results on empirical Bayes reliability obtained with the use of the “popular” squared error loss function, we shall derive some expressions corresponding to empirical Bayes reliability estimates obtained with the Higgins–Tsokos, the Harris and our proposed logarithmic loss functions. The concept of efficiency, along with the notion of integrated mean square error, will be used as a criterion to numerically compare our results.

Psychological treatment and therapeutic change in incarcerated rapists

Directory of Open Access Journals (Sweden)

Ana Martínez-Catena

2017-01-01

Full Text Available Abstract Most Spanish prisons provide specialised treatment for incarcerated sex offenders, both rapists and child molesters. This treatment is a cognitive-behavioural intervention that has shown relative effectiveness in previous research. With regard to offenders’ rehabilitation, recidivism assessments are necessary as a final measure of treatment effectiveness. However, the evaluation of recidivism by itself does not provide sufficient information on the treatment process and the specific effects that treated subjects could undergo. This paper aims to analyse the therapeutic effectiveness of psychological treatment provided to rapists (in general, males sentenced for committing a sexual offence against women. To this aim, a group of treated rapists (N=153 serving a sentence in prison was analysed. Using a specially designed scale (PASSO, the global therapeutic change and ten specific variables (including assertiveness, readiness to change, cognitive distortions, impulsivity, etc. were assessed. The within-subjects comparison showed that treated sex offenders improved, in therapeutic terms, globally as well as in most of the specific variables assessed (improvements not experimented by the control group. Also, different therapeutic subscales showed relevant associations between them. The findings regarding treatment effectiveness are discussed.

Mechanisms of change in psychotherapy for depression: An empirical update and evaluation of research aimed at identifying psychological mediators.

Science.gov (United States)

Lemmens, Lotte H J M; Müller, Viola N L S; Arntz, Arnoud; Huibers, Marcus J H

2016-12-01

We present a systematic empirical update and critical evaluation of the current status of research aimed at identifying a variety of psychological mediators in various forms of psychotherapy for depression. We summarize study characteristics and results of 35 relevant studies, and discuss the extent to which these studies meet several important requirements for mechanism research. Our review indicates that in spite of increased attention for the topic, advances in theoretical consensus about necessities for mechanism research, and sophistication of study designs, research in this field is still heterogeneous and unsatisfactory in methodological respect. Probably the biggest challenge in the field is demonstrating the causal relation between change in the mediator and change in depressive symptoms. The field would benefit from a further refinement of research methods to identify processes of therapeutic change. Recommendations for future research are discussed. However, even in the most optimal research designs, explaining psychotherapeutic change remains a challenge. Psychotherapy is a multi-dimensional phenomenon that might work through interplay of multiple mechanisms at several levels. As a result, it might be too complex to be explained in relatively simple causal models of psychological change. Copyright © 2016 Elsevier Ltd. All rights reserved.

Rapid treatment-induced brain changes in pediatric CRPS.

Science.gov (United States)

Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David

2016-03-01

To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex- and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation.

Pluvials, Droughts, Energetics, and the Mongol Empire

Science.gov (United States)

Hessl, A. E.; Pederson, N.; Baatarbileg, N.

2012-12-01

consistent with a well-documented volcanic eruption that caused massive crop damage and famine throughout much of Europe. In Mongol history, this abrupt cooling also coincides with the move of the capital from Central Mongolia (Karakorum) to China (Beijing). In combination, the tree-ring records of water and temperature suggest that 1) the rise of the Mongol Empire occurred during an unusually consistent warm and wet climate and 2) the disintegration of the Empire occurred following a plunge into cold and dry conditions in Central Mongolia. These results represent the first step of a larger project integrating physical science and history to understand the role of energy in the evolution of the Mongol Empire. Using data from historic documents, ecological modeling, tree rings, and sediment cores, we will investigate whether the expansion and contraction of the empire was related to moisture and temperature availability and thus grassland productivity associated with climate change in the Orkhon Valley.

Dissociative identity disorder: An empirical overview.

Science.gov (United States)

Dorahy, Martin J; Brand, Bethany L; Sar, Vedat; Krüger, Christa; Stavropoulos, Pam; Martínez-Taboas, Alfonso; Lewis-Fernández, Roberto; Middleton, Warwick

2014-05-01

Despite its long and auspicious place in the history of psychiatry, dissociative identity disorder (DID) has been associated with controversy. This paper aims to examine the empirical data related to DID and outline the contextual challenges to its scientific investigation. The overview is limited to DID-specific research in which one or more of the following conditions are met: (i) a sample of participants with DID was systematically investigated, (ii) psychometrically-sound measures were utilised, (iii) comparisons were made with other samples, (iv) DID was differentiated from other disorders, including other dissociative disorders, (v) extraneous variables were controlled or (vi) DID diagnosis was confirmed. Following an examination of challenges to research, data are organised around the validity and phenomenology of DID, its aetiology and epidemiology, the neurobiological and cognitive correlates of the disorder, and finally its treatment. DID was found to be a complex yet valid disorder across a range of markers. It can be accurately discriminated from other disorders, especially when structured diagnostic interviews assess identity alterations and amnesia. DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma. The prevalence of DID appears highest in emergency psychiatric settings and affects approximately 1% of the general population. Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions. They are also providing an understanding of the potential metacognitive origins of amnesia. Phase-oriented empirically-guided treatments are emerging for DID. The empirical literature on DID is accumulating, although some areas remain under-investigated. Existing data show DID as a complex, valid and not uncommon disorder, associated with developmental and cultural variables, that is amenable to

Changes in different organic matter fractions during conventional treatment and advanced treatment

Institute of Scientific and Technical Information of China (English)

Chao Chen; Xiaojian Zhang; Lingxia Zhu; Wenjie He; Hongda Han

2011-01-01

XAD-8 resin isolation of organic matter in water was used to divide organic matter into the hydrophobic and hydrophilic fractions.A pilot plant was used to investigate the change in both fractions during conventional and advanced treatment processes.The treatment of hydrophobic organics (HPO), rather than hydrophilic organicas (HPI), should carry greater emphasis due to HPO's higher trihalomethane formation potential (THMFP) and haloacetic acid formation potential (HAAFP).The removal of hydrophobic matter and its transmission into hydrophilic matter reduced ultimate DBP yield during the disinfection process.The results showed that sand filtration, ozonation, and biological activated carbon (BAC) filtration had distinct influences on the removal of both organic fractions.Additionally, the combination of processes changed the organic fraction proportions present during treatment.The use of ozonation and BAC maximized organic matter removal efficiency, especially for the hydrophobic fraction.In sum, the combination of pre-ozonation,conventional treatment, and O3-BAC removed 48％ of dissolved organic carbon (DOC), 60％ of HPO, 30％ of HPI, 63％ of THMFP,and 85％ of HAAFP.The use of conventional treatment and O3-BAC without pre-ozonation had a comparable performance, removing 51％ of DOC, 56％ of HPO, 45％ of HPI, 61％ of THMFP, and 72％ of HAAFP.The effectiveness of this analysis method indicated that resin isolation and fractionation should be standardized as an applicable test to help assess water treatment process efficiency.

Therapeutic assessment promotes treatment readiness but does not affect symptom change in patients with personality disorders: Findings from a randomized clinical trial

NARCIS (Netherlands)

de Saeger, H.; Kamphuis, J.H.; Finn, S.E.; Smith, J.D.; Verheul, R.; van Busschbach, J.J.; Feenstra, D.J.; Dine, J.; Horn, E.K.

2014-01-01

The field of clinical personality assessment is lacking in published empirical evidence regarding its treatment and clinical utility. This article reports on a randomized controlled clinical trial (N = 74) allocating patients awaiting treatment in a specialized clinic for personality disorders to

Empirical Descriptions of Criminal Sentencing Decision-Making

Directory of Open Access Journals (Sweden)

Rasmus H. Wandall

2014-05-01

Full Text Available The article addresses the widespread use of statistical causal modelling to describe criminal sentencing decision-making empirically in Scandinavia. The article describes the characteristics of this model, and on this basis discusses three aspects of sentencing decision-making that the model does not capture: 1 the role of law and legal structures in sentencing, 2 the processes of constructing law and facts as they occur in the processes of handling criminal cases, and 3 reflecting newer organisational changes to sentencing decision-making. The article argues for a stronger empirically based design of sentencing models and for a more balanced use of different social scientific methodologies and models of sentencing decision-making.

Recent advances in behavioral addiction treatments: focusing on mechanisms of change.

Science.gov (United States)

Longabaugh, Richard; Magill, Molly

2011-10-01

In the latter half of the 20th century, research on behavioral treatments for addictions aimed to develop and test effective treatments. Among the treatments found to be at least moderately effective, direct comparisons failed to reveal consistent superiority of one approach over another. This ubiquitous finding held true despite underlying theories that differed markedly in their proposed causal processes related to patient change. In the 21st century, the focus of treatment research is increasingly on how treatment works for whom rather than whether it works. Studies of active treatment ingredients and mechanisms of behavioral change, while promising, have yielded inconsistent results. Simple mediation analysis may need to be expanded via inclusion of models testing for moderated mediation, mediated moderation, and conditional indirect effects. Examples are offered as to how these more complex models can lead to increased understanding of the conditions under which specific treatment interventions will be effective and mechanisms of change operative in improving behavioral treatments for addictions.

Functional Measurement in the Field of Empirical Bioethics

Science.gov (United States)

Mullet, Etienne; Sorum, Paul C.; Teysseire, Nathalie; Nann, Stephanie; Martinez, Guadalupe Elizabeth Morales; Ahmed, Ramadan; Kamble, Shanmukh; Olivari, Cecilia; Sastre, Maria Teresa Munoz

2012-01-01

We present, in a synthetic way, some of the main findings from five studies that were conducted in the field of empirical bioethics, using the Functional Measurement framework. These studies were about (a) the rationing of rare treatments, (b) adolescents' abortions, (c) end-of-life decision-making regarding damaged neonates, (d) end-of-life…

Reflective equilibrium and empirical data: third person moral experiences in empirical medical ethics.

Science.gov (United States)

De Vries, Martine; Van Leeuwen, Evert

2010-11-01

In ethics, the use of empirical data has become more and more popular, leading to a distinct form of applied ethics, namely empirical ethics. This 'empirical turn' is especially visible in bioethics. There are various ways of combining empirical research and ethical reflection. In this paper we discuss the use of empirical data in a special form of Reflective Equilibrium (RE), namely the Network Model with Third Person Moral Experiences. In this model, the empirical data consist of the moral experiences of people in a practice. Although inclusion of these moral experiences in this specific model of RE can be well defended, their use in the application of the model still raises important questions. What precisely are moral experiences? How to determine relevance of experiences, in other words: should there be a selection of the moral experiences that are eventually used in the RE? How much weight should the empirical data have in the RE? And the key question: can the use of RE by empirical ethicists really produce answers to practical moral questions? In this paper we start to answer the above questions by giving examples taken from our research project on understanding the norm of informed consent in the field of pediatric oncology. We especially emphasize that incorporation of empirical data in a network model can reduce the risk of self-justification and bias and can increase the credibility of the RE reached. © 2009 Blackwell Publishing Ltd.

Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies

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Christian Roesler

2013-10-01

Full Text Available Since the 1990s several research projects and empirical studies (process and outcome on Jungian Psychotherapy have been conducted mainly in Germany and Switzerland. Prospective, naturalistic outcome studies and retrospective studies using standardized instruments and health insurance data as well as several qualitative studies of aspects of the psychotherapeutic process will be summarized. The studies are diligently designed and the results are well applicable to the conditions of outpatient practice. All the studies show significant improvements not only on the level of symptoms and interpersonal problems, but also on the level of personality structure and in every day life conduct. These improvements remain stable after completion of therapy over a period of up to six years. Several studies show further improvements after the end of therapy, an effect which psychoanalysis has always claimed. Health insurance data show that, after Jungian therapy, patients reduce health care utilization to a level even below the average of the total population. Results of several studies show that Jungian treatment moves patients from a level of severe symptoms to a level where one can speak of psychological health. These significant changes are reached by Jungian therapy with an average of 90 sessions, which makes Jungian psychotherapy an effective and cost-effective method. Process studies support Jungian theories on psychodynamics and elements of change in the therapeutic process. So finally, Jungian psychotherapy has reached the point where it can be called an empirically proven, effective method.

Empirical research in medical ethics: How conceptual accounts on normative-empirical collaboration may improve research practice

Science.gov (United States)

2012-01-01

Background The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration and studies which use socio-empirical methods to investigate ethically relevant issues in concrete social contexts. Discussion A considered reference to normative research questions can be expected from good quality empirical research in medical ethics. However, a significant proportion of empirical studies currently published in medical ethics lacks such linkage between the empirical research and the normative analysis. In the first part of this paper, we will outline two typical shortcomings of empirical studies in medical ethics with regard to a link between normative questions and empirical data: (1) The complete lack of normative analysis, and (2) cryptonormativity and a missing account with regard to the relationship between 'is' and 'ought' statements. Subsequently, two selected concepts of empirical-normative collaboration will be presented and how these concepts may contribute to improve the linkage between normative and empirical aspects of empirical research in medical ethics will be demonstrated. Based on our analysis, as well as our own practical experience with empirical research in medical ethics, we conclude with a sketch of concrete suggestions for the conduct of empirical research in medical ethics. Summary High quality empirical research in medical ethics is in need of a considered reference to normative analysis. In this paper, we demonstrate how conceptual approaches of empirical-normative collaboration can enhance empirical research in medical ethics with regard to the link between empirical research and normative analysis. PMID:22500496

Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

DEFF Research Database (Denmark)

Faber, J; Petersen, L; Wiinberg, N

2002-01-01

by LT(4) (p treatment in SH results in changes in hemodynamic parameters of potentially beneficial character. SH and overt hypothyroidism should......In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH......) and T(3) estimates) LT(4) treatment resulted in 6% reduction in supine MAP (p treatment (p

Angulation change of the third molar tooth in orthodontic treatment

Directory of Open Access Journals (Sweden)

Ardiansyah S. Pawinru

2017-04-01

Full Text Available Objective : Impaction of the third molar tooth mandibular is often found in patients with orthodontic treatment. In orthodontic treatment, extraction cases of impaction of the third molar tooth are usually performed, but the patients often refuse this extraction. Extraction of premolar has a good effect on the third molar mandibular angulation during treatment. Material and Methods : This study is a retrospective clinical study with descriptive analytic to find out the effect of the first mandibular premolar tooth extraction to angulation change of the third molar mandibular in orthodontic treatment with a standard edgewise method. Angulation change was performed by comparing the third molar mandibular angulation before and after orthodontic treatment with panoramic radiographs. Angulation of the third molar tooth mandibular was calculated from the angle formed between the long axis of the tooth with the reference line infraorbita. Results : The sample comprised 60 of impacted mandibular third molar region of the left and right regions of 30 patients who had been treated declared cured in clinic of orthodontic specialist of Dentistry Faculty Padjadjaran University. The sample was divided into three (3 groups of patients before treatment angulation of the third molar tooth mandibular under 300, 300 to 600 and above 60o, then measured change of angulation and observed whether it increased, fixed or decreased. Results were analyzed by T- test and Wilcoxon test showed that there was a significant change in angulation of the third molar mandibular in orthodontic treatment with the first premolar tooth mandibular extraction. Conclusion : This study is that the first premolar tooth mandibular extraction affects the angulation of the third molar tooth mandibular after orthodontic treatment.

Motivation for change as a predictor of treatment response for dysthymia.

Science.gov (United States)

Frías Ibáñez, Álvaro; González Vallespí, Laura; Palma Sevillano, Carol; Farriols Hernando, Núria

2016-05-01

Dysthymia constitutes a chronic, mild affective disorder characterized by heterogeneous treatment effects. Several predictors of clinical response and attendance have been postulated, although research on the role of the psychological variables involved in this mental disorder is still scarce. Fifty-four adult patients, who met criteria for dysthymia completed an ongoing naturalistic treatment based on the brief interpersonal psychotherapy (IPT-B), which was delivered bimonthly over 16 months. As potential predictor variables, the therapeutic alliance, coping strategies, perceived self-efficacy, and motivation for change were measured at baseline. Outcome variables were response to treatment (Clinical Global Impression and Beck’s Depression Inventory) and treatment attendance. Stepwise multiple linear regression analyses revealed that higher motivation for change predicted better response to treatment. Moreover, higher motivation for change also predicted treatment attendance. Therapeutic alliance was not a predictor variable of neither clinical response nor treatment attendance. These preliminary findings support the adjunctive use of motivational interviewing (MI) techniques in the treatment of dysthymia. Further research with larger sample size and follow-up assessment is warranted.

Health Status and Health Dynamics in an Empirical Model of Expected Longevity*

Science.gov (United States)

Benítez-Silva, Hugo; Ni, Huan

2010-01-01

Expected longevity is an important factor influencing older individuals’ decisions such as consumption, savings, purchase of life insurance and annuities, claiming of Social Security benefits, and labor supply. It has also been shown to be a good predictor of actual longevity, which in turn is highly correlated with health status. A relatively new literature on health investments under uncertainty, which builds upon the seminal work by Grossman (1972), has directly linked longevity with characteristics, behaviors, and decisions by utility maximizing agents. Our empirical model can be understood within that theoretical framework as estimating a production function of longevity. Using longitudinal data from the Health and Retirement Study, we directly incorporate health dynamics in explaining the variation in expected longevities, and compare two alternative measures of health dynamics: the self-reported health change, and the computed health change based on self-reports of health status. In 38% of the reports in our sample, computed health changes are inconsistent with the direct report on health changes over time. And another 15% of the sample can suffer from information losses if computed changes are used to assess changes in actual health. These potentially serious problems raise doubts regarding the use and interpretation of the computed health changes and even the lagged measures of self-reported health as controls for health dynamics in a variety of empirical settings. Our empirical results, controlling for both subjective and objective measures of health status and unobserved heterogeneity in reporting, suggest that self-reported health changes are a preferred measure of health dynamics. PMID:18187217

Empirical research on Waldorf education

OpenAIRE

Randoll, Dirk; Peters, Jürgen

2015-01-01

Waldorf education began in 1919 with the first Waldorf School in Stuttgart and nowadays is widespread in many countries all over the world. Empirical research, however, has been rare until the early nineties and Waldorf education has not been discussed within educational science so far. This has changed during the last decades. This article reviews the results of surveys during the last 20 years and is mainly focused on German Waldorf Schools, because most investigations have been done in thi...

Time to Guideline-Based Empiric Antibiotic Therapy in the Treatment of Pneumonia in a Community Hospital: A Retrospective Review.

Science.gov (United States)

Erwin, Beth L; Kyle, Jeffrey A; Allen, Leland N

2016-08-01

The 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines for hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health care-associated pneumonia (HCAP) stress the importance of initiating prompt appropriate empiric antibiotic therapy. This study's purpose was to determine the percentage of patients with HAP, VAP, and HCAP who received guideline-based empiric antibiotic therapy and to determine the average time to receipt of an appropriate empiric regimen. A retrospective chart review of adults with HAP, VAP, or HCAP was conducted at a community hospital in suburban Birmingham, Alabama. The hospital's electronic medical record system utilized International Classification of Diseases, Ninth Revision (ICD-9) codes to identify patients diagnosed with pneumonia. The percentage of patients who received guideline-based empiric antibiotic therapy was calculated. The mean time from suspected diagnosis of pneumonia to initial administration of the final antibiotic within the empiric regimen was calculated for patients who received guideline-based therapy. Ninety-three patients met the inclusion criteria. The overall guideline adherence rate for empiric antibiotic therapy was 31.2%. The mean time to guideline-based therapy in hours:minutes was 7:47 for HAP and 28:16 for HCAP. For HAP and HCAP combined, the mean time to appropriate therapy was 21:55. Guideline adherence rates were lower and time to appropriate empiric therapy was greater for patients with HCAP compared to patients with HAP. © The Author(s) 2015.

Forecasting land cover change impacts on drinking water treatment costs in Minneapolis, Minnesota

Science.gov (United States)

Woznicki, S. A.; Wickham, J.

2017-12-01

Source protection is a critical aspect of drinking water treatment. The benefits of protecting source water quality in reducing drinking water treatment costs are clear. However, forecasting the impacts of environmental change on source water quality and its potential to influence future treatment processes is lacking. The drinking water treatment plant in Minneapolis, MN has recognized that land cover change threatens water quality in their source watershed, the Upper Mississippi River Basin (UMRB). Over 1,000 km2 of forests, wetlands, and grasslands in the UMRB were lost to agriculture from 2008-2013. This trend, coupled with a projected population increase of one million people in Minnesota by 2030, concerns drinking water treatment plant operators in Minneapolis with respect to meeting future demand for clean water in the UMRB. The objective of this study is to relate land cover change (forest and wetland loss, agricultural expansion, urbanization) to changes in treatment costs for the Minneapolis, MN drinking water utility. To do this, we first developed a framework to determine the relationship between land cover change and water quality in the context of recent historical changes and projected future changes in land cover. Next we coupled a watershed model, the Soil and Water Assessment Tool (SWAT) to projections of land cover change from the FOREcasting SCEnarios of Land-use Change (FORE-SCE) model for the mid-21st century. Using historical Minneapolis drinking water treatment data (chemical usage and costs), source water quality in the UMRB was linked to changes in treatment requirements as a function of projected future land cover change. These analyses will quantify the value of natural landscapes in protecting drinking water quality and future treatment processes requirements. In addition, our study provides the Minneapolis drinking water utility with information critical to their planning and capital improvement process.

Review of the Empirical and Clinical Support for Group Therapy Specific to Sexual Abusers.

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Jennings, Jerry L; Deming, Adam

2017-12-01

This review compiles 48 empirical studies and 55 clinical/practice articles specific to group therapy with sex offenders. Historically, group therapy has always been the predominant modality in sex offender-specific treatment. In the first decades of the field, treatment applied a psychoanalytic methodology that, although not empirically supported, fully appreciated the primary therapeutic importance of the group modality. Conversely, since the early 1980s, treatment has applied a cognitive behavioral method, but the field has largely neglected the therapeutic value of interpersonal group dynamics. The past decade has seen a growing re-appreciation of general therapeutic processes and more holistic approaches in sex offender treatment, and there is an emerging body of empirical research which, although often indirectly concerned with group, has yielded three definitive conclusions. First, the therapeutic qualities of the group therapist-specifically warmth, empathy, encouragement, and guidance-can strongly affect outcomes. Second, the quality of group cohesion can profoundly affect the effectiveness of treatment. Third, confrontational approaches in group therapy are ineffective, if not counter-therapeutic, and overwhelmingly rated as not helpful by sex offenders themselves. Additional conclusions are less strongly supported, but include compelling evidence that sex offenders generally prefer group therapy over individual therapy, that group therapy appears equally effective to individual therapy, and that mixing or separating groups by offense type is not important to therapeutic climate. Other group techniques and approaches specific to sexual abuse treatment are also summarized.

Challenges of Empirical Antibiotic Therapy for Community-Acquired Pneumonia in Children

Directory of Open Access Journals (Sweden)

Charlene M.C. Rodrigues, MBChB, MRCPCH

2017-01-01

Conclusions: Effective and timely treatment is required for CAP and empirical antibiotics are evidence-based and appropriate in most settings. However, better diagnostics and education to target treatment may help to prevent antibiotic resistance. Ensuring the secure financing of clean food and water, sanitation, and public health infrastructure are also required to reduce the burden of disease in children in developing countries.

What 'empirical turn in bioethics'?

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Hurst, Samia

2010-10-01

Uncertainty as to how we should articulate empirical data and normative reasoning seems to underlie most difficulties regarding the 'empirical turn' in bioethics. This article examines three different ways in which we could understand 'empirical turn'. Using real facts in normative reasoning is trivial and would not represent a 'turn'. Becoming an empirical discipline through a shift to the social and neurosciences would be a turn away from normative thinking, which we should not take. Conducting empirical research to inform normative reasoning is the usual meaning given to the term 'empirical turn'. In this sense, however, the turn is incomplete. Bioethics has imported methodological tools from empirical disciplines, but too often it has not imported the standards to which researchers in these disciplines are held. Integrating empirical and normative approaches also represents true added difficulties. Addressing these issues from the standpoint of debates on the fact-value distinction can cloud very real methodological concerns by displacing the debate to a level of abstraction where they need not be apparent. Ideally, empirical research in bioethics should meet standards for empirical and normative validity similar to those used in the source disciplines for these methods, and articulate these aspects clearly and appropriately. More modestly, criteria to ensure that none of these standards are completely left aside would improve the quality of empirical bioethics research and partly clear the air of critiques addressing its theoretical justification, when its rigour in the particularly difficult context of interdisciplinarity is what should be at stake.

AN EMPIRICAL METHOD FOR MATERIALITY: WOULD CONFLICT OF INTEREST DISCLOSURES CHANGE PATIENT DECISIONS?

Science.gov (United States)

Spece, Roy; Yokum, David; Okoro, Andrea-Gale; Robertson Christopher

2014-01-01

The law has long been concerned with the agency problems that arise when advisors, such as attorneys or physicians, put themselves in financial relationships that create conflicts of interest. If the financial relationship is "material" to the transactions proposed by the advisor, then non-disclosure of the relationship may be pertinent to claims of malpractice, informed consent, and even fraud, as well as to professional discipline. In these sorts of cases, materiality is closely related to the question of causation, roughly turning on whether the withheld information might have changed the decision of a reasonable advisee (i.e., a patient). The injured plaintiff will predictably testify that the information would have impacted his or her choice, but that self-serving testimony may be unreliable. The fact finder is left to speculate about the counterfactual world in which the information was disclosed. This Article shows how randomized vignette-based experimentation may create a valuable form of evidence to address these questions, for both litigation and policymaking. To demonstrate this method and investigate conflicts of interest in healthcare in particular, we recruited 691 human subjects and asked them to imagine themselves as patients facing a choice about whether to undergo a cardiac stenting procedure recommended by a cardiologist. We manipulated the vignettes in a 2 x 3 between-subjects design, where we systematically varied the appropriateness of the proposed treatment, which was described in terms of patient risk without the procedure (low or high), and manipulated the type of disclosure provided by the physician (none, standard, or enhanced). We used physician ownership of the specialty hospital where the surgery would be performed as the conflict of interest, disclosed or not, and the "enhanced" disclosure included notice that such relationships have been associated with biases in prescribing behavior. We found that the mock patients were

On the importance of prompt oxygen changes for hypofractionated radiation treatments

International Nuclear Information System (INIS)

Kissick, Michael; Campos, David; Van der Kogel, Albert; Kimple, Randall

2013-01-01

This discussion is motivated by observations of prompt oxygen changes occurring prior to a significant number of cancer cells dying (permanently stopping their metabolic activity) from therapeutic agents like large doses of ionizing radiation. Such changes must be from changes in the vasculature that supplies the tissue or from the metabolic changes in the tissue itself. An adapted linear–quadratic treatment is used to estimate the cell survival variation magnitudes from repair and reoxygenation from a two-fraction treatment in which the second fraction would happen prior to significant cell death from the first fraction, in the large fraction limit. It is clear the effects of oxygen changes are likely to be the most significant factor for hypofractionation because of large radiation doses. It is a larger effect than repair. Optimal dose timing should be determined by the peak oxygen timing. A call is made to prioritize near real time measurements of oxygen dynamics in tumors undergoing hypofractionated treatments in order to make these treatments adaptable and patient-specific. (note)

Pre-treatment predictors and in-treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia.

Science.gov (United States)

Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold; Martinsen, Egil; Gude, Tore; Hedley, Liv Margaret; Abrahamsen, Gun

2010-01-01

We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

Orthodontic treatment plan changed by 3D images

International Nuclear Information System (INIS)

Yordanova, G.; Stanimirov, P.

2014-01-01

Clinical application of CBCT is most often enforced in dental phenomenon of impacted teeth, hyperodontia, transposition, ankyloses or root resorption and other pathologies in the maxillofacial area. The goal, we put ourselves, is to show how the information from 3D images changes the protocol of the orthodontic treatment. The material, we presented six our clinical cases and the change in the plan of the treatment, which has used after analyzing the information carried on the three planes of CBCT. These cases are casuistic in the orthodontic practice and require individual approach to each of them during their analysis and decision taken. The discussion made by us is in line with reveal of the impacted teeth, where we need to evaluate their vertical depth and mediodistal ratios with the bond structures. At patients with hyperodontia, the assessment is of outmost importance to decide which of the teeth to be extracted and which one to be arranged into the dental arch. The conclusion we make is that diagnostic information is essential for decisions about treatment plan. The exact graphs will lead to better treatment plan and more predictable results. (authors) Key words: CBCT. IMPACTED CANINES. HYPERODONTIA. TRANSPOSITION

Empiric auto-titrating CPAP in people with suspected obstructive sleep apnea.

Science.gov (United States)

Drummond, Fitzgerald; Doelken, Peter; Ahmed, Qanta A; Gilbert, Gregory E; Strange, Charlie; Herpel, Laura; Frye, Michael D

2010-04-15

Efficient diagnosis and treatment of obstructive sleep apnea (OSA) can be difficult because of time delays imposed by clinic visits and serial overnight polysomnography. In some cases, it may be desirable to initiate treatment for suspected OSA prior to polysomnography. Our objective was to compare the improvement of daytime sleepiness and sleep-related quality of life of patients with high clinical likelihood of having OSA who were randomly assigned to receive empiric auto-titrating continuous positive airway pressure (CPAP) while awaiting polysomnogram versus current usual care. Serial patients referred for overnight polysomnography who had high clinical likelihood of having OSA were randomly assigned to usual care or immediate initiation of auto-titrating CPAP. Epworth Sleepiness Scale (ESS) scores and the Functional Outcomes of Sleep Questionnaire (FOSQ) scores were obtained at baseline, 1 month after randomization, and again after initiation of fixed CPAP in control subjects and after the sleep study in auto-CPAP patients. One hundred nine patients were randomized. Baseline demographics, daytime sleepiness, and sleep-related quality of life scores were similar between groups. One-month ESS and FOSQ scores were improved in the group empirically treated with auto-titrating CPAP. ESS scores improved in the first month by a mean of -3.2 (confidence interval -1.6 to -4.8, p life in a cohort of patients awaiting polysomnography who had a high pretest probability of having OSA. Additional studies are needed to evaluate the applicability of empiric treatment to other populations.

Empirical evidence for site coefficients in building code provisions

Science.gov (United States)

Borcherdt, R.D.

2002-01-01

Site-response coefficients, Fa and Fv, used in U.S. building code provisions are based on empirical data for motions up to 0.1 g. For larger motions they are based on theoretical and laboratory results. The Northridge earthquake of 17 January 1994 provided a significant new set of empirical data up to 0.5 g. These data together with recent site characterizations based on shear-wave velocity measurements provide empirical estimates of the site coefficients at base accelerations up to 0.5 g for Site Classes C and D. These empirical estimates of Fa and Fnu; as well as their decrease with increasing base acceleration level are consistent at the 95 percent confidence level with those in present building code provisions, with the exception of estimates for Fa at levels of 0.1 and 0.2 g, which are less than the lower confidence bound by amounts up to 13 percent. The site-coefficient estimates are consistent at the 95 percent confidence level with those of several other investigators for base accelerations greater than 0.3 g. These consistencies and present code procedures indicate that changes in the site coefficients are not warranted. Empirical results for base accelerations greater than 0.2 g confirm the need for both a short- and a mid- or long-period site coefficient to characterize site response for purposes of estimating site-specific design spectra.

Empirical reality, empirical causality, and the measurement problem

International Nuclear Information System (INIS)

d'Espagnat, B.

1987-01-01

Does physics describe anything that can meaningfully be called independent reality, or is it merely operational? Most physicists implicitly favor an intermediate standpoint, which takes quantum physics into account, but which nevertheless strongly holds fast to quite strictly realistic ideas about apparently obvious facts concerning the macro-objects. Part 1 of this article, which is a survey of recent measurement theories, shows that, when made explicit, the standpoint in question cannot be upheld. Part 2 brings forward a proposal for making minimal changes to this standpoint in such a way as to remove such objections. The empirical reality thus constructed is a notion that, to some extent, does ultimately refer to the human means of apprehension and of data processing. It nevertheless cannot be said that it reduces to a mere name just labelling a set of recipes that never fail. It is shown that their usual notion of macroscopic causality must be endowed with similar features

Sample Dilution and Bacterial Community Composition Influence Empirical Leucine-to-Carbon Conversion Factors in Surface Waters of the World's Oceans

KAUST Repository

Teira, Eva; Hernando-Morales, Ví ctor; Cornejo-Castillo, Francisco M.; Alonso-Sá ez, Laura; Sarmento, Hugo; Valencia-Vila, Joaquí n; Serrano Catalá , Teresa; Herná ndez-Ruiz, Marta; Varela, Marta M.; Ferrera, Isabel; Moran, Xose Anxelu G.; Gasol, Josep M.

2015-01-01

The transformation of leucine incorporation rates to prokaryotic carbon production rates requires the use of either theoretical or empirically determined conversion factors. Empirical leucine-to-carbon conversion factors (eCFs) vary widely across environments, and little is known about their potential controlling factors. We conducted 10 surface seawater manipulation experiments across the world's oceans, where the growth of the natural prokaryotic assemblages was promoted by filtration (i.e., removal of grazers [F treatment]) or filtration combined with dilution (i.e., also relieving resource competition [FD treatment]). The impact of sunlight exposure was also evaluated in the FD treatments, and we did not find a significant effect on the eCFs. The eCFs varied from 0.09 to 1.47 kg C mol Leu−1 and were significantly lower in the FD than in the F samples. Also, changes in bacterial community composition during the incubations, as assessed by automated ribosomal intergenic spacer analysis (ARISA), were more pronounced in the FD than in the F treatments, compared to unmanipulated controls. Thus, we discourage the common procedure of diluting samples (in addition to filtration) for eCF determination. The eCFs in the filtered treatment were negatively correlated with the initial chlorophyll a concentration, picocyanobacterial abundance (mostly Prochlorococcus), and the percentage of heterotrophic prokaryotes with high nucleic acid content (%HNA). The latter two variables explained 80% of the eCF variability in the F treatment, supporting the view that both Prochlorococcus and HNA prokaryotes incorporate leucine in substantial amounts, although this results in relatively low carbon production rates in the oligotrophic ocean.

Sample Dilution and Bacterial Community Composition Influence Empirical Leucine-to-Carbon Conversion Factors in Surface Waters of the World's Oceans

KAUST Repository

Teira, Eva

2015-09-25

The transformation of leucine incorporation rates to prokaryotic carbon production rates requires the use of either theoretical or empirically determined conversion factors. Empirical leucine-to-carbon conversion factors (eCFs) vary widely across environments, and little is known about their potential controlling factors. We conducted 10 surface seawater manipulation experiments across the world\\'s oceans, where the growth of the natural prokaryotic assemblages was promoted by filtration (i.e., removal of grazers [F treatment]) or filtration combined with dilution (i.e., also relieving resource competition [FD treatment]). The impact of sunlight exposure was also evaluated in the FD treatments, and we did not find a significant effect on the eCFs. The eCFs varied from 0.09 to 1.47 kg C mol Leu−1 and were significantly lower in the FD than in the F samples. Also, changes in bacterial community composition during the incubations, as assessed by automated ribosomal intergenic spacer analysis (ARISA), were more pronounced in the FD than in the F treatments, compared to unmanipulated controls. Thus, we discourage the common procedure of diluting samples (in addition to filtration) for eCF determination. The eCFs in the filtered treatment were negatively correlated with the initial chlorophyll a concentration, picocyanobacterial abundance (mostly Prochlorococcus), and the percentage of heterotrophic prokaryotes with high nucleic acid content (%HNA). The latter two variables explained 80% of the eCF variability in the F treatment, supporting the view that both Prochlorococcus and HNA prokaryotes incorporate leucine in substantial amounts, although this results in relatively low carbon production rates in the oligotrophic ocean.

Empiric Piperacillin-Tazobactam versus Carbapenems in the Treatment of Bacteraemia Due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae.

Science.gov (United States)

Ng, Tat Ming; Khong, Wendy X; Harris, Patrick N A; De, Partha P; Chow, Angela; Tambyah, Paul A; Lye, David C

2016-01-01

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a common cause of bacteraemia in endemic countries and may be associated with high mortality; carbapenems are considered the drug of choice. Limited data suggest piperacillin-tazobactam could be equally effective. We aimed to compare 30-day mortality of patients treated empirically with piperacillin-tazobactam versus a carbapenem in a multi-centre retrospective cohort study in Singapore. Only patients with active empiric monotherapy with piperacillin-tazobactam or a carbapenem were included. A propensity score for empiric carbapenem therapy was derived and an adjusted multivariate analysis of mortality was conducted. A total of 394 patients had ESBL-Escherichia.coli and ESBL-Klebsiella pneumoniae bacteraemia of which 23.1% were community acquired cases. One hundred and fifty-one received initial active monotherapy comprising piperacillin-tazobactam (n = 94) or a carbapenem (n = 57). Patients who received carbapenems were less likely to have health-care associated risk factors and have an unknown source of bacteraemia, but were more likely to have a urinary source. Thirty-day mortality was comparable between those who received empiric piperacillin-tazobactam and a carbapenem (29 [30.9%] vs. 17 [29.8%]), P = 0.89). Those who received empiric piperacillin-tazobactam had a lower 30-day acquisition of multi-drug resistant and fungal infections (7 [7.4%] vs. 14 [24.6%]), Pcarbapenem.

Cognitive Changes After Adjuvant Treatment in Older Adults with Early-Stage Breast Cancer.

Science.gov (United States)

Lange, Marie; Heutte, Natacha; Noal, Sabine; Rigal, Olivier; Kurtz, Jean-Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Leconte, Alexandra; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Tron, Laure; Castel, Hélène; Eustache, Francis; Giffard, Bénédicte; Joly, Florence

2018-06-22

Group-based trajectory modeling is particularly important to identify subgroups of patients with pathological cognitive changes after cancer treatment. To date, only one study has explored cognitive trajectories in older patients with cancer. The present article describes objective cognitive changes before to after adjuvant treatment in older adults with early-stage breast cancer (EBC) after adjuvant treatment compared with healthy controls. Participants were patients ≥65 years of age with newly diagnosed EBC and healthy controls (age-, sex-, and education-matched). The pretreatment assessment was conducted before adjuvant therapy, and the post-treatment assessment after the end of the first adjuvant treatment. Objective cognitive changes before to after treatment were evaluated based on the Reliable Change Index for cognitive decline accounting for cognitive impairment status. The sample consisted of women newly diagnosed with EBC ( n  = 118) and healthy controls ( n  = 62). Five patterns of changes before to after treatment were identified based on the presence of cognitive decline and cognitive impairment. The distribution of these five change patterns was statistically significant ( p  = .0001). Thirty-six percent of patients had phase shift changes, 31% without initial objective cognitive impairment developed impairment, 15% had a normal aging, 12% had a nonpathological decline, and 6% experienced accelerated cognitive decline. This study described for the first time objective cognitive changes before to after treatment of older adults with EBC immediately after the end of adjuvant treatment. A longer-term remote follow-up of adjuvant treatment is needed to better understand the cognitive trajectories of older patients with EBC. The Oncologist IMPLICATIONS FOR PRACTICE: After the end of adjuvant treatment, 31% of older adults with early-stage breast cancer without initial objective cognitive impairment developed impairment, and 6% experienced

How to measure the impacts of antibiotic resistance and antibiotic development on empiric therapy: new composite indices.

Science.gov (United States)

Hughes, Josie S; Hurford, Amy; Finley, Rita L; Patrick, David M; Wu, Jianhong; Morris, Andrew M

2016-12-16

We aimed to construct widely useable summary measures of the net impact of antibiotic resistance on empiric therapy. Summary measures are needed to communicate the importance of resistance, plan and evaluate interventions, and direct policy and investment. As an example, we retrospectively summarised the 2011 cumulative antibiogram from a Toronto academic intensive care unit. We developed two complementary indices to summarise the clinical impact of antibiotic resistance and drug availability on empiric therapy. The Empiric Coverage Index (ECI) measures susceptibility of common bacterial infections to available empiric antibiotics as a percentage. The Empiric Options Index (EOI) varies from 0 to 'the number of treatment options available', and measures the empiric value of the current stock of antibiotics as a depletable resource. The indices account for drug availability and the relative clinical importance of pathogens. We demonstrate meaning and use by examining the potential impact of new drugs and threatening bacterial strains. In our intensive care unit coverage of device-associated infections measured by the ECI remains high (98%), but 37-44% of treatment potential measured by the EOI has been lost. Without reserved drugs, the ECI is 86-88%. New cephalosporin/β-lactamase inhibitor combinations could increase the EOI, but no single drug can compensate for losses. Increasing methicillin-resistant Staphylococcus aureus (MRSA) prevalence would have little overall impact (ECI=98%, EOI=4.8-5.2) because many Gram-positives are already resistant to β-lactams. Aminoglycoside resistance, however, could have substantial clinical impact because they are among the few drugs that provide coverage of Gram-negative infections (ECI=97%, EOI=3.8-4.5). Our proposed indices summarise the local impact of antibiotic resistance on empiric coverage (ECI) and available empiric treatment options (EOI) using readily available data. Policymakers and drug developers can use the

When complexity science meets implementation science: a theoretical and empirical analysis of systems change.

Science.gov (United States)

Braithwaite, Jeffrey; Churruca, Kate; Long, Janet C; Ellis, Louise A; Herkes, Jessica

2018-04-30

Implementation science has a core aim - to get evidence into practice. Early in the evidence-based medicine movement, this task was construed in linear terms, wherein the knowledge pipeline moved from evidence created in the laboratory through to clinical trials and, finally, via new tests, drugs, equipment, or procedures, into clinical practice. We now know that this straight-line thinking was naïve at best, and little more than an idealization, with multiple fractures appearing in the pipeline. The knowledge pipeline derives from a mechanistic and linear approach to science, which, while delivering huge advances in medicine over the last two centuries, is limited in its application to complex social systems such as healthcare. Instead, complexity science, a theoretical approach to understanding interconnections among agents and how they give rise to emergent, dynamic, systems-level behaviors, represents an increasingly useful conceptual framework for change. Herein, we discuss what implementation science can learn from complexity science, and tease out some of the properties of healthcare systems that enable or constrain the goals we have for better, more effective, more evidence-based care. Two Australian examples, one largely top-down, predicated on applying new standards across the country, and the other largely bottom-up, adopting medical emergency teams in over 200 hospitals, provide empirical support for a complexity-informed approach to implementation. The key lessons are that change can be stimulated in many ways, but a triggering mechanism is needed, such as legislation or widespread stakeholder agreement; that feedback loops are crucial to continue change momentum; that extended sweeps of time are involved, typically much longer than believed at the outset; and that taking a systems-informed, complexity approach, having regard for existing networks and socio-technical characteristics, is beneficial. Construing healthcare as a complex adaptive system

Changes of wood cell walls in response to hygro-mechanical steam treatment.

Science.gov (United States)

Guo, Juan; Song, Kunlin; Salmén, Lennart; Yin, Yafang

2015-01-22

The effects of compression combined with steam treatment (CS-treatment), i.e. a hygro-mechanical steam treatment on Spruce wood were studied on a cell-structure level to understand the chemical and physical changes of the secondary cell wall occurring under such conditions. Specially, imaging FT-IR microscopy, nanoindentation and dynamic vapour absorption were used to track changes in the chemical structure, in micromechanical and hygroscopic properties. It was shown that CS-treatment resulted in different changes in morphological, chemical and physical properties of the cell wall, in comparison with those under pure steam treatment. After CS-treatment, the cellular structure displayed significant deformations, and the biopolymer components, e.g. hemicellulose and lignin, were degraded, resulting in decreased hygroscopicity and increased mechanical properties of the wood compared to both untreated and steam treated wood. Moreover, CS-treatment resulted in a higher degree of degradation especially in earlywood compared to a more uniform behaviour of wood treated only by steam. Copyright © 2014 Elsevier Ltd. All rights reserved.

The economics of climate change mitigation in developing countries - methodological and empirical results

Energy Technology Data Exchange (ETDEWEB)

Halsnaes, K.

1997-12-01

This thesis presents a methodological and empirical discussion of the costs associated with implementing greenhouse gas reduction strategies in developing countries. It presents a methodological framework for national costing studies and evaluates a number of associated valuation methods. The methodological framework has been applied in several developing countries as part of a UNEP project in which the author has participated, and reference is made to the results of these country studies. Some of the theoretical issues associated with the determination of the costs of emission reductions are discussed with reference to a number of World Bank and UN guidelines for project analysis in developing countries. The use of several accounting prices is recommended for mitigation projects, with a distinction being made between internationally and domestically traded goods. The consequences of using different accounting prices are discussed with respect to the methodology applied in the UNEP country studies. In conclusion the thesis reviews the results of some of the most important international studies of greenhouse gas emissions in developing countries. The review, which encompasses a total of 27 country studies, was undertaken by the author for the Intergovernmental Panel of Climate Change, the IPCC. Its conclusion is that the UNEP methodological framework and associated country study results are consistent with the recommendations and conclusions of the IPCC. (EG) 23 refs.

The economics of climate change mitigation in developing countries -methodological and empirical results

International Nuclear Information System (INIS)

Halsnaes, K.

1997-12-01

This thesis presents a methodological and empirical discussion of the costs associated with implementing greenhouse gas reduction strategies in developing countries. It presents a methodological framework for national costing studies and evaluates a number of associated valuation methods. The methodological framework has been applied in several developing countries as part of a UNEP project in which the author has participated, and reference is made to the results of these country studies. Some of the theoretical issues associated with the determination of the costs of emission reductions are discussed with reference to a number of World Bank and UN guidelines for project analysis in developing countries. The use of several accounting prices is recommended for mitigation projects, with a distinction being made between internationally and domestically traded goods. The consequences of using different accounting prices are discussed with respect to the methodology applied in the UNEP country studies. In conclusion the thesis reviews the results of some of the most important international studies of greenhouse gas emissions in developing countries. The review, which encompasses a total of 27 country studies, was undertaken by the author for the Intergovernmental Panel of Climate Change, the IPCC. Its conclusion is that the UNEP methodological framework and associated country study results are consistent with the recommendations and conclusions of the IPCC. (EG) 23 refs

Empirical Test Case Specification

DEFF Research Database (Denmark)

Kalyanova, Olena; Heiselberg, Per

This document includes the empirical specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one. I....... In the comparative approach the outcomes of different software tools are compared, while in the empirical approach the modelling results are compared with the results of experimental test cases....

An Empirical Analysis of the Relationship between Minimum Wage ...

African Journals Online (AJOL)

An Empirical Analysis of the Relationship between Minimum Wage, Investment and Economic Growth in Ghana. ... In addition, the ratio of public investment to tax revenue must increase as minimum wage increases since such complementary changes are more likely to lead to economic growth. Keywords: minimum wage ...

Estimating evapotranspiration change due to forest treatment and fire at the basin scale in the Sierra Nevada, California

Science.gov (United States)

Roche, J. W.; Goulden, M.; Bales, R. C.

2017-12-01

Increased forest evapotranspiration (ET) coupled with snowpack decreases in a warming climate is likely to decrease runoff and increase forest drought stress. Field experiments and modeling suggest that forest thinning can reduce ET and thus increase potential runoff relative to untreated areas. We investigated the potential magnitude and duration of ET decreases resulting from forest-thinning treatments and fire using a robust empirical relation between Landsat-derived mean-annual normalized difference vegetation index (NDVI) and annual ET measured at flux towers. Among forest treatments, the minimum observed NDVI change required to produce a significant departure from control plots with NDVI of about 0.70 was -0.07 units, corresponding to a basal-area reduction of 3.1 m2 ha-1, and equivalent to an estimated ET reduction of -102 mm yr-1. Intensive thinning in highly productive forests that approached pre-fire-exclusion densities reduced basal area by 40-50%, generating estimated ET reductions of 152-216 mm yr-1 over five years following treatment. Between 1990 and 2008, fires in the American River basin generated more than twice the ET reduction per unit area than those in the Kings River basin, corresponding to greater water and energy limitations in the latter and greater fire severity in the former. A rough extrapolation of these results to the entire American River watershed, much of which would have burned naturally during this 19-year period, could result in ET reductions that approach 10% of full natural flows for drought years and 5% averaged over all years. This work demonstrates the potential utility to estimate forest ET change at the patch scale, which in turn may allow managers to estimate thinning benefits in areas lacking detailed hydrologic measurements.

Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

DEFF Research Database (Denmark)

Løhmann, Ditte

-MDS/AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two...... years after finishing treatment. We included all children (n=14) who where diagnosed from October 2006 to January 2011 at our department and treated according to the EURAMOS-1 protocol. Four patients relapsed and died before the end of the study period. We found noteworthy changes in MCV, platelets...... for osteosarcoma developed haematological abnormalities similar to early MDS but few developed t-MDS/AML. Close monitoring of patients recovering from osteosarcoma is essential. Keywords: Osteosarcoma, t-MDS/AML, Haematological abnormalities, Children...

Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment.

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Nordahl, Håkon; Havnen, Audun; Hansen, Bjarne; Öst, Lars-Göran; Kvale, Gerd

2018-04-01

Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

An Empirical Examination of Symptom Substitution Associated with Behavior Therapy for Tourette's Disorder

Science.gov (United States)

Peterson, Alan L.; McGuire, Joseph F.; Wilhelm, Sabine; Piacentini, John; Woods, Douglas W.; Walkup, John T.; Hatch, John P.; Villarreal, Robert; Scahill, Lawrence

2018-01-01

Over the past 6 decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a longstanding concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and vocal tics associated with Tourette’s disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using 4 methods: (1) the onset of new tic symptoms; (2) the occurrence of adverse events; (3) change in tic medications; and (4) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight participants with Tourette’s disorder or persistent motor or vocal tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for tics. Both therapies consisted of 8 sessions over 10 weeks. Results indicated that participants treated with behavior therapy were not more likely to have an onset of new tic symptoms, experience adverse events, increase tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to participants treated with supportive therapy. Further analysis suggested that the emergence of new tics was attributed with the normal waxing and waning nature of Tourette’s disorder. Findings provide empirical support to counter the longstanding concern of symptom substitution in response to behavior therapy for individuals with Tourette's Disorder. PMID:26763495

An Empirical Examination of Symptom Substitution Associated With Behavior Therapy for Tourette's Disorder.

Science.gov (United States)

Peterson, Alan L; McGuire, Joseph F; Wilhelm, Sabine; Piacentini, John; Woods, Douglas W; Walkup, John T; Hatch, John P; Villarreal, Robert; Scahill, Lawrence

2016-01-01

Over the past six decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a long-standing concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and vocal tics associated with Tourette's disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using four methods: (a) the onset of new tic symptoms, (b) the occurrence of adverse events, (c) change in tic medications, and (d) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight participants with Tourette's disorder or persistent motor or vocal tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for tics. Both therapies consisted of eight sessions over 10 weeks. Results indicated that participants treated with behavior therapy were not more likely to have an onset of new tic symptoms, experience adverse events, increase tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to participants treated with supportive therapy. Further analysis suggested that the emergence of new tics was attributed with the normal waxing and waning nature of Tourette's disorder. Findings provide empirical support to counter the long-standing concern of symptom substitution in response to behavior therapy for individuals with Tourette's disorder. Copyright © 2015. Published by Elsevier Ltd.

Empirical Support for Perceptual Conceptualism

Directory of Open Access Journals (Sweden)

Nicolás Alejandro Serrano

2018-03-01

Full Text Available The main objective of this paper is to show that perceptual conceptualism can be understood as an empirically meaningful position and, furthermore, that there is some degree of empirical support for its main theses. In order to do this, I will start by offering an empirical reading of the conceptualist position, and making three predictions from it. Then, I will consider recent experimental results from cognitive sciences that seem to point towards those predictions. I will conclude that, while the evidence offered by those experiments is far from decisive, it is enough not only to show that conceptualism is an empirically meaningful position but also that there is empirical support for it.

Neural and behavioural changes in male periadolescent mice after prolonged nicotine-MDMA treatment.

Science.gov (United States)

Adeniyi, Philip A; Ishola, Azeez O; Laoye, Babafemi J; Olatunji, Babawale P; Bankole, Oluwamolakun O; Shallie, Philemon D; Ogundele, Olalekan M

2016-02-01

The interaction between MDMA and Nicotine affects multiple brain centres and neurotransmitter systems (serotonin, dopamine and glutamate) involved in motor coordination and cognition. In this study, we have elucidated the effect of prolonged (10 days) MDMA, Nicotine and a combined Nicotine-MDMA treatment on motor-cognitive neural functions. In addition, we have shown the correlation between the observed behavioural change and neural structural changes induced by these treatments in BALB/c mice. We observed that MDMA (2 mg/Kg body weight; subcutaneous) induced a decline in motor function, while Nicotine (2 mg/Kg body weight; subcutaneous) improved motor function in male periadolescent mice. In combined treatment, Nicotine reduced the motor function decline observed in MDMA treatment, thus no significant change in motor function for the combined treatment versus the control. Nicotine or MDMA treatment reduced memory function and altered hippocampal structure. Similarly, a combined Nicotine-MDMA treatment reduced memory function when compared with the control. Ultimately, the metabolic and structural changes in these neural systems were seen to vary for the various forms of treatment. It is noteworthy to mention that a combined treatment increased the rate of lipid peroxidation in brain tissue.

A heuristic model linking yoga philosophy and self-reflection to examine underlying mechanisms of add-on yoga treatment in schizophrenia.

Science.gov (United States)

Rao, Naren; Menon, Sangeetha

2016-06-01

Preliminary evidence suggests efficacy of yoga as add-on treatment for schizophrenia, but the underlying mechanism by which yoga improves the symptoms of schizophrenia is not completely understood. Yoga improves self-reflection in healthy individuals, and self-reflection abnormalities are typically seen in schizophrenia. However, whether yoga treatment improves impairments in self-reflection typically seen in patients with schizophrenia is not examined. This paper discusses the potential mechanism of yoga in the treatment of schizophrenia and proposes a testable hypothesis for further empirical studies. It is proposed that self-reflection abnormalities in schizophrenia improve with yoga and the neurobiological changes associated with this can be examined using empirical behavioural measures and neuroimaging measures such as magnetic resonance imaging.

A Model of Therapist Competencies for the Empirically Supported Interpersonal Psychotherapy for Adolescent Depression

Science.gov (United States)

Sburlati, Elizabeth S.; Lyneham, Heidi J.; Mufson, Laura H.; Schniering, Carolyn A.

2012-01-01

In order to treat adolescent depression, a number of empirically supported treatments (ESTs) have been developed from both the cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT-A) frameworks. Research has shown that in order for these treatments to be implemented in routine clinical practice (RCP), effective therapist…

A retrospective analysis of the change in anti-malarial treatment policy: Peru

Directory of Open Access Journals (Sweden)

Vincent-Mark Arlene

2009-04-01

Full Text Available Abstract Background National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. Objectives To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru. Methods Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents, a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. Results The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b engaging in collaborative teamwork among nationals and between nationals and international collaborators, c respect for and inclusion of district-level staff in all phases of the process, d reliance on high levels of technical and scientific knowledge, e use of standardized protocols to collect data, and f transparency. Conclusion Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the

Evolution of the empirical and theoretical foundations of eyewitness identification reform.

Science.gov (United States)

Clark, Steven E; Moreland, Molly B; Gronlund, Scott D

2014-04-01

Scientists in many disciplines have begun to raise questions about the evolution of research findings over time (Ioannidis in Epidemiology, 19, 640-648, 2008; Jennions & Møller in Proceedings of the Royal Society, Biological Sciences, 269, 43-48, 2002; Mullen, Muellerleile, & Bryan in Personality and Social Psychology Bulletin, 27, 1450-1462, 2001; Schooler in Nature, 470, 437, 2011), since many phenomena exhibit decline effects-reductions in the magnitudes of effect sizes as empirical evidence accumulates. The present article examines empirical and theoretical evolution in eyewitness identification research. For decades, the field has held that there are identification procedures that, if implemented by law enforcement, would increase eyewitness accuracy, either by reducing false identifications, with little or no change in correct identifications, or by increasing correct identifications, with little or no change in false identifications. Despite the durability of this no-cost view, it is unambiguously contradicted by data (Clark in Perspectives on Psychological Science, 7, 238-259, 2012a; Clark & Godfrey in Psychonomic Bulletin & Review, 16, 22-42, 2009; Clark, Moreland, & Rush, 2013; Palmer & Brewer in Law and Human Behavior, 36, 247-255, 2012), raising questions as to how the no-cost view became well-accepted and endured for so long. Our analyses suggest that (1) seminal studies produced, or were interpreted as having produced, the no-cost pattern of results; (2) a compelling theory was developed that appeared to account for the no-cost pattern; (3) empirical results changed over the years, and subsequent studies did not reliably replicate the no-cost pattern; and (4) the no-cost view survived despite the accumulation of contradictory empirical evidence. Theories of memory that were ruled out by early data now appear to be supported by data, and the theory developed to account for early data now appears to be incorrect.

Time-varying volatility in Malaysian stock exchange: An empirical study using multiple-volatility-shift fractionally integrated model

Science.gov (United States)

Cheong, Chin Wen

2008-02-01

This article investigated the influences of structural breaks on the fractionally integrated time-varying volatility model in the Malaysian stock markets which included the Kuala Lumpur composite index and four major sectoral indices. A fractionally integrated time-varying volatility model combined with sudden changes is developed to study the possibility of structural change in the empirical data sets. Our empirical results showed substantial reduction in fractional differencing parameters after the inclusion of structural change during the Asian financial and currency crises. Moreover, the fractionally integrated model with sudden change in volatility performed better in the estimation and specification evaluations.

Multidisciplinary approach to the treatment of invasive fungal infections in adult patients. Prophylaxis, empirical, preemptive or targeted therapy, which is the best in the different hosts?

Directory of Open Access Journals (Sweden)

Rafael Zaragoza

2008-11-01

Full Text Available Rafael Zaragoza1, Javier Pemán2, Miguel Salavert3, Ángel Viudes2, Amparo Solé4, Isidro Jarque5, Emilio Monte6, Eva Romá6, Emilia Cantón71Servicio de Medicina Intensiva, Hospital Universitario Dr Peset, Valencia, Spain; 2Servicio de Microbiología; 3Unidad de Enfermedades Infecciosas; 4Unidad de Trasplante Pulmonar; 5Servicio de Hematología; 6Servicio de Farmacia; 7Unidad de Microbiología Experimental, Centro de Investigación, Hospital Universitario La Fe Valencia, SpainAbstract: The high morbidity, mortality, and health care costs associated with invasive fungal infections, especially in the critical care setting and immunocompromised host, have made it an excellent target for prophylactic, empiric, and preemptive therapy interventions principally based on early identification of risk factors. Early diagnosis and treatment are associated with a better prognosis. In the last years there have been important developments in antifungal pharmacotherapy. An approach to the new diagnosis tools in the clinical mycology laboratory and an analysis of the use new antifungal agents and its application in different clinical situations has been made. Furthermore, an attempt of developing a state of the art in each clinical scenario (critically ill, hematological, and solid organ transplant patients has been performed, trying to choose the best strategy for each clinical situation (prophylaxis, pre-emptive, empirical, or targeted therapy. The high mortality rates in these settings make mandatory the application of early de-escalation therapy in critically ill patients with fungal infection. In addition, the possibility of antifungal combination therapy might be considered in solid organ transplant and hematological patients.Keywords: invasive fungal infections, prophylaxis, empirical therapy, preemptive treatment, targeted therapy

Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

Science.gov (United States)

Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

2011-01-01

Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

Exploring mechanisms of change in cognitive therapy and interpersonal psychotherapy for adult depression.

Science.gov (United States)

Lemmens, Lotte H J M; Galindo-Garre, Francisca; Arntz, Arnoud; Peeters, Frenk; Hollon, Steven D; DeRubeis, Robert J; Huibers, Marcus J H

2017-07-01

The present study explored the temporal relationships between change in five candidate causal mechanisms and change in depressive symptoms in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression. Furthermore, hypotheses concerning the mediation of change in these treatments were tested. Patients were 151 depressed adult outpatients treated with either CT (n = 76) or IPT (n = 75). Depression severity was assessed with the BDI-II. Candidate mediators included both therapy-specific as well as common factors. Measures were taken multiple times over the course of treatment (baseline, mid-, and post-treatment). Pearson's correlations and Latent-Difference-Score models were used to examine the direct and indirect relationships between (change in) the candidate mediators and (subsequent) (change in) depression. Patients showed improvement on all measures. No differential effects in pre- to post-treatment changes were observed between the two conditions. However, change in interpersonal functioning occurred more rapidly in IPT. Only little empirical support for the respective theoretical models of change in CT and IPT was found. Future studies should pay special attention to the timing of assessments and within-patient variance. Copyright © 2017 Elsevier Ltd. All rights reserved.

An empirical framework for tropical cyclone climatology

Energy Technology Data Exchange (ETDEWEB)

Kang, Nam-Young [Korea Meteorological Administration, Seoul (Korea, Republic of); Florida State University, Tallahassee, FL (United States); Elsner, James B. [Florida State University, Tallahassee, FL (United States)

2012-08-15

An empirical approach for analyzing tropical cyclone climate is presented. The approach uses lifetime-maximum wind speed and cyclone frequency to induce two orthogonal variables labeled ''activity'' and ''efficiency of intensity''. The paired variations of activity and efficiency of intensity along with the opponent variations of frequency and intensity configure a framework for evaluating tropical cyclone climate. Although cyclone activity as defined in this framework is highly correlated with the commonly used exponent indices like accumulated cyclone energy, it does not contain cyclone duration. Empirical quantiles are used to determine threshold intensity levels, and variant year ranges are used to find consistent trends in tropical cyclone climatology. In the western North Pacific, cyclone activity is decreasing despite increases in lifetime-maximum intensity. This is due to overwhelming decreases in cyclone frequency. These changes are also explained by an increasing efficiency of intensity. The North Atlantic shows different behavior. Cyclone activity is increasing due to increasing frequency and, to a lesser extent, increasing intensity. These changes are also explained by a decreasing efficiency of intensity. Tropical cyclone trends over the North Atlantic basin are more consistent over different year ranges than tropical cyclone trends over the western North Pacific. (orig.)

Robot Wars: US Empire and geopolitics in the robotic age

Science.gov (United States)

Shaw, Ian GR

2017-01-01

How will the robot age transform warfare? What geopolitical futures are being imagined by the US military? This article constructs a robotic futurology to examine these crucial questions. Its central concern is how robots – driven by leaps in artificial intelligence and swarming – are rewiring the spaces and logics of US empire, warfare, and geopolitics. The article begins by building a more-than-human geopolitics to de-center the role of humans in conflict and foreground a worldly understanding of robots. The article then analyzes the idea of US empire, before speculating upon how and why robots are materializing new forms of proxy war. A three-part examination of the shifting spaces of US empire then follows: (1) Swarm Wars explores the implications of miniaturized drone swarming; (2) Roboworld investigates how robots are changing US military basing strategy and producing new topological spaces of violence; and (3) The Autogenic Battle-Site reveals how autonomous robots will produce emergent, technologically event-ful sites of security and violence – revolutionizing the battlespace. The conclusion reflects on the rise of a robotic US empire and its consequences for democracy. PMID:29081605

Empirical comparison of four baseline covariate adjustment methods in analysis of continuous outcomes in randomized controlled trials

Directory of Open Access Journals (Sweden)

Zhang S

2014-07-01

Full Text Available Shiyuan Zhang,1 James Paul,2 Manyat Nantha-Aree,2 Norman Buckley,2 Uswa Shahzad,2 Ji Cheng,2 Justin DeBeer,5 Mitchell Winemaker,5 David Wismer,5 Dinshaw Punthakee,5 Victoria Avram,5 Lehana Thabane1–41Department of Clinical Epidemiology and Biostatistics, 2Department of Anesthesia, McMaster University, Hamilton, ON, Canada; 3Biostatistics Unit/Centre for Evaluation of Medicines, St Joseph's Healthcare - Hamilton, Hamilton, ON, Canada; 4Population Health Research Institute, Hamilton Health Science/McMaster University, 5Department of Surgery, Division of Orthopaedics, McMaster University, Hamilton, ON, CanadaBackground: Although seemingly straightforward, the statistical comparison of a continuous variable in a randomized controlled trial that has both a pre- and posttreatment score presents an interesting challenge for trialists. We present here empirical application of four statistical methods (posttreatment scores with analysis of variance, analysis of covariance, change in scores, and percent change in scores, using data from a randomized controlled trial of postoperative pain in patients following total joint arthroplasty (the Morphine COnsumption in Joint Replacement Patients, With and Without GaBapentin Treatment, a RandomIzed ControlLEd Study [MOBILE] trials.Methods: Analysis of covariance (ANCOVA was used to adjust for baseline measures and to provide an unbiased estimate of the mean group difference of the 1-year postoperative knee flexion scores in knee arthroplasty patients. Robustness tests were done by comparing ANCOVA with three comparative methods: the posttreatment scores, change in scores, and percentage change from baseline.Results: All four methods showed similar direction of effect; however, ANCOVA (-3.9; 95% confidence interval [CI]: -9.5, 1.6; P=0.15 and the posttreatment score (-4.3; 95% CI: -9.8, 1.2; P=0.12 method provided the highest precision of estimate compared with the change score (-3.0; 95% CI: -9.9, 3.8; P=0

Treatment Response to an Intensive Summer Treatment Program for Adolescents with ADHD

Science.gov (United States)

Sibley, Margaret H.; Smith, Bradley H.; Evans, Steven W.; Pelham, William E.; Gnagy, Elizabeth M.

2012-01-01

Objective: There are presently almost no empirically validated treatments for adolescents with ADHD. However, in childhood, behavioral treatments for ADHD typically include behavioral parent training, classroom interventions, and intensive child-directed interventions. Method: The present investigation examines treatment gains following an 8-week…

Sample dilution and bacterial community composition influence empirical leucine-to-carbon conversion factors in surface waters of the world's oceans.

Science.gov (United States)

Teira, Eva; Hernando-Morales, Víctor; Cornejo-Castillo, Francisco M; Alonso-Sáez, Laura; Sarmento, Hugo; Valencia-Vila, Joaquín; Serrano Catalá, Teresa; Hernández-Ruiz, Marta; Varela, Marta M; Ferrera, Isabel; Gutiérrez Morán, Xosé Anxelu; Gasol, Josep M

2015-12-01

The transformation of leucine incorporation rates to prokaryotic carbon production rates requires the use of either theoretical or empirically determined conversion factors. Empirical leucine-to-carbon conversion factors (eCFs) vary widely across environments, and little is known about their potential controlling factors. We conducted 10 surface seawater manipulation experiments across the world's oceans, where the growth of the natural prokaryotic assemblages was promoted by filtration (i.e., removal of grazers [F treatment]) or filtration combined with dilution (i.e., also relieving resource competition [FD treatment]). The impact of sunlight exposure was also evaluated in the FD treatments, and we did not find a significant effect on the eCFs. The eCFs varied from 0.09 to 1.47 kg C mol Leu(-1) and were significantly lower in the FD than in the F samples. Also, changes in bacterial community composition during the incubations, as assessed by automated ribosomal intergenic spacer analysis (ARISA), were more pronounced in the FD than in the F treatments, compared to unmanipulated controls. Thus, we discourage the common procedure of diluting samples (in addition to filtration) for eCF determination. The eCFs in the filtered treatment were negatively correlated with the initial chlorophyll a concentration, picocyanobacterial abundance (mostly Prochlorococcus), and the percentage of heterotrophic prokaryotes with high nucleic acid content (%HNA). The latter two variables explained 80% of the eCF variability in the F treatment, supporting the view that both Prochlorococcus and HNA prokaryotes incorporate leucine in substantial amounts, although this results in relatively low carbon production rates in the oligotrophic ocean. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Schema therapy for borderline personality disorder: a comprehensive review of its empirical foundations, effectiveness and implementation possibilities.

Science.gov (United States)

Sempértegui, Gabriela A; Karreman, Annemiek; Arntz, Arnoud; Bekker, Marrie H J

2013-04-01

Borderline personality disorder is a serious psychiatric disorder for which the effectiveness of the current pharmacotherapeutical and psychotherapeutic approaches has shown to be limited. In the last decades, schema therapy has increased in popularity as a treatment of borderline personality disorder; however, systematic evaluation of both effectiveness and empirical evidence for the theoretical background of the therapy is limited. This literature review comprehensively evaluates the current empirical status of schema therapy for borderline personality disorder. We first described the theoretical framework and reviewed its empirical foundations. Next, we examined the evidence regarding effectiveness and implementability. We found evidence for a considerable number of elements of Young's schema model; however, the strength of the results varies and there are also mixed results and some empirical blanks in the theory. The number of studies on effectiveness is small, but reviewed findings suggest that schema therapy is a promising treatment. In Western-European societies, the therapy could be readily implemented as a cost-effective strategy with positive economic consequences. Copyright © 2012 Elsevier Ltd. All rights reserved.

Climate Change and Maize Production: Empirical Evidence from ...

African Journals Online (AJOL)

Michael Madukwe

humanity with food and fiber, while climate is the primary determinant of agricultural ... Extension systems can help farmers deal with climate change by providing them information on causes and effects of climate change as well as adaptive ...

Narrative and emotion process in psychotherapy: an empirical test of the Narrative-Emotion Process Coding System (NEPCS).

Science.gov (United States)

Boritz, Tali Z; Bryntwick, Emily; Angus, Lynne; Greenberg, Leslie S; Constantino, Michael J

2014-01-01

While the individual contributions of narrative and emotion processes to psychotherapy outcome have been the focus of recent interest in psychotherapy research literature, the empirical analysis of narrative and emotion integration has rarely been addressed. The Narrative-Emotion Processes Coding System (NEPCS) was developed to provide researchers with a systematic method for identifying specific narrative and emotion process markers, for application to therapy session videos. The present study examined the relationship between NEPCS-derived problem markers (same old storytelling, empty storytelling, unstoried emotion, abstract storytelling) and change markers (competing plotlines storytelling, inchoate storytelling, unexpected outcome storytelling, and discovery storytelling), and treatment outcome (recovered versus unchanged at therapy termination) and stage of therapy (early, middle, late) in brief emotion-focused (EFT), client-centred (CCT), and cognitive (CT) therapies for depression. Hierarchical linear modelling analyses demonstrated a significant Outcome effect for inchoate storytelling (p = .037) and discovery storytelling (p = .002), a Stage × Outcome effect for abstract storytelling (p = .05), and a Stage × Outcome × Treatment effect for competing plotlines storytelling (p = .001). There was also a significant Stage × Outcome effect for NEPCS problem markers (p = .007) and change markers (p = .03). The results provide preliminary support for the importance of assessing the contribution of narrative-emotion processes to efficacious treatment outcomes in EFT, CCT, and CT treatments of depression.

Empirical ethics, context-sensitivity, and contextualism.

Science.gov (United States)

Musschenga, Albert W

2005-10-01

In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen because of its associations with "descriptive ethics." Unlike descriptive ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position.

Changes in Transformational Leadership and Empirical Quality Outcomes in a Finnish Hospital over a Two-Year Period: A Longitudinal Study

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Mäntynen, Raija; Vehviläinen-Julkunen, Katri; Partanen, Pirjo; Turunen, Hannele; Miettinen, Merja; Kvist, Tarja

2014-01-01

This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n 1 = 499, n 2 = 498) and patient safety culture (n 1 = 234, n 2 = 512) and using both postal and web-based surveys to gather information on job satisfaction (n 1 = 1176, n 2 = 779). Questionnaires were used to collect data on care satisfaction from patients (n 1 = 678, n 2 = 867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes. PMID:25009744

Empirical Hamiltonians

International Nuclear Information System (INIS)

Peggs, S.; Talman, R.

1987-01-01

As proton accelerators get larger, and include more magnets, the conventional tracking programs which simulate them run slower. The purpose of this paper is to describe a method, still under development, in which element-by-element tracking around one turn is replaced by a single man, which can be processed far faster. It is assumed for this method that a conventional program exists which can perform faithful tracking in the lattice under study for some hundreds of turns, with all lattice parameters held constant. An empirical map is then generated by comparison with the tracking program. A procedure has been outlined for determining an empirical Hamiltonian, which can represent motion through many nonlinear kicks, by taking data from a conventional tracking program. Though derived by an approximate method this Hamiltonian is analytic in form and can be subjected to further analysis of varying degrees of mathematical rigor. Even though the empirical procedure has only been described in one transverse dimension, there is good reason to hope that it can be extended to include two transverse dimensions, so that it can become a more practical tool in realistic cases

Climate Change and Maize Production: Empirical Evidence from ...

African Journals Online (AJOL)

Michael Madukwe

been argued for as major reasons for global climate change. IPCC (2007) confirmed global fluctuations in ... examine adaptation strategies for climate change; and analyse fishers' livelihoods and adaptive capacity. ... (vii) Average annual income from fishing: Respondents were asked to state their income from fishing. 2.

Empiric validation of a process for behavior change.

Science.gov (United States)

Elliot, Diane L; Goldberg, Linn; MacKinnon, David P; Ranby, Krista W; Kuehl, Kerry S; Moe, Esther L

2016-09-01

Most behavior change trials focus on outcomes rather than deconstructing how those outcomes related to programmatic theoretical underpinnings and intervention components. In this report, the process of change is compared for three evidence-based programs' that shared theories, intervention elements and potential mediating variables. Each investigation was a randomized trial that assessed pre- and post- intervention variables using survey constructs with established reliability. Each also used mediation analyses to define relationships. The findings were combined using a pattern matching approach. Surprisingly, knowledge was a significant mediator in each program (a and b path effects [pbehavior change.

Empire as a Geopolitical Figure

DEFF Research Database (Denmark)

Parker, Noel

2010-01-01

This article analyses the ingredients of empire as a pattern of order with geopolitical effects. Noting the imperial form's proclivity for expansion from a critical reading of historical sociology, the article argues that the principal manifestation of earlier geopolitics lay not in the nation...... but in empire. That in turn has been driven by a view of the world as disorderly and open to the ordering will of empires (emanating, at the time of geopolitics' inception, from Europe). One implication is that empires are likely to figure in the geopolitical ordering of the globe at all times, in particular...... after all that has happened in the late twentieth century to undermine nationalism and the national state. Empire is indeed a probable, even for some an attractive form of regime for extending order over the disorder produced by globalisation. Geopolitics articulated in imperial expansion is likely...

Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

OpenAIRE

Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

2015-01-01

Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclos...

[Chronic pain patients' readiness to change after multimodal treatment. Short- and long-term effects].

Science.gov (United States)

Küchler, A; Sabatowski, R; Kaiser, U

2012-12-01

Patients' readiness to behavioural changes according to the transtheoretical model (TTM) and criteria of treatment outcome are positively associated and have in part already been confirmed. For a stable effect of therapeutic treatment, patients' readiness to change seems indispensable for an independent and active pain management. Thus, in addition to an enhanced quality of life, increasing patients' motivation is a declared objective of the treatment at Dresden's Comprehensive Pain Center. In this study, it was examined how the readiness to change develops in the course of and during the 2 years following the multimodal treatment program. Furthermore, associations between outcome criteria of the treatment and patients' readiness to change were explored. The database constitutes 169 patients who took part in a 4-week interdisciplinary, partially residential pain treatment. Beside the Freiburg Pain Stages questionnaire ("Frieburger Fragebogen - Stadien der Bewältigung chronischer Schmerzen", FF-STABS), a comprehensive pain diagnostic inventory including the Pain Disability Index (PDI), the SF-36 questionnaire, and the Hospital Anxiety and Depression Scale (HADS) was completed at six different time points (beginning of treatment, end of treatment, booster session after 10 weeks, after 6, 12, and 24 months). The statistical analyses were performed with SPSS 16.0 including nonparametric analyses and variance analyses. Significant differences in the level of readiness to change between the beginning of treatment and all follow-up measures were observed. The average patients' readiness to change was still higher after 2 years than at the first measurement. However, a differentiated consideration revealed a small portion of patients who showed no change or even a reduction of motivation. After an additional week (booster session), the stages of readiness to change remained stable, irrespective of the direction of the previous change. Regarding therapeutic outcome

What we know and what we need to learn about the treatment of dissociative disorders.

Science.gov (United States)

Brand, Bethany L

2012-01-01

In this editorial, I briefly review research design issues and the current treatment research for dissociative disorders (DD), discuss the limitations and challenges of conducting treatment studies for patients with DD, and conclude by describing what I see as the first wave and second wave in the field of dissociation. Insurers and federally funded programs are increasingly requiring that treatment be empirically supported in order for treatment to be reimbursed. For example, psychoanalysis will no longer be reimbursed in The Netherlands because of what is perceived as a lack of empirical support. Other countries have also established standards about the treatments that have sufficient empirical support to merit government payment. I believe it is only a matter of time before it is common for patients with DD to be required to seek out empirically supported treatment if they want treatment to be reimbursed. We need to financially support treatment studies in order to develop a more solid empirical basis for the treatment of DD.

Translucency changes of direct esthetic restorative materials after curing, aging and treatment

Directory of Open Access Journals (Sweden)

Yong-Keun Lee

2016-11-01

Full Text Available The purpose of this article was to review the changes in translucency of direct esthetic restorative materials after curing, aging and treatment. As a criterion for the evaluation of clinical translucency changes, visual perceptibility threshold in translucency parameter difference (ΔTP of 2 was used. Translucency changes after curing were perceivable depending on experimental methods and products (largest ΔTP in resin composites = 15.9. Translucency changes after aging were reported as either relatively stable or showed perceivable changes by aging protocols (largest ΔTP in resin composites = -3.8. Translucency changes after curing, aging and treatment were perceivable in several products and experimental methods. Therefore, shade matching of direct esthetic materials should be performed considering these instabilities of translucency in direct esthetic materials.

Changes in the self during cognitive behavioural therapy for social anxiety disorder: A systematic review.

Science.gov (United States)

Gregory, Bree; Peters, Lorna

2017-03-01

A consistent feature across cognitive-behavioural models of social anxiety disorder (SAD) is the central role of the self in the emergence and maintenance of the disorder. The strong emphasis placed on the self in these models and related empirical research has also been reflected in evidence-based treatments for the disorder. This systematic review provides an overview of the empirical literature investigating the role of self-related constructs (e.g., self-beliefs, self-images, self-focused attention) proposed in cognitive models of SAD, before examining how these constructs are modified during and following CBT for SAD. Forty-one studies met the inclusion criteria. Guided by Stopa's (2009a, b) model of self, most studies examined change in self-related content, followed by change in self-related processing. No study examined change in self-structure. Pre- to post-treatment reductions were observed in self-related thoughts and beliefs, self-esteem, self-schema, self-focused attention, and self-evaluation. Change in self-related constructs predicted and/or mediated social anxiety reduction, however relatively few studies examined this. Papers were limited by small sample sizes, failure to control for depression symptoms, lack of waitlist, and some measurement concerns. Future research directions are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Climate Change and Maize Production: Empirical Evidence from ...

African Journals Online (AJOL)

An estimated 80% of the maize crop suffers periodic yield reduction due to drought stress. Drought at flowering and grain filling period may cause losses of 40-90%. Predicated on the argument that climate change resulted from changes in climatic elements such as rainfall, this study aimed at investigating the relationship ...

Understanding placebo, nocebo, and iatrogenic treatment effects.

Science.gov (United States)

Bootzin, Richard R; Bailey, Elaine T

2005-07-01

Placebo and nonplacebo treatments have both positive and negative effects on patient outcomes. To better understand the patterning of treatment effects, three specific interventions will be discussed that are reported to produce more harm than benefit: critical incident stress debriefing, group therapy for adolescents with conduct disorders, and psychotherapy for dissociative identity disorder. In each case, there is an interaction between mechanisms thought to underlie both placebo and specific treatment effects. Mechanisms hypothesized to underlie placebo and nocebo effects include patient expectancy, self-focused attention to symptoms, motivation to change, and sociocultural role-enactment cues. In the three treatments discussed, specific mechanisms interact with nonspecific mechanisms to produce iatrogenic effects. To advance knowledge, it is important both to specify the theory of treatment and its expected outcomes and to put the theory to test. Only with attention to the empirical findings from programmatic research of specific and nonspecific effects and their interaction is it possible to improve the outcomes of treatment beyond the status quo.

Semi-empirical calculations on the structure of the uronium ion

NARCIS (Netherlands)

Harkema, Sybolt

1972-01-01

Semi-empirical calculations (CNDO/2) on the structure of the uronium ion are presented. Assuming a planar ion with fixed bond lengths, the bond angles involving the heavy atoms can be calculated with fair accuracy. Changes in bond length and angles, which occur upon protonation of the urea molecule,

Clinical Significance: a Therapeutic Approach Topsychological Assessment in Treatment Planning

Directory of Open Access Journals (Sweden)

Afolabi Olusegun Emmanuel

2015-06-01

Full Text Available Psychological assessment has long been reported as a key component of clinical psychology. This paper examines the complexities surrounding the clinical significance of therapeutic approach to treatment planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed, 1 a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2 explained the conceptual meaning of clinical significant change in therapeutic assessment, 3 answered some of the questions regarding practicability and the clinical significance of therapeutic approach to treatment plans, particularly during or before treatment, 4 linked therapeutic assessment to change in clients’ clinical impression, functioning and therapeutic needs 5 analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the layman and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as ‘changed’ or ‘unchanged’ on the basis of clinical significance criteria.

Theological reflections on empire

Directory of Open Access Journals (Sweden)

Allan A. Boesak

2009-11-01

Full Text Available Since the meeting of the World Alliance of Reformed Churches in Accra, Ghana (2004, and the adoption of the Accra Declaration, a debate has been raging in the churches about globalisation, socio-economic justice, ecological responsibility, political and cultural domination and globalised war. Central to this debate is the concept of empire and the way the United States is increasingly becoming its embodiment. Is the United States a global empire? This article argues that the United States has indeed become the expression of a modern empire and that this reality has considerable consequences, not just for global economics and politics but for theological refl ection as well.

Facial soft tissue changes after orthodontic treatment | Aksakalli ...

African Journals Online (AJOL)

Objectives: To successfully meet expectations on facial esthetics, it is important to understand normal craniofacial growth and the impact of orthodontic treatment thereon. To date, there have been few studies documenting changes in facial esthetics through photography. The objective of this study was to compare facial soft ...

Climate Change and Maize Production: Empirical Evidence from ...

African Journals Online (AJOL)

Michael Madukwe

The study examined the adaptation strategies to climate change in Oke ... adverse effects of climate on their health and well-being and take advantage of the ... to climate change at the farm level of the food crop farmers in Oke-Ogun area of ... of the famers were married while 7.5% were divorced. The educational level of the ...

Treatment Outcome and Metacognitive Change in CBT and GET for Chronic Fatigue Syndrome.

Science.gov (United States)

Fernie, Bruce A; Murphy, Gabrielle; Wells, Adrian; Nikčević, Ana V; Spada, Marcantonio M

2016-07-01

Studies have reported that Cognitive Behavioural Therapy (CBT) and Graded Exercise Therapy (GET) are effective treatments for Chronic Fatigue Syndrome (CFS). One hundred and seventy-one patients undertook a course of either CBT (n = 116) or GET (n = 55) and were assessed on a variety of self-report measures at pre- and posttreatment and follow-up. In this paper we present analyses on treatment outcomes for CBT and GET in routine clinical practice and evaluate whether changes on subscales of the Metacognitions Questionnaire-30 (MCQ-30) predict fatigue severity independently of changes in other covariates, and across the two treatment modalities. Both CBT and GET were equally effective at decreasing fatigue, anxiety, and depression, and at increasing physical functioning. Changes on the subscales of the MCQ-30 were also found to have a significant effect on fatigue severity independently of changes in other covariates and across treatment modalities. The findings from the current study suggest that CFS treatment protocols for CBT and GET, based on those from the PACE trial, achieve similar to poorer outcomes in routine clinical practice as in a RCT.

Urban and regional change in Australia: an empirical introduction

OpenAIRE

K O'Connor

1984-01-01

The distribution of Australian population has changed in recent years, and preliminary analysis has interpreted that change as consistent with North American experience. That interpretation involved an understanding of population change associated with climate factors, and a restructuring of industry which favoured new sectors in new locations. To explore patterns in Australian population change, shares of national population in each state for the period 1971 - 1981 were analysed. That inform...

Theoretical and Empirical Review of Asset Pricing Models: A Structural Synthesis

Directory of Open Access Journals (Sweden)

Saban Celik

2012-01-01

Full Text Available The purpose of this paper is to give a comprehensive theoretical review devoted to asset pricing models by emphasizing static and dynamic versions in the line with their empirical investigations. A considerable amount of financial economics literature devoted to the concept of asset pricing and their implications. The main task of asset pricing model can be seen as the way to evaluate the present value of the pay offs or cash flows discounted for risk and time lags. The difficulty coming from discounting process is that the relevant factors that affect the pay offs vary through the time whereas the theoretical framework is still useful to incorporate the changing factors into an asset pricing models. This paper fills the gap in literature by giving a comprehensive review of the models and evaluating the historical stream of empirical investigations in the form of structural empirical review.

Empirical equations for viscosity and specific heat capacity determination of paraffin PCM and fatty acid PCM

Science.gov (United States)

Barreneche, C.; Ferrer, G.; Palacios, A.; Solé, A.; Inés Fernández, A.; Cabeza, L. F.

2017-10-01

Phase change materials (PCM) used in thermal energy storage (TES) systems have been presented, over recent years, as one of the most effective options in energy storage. Paraffin and fatty acids are some of the most used PCM in TES systems, as they have high phase change enthalpy and in addition they do not present subcooling nor hysteresis and have proper cycling stability. The simulations and design of TES systems require the knowledge of the thermophysical properties of PCM. Thermal conductivity, viscosity, specific heat capacity (Cp) can be experimentally determined, but these are material and time consuming tasks. To avoid or to reduce them, and to have reliable data without the need of experimentation, thermal properties can be calculated by empirical equations. In this study, five different equations are given to calculate the viscosity and specific heat capacity of fatty acid PCM and paraffin PCM. Two of these equations concern, respectively, the empirical calculation of the viscosity and liquid Cp of the whole paraffin PCM family, while the other three equations presented are for the corresponding calculation of viscosity, solid Cp, liquid Cp of the whole fatty acid family of PCM. Therefore, this study summarize the work performed to obtain the main empirical equations to measure the above mentioned properties for whole fatty acid PCM family and whole paraffin PCM family. Moreover, empirical equations have been obtained to calculate these properties for other materials of these PCM groups and these empirical equations can be extrapolated for PCM with higher or lower phase change temperatures within a lower relative error 4%.

Ethical and Epistemic Dilemmas in Empirically-Engaged Philosophy of Education

Science.gov (United States)

Newman, Anne; Glass, Ronald David

2015-01-01

This essay examines several ethical and epistemological issues that arise when philosophers conduct empirical research focused on, or in collaboration with, community groups seeking to bring about systemic change. This type of research can yield important policy lessons about effective community-driven reform and how to incorporate the voices of…

Semiphysiological versus Empirical Modelling of the Population Pharmacokinetics of Free and Total Cefazolin during Pregnancy

Directory of Open Access Journals (Sweden)

J. G. Coen van Hasselt

2014-01-01

Full Text Available This work describes a first population pharmacokinetic (PK model for free and total cefazolin during pregnancy, which can be used for dose regimen optimization. Secondly, analysis of PK studies in pregnant patients is challenging due to study design limitations. We therefore developed a semiphysiological modeling approach, which leveraged gestation-induced changes in creatinine clearance (CrCL into a population PK model. This model was then compared to the conventional empirical covariate model. First, a base two-compartmental PK model with a linear protein binding was developed. The empirical covariate model for gestational changes consisted of a linear relationship between CL and gestational age. The semiphysiological model was based on the base population PK model and a separately developed mixed-effect model for gestation-induced change in CrCL. Estimates for baseline clearance (CL were 0.119 L/min (RSE 58% and 0.142 L/min (RSE 44% for the empirical and semiphysiological models, respectively. Both models described the available PK data comparably well. However, as the semiphysiological model was based on prior knowledge of gestation-induced changes in renal function, this model may have improved predictive performance. This work demonstrates how a hybrid semiphysiological population PK approach may be of relevance in order to derive more informative inferences.

ED pharmacist monitoring of provider antibiotic selection aids appropriate treatment for outpatient UTI.

Science.gov (United States)

Lingenfelter, Erin; Drapkin, Zachary; Fritz, Kelly; Youngquist, Scott; Madsen, Troy; Fix, Megan

2016-08-01

We sought to determine whether an emergency department (ED) pharmacist could aid in the monitoring and correction of inappropriate empiric antibiotic selection for urinary tract infections in an outpatient ED population. Urine cultures with greater than 100 000 CFU/mL bacteria from the University of Utah Emergency Department over 1 year (October 2011-Sept 2012) were identified using our electronic medical record system. Per ED protocol, an ED pharmacist reviews all cultures and performs a chart review of patient symptoms, diagnosis, and discharge antibiotics to determine whether the treatment was appropriate. A retrospective review of this process was performed to identify how often inappropriate treatment was recognized and intervened on by an ED pharmacist. Of the 180 cultures included, a total of 42 (23%) of empiric discharge treatments were considered inappropriate and required intervention. In 35 (83%) of 42 patients, the ED pharmacist was able to contact the patient and make appropriate changes; the remaining 7 patients were unable to be contacted, and no change could be made in their treatment. A chart review of all urine cultures with greater than 100 000 CFU/mL performed by an ED pharmacist helped identify inappropriate treatment in 23% of patients discharged to home with the diagnosis of urinary tract infection. Of these patients who had received inappropriate treatment, an ED pharmacist was able to intervene in 83% of cases. These data highlight the role of ED pharmacists in improving patient care after discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

Art and artistic processes bridge knowledge systems about social-ecological change: An empirical examination with Inuit artists from Nunavut, Canada

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Kaitlyn J. Rathwell

2016-06-01

Full Text Available The role of art and artistic processes is one fruitful yet underexplored area of social-ecological resilience. Art and art making can nurture Indigenous knowledge and at the same time bridge knowledge across generations and cultures (e.g., Inuit and scientific. Experiences in two Inuit communities in northern Canada (Cape Dorset and Pangnirtung, Nunavut provide the context in which we empirically examine the mechanisms through which art and art making may bridge knowledge systems about social-ecological change. Art making and artworks create continuity between generations via symbols and skill development (e.g., seal skin stretching for a modern artistic mural and by creating mobile and adaptive boundary objects that function as a shared reference point to connect different social worlds. Our results indicate how art and artistic processes may bridge knowledge systems through six mechanisms, and in so doing contribute to social-ecological resilience during change and uncertainty. These mechanisms are (1 embedding knowledge, practice and belief into art objects; (2 sharing knowledge using the language of art; (3 sharing of art making skills; (4 art as a contributor to monitoring social-ecological change; (5 the role of art in fostering continuity through time; and (6 art as a site of knowledge coproduction.

Recent Advances in Behavioral Addiction Treatments: Focusing on Mechanisms of Change

OpenAIRE

Longabaugh, Richard; Magill, Molly

2011-01-01

In the latter half of the 20th century, research on behavioral treatments for addictions aimed to develop and test effective treatments. Among treatments found to be at least moderately effective, direct comparisons failed to reveal consistent superiority of one approach over another. This ubiquitous finding held true despite underlying theories that differed markedly in their proposed causal processes related to patient change. In the 21st century the focus of treatment research is increasin...

The response of substance use disorder treatment providers to changes in macroeconomic conditions.

Science.gov (United States)

Cantor, Jonathan; Stoller, Kenneth B; Saloner, Brendan

2017-10-01

To study how substance use disorder (SUD) treatment providers respond to changes in economic conditions. 2000-2012 National Survey of Substance Abuse Treatment Services (N-SSATS) which contains detailed information on specialty SUD facilities in the United States. We use fixed-effects regression to study how changes in economic conditions, proxied by state unemployment rates, impact treatment setting, accepted payment forms, charity care, offered services, special programs, and use of pharmacotherapies by specialty SUD treatment providers. Secondary data analysis in the N-SSATS. Our findings suggest a one percentage point increase in the state unemployment rate is associated with a 2.5% reduction in outpatient clients by non-profit providers and a 1.8% increase in the acceptance of private insurance as a form of payment overall. We find no evidence that inpatient treatment, the provision of charity care, offered services, or special programs are impacted by changes in the state unemployment rate. However, a one percentage point increase in the state unemployment rate leads to a 2.5% increase in the probability that a provider uses pharmacotherapies to treat addiction. Deteriorating economic conditions may increase financial pressures on treatment providers, prompting them to seek new sources of revenue or to change their care delivery models. Copyright © 2017 Elsevier Inc. All rights reserved.

Changing the course of schizophrenia - predictors of treatment ...

African Journals Online (AJOL)

Changing the course of schizophrenia - predictors of treatment outcome revisited. R Emsley, P Oosthuizen, D Niehaus, L Koen, B chiliza. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4102/sajpsychiatry.v13i1.4.

Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study

NARCIS (Netherlands)

van der Eerden, M. M.; Vlaspolder, F.; de Graaff, C. S.; Groot, T.; Bronsveld, W.; Jansen, H. M.; Boersma, W. G.

2005-01-01

Background: There is much controversy about the ideal approach to the management of community acquired pneumonia ( CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics. Methods: In a prospective randomised open study performed

The Theoretical and Empirical Basis for Meditation as an Intervention for PTSD

Science.gov (United States)

Lang, Ariel J.; Strauss, Jennifer L.; Bomyea, Jessica; Bormann, Jill E.; Hickman, Steven D.; Good, Raquel C.; Essex, Michael

2012-01-01

In spite of the existence of good empirically supported treatments for posttraumatic stress disorder (PTSD), consumers and providers continue to ask for more options for managing this common and often chronic condition. Meditation-based approaches are being widely implemented, but there is minimal research rigorously assessing their effectiveness.…

The changing trend in marketing of financial services: an empirical study on bank performance in Nigeria

Directory of Open Access Journals (Sweden)

Abiodun Eniola Alao

2014-07-01

Full Text Available The long years of marketing practices in the Nigerian banking industry has recorded low level standards relative to global standard practice. The effect on the overall industry performance measurable basically in terms of customer satisfaction, customer loyalty and brand equity has been on the negativity. In some cases, banks overall performance level was never assessed based on customer orientation, value and other customer related measures rather on some quick financial indicators. This poor orientation towards marketing has rather become a forgone especially in the banking area of financial services in Nigeria. This study was therefore conducted to examine the changing trend towards embracing marketing philosophy and the extent of the banks’ performance level in response to changing expectations of customers. Theoretical issues relating marketing, customer philosophy, financial marketing, customer loyalty, satisfaction, and brand equity were explored to establish the key performance variables and the existing relationships amongst them. Empirical study was equally carried out with the use of questionnaire, administered on randomly selected banks’ customers and management staff. Data collected were analyzed on the basis of critical measures which include customer awareness, market sensitivity to financial delivery, customer profile and sophistication through the use of Spearman Rank Correlation Coefficient. The result among other things shows that there is a significant relationship between the new trend towards marketing orientation, financial services in the banking industry and performance level. Based on this study, we recommend improved marketing performance and training to enhance service delivery, customer satisfaction, and customer loyalty across all banks in the geographical places of the Nigerian financial markets.

Birds of the Mongol Empire

OpenAIRE

Eugene N. Anderson

2016-01-01

The Mongol Empire, the largest contiguous empire the world has ever known, had, among other things, a goodly number of falconers, poultry raisers, birdcatchers, cooks, and other experts on various aspects of birding. We have records of this, largely in the Yinshan Zhengyao, the court nutrition manual of the Mongol empire in China (the Yuan Dynasty). It discusses in some detail 22 bird taxa, from swans to chickens. The Huihui Yaofang, a medical encyclopedia, lists ten taxa used medicinally. Ma...

Wireless and empire geopolitics radio industry and ionosphere in the British Empire 1918-1939

CERN Document Server

Anduaga, Aitor

2009-01-01

Although the product of consensus politics, the British Empire was based on communications supremacy and the knowledge of the atmosphere. Focusing on science, industry, government, the military, and education, this book studies the relationship between wireless and Empire throughout the interwar period.

Systematic risk and liquidity : an empirical study comparing Norwegian equity certificates before and after the regulation in 2009

OpenAIRE

Hatlevik, Håkon; Einvik, Christian

2014-01-01

In 2009, the Norwegian savings banks industry was subject to a regulation change, which resulted in a modification of the instrument issued by these banks. Thus, in this empirical study we compare the systematic risk and liquidity of equity certificates issued by Norwegian savings banks before and after the regulation change. We go about estimating systematic risk and liquidity using regression analysis. In order to estimate systematic risk we use the empirical model of the CAPM often referre...

A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology

Science.gov (United States)

Forbes, Miriam K.; Baillie, Andrew J.; Eaton, Nicholas R.; Krueger, Robert F.

2017-01-01

Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or “spectra”). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research. PMID:28121167

Empirical Music Aesthetics

DEFF Research Database (Denmark)

Grund, Cynthia M.

The toolbox for empirically exploring the ways that artistic endeavors convey and activate meaning on the part of performers and audiences continues to expand. Current work employing methods at the intersection of performance studies, philosophy, motion capture and neuroscience to better understand...... musical performance and reception is inspired by traditional approaches within aesthetics, but it also challenges some of the presuppositions inherent in them. As an example of such work I present a research project in empirical music aesthetics begun last year and of which I am a team member....

Changing Assumptions and Progressive Change in Theories of Strategic Organization

DEFF Research Database (Denmark)

Foss, Nicolai J.; Hallberg, Niklas L.

2017-01-01

are often decoupled from the results of empirical testing, changes in assumptions seem closely intertwined with theoretical progress. Using the case of the resource-based view, we suggest that progressive change in theories of strategic organization may come about as a result of scholarly debate and dispute......A commonly held view is that strategic organization theories progress as a result of a Popperian process of bold conjectures and systematic refutations. However, our field also witnesses vibrant debates or disputes about the specific assumptions that our theories rely on, and although these debates...... over what constitutes proper assumptions—even in the absence of corroborating or falsifying empirical evidence. We also discuss how changing assumptions may drive future progress in the resource-based view....

The importance of culture in treating abused and neglected children: an empirical review.

Science.gov (United States)

Cohen, J A; Deblinger, E; Mannarino, A P; de Arellano, M A

2001-05-01

There is growing evidence that cultural factors may influence symptom development and treatment referral patterns among abused and neglected children. To date, few treatment outcome studies have specifically examined the impact of race, culture, or ethnicity on treatment response among maltreated children. Those that have attempted to include these factors have typically suffered from lack of clarity of the meaning of these terms. This article reviews the available empirical evidence that addresses the influence of culture on symptom formation, treatment-seeking behaviors, treatment preference, and response following child maltreatment. Hypotheses regarding these findings are addressed, and implications for practice, research, and public policy are discussed.

Empirical philosophy of science

DEFF Research Database (Denmark)

Wagenknecht, Susann; Nersessian, Nancy J.; Andersen, Hanne

2015-01-01

A growing number of philosophers of science make use of qualitative empirical data, a development that may reconfigure the relations between philosophy and sociology of science and that is reminiscent of efforts to integrate history and philosophy of science. Therefore, the first part...... of this introduction to the volume Empirical Philosophy of Science outlines the history of relations between philosophy and sociology of science on the one hand, and philosophy and history of science on the other. The second part of this introduction offers an overview of the papers in the volume, each of which...... is giving its own answer to questions such as: Why does the use of qualitative empirical methods benefit philosophical accounts of science? And how should these methods be used by the philosopher?...

An Empirical Analysis of the Changing Role of the German Bundesbank after 1983

DEFF Research Database (Denmark)

Juselius, Katarina

and expansion or contraction of money supply had the expected effect on prices, income, and interest rates. After 1983, the conventional mechanisms no longer seemed to work. The empirical analysis pointed to the crucial role of the bond rate in the system, particularly for the more recent period......A cointegrated VAR model describing a small macroeconomic system consisting of money, income, prices, and interest rates is estimated on split sample data before and after 1983. The monetary mechanisms were found to be significantly different. Before 1983, the money supply seemed controlable...

Do symptom-specific stages of change predict eating disorder treatment outcome?

Science.gov (United States)

Ackard, Diann M; Cronemeyer, Catherine L; Richter, Sara; Egan, Amber

2015-03-01

Interview methods to assess stages of change (SOC) in eating disorders (ED) indicate that SOC are positively correlated with symptom improvement over time. However, interviews require significant time and staff training and global measures of SOC do not capture varying levels of motivation across ED symptoms. This study used a self-report, ED symptom-specific SOC measure to determine prevalence of stages across symptoms and identify if SOC predict treatment outcome. Participants [N = 182; age 13-58 years; 92% Caucasian; 96% female; average BMI 21.7 (SD = 5.9); 50% ED not otherwise specified (EDNOS), 30.8% bulimia nervosa (BN), 19.2% anorexia nervosa (AN)] seeking ED treatment at a diverse-milieu multi-disciplinary facility in the United States completed stages of change, behavioral (ED symptom use and frequency) and psychological (ED concerns, anxiety, depression) measures at intake assessment and at 3, 6 and 12 months thereafter. Descriptive summaries were generated using ANOVA or Kruskal-Wallis (continuous) and χ (2) (categorical) tests. Repeated measures linear regression models with autoregressive correlation structure predicted treatment outcome. At intake assessment, 53.3% of AN, 34.0% of BN and 18.1% of EDNOS patients were in Preparation/Action. Readiness to change specific symptoms was highest for binge-eating (57.8%) and vomiting (56.5%). Frequency of fasting and restricting behaviors, and scores on all eating disorder and psychological measures improved over time regardless of SOC at intake assessment. Symptom-specific SOC did not predict reductions in ED symptom frequency. Overall SOC predicted neither improvement in Eating Disorder Examination Questionnaire (EDE-Q) scores nor reduction in depression or trait anxiety; however, higher overall SOC predicted lower state anxiety across follow-up. Readiness to change ED behaviors varies considerably. Most patients reduced eating disorder behaviors and increased psychological functioning regardless of stages

An empirical system for probabilistic seasonal climate prediction

Science.gov (United States)

Eden, Jonathan; van Oldenborgh, Geert Jan; Hawkins, Ed; Suckling, Emma

2016-04-01

Preparing for episodes with risks of anomalous weather a month to a year ahead is an important challenge for governments, non-governmental organisations, and private companies and is dependent on the availability of reliable forecasts. The majority of operational seasonal forecasts are made using process-based dynamical models, which are complex, computationally challenging and prone to biases. Empirical forecast approaches built on statistical models to represent physical processes offer an alternative to dynamical systems and can provide either a benchmark for comparison or independent supplementary forecasts. Here, we present a simple empirical system based on multiple linear regression for producing probabilistic forecasts of seasonal surface air temperature and precipitation across the globe. The global CO2-equivalent concentration is taken as the primary predictor; subsequent predictors, including large-scale modes of variability in the climate system and local-scale information, are selected on the basis of their physical relationship with the predictand. The focus given to the climate change signal as a source of skill and the probabilistic nature of the forecasts produced constitute a novel approach to global empirical prediction. Hindcasts for the period 1961-2013 are validated against observations using deterministic (correlation of seasonal means) and probabilistic (continuous rank probability skill scores) metrics. Good skill is found in many regions, particularly for surface air temperature and most notably in much of Europe during the spring and summer seasons. For precipitation, skill is generally limited to regions with known El Niño-Southern Oscillation (ENSO) teleconnections. The system is used in a quasi-operational framework to generate empirical seasonal forecasts on a monthly basis.

Assessment of empirical antibiotic therapy optimisation in six hospitals: an observational cohort study.

Science.gov (United States)

Braykov, Nikolay P; Morgan, Daniel J; Schweizer, Marin L; Uslan, Daniel Z; Kelesidis, Theodoros; Weisenberg, Scott A; Johannsson, Birgir; Young, Heather; Cantey, Joseph; Srinivasan, Arjun; Perencevich, Eli; Septimus, Edward; Laxminarayan, Ramanan

2014-12-01

Modification of empirical antimicrobials when warranted by culture results or clinical signs is recommended to control antimicrobial overuse and resistance. We aimed to assess the frequency with which patients were started on empirical antimicrobials, characteristics of the empirical regimen and the clinical characteristics of patients at the time of starting antimicrobials, patterns of changes to empirical therapy at different timepoints, and modifiable factors associated with changes to the initial empirical regimen in the first 5 days of therapy. We did a chart review of adult inpatients receiving one or more antimicrobials in six US hospitals on 4 days during 2009 and 2010. Our primary outcome was the modification of antimicrobial regimen on or before the 5th day of empirical therapy, analysed as a three-category variable. Bivariate analyses were used to establish demographic and clinical variables associated with the outcome. Variables with p values below 0·1 were included in a multivariable generalised linear latent and mixed model with multinomial logit link to adjust for clustering within hospitals and accommodate a non-binary outcome variable. Across the six study sites, 4119 (60%) of 6812 inpatients received antimicrobials. Of 1200 randomly selected patients with active antimicrobials, 730 (61%) met inclusion criteria. At the start of therapy, 220 (30%) patients were afebrile and had normal white blood cell counts. Appropriate cultures were collected from 432 (59%) patients, and 250 (58%) were negative. By the 5th day of therapy, 12·5% of empirical antimicrobials were escalated, 21·5% were narrowed or discontinued, and 66·4% were unchanged. Narrowing or discontinuation was more likely when cultures were collected at the start of therapy (adjusted OR 1·68, 95% CI 1·05-2·70) and no infection was noted on an initial radiological study (1·76, 1·11-2·79). Escalation was associated with multiple infection sites (2·54, 1·34-4·83) and a positive

76 FR 17617 - Changes to Treatments for Citrus Fruit From Australia

Science.gov (United States)

2011-03-30

... Inspection Service [Docket No. APHIS-2008-0140] Changes to Treatments for Citrus Fruit From Australia AGENCY... Australia into the United States. These new treatments will continue to prevent the introduction or... from Australia into the United States. We also proposed to establish an approved irradiation dose for...

Does phasic trauma treatment make patients with dissociative identity disorder treatment more dissociative?

Science.gov (United States)

Brand, Bethany; Loewenstein, Richard J

2014-01-01

Proponents of the iatrogenic model of the etiology of dissociative identity disorder (DID) have expressed concern that treatment focused on direct engagement and interaction with dissociated self-states harms DID patients. However, empirical data have shown that this type of DID treatment is beneficial. Analyzing data from the prospective Treatment of Patients With Dissociative Disorders (TOP DD) Study, we test empirically whether DID treatment is associated with clinically adverse manifestations of dissociated self-states: acting so differently that one feels like different people, hearing voices, and dissociative amnesia. We show that, over the course of the study, there were significant decreases in feeling like different people and hearing voices. These results indicate that this form of DID treatment does not lead to symptomatic worsening in these dimensions, as predicted by the iatrogenic model. Indeed, treatment provided by TOP DD therapists reduced, rather than increased, the extent to which patients experienced manifestations of pathological dissociation. Because severe symptomatology and impairment are associated with DID, iatrogenic harm may come from depriving DID patients of treatment that targets DID symptomatology.

YOUTH STUDIES – A SPECIFIC GENRE OF THE EMPIRICAL PARADIGM IN SOCIAL SCIENCES

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Agnė Dorelaitienė

2017-09-01

Full Text Available The article presents the situation of youth in contemporary society. Neoliberal economy, ageing society, rapid globalisation, technological changes, increase of social risk have prompted specific, historically unfamiliar, and fairly difficult to forecast social change. Social adaptation and construction of own identity are becoming challenging to youth as a specific social group in this period of great uncertainty, risk, and opportunities. Youth studies are referred to as one of the means to help understand the youth phenomenon and form the respective policy. Aim of the article is to reveal the role of youth studies as a specific interdisciplinary genre of the empirical-analytic paradigm in social sciences. Research objectives: (1 To identify the traditions of youth studies and differences between them; (2. To reveal the specific character of youth studies as an empirical paradigm in the contemporary context. Analysis of scientific sources and document analysis are used for achievement of the goal and objectives. Since the 20th century, youth studies have been developing as an independent research discipline and tradition. Perception of the notion of a young person has been changing along with development of the paradigmatic and methodological research traditions. Modernity has doubtlessly contributed to a young person finding his/her place in other age groups and putting an emphasis on the importance of youth as a specific social group. Recently, youth has been viewed as both the risk and the opportunity group. Although qualitative research, in particular, where youth emancipation is aspired, prevails in the contemporary research tradition, the empirical-analytic paradigm has not lost its relevance. The research has demonstrated that empirical-analytic paradigm is a specific genre of the youth studies characterised by quantitative approach and strong link to politics and practical situation of the phenomenon.

Economic Comparison of an Empirical Versus Diagnostic-Driven Strategy for Treating Invasive Fungal Disease in Immunocompromised Patients.

Science.gov (United States)

Barnes, Rosemary; Earnshaw, Stephanie; Herbrecht, Raoul; Morrissey, Orla; Slavin, Monica; Bow, Eric; McDade, Cheryl; Charbonneau, Claudie; Weinstein, David; Kantecki, Michal; Schlamm, Haran; Maertens, Johan

2015-06-01

Patients with persistent or recurrent neutropenic fevers at risk of invasive fungal disease (IFD) are treated empirically with antifungal therapy (AFT). Early treatment using a diagnostic-driven (DD) strategy may reduce clinical and economic burdens. We compared costs and outcomes of both strategies from a UK perspective. An empirical strategy with conventional amphotericin B deoxycholate (C-AmB), liposomal amphotericin B (L-AmB), or caspofungin was compared with a DD strategy (initiated based on positive ELISA results for galactomannan antigen) and/or positive results for Aspergillus species on polymerase chain reaction assay) using C-AmB, voriconazole, or L-AmB in a decision-analytic model. Rates of IFD incidence, overall mortality, and IFD-related mortality in adults expected to be neutropenic for ≥10 days were obtained. The empirical strategy was assumed to identify 30% of IFD and targeted AFT to improve survival by a hazard ratio of 0.589. AFT-specific adverse events were obtained from a summary of product characteristics. Resource use was obtained, and costs were estimated by using standard UK costing sources. All costs are presented in 2012 British pounds sterling. Total costs were 32% lower for the DD strategy (£1561.29) versus the empirical strategy (£2301.93) due to a reduced incidence of adverse events and decreased use of AFT. Administration of AFT was reduced by 41% (DD strategy, 74 of 1000; empirical strategy, 125 of 1000), with similar survival rates. This study suggests that a DD strategy is likely to be cost-saving versus empirical treatment for immunocompromised patients with persistent or recurrent neutropenic fevers. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Comparing the model-simulated global warming signal to observations using empirical estimates of unforced noise

Science.gov (United States)

Brown, Patrick T.; Li, Wenhong; Cordero, Eugene C.; Mauget, Steven A.

2015-01-01

The comparison of observed global mean surface air temperature (GMT) change to the mean change simulated by climate models has received much public and scientific attention. For a given global warming signal produced by a climate model ensemble, there exists an envelope of GMT values representing the range of possible unforced states of the climate system (the Envelope of Unforced Noise; EUN). Typically, the EUN is derived from climate models themselves, but climate models might not accurately simulate the correct characteristics of unforced GMT variability. Here, we simulate a new, empirical, EUN that is based on instrumental and reconstructed surface temperature records. We compare the forced GMT signal produced by climate models to observations while noting the range of GMT values provided by the empirical EUN. We find that the empirical EUN is wide enough so that the interdecadal variability in the rate of global warming over the 20th century does not necessarily require corresponding variability in the rate-of-increase of the forced signal. The empirical EUN also indicates that the reduced GMT warming over the past decade or so is still consistent with a middle emission scenario's forced signal, but is likely inconsistent with the steepest emission scenario's forced signal. PMID:25898351

Comparing the model-simulated global warming signal to observations using empirical estimates of unforced noise.

Science.gov (United States)

Brown, Patrick T; Li, Wenhong; Cordero, Eugene C; Mauget, Steven A

2015-04-21

The comparison of observed global mean surface air temperature (GMT) change to the mean change simulated by climate models has received much public and scientific attention. For a given global warming signal produced by a climate model ensemble, there exists an envelope of GMT values representing the range of possible unforced states of the climate system (the Envelope of Unforced Noise; EUN). Typically, the EUN is derived from climate models themselves, but climate models might not accurately simulate the correct characteristics of unforced GMT variability. Here, we simulate a new, empirical, EUN that is based on instrumental and reconstructed surface temperature records. We compare the forced GMT signal produced by climate models to observations while noting the range of GMT values provided by the empirical EUN. We find that the empirical EUN is wide enough so that the interdecadal variability in the rate of global warming over the 20(th) century does not necessarily require corresponding variability in the rate-of-increase of the forced signal. The empirical EUN also indicates that the reduced GMT warming over the past decade or so is still consistent with a middle emission scenario's forced signal, but is likely inconsistent with the steepest emission scenario's forced signal.

Routine Treatment of Cervical Cytological Cell Changes

Science.gov (United States)

Huber, J.; Pötsch, B.; Gantschacher, M.; Templ, M.

2016-01-01

Introduction: Diagnosis and treatment of vaginal and cervical cytological cell changes are described in European and national guidelines. The aim of this data collection was to evaluate the remission rates of PAP III and PAP III D cytological findings in patients over a period of 3–4 months. Method: The current state of affairs in managing suspicious and cytological findings (PAP III, and III D) in gynecological practice was assessed in the context of a data collection survey. An evaluation over a period of 24 months was conducted on preventative measures, the occurrence and changes to normal/suspect/pathological findings and therapy management (for suspicious or pathological findings). Results: 307 female patients were included in the analysis. At the time of the survey 186 patients (60.6 %) had PAP III and 119 (38.8 %) had PAP III D findings. The spontaneous remission rate of untreated PAP III patients was 6 % and that of untreated PAP III D patients was 11 %. The remission rates of patients treated with a vaginal gel were 77 % for PAP III and 71 % for PAP III D. Conclusion: A new treatment option was used in gynecological practice on patients with PAP III and PAP III D findings between confirmation and the next follow-up with excellent success. PMID:27761030

Kinetic and empirical design criteria for constructed wetlands

International Nuclear Information System (INIS)

Nix, P.G.; Gulley, J.R.

1995-01-01

A study was conducted to demonstrate the capabilities of wetlands as long-term, self-sustaining natural systems for the treatment of large quantities of waste water released from tailings ponds after mine abandonment. Constructed wetlands were built and planted with aquatic plants. The experimental design included three replicate trenches for each of two treatment systems. The objective of the research was to assess the optimum contaminant loading rates which would result in an acceptable quality of the effluent water. Using empirical data (i.e., hydrocarbon loading rates versus effluent quality), the optimal range of hydrocarbon loading was 5 to 25 gTEH/m 2/ month. Using more conservative kinetic data (i.e. microbial mineralization rates), the range of optimal treatment effectiveness was 9.6 to 13.2 gTEH/m 2/ month. The two design criteria methodologies were calculated using two independent analytical methods. The similarity in results was judged to be a confirmation of their accuracy. 20 refs., 5 figs

Simulated vs. empirical weather responsiveness of crop yields: US evidence and implications for the agricultural impacts of climate change

Science.gov (United States)

Mistry, Malcolm N.; Wing, Ian Sue; De Cian, Enrica

2017-07-01

Global gridded crop models (GGCMs) are the workhorse of assessments of the agricultural impacts of climate change. Yet the changes in crop yields projected by different models in response to the same meteorological forcing can differ substantially. Through an inter-method comparison, we provide a first glimpse into the origins and implications of this divergence—both among GGCMs and between GGCMs and historical observations. We examine yields of rainfed maize, wheat, and soybeans simulated by six GGCMs as part of the Inter-Sectoral Impact Model Intercomparison Project-Fast Track (ISIMIP-FT) exercise, comparing 1981-2004 hindcast yields over the coterminous United States (US) against US Department of Agriculture (USDA) time series for about 1000 counties. Leveraging the empirical climate change impacts literature, we estimate reduced-form econometric models of crop yield responses to temperature and precipitation exposures for both GGCMs and observations. We find that up to 60% of the variance in both simulated and observed yields is attributable to weather variation. A majority of the GGCMs have difficulty reproducing the observed distribution of percentage yield anomalies, and exhibit aggregate responses that show yields to be more weather-sensitive than in the observational record over the predominant range of temperature and precipitation conditions. This disparity is largely attributable to heterogeneity in GGCMs’ responses, as opposed to uncertainty in historical weather forcings, and is responsible for widely divergent impacts of climate on future crop yields.

The Influence of Globalization on the Change and Convergence of Social Security Transfer: An Empirical Analysis for OECD Counties

Directory of Open Access Journals (Sweden)

Jinyoung Hwang

2007-12-01

Full Text Available Using a cross-section of OECD countries, this paper examines the relationship between globalization and the change and convergence of social security transfer. Globalization has arguably had a profound impact on the use of social protection in states, since it is normally accompanied with increases in income inequality, polarization, and unemployment. In addition, globalization may lead to socio- economic policy harmonization across countries. The empirical results show that there exists a significant and positive relationship between social security transfer in GDP and the globalization index based on political, economic, and social integrations. Also, we found the convergence phenomenon of social security transfer in OECD countries, applying the traditional methodology of convergence and convergence. Therefore, there is evidence in OECD countries that globalization indirectly affects the convergence of social security transfer in addition to direct relation to social security transfer in GDP.

Final Empirical Test Case Specification

DEFF Research Database (Denmark)

Kalyanova, Olena; Heiselberg, Per

This document includes the empirical specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one....

Empire vs. Federation

DEFF Research Database (Denmark)

Gravier, Magali

2011-01-01

The article discusses the concepts of federation and empire in the context of the European Union (EU). Even if these two concepts are not usually contrasted to one another, the article shows that they refer to related type of polities. Furthermore, they can be used at a time because they shed light...... on different and complementary aspects of the European integration process. The article concludes that the EU is at the crossroads between federation and empire and may remain an ‘imperial federation’ for several decades. This could mean that the EU is on the verge of transforming itself to another type...

Empirical Study on the Indicators of Sustainable Performance – the Sustainability Balanced Scorecard, Effect of Strategic Organizational Change

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Maria Radu

2012-06-01

Full Text Available The sustainable organizational change has an ever increasing importance, leading to the rethinking of the management and systems of performance measurement and monitoring within the companies. As a reaction to current economic phenomena, in the first section of this work we tried to bring out the need for using the couple Balanced Scorecard - Corporate Social Responsibility by companies. Thus, companies involved in sustainable actions must grant a great importance to the impact of environmental, social and economic factors in providing added value, informing the interested parties and reflecting the reporting of sustainable performance. As a consequence, in the second part of the work we present the Sustainability Balanced Scorecard for the implementation of efficient strategies which cumulate the economic, social and environmental aspects as integrating system for sustainable performance and as a new challenge for organizational change. The key performance indicators included in the Sustainability Balanced Scorecard are quantified by the indicators of sustainable development, based on which the empirical research described in the third section of the work was achieved. Through the quantitative analysis of the economic and ecological indicators (Gross Domestic Product per capita, respective, Environmental Performance Index in correlation with the social indicator (Global Competitive Index, we conclude that the implementation of green strategies by companies leads to sustainable economic growth.

A Balanced Theoretical and Empirical Approach for the Development of a Design Support Tool

DEFF Research Database (Denmark)

Jensen, Thomas Aakjær; Hansen, Claus Thorp

1996-01-01

The introduction of a new design support system may change the engineering designer's work situation. Therefore, it may not be possible to derive all the functionalities for a design support system from solely empirical studies of manual design work. Alternatively the design support system could ...... system, indicating a proposal for how to balance a theoretical and empirical approach. The result of this research will be utilized in the development of a Designer's Workbench to support the synthesis activity in mechanical design....

Strategy implementation and organizational change in healthcare organizations - a distributed change leadership perspective

DEFF Research Database (Denmark)

Holm, Anna B.; Ulhøi, John Parm

This paper examines some theoretical underpinnings of distributed leadership and its ability to serve as change leadership during the process of major organizational changes in healthcare organizations. The study was initiated as part of a larger research project on distributed leadership (DL......) in the healthcare sector, financed by a research grant addressing both empirical and theoretical questions. The paper clarifies the relationship between distributed leadership and change leadership, and more specifically, the characteristics of distributed leadership in the change leadership process. We also...... propose a distributed change leadership (DCL) model that permits further development of research design and empirical studies of DCL. On a more general side, with this paper we shed more light on some aspects of leadership patterns in healthcare, where there is a distinct gap....

Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa—Treatment Satisfaction and the Perception of Change

Directory of Open Access Journals (Sweden)

Camilla Lindvall Dahlgren

2017-04-01

Full Text Available Cognitive remediation therapy (CRT has recently been developed for children and adolescents with anorexia nervosa (AN. It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little is known regarding the specifics of its feasibility, and the perception of change associated with the intervention. Consequently, the aim of the current study was to explore service users’ perspective on CRT with a specific focus on treatment delivery, treatment content, and perceived change. Twenty adolescents (age 13–18 with AN participated in a 10-session course of CRT. A 20-item treatment evaluation questionnaire was administered at the end of treatment, focusing on four aspects of the intervention: (1 general attitudes towards treatment, (2 treatment specifics, (3 the perception of change and (4 the patient-therapist relation. The main findings suggest high levels of treatment satisfaction, but somewhat limited perceptions of change. The current study is one of the most detailed accounts of adolescents’ perspective on CRT published on eating disorders, and highlights several important aspects of the treatment viewed through the eye of the receiver.

[Relationship between cocaine dependence treatment and personal values of openness to change and conservation].

Science.gov (United States)

Galdós, Jesús Saiz; Sánchez, Isabel Martínez

2010-01-01

To analyze the relationship between participation in a drug addiction treatment program and Schwartz's values of Openness to change (Self-direction, Stimulation and Hedonism) and Conservation (Tradition, Conformity and Security) in cocaine users. The present quasi-experimental study was carried out on a sample of 411 adult cocaine users, grouped according to whether they had begun treatment more than three months earlier or less than three months earlier or they were not receiving any treatment. Using Schwartz's Personal Values Questionnaire (PVQ), we measured the priority given by each of these groups to the values of Conservation and Openness to change. Participants who had initiated the treatment more than three months earlier tended to score lower in the values of Openness to change than those who were not in treatment, though there were no significant differences in these values between those who were not in treatment and those who had been in treatment for less than three months. On the other hand, it was observed that participants in treatment, regardless of the time spent in treatment, scored higher in values of Conservation than the cocaine users who were not in treatment. These results reveal the relationship between attendance on a cocaine-dependence treatment program and personal values, together with their potential importance in treatment and rehabilitation programs for cocaine users.

A new prescription for empirical ethics research in pharmacy: a critical review of the literature

OpenAIRE

Cooper, R J; Bissell, P; Wingfield, J

2007-01-01

Empirical ethics research is increasingly valued in bioethics and healthcare more generally, but there remain as yet under-researched areas such as pharmacy, despite the increasingly visible attempts by the profession to embrace additional roles beyond the supply of medicines. A descriptive and critical review of the extant empirical pharmacy ethics literature is provided here. A chronological change from quantitative to qualitative approaches is highlighted in this review, as well as differi...

The Apocalyptic Empire of America L’Empire apocalyptique américain

Directory of Open Access Journals (Sweden)

Akça Ataç

2009-10-01

Full Text Available En général, les études traitant de « l’Empire » américain tendent à chercher à comprendre celui-ci à partir de termes concrets tels que la frontière, l’intervention militaire, le commerce international. Néanmoins, les Empires sont d’abord le résultat de profondes traditions intellectuelles intangibles qui encouragent et justifient les actions entreprises dans le cadre de politiques impériales. Dans le cas de l’Amérique, les fondements intellectuels du nouvel idéal impérial sont ancrés dans la vision apocalyptique transportée dans les bagages des premiers colons puritains. Si l’on ne prend pas en compte cet ancrage apocalyptique, on ne peut saisir, dans leur totalité, les principes fondamentaux de « l’Empire » américain. On devrait examiner des termes qui entrent en résonance avec le discours impérial tels que « mission » et « destinée » ainsi que de l’engagement explicite dans la rhétorique présidentielle en faveur de « l’amélioration » du monde à n’importe quel prix du point de vue de cette croyance apocalyptique éternelle. Cet article essaie d’élucider l’origine et l’essence de la vision apocalyptique américaine en portant une attention particulière sur son influence dans la genèse du concept d’Empire américain.

The Changing Treatment Landscape for Metastatic Urothelial Carcinoma.

Science.gov (United States)

Flaig, Thomas W

2018-05-01

Urothelial carcinoma is the predominant histologic type of bladder cancer. After 30 years of minimal progress in the treatment of advanced-stage disease, recent advances in the genomic characterization of urothelial cancer and breakthroughs in bladder cancer therapeutics have rejuvenated the field. Nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab are among the exciting recent novel therapeutic advances gaining approvals by the FDA for treatment of advanced-stage urothelial carcinoma. Yet the challenge for clinicians is to determine the optimal choice of agents as first-line or second-line therapy and which offers the best chance for overall survival for the individual patient in this rapidly changing field. Copyright © 2018 by the National Comprehensive Cancer Network.

Rape: psychopathology, theory and treatment.

Science.gov (United States)

Gannon, Theresa A; Collie, Rachael M; Ward, Tony; Thakker, Jo

2008-07-01

Whether treatment programs are effective at rehabilitating rapists is yet to be determined empirically. From a scientist-practitioner perspective, treatment should be based on an empirical understanding of rape and rapists, and evidence-based knowledge of treatment outcome with rapists. In this paper we comprehensively review the characteristics of rapists, etiological features implicated in the commission of rape, and relevant treatment outcome research. We pay particular attention to contemporary knowledge about the core vulnerabilities and features required to understand and treat rapists effectively, and, where possible, highlight similarities and differences between rapists, child molesters and non-sexual violent offenders. We use an epistemological framework to (a) critique the various etiological accounts of rape available and (b) help guide professionals' use of such knowledge in both treatment design and evaluation. Gaps in the understanding of rapists' characteristics and etiological features are highlighted, as are discrepancies between current knowledge and treatment approaches. We conclude by highlighting areas for future research and practice innovation.

Pluvials, Droughts, the Mongol Empire, and Modern Mongolia

Science.gov (United States)

Hessl, A. E.; Pederson, N.; Baatarbileg, N.; Anchukaitis, K. J.

2013-12-01

Understanding the connections between climate, ecosystems, and society during historical and modern climatic transitions requires annual resolution records with high fidelity climate signals. Many studies link the demise of complex societies with deteriorating climate conditions, but few have investigated the connection between climate, surplus energy, and the rise of empires. Inner Asia in the 13th century underwent a major political transformation requiring enormous energetic inputs that altered human history. The Mongol Empire, centered on the city of Karakorum, became the largest contiguous land empire in world history (Fig. 1 inset). Powered by domesticated grazing animals, the empire grew at the expense of sedentary agriculturalists across Asia, the Middle East, and Eastern Europe. Although some scholars and conventional wisdom agree that dry conditions spurred the Mongol conquests, little paleoenvironmental data at annual resolution are available to evaluate the role of climate in the development of the Mongol Empire. Here we present a 2600 year tree-ring reconstruction of warm-season, self-calibrating Palmer Drought Severity Index (scPDSI), a measure of water balance, derived from 107 live and dead Siberian pine (Pinus sibirica) trees growing on a Holocene lava flow in central Mongolia. Trees growing on the Khorgo lava flow today are stunted and widely spaced, occurring on microsites with little to no soil development. These trees are extremely water-stressed and their radial growth is well-correlated with both drought (scPDSI) and grassland productivity (Normalized Difference Vegetation Index (NDVI)). Our reconstruction, calibrated and validated on instrumental June-September scPDSI (1959-2009) accounts for 55.8% of the variability in the regional scPDSI when 73% of the annual rainfall occurs. Our scPDSI reconstruction places historic and modern social change in Mongolia in the context of the range of climatic variability during the Common Era. Our record

Changes in the uterus after maternal treatment with diethylstilbestrol

International Nuclear Information System (INIS)

Sanders, F.B.M.; Dony, J.M.J.; Rosenbusch, G.; Katholieke Univ. Nijmegen

1985-01-01

In the fifties and sixties pregnant women with a history of habitual abortions or premature deliveries were treated with DES (diethylstilboestrol). This treatment can lead to certain pathognomonic uterine changes in the daughters, that are recognizable on hysterosalpingographs. Because of the obstetric consequences, it is important to interpret these changes correctly. The findings in 7 patients are described. As most of the DES-daughters are now coming into reproductive age, gynecologists and radiologists will be confronted more frequently with their specific problems. (orig.) [de

Protection for Sale Under Monopolistic Competition: An Empirical Investigation

OpenAIRE

Pao-Li Chang; Myoung-jae Lee

2006-01-01

This paper proposes a general empirical framework to estimate the protection-for-sale model, where the protection regime shifts according to a sector's market structure (perfectly or monop-olistically competitive). We base the protection structure on Grossman and Helpman (1994) for the subset of perfectly competitive sectors and on Chang (2005) for the subset of monop- olistically competitive sectors. The two protection regimes are simultaneously estimated with joint constraints. The results ...

Urban and regional change in Australia: an empirical introduction.

Science.gov (United States)

O'connor, K

1984-08-01

Recent changes in the spatial distribution of the population in Australia are examined. In particular, changes in population by state are analyzed for the period 1971-1981. The relationship of these changes to shifts in economic activity, private investment, and banking activity is considered. "Results show there have been only small shifts toward population growth areas. These results are interpreted in part as a consequence of nonlocal multipliers and linkages back to established areas, but also as a reflection of the unique features of the Australian urban and regional system." excerpt

Regarding Societal Change

Directory of Open Access Journals (Sweden)

Leda Blackwood

2013-12-01

Full Text Available In this paper we introduce our special thematic section on societal change. We begin by providing an overview of the aims of the section, and how these aims grew out of a need to address conceptual and empirical challenges in the study of societal change. In response to these challenges, the section was intended to provide a forum for theoretical and empirical work from a range of disciplinary perspectives on how societies change, and how such change can be understood. Together, the contributions argue for (1 the need to contextualize the study of societal change, (2 the value of considering factors and processes other than collective action in transforming societies, (3 the importance of ideology and its operation through social institutions such as news media, and (4 an imperative to ensure that our research is fully engaged with society in terms of its grounding in social issues, its sensitivity to our own social context as researchers, and in its practices and outcomes.

Review essay: empires, ancient and modern.

Science.gov (United States)

Hall, John A

2011-09-01

This essay drews attention to two books on empires by historians which deserve the attention of sociologists. Bang's model of the workings of the Roman economy powerfully demonstrates the tributary nature of per-industrial tributary empires. Darwin's analysis concentrates on modern overseas empires, wholly different in character as they involved the transportation of consumption items for the many rather than luxury goods for the few. Darwin is especially good at describing the conditions of existence of late nineteenth century empires, noting that their demise was caused most of all by the failure of balance of power politics in Europe. Concluding thoughts are offered about the USA. © London School of Economics and Political Science 2011.

A clinical treatment intervention for dysphoria: externalizing metaphors therapy.

Science.gov (United States)

McGuinty, Everett; Armstrong, David; Carrière, Anne-Marie

2014-01-01

The purpose of this article is to explore a novel, short-term treatment intervention for internalizing behaviours. This intervention is primarily based upon an externalizing process, transforming of metaphoric imagery, and shifting of underlying maladaptive emotional schemas. This article addresses the clinical population of children and youth, specifically through outlining the protocol, externalizing metaphors therapy. A selective review of significant works regarding the efficacy of short-term therapy was conducted, including the process of change within narrative therapy. It is proposed that two specific processes account for the mental health change experienced by clients who receive this new treatment intervention: (1) externalization of problems and (2) purposeful client-generated metaphor manipulation, impacting upon underlying schemas. From these theoretical constructs, the present article outlines a three-session treatment protocol that manualizes these key clinical processes. A case study is presented to illustrate this intervention for anxiety and depression. Further clinical research is underway to address the testable hypotheses resulting from the current theoretical model. Clinical trials in brief psychotherapy are suggested to empirically evaluate the efficacy of this new treatment intervention for dysphoria. This article outlines a short-term treatment intervention for anxiety and depression (dysphoira) through a novel 3-session model, where the clinician-practitioner can obtain competency through a one-day workshop.Its relevance for the clinical researcher and the mental health community is in its versatility in addressing internalizing behavior for four clinical populations: (1) children and adolescents; (2) children and adolescents on the autism spectrum; (3) adults in general; and, (4) adults with a dual-diagnosis. The treatment protocol described within is based upon the externalizing and deconstructive properties of Narrative Therapy, and the

PROBLEMS WITH WIREDU'S EMPIRICALISM Martin Odei Ajei1 ...

African Journals Online (AJOL)

In his “Empiricalism: The Empirical Character of an African Philosophy”,. Kwasi Wiredu sets out ... others, that an empirical metaphysical system contains both empirical ..... realms which multiple categories of existents inhabit and conduct their being in .... to a mode of reasoning that conceives categories polarized by formal.

Forest canopy effects on snow accumulation and ablation: an integrative review of empirical results

Science.gov (United States)

Andres Varhola; Nicholas C. Coops; Markus Weiler; R. Dan Moore

2010-01-01

The past century has seen significant research comparing snow accumulation and ablation in forested and open sites. In this review we compile and standardize the results of previous empirical studies to generate statistical relations between changes in forest cover and the associated changes in snow accumulation and ablation rate. The analysis drew upon 33 articles...

Outcomes of changing immunosuppressive therapy after treatment failure in patients with noninfectious uveitis.

Science.gov (United States)

Joshi, Lavnish; Talat, Lazha; Yaganti, Satish; Sandhu, Sartaj; Taylor, Simon R J; Wakefield, Denis; McCluskey, Peter; Lightman, Susan

2014-05-01

To evaluate the outcomes of changing immunosuppressive therapy for noninfectious uveitis after failure. Retrospective cohort study. Patients with noninfectious uveitis managed at 2 tertiary uveitis clinics in the United Kingdom and Australia. Participants with a history of using immunosuppressive therapy were identified in clinics, and notes were reviewed by doctors trained in uveitis therapy. Each treatment episode/course (starting or changing a therapy) was identified, and demographic details, clinical characteristics, drug used (second-line immunosuppressive agent [ISA] or biologicals), and drug doses were obtained. For each treatment episode, the reasons for changing therapy, corticosteroid-sparing effects, and control of inflammation were determined. A total of 147 patients were identified who underwent 309 different treatment episodes. Fifty-five percent of patients eventually required a change in treatment after their first treatment episode/course. Forty-five episodes involved switching from one ISA to another, with 50% to 100% of these patients achieving "success" (prednisolone ≤10 mg and sustained control) with the new ISA. A combination of ISAs were used in 53 episodes, with "success" being achieved in 50% to 71% of these patients. Biological agents were used in 45 episodes, the most common one being infliximab, which achieved success in 80% of patients. Our data suggest that control of inflammation can be achieved after switching or combining ISAs. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Enhancing motivation for change in treatment-resistant eating disorders.

Science.gov (United States)

Vitousek, K; Watson, S; Wilson, G T

1998-06-01

Denial and resistance to change are prominent features in most patients with anorexia nervosa. The egosyntonic quality of symptoms can contribute to inaccuracy in self-report, avoidance of treatment, difficulties in establishing a therapeutic relationship, and high rates of attrition and relapse. Individuals with bulimia nervosa are typically more motivated to recover, but often ambivalent about forfeiting the ideal of slenderness and the protective functions of binge-purge behavior. Few attempts have been made to assess denial and resistance in the eating disorders, or to examine alternative strategies for enhancing motivation to change. Review of the clinical literature indicates a striking convergence of recommendations across conceptually distinct treatment approaches. Clinicians are encouraged to acquire a frame of reference that can help them understand the private experience of individuals with eating disorders, empathize with their distress at the prospect of weight gain, and acknowledge the difficulty of change. The Socratic method seems particularly well-suited to work with this population because of its emphasis on collaboration, openness, curiosity, patience, focused and systematic inquiry, and individual discovery. Four themes are crucial in engaging reluctant eating-disordered clients in therapy: the provision of psychoeducational material, an examination of the advantages and disadvantages of symptoms, the explicit use of experimental strategies, and an exploration of personal values.

Is There a ‘Mystery of Currency Exposure’? An Empirical Study of A-Share Listed Companies

OpenAIRE

Feixiang Chen; Li Ju

2011-01-01

Given companies’ dynamic responses to expected exchange rate changes, this article improves on current methods of measuring exposure to foreign exchange rate changes by breaking down the spot exchange rate changes into expected changes and unexpected changes. The currency risk exposure coefficients resulting from an empirical analysis of Shanghai Stock Exchange A share listed companies on whose reported performance foreign exchange changes have a direct impact have a high significance level, ...

Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments.

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Naqvi, Nasir H; Morgenstern, Jon

2015-01-01

Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms.

What drives adult personality development? : A comparison of theoretical perspectives and empirical evidence

NARCIS (Netherlands)

Specht, J.; Bleidorn, W.; Denissen, J.J.A.; Hennecke, M.; Hutteman, R.; Luhmann, M.; Orth, U.; Reitz, A.K.; Zimmerman, J.

2014-01-01

Increasing numbers of empirical studies provide compelling evidence that personality traits change across the entire lifespan. What initiates this continuing personality development and how does this development proceed? In this paper, we compare six theoretical perspectives that offer testable

Modulation of sociotechnical change as climate change challenge

International Nuclear Information System (INIS)

Arentsen, M.J.; Eberg, J.W.

2001-01-01

Results of the MATRIC (Management of Technology Responses to the Climate Change Challenge) project are summarized. The project empirically studied technological change and innovation to learn more about the contingencies conditioning and influencing these processes with the aim to recommend national technology oriented climate change policies. The first chapter explains the background, the central research question, the structure and the methodology of Matric. The central research question was how to modulate the ongoing dynamics of socio-technical change to the climate change needs. Chapter two summarizes the core of the analytical framework of Matric. The fundamental idea of social embedding of technology has been the analytical point of departure of the Matric project. It says that innovations emerge and technology changes in close interaction with its social environment. The social environment turns out to be a strong conditioner of technological change and development and therefore, technology and its embedding social environment tend to co-evolve in the course of time. Co-evolution of technology and its social environment theoretically draws on evolutionary oriented economics and sociology. Both theoretical traditions are in turn inspired by biologically oriented. Chapter three summarizes the empirical findings of the analysis of socio-technical change patterns in three cases: electricity generation and use, car-based transport and mobility and eco-efficiency in industrial production. The cases have been selected for their climate change impact and for their social and economic significance. Chapter four comparatively analyzes the significance of the analytical and empirical findings of Matric for the central research question of the project. The chapter comparatively analysis the general pattern of the development, the change and development of the socio-technical regimes, the socio-technical governance arrangements and processes and the public policy

Plant water potential improves prediction of empirical stomatal models.

Directory of Open Access Journals (Sweden)

William R L Anderegg

Full Text Available Climate change is expected to lead to increases in drought frequency and severity, with deleterious effects on many ecosystems. Stomatal responses to changing environmental conditions form the backbone of all ecosystem models, but are based on empirical relationships and are not well-tested during drought conditions. Here, we use a dataset of 34 woody plant species spanning global forest biomes to examine the effect of leaf water potential on stomatal conductance and test the predictive accuracy of three major stomatal models and a recently proposed model. We find that current leaf-level empirical models have consistent biases of over-prediction of stomatal conductance during dry conditions, particularly at low soil water potentials. Furthermore, the recently proposed stomatal conductance model yields increases in predictive capability compared to current models, and with particular improvement during drought conditions. Our results reveal that including stomatal sensitivity to declining water potential and consequent impairment of plant water transport will improve predictions during drought conditions and show that many biomes contain a diversity of plant stomatal strategies that range from risky to conservative stomatal regulation during water stress. Such improvements in stomatal simulation are greatly needed to help unravel and predict the response of ecosystems to future climate extremes.

Department Chairs as Change Agents: Leading Change in Resistant Environments

Science.gov (United States)

Gaubatz, Julie A.; Ensminger, David C.

2017-01-01

Change process research often discusses barriers that impede organizational change (e.g., Banta, 1997; Cavacuiti and Locke, 2013; Mutchler, 1990; Stewart et al., 2012); however, no empirical research has addressed how behaviors established in leadership models counteract these barriers. This study explored these two interconnected constructs of…

Self-Directed Gambling Changes: Trajectory of Problem Gambling Severity in Absence of Treatment.

Science.gov (United States)

Kushnir, Vladyslav; Godinho, Alexandra; Hodgins, David C; Hendershot, Christian S; Cunningham, John A

2018-03-27

Most problem gamblers do not seek formal treatment, recovering on their own through cognitive re-appraisal or self-help strategies. Although barriers to treatment have been extensively studied, there is a paucity of research on self-directed changes in problem gambling and very few studies have examined these changes prospectively. The aim of this study was to examine the trajectory of gambling severity and behavior change over an 18-month period, among a sample of non-treatment seeking/attending problem gamblers recruited from the community (N = 204) interested in quitting or reducing gambling. Separate mixed effects models revealed that in absence of formal treatment, significant reductions in gambling severity, frequency, and amount gambled could be observed over the course of a 6 to 9-month period and that changes experienced within the first 12 months were maintained for an extended 6 months. Problem gambling severity at baseline was significantly associated with changes in severity over time, such that participants with more severe gambling problems demonstrated greater reductions in their gambling severity over time. A total of 11.1% of participants gambled within a low-risk threshold at 18 months, although 28.7% of the sample reported consecutive gambling severity scores below problem levels for the duration of 1 year or longer. The findings suggest that among problem gamblers motivated to quit or reduce their gambling, significant self-directed changes in gambling severity can occur over a relatively short time. Additional prospective studies are needed to document the role of specific self-help tools or thought processes in exacting gambling changes.

Trends of Empirical Research in South Korean Mental Health Social Work

Science.gov (United States)

Song, In Han; Lee, Eun Jung

2017-01-01

Since the introduction of evidence-based practice in South Korea, it has gained significant attention for its potential to promote the efficacy of social work services and to integrate knowledge and practice in mental health social work. In order to see how empirical research in South Korean mental health social work has changed, we examined…

Empirical Comparison of Two Psychological Therapies: Self Psychology and Cognitive Orientation in the Treatment of Anorexia and Bulimia

Science.gov (United States)

Bachar, Eytan; Latzer, Yael; Kreitler, Shulamit; Berry, Elliot M.

1999-01-01

The authors investigated the applicability of self psychological treatment (SPT) and cognitive orientation treatment (COT) to the treatment of anorexia and bulimia. Thirty-three patients participated in this study. The bulimic patients (n = 25) were randomly assigned either to SPT, COT, or control/nutritional counseling only (C/NC). The anorexic patients (n = 8) were randomly assigned to either SPT or COT. Patients were administered a battery of outcome measures assessing eating disorders symptomatology, attitudes toward food, self structure, and general psychiatric symptoms. After SPT, significant improvement was observed. After COT, slight but nonsignificant improvement was observed. After C/NC, almost no changes could be detected.(The Journal of Psychotherapy Practice and Research 1999; 8:115–128) PMID:10079459

Trade liberalization, social policies and health: an empirical case study.

Science.gov (United States)

McNamara, Courtney

2015-10-12

This study investigates the health impacts of a major liberalization episode in the textile and clothing (T&C) sector. This episode triggered substantial shifts in employment across a wide range of countries. It is the first study to empirically link trade liberalization to health via changes in employment and offers some of the first empirical insights on how trade liberalization interacts with social policies to influence health. Data from 32 T&C reliant countries were analysed in reference to the pre- and post-liberalization periods of 2000-2004 and 2005-2009. Fuzzy-set qualitative comparative analysis (fsQCA) was used to examine the association between countries' a) level of development b) labour market and welfare state protections c) T&C employment changes and d) changes in adult female and infant mortality rates. Process tracing was used to further investigate these associations through twelve in-depth country studies. Results from the fsQCA relate changes in employment after the phase-out to both changing adult female and infant mortality rates. Findings from the in-depth country studies suggest that the worsening of adult female mortality rates is related to workers' lack of social protection, both in the context of T&C employment growth and loss. Overall, it is found that social protection is often inaccessible to the type of workers who may be the most vulnerable to processes of liberalization and that many workers are particularly vulnerable due to the structure of social protection policies. Social policies are therefore found to both moderate pathways to health and influence the type of health-related pathways resulting from trade liberalizing policies.

The impact of real life treatment strategies for Candida peritonitis-A retrospective analysis.

Science.gov (United States)

Dubler, S; Laun, M; Koch, C; Hecker, A; Weiterer, S; Siegler, B H; Röhrig, R; Weigand, M A; Lichtenstern, C

2017-07-01

Candida species are commonly detected isolates from abdominal foci. The question remains as to who would benefit from early empiric treatment in cases of Candida peritonitis. This study collected real-life data on critically ill patients with Candida peritonitis to estimate the relevance of the chosen treatment strategy on the outcome of these patients. One hundred and thirty-seven surgical intensive care unit (ICU) patients with intra-abdominal invasive Candidiasis were included in the study. Fifty-six patients did not get any antifungal agent. Twenty-nine patients were empirically treated, and 52 patients were specifically treated. In the group without, with empiric and with specific antifungal treatment, the 30-day mortality rate was 33.9, 48.3 and 44.2 respectively. Candida albicans was the most frequently found species. Seven patients in the specific treatment group and one patient in the empiric treatment group emerged with candidaemia. Age, leucocyte count, APACHE II Score and acute liver failure were independent predictors of 30-day mortality in patients with Candida peritonitis. Not all patients with Candida peritonitis received antifungal treatment in real clinical practice. Patients with higher morbidity more often got antifungals. Early empirical therapy has not been associated with a better 30-day mortality. © 2017 Blackwell Verlag GmbH.

Economic evaluation of empirical antisecretory therapy versus Helicobacter pylori test for management of dyspepsia: a randomized trial in primary care.

Science.gov (United States)

Jarbol, Dorte Ejg; Bech, Mickael; Kragstrup, Jakob; Havelund, Troels; Schaffalitzky de Muckadell, Ove B

2006-01-01

An economic evaluation was performed of empirical antisecretory therapy versus test for Helicobacter pylori in the management of dyspepsia patients presenting in primary care. A randomized trial in 106 general practices in the County of Funen, Denmark, was designed to include prospective collection of clinical outcome measures and resource utilization data. Dyspepsia patients (n = 722) presenting in general practice with more than 2 weeks of epigastric pain or discomfort were managed according to one of three initial management strategies: (i) empirical antisecretory therapy, (ii) testing for Helicobacter pylori, or (iii) empirical antisecretory therapy, followed by Helicobacter pylori testing if symptoms improved. Cost-effectiveness and incremental cost-effectiveness ratios of the strategies were determined. The mean proportion of days without dyspeptic symptoms during the 1-year follow-up was 0.59 in the group treated with empirical antisecretory therapy, 0.57 in the H. pylori test-and-eradicate group, and 0.53 in the combination group. After 1 year, 23 percent, 26 percent, and 22 percent, respectively, were symptom-free. Applying the proportion of days without dyspeptic symptoms, the cost-effectiveness for empirical treatment, H. pylori test and the combination were 12,131 Danish kroner (DKK), 9,576 DKK, and 7,301 DKK, respectively. The incremental cost-effectiveness going from the combination strategy to empirical antisecretory treatment or H. pylori test alone was 54,783 DKK and 39,700 DKK per additional proportion of days without dyspeptic symptoms. Empirical antisecretory therapy confers a small insignificant benefit but costs more than strategies based on test for H. pylori and is probably not a cost-effective strategy for the management of dyspepsia in primary care.

Birds of the Mongol Empire

Directory of Open Access Journals (Sweden)

Eugene N. Anderson

2016-09-01

Full Text Available The Mongol Empire, the largest contiguous empire the world has ever known, had, among other things, a goodly number of falconers, poultry raisers, birdcatchers, cooks, and other experts on various aspects of birding. We have records of this, largely in the Yinshan Zhengyao, the court nutrition manual of the Mongol empire in China (the Yuan Dynasty. It discusses in some detail 22 bird taxa, from swans to chickens. The Huihui Yaofang, a medical encyclopedia, lists ten taxa used medicinally. Marco Polo also made notes on Mongol bird use. There are a few other records. This allows us to draw conclusions about Mongol ornithology, which apparently was sophisticated and detailed.

A global empirical system for probabilistic seasonal climate prediction

Science.gov (United States)

Eden, J. M.; van Oldenborgh, G. J.; Hawkins, E.; Suckling, E. B.

2015-12-01

Preparing for episodes with risks of anomalous weather a month to a year ahead is an important challenge for governments, non-governmental organisations, and private companies and is dependent on the availability of reliable forecasts. The majority of operational seasonal forecasts are made using process-based dynamical models, which are complex, computationally challenging and prone to biases. Empirical forecast approaches built on statistical models to represent physical processes offer an alternative to dynamical systems and can provide either a benchmark for comparison or independent supplementary forecasts. Here, we present a simple empirical system based on multiple linear regression for producing probabilistic forecasts of seasonal surface air temperature and precipitation across the globe. The global CO2-equivalent concentration is taken as the primary predictor; subsequent predictors, including large-scale modes of variability in the climate system and local-scale information, are selected on the basis of their physical relationship with the predictand. The focus given to the climate change signal as a source of skill and the probabilistic nature of the forecasts produced constitute a novel approach to global empirical prediction. Hindcasts for the period 1961-2013 are validated against observations using deterministic (correlation of seasonal means) and probabilistic (continuous rank probability skill scores) metrics. Good skill is found in many regions, particularly for surface air temperature and most notably in much of Europe during the spring and summer seasons. For precipitation, skill is generally limited to regions with known El Niño-Southern Oscillation (ENSO) teleconnections. The system is used in a quasi-operational framework to generate empirical seasonal forecasts on a monthly basis.

CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders.

Science.gov (United States)

Legerstee, Jeroen S; Tulen, Joke H M; Dierckx, Bram; Treffers, Philip D A; Verhulst, Frank C; Utens, Elisabeth M W J

2010-02-01

This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Ninety-one children with an anxiety disorder were included in the present study. Children received a standardized stepped-care CBT. Three treatment response groups were distinguished: initial responders (anxiety disorder free after phase one: child-focused CBT), secondary responders (anxiety disorder free after phase two: child-parent-focused CBT), and treatment non-responders. Treatment response was determined using a semi-structured clinical interview. Children performed a pictorial dot-probe task before and after stepped-care CBT (i.e., before phase one and after phase two CBT). Changes in selective attention to severely threatening pictures, but not to mildly threatening pictures, were significantly associated with treatment success. At pre-treatment assessment, initial responders selectively attended away from severely threatening pictures, whereas secondary responders selectively attended toward severely threatening pictures. After stepped-care CBT, initial and secondary responders did not show any selectivity in the attentional processing of severely threatening pictures. Treatment non-responders did not show any changes in selective attention due to CBT. Initial and secondary treatment responders showed a reduction of their predisposition to selectively attend away or toward severely threatening pictures, respectively. Treatment non-responders did not show any changes in selective attention. The pictorial dot-probe task can be considered a potentially valuable tool in assigning children to appropriate treatment formats as well as for monitoring changes in selective attention during the course of CBT.

Dietary changes and food intake in the first year after breast cancer treatment.

Science.gov (United States)

Vance, Vivienne; Campbell, Sharon; McCargar, Linda; Mourtzakis, Marina; Hanning, Rhona

2014-06-01

Understanding dietary habits of women after breast cancer is a critical first step in developing nutrition guidelines that will support weight management and optimal health in survivorship; however, limited data are available. The objective of this study was to describe changes in diet among breast cancer survivors in the first year after treatment, and to evaluate these changes in the context of current dietary intake. Changes in diet were assessed in 28 early stage breast cancer survivors, using a self-reported survey in which women identified changes in food intake since their diagnosis. Current dietary intake was estimated from 3-day food records and described relative to current recommendations. The majority of women reported changes in diet after diagnosis, most common being an increase in vegetables/fruit and fish, lower intake of red meat, and reduced alcohol. Many women reported that these changes were initiated during active treatment. Dietary changes were largely consistent with current recommendations for cancer prevention; however, some women were still above the guidelines for total and saturated fat, and many were below recommendations for vegetables/fruit, milk/alternatives, calcium, and vitamin D. Evidence that some women are willing and able to initiate positive changes in diet early in the treatment trajectory suggests that early intervention may be effective in promoting dietary habits that will assist with weight management and overall health. Data on current dietary intake highlights several possible targets for dietary intervention in this population.

In vitro early changes in intercellular junctions by treatment with a chemical carcinogen.

Science.gov (United States)

Tachikawa, T; Kohno, Y; Matsui, Y; Yoshiki, S

1986-06-01

To examine early intercellular junction changes caused by treatment with 9,10-dimethyl-1,2-benzanthracene (DMBA), rat lingual epithelium was cultivated in isolation and observed by electrophysiological, freeze-fracture and whole-mount electron microscopy. Electrophysiological measurements showed a transient decrease in membrane potential of -10.2 mV 6 h after the treatment. It returned to almost the same level as that of the control group 1 day later. Six hours after treatment, input resistance decreased rapidly to 5.3 M omega but increased to 18.0 M omega 12 h after treatment. Transient reduction of input resistance and membrane potential occurred prior to the decrease in the coupling ratio 6 h after treatment with DMBA. In freeze-fracture replicas, the number of gap junctions decreased by approximately 45% of the control value 6 h after treatment with DMBA. At 12 h and thereafter, the number and area of gap junctions subsequently decreased by 60-80% of the control value. Alterations in the number and area of desmosomes were similar to those of the gap junctions. The formation of epithelial cytoskeletons, partially devoid of the 2-4 and 5-8 nm filaments was also observed. A decrease in the density of filament networks beneath the plasma membranes was especially apparent. Treatment with a carcinogen brought about morphological cellular changes as early as 6 h after treatment, and such early changes might trigger metabolic cellular abnormalities. Affected cells appear to move away from normal cells in a process of repeated destruction and revision of intercellular junctions, and cytoskeletons.

Late mental health changes in tortured refugees in multidisciplinary treatment

DEFF Research Database (Denmark)

Carlsson, Jessica Mariana; Olsen, Dorte Reff; Kastrup, Marianne

2010-01-01

to the Rehabilitation and Research Centre for Torture Victims in 2001 to 2002. Data on background, trauma, present social situation, mental symptoms (Hopkins Symptom Checklist-25, Hamilton Depression Scale, Harvard Trauma Questionnaire), and on health-related quality of life (World Health Organization Quality of Life......-Bref) were collected before treatment and after 9 and 23 months. No substantial changes in mental health were observed at the 9-month follow-up, and the minor decrease in some symptoms observed between the 9 and 23 months may reflect regression toward the mean or the natural course of symptoms in this cohort......The aim of this study was to examine long-term changes in symptoms of post-traumatic stress disorder, depression, anxiety, and in health-related quality of life in traumatized refugees 23 months after admission to multidisciplinary treatment. The study group comprised 45 persons admitted...

Life changes among homeless persons with mental illness: a longitudinal study of housing first and usual treatment.

Science.gov (United States)

Nelson, Geoffrey; Patterson, Michelle; Kirst, Maritt; Macnaughton, Eric; Isaak, Corinne A; Nolin, Danielle; McAll, Christopher; Stergiopoulos, Vicky; Townley, Greg; MacLeod, Timothy; Piat, Myra; Goering, Paula N

2015-06-01

This study compared the life changes of homeless people with mental illness participating in Housing First or treatment as usual and examined factors related to various changes. Semistructured narrative interviews were conducted with 219 participants in five Canadian cities at baseline; 197 were interviewed again at 18 months after random assignment to Housing First (N=119) or treatment as usual (N=78). Interviews were coded across 13 life domains, and each participant was categorized as reporting positive, mixed-neutral, or negative changes. Housing First and treatment as usual participants were compared with respect to change patterns. Thematic analysis was used to examine factors related to various changes. The percentage of participants in Housing First reporting positive changes was more than double that for participants in treatment as usual, and treatment as usual participants were four times more likely than Housing First participants to report negative changes. Factors related to positive changes included having stable good-quality housing, increased control over substance use, positive relationships and social support, and valued social roles. Factors related to negative changes included precarious housing, negative social contacts, isolation, heavy substance use, and hopelessness. Factors related to mixed-neutral changes were similar to those for participants reporting negative changes but were less intense. Housing First with intensive support was related to more positive changes among homeless adults with mental illness across five Canadian cities. Those with poor housing or support, more common in treatment as usual, continued to struggle. These findings are relevant for services and social change to benefit this population.

Treating Pediatric Obesity Using an Empirically Supported Treatment: A Case Report

Science.gov (United States)

Cunningham, Phillippe B.; Ellis, Deborah A.; Naar-King, Sylvie

2010-01-01

Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy…

Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change.

Science.gov (United States)

Becan, Jennifer E; Knight, Danica K; Crawley, Rachel D; Joe, George W; Flynn, Patrick M

2015-03-01

Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (time 1) and 35 days after admission (time 2). The design consisted of a comparison sample (n=281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n=238). Repeated measures ANCOVAs were conducted using each time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation. Copyright © 2015 Elsevier Inc. All rights reserved.

Why tackle a far-off problem? Municipal resistance to climate change adaptation from an organisational change perspective

NARCIS (Netherlands)

van den Berg, Maya Marieke; Coenen, Franciscus H.J.M.

2012-01-01

Although the importance of local government is often emphasized when it comes to climate change adaptation, empirical data reveal that local efforts have been rather limited. Why does one observe this paradoxical situation? This article presents empirical data gathered through a questionnaire (n=70)

Horizontal Price Transmission in Agricultural Markets: Fundamental Concepts and Open Empirical Issues

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Giulia Listorti

2012-05-01

Full Text Available Following the dramatic changes experienced by the prices of agricultural commodities in 2007-2008, the analysis of horizontal price transmission mechanisms in agricultural markets has attracted renewed interest. In particular, this has led to the emergence of new challenges for the empirical analysis. How to model the increasing volatility and non linear behaviour of prices, to assess the impact of the policy responses to market turbulence, and how to account for the increasing interconnections between agricultural and non-agricultural commodity markets are amongst the most investigated issues. Building on a common analytical framework, this paper discusses and reviews the most recent methodological developments and empirical contributions in the field.

Dimensional Changes of Nb$_{3}$Sn Rutherford Cables During Heat Treatment

CERN Document Server

Rochepault, E; Ambrosio, G; Anerella, M; Ballarino, A; Bonasia, A; Bordini, B; Cheng, D; Dietderich, D R; Felice, H; Garcia Fajardo, L; Ghosh, A; Holik, E F; Izquierdo Bermudez, S; Perez, J C; Pong, I; Schmalzle, J; Yu, M

2016-01-01

In high field magnet applications, Nb$_{3}$Sn coils undergo a heat treatment step after winding. During this stage, coils radially expand and longitudinally contract due to the Nb$_{3}$Sn phase change. In order to prevent residual strain from altering superconducting performances, the tooling must provide the adequate space for these dimensional changes. The aim of this paper is to understand the behavior of cable dimensions during heat treatment and to provide estimates of the space to be accommodated in the tooling for coil expansion and contraction. This paper summarizes measurements of dimensional changes on strands, single Rutherford cables, cable stacks, and coils performed between 2013 and 2015. These samples and coils have been performed within a collaboration between CERN and the U.S. LHC Accelerator Research Program to develop Nb$_{3}$Sn quadrupole magnets for the HiLumi LHC. The results are also compared with other high field magnet projects.

Expert opinion vs. empirical evidence

Science.gov (United States)

Herman, Rod A; Raybould, Alan

2014-01-01

Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

Associations between change in sedentary behavior and outcome in standard behavioral weight loss treatment.

Science.gov (United States)

Kerrigan, Stephanie G; Call, Christine; Schaumberg, Katherine; Forman, Evan; Butryn, Meghan L

2018-03-01

Sedentary behavior, particularly in prolonged periods, is an important determinant of health. Little research exploring changes in sedentary behavior during behavioral weight loss programs exists. This study evaluated the magnitude of changes in total and prolonged sedentary behavior and how these changes related to changes in weight and cardiovascular outcomes during a behavioral weight loss program. Participants (n = 450) in two lifestyle modification programs underwent assessments of sedentary behavior (by accelerometry), weight, waist circumference, blood pressure, and resting heart rate at baseline and after 6 months of treatment. Sedentary behavior was defined as both total and prolonged (≥30 continuous minutes) sedentary minutes/day. Reductions in total and prolonged sedentary time were significant and were accounted for by increases in moderate-to-vigorous physical activity (MVPA). Only changes in MVPA significantly predicted change in weight when entered into a model simultaneously with changes in sedentary behavior. Changes in total and prolonged sedentary time were not associated with changes in waist circumference, heart rate, or blood pressure. Change in sedentary time was not independently associated with change in health outcomes during a behavioral weight loss treatment. High variability in changes in sedentary time indicate that individual differences may be important to examine. Reducing sedentary time may not be powerful enough to impact these health outcomes above the effects of other changes made during these programs; alternatively, it may be that increasing focus in treatment on reducing sedentary time may engender greater decreases in sedentariness, which could lead to better health outcomes.

Determinants of Financing Decisions in Innovative Firms: A Review on Theoretical Backgrounds and Empirical Evidence

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Mihaela Diaconu

2016-01-01

Full Text Available We review some of the main aspects highlighted in the literature on financing innovation. Thetheoretical background related to the distinctive features of innovative firms impacting theirfinancing decisions and the empirical evidence is reviewed. The growing literature on the financingof innovation shows that the theoretical and empirical work are not always constant across thevarious samples and situations faced by firms as a result of generating new findings. We highlightthe interaction between financing choices for innovation and changing internal and externalcondition firms operate.

Treatment changes in patients with psoriasis on etanercept or adalimumab

DEFF Research Database (Denmark)

Lee, Erica B; Amin, Mina; Egeberg, Alexander

2018-01-01

PURPOSE: To determine the frequency of and reasons for treatment changes in patients with psoriasis. MATERIALS AND METHODS: A retrospective chart review of 140 patients with psoriasis treated with adalimumab or etanercept seen at Kaiser Permanente Los Angeles Medical Center between September 20, ...

A Method for Measuring Treatment Effects on the Treated without Randomization

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P.A.V.B. Swamy

2016-03-01

Full Text Available This paper contributes to the literature on the estimation of causal effects by providing an analytical formula for individual specific treatment effects and an empirical methodology that allows us to estimate these effects. We derive the formula from a general model with minimal restrictions, unknown functional form and true unobserved variables such that it is a credible model of the underlying real world relationship. Subsequently, we manipulate the model in order to put it in an estimable form. In contrast to other empirical methodologies, which derive average treatment effects, we derive an analytical formula that provides estimates of the treatment effects on each treated individual. We also provide an empirical example that illustrates our methodology.

Climate Change and Maize Production: Empirical Evidence from ...

African Journals Online (AJOL)

Michael Madukwe

Farmers' Adaptation Initiatives to the Impact of Climate Change on Agriculture in Northern ... Environment Department, University of York, United Kingdom, E– mail: ... The 2005 Food and Agriculture Organization (FAO) Global Forest Resources ... The out migration of indigenous youths to seek for economic opportunities.

Skeletal and dental changes induced by bionator in early treatment of class II

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Dirceu Barnabé Raveli

2016-09-01

Full Text Available The purpose was to investigate the amount of skeletal and dentoalveolar changes after early treatment of Class II, Division 1 malocclusion with bionator appliance in prepubertal growing patients. Forty Class II patients were divided in two groups. Treated group consisted of 20 subjects treated consecutively with bionator. Mean age at the start of treatment (T0 was 9.1 years, while it was 10.6 years at the end of treatment (T1. Mean treatment time was 17.7 months. Pretreatment and post-treatment cephalometric records of treated group were evaluated and compared with a control group consisted of 20 patients with untreated Class II malocclusion. Intergroup comparisons were performed using Student’s t-tests and chi-square test with Yates’ correction at a significance level of 5 per cent. Bionator appliance was effective in generating differential growth between the jaws. Cephalometric skeletal measurements ANB, WITS, Lafh, Co-A and dental L6-Mp, U1.Pp, IsIi, OB, OJ showed statistically significantly different from the control. Bionator induced more dentoalveolar changes than skeletal during treatment in prepubertal stage.

Sensitivity of ab Initio vs Empirical Methods in Computing Structural Effects on NMR Chemical Shifts for the Example of Peptides.

Science.gov (United States)

Sumowski, Chris Vanessa; Hanni, Matti; Schweizer, Sabine; Ochsenfeld, Christian

2014-01-14

The structural sensitivity of NMR chemical shifts as computed by quantum chemical methods is compared to a variety of empirical approaches for the example of a prototypical peptide, the 38-residue kaliotoxin KTX comprising 573 atoms. Despite the simplicity of empirical chemical shift prediction programs, the agreement with experimental results is rather good, underlining their usefulness. However, we show in our present work that they are highly insensitive to structural changes, which renders their use for validating predicted structures questionable. In contrast, quantum chemical methods show the expected high sensitivity to structural and electronic changes. This appears to be independent of the quantum chemical approach or the inclusion of solvent effects. For the latter, explicit solvent simulations with increasing number of snapshots were performed for two conformers of an eight amino acid sequence. In conclusion, the empirical approaches neither provide the expected magnitude nor the patterns of NMR chemical shifts determined by the clearly more costly ab initio methods upon structural changes. This restricts the use of empirical prediction programs in studies where peptide and protein structures are utilized for the NMR chemical shift evaluation such as in NMR refinement processes, structural model verifications, or calculations of NMR nuclear spin relaxation rates.

Essays on empirical likelihood in economics

NARCIS (Netherlands)

Gao, Z.

2012-01-01

This thesis intends to exploit the roots of empirical likelihood and its related methods in mathematical programming and computation. The roots will be connected and the connections will induce new solutions for the problems of estimation, computation, and generalization of empirical likelihood.

A Review on Assessment and Treatment for Depression in Malaysia

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Firdaus Mukhtar

2011-01-01

Full Text Available This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation.

A Review on Assessment and Treatment for Depression in Malaysia

Science.gov (United States)

Mukhtar, Firdaus; Oei, Tian P. S.

2011-01-01

This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT) was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation. PMID:21804939

Color changes in pork in relation to high pressure treatment

DEFF Research Database (Denmark)

Bak, Kathrine Holmgaard

treatment and during a six-day storage period was investigated via surface reflectance. Spectroscopic studies (in the form of surface reflectance, UV-vis, and circular dichroism) on the effect of HP treatment on the soluble protein fraction of porcine LD were conducted attempting to explain the color......-denatured ferric myoglobin species was not similar to the heat-denatured pigment, ferrihemochrome, but instead a closely related species sharing features of denatured gobin, ferric iron, and brown color. The reversibility of the pressure-induced changes often observed for various myoglobin forms in solution were...

Leading change: a concept analysis.

Science.gov (United States)

Nelson-Brantley, Heather V; Ford, Debra J

2017-04-01

To report an analysis of the concept of leading change. Nurses have been called to lead change to advance the health of individuals, populations, and systems. Conceptual clarity about leading change in the context of nursing and healthcare systems provides an empirical direction for future research and theory development that can advance the science of leadership studies in nursing. Concept analysis. CINAHL, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Health Business Elite and Business Source Premier databases were searched using the terms: leading change, transformation, reform, leadership and change. Literature published in English from 2001 - 2015 in the fields of nursing, medicine, organizational studies, business, education, psychology or sociology were included. Walker and Avant's method was used to identify descriptions, antecedents, consequences and empirical referents of the concept. Model, related and contrary cases were developed. Five defining attributes of leading change were identified: (a) individual and collective leadership; (b) operational support; (c) fostering relationships; (d) organizational learning; and (e) balance. Antecedents were external or internal driving forces and organizational readiness. The consequences of leading change included improved organizational performance and outcomes and new organizational culture and values. A theoretical definition and conceptual model of leading change were developed. Future studies that use and test the model may contribute to the refinement of a middle-range theory to advance nursing leadership research and education. From this, empirically derived interventions that prepare and enable nurses to lead change to advance health may be realized. © 2016 John Wiley & Sons Ltd.

The urban health transition hypothesis: empirical evidence of an avian influenza Kuznets curve in Vietnam?

Science.gov (United States)

Spencer, James Herbert

2013-04-01

The literature on development has focused on the concept of transition in understanding the emergent challenges facing poor but rapidly developing countries. Scholars have focused extensively on the health and urban transitions associated with this change and, in particular, its use for understanding emerging infectious diseases. However, few have developed explicit empirical measures to quantify the extent to which a transitions focus is useful for theory, policy, and practice. Using open source data on avian influenza in 2004 and 2005 and the Vietnam Census of Population and Housing, this paper introduces the Kuznets curve as a tool for empirically estimating transition and disease. Findings suggest that the Kuznets curve is a viable tool for empirically assessing the role of transitional dynamics in the emergence of new infectious diseases.

An Empirical Study on Key Indicators of Environmental Quality: Green Budgeting - a Catalyst for Sustainable Economy and a Factor for Institutional Change

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Violeta – Maria Cimpoeru

2012-06-01

Full Text Available This paper presents the phenomenon of institutional change through the implementation of sustainable strategies of medium-term budgeting, having as an effect the growth of opportunity to attract proper resources for social and environmental programs. The study analyzes green budget practices and suggests several ways to use them in order to ensure consistency in implementing key elements of sustainable economy. Thus, we conducted an empirical study to explain the decisive factors impact (greenhouse gas emissions and national income on health expenditure and we obtained statistically significant positive relationship, suggesting that green budgeting is an important factor for sustainable economy. The reasons behind the introduction of a sustainable perspective for budgeting in any country are important since they will dictate, to a large extent, the way the medium term budgeting will be institutionalized

[Research on the hospital construction and structure in Daehan empire and colonial modern period].

Science.gov (United States)

Han, Dong Gwan; Ryu, Chang Ug; Ko, Sang Kyun; Jung, Jae Kook; Moon, Jong Youn; Park, Yoon Hyung

2011-12-31

It was the late Chosun Dynasty and Daehan Empire era that Western Medicine has firstly been introduced to Korea, previously operating on a basis of Korean traditional medicine. Western Medicine has been introduced by American missionary and Japanese Imperialism. An introduction of Western Medicine made it feasible to proceed new type medical care including operation, leading to require a new form of medical facilities. In the beginning, new facilities were constructed by Japanese Imperialism. Other hand many of facilities including Severance Hospital were established by missionaries. First of all, Daehan Empire established and managed a modern type of medical facility named "Jejoongwon" in 1885 as a government institution hospital. The Red Cross Hospital built in 1889. Afterwards, Jejoongwon and the Red Cross Hospital were taken over to missionary hospital and Japanese Imperialism, respectively. Japanese Imperialists firstly have protected their nationals residing in Chosun but have proceeded care a few Chosun people to exploit medical treatment as a mean to advertise superiority of the Empire of Japan. The facility that has firstly been established and managed was Jeseang Hospital in Busan in 1877, leading to establish in Wonju, Wonsan, and Mokpo. Afterwards, Japan has organized "Donginhoi" as a civil invasion organization, leading for "Donginhoi" to established "Dongin Hospital" in Pyeongyang, Daegu, and Seoul. Since 1909, governmental leading medical facility named Jahye Hospital was established according to an imperial order, leading to establish 32 hospitals all over the nation. American missionaries have established and managed 28 hospitals started from Severance Hospital built in 1904. However, Chosun doctors started to having educated and opening up their own hospital since 1920, leading for many of medical facilities to be established, but most of them have taken different roles followed by 6.25 War and economic development period. However, some of them

Orthodontic treatment effects on inflammatory marker profiles in saliva before and after 2 archwire changes

Science.gov (United States)

Yamamoto, Zulham; Jaafar, Ikmal Mohamad; Rohaya, M. A. W.; Abidin, Intan Zarina Zainol; Senafi, Sahidan; Ariffin, Zaidah Zainal; Ariffin, Shahrul Hisham Zainal

2013-11-01

Periodontal tissue changes exerted by external forces in orthodontic treatment allow tooth movement. The changes in periodontal tissues i.e. inflammation can be monitored using gingival crevicular fluid (GCF). GCF is a component of saliva. Saliva could be used to monitor periodontal disease progression. The use of saliva to monitor periodontal tissues changes during orthodontic treatment is still unknown. Therefore, we observed the profiles of inflammatory markers namely creatine kinase ('CK), nitric oxide (NO), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) in saliva of orthodontic patients to evaluate their importance in orthodontic treatment. A total of 21 subjects (13 female and 8 male) participated in this study. Samples were collected from gingival crevicular fluid at three period of archwire changes: baseline (M0), 2 weeks after 0.014" NiTi archwire (M1), and 2 weeks after 0.018" NiTi archwire (M2). All enzyme activities i.e. CK, LDH and AST were measured spectrophotometrically at 340 nm. Griess assay was used to measure nitric oxide level. CK activity, NO level, LDH activity and AST activity in saliva samples did not show significant differences among period of archwire changes. The use of inflammatory marker profiles in saliva may not represent the changes in periodontal tissues during orthodontic treatment.

The colonial world as mission and mandate: leprosy and empire, 1900-1940.

Science.gov (United States)

Worboys, M

2000-01-01

The history of medicine in twentieth-century empires has been dominated by studies of "imperial tropical medicine" (ITM) and its consequences. Historians have been fascinated by the work of medical scientists and doctors in the age of high imperialism, and there are many studies of medicine as a "tool of empire." This paper reviews work that explores colonial medicine as a broader enterprise than ITM in three spheres: missionary activity, modernization, and protection of the health and welfare of indigenous peoples. To illustrate the themes of mission and mandate, it discusses the development of policies to control leprosy in the tropical African and Asian colonies of Britain in the first half of this century, especially the work of the British Empire Leprosy Relief Association (BELRA). Although BELRA's efforts did little to change imperial medical and health agendas, they had an important impact locally and ideologically, and show how closely interwoven the themes of Christian caring, medical humanism, colonial development, and welfare policy had become by the outbreak of the Second World War.

Integrated empirical ethics: loss of normativity?

Science.gov (United States)

van der Scheer, Lieke; Widdershoven, Guy

2004-01-01

An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances.

Motivational stage of change in young patients undergoing day treatment for eating disorders.

Science.gov (United States)

Bustin, Lisa A; Lane-Loney, Susan E; Hollenbeak, Christopher S; Ornstein, Rollyn M

2013-01-01

The objective was to determine whether motivation to change is significantly altered over the course of partial hospitalization in children and adolescents with eating disorders (EDs). This study was a retrospective chart review of 30 sets of adolescents and their parents who completed the Motivational Stage of Change for Adolescents Recovering from an Eating Disorder (MSCARED) at both intake and discharge from partial hospitalization. The main outcome variables included change in stage of change (SOC) for patients and their parents. Secondary outcomes included correlations between SOC and other baseline variables, as well as changes in SOC and psychological test scores. The SOC was significantly higher at discharge than at intake in both the patients and parents, but the two groups were not in agreement at discharge. The change in the SOC was correlated with change in Children's Eating Attitudes Test scores. Assessment of decisional balance showed correlations with SOC. Age, change in weight, and psychiatric diagnoses did not correlate with initial SOC. The MSCARED may be a useful tool for monitoring young ED patients' psychological improvements with day treatment. Initial SOC is not predictive of treatment outcomes.

Empirical agent-based modelling challenges and solutions

CERN Document Server

Barreteau, Olivier

2014-01-01

This instructional book showcases techniques to parameterise human agents in empirical agent-based models (ABM). In doing so, it provides a timely overview of key ABM methodologies and the most innovative approaches through a variety of empirical applications.  It features cutting-edge research from leading academics and practitioners, and will provide a guide for characterising and parameterising human agents in empirical ABM.  In order to facilitate learning, this text shares the valuable experiences of other modellers in particular modelling situations. Very little has been published in the area of empirical ABM, and this contributed volume will appeal to graduate-level students and researchers studying simulation modeling in economics, sociology, ecology, and trans-disciplinary studies, such as topics related to sustainability. In a similar vein to the instruction found in a cookbook, this text provides the empirical modeller with a set of 'recipes'  ready to be implemented. Agent-based modeling (AB...

Empirical Legality and Effective Reality

Directory of Open Access Journals (Sweden)

Hernán Pringe

2015-08-01

Full Text Available The conditions that Kant’s doctrine establishes are examined for the predication of the effective reality of certain empirical objects. It is maintained that a for such a predication, it is necessary to have not only perception but also a certain homogeneity of sensible data, and b the knowledge of the existence of certain empirical objects depends on the application of regulative principles of experience.

Changes in Body Compositions and Basal Metabolic Rates during Treatment of Graves’ Disease

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Min Joo Kim

2018-01-01

Full Text Available Objectives. Because thyroid hormone is an important determinant of body weight and basal metabolic rate, we investigated the changes in the basal metabolic rate and body composition sequentially after treatment for Graves’ disease. Methods. A prospective cohort study was performed with six women newly diagnosed with Graves’ disease. During a 52-week treatment of methimazole, body composition, resting respiratory expenditure (REE, and handgrip strength were measured consecutively. Results. After methimazole treatment, body weight was initially increased (0–8 weeks, subsequently plateaued (8–24 weeks, and gradually decreased in the later period (24–52 weeks despite the decreased food intake. The measured REE was 40% higher than the predicted REE at baseline, and it gradually decreased after treatment. REE positively correlated with thyroid hormone levels, peripheral deiodinase activity, and thyroid’s secretory capacity. Body compositional analyses showed that the fat mass increased during an earlier period (4–12 weeks, while the lean mass increased significantly during the later period (26–52 weeks. Consistent with the lean mass changes, muscle strength also significantly increased during the later period. Conclusions. Treatment of Graves’ disease increased body weight and fat mass transiently with decreased REE. However, long-term compositional changes moved in a beneficial direction increasing lean mass and reinforcing muscle strength, following decreasing fat percentages.

A Research Agenda for Appearance Changes Due to Breast Cancer Treatment

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Mia K. Markey

2008-01-01

Full Text Available Breast cancer is one of the most prevalent forms of cancer in the US. It is estimated that more than 180,000 American women will be diagnosed with invasive breast cancer in 2008. Fortunately, the survival rate is relatively high and continually increasing due to improved detection techniques and treatment methods. However, maintaining quality of life is a factor often under emphasized for breast cancer survivors. Breast cancer treatments are invasive and can lead to deformation of the breast. Breast reconstruction is important for restoring the survivor’s appearance. However, more work is needed to develop technologies for quantifying surgical outcomes and understanding women’s perceptions of changes in their appearance. A method for objectively measuring breast anatomy is needed in order to help both the breast cancer survivors and their surgeons take expected changes to the survivor’s appearance into account when considering various treatment options. In the future, augmented reality tools could help surgeons reconstruct a survivor’s breasts to match her preferences as much as possible.

Empirical comparison of theories

International Nuclear Information System (INIS)

Opp, K.D.; Wippler, R.

1990-01-01

The book represents the first, comprehensive attempt to take an empirical approach for comparative assessment of theories in sociology. The aims, problems, and advantages of the empirical approach are discussed in detail, and the three theories selected for the purpose of this work are explained. Their comparative assessment is performed within the framework of several research projects, which among other subjects also investigate the social aspects of the protest against nuclear power plants. The theories analysed in this context are the theory of mental incongruities and that of the benefit, and their efficiency in explaining protest behaviour is compared. (orig./HSCH) [de

Teaching Empirical Software Engineering Using Expert Teams

DEFF Research Database (Denmark)

Kuhrmann, Marco

2017-01-01

Empirical software engineering aims at making software engineering claims measurable, i.e., to analyze and understand phenomena in software engineering and to evaluate software engineering approaches and solutions. Due to the involvement of humans and the multitude of fields for which software...... is crucial, software engineering is considered hard to teach. Yet, empirical software engineering increases this difficulty by adding the scientific method as extra dimension. In this paper, we present a Master-level course on empirical software engineering in which different empirical instruments...... an extra specific expertise that they offer as service to other teams, thus, fostering cross-team collaboration. The paper outlines the general course setup, topics addressed, and it provides initial lessons learned....

Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review

Science.gov (United States)

Gudayol-Ferré, Esteve; Peró-Cebollero, Maribel; González-Garrido, Andrés A.; Guàrdia-Olmos, Joan

2015-01-01

Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity. PMID:26578927

Mediation of the relationship of behavioural treatment type and changes in psychological predictors of healthy eating by body satisfaction changes in women with obesity.

Science.gov (United States)

Annesi, James J

Psychological correlates of both short- and long-term weight loss are poorly understood. Changes in satisfaction with one's body might serve to motivate healthier eating by mediating treatments' effect on psychological factors previously suggested to be associated with weight loss. Women with obesity (age 48.6±7.1 years; BMI 35.4±3.3kg/m 2 ) were randomly assigned to social cognitive theory-based weight-management treatments that were either group sessions emphasizing physical activity-derived self-regulation (experimental; n=53) or review of a written manual and phone support (comparison; n=54). Changes in weight, physical activity, body satisfaction, negative mood, and self-efficacy and self-regulation for controlled eating were assessed over 3, 6, 12, and 24 months. The experimental treatment was associated with significantly more favourable changes across variables. Over 6, 12, and 24 months, body satisfaction change mediated relationships between treatment type and changes in each of the psychological predictors of healthier eating (mood, self-efficacy, self-regulation). Reciprocal, mutually reinforcing, relationships between changes in body satisfaction and those psychological predictors were also found. Increased physical activity was associated with improved body satisfaction, even after controlling for weight changes. Findings increased understandings of the role of body satisfaction in improving psychological predictors of healthier eating over both the short- and longer-term. Results also suggested that body satisfaction could be improved through increased physical activity, irrespective of change in weight. Although results were limited to women with class 1 and 2 obesity, findings on interactions of psychological factors associated with eating changes have implications for the architecture of improved behavioural treatments. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Space evolution model and empirical analysis of an urban public transport network

Science.gov (United States)

Sui, Yi; Shao, Feng-jing; Sun, Ren-cheng; Li, Shu-jing

2012-07-01

This study explores the space evolution of an urban public transport network, using empirical evidence and a simulation model validated on that data. Public transport patterns primarily depend on traffic spatial-distribution, demands of passengers and expected utility of investors. Evolution is an iterative process of satisfying the needs of passengers and investors based on a given traffic spatial-distribution. The temporal change of urban public transport network is evaluated both using topological measures and spatial ones. The simulation model is validated using empirical data from nine big cities in China. Statistical analyses on topological and spatial attributes suggest that an evolution network with traffic demands characterized by power-law numerical values which distribute in a mode of concentric circles tallies well with these nine cities.

Umayyad Relations with Byzantium Empire

Directory of Open Access Journals (Sweden)

Mansoor Haidari

2017-06-01

Full Text Available This research investigates the political and military relations between Umayyad caliphates with the Byzantine Empire. The aim of this research is to clarify Umayyad caliphate’s relations with the Byzantine Empire. We know that these relations were mostly about war and fight. Because there were always intense conflicts between Muslims and the Byzantine Empire, they had to have an active continuous diplomacy to call truce and settle the disputes. Thus, based on the general policy of the Umayyad caliphs, Christians were severely ignored and segregated within Islamic territories. This segregation of the Christians was highly affected by political relationships. It is worthy of mentioning that Umayyad caliphs brought the governing style of the Sassanid kings and Roman Caesar into the Islamic Caliphate system but they didn’t establish civil institutions and administrative organizations.

Empirical training for conditional random fields

NARCIS (Netherlands)

Zhu, Zhemin; Hiemstra, Djoerd; Apers, Peter M.G.; Wombacher, Andreas

2013-01-01

In this paper (Zhu et al., 2013), we present a practi- cally scalable training method for CRFs called Empir- ical Training (EP). We show that the standard train- ing with unregularized log likelihood can have many maximum likelihood estimations (MLEs). Empirical training has a unique closed form MLE

Empirical complexities in the genetic foundations of lethal mutagenesis.

Science.gov (United States)

Bull, James J; Joyce, Paul; Gladstone, Eric; Molineux, Ian J

2013-10-01

From population genetics theory, elevating the mutation rate of a large population should progressively reduce average fitness. If the fitness decline is large enough, the population will go extinct in a process known as lethal mutagenesis. Lethal mutagenesis has been endorsed in the virology literature as a promising approach to viral treatment, and several in vitro studies have forced viral extinction with high doses of mutagenic drugs. Yet only one empirical study has tested the genetic models underlying lethal mutagenesis, and the theory failed on even a qualitative level. Here we provide a new level of analysis of lethal mutagenesis by developing and evaluating models specifically tailored to empirical systems that may be used to test the theory. We first quantify a bias in the estimation of a critical parameter and consider whether that bias underlies the previously observed lack of concordance between theory and experiment. We then consider a seemingly ideal protocol that avoids this bias-mutagenesis of virions-but find that it is hampered by other problems. Finally, results that reveal difficulties in the mere interpretation of mutations assayed from double-strand genomes are derived. Our analyses expose unanticipated complexities in testing the theory. Nevertheless, the previous failure of the theory to predict experimental outcomes appears to reside in evolutionary mechanisms neglected by the theory (e.g., beneficial mutations) rather than from a mismatch between the empirical setup and model assumptions. This interpretation raises the specter that naive attempts at lethal mutagenesis may augment adaptation rather than retard it.

Treatment and prevention of invasive pneumococcal disease.

Science.gov (United States)

Domínguez-Alegría, A R; Pintado, V; Barbolla, I

2018-02-12

Invasive pneumococcal disease is a severe infection that mainly affects patients with associated comorbidity. The paediatric conjugate vaccination has resulted in a change in the adult vaccination strategy. The antibiotic resistance of pneumococcus is not currently a severe problem. Nevertheless, the World Health Organisation has included pneumococcus among the bacteria whose treatment requires the introduction of new drugs, such as ceftaroline and ceftobiprole. Although the scientific evidence is still limited, the combination of beta-lactams and macrolides is recommended as empiric therapy for bacteraemic pneumococcal pneumonia. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Beyond Autism Treatment: The Application of Applied Behavior Analysis in the Treatment of Emotional and Psychological Disorders

Science.gov (United States)

Ross, Robert K.

2007-01-01

The field of applied behavior analysis (ABA) has increasingly come to be associated with the treatment of autism in young children. This phenomenon is largely the result of empirical research demonstrating effective treatment outcomes in this population. The same cannot be said with regard to the treatment of conditions often referred to as…

Empirical Phenomenology: A Qualitative Research Approach (The ...

African Journals Online (AJOL)

Empirical Phenomenology: A Qualitative Research Approach (The Cologne Seminars) ... and practical application of empirical phenomenology in social research. ... and considers its implications for qualitative methods such as interviewing ...

Empirical logic and quantum mechanics

International Nuclear Information System (INIS)

Foulis, D.J.; Randall, C.H.

1976-01-01

This article discusses some of the basic notions of quantum physics within the more general framework of operational statistics and empirical logic (as developed in Foulis and Randall, 1972, and Randall and Foulis, 1973). Empirical logic is a formal mathematical system in which the notion of an operation is primitive and undefined; all other concepts are rigorously defined in terms of such operations (which are presumed to correspond to actual physical procedures). (Auth.)

Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa.

Science.gov (United States)

Collin, Paula; Karatzias, Thanos; Power, Kevin; Howard, Ruth; Grierson, David; Yellowlees, Alex

2016-03-30

Self-esteem improvement is one of the main targets of inpatient eating disorder programmes. The present study sought to examine multi-dimensional self-esteem and magnitude of change in eating psychopathology among adults participating in a specialist inpatient treatment programme for anorexia nervosa. A standardised assessment battery, including multi-dimensional measures of eating psychopathology and self-esteem, was completed pre- and post-treatment for 60 participants (all white Scottish female, mean age=25.63 years). Statistical analyses indicated that self-esteem improved with eating psychopathology and weight over the course of treatment, but that improvements were domain-specific and small in size. Global self-esteem was not predictive of treatment outcome. Dimensions of self-esteem at baseline (Lovability and Moral Self-approval), however, were predictive of magnitude of change in dimensions of eating psychopathology (Shape and Weight Concern). Magnitude of change in Self-Control and Lovability dimensions were predictive of magnitude of change in eating psychopathology (Global, Dietary Restraint, and Shape Concern). The results of this study demonstrate that the relationship between self-esteem and eating disorder is far from straightforward, and suggest that future research and interventions should focus less exclusively on self-esteem as a uni-dimensional psychological construct. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Empirical Moral Philosophy and Teacher Education

Science.gov (United States)

Schjetne, Espen; Afdal, Hilde Wågsås; Anker, Trine; Johannesen, Nina; Afdal, Geir

2016-01-01

In this paper, we explore the possible contributions of empirical moral philosophy to professional ethics in teacher education. We argue that it is both possible and desirable to connect knowledge of how teachers empirically do and understand professional ethics with normative theories of teachers' professional ethics. Our argument is made in…

Cohort differences in dementia recognition and treatment indicators among assisted living residents in Maryland: did a change in the resident assessment tool make a difference?

Science.gov (United States)

Samus, Quincy M; Vavilikolanu, Amrita; Mayer, Lawrence; McNabney, Matthew; Brandt, Jason; Lyketsos, Constantine G; Rosenblatt, Adam

2013-12-01

There is a lack of empirical evidence about the impact of regulations on dementia care quality in assisted living (AL). We examined cohort differences in dementia recognition and treatment indicators between two cohorts of AL residents with dementia, evaluated prior to and following a dementia-related policy modification to more adequately assess memory and behavioral problems. Cross-sectional comparison of two AL resident cohorts was done (Cohort 1 [evaluated 2001-2003] and Cohort 2 [evaluated 2004-2006]) from the Maryland Assisted Living studies. Initial in-person evaluations of residents with dementia (n = 248) were performed from a random sample of 28 AL facilities in Maryland (physician examination, clinical characteristics, and staff and family recognition of dementia included). Adequacy of dementia workup and treatment was rated by an expert consensus panel. Staff recognition of dementia was better in Cohort 1 than in Cohort 2 (77% vs. 63%, p = 0.011), with no significant differences in family recognition (86% vs. 85%, p = 0.680), or complete treatment ratings (52% vs. 64%, p = 0.060). In adjusted logistic regression, cognitive impairment and neuropsychiatric symptoms correlated with staff recognition; and cognitive impairment correlated with family recognition. Increased age and cognitive impairment reduced odds of having a complete dementia workup. Odds of having complete dementia treatment was reduced by age and having more depressive symptoms. Cohort was not predictive of dementia recognition or treatment indicators in adjusted models. We noted few cohort differences in dementia care indicators after accounting for covariates, and concluded that rates of dementia recognition and treatment did not appear to change much organically following the policy modifications.

Early change in coping strategies in responsive treatments for borderline personality disorder: A mediation analysis.

Science.gov (United States)

Kramer, Ueli; Keller, Sabine; Caspar, Franz; de Roten, Yves; Despland, Jean-Nicolas; Kolly, Stéphane

2017-05-01

Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Therefore, change in the frequency of certain patients' coping strategies-aiming at emotion regulation-are among the most promising mechanisms of change in treatments for BPD. In parallel, it was highlighted that therapist responsiveness significantly contributed to outcome across treatment approaches (Stiles, 2009). Based on a randomized controlled trial (Kramer et al., 2014), the present process-outcome mediation analysis aims at examining the patient's early change in frequency of coping strategies-in particular the decrease in behavioral forms of coping-as potential mechanism of change in responsive treatments for BPD. A total of 57 patients with BPD were included in the present analysis, out of whom 27 were randomly assigned to a 10-session psychiatric treatment and 30 to a 10-session psychiatric treatment augmented with the responsive intervention of the motive-oriented therapeutic relationship (Caspar, 2007). The 1st, 5th, and 9th session of each therapy were transcribed and analyzed using the Coping Action Pattern Rating Scale (Perry et al., 2005; 171 sessions analyzed in total), a validated observer-rated method for assessing coping strategies in the therapy process. Psychological distress was assessed using the OQ-45 at intake, after Session 5, and after Session 10. The results confirmed a responsiveness effect associated with the motive-oriented therapeutic relationship and showed a significant decrease in frequency of behavioral forms of coping, F(1, 54) = 3.09, p = .05, d = .56, which was not different between the 2 conditions. In addition, we demonstrated that the early decrease in behavioral forms of coping between Sessions 1 and 5 partially mediated the link between the group assignment and the change in psychological distress between Sessions 5 and 10. These results shed light on the centrality of therapist responsiveness in treatments for

Investigation of induced changes after treatment with ionizing radiation and saturated steam in the case of paprika

International Nuclear Information System (INIS)

Kispeter, J.; Bajusz-Kabok, K.; Fekete, M.; Szabo, G.; Fodor, E.; Pali, T.

2002-01-01

Complete text of publication follows. Beside conventional food preservation methods, such new physical methods are also applied as ionising radiation, high hydrostatic pressure, high-tension gradient, fluctuating strong magnetic field as well as treatments with high-pressure saturated steam and microwaves. Since radiation treatment is the best known, it can be regarded as a basic method in comparative tests. In our work the preservation-induced changes were investigated for paprika griests of various origin and quality (different dyestuff contents). Samples were treated with ionising radiation, high-pressure saturated steam (140 deg C, 30 s) or with combinations of these. The changes were followed as a function of absorbed dose (2, 5, 7.5, 10 kGy) and storage time (0, 1, 2, 4, 12 weeks) using colour measurements, rheological and ESR methods. Our results are summarised as follows: (1) The treatment with high-pressure saturated steam is equivalent to that of 5 kGy absorbed γ-doses. Significant changes in dyestuff contents and surface colours can't be detected immediately after treatments. After storage of 12 weeks, decomposition of dyestuffs and changes in surface colours in samples treated with saturated steam are 20% greater than in control. Radiation results in a slight (few %) dyestuff decomposition and colour change (i.e. discolouration). (2) Rheological characteristics were changed in both treatments (apparent viscosities were increased) during storage. This is a reversible and permanent change in the case of treatments with ionising radiation and with high-pressure saturated steam, respectively. (3) Changes induced by microwave treatment are in accordance with rheological changes. (4) Treatment with saturated steam results in a decrease in the cellulose free radical content. The decrease is inversely proportional to dyestuff contents. (5) Decrease of cellulose radical concentration with the storage time is of exponential-like character. Radicals disappear at

Is a night better than a day: Empirical evidence

Directory of Open Access Journals (Sweden)

A. Deshkovski

2014-12-01

Full Text Available In this study, we analyze the portfolio allocation based on time asymmetry of stock characteristics. In particular, we analyzed the empirical data of changes in financial stock prices during the day period and during the night period and have found that characteristics such as mean and variance are different for changes during the day and changes during the night. Also, the portfolio characteristics, such as covariance between stocks, differ on whether we take into account day changes or night changes in prices. That greatly affects the allocation of fund to the portfolio for an investor who trades frequently. The portfolio should be re-balanced every day in order to achieve optimality and much higher return. At the same level of risk the returns on this new portfolio may by several times larger than the returns on a portfolio without everyday re-balancing. We computed numerically the allocation of funds for the stocks from the finance industry and showed that the increase in returns is substantial.

Drinking-water treatment, climate change, and childhood gastrointestinal illness projections for northern Wisconsin (USA) communities drinking untreated groundwater

Science.gov (United States)

Uejio, Christopher K.; Christenson, Megan; Moran, Colleen; Gorelick, Mark

2017-06-01

This study examined the relative importance of climate change and drinking-water treatment for gastrointestinal illness incidence in children (age first quantified the observed (1991-2010) precipitation and gastrointestinal illness associations after controlling for seasonality and temporal trends. Precipitation likely transported pathogens into drinking-water sources or into leaking water-distribution networks. Building on observed relationships, the second analysis projected how climate change and drinking-water treatment installation may alter gastrointestinal illness incidence. Future precipitation values were modeled by 13 global climate models and three greenhouse-gas emissions levels. The second analysis was rerun using three pathways: (1) only climate change, (2) climate change and the same slow pace of treatment installation observed over 1991-2010, and (3) climate change and the rapid rate of installation observed over 2011-2016. The results illustrate the risks that climate change presents to small rural groundwater municipalities without drinking water treatment. Climate-change-related seasonal precipitation changes will marginally increase the gastrointestinal illness incidence rate (mean: ˜1.5%, range: -3.6-4.3%). A slow pace of treatment installation somewhat decreased precipitation-associated gastrointestinal illness incidence (mean: ˜3.0%, range: 0.2-7.8%) in spite of climate change. The rapid treatment installation rate largely decreases the gastrointestinal illness incidence (mean: ˜82.0%, range: 82.0-83.0%).

Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population.

Science.gov (United States)

Mazdaki, Alireza; Ghiasvand, Hesam; Sarabi Asiabar, Ali; Naghdi, Seyran; Aryankhesal, Aidin

2016-01-01

Helicobacter pylori may cause many gastrointestinal problems in developing countries such as Iran. We aimed to analyze the cost- effectiveness and cost- utility of the test-and-treat and empirical treatment strategies in managing Helicobacter pylori infection. This was a Markov based economic evaluation. Effectiveness was defined as the symptoms free numbers and QALYs in 100,000 hypothetical adults. The sensitivity analysis was based on Monte Carlo approach. In the test- and- treat strategy, if the serology is the first diagnostic test vs. histology, the cost per symptoms free number would be 291,736.1 Rials while the cost per QALYs would be 339,226.1 Rials. The cost per symptoms free number and cost per QALYs when the 13 C-UBT was used as the first diagnostic test vs. serology was 1,283,200 and 1,492,103 Rials, respectively. In the empirical strategy, if histology is used as the first diagnostic test vs. 13 CUBT, the cost per symptoms free numbers and cost per QALYs would be 793,234 and 955,698 Rials, respectively. If serology were used as the first diagnostic test vs. histology, the cost per symptoms free and QALYs would be 793,234 and 368941 Rials, respectively. There was no significant and considerable dominancy between the alternatives and the diagnostic tests.

Assessing the impacts of changes in treatment technology on energy and greenhouse gas balances for organic waste and wastewater treatment using historical data.

Science.gov (United States)

Poulsen, Tjalfe G; Hansen, Jens Aage

2009-11-01

Historical data on organic waste and wastewater treatment during the period of 1970-2020 were used to assess the impact of treatment on energy and greenhouse gas (GHG) balances. The assessment included the waste fractions: Sewage sludge, food waste, yard waste and other organic waste (paper, plastic, etc.). Data were collected from Aalborg, a municipality located in Northern Denmark. During the period from 1970-2005, Aalborg Municipality has changed its waste treatment strategy from landfilling of all wastes toward composting of yard waste and incineration with combined heat and power production from the remaining organic municipal waste. Wastewater treatment has changed from direct discharge of untreated wastewater to full organic matter and nutrient (N, P) removal combined with anaerobic digestion of the sludge for biogas production with power and heat generation. These changes in treatment technology have resulted in the waste and wastewater treatment systems in Aalborg progressing from being net consumers of energy and net emitters of GHG, to becoming net producers of energy and net savers of GHG emissions (due to substitution of fossil fuels elsewhere). If it is assumed that the organic waste quantity and composition is the same in 1970 and 2005, the technology change over this time period has resulted in a progression from a net annual GHG emission of 200 kg CO( 2)-eq. capita(-1) in 1970 to a net saving of 170 kg CO(2)-eq. capita(-1) in 2005 for management of urban organic wastes.

Changes in levels of cytokines in the treatment of infected wounds and festering in children

Directory of Open Access Journals (Sweden)

O. V. Spakhi

2016-12-01

Full Text Available Informative and prognostic significance of cytokines in assessing the effectiveness of treatment tactics no doubt. The aim was to study the levels of pro- and anti-inflammatory cytokines in the dynamics of the treatment of infected wounds and purulent (IWP in children using the proposed optimized local treatment compared with standard procedure. Materials and methods. 45 children with IWP who were treated in the department of purulent surgery of Zaporozhye Regional Children's Hospital during the period of 2015-2016 years were divided into main (n = 26 and control groups (n = 19 depending on the tactics of treatment. The therapy of the main group patients were added by optimized integrated local treatment, which included a combination of magnetic therapy, antibacterial drug liposomal solutions and hirudotherapy. Efficacy of treatment was assessed by clinical characteristics and serum levels of IL-1β and IL-10 on the 1st and the 7th day of treatment. Results. The highest levels of pro-inflammatory IL-1β were defined in children with lymphadenitis on the first day of treatment. Common trends in the dynamics of cytokines content changes on the 7th day were in the line with generally accepted: decreased in IL-1β and increased in IL-10 levels. The level of IL-1β was not statistically different on the 7th day only in children with phlegmon. The most significant changes in IL-10 were observed in children with abscesses and lymphadenitis than in children with infected wound and phlegmon. Changes in markers of inflammation conform to positive changes in the clinical course of wound healing in children at the study. Generally, there was a lag dynamics of cytokines changes in the children who received standard therapy compared with the children who received the proposed optimized local treatment. Conclusions. The use of proposed IWP complex treatment in children showed the most significant effect on the anti-inflammatory IL-10 level in children with

Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change

Science.gov (United States)

Styła, Rafał

2015-01-01

Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and “V” shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a “V” shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and “V” shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. PMID:26579001

Pivotal response treatment for autism spectrum disorder: current perspectives

Directory of Open Access Journals (Sweden)

Lei J

2017-06-01

Full Text Available Jiedi Lei, Pamela Ventola Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA Abstract: Pivotal response treatment (PRT is an evidence-based behavioral intervention based on applied behavior analysis principles aimed to improve social communication skills in individuals with autism spectrum disorder (ASD. PRT adopts a more naturalistic approach and focuses on using a number of strategies to help increase children’s motivation during intervention. Since its conceptualization, PRT has received much empirical support for eliciting therapeutic gains in greater use of functional social communication skills in individuals with ASD. Building upon the empirical evidence supporting PRT, recent advancements have increasingly turned to using interdisciplinary research integrating neuroimaging techniques and behavioral measures to help identify objective biomarkers of treatment, which have two primary purposes. First, neuroimaging results can help characterize how PRT may elicit change, and facilitate partitioning of the heterogeneous profiles of neural mechanisms underlying similar profile of behavioral changes observed over PRT. Second, neuroimaging provides an objective means to both map and track how biomarkers may serve as reliable and sensitive predictors of responder profiles to PRT, assisting clinicians to identify who will most likely benefit from PRT. Together, a better understanding of both mechanisms of change and predictors of responder profile will help PRT to serve as a more precise and targeted intervention for individuals with ASD, thus moving towards the goal of precision medicine and improving quality of care. This review focuses on the recent emerging neuroimaging evidences supporting PRT, offering current perspectives on the importance of interdisciplinary research to help clinicians better understand how PRT works and predict who will respond to PRT. Keywords: PRT, ASD, biomarkers, neuroimaging

An improved empirical dynamic control system model of global mean sea level rise and surface temperature change

Science.gov (United States)

Wu, Qing; Luu, Quang-Hung; Tkalich, Pavel; Chen, Ge

2018-04-01

Having great impacts on human lives, global warming and associated sea level rise are believed to be strongly linked to anthropogenic causes. Statistical approach offers a simple and yet conceptually verifiable combination of remotely connected climate variables and indices, including sea level and surface temperature. We propose an improved statistical reconstruction model based on the empirical dynamic control system by taking into account the climate variability and deriving parameters from Monte Carlo cross-validation random experiments. For the historic data from 1880 to 2001, we yielded higher correlation results compared to those from other dynamic empirical models. The averaged root mean square errors are reduced in both reconstructed fields, namely, the global mean surface temperature (by 24-37%) and the global mean sea level (by 5-25%). Our model is also more robust as it notably diminished the unstable problem associated with varying initial values. Such results suggest that the model not only enhances significantly the global mean reconstructions of temperature and sea level but also may have a potential to improve future projections.

Changes in Bacterial Resistance Patterns of Pediatric Urinary Tract Infections and Rationale for Empirical Antibiotic Therapy

Directory of Open Access Journals (Sweden)

İbrahim Gökçe

2017-10-01

Full Text Available Background: The causative agent spectrum and resistance patterns of urinary tract infections in children are affected by many factors. Aims: To demonstrate antibiotic resistance in urinary tract infections and changing ratio in antibiotic resistance by years. Study Design: Retrospective cross-sectional study. Methods: We analysed antibiotic resistance patterns of isolated Gram (- bacteria during the years 2011-2014 (study period 2 in children with urinary tract infections. We compared these findings with data collected in the same centre in 2001-2003 (study period 1. Results: Four hundred and sixty-five uncomplicated community-acquired Gram (- urinary tract infections were analysed from 2001-2003 and 400 from 2011-2014. Sixty-one percent of patients were female (1.5 girls : 1 boy. The mean age of children included in the study was 3 years and 9 months. Escherichia coli was the predominant bacteria isolated during both periods of the study (60% in study period 1 and 73% in study period 2. Bacteria other than E. coli demonstrated a higher level of resistance to all of the antimicrobials except trimethoprim-sulfamethoxazole than E. coli bacteria during the years 2011-2014. In our study, we found increasing resistance trends of urinary pathogens for cefixime (from 1% to 15%, p0.05. Conclusion: In childhood urinary tract infections, antibiotic resistance should be evaluated periodically and empiric antimicrobial therapy should be decided according to antibiotic sensitivity results

Weight Change over the Course of Binge Eating Disorder Treatment: Relationship to Binge Episodes and Psychological Factors.

Science.gov (United States)

Pacanowski, Carly R; Mason, Tyler B; Crosby, Ross D; Mitchell, James E; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B

2018-05-01

Treatment for binge eating disorder (BED), a condition associated with both excess adiposity and psychological distress, has not typically produced significant weight loss despite reducing binge eating. Characterizing factors that promote or inhibit weight loss in individuals with co-occurring BED and obesity may help explain overall nonsignificant weight changes during treatment. In this study, 189 adults with BED participated in a randomized clinical trial evaluating the efficacy of 5 months of cognitive behavioral therapy. Assessments included measured height and weight at baseline, midtreatment, end of treatment (EOT), and 6-month follow-up, the Eating Disorder Examination interview, and questionnaires. During treatment, there was a mean weight gain of 1.3 ± 12.0 lb. Twenty-two percent of the sample lost ≥ 5 lb, and 25% of the sample gained ≥ 8 lb. Results showed that baseline objective binge eating episodes predicted weight over treatment. Changes in weight were significantly positively related to concurrent changes in shape concern, weight concern, and disinhibition, but not binge eating episodes. Changes in objective binge eating episodes from baseline to EOT were associated with changes in weight from EOT to follow-up. Further investigation of eating behavior during BED treatment to understand the energy balance contributions to weight change or stability is warranted. © 2018 The Obesity Society.

Preferences for trauma treatment: A systematic review of the empirical literature.

Science.gov (United States)

Simiola, Vanessa; Neilson, Elizabeth C; Thompson, Richard; Cook, Joan M

2015-11-01

The prevalence of trauma histories and related psychological problems is high in general clinical settings, but little is known about trauma patient preferences for mental health treatment. The purpose of this article is to systematically review and synthesize the literature on treatment preferences in survivors of traumatic events. Studies were identified using comprehensive searches of PsycINFO, Medline, PubMed, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between January 1980 and September 2014, in English that reported patient preference of treatment for trauma related disorders in either clinical or nonclinical (e.g., analog) samples. The total number of individual participants was 6,091. Of the identified studies, 35 were quantitative and 6 were qualitative. Methodological concerns included the use of analog samples, small sample sizes, and the assessment of a limited number of treatment options (e.g., asking about only 1 type of psychotherapy or medication). Overall, participants expressed a preference for psychotherapy over medication and for talking about their trauma. Understanding and addressing trauma patient preferences may assist in improving treatment initiation as well as facilitate engagement, retention and outcome. (c) 2015 APA, all rights reserved).

Occlusal bite force change after orthodontic treatment with Andresen functional appliance.

Science.gov (United States)

Al-Khateeb, Susan N; Abu Alhaija, Elham S; Majzoub, Sami

2015-04-01

The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects. OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements. No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P appliance caused a significant reduction in OBF immediately after treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

A preliminary study of mechanistic approach in pavement design to accommodate climate change effects

Science.gov (United States)

Harnaeni, S. R.; Pramesti, F. P.; Budiarto, A.; Setyawan, A.

2018-03-01

Road damage is caused by some factors, including climate changes, overload, and inappropriate procedure for material and development process. Meanwhile, climate change is a phenomenon which cannot be avoided. The effects observed include air temperature rise, sea level rise, rainfall changes, and the intensity of extreme weather phenomena. Previous studies had shown the impacts of climate changes on road damage. Therefore, several measures to anticipate the damage should be considered during the planning and construction in order to reduce the cost of road maintenance. There are three approaches generally applied in the design of flexible pavement thickness, namely mechanistic approach, mechanistic-empirical (ME) approach and empirical approach. The advantages of applying mechanistic approach or mechanistic-empirical (ME) approaches are its efficiency and reliability in the design of flexible pavement thickness as well as its capacity to accommodate climate changes in compared to empirical approach. However, generally, the design of flexible pavement thickness in Indonesia still applies empirical approach. This preliminary study aimed to emphasize the importance of the shifting towards a mechanistic approach in the design of flexible pavement thickness.

Empirical Research In Engineering Design

DEFF Research Database (Denmark)

Ahmed, Saeema

2007-01-01

Increasingly engineering design research involves the use of empirical studies that are conducted within an industrial environment [Ahmed, 2001; Court 1995; Hales 1987]. Research into the use of information by designers or understanding how engineers build up experience are examples of research...... of research issues. This paper describes case studies of empirical research carried out within industry in engineering design focusing upon information, knowledge and experience in engineering design. The paper describes the research methods employed, their suitability for the particular research aims...

On the Sophistication of Naïve Empirical Reasoning: Factors Influencing Mathematicians' Persuasion Ratings of Empirical Arguments

Science.gov (United States)

Weber, Keith

2013-01-01

This paper presents the results of an experiment in which mathematicians were asked to rate how persuasive they found two empirical arguments. There were three key results from this study: (a) Participants judged an empirical argument as more persuasive if it verified that integers possessed an infrequent property than if it verified that integers…

Using the Milieu: Treatment-Environment Consistency.

Science.gov (United States)

Szekais, Barbara

1985-01-01

Describes trial use of milieu and activity-based therapy in two adult day centers to increase client involvement in physical and social environments of treatment settings. Reports results from empirical observations and recommends further investigation of this treatment modality in settings for the elderly. (Author/NRB)

Change in Depressive Symptoms among Treatment-Seeking College Students Who Are Sexual Minorities

Science.gov (United States)

Effrig, Jessica C.; Maloch, Janelle K.; McAleavey, Andrew; Locke, Benjamin D.; Bieschke, Kathleen J.

2014-01-01

Changes in students' depressive symptoms during the course of treatment at college counseling centers were examined by sexual orientation. In Study 1, results showed that depressive symptoms decreased similarly across sexual orientation groups during the course of treatment. In Study 2, family support did not moderate the relationship between…

Two concepts of empirical ethics.

Science.gov (United States)

Parker, Malcolm

2009-05-01

The turn to empirical ethics answers two calls. The first is for a richer account of morality than that afforded by bioethical principlism, which is cast as excessively abstract and thin on the facts. The second is for the facts in question to be those of human experience and not some other, unworldly realm. Empirical ethics therefore promises a richer naturalistic ethics, but in fulfilling the second call it often fails to heed the metaethical requirements related to the first. Empirical ethics risks losing the normative edge which necessarily characterizes the ethical, by failing to account for the nature and the logic of moral norms. I sketch a naturalistic theory, teleological expressivism (TE), which negotiates the naturalistic fallacy by providing a more satisfactory means of taking into account facts and research data with ethical implications. The examples of informed consent and the euthanasia debate are used to illustrate the superiority of this approach, and the problems consequent on including the facts in the wrong kind of way.

Experimental Simulation of the Effects of an Initial Antibiotic Treatment on a Subsequent Treatment after Initial Therapy Failure

NARCIS (Netherlands)

Feng, Yanfang; Händel, Nadine; de Groot, Marnix H. P.; Brul, Stanley; Schultsz, Constance; ter Kuile, Benno H.

2014-01-01

Therapy failure of empirical antibiotic treatments prescribed by primary care physicians occurs commonly. The effect of such a treatment on the susceptibility to second line antimicrobial drugs is unknown. Resistance to amoxicillin was rapidly induced or selected in E. coli at concentrations

Empirical methods for modeling landscape change, ecosystem services, and biodiversity

Science.gov (United States)

David Lewis; Ralph. Alig

2009-01-01

The purpose of this paper is to synthesize recent economics research aimed at integrating discrete-choice econometric models of land-use change with spatially-explicit landscape simulations and quantitative ecology. This research explicitly models changes in the spatial pattern of landscapes in two steps: 1) econometric estimation of parcel-scale transition...

Combining empirical and theory-based land-use modelling approaches to assess economic potential of biofuel production avoiding iLUC: Argentina as a case study

NARCIS (Netherlands)

Diogo, V.; van der Hilst, F.; van Eijck, J.; Verstegen, J.A.; Hilbert, J.; Carballo, S.; Volante, J.; Faaij, A.

2014-01-01

In this paper, a land-use modelling framework is presented combining empirical and theory-based modelling approaches to determine economic potential of biofuel production avoiding indirect land-use changes (iLUC) resulting from land competition with other functions. The empirical approach explores

An Attitudinal Explanation of Biases in the Criminal Justice System: An Empirical Testing of Defensive Attribution Theory

Science.gov (United States)

Herzog, Sergio

2008-01-01

Theoretical perspectives, supported by empirical evidence, have consistently argued that the judicial treatment of offenders by criminal justice agents is sometimes biased by extralegal factors, such as offenders' sociodemographic characteristics. According to defensive attribution theory, individuals tend to protect themselves against unfortunate…

An empirical model for salt removal percentage in water under the effect of different current intensities of current carrying coil at different flow rates

Directory of Open Access Journals (Sweden)

Rameen S. AbdelHady

2011-10-01

Full Text Available The magnetic treatment of hard water is an alternative, simple approach by which the hard water that needs to be treated flows through a magnetic field. This field is created by inducing current in a coil wrapped around a pipe. Consequently some of its properties, such as total dissolved salts (TDS, conductivity (Ec and PH change. The primary purpose of hard water treatment is to decrease TDS in the incoming liquid stream. Using performance data from the application of different magnetic field densities on the different flow levels of water, empirical mathematical models were developed relating the salt removal percentage (SRP to operating flow rate and current of the coil. The obtained experimental results showed that the SRP increased with increasing the current at low flow rates (up to 0.75 ml/s.

Fuel accumulation and forest structure change following hazardous fuel reduction treatments throughout California

Science.gov (United States)

Nicole M. Vaillant; Erin K. Noonan-Wright; Alicia L. Reiner; Carol M. Ewell; Benjamin M. Rau; Josephine A. Fites-Kaufman; Scott N. Dailey

2015-01-01

Altered fuel conditions coupled with changing climate have disrupted fire regimes of forests historically characterised by high-frequency and low-to-moderate-severity fire. Managers use fuel treatments to abate undesirable fire behaviour and effects. Short-term effectiveness of fuel treatments to alter fire behaviour and effects is well documented; however, long-term...

Urinary catheter-associated microbiota change in accordance with treatment and infection status.

Science.gov (United States)

Bossa, Laetitia; Kline, Kimberly; McDougald, Diane; Lee, Bonsan Bonne; Rice, Scott A

2017-01-01

The use of long-term catheterisation to manage insensate bladders, often associated with spinal cord injury (SCI), increases the risk of microbial colonisation and infection of the urinary tract. Urinary tract infection (UTI) is typically diagnosed and treated based on the culturing of organisms from the urine, although this approach overlooks low titer, slow growing and non-traditional pathogens. Here, we present an investigation of the urinary tract microbiome in catheterised SCI individuals, using T-RFLP and metagenomic sequencing of the microbial community. We monitored three neurogenic patients over a period of 12 months, who were part of a larger study investigating the efficacy of probiotics in controlling UTIs, to determine how their urinary tract microbial community composition changed over time and in relation to probiotic treatment regimens. Bacterial biofilms adherent to urinary catheters were examined as a proxy for bladder microbes. The microbial community composition of the urinary tract differed significantly between individuals. Probiotic therapy resulted in a significant change in the microbial community associated with the catheters. The community also changed as a consequence of UTI and this shift in community composition preceded the clinical diagnosis of infection. Changes in the microbiota due to probiotic treatment or infection were transient, resolving to microbial communities similar to their pre-treatment communities, suggesting that the native community was highly resilient. Based on these results, we propose that monitoring a patient's microbial community can be used to track the health of chronically catheterized patients and thus, can be used as part of a health-status monitoring program.

What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme.

Science.gov (United States)

Kealy, David; Joyce, Anthony S; Weber, Rainer; Ehrenthal, Johannes C; Ogrodniczuk, John S

2018-02-13

Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction. Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme. Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up. While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change. The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction. This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress

Tourist Satisfaction Enhancement Using Mobile QR Code Payment: An Empirical Investigation

Directory of Open Access Journals (Sweden)

Liguo Lou

2017-07-01

Full Text Available Innovative technologies have greatly changed people’s lives, including their travel experiences. This study investigates the antecedents and outcomes of the quick response (QR code payment technology used in tourism to provide empirical evidence that mobile technologies can be used to enhance tourist satisfaction. An empirical analysis using 247 field survey responses reveals that relative advantage, compatibility, and observability innovation attributes significantly affect tourists’ attitudes positively toward QR code payment services, which results in their use of the technology while traveling. However, image—the subjective norm in innovation diffusion—has no effect on such use. Furthermore, the study confirms that the use of the QR code payment technology in tourism influences an individual’s transaction satisfaction and travel satisfaction, suggesting that this technology can be used to advance the tourism industry. Theoretical and practical implications of the findings and future research directions are also discussed.

Using an Empirical Binomial Hierarchical Bayesian Model as an Alternative to Analyzing Data from Multisite Studies

Science.gov (United States)

Hardin, J. Michael; Anderson, Billie S.; Woodby, Lesa L.; Crawford, Myra A.; Russell, Toya V.

2008-01-01

This article explores the statistical methodologies used in demonstration and effectiveness studies when the treatments are applied across multiple settings. The importance of evaluating and how to evaluate these types of studies are discussed. As an alternative to standard methodology, the authors of this article offer an empirical binomial…

Changes in nail keratin observed by Raman spectroscopy after Nd:YAG laser treatment.

Science.gov (United States)

Shin, Min Kyung; Kim, Tae In; Kim, Wan Sun; Park, Hun-Kuk; Kim, Kyung Sook

2017-04-01

Lasers and photodynamic therapy have been considered a convergence treatment for onychomycosis, which is a fungal infection on the nail bed and nail plate. Laser therapies have shown satisfactory results without significant complications for onychomycosis; however, the mechanism of clearing remains unknown. In this work, we investigated changes in the chemical structure of nail keratin induced by Nd:YAG laser using Raman spectroscopy. Toe nails with onychomycosis were treated with 1064 nm Nd:YAG laser. After laser treatment, the disulfide band (490-590 cm -1 ) of nail keratin was rarely observed or was reduced in intensity. The amide I band (1500-1700 cm -1 ) also showed changes induced by the laser. The α-helical (1652 cm -1 ) structures dominated the β-sheet (1673 cm -1 ) in nontreated nail, but the opposite phenomenon was observed after laser treatment. © 2016 Wiley Periodicals, Inc.

Shape of the self-concept clarity change during group psychotherapy predicts the outcome: An empirical validation of the theoretical model of the self-concept change

Directory of Open Access Journals (Sweden)

Rafał eStyła

2015-10-01

Full Text Available Background: Self-concept clarity describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of self-concept clarity change (especially stable increase and V shape observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable self-concept clarity increase is needed for the participants with a rather healthy personality structure, while self-concept clarity change characterized by a V shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M=5.8 was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale, Symptoms’ Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The Self-Concept Clarity Scale was also administered every two weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable self-concept clarity increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and V shape of self-concept clarity change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of self-concept clarity is a sign of a good treatment prognosis.

Quantifying the number of lane changes in traffic : An empirical analysis

NARCIS (Netherlands)

Knoop, V.L.; Hoogendoorn, S.P.; Shiomi, Y.; Buisson, C.

2012-01-01

Lane changes are an important aspect of freeway flow. Most lane change models are microscopic, describing whether individual vehicles/drives will change lanes, and hence are calibrated microscopically. Macroscopic validation often is restricted to the distribution of vehicles across lanes. To the

Identifying MRI markers to evaluate early treatment-related changes post-laser ablation for cancer pain management

Science.gov (United States)

Tiwari, Pallavi; Danish, Shabbar; Madabhushi, Anant

2014-03-01

Laser interstitial thermal therapy (LITT) has recently emerged as a new treatment modality for cancer pain management that targets the cingulum (pain center in the brain), and has shown promise over radio-frequency (RF) based ablation which is reported to provide temporary relief. One of the major advantages enjoyed by LITT is its compatibility with magnetic resonance imaging (MRI), allowing for high resolution in vivo imaging to be used in LITT procedures. Since laser ablation for pain management is currently exploratory and is only performed at a few centers worldwide, its short-, and long-term effects on the cingulum are currently unknown. Traditionally treatment effects are evaluated by monitoring changes in volume of the ablation zone post-treatment. However, this is sub-optimal since it involves evaluating a single global parameter (volume) to detect changes pre-, and post-MRI. Additionally, the qualitative observations of LITT-related changes on multi-parametric MRI (MPMRI) do not specifically address differentiation between the appearance of treatment related changes (edema, necrosis) from recurrence of the disease (pain recurrence). In this work, we explore the utility of computer extracted texture descriptors on MP-MRI to capture early treatment related changes on a per-voxel basis by extracting quantitative relationships that may allow for an in-depth understanding of tissue response to LITT on MRI, subtle changes that may not be appreciable on original MR intensities. The second objective of this work is to investigate the efficacy of different MRI protocols in accurately capturing treatment related changes within and outside the ablation zone post-LITT. A retrospective cohort of studies comprising pre- and 24-hour post-LITT 3 Tesla T1-weighted (T1w), T2w, T2-GRE, and T2-FLAIR acquisitions was considered. Our scheme involved (1) inter-protocol as well as inter-acquisition affine registration of pre- and post-LITT MRI, (2) quantitation of MRI parameters

Pre-treatment attachment anxiety predicts change in depressive symptoms in women who complete day hospital treatment for anorexia and bulimia nervosa.

Science.gov (United States)

Keating, Leah; Tasca, Giorgio A; Bissada, Hany

2015-03-01

Individuals with eating disorders are prone to depressive symptoms. This study examines whether depressive symptoms can change in women who complete intensive day treatment for anorexia and bulimia nervosa (BN), and whether these changes are associated with pre-treatment attachment insecurity. Participants were 141 women with anorexia nervosa restricting type (n = 24), anorexia nervosa binge purge type (n = 30), and BN (n = 87) who completed a day hospital treatment programme for eating disorders. They completed a pre-treatment self-report measure of attachment, and a pre-treatment and post-treatment self-report measure of depressive symptoms. Participants experienced significant reductions in depressive symptoms at post-treatment. Eating disorder diagnosis was not related to these improvements. However, participants lower in attachment anxiety experienced significantly greater improvement in depressive symptoms than those who were higher in attachment anxiety. These results suggest that clinicians may tailor eating disorders treatments to patients' attachment patterns and focus on their pre-occupation with relationships and affect regulation to improve depressive symptoms. That depressive symptoms can decrease in women who complete day hospital treatment for anorexia and BN. That improvements in depressive symptoms do not vary according to eating disorder diagnosis in these women. That patients who complete treatment and who have higher attachment anxiety experience less improvements in depressive symptoms compared to those lower in attachment anxiety. That clinicians may attend to aspects of attachment anxiety, such as need for approval and up-regulation of emotions, to improve depressive symptoms in female patients with eating disorders. © 2014 The British Psychological Society.

Cervical vertebral bone mineral density changes in adolescents during orthodontic treatment.

Science.gov (United States)

Crawford, Bethany; Kim, Do-Gyoon; Moon, Eun-Sang; Johnson, Elizabeth; Fields, Henry W; Palomo, J Martin; Johnston, William M

2014-08-01

The cervical vertebral maturation (CVM) stages have been used to estimate facial growth status. In this study, we examined whether cone-beam computed tomography images can be used to detect changes of CVM-related parameters and bone mineral density distribution in adolescents during orthodontic treatment. Eighty-two cone-beam computed tomography images were obtained from 41 patients before (14.47 ± 1.42 years) and after (16.15 ± 1.38 years) orthodontic treatment. Two cervical vertebral bodies (C2 and C3) were digitally isolated from each image, and their volumes, means, and standard deviations of gray-level histograms were measured. The CVM stages and mandibular lengths were also estimated after converting the cone-beam computed tomography images. Significant changes for the examined variables were detected during the observation period (P ≤0.018) except for C3 vertebral body volume (P = 0.210). The changes of CVM stage had significant positive correlations with those of vertebral body volume (P ≤0.021). The change of the standard deviation of bone mineral density (variability) showed significant correlations with those of vertebral body volume and mandibular length for C2 (P ≤0.029). The means and variability of the gray levels account for bone mineral density and active remodeling, respectively. Our results indicate that bone mineral density distribution and the volume of the cervical vertebral body changed because of active bone remodeling during maturation. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Trade and Empire

DEFF Research Database (Denmark)

Bang, Peter Fibiger

2007-01-01

This articles seeks to establish a new set of organizing concepts for the analysis of the Roman imperial economy from Republic to late antiquity: tributary empire, port-folio capitalism and protection costs. Together these concepts explain better economic developments in the Roman world than the...

Quantitative analyses of empirical fitness landscapes

International Nuclear Information System (INIS)

Szendro, Ivan G; Franke, Jasper; Krug, Joachim; Schenk, Martijn F; De Visser, J Arjan G M

2013-01-01

The concept of a fitness landscape is a powerful metaphor that offers insight into various aspects of evolutionary processes and guidance for the study of evolution. Until recently, empirical evidence on the ruggedness of these landscapes was lacking, but since it became feasible to construct all possible genotypes containing combinations of a limited set of mutations, the number of studies has grown to a point where a classification of landscapes becomes possible. The aim of this review is to identify measures of epistasis that allow a meaningful comparison of fitness landscapes and then apply them to the empirical landscapes in order to discern factors that affect ruggedness. The various measures of epistasis that have been proposed in the literature appear to be equivalent. Our comparison shows that the ruggedness of the empirical landscape is affected by whether the included mutations are beneficial or deleterious and by whether intragenic or intergenic epistasis is involved. Finally, the empirical landscapes are compared to landscapes generated with the rough Mt Fuji model. Despite the simplicity of this model, it captures the features of the experimental landscapes remarkably well. (paper)

Evaluation of Climate Change Impact on Drinking Water Treatment Plant Operation

Science.gov (United States)

It is anticipated that global climate change will adversely impact source water quality in many areas of the United States and, therefore, will influence the design and operation of current and future drinking water treatment systems. Some of these impacts may lead to violations ...

Empirical pseudo-potential studies on electronic structure

Indian Academy of Sciences (India)

Theoretical investigations of electronic structure of quantum dots is of current interest in nanophase materials. Empirical theories such as effective mass approximation, tight binding methods and empirical pseudo-potential method are capable of explaining the experimentally observed optical properties. We employ the ...

Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis.

Science.gov (United States)

Zilberberg, Marya D; Nathanson, Brian H; Sulham, Kate; Fan, Weihong; Shorr, Andrew F

2017-04-17

Drug resistance among gram-negative pathogens is a risk factor for inappropriate empiric treatment (IET), which in turn increases the risk for mortality. We explored the impact of carbapenem-resistant Enterobacteriaceae (CRE) on the risk of IET and of IET on outcomes in patients with Enterobacteriaceae infections. We conducted a retrospective cohort study in Premier Perspective database (2009-2013) of 175 US hospitals. We included all adult patients with community-onset culture-positive urinary tract infection (UTI), pneumonia, or sepsis as a principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure, treated with antibiotics within 2 days of admission. We employed regression modeling to compute adjusted association of presence of CRE with risk of receiving IET, and of IET on hospital mortality, length of stay (LOS) and costs. Among 40,137 patients presenting to the hospital with an Enterobacteriaceae UTI, pneumonia or sepsis, 1227 (3.1%) were CRE. In both groups, the majority of the cases were UTI (51.4% CRE and 54.3% non-CRE). Those with CRE were younger (66.6+/-15.3 vs. 69.1+/-15.9 years, p pneumonia or sepsis was comparable to other national estimates. Infection with CRE was associated with a four-fold increased risk of receiving IET, which in turn increased mortality, LOS and costs.

Transmasculine people's vocal situations: a critical review of gender-related discourses and empirical data.

Science.gov (United States)

Azul, David

2015-01-01

Transmasculine people assigned female sex at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Some voice researchers and clinicians suggest that transmasculine people do not need attention because testosterone treatment leads to a satisfactory masculinization of their voice organs and voices. Others, however, argue that transmasculine people are a heterogeneous group whose members might not share the same body type, gender identity or desire for medical approaches to gender transitioning. Therefore, testosterone-induced voice changes may not necessarily meet the needs and expectations of all transmasculine people. To evaluate the gender-related discursive and empirical data about transmasculine people's vocal situations to identify gaps in the current state of knowledge and to make suggestions for future voice research and clinical practice. A comprehensive review of peer-reviewed academic and clinical literature was conducted. Publications were identified by searching seven electronic databases and bibliographies of relevant articles. Thirty-one publications met inclusion criteria. Discourses and empirical data were analysed thematically. Potential problem areas that transmasculine people may experience were identified and the quality of evidence appraised. The extent and quality of voice research conducted with transmasculine people so far was found to be limited. There was mixed evidence to suggest that transmasculine people's vocal situations could be regarded as problematic. The diversity that characterizes the transmasculine population received little attention and the complexity of the factors that contribute to a successful or unsuccessful vocal communication of gender in this group appeared to be under-researched. While most transmasculine people treated with testosterone can expect a lowering of their pitch, it remains unclear whether the extent of the pitch change is enough

An Empirical Taxonomy of Crowdfunding Intermediaries

OpenAIRE

Haas, Philipp; Blohm, Ivo; Leimeister, Jan Marco

2014-01-01

Due to the recent popularity of crowdfunding, a broad magnitude of crowdfunding intermediaries has emerged, while research on crowdfunding intermediaries has been largely neglected. As a consequence, existing classifications of crowdfunding intermediaries are conceptual, lack theoretical grounding, and are not empirically validated. Thus, we develop an empirical taxonomy of crowdfunding intermediaries, which is grounded in the theories of two-sided markets and financial intermediation. Integr...

Autonomous e-coaching in the wild: Empirical validation of a model-based reasoning system

OpenAIRE

Kamphorst, B.A.; Klein, M.C.A.; van Wissen, A.

2014-01-01

Autonomous e-coaching systems have the potential to improve people's health behaviors on a large scale. The intelligent behavior change support system eMate exploits a model of the human agent to support individuals in adopting a healthy lifestyle. The system attempts to identify the causes of a person's non-adherence by reasoning over a computational model (COMBI) that is based on established psychological theories of behavior change. The present work presents an extensive, monthlong empiric...

Mergers and Acquisitions in the Spanish Banking Industry: some Empirical Evidence.

OpenAIRE

Ignacio Fuentes; Teresa Sastre

1999-01-01

Since the late eighties, the Spanish banking system has been undergoing major changes that have affected both its structure and the nature of strategic interaction among banking institutions. Various different strategies have been adopted to tackle the demands of this new operating environment, one such strategy having been consolidation via mergers and acquisitions. This paper attempts to provide some empirical evidence on the impact of the consolidation process on the monetary transmission ...

Ancient DNA analysis suggests negligible impact of the Wari Empire expansion in Peru's central coast during the Middle Horizon

OpenAIRE

Valverde, G.; Romero, M.; Espinoza, I.; Cooper, A.; Fehren-Schmitz, L.; Llamas, B.; Haak, W.

2016-01-01

The analysis of ancient human DNA from South America allows the exploration of pre-Columbian population history through time and to directly test hypotheses about cultural and demographic evolution. The Middle Horizon (650?1100 AD) represents a major transitional period in the Central Andes, which is associated with the development and expansion of ancient Andean empires such as Wari and Tiwanaku. These empires facilitated a series of interregional interactions and socio-political changes, wh...

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study.

Science.gov (United States)

Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang; Petersen, Pelle Trier; Lindhardt, Bjarne Ørskov; von Plessen, Christian; Rohde, Gernot; Ravn, Pernille

2017-04-20

Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy. Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis. We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.

Gazprom: the new empire

International Nuclear Information System (INIS)

Guillemoles, A.; Lazareva, A.

2008-01-01

Gazprom is conquering the world. The Russian industrial giant owns the hugest gas reserves and enjoys the privilege of a considerable power. Gazprom edits journals, owns hospitals, airplanes and has even built cities where most of the habitants work for him. With 400000 workers, Gazprom represents 8% of Russia's GDP. This inquiry describes the history and operation of this empire and show how its has become a masterpiece of the government's strategy of russian influence reconquest at the world scale. Is it going to be a winning game? Are the corruption affairs and the expected depletion of resources going to weaken the empire? The authors shade light on the political and diplomatic strategies that are played around the crucial dossier of the energy supply. (J.S.)

Changes in prefrontal and amygdala activity during olanzapine treatment in schizophrenia.

Science.gov (United States)

Blasi, Giuseppe; Popolizio, Teresa; Taurisano, Paolo; Caforio, Grazia; Romano, Raffaella; Di Giorgio, Annabella; Sambataro, Fabio; Rubino, Valeria; Latorre, Valeria; Lo Bianco, Luciana; Fazio, Leonardo; Nardini, Marcello; Weinberger, Daniel R; Bertolino, Alessandro

2009-07-15

Earlier imaging studies in schizophrenia have reported abnormal amygdala and prefrontal cortex activity during emotion processing. We investigated with functional magnetic resonance imaging (fMRI) during emotion processing changes in activity of the amygdala and of prefrontal cortex in patients with schizophrenia during 8 weeks of olanzapine treatment. Twelve previously drug-free/naive patients with schizophrenia were treated with olanzapine for 8 weeks and underwent two fMRI scans after 4 and 8 weeks of treatment during implicit and explicit emotional processing. Twelve healthy subjects were also scanned twice to control for potential repetition effects. Results showed a diagnosis by time interaction in left amygdala and a diagnosis by time by task interaction in right ventrolateral prefrontal cortex. In particular, activity in left amygdala was greater in patients than in controls at the first scan during both explicit and implicit processing, while it was lower in patients at the second relative to the first scan. Furthermore, during implicit processing, right ventrolateral prefrontal cortex activity was lower in patients than controls at the first scan, while it was greater in patients at the second relative to the first scan. These results suggest that longitudinal treatment with olanzapine may be associated with specific changes in activity of the amygdala and prefrontal cortex during emotional processing in schizophrenia.

Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

Directory of Open Access Journals (Sweden)

Maryam Poosti

2012-09-01

Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction.

Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

Directory of Open Access Journals (Sweden)

Maryam Poosti

2013-01-01

Full Text Available Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction

Hematological and histopathological changes in female albino rats after gamma irradiation and /or piper nigrum treatment

International Nuclear Information System (INIS)

Ali, S.E.; Hanna, L.S.; Khattab, H.M.

2003-01-01

This study was carried out to investigate the effect of whole body gamma irradiation, at dose level of 6.0 Gy (single dose), and or daily treatment with P. nigrum (black pepper) at doses of 160 and 320 mg/kg body weight up to 36, 71 and 99 days on some hematological aspects as well as histopathological changes in lung, kidney and brain tissues of female albino rats. The results revealed that whole body gamma irradiation significantly elevated the values of red blood cells (RBCs), white blood cells (WBCs) and hematocrit percentage (HC %) but hemoglobin level was significantly decreased. These changes were ameliorated after treatment with P. nigrum. Non-significant changes were obtained regarding the effect of both doses of P. nigrum on red and white blood cell counts throughout the three time intervals. However, a dose of 160 mg/kg body weight of P. nigrum significantly reduced the hemoglobin contents throughput the experimental period. Histopathological examination revealed that lung, kidney and brain tissues showed marked to moderate pathological changes after irradiation and/or P.nigrum treatments. However, treatment with P. nigrum showed positive effect against the harmful effects of gamma irradiation, concerning kidney and brain. Although no malignant transformation could be detected, the resultant marked alveolar inflammation, bronchial wall hyperplasia and reactive astrocytic proliferation are important pathological changes that should be considered as pre-neoplastic changes

The Voice of Experience: Diet and Weight Change in Women with Breast Cancer Associate with Psychosocial and Treatment-Related Challenges.

Science.gov (United States)

Vance, Vivienne; Campbell, Sharon; Mccargar, Linda; Mourtzakis, Marina; Hanning, Rhona

2017-06-01

This study investigated relationships between psychosocial and treatment-related factors, diet, and weight change in women treated with chemotherapy for early-stage breast cancer. Comprehensive qualitative interviews were conducted with 28 women who were within 12 months of completing chemotherapy treatment. Changes in food intake and eating patterns were universal over the course of chemotherapy, with broad variability in treatment effects and associated dietary responses linked to weight change. Increased appetite, food cravings, and intake of energy-dense comfort foods were more common among women who gained weight during treatment (n = 11). Changes in taste, nausea, and emotional distress were central in promoting these dietary responses. Women who lost weight during treatment (n = 6) tended to report more severe and persistent side effects of treatment leading to poor appetite and lower food intake, and they were more likely to live alone. While the etiology of weight change in this population is complex, this study suggests that changes in food intake related to treatment and psychosocial challenges may play an important role for some women. These findings may help to identify women who are most at risk of weight change during treatment and may inform the development of tailored dietary interventions.

Trophic interaction modifications: an empirical and theoretical framework.

Science.gov (United States)

Terry, J Christopher D; Morris, Rebecca J; Bonsall, Michael B

2017-10-01

Consumer-resource interactions are often influenced by other species in the community. At present these 'trophic interaction modifications' are rarely included in ecological models despite demonstrations that they can drive system dynamics. Here, we advocate and extend an approach that has the potential to unite and represent this key group of non-trophic interactions by emphasising the change to trophic interactions induced by modifying species. We highlight the opportunities this approach brings in comparison to frameworks that coerce trophic interaction modifications into pairwise relationships. To establish common frames of reference and explore the value of the approach, we set out a range of metrics for the 'strength' of an interaction modification which incorporate increasing levels of contextual information about the system. Through demonstrations in three-species model systems, we establish that these metrics capture complimentary aspects of interaction modifications. We show how the approach can be used in a range of empirical contexts; we identify as specific gaps in current understanding experiments with multiple levels of modifier species and the distributions of modifications in networks. The trophic interaction modification approach we propose can motivate and unite empirical and theoretical studies of system dynamics, providing a route to confront ecological complexity. © 2017 The Authors. Ecology Letters published by CNRS and John Wiley & Sons Ltd.

[Changes of menstruation patterns and adverse effects during the treatment of LNG-IUS for symptomatic adenomyosis].

Science.gov (United States)

Li, L; Leng, J H; Zhang, J J; Jia, S Z; Li, X Y; Shi, J H; Dai, Y; Zhang, J R; Li, T; Xu, X X; Liu, Z Z; You, S S; Chang, X Y; Lang, J H

2016-09-25

Objective: To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system(LNG-IUS)for symptomatic adenomyosis in a prospective cohort study. Methods: From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients' parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results: Totally 1 100 cases met inclusion criteria, with median age 36 years(range 20-44 years), median follow-up 35 months(range 1 -108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383)and 29.6%(82/277)patients achieved amenorrhea respectively( P 12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status(all P > 0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions: During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened-menstruation being the most common manifestations, while adverse effects decrease significantly. Changes of

Neural Rhythms of Change: Long-Term Improvement after Successful Treatment in Children with Disruptive Behavior Problems

Directory of Open Access Journals (Sweden)

Steven Woltering

2015-01-01

Full Text Available Neural changes were investigated for children with disruptive behavior problems one year after a treatment program ended. Thirty-nine children and their parents visited the research lab before, after, and a year after treatment ended. During those lab visits, electroencephalography (EEG was recorded during a challenging Go/No-go task. Treatment consisted of intensive 14-week combined cognitive behavioral therapy and parent management training sessions. For the analysis, participants were divided into long-term improvers (IMPs and long-term nonimprovers (NIMPs based on changes in their externalizing problem scores. The results showed early no-go theta power (4–8 Hz, 100–250 ms decreased for long-term IMPs compared to NIMPs. When participants were divided based on changes in their comorbid internalizing symptoms, effects were stronger and reductions in theta power were found for early as well as later phases (250–650 ms. We provided preliminary evidence that theta power is a useful neural measure to trace behavioral change linked to improved self-regulation even up to a year after treatment ended. Results may have implications for the characterization of children with disruptive behavior problems and may lead to the development of novel markers of treatment success.

Intermodal connectivity in Europe, an empirical exploration

NARCIS (Netherlands)

de Langen, P.W.; Lases Figueroa, D.M.; van Donselaar, K.H.; Bozuwa, J.

2017-01-01

In this paper we analyse the intermodal connectivity in Europe. The empirical analysis is to our knowledge the first empirical analysis of intermodal connections, and is based on a comprehensive database of intermodal connections in Europe. The paper focuses on rail and barge services, as they are

The emerging empirics of evolutionary economic geography

NARCIS (Netherlands)

Boschma, R.A.; Frenken, K.

2011-01-01

Following last decade’s programmatic papers on Evolutionary Economic Geography, we report on recent empirical advances and how this empirical work can be positioned vis-a`-vis other strands of research in economic geography. First, we review studies on the path dependent nature of clustering, and

The emerging empirics of evolutionary economic geography

NARCIS (Netherlands)

Boschma, R.A.; Frenken, K.

2010-01-01

Following last decade’s programmatic papers on Evolutionary Economic Geography, we report on recent empirical advances and how this empirical work can be positioned vis-à-vis other strands of research in economic geography. First, we review studies on the path dependent nature of clustering, and how

The emerging empirics of evolutionary economic geography.

NARCIS (Netherlands)

Boschma, R.A.; Frenken, K.

2011-01-01

Following last decade’s programmatic papers on Evolutionary Economic Geography, we report on recent empirical advances and how this empirical work can be positioned vis-a`-vis other strands of research in economic geography. First, we review studies on the path dependent nature of clustering, and

Early outcomes of empiric embolization of tumor-related gastrointestinal hemorrhage in patients with advanced malignancy.

Science.gov (United States)

Tandberg, Daniel J; Smith, Tony P; Suhocki, Paul V; Pabon-Ramos, Waleska; Nelson, Rendon C; Desai, Svetang; Branch, Stanley; Kim, Charles Y

2012-11-01

To report short-term results of empiric transcatheter embolization for patients with advanced malignancy and gastrointestinal (GI) hemorrhage directly from a tumor invading the GI tract wall. Between 2005 and 2011, 37 mesenteric angiograms were obtained in 26 patients with advanced malignancy (20 men, six women; mean age, 56.2 y) with endoscopically confirmed symptomatic GI hemorrhage from a tumor invading the GI tract wall. Angiographic findings and clinical outcomes were retrospectively evaluated. Clinical success was defined as absence of signs and symptoms of hemorrhage for at least 30 day following embolization. Active extravasation was demonstrated in three cases. Angiographic abnormalities related to a GI tract tumor were identified on 35 of 37 angiograms, including tumor neovascularity (n = 21), tumor enhancement (n = 24), and luminal irregularity (n = 5). In the absence of active extravasation, empiric embolization with particles and/or coils was performed in 25 procedures. Cessation of hemorrhage (ie, clinical success) occurred more frequently when empiric embolization was performed (17 of 25 procedures; 68%) than when embolization was not performed (two of nine; 22%; P = .03). Empiric embolization resulted in clinical success in 10 of 11 patients with acute GI bleeding (91%), compared with seven of 14 patients (50%) with chronic GI bleeding (P = .04). No ischemic complications were encountered. In patients with advanced malignancy, in the absence of active extravasation, empiric transcatheter arterial embolization for treatment of GI hemorrhage from a direct tumor source demonstrated a 68% short-term success rate, without any ischemic complications. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Analysis of physiological responses associated with emotional changes induced by viewing video images of dental treatments.

Science.gov (United States)

Sekiya, Taki; Miwa, Zenzo; Tsuchihashi, Natsumi; Uehara, Naoko; Sugimoto, Kumiko

2015-03-30

Since the understanding of emotional changes induced by dental treatments is important for dentists to provide a safe and comfortable dental treatment, we analyzed physiological responses during watching video images of dental treatments to search for the appropriate objective indices reflecting emotional changes. Fifteen healthy young adult subjects voluntarily participated in the present study. Electrocardiogram (ECG), electroencephalogram (EEG) and corrugator muscle electromyogram (EMG) were recorded and changes of them by viewing videos of dental treatments were analyzed. The subjective discomfort level was acquired by Visual Analog Scale method. Analyses of autonomic nervous activities from ECG and four emotional factors (anger/stress, joy/satisfaction, sadness/depression and relaxation) from EEG demonstrated that increases in sympathetic nervous activity reflecting stress increase and decreases in relaxation level were induced by the videos of infiltration anesthesia and cavity excavation, but not intraoral examination. The corrugator muscle activity was increased by all three images regardless of video contents. The subjective discomfort during watching infiltration anesthesia and cavity excavation was higher than intraoral examination, showing that sympathetic activities and relaxation factor of emotion changed in a manner consistent with subjective emotional changes. These results suggest that measurement of autonomic nervous activities estimated from ECG and emotional factors analyzed from EEG is useful for objective evaluation of subjective emotion.

Evaluating the dosimetric effect of treatment-induced changes in virally mediated head and neck cancer patients

International Nuclear Information System (INIS)

Brown, Elizabeth; Owen, Rebecca; Mengersen, Kerrie; Harden, Fiona; Porceddu, Sandro

2013-01-01

Patients with virally mediated head and neck cancer (VMHNC) often present with advanced nodal disease that is highly radioresponsive as demonstrated by tumour and nodal regression during treatment. The resultant changes may impact on the planned dose distribution and so adversely affect the therapeutic ratio. The aim of this study was to evaluate the dosimetric effect of treatment-induced anatomical changes in VMHNC patients who had undergone a replan. Thirteen patients with virally mediated oropharyngeal or nasopharyngeal cancer who presented for definitive radiotherapy between 2005 and 2010 and who had a replan generated were investigated. The dosimetric effect of anatomical changes was quantified by comparing dose–volume histograms (DVH) of primary and nodal gross target volumes and organs at risk (OAR), including spinal cord and parotid glands, from the original plan and a comparison plan. Eleven three-dimensional conformal radiation therapy (3DCRT) and two intensity modulated radiation therapy (IMRT) plans were evaluated. Dose to the spinal cord and brainstem increased by 4.1% and 2.6%, respectively. Mean dose to the parotid glands also increased by 3.5%. In contrast, the dose received by 98% of the primary and nodal gross tumour volumes decreased by 0.15% and 0.3%, respectively, when comparing the initial treatment plan to the comparison plan. In this study, treatment-induced anatomical changes had the greatest impact on OAR dose with negligible effect on the dose to nodal gross tumour volumes. In the era of IMRT, accounting for treatment-induced anatomical changes is important as focus is placed on minimizing the acute and long-term side effects of treatment

Empirical antimicrobial therapy for late‐onset sepsis in a neonatal unit with high prevalence of coagulase‐negative Staphylococcus

Directory of Open Access Journals (Sweden)

Roberta Maia de Castro Romanelli

2016-09-01

Conclusions: Modification of the empiric treatment regimen for neonatal late‐onset sepsis with use of oxacillin showed a significant reduction in S. aureus infections, as well as a reduction in the frequency of infections with major organ system involvement and mortality due to infection with this microorganism. As a result, oxacillin can be considered as an effective treatment for late‐onset sepsis, making it possible to avoid broad‐spectrum antibiotics.

Methods for Calculating Empires in Quasicrystals

Directory of Open Access Journals (Sweden)

Fang Fang

2017-10-01

Full Text Available This paper reviews the empire problem for quasiperiodic tilings and the existing methods for generating the empires of the vertex configurations in quasicrystals, while introducing a new and more efficient method based on the cut-and-project technique. Using Penrose tiling as an example, this method finds the forced tiles with the restrictions in the high dimensional lattice (the mother lattice that can be cut-and-projected into the lower dimensional quasicrystal. We compare our method to the two existing methods, namely one method that uses the algorithm of the Fibonacci chain to force the Ammann bars in order to find the forced tiles of an empire and the method that follows the work of N.G. de Bruijn on constructing a Penrose tiling as the dual to a pentagrid. This new method is not only conceptually simple and clear, but it also allows us to calculate the empires of the vertex configurations in a defected quasicrystal by reversing the configuration of the quasicrystal to its higher dimensional lattice, where we then apply the restrictions. These advantages may provide a key guiding principle for phason dynamics and an important tool for self error-correction in quasicrystal growth.

Empirical analysis of change metrics for software fault prediction

NARCIS (Netherlands)

Choudhary, Garvit Rajesh; Kumar, Sandeep; Kumar, Kuldeep; Mishra, Alok; Catal, Cagatay

2018-01-01

A quality assurance activity, known as software fault prediction, can reduce development costs and improve software quality. The objective of this study is to investigate change metrics in conjunction with code metrics to improve the performance of fault prediction models. Experimental studies are

Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults.

Science.gov (United States)

Pfeifer, M; Verhovec, R; Zizek, B; Prezelj, J; Poredos, P; Clayton, R N

1999-02-01

Hypopituitary patients have increased mortality from vascular disease, and in these patients, early markers of atherosclerosis [increased carotid artery intima-media thickness (IMT) and reduced distensibility] are more prevalent. As GH replacement can reverse some risk factors of atherosclerosis, the present study examined the effect of GH treatment on morphological and functional changes in the carotid and brachial arteries of GH-deficient (GHD) adults. Eleven GHD hypopituitary men (24-49 yr old) were treated with recombinant human GH (0.018 U/kg BW x day) for 18 months. IMT of the common carotid artery (CCA) and the carotid bifurcation (CB), and flow-mediated endothelium-dependent dilation (EDD) of the brachial artery were measured by B mode ultrasound before and at 3, 6, 12, and 18 months of treatment, and values were compared with those in 12 age-matched control men. Serum concentrations of lipids, lipoprotein(a), insulin-like growth factor I (IGF-I), and IGF-binding protein-3 (IGFBP-3) were also measured. In GHD men before treatment the IMTs of the CCA [mean(SD), 0.67(0.05) mm] and CB [0.75(0.04) mm] were significantly greater (P < 0.001) than those in control men [0.52(0.07) and 0.65(0.07) mm, respectively]. GH treatment normalized the IMT of the CCA by 6 months [0.53(0.04) mm] and that of the CB by 3 months [0.68(0.05) mm]. The IMT of the carotid artery (CCA and CB) was negatively correlated with serum IGF-I (r = -0.53; P < 0.0001). There was a significant improvement in flow-mediated EDD of the brachial artery at 3 months, which was sustained at 6 and 18 months of GH treatment (P < 0.05). GH treatment increased high density lipoprotein cholesterol at 3 and 6 months, but did not reduce total or low density lipoprotein cholesterol and was without effect on lipoprotein(a). There was no correlation between plasma lipids and changes in IMT or EDD of the arteries examined. In conclusion, GH treatment of hypopituitary GHD men reverses early morphological and

Changes in spatiotemporal gait parameters following intravenous immunoglobulin treatment for chronic inflammatory demyelinating polyneuropathy.

Science.gov (United States)

Vo, Mary L; Chin, Russell L; Miranda, Caroline; Latov, Norman

2017-10-01

Gait impairment is a common presenting symptom in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). However, gait parameters have not previously been evaluated in detail as potential independent outcome measures. We prospectively measured changes in spatiotemporal gait parameters of 20 patients with CIDP at baseline and following treatment with intravenous immunoglobulin (IVIG), using GAITRite® a computerized walkway system with embedded sensors. Overall, study patients showed significant improvements in gait velocity, cadence, stride length, double support time, stance phase, and swing phase following IVIG treatment. Mean changes in velocity, stance phase, and swing phase, exhibited the greatest statistical significance among the subgroup that exhibited clinically meaningful improvement in Inflammatory Neuropathy Cause and Treatment disability score, Medical Research Council sum score, and grip strength. Assessment of gait parameters, in particular velocity, step phase and swing phase, is a potentially sensitive outcome measure for evaluating treatment response in CIDP. Muscle Nerve 56: 732-736, 2017. © 2017 Wiley Periodicals, Inc.

Kindness in Australia: an empirical critique of moral decline sociology.

Science.gov (United States)

Habibis, Daphne; Hookway, Nicholas; Vreugdenhil, Anthea

2016-09-01

A new sociological agenda is emerging that interrogates how morality can be established in the absence of the moral certainties of the past but there is a shortage of empirical work on this topic. This article establishes a theoretical framework for the empirical analysis of everyday morality drawing on the work of theorists including Ahmed, Bauman and Taylor. It uses the Australian Survey of Social Attitudes to assess the state and shape of contemporary moralities by asking how kind are Australians, how is its expression socially distributed, and what are the motivations for kindness. The findings demonstrate that Australians exhibit a strong attachment and commitment to kindness as a moral value that is primarily motivated by interiorized sources of moral authority. We argue these findings support the work of theorists such as Ahmed and Taylor who argue authenticity and embodied emotion are legitimate sources of morality in today's secular societies. The research also provides new evidence that generational changes are shaping understandings and practices of kindness in unexpected ways. © London School of Economics and Political Science 2016.

Motivators for resolving or seeking help for gambling problems: a review of the empirical literature.

Science.gov (United States)

Suurvali, Helen; Hodgins, David C; Cunningham, John A

2010-03-01

This literature review summarizes recent empirical research on the reasons disordered gamblers try, through treatment or otherwise, to resolve or reduce their gambling problems. Relevant databases and bibliographies were searched for English-language studies, published since 1998, that asked gamblers themselves about motivators for action. Found were ten studies addressing reasons for trying to resolve or reduce gambling problems, five addressing reasons for seeking help and four addressing reasons for requesting self-exclusion from casinos. Help-seeking occurred largely in response to gambling-related harms (especially financial problems, relationship issues and negative emotions) that had already happened or that were imminent. Resolution was often motivated by the same kinds of harms but evaluation/decision-making and changes in lifestyle or environment played a more prominent role. Self-exclusion was motivated by harms, evaluation/decision-making and a wish to regain control. Awareness and educational materials could incorporate messages that might encourage heavy gamblers to make changes before harms became too great. Intervention development could also benefit from more research on the motivators leading to successful (vs. failed) resolution, as well as on the ways in which disordered gamblers are able to overcome specific barriers to seeking help or reaching resolution.

Upscaling Empirically Based Conceptualisations to Model Tropical Dominant Hydrological Processes for Historical Land Use Change

Science.gov (United States)

Toohey, R.; Boll, J.; Brooks, E.; Jones, J.

2009-12-01

Surface runoff and percolation to ground water are two hydrological processes of concern to the Atlantic slope of Costa Rica because of their impacts on flooding and drinking water contamination. As per legislation, the Costa Rican Government funds land use management from the farm to the regional scale to improve or conserve hydrological ecosystem services. In this study, we examined how land use (e.g., forest, coffee, sugar cane, and pasture) affects hydrological response at the point, plot (1 m2), and the field scale (1-6ha) to empirically conceptualize the dominant hydrological processes in each land use. Using our field data, we upscaled these conceptual processes into a physically-based distributed hydrological model at the field, watershed (130 km2), and regional (1500 km2) scales. At the point and plot scales, the presence of macropores and large roots promoted greater vertical percolation and subsurface connectivity in the forest and coffee field sites. The lack of macropores and large roots, plus the addition of management artifacts (e.g., surface compaction and a plough layer), altered the dominant hydrological processes by increasing lateral flow and surface runoff in the pasture and sugar cane field sites. Macropores and topography were major influences on runoff generation at the field scale. Also at the field scale, antecedent moisture conditions suggest a threshold behavior as a temporal control on surface runoff generation. However, in this tropical climate with very intense rainstorms, annual surface runoff was less than 10% of annual precipitation at the field scale. Significant differences in soil and hydrological characteristics observed at the point and plot scales appear to have less significance when upscaled to the field scale. At the point and plot scales, percolation acted as the dominant hydrological process in this tropical environment. However, at the field scale for sugar cane and pasture sites, saturation-excess runoff increased as

New empirical relationship between grain size distribution and hydraulic conductivity for ephemeral streambed sediments

KAUST Repository

Rosas, Jorge

2014-07-19

Grain size distribution, porosity, and hydraulic conductivity were determined for 39 sediment samples collected from ephemeral streams (wadis) in western Saudi Arabia. The measured hydraulic conductivity values were then compared to values calculated using 20 different empirical equations commonly used to estimate hydraulic conductivity from grain size analyses. It was found that most of the hydraulic conductivity values estimated from the empirical equations correlated very poorly with the measured hydraulic conductivity values. Modifications of the empirical equations, including changes to special coefficients and statistical offsets, were made to produce modified equations that considerably improved the hydraulic conductivity estimates from grain size data for wadi sediments. The Chapuis, Hazen, Kozeny, Slichter, Terzaghi, and Barr equations produced the best correlations, but still had relatively high predictive errors. The Chapius equation was modified for wadi sediments by incorporating mud percentage and the standard deviation (in phi units) into a new equation that reduced the predicted hydraulic conductivity error to ±14.1 m/day. The equation is best applied to ephemeral stream samples that have hydraulic conductive values greater than 2 m/day.

New empirical relationship between grain size distribution and hydraulic conductivity for ephemeral streambed sediments

KAUST Repository

Rosas, Jorge; Jadoon, Khan; Missimer, Thomas M.

2014-01-01

Grain size distribution, porosity, and hydraulic conductivity were determined for 39 sediment samples collected from ephemeral streams (wadis) in western Saudi Arabia. The measured hydraulic conductivity values were then compared to values calculated using 20 different empirical equations commonly used to estimate hydraulic conductivity from grain size analyses. It was found that most of the hydraulic conductivity values estimated from the empirical equations correlated very poorly with the measured hydraulic conductivity values. Modifications of the empirical equations, including changes to special coefficients and statistical offsets, were made to produce modified equations that considerably improved the hydraulic conductivity estimates from grain size data for wadi sediments. The Chapuis, Hazen, Kozeny, Slichter, Terzaghi, and Barr equations produced the best correlations, but still had relatively high predictive errors. The Chapius equation was modified for wadi sediments by incorporating mud percentage and the standard deviation (in phi units) into a new equation that reduced the predicted hydraulic conductivity error to ±14.1 m/day. The equation is best applied to ephemeral stream samples that have hydraulic conductive values greater than 2 m/day.

An empirical analysis of Diaspora bonds

OpenAIRE

AKKOYUNLU, Şule; STERN, Max

2018-01-01

Abstract. This study is the first to investigate theoretically and empirically the determinants of Diaspora Bonds for eight developing countries (Bangladesh, Ethiopia, Ghana, India, Lebanon, Pakistan, the Philippines, and Sri-Lanka) and one developed country - Israel for the period 1951 and 2008. Empirical results are consistent with the predictions of the theoretical model. The most robust variables are the closeness indicator and the sovereign rating, both on the demand-side. The spread is ...

Translating organizational change

DEFF Research Database (Denmark)

Scheuer, John Damm

2016-01-01

in organizational studies for making descriptions of studied empirical phenomena rather than developing theories and giving normative advice about how organizations or organizational change processes may be theorized, analyzed, managed and/or organized better. A new ANT-inspired theory about the characteristics...

THORACOLUMBAR BURST FRACTURE: STRUCTURAL CHANGES AND CLINICAL OUTCOME OF TREATMENT

Directory of Open Access Journals (Sweden)

Rodrigo Arnold Tisot

2016-03-01

Full Text Available ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05 between initial collapse and SF-36 domains in both groups (operated and non-operated. Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.

How rational should bioethics be? The value of empirical approaches.

Science.gov (United States)

Alvarez, A A

2001-10-01

Rational justification of claims with empirical content calls for empirical and not only normative philosophical investigation. Empirical approaches to bioethics are epistemically valuable, i.e., such methods may be necessary in providing and verifying basic knowledge about cultural values and norms. Our assumptions in moral reasoning can be verified or corrected using these methods. Moral arguments can be initiated or adjudicated by data drawn from empirical investigation. One may argue that individualistic informed consent, for example, is not compatible with the Asian communitarian orientation. But this normative claim uses an empirical assumption that may be contrary to the fact that some Asians do value and argue for informed consent. Is it necessary and factual to neatly characterize some cultures as individualistic and some as communitarian? Empirical investigation can provide a reasonable way to inform such generalizations. In a multi-cultural context, such as in the Philippines, there is a need to investigate the nature of the local ethos before making any appeal to authenticity. Otherwise we may succumb to the same ethical imperialism we are trying hard to resist. Normative claims that involve empirical premises cannot be reasonable verified or evaluated without utilizing empirical methods along with philosophical reflection. The integration of empirical methods to the standard normative approach to moral reasoning should be reasonably guided by the epistemic demands of claims arising from cross-cultural discourse in bioethics.

Merging expert and empirical data for rare event frequency estimation: Pool homogenisation for empirical Bayes models

International Nuclear Information System (INIS)

Quigley, John; Hardman, Gavin; Bedford, Tim; Walls, Lesley

2011-01-01

Empirical Bayes provides one approach to estimating the frequency of rare events as a weighted average of the frequencies of an event and a pool of events. The pool will draw upon, for example, events with similar precursors. The higher the degree of homogeneity of the pool, then the Empirical Bayes estimator will be more accurate. We propose and evaluate a new method using homogenisation factors under the assumption that events are generated from a Homogeneous Poisson Process. The homogenisation factors are scaling constants, which can be elicited through structured expert judgement and used to align the frequencies of different events, hence homogenising the pool. The estimation error relative to the homogeneity of the pool is examined theoretically indicating that reduced error is associated with larger pool homogeneity. The effects of misspecified expert assessments of the homogenisation factors are examined theoretically and through simulation experiments. Our results show that the proposed Empirical Bayes method using homogenisation factors is robust under different degrees of misspecification.

Are Changes in Consumption of “Healthy” Foods Related to Changes in Consumption of “Unhealthy” Foods During Pediatric Obesity Treatment?

Directory of Open Access Journals (Sweden)

Hollie A. Raynor

2012-04-01

Full Text Available Increasing fruits and vegetables (FVs, a dietary recommendation for pediatric weight management, is theorized to reduce energy intake by reducing intake of more energy-dense foods, such as snack foods (SFs. This study examined the relationship between changes in FV, SF, and energy intake in children enrolled in a 6-month, family-based behavioral pediatric weight management trial. Secondary data analyses examined dietary intake in 80 overweight ( ≥ 85th to < 95th percentile for body mass index [BMI] and obese ( ≥ 95th percentile for BMI children (7.2 ± 1.7 years with complete dietary records at 0 and 6 months. Participants were randomized to one of three treatment conditions: (1 increased growth monitoring with feedback; (2 decrease SFs and sugar sweetened beverages; or (3 increase FVs and low-fat dairy. With treatment condition controlled in all analyses, FV intake significantly increased, while SF and energy intake decreased, but not significantly, from 0 to 6 months. Change in FV intake was not significantly associated with change in SF consumption. Additionally, change in FV intake was not significantly related to change in energy intake. However, reduction in SF intake was significantly related to reduction in energy intake. Changing only FVs, as compared to changing other dietary behaviors, during a pediatric obesity intervention may not assist with reducing energy intake.

Hospital Capacity, Waiting Times and Sick Leave Duration - an Empirical Analysis of a Norwegian Health Policy Reform

OpenAIRE

Aakvik, Arild; Holmås, Tor Helge; Kjerstad, Egil

2012-01-01

A health policy reform aiming to reduce hospital waiting times and sickness absences, the Faster Return to Work (FRW) scheme, is evaluated by creating treatment and control groups to facilitate causal interpretations of the empirical results. We use a unique dataset on individuals where we match hospital data with social security data and socio-economic characteristics. The main idea behind the reform is that long waiting times for hospital treatment lead to unnecessarily long periods of sick...

Institutionalization of Planned Organizational Change,

Science.gov (United States)

1978-09-01

organizational change in the context of labor- management relations. One of their basic arguments is that the company and management have conflicting...planned organizational interventions. From the modest number of empirical studies on planned organizational change in a union- management context...new forms of work organization have emphasized the need to increase our understanding of oraganizational change processes. This paper has elaborated

Malaria treatment policy change and implementation: the case of Uganda.

Science.gov (United States)

Nanyunja, Miriam; Nabyonga Orem, Juliet; Kato, Frederick; Kaggwa, Mugagga; Katureebe, Charles; Saweka, Joaquim

2011-01-01

Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

Malaria Treatment Policy Change and Implementation: The Case of Uganda

Directory of Open Access Journals (Sweden)

Miriam Nanyunja

2011-01-01

Full Text Available Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

On radiation damage to normal tissues and its treatment. Pt. 2

International Nuclear Information System (INIS)

Michalowski, A.S.

1994-01-01

In addition to transiently inhibiting cell cycle progression and sterilizing those cells capable of proliferation, irradiation disturbs the homeostasis effected by endogenous mediators of intercellular communication (humoral component of tissue response to radiation). Changes in the mediator levels may modulate radiation effects either by a assisting a return to normality (e.g., through a rise in H-type cell lineage-specific growth factors) or by aggravating the damage. The latter mode is illustrated with reports on changes in eicosanoid levels after irradiation and on results of empirical treatment of radiation injuries with anti-inflammatory drugs. Prodromal, acute and chronic effects of radiation are accompanied by excessive production of eicosanoids (prostaglandins, prostacyclin, thromboxanes and leukotrienes). These endogenous mediators of inflammatory reactions may be responsible for the vasodilatation, vasoconstriction, increased microvascular permeability, thrombosis and chemotaxis observed after radiation exposure. Glucocorticoids inhibit eicosanoid synthesis primarily by interfering with phospholipase A 2 whilst non-steroidal anti-inflammatory drugs prevent prostaglandin/thromboxane synthesis by inhibiting cycloxygenase. When administered after irradiation on empirical grounds, drugs belonging to both groups tend to attenuate a range of prodomal, acute and chronic effects of radiation in man and animals. Taken together, these two sets of observations are highly suggestive of a contribution of humoral factors to the adverse responses of normal tissues and organs to radiation. A full account of radiation damage should therefore consist of complementary descriptions of cellular and humoral events. Further studies on anti-inflammatory drug treatment of radiation damage to normal organs are justified and desirable. (orig.)

Mechanisms of change in psychotherapy for depression : An empirical update and evaluation of research aimed at identifying psychological mediators

NARCIS (Netherlands)

Lemmens, L.H.J.M.; Müller, V.N.L.S.; Arntz, A.; Huibers, M.J.H.

2016-01-01

We present a systematic empirical update and critical evaluation of the current status of research aimed at identifying a variety of psychological mediators in various forms of psychotherapy for depression. We summarize study characteristics and results of 35 relevant studies, and discuss the extent

Empirical mode decomposition and k-nearest embedding vectors for timely analyses of antibiotic resistance trends.

Science.gov (United States)

Teodoro, Douglas; Lovis, Christian

2013-01-01

Antibiotic resistance is a major worldwide public health concern. In clinical settings, timely antibiotic resistance information is key for care providers as it allows appropriate targeted treatment or improved empirical treatment when the specific results of the patient are not yet available. To improve antibiotic resistance trend analysis algorithms by building a novel, fully data-driven forecasting method from the combination of trend extraction and machine learning models for enhanced biosurveillance systems. We investigate a robust model for extraction and forecasting of antibiotic resistance trends using a decade of microbiology data. Our method consists of breaking down the resistance time series into independent oscillatory components via the empirical mode decomposition technique. The resulting waveforms describing intrinsic resistance trends serve as the input for the forecasting algorithm. The algorithm applies the delay coordinate embedding theorem together with the k-nearest neighbor framework to project mappings from past events into the future dimension and estimate the resistance levels. The algorithms that decompose the resistance time series and filter out high frequency components showed statistically significant performance improvements in comparison with a benchmark random walk model. We present further qualitative use-cases of antibiotic resistance trend extraction, where empirical mode decomposition was applied to highlight the specificities of the resistance trends. The decomposition of the raw signal was found not only to yield valuable insight into the resistance evolution, but also to produce novel models of resistance forecasters with boosted prediction performance, which could be utilized as a complementary method in the analysis of antibiotic resistance trends.

The implications of starvation induced psychological changes for the ethical treatment of hunger strikers.

Science.gov (United States)

Fessler, D M T

2003-08-01

To evaluate existing ethical guidelines for the treatment of hunger strikers in light of findings on psychological changes that accompany the cessation of food intake. Electronic databases were searched for (a) editorials and ethical proclamations on hunger strikers and their treatment; (b) studies of voluntary and involuntary starvation, and (c) legal cases pertaining to hunger striking. Additional studies were gathered in a snowball fashion from the published material cited in these databases. Material was included if it (a) provided ethical or legal guidelines; (b) shed light on psychological changes accompanying starvation, or (c) illustrated the practice of hunger striking. Authors' observations, opinions, and conclusions were noted. Although the heterogeneous nature of the sources precluded statistical analysis, starvation appears to be accompanied by marked psychological changes. Some changes clearly impair competence, in which case physicians are advised to follow advance directives obtained early in the hunger strike. More problematic are increases in impulsivity and aggressivity, changes which, while not impairing competence, enhance the likelihood that patients will starve themselves to death.

Management of genetic epilepsies: From empirical treatment to precision medicine.

Science.gov (United States)

Striano, Pasquale; Vari, Maria Stella; Mazzocchetti, Chiara; Verrotti, Alberto; Zara, Federico

2016-05-01

Despite the over 20 antiepileptic drugs (AEDs) now licensed for epilepsy treatment, seizures can be effectively controlled in about ∼70% of patients. Thus, epilepsy treatment is still challenging in about one third of patients and this may lead to a severe medically, physically, and socially disabling condition. However, there is clear evidence of heterogeneity of response to existing AEDs and a significant unmet need for effective intervention. A number of studies have shown that polymorphisms may influence the poor or inadequate therapeutic response as well as the occurrence of adverse effects. In addition, the new frontier of genomic technologies, including chromosome microarrays and next-generation sequencing, improved our understanding of the genetic architecture of epilepsies. Recent findings in some genetic epilepsy syndromes provide insights into mechanisms of epileptogenesis, unrevealing the role of a number of genes with different functions, such as ion channels, proteins associated to the vesical synaptic cycle or involved in energy metabolism. The rapid progress of high-throughput genomic sequencing and corresponding analysis tools in molecular diagnosis are revolutionizing the practice and it is a fact that for some monogenic epilepsies the molecular confirmation may influence the choice of the treatment. Moreover, the novel genetic methods, that are able to analyze all known genes at a reasonable price, are of paramount importance to discover novel therapeutic avenues and individualized (or precision) medicine. Copyright © 2016 Elsevier Ltd. All rights reserved.

Antibiotics in the treatment of patients with lower back pain associated with Modic changes: a case series.

Science.gov (United States)

Gupta, Gaurav; Jarzem, Peter; Meredith, Sean; Radhakrishna, Mohan; Besemann, Markus; Elgueta, Maria Francisca; Charghi, Roshanak; Chankowsky, Jeffrey

2017-01-01

To determine the clinical effect of antibiotic treatment for patients with low back pain and Modic 1 changes. This is a retrospective case series of patients treated at the Canadian Forces Health Services Centre in Ottawa and the McGill University Health Centre. Where available, pain, functional, and imaging outcomes in 11 patients treated between 2013 and 2015 were analyzed to determine effect of antibiotic treatment for patients with low back pain and associated Modic 1 changes on magnetic resonance imaging. Conservatively, only 3 of 11 patients met the criteria for improvement for pain and/or function. While a larger proportion improved in the long term, outcomes were not thought to be temporally attributable to antibiotic treatment, as in most cases, ongoing therapy, medications, and/or injections were required. There did not appear to be a correlation between clinical improvement and associated end plate volume involvement for Modic changes. Antibiotics for the treatment of low back pain in the context of Modic changes on MRI did not generally provide significant improvement in pain and function for patients in this small cohort. Despite early excitement regarding this treatment, further research is required.

Technological advances in the treatment of trauma: a review of promising practices.

Science.gov (United States)

Paul, Lisa A; Hassija, Christina M; Clapp, Joshua D

2012-11-01

Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting. Technological innovations in this literature aim to expand availability of empirically based intervention, increase treatment adherence and acceptability, and overcome barriers commonly encountered with conventional trauma-focused treatment. Much of the current research on these technological developments consists of brief reviews and case studies of the separate therapy modalities. Although this work serves to document the appeal and utility of these innovations, it does not provide comprehensive information about the host of options available. To that end, the three general categories of technological advances in trauma therapy (i.e., videoconferencing, e-Health, virtual reality) are reviewed here, including information regarding their empirical support and suggestions for future research and clinical practice.

Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis

Directory of Open Access Journals (Sweden)

Barata José T

2009-02-01

Full Text Available Abstract Background Changes in body image and subjective well-being variables (e.g. self-esteem are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. Methods Participants (BMI = 31.1 ± 4.1 kg/m2; age = 38.4 ± 6.7 y were 144 women who attended a 12-month obesity treatment program and a comparison group (n = 49, who received a general health education program. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. Results At 12 months, the intervention group had greater weight loss (-5.6 ± 6.8% vs. -1.2 ± 4.6%, p Conclusion Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs.

Changes in Perception of Selected Concepts That Accompany Differing Leadership Treatments.

Science.gov (United States)

Callan, Laurence Brian

A study was made of effects of two different leadership treatments on perception of nonverbal stimuli relating to concepts of leaders, authority, and cohesion as measured by changes in the Semantic Differential Scale. Subjects (28 Yaqui Indian and Mexican-American members of the Neighborhood Youth Corps) were randomly assigned to an autocratic…

Change of International Restless Legs Syndrome Study Group Rating Scale subscales with treatment and placebo: a pilot study

Directory of Open Access Journals (Sweden)

Mitchell UH

2014-02-01

Full Text Available Ulrike H Mitchell,1 Sterling C Hilton2 1Brigham Young University, Department of Exercise Sciences, 2Department of Educational Leadership and Foundations, Provo, UT, USA Background: In 2003, the 10-question International Restless Legs Syndrome Study Group Rating Scale (IRLS was developed as a means of assessing the severity of restless legs syndrome. Two subscales were identified: symptom severity (SS 1 and symptom impact (SS 2. Only one study has investigated the subscales' responsiveness to a 12-week treatment with ropinirole. This current study was undertaken to assess the impact of a 4-week, non-pharmaceutical treatment on the two subscales and to explore whether or not both subscales were impacted by the observed placebo effect. Methods: The pooled data from questionnaires of 58 patients (41 from both treatment groups and 17 from the sham treatment control group, who participated in two clinical studies, were reviewed. Their change in score over a 4-week trial was computed. The average change in both subscales in both groups was computed and t-tests were performed. Results: In the treatment group, the average scores of both subscales changed significantly from baseline to week 4 (P<0.005 for both. Compared to the control, SS 1 changed (P<0.001, but not SS 2 (P=0.18. In the sham treatment group, the scores for SS 1 changed significantly (P=0.002, but not for SS 2 (P=0.2. Conclusion: This study corroborated findings from an earlier study in which both subscales changed with a 12-week drug treatment. It also showed that the observed placebo effect is attributed to a small but significant change in symptom severity, but not symptom impact. Keywords: restless legs syndrome, RLS severity scale, IRLS subscales, symptom impact, symptom severity

How do we know about resilience? An analysis of empirical research on resilience, and implications for interdisciplinary praxis

International Nuclear Information System (INIS)

Downes, Barbara J; Miller, Fiona; Barnett, Jon; Glaister, Alena; Ellemor, Heidi

2013-01-01

We sought to understand how knowledge about resilience is produced. We examined empirical research into resilience from the social and natural sciences, randomly selected a sample of these studies and analysed their methods using common criteria to enable comparison. We found that studies of resilience from social scientists largely focus on the response of individuals to human-induced change events, while those from natural scientists largely focus on the response of ecological communities and populations to both environmental and human-induced change events. Most studies were of change over short time periods and focused on small spatial scales. Social science studies were dominated by one-off surveys, whereas natural science studies used a diversity of study designs to draw inferences about cause-and-effect. Whilst these differences typically reflect epistemological and methodological traditions, they also imply quite different understandings of resilience. We suggest that there are significant methodological barriers to producing empirical evidence about interactions between complex social and ecological systems. (letter)

Alliance-focused therapy for anorexia nervosa: integrative relational and behavioral change treatments in a single-case experimental design.

Science.gov (United States)

Satir, Dana A; Goodman, David M; Shingleton, Rebecca M; Porcerelli, John H; Gorman, Bernard S; Pratt, Elizabeth M; Barlow, David H; Thompson-Brenner, Heather

2011-12-01

Evidence supporting outpatient treatments for anorexia nervosa (AN) is severely lacking, due to low retention and poor outcome. One explanation for drop-out is weak treatment alliances. A single-case experimental analysis accompanied by in-depth qualitative description is presented for Ms. O, who received a novel treatment for AN called Alliance Focused Treatment (AFT) that attends to ruptures in the alliance, interpersonal difficulties and emotional avoidance. At intake Ms. O met diagnostic criteria for AN, Major Depressive Disorder, and Social Phobia. She was characterized as having symptoms of Obsessive Compulsive, Avoidant, and Depressive personality disorders. Treatment began with a Baseline followed by the experimental (AFT) and comparison treatments (Behavioral Change Treatment [BCT]) using a replicated experimental single-case phase change design. Graphs of slopes of kilocalorie and alliance change facilitated observation of treatment effects. Ms. O participated in 16 sessions of AFT and 8 sessions of BCT with specific benefits. Ratings of the treatment alliance were consistently high and she evidenced significant changes in weight, quality of life, and personality pathology. Associations between rupture/repair episodes and kilocalorie increases were observed. The utility of the treatment relationship in facilitating emotional expression was evident. At posttreatment, Ms. O endorsed cognitive AN symptoms, although these were not explicitly treated. This study provides preliminary support for the feasibility and effect of AFT and BCT, and highlights the importance of the alliance in treating adults with AN. Further research on emotion regulation in AN and its effect on the treatment relationship are needed.

Influence of Microstructure and Composition Changes on Mechanical Characteristics of Aluminium Alloy After Heating and Cooling Treatment

International Nuclear Information System (INIS)

Sigit; Nuraini, E; Martoyo

1998-01-01

Influences of microstructure and chemical composition changes on mechanical characteristics of AIMg2 which were heated at 85-500 0 C and cooled with sands, water or air have been studied. Microstructure observation was carried out using optical microscope, while chemical composition determination by atomic absorption spectrophotometry (AAS). AIMg2 which has been heated at the relatively low temperature i. e, 200 0 C during 6 hours and cooled using sands showed a small change microstructure, but those will be clearly observed on the treatment at 300 0 C. The microstructure change is in agreement with the change of mechanical characteristic, I. e., the decreasing of tensile strength and hardness and increasing of elongation. After the temperature of treatment is higher than 300 0 C, the decreasing of the tensile strength was relatively constant, while the hardness increased. The microstructure of AIMg2 resulted from the heat treatment at temperature of 500 0 C was different with that of 300 0 C. Heat treatment at 500 0 C following by cooling in the sands, water or air respectively gave similar microstructure. Those also caused the change of alloying element content which was in agreement with decreasing of mechanical characteristics

Regulation management in the power industry. Results of an empirical analysis with particular consideration of institutional change; Regulierungsmanagement in der Energiewirtschaft. Ergebnisse einer empirischen Analyse unter besonderer Beruecksichtigung des institutionellen Wandels

Energy Technology Data Exchange (ETDEWEB)

Schuchardt, Lukas D.

2012-11-01

With the introduction of regulation by incentives in 2009, German grid operators were faced with a new challenge, i.e. economic efficiency instead of technical excellence became the determining factor on which decisions for actions were based. To these new requirements, grid operators reacted by introducing a central regulation management department. The book presents an empirical investigation of the tasks, organisational structure and goals of the new department and analyses the institutional changes in the structure of grid operating utilities.

Empirical and simulated critical loads for nitrogen deposition in California mixed conifer forests

International Nuclear Information System (INIS)

Fenn, M.E.; Jovan, S.; Yuan, F.; Geiser, L.; Meixner, T.; Gimeno, B.S.

2008-01-01

Empirical critical loads (CL) for N deposition were determined from changes in epiphytic lichen communities, elevated NO 3 - leaching in streamwater, and reduced fine root biomass in ponderosa pine (Pinus ponderosa Dougl. ex Laws.) at sites with varying N deposition. The CL for lichen community impacts of 3.1 kg ha -1 year -1 is expected to protect all components of the forest ecosystem from the adverse effects of N deposition. Much of the western Sierra Nevada is above the lichen-based CL, showing significant changes in lichen indicator groups. The empirical N deposition threshold and that simulated by the DayCent model for enhanced NO 3 - leaching were 17 kg N ha -1 year -1 . DayCent estimated that elevated NO 3 - leaching in the San Bernardino Mountains began in the late 1950s. Critical values for litter C:N (34.1), ponderosa pine foliar N (1.1%), and N concentrations (1.0%) in the lichen Letharia vulpina ((L.) Hue) are indicative of CL exceedance. - Critical loads for N deposition effects on lichens, trees and nitrate leaching provide benchmarks for protecting California forests

Empirical and simulated critical loads for nitrogen deposition in California mixed conifer forests

Energy Technology Data Exchange (ETDEWEB)

Fenn, M.E. [USDA Forest Service, Pacific Southwest Research Station, 4955 Canyon Crest Drive, Riverside, CA 92507 (United States)], E-mail: mfenn@fs.fed.us; Jovan, S. [USDA Forest Service, Pacific Northwest Research Station, 620 SW Main, Suite 400, Portland, OR 97205 (United States); Yuan, F. [Department of Hydrology and Water Resources, University of Arizona, Tucson, AZ 85721 (United States); Geiser, L. [USDA Forest Service, Pacific Northwest Air Resource Management Program, PO Box 1148, Corvallis, OR 97339 (United States); Meixner, T. [Department of Hydrology and Water Resources, University of Arizona, Tucson, AZ 85721 (United States); Gimeno, B.S. [Ecotoxicology of Air Pollution, CIEMAT (ed. 70), Avda. Complutense 22, 28040 Madrid (Spain)

2008-10-15

Empirical critical loads (CL) for N deposition were determined from changes in epiphytic lichen communities, elevated NO{sub 3}{sup -} leaching in streamwater, and reduced fine root biomass in ponderosa pine (Pinus ponderosa Dougl. ex Laws.) at sites with varying N deposition. The CL for lichen community impacts of 3.1 kg ha{sup -1} year{sup -1} is expected to protect all components of the forest ecosystem from the adverse effects of N deposition. Much of the western Sierra Nevada is above the lichen-based CL, showing significant changes in lichen indicator groups. The empirical N deposition threshold and that simulated by the DayCent model for enhanced NO{sub 3}{sup -}leaching were 17 kg N ha{sup -1} year{sup -1}. DayCent estimated that elevated NO{sub 3}{sup -} leaching in the San Bernardino Mountains began in the late 1950s. Critical values for litter C:N (34.1), ponderosa pine foliar N (1.1%), and N concentrations (1.0%) in the lichen Letharia vulpina ((L.) Hue) are indicative of CL exceedance. - Critical loads for N deposition effects on lichens, trees and nitrate leaching provide benchmarks for protecting California forests.

Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder.

Science.gov (United States)

Brand, Bethany L; Sar, Vedat; Stavropoulos, Pam; Krüger, Christa; Korzekwa, Marilyn; Martínez-Taboas, Alfonso; Middleton, Warwick

2016-01-01

Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status. Clinicians who accept these myths as facts are unlikely to carefully assess for dissociation. Accurate diagnoses are critical for appropriate treatment planning. If DID is not targeted in treatment, it does not appear to resolve. The myths we have highlighted may also impede research about DID. The cost of ignorance about DID is high not only for individual patients but for the whole support system in which they reside. Empirically derived knowledge about DID has replaced outdated myths. Vigorous dissemination of the knowledge base about this complex disorder is warranted.

An empirical test of new developments in coalition theory for the design of international environmental agreements

NARCIS (Netherlands)

Finus, M.; Sáiz Pérez, M.E.; Hendrix, E.M.T.

2009-01-01

We consider new developments in coalition theory for the design of international environmental agreements (IEAs). Applying an empirical model on climate change that comprises benefit and cost estimates from abatement for 12 world regions, we analyze how the design of an agreement affects the success

Estimation of wildfire size and risk changes due to fuels treatments

Science.gov (United States)

Cochrane, M.A.; Moran, C.J.; Wimberly, M.C.; Baer, A.D.; Finney, M.A.; Beckendorf, K.L.; Eidenshink, J.; Zhu, Z.

2012-01-01

Human land use practices, altered climates, and shifting forest and fire management policies have increased the frequency of large wildfires several-fold. Mitigation of potential fire behaviour and fire severity have increasingly been attempted through pre-fire alteration of wildland fuels using mechanical treatments and prescribed fires. Despite annual treatment of more than a million hectares of land, quantitative assessments of the effectiveness of existing fuel treatments at reducing the size of actual wildfires or how they might alter the risk of burning across landscapes are currently lacking. Here, we present a method for estimating spatial probabilities of burning as a function of extant fuels treatments for any wildland fire-affected landscape. We examined the landscape effects of more than 72 000 ha of wildland fuel treatments involved in 14 large wildfires that burned 314 000 ha of forests in nine US states between 2002 and 2010. Fuels treatments altered the probability of fire occurrence both positively and negatively across landscapes, effectively redistributing fire risk by changing surface fire spread rates and reducing the likelihood of crowning behaviour. Trade offs are created between formation of large areas with low probabilities of increased burning and smaller, well-defined regions with reduced fire risk.

The future context of work in the business environment in South Africa: Some empirical evidence

OpenAIRE

PS Nel; AJ Du Plessis; AE Marx

2014-01-01

The future is uncertain, but management needs to determine and also be informed about possible change trends. This research, however, reports on empirical results of the views of South African HRM practitioners to identify and prioritise business change trends for 2002 and 2010 in terms of the “hard” or “soft” HRM debate in the literature. All organisations employing HRM practitioners were include and a total of 1640 questionnaires were distributed resulting in 207 useable responses.   ...

British Teachers' Transnational Work within and beyond the British Empire after the Second World War

Science.gov (United States)

Whitehead, Kay

2017-01-01

Focusing on British graduates from Gipsy Hill Training College (GHTC) in London, this article illustrates transnational history's concerns with the reciprocal flows of people and ideas within and beyond the British Empire. GHTC's progressive curriculum and culture positioned women teachers as agents of change, and the article highlights the lives…

Countertransference when working with narcissistic personality disorder: An empirical investigation.

Science.gov (United States)

Tanzilli, Annalisa; Muzi, Laura; Ronningstam, Elsa; Lingiardi, Vittorio

2017-06-01

Narcissistic personality disorder (NPD) is one of the most challenging clinical syndromes to treat in psychotherapy, especially due to the difficulties of establishing a good enough therapist-patient relationship. Countertransference responses to NPD can be particularly intense, frustrating, and difficult to manage, as is often reported in the clinical literature though not clearly supported empirically. The aims of this study were to (a) investigate the relationship between patients' NPD and therapists' responses; (b) examine the associations between patient, clinician, therapy variables and clinicians' reactions during treatment of NPD patients; and (c) provide an empirically derived portrait of countertransference with NPD. A sample of psychiatrists and clinical psychologists (N = 67) completed the Therapist Response Questionnaire to identify patterns of countertransference, the Shedler-Westen Assessment Procedure-200, and the Global Assessment of Functioning Scale to assess the personality pathology and psychosocial functioning of a patient in their care. The results showed that NPD was positively associated with hostile/angry, criticized/devalued, helpless/inadequate, and disengaged countertransference and negatively associated with therapists' positive response, regardless of patients' personality and psychosocial functioning. NPD patients with stronger traits of cluster B personality pathology tended to elicit more negative and heterogeneous countertransference reactions than NPD patients without these features. The countertransference patterns with NPD patients were not strongly influenced by the variables of clinicians and therapy, with the exception of clinical experience. Overall, the portrait of therapists' reactions to NPD provided a clinically nuanced and empirically founded description strongly resembling theoretical-clinical accounts. The therapeutic implications of these findings were discussed. (PsycINFO Database Record (c) 2017 APA, all rights

Changing trends in the aetiology, treatment and outcomes of bloodstream infection occurring in the first year after solid organ transplantation: a single-centre prospective cohort study.

Science.gov (United States)

Oriol, Isabel; Sabé, Núria; Simonetti, Antonella F; Lladó, Laura; Manonelles, Anna; González, Jose; Tubau, Fe; Carratalà, Jordi

2017-09-01

To analyse trends in the aetiology, treatment and outcomes of bloodstream infection (BSI) within the first year post-transplant over the last 10-year period, we prospectively recorded all episodes of BSI occurring in solid organ transplant (SOT) recipients during the first year post-transplant from 2007 to 2016. Trends of factors were analysed by 2-year periods. Of 475 consecutive episodes of BSI, 218 occurred within a year of SOT in 178 SOT recipients. Gram-positive BSI decreased over time (40.5-2.2%). In contrast, there was a steady increase in Gram-negative bacilli (GNB) BSI (54.1-93.3%; P < 0.001), mainly due to Pseudomonas aeruginosa (2.4-20.4%) and Klebsiella pneumoniae (7.1-26.5%). Multidrug-resistant (MDR) GNB (4.8-38.8%; P < 0.001) rose dramatically, especially due to extended-spectrum β-lactamase (ESBL) production (7.1-34.7%). There was a sharp rise in the use of carbapenems, both as empirical (11.9-55.3%; P < 0.001) and as targeted antibiotic treatment (11.9-46.9%; P < 0.001). In conclusion, today, GNB are the leading causative agents of BSI in SOT recipients within the first year after SOT. In addition, MDR GNB have emerged mainly due to ESBL-producing strains. In spite of these changes, length of hospital stay, days of treatment and mortality have remained stable over time. © 2017 Steunstichting ESOT.

Empirical Evidence from Kenya

African Journals Online (AJOL)

FIRST LADY

2011-01-18

Jan 18, 2011 ... Empirical results reveal that consumption of sugar in. Kenya varies ... experiences in trade in different regions of the world. Some studies ... To assess the relationship between domestic sugar retail prices and sugar sales in ...

Derivatives in South Africa – an empirical investigation