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Sample records for depression breakthrough collaborative

  1. Quality improvement in depression care in the Netherlands: the Depression Breakthrough Collaborative. A quality improvement report.

    NARCIS (Netherlands)

    Franx, G.C.; Meeuwissen, J.A.; Sinnema, H.; Spijker, J.; Huyser, J.; Wensing, M.J.P.; Lange, J.

    2009-01-01

    BACKGROUND: Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1) the content of care is often not completely consistent with recommendations in guidelines and (2) the organization of

  2. Hand Hygiene Improvement and Sustainability: Assessing a Breakthrough Collaborative in Western Switzerland.

    Science.gov (United States)

    Staines, Anthony; Amherdt, Isabelle; Lécureux, Estelle; Petignat, Christiane; Eggimann, Philippe; Schwab, Marcos; Pittet, Didier

    2017-12-01

    OBJECTIVE To assess hand hygiene improvement and sustainability associated with a Breakthrough Collaborative. DESIGN Multicenter analysis of hand hygiene compliance through direct observation by trained observers. SETTING A total of 5 publicly funded hospitals in 14 locations, with a total of 1,152 beds, in the County of Vaud, Switzerland. PARTICIPANTS Clinical staff. INTERVENTIONS In total, 59,272 opportunities for hand hygiene were monitored for the duration of the study, for an average of 5,921 per audit (range, 5,449-6,852). An 18-month Hand Hygiene Breakthrough Collaborative was conducted to implement the WHO multimodal promotional strategy including improved access to alcohol-based hand rub, education, performance measurement and feedback, reminders and communication, leadership engagement, and safety culture. RESULTS Overall hand hygiene compliance improved from 61.9% to 88.3% (Pstrategy for content and measurement was associated with significant and substantial improvement in compliance across all professions, all hand hygiene indications, and all participating hospitals. Infect Control Hosp Epidemiol 2017;38:1420-1427.

  3. Collaborative care for depression in general practice

    DEFF Research Database (Denmark)

    Brinck-Claussen, Ursula Ødum; Curth, Nadja Kehler; Davidsen, Annette Sofie

    2017-01-01

    Background: Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish...... context. We therefore developed a model for CC (the Collabri model) to treat people with depression in general practice in Denmark. Since systematic identification of patients is an “active ingredient” in CC and some literature suggests case finding as the best alternative to standard detection, the two...... detection methods are examined as part of the study. The aim is to investigate if treatment according to the Collabri model has an effect on depression symptoms when provided to people with depression in general practice in Denmark, and to examine if case finding is a better method to detect depression...

  4. Integrated care for patients with a stroke in the Netherlands: results and experiences from a national Breakthrough Collaborative Improvement project

    Directory of Open Access Journals (Sweden)

    M.M.N. Minkman

    2005-03-01

    Full Text Available Purpose: This article considers the question if measurable improvements are achieved in the quality of care in stroke services by using a Breakthrough collaborative quality improvement model. Context of case: Despite the availability of explicit criteria, evidence based guidelines, national protocols and examples of best practices; stroke care in the Netherlands did not improve substantially yet. For that reason a national collaborative started in 2002 to improve integrated stroke care in 23 self selected stroke services. Data sources: Characteristics of sites, teams, aims and changes were assessed by using a questionnaire and monthly self-reports of teams. Progress in achieving significant quality improvement has been assessed on a five point Likert scale (IHI score. Case description: The stroke services (n=23 formed multidisciplinary teams, which worked together in a collaborative based on the IHI Breakthrough Series Model. Teams received instruction in quality improvement, reviewed self reported performance data, identified bottlenecks and improvement goals, and implemented “potentially better practices” based on criteria from the Edisse study, evidence based guidelines, own ideas and expert opinion. Conclusion and discussion: Quality of care has been improved in most participating stroke services. Eighty-seven percent of the teams have improved their care significantly on at least one topic. About 34% of the teams have achieved significant improvement on all aims within the time frame of the project. The project has contributed to the further development and spread of integrated stroke care in the Netherlands.

  5. Using a virtual breakthrough series collaborative to reduce postoperative respiratory failure in 16 Veterans Health Administration hospitals.

    Science.gov (United States)

    Zubkoff, Lisa; Neily, Julia; Mills, Peter D; Borzecki, Ann; Shin, Marlena; Lynn, Marilyn M; Gunnar, William; Rosen, Amy

    2014-01-01

    The Institute for Healthcare Improvement (IHI) Virtual Breakthrough Series (VBTS) process was used in an eight-month (June 2011-January 2012) quality improvement (QI) project to improve care related to reducing postoperative respiratory failure. The VBTS collaborative drew on Patient Safety Indicator 11: Postoperative Respiratory Failure Rate to guide changes in care at the bedside. Sixteen Veterans Health Administration hospitals, each representing a regional Veterans Integrated Service Network, participated in the QI project. During the prework phase (initial two months), hospitals formed multidisciplinary teams, selected measures related to their goals, and collected baseline data. The six-month action phase included group conference calls in which the faculty presented clinical background on the topic, discussed evidence-based processes of care, and/or presented content regarding reducing postoperative respiratory failure. During a final, six-month continuous improvement and spread phase, teams were to continue implementing changes as part of their usual processes. The six most commonly reported interventions to reduce postoperative respiratory failure focused on improving incentive spirometer use, documenting implementation of targeted interventions, oral care, standardized orders, early ambulation, and provider education. A few teams reported reduced ICU readmissions for respiratory failure. The VBTS collaborative helped teams implement process changes to help reduce postoperative respiratory complications. Teams reported initial success at implementing site-specific improvements using real-time data. The VBTS model shows promise for knowledge sharing and efficient multifacility improvement efforts, although long-term sustainability and testing in these and other settings need to be examined.

  6. A Pilot for Improving Depression Care on College Campuses: Results of the College Breakthrough Series-Depression (CBS-D) Project

    Science.gov (United States)

    Chung, Henry; Klein, Michael C.; Silverman, Daniel; Corson-Rikert, Janet; Davidson, Eleanor; Ellis, Patricia; Kasnakian, Caroline

    2011-01-01

    Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to…

  7. The Breakthrough Series Collaborative on Service Integration: A Mixed Methods Study of a Strengths-Based Initiative

    Directory of Open Access Journals (Sweden)

    Cynthia A. Lietz

    2010-11-01

    Full Text Available Arizona’s Department of Economic Security (DES engaged in a strengths-based initiative to increase quality and integration of human services. Twenty teams including employees from state agencies, community leaders, and families were brought together to discuss and implement improvements to a variety of social services. A mixed methods study was conducted to explore the complex process of forming diverse teams to strengthen social services. Specifically, the research team conducted focus groups to collect qualitative data from a purposive sample of the teams to explore their experiences in greater depth. Analysis of the data led to the development of an online survey instrument that allowed all collaborative members an opportunity to participate in the study. Findings suggest that while the teams faced many challenges, a commitment to the process brought perseverance, communication, and creativity allowing this collaborative to initiate 105 activities to bring about positive changes in social services within their communities.

  8. Breakthrough bargaining.

    Science.gov (United States)

    Kolb, D M; Williams, J

    2001-02-01

    Unspoken, subtle parts of a bargaining process--also known as the shadow negotiation--can set the tone for a successful negotiation. Deborah Kolb and Judith Williams, whose book The Shadow Negotiation was the starting point for this article, say there are three strategies businesspeople can use to guide these hidden interactions. Power moves are used when two negotiating parties hold unequal power--for instance, subordinates and bosses; new and existing employees; and people of different races, ages, or genders. These strategies, such as casting the status quo in an unfavorable light, can help parties realize that they must negotiate: they will be better off if they do and worse off if they don't. Process moves affect how negotiation issues are received by both sides in the process, even though they do not address substantive issues. Working outside of the actual bargaining process, one party can suggest ideas or marshal support that can shape the agenda and influence how others view the negotiation. Appreciative moves alter the tone or atmosphere so that a more collaborative exchange is possible. They shift the dynamics of the shadow negotiation away from the adversarial--helping parties to save face--and thus build trust and encourage dialogue. These strategic moves don't guarantee that all bargainers will walk away winners, but they help to get stalled negotiations moving--out of the dark of unspoken power plays and into the light of true dialogue.

  9. The Depression Inventory Development Workgroup: A Collaborative, Empirically Driven Initiative to Develop a New Assessment Tool for Major Depressive Disorder.

    Science.gov (United States)

    Vaccarino, Anthony L; Evans, Kenneth R; Kalali, Amir H; Kennedy, Sidney H; Engelhardt, Nina; Frey, Benicio N; Greist, John H; Kobak, Kenneth A; Lam, Raymond W; MacQueen, Glenda; Milev, Roumen; Placenza, Franca M; Ravindran, Arun V; Sheehan, David V; Sills, Terrence; Williams, Janet B W

    2016-01-01

    The Depression Inventory Development project is an initiative of the International Society for CNS Drug Development whose goal is to develop a comprehensive and psychometrically sound measurement tool to be utilized as a primary endpoint in clinical trials for major depressive disorder. Using an iterative process between field testing and psychometric analysis and drawing upon expertise of international researchers in depression, the Depression Inventory Development team has established an empirically driven and collaborative protocol for the creation of items to assess symptoms in major depressive disorder. Depression-relevant symptom clusters were identified based on expert clinical and patient input. In addition, as an aid for symptom identification and item construction, the psychometric properties of existing clinical scales (assessing depression and related indications) were evaluated using blinded datasets from pharmaceutical antidepressant drug trials. A series of field tests in patients with major depressive disorder provided the team with data to inform the iterative process of scale development. We report here an overview of the Depression Inventory Development initiative, including results of the third iteration of items assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain and appetite. The strategies adopted from the Depression Inventory Development program, as an empirically driven and collaborative process for scale development, have provided the foundation to develop and validate measurement tools in other therapeutic areas as well.

  10. A High School Depression and Suicide Prevention Program: A Collaboration between Health Education and Psychological Services.

    Science.gov (United States)

    Moilanen, Donna L.; Bradbury, Susan

    2002-01-01

    Examined a collaboration between health education and psychological services in generating a high school depression and suicide prevention program. The five-component program raised awareness of teen depression and suicide, increased communication about these issues within the school and community, and provided information about available…

  11. Developing an evaluation framework for consumer-centred collaborative care of depression using input from stakeholders.

    Science.gov (United States)

    McCusker, Jane; Yaffe, Mark; Sussman, Tamara; Kates, Nick; Mulvale, Gillian; Jayabarathan, Ajantha; Law, Susan; Haggerty, Jeannie

    2013-03-01

    To develop a framework for research and evaluation of collaborative mental health care for depression, which includes attributes or domains of care that are important to consumers. A literature review on collaborative mental health care for depression was completed and used to guide discussion at an interactive workshop with pan-Canadian participants comprising people treated for depression with collaborative mental health care, as well as their family members; primary care and mental health practitioners; decision makers; and researchers. Thematic analysis of qualitative data from the workshop identified key attributes of collaborative care that are important to consumers and family members, as well as factors that may contribute to improved consumer experiences. The workshop identified an overarching theme of partnership between consumers and practitioners involved in collaborative care. Eight attributes of collaborative care were considered to be essential or very important to consumers and family members: respectfulness; involvement of consumers in treatment decisions; accessibility; provision of information; coordination; whole-person care; responsiveness to changing needs; and comprehensiveness. Three inter-related groups of factors may affect the consumer experience of collaborative care, namely, organizational aspects of care; consumer characteristics and personal resources; and community resources. A preliminary evaluation framework was developed and is presented here to guide further evaluation and research on consumer-centred collaborative mental health care for depression.

  12. Social Support, a Mediator in Collaborative Depression Care for Cancer Patients

    Science.gov (United States)

    Oh, Hyunsung; Ell, Kathleen

    2015-01-01

    Objective: This study assessed whether perceived social support (PSS) is a factor in improving physical and functional well-being observed among cancer patients receiving collaborative depression care. Methods: A secondary analysis was conducted of data collected in a randomized clinical trial testing the effectiveness of collaborative depression…

  13. Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial.

    Science.gov (United States)

    Richards, David A; Hill, Jacqueline J; Gask, Linda; Lovell, Karina; Chew-Graham, Carolyn; Bower, Peter; Cape, John; Pilling, Stephen; Araya, Ricardo; Kessler, David; Bland, J Martin; Green, Colin; Gilbody, Simon; Lewis, Glyn; Manning, Chris; Hughes-Morley, Adwoa; Barkham, Michael

    2013-08-19

    To compare the clinical effectiveness of collaborative care with usual care in the management of patients with moderate to severe depression. Cluster randomised controlled trial. 51 primary care practices in three primary care districts in the United Kingdom. 581 adults aged 18 years and older who met ICD-10 (international classification of diseases, 10th revision) criteria for a depressive episode on the revised Clinical Interview Schedule. We excluded acutely suicidal patients and those with psychosis, or with type I or type II bipolar disorder; patients whose low mood was associated with bereavement or whose primary presenting problem was alcohol or drug abuse; and patients receiving psychological treatment for their depression by specialist mental health services. We identified potentially eligible participants by searching computerised case records in general practices for patients with depression. Collaborative care, including depression education, drug management, behavioural activation, relapse prevention, and primary care liaison, was delivered by care managers. Collaborative care involved six to 12 contacts with participants over 14 weeks, supervised by mental health specialists. Usual care was family doctors' standard clinical practice. Depression symptoms (patient health questionnaire 9; PHQ-9), anxiety (generalised anxiety disorder 7; GAD-7), and quality of life (short form 36 questionnaire; SF-36) at four and 12 months; satisfaction with service quality (client satisfaction questionnaire; CSQ-8) at four months. 276 participants were allocated to collaborative care and 305 allocated to usual care. At four months, mean depression score was 11.1 (standard deviation 7.3) for the collaborative care group and 12.7 (6.8) for the usual care group. After adjustment for baseline depression, mean depression score was 1.33 PHQ-9 points lower (95% confidence interval 0.35 to 2.31, P=0.009) in participants receiving collaborative care than in those receiving usual

  14. Breakthrough cancer pain

    DEFF Research Database (Denmark)

    Davies, Andrew; Buchanan, Alison; Zeppetella, Giovambattista

    2013-01-01

    Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients.......Breakthrough pain is common in patients with cancer and is a significant cause of morbidity in this group of patients....

  15. Collaborative care for sick-listed workers with major depressive disorder: a randomised controlled trial from the Netherlands Depression Initiative aimed at return to work and depressive symptoms.

    Science.gov (United States)

    Vlasveld, Moniek C; van der Feltz-Cornelis, Christina M; Adèr, Herman J; Anema, Johannes R; Hoedeman, Rob; van Mechelen, Willem; Beekman, Aartjan T F

    2013-04-01

    Major depressive disorder (MDD) is associated with absenteeism. In this study, the effectiveness of collaborative care, with a focus on return to work (RTW), was evaluated in its effect on depressive symptoms and the duration until RTW in sick-listed workers with MDD in the occupational health setting. In this randomised controlled trial, 126 sick-listed workers with MDD were randomised to usual care (N=61) or collaborative care (N=65). Collaborative care was applied by the occupational physician care manager, supported by a web-based tracking system and a consultant psychiatrist. Primary outcome measure was time to response. Secondary outcome measures were time to remission, depressive symptoms as continuous measure and the duration until full RTW. Collaborative care participants had a shorter time to response, with a difference of 2.8 months. However, no difference was found on time to remission or depressive symptoms as continuous measure. With a mean of 190 days in the collaborative care group, and 210 days in the usual care group, the groups did not differ significantly from each other in the duration until full RTW. Adherence to the collaborative care intervention was low. These results do not justify a widespread implementation of collaborative care in occupational healthcare, as it was operationalised in this study. However, since the study might have been underpowered for RTW and because treatment integrity was low, further research, with larger sample sizes, is needed to develop the best fitting (collaborative care) model for addressing RTW in depressed sick-listed workers. : ISRCTN78462860.

  16. Effectiveness of Collaborative Care for Depression in Public-Sector Primary Care Clinics Serving Latinos.

    Science.gov (United States)

    Lagomasino, Isabel T; Dwight-Johnson, Megan; Green, Jennifer M; Tang, Lingqi; Zhang, Lily; Duan, Naihua; Miranda, Jeanne

    2017-04-01

    Quality improvement interventions for depression care have been shown to be effective for improving quality of care and depression outcomes in settings with primarily insured patients. The aim of this study was to determine the impact of a collaborative care intervention for depression that was tailored for low-income Latino patients seen in public-sector clinics. A total of 400 depressed patients from three public-sector primary care clinics were enrolled in a randomized controlled trial of a tailored collaborative care intervention versus enhanced usual care. Social workers without previous mental health experience served as depression care specialists for the intervention patients (N=196). Depending on patient preference, they delivered a cognitive-behavioral therapy (CBT) intervention or facilitated antidepressant medication given by primary care providers or both. In enhanced usual care, patients (N=204) received a pamphlet about depression, a letter for their primary care provider stating that they had a positive depression screen, and a list of local mental health resources. Intent-to-treat analyses examined clinical and process-of-care outcomes at 16 weeks. Compared with patients in the enhanced usual care group, patients in the intervention group had significantly improved depression, quality of life, and satisfaction outcomes (ppublic-sector clinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

  17. Impact of Collaborative Care on Absenteeism for Depressed Employees Seen in Primary Care Practices: A Retrospective Cohort Study.

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    Adaji, Akuh; Newcomb, Richard D; Wang, Zhen; Williams, Mark

    2018-01-01

    The impact of "real world" collaborative care on depression and absenteeism for depressed employees seen in primary care practices using objective employer absence data. A retrospective cohort study comparing depressed employees seen in primary care practices who enrolled for a "real world" collaborative care program to practice as usual (PAU) on objective absence days and depression response and remission at 6, and 12-month time periods. Absence days were more in the collaborative care group compared with the PAU group at 3 and 6 months but at 12 months the difference was no longer statistically significant. Collaborative care led to better response and remission depression scores compared with PAU at 12 months. Collaborative care led to faster improvement in depression symptoms but did not translate to less time away from work.

  18. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

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    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  19. Why Collaborative Care for Depressed Patients is so Difficult: A Belgian Qualitative Study

    Directory of Open Access Journals (Sweden)

    Kris Van den Broeck

    2017-06-01

    Full Text Available Although current guidelines recommend collaborative care for severely depressed patients, few patients get adequate treatment. In this study we aimed to identify the thresholds for interdisciplinary collaboration amongst practitioners when treating severely depressed patients. In addition, we aimed to identify specific and feasible steps that may add to improved collaboration amongst first and second level Belgian health care providers when treating depressed patients. In two standard focus groups (n = 8; n = 12, general practitioners and psychiatrists first outlined current practice and its shortcomings. In a next phase, the same participants were gathered in nominal groups to identify and prioritise steps that could give rise to improved collaboration. Thematic analyses were performed. Though some barriers for interdisciplinary collaboration may seem easy to overcome, participants stressed the importance of certain boundary conditions on a macro- (e.g., financing of care, secure communication technology and meso-level (e.g., support for first level practitioner. Findings are discussed against the background of frameworks on collaboration in healthcare and recent developments in mental health care.

  20. Collaborative care for depression in European countries: a systematic review and meta-analysis.

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    Sighinolfi, Cecilia; Nespeca, Claudia; Menchetti, Marco; Levantesi, Paolo; Belvederi Murri, Martino; Berardi, Domenico

    2014-10-01

    This is a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effectiveness of collaborative care compared to Primary Care Physician's (PCP's) usual care in the treatment of depression, focusing on European countries. A systematic review of English and non-English articles, from inception to March 2014, was performed using database PubMed, British Nursing Index and Archive, Ovid Medline (R), PsychINFO, Books@Ovid, PsycARTICLES Full Text, EMBASE Classic+Embase, DARE (Database of Abstract of Reviews of Effectiveness) and the Cochrane Library electronic database. Search term included depression, collaborative care, physician family and allied health professional. RCTs comparing collaborative care to usual care for depression in primary care were included. Titles and abstracts were independently examined by two reviewers, who extracted from the included trials information on participants' characteristics, type of intervention, features of collaborative care and type of outcome measure. The 17 papers included, regarding 15 RCTs, involved 3240 participants. Primary analyses showed that collaborative care models were associated with greater improvement in depression outcomes in the short term, within 3 months (standardized mean difference (SMD) -0.19, 95% CI=-0.33; -0.05; p=0.006), medium term, between 4 and 11 months (SMD -0.24, 95% CI=-0.39; -0.09; p=0.001) and medium-long term, from 12 months and over (SMD -0.21, 95% CI=-0.37; -0.04; p=0.01), compared to usual care. The present review, specifically focusing on European countries, shows that collaborative care is more effective than treatment as usual in improving depression outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Comparative Studies of Collaborative Team Depression Care Adoption in Safety Net Clinics

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    Ell, Kathleen; Wu, Shinyi; Guterman, Jeffrey; Schulman, Sandra-Gross; Sklaroff, Laura; Lee, Pey-Jiuan

    2018-01-01

    Purpose: To evaluate three approaches adopting collaborative depression care model in Los Angeles County safety net clinics with predominantly Latino type 2 diabetes patients. Methods: Pre-post differences in treatment rates and symptom reductions were compared between baseline, 6-month, and 12-month follow-ups for each approach: (a) Multifaceted…

  2. What are the barriers and facilitators to implementing Collaborative Care for depression? A systematic review.

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    Wood, Emily; Ohlsen, Sally; Ricketts, Thomas

    2017-05-01

    Collaborative Care is an evidence-based approach to the management of depression within primary care services recommended within NICE Guidance. However, uptake within the UK has been limited. This review aims to investigate the barriers and facilitators to implementing Collaborative Care. A systematic review of the literature was undertaken to uncover what barriers and facilitators have been reported by previous research into Collaborative Care for depression in primary care. The review identified barriers and facilitators to successful implementation of Collaborative Care for depression in 18 studies across a range of settings. A framework analysis was applied using the Collaborative Care definition. The most commonly reported barriers related to the multi-professional approach, such as staff and organisational attitudes to integration, and poor inter-professional communication. Facilitators to successful implementation particularly focussed on improving inter-professional communication through standardised care pathways and case managers with clear role boundaries and key underpinning personal qualities. Not all papers were independent title and abstract screened by multiple reviewers thus limiting the reliability of the selected studies. There are many different frameworks for assessing the quality of qualitative research and little consensus as to which is most appropriate in what circumstances. The use of a quality threshold led to the exclusion of six papers that could have included further information on barriers and facilitators. Although the evidence base for Collaborative Care is strong, and the population within primary care with depression is large, the preferred way to implement the approach has not been identified. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Investigating the effect of collaborative care on depression, anxiety, and stress of patients after coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Parastoo Rezapour

    2016-02-01

    Full Text Available Background: Coronary artery disease and its associated treatment interventions such as angioplasty can lead to emotional problems, including depression, anxiety, and stress, in patients and might have adverse effects on the recovery process. This study aimed to evaluate the effect of collaborative care model on depression, anxiety, and stress in patients after coronary angioplasty. Methods: This clinical trial was conducted on 50 patients undergoing coronary angioplasty, who were referred to intensive care unit and surgical ward of one of the hospitals of Isfahan, Iran, in 2015. Samples were selected through randomized convenience sampling and were divided into intervention and control group (n=25 for each group. Collaborative care model, consisting of four stages of motivation, preparation, engagement, and evaluation, was implemented for the intervention group through five 45-60 minute sessions and a three-month telephone follow-up. Data was collected using depression, anxiety, and stress scale (DASS-42 before and one month after the intervention from both groups. Data were analyzed using descriptive statistics, Chi-square, as well as independent and paired t-tests in SPSS, version 18. Results: In this study, mean score of depression was significantly decreased in the intervention group after the implementation of collaborative model (from 31.6±3.7 to 6.3±5.03 (P<0.001, and mean anxiety and stress scores were reduced from 32.6±3.04 and 32.2±3.3 to 6.2±4.1 and 8.5±4.8, respectively (P<0.001. In this regard, a significant difference was observed between the intervention and control groups (P<0.001. Conclusion: Implementation of collaborative care could be associated with lower depression, anxiety, and stress in patients after coronary angioplasty. Therefore, its application is recommended as an effective method for such patients.

  4. Enablers and barriers to implementing collaborative care for anxiety and depression: a systematic qualitative review.

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    Overbeck, Gritt; Davidsen, Annette Sofie; Kousgaard, Marius Brostrøm

    2016-12-28

    Collaborative care is an increasingly popular approach for improving quality of care for people with mental health problems through an intensified and structured collaboration between primary care providers and health professionals with specialized psychiatric expertise. Trials have shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing collaborative care for patients with anxiety and depression. We developed a comprehensive search strategy in cooperation with a research librarian and performed a search in five databases (EMBASE, PubMed, PsycINFO, ProQuest, and CINAHL). All authors independently screened titles and abstracts and reviewed full-text articles. Studies were included if they were published in English and based on the original qualitative data on the implementation of a collaborative care intervention targeted at depression or anxiety in an adult patient population in a high-income country. Our subsequent analysis employed the normalization process theory (NPT). We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care providers was found to be critical but sometimes difficult. Enablers included physician champions, reimbursement for extra work, and feedback on the effectiveness of collaborative care. The social and professional skills of the care managers seemed critical for integrating collaborative care in the primary health care clinic. Day-to-day implementation was also found to be facilitated by the care managers being located in the clinic since this supports regular face-to-face interactions between physicians and care managers

  5. Developing a national dissemination plan for collaborative care for depression: QUERI Series

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    Rubenstein Lisa V

    2008-12-01

    Full Text Available Abstract Background Little is known about effective strategies for disseminating and implementing complex clinical innovations across large healthcare systems. This paper describes processes undertaken and tools developed by the U.S. Department of Veterans Affairs (VA Mental Health Quality Enhancement Research Initiative (MH-QUERI to guide its efforts to partner with clinical leaders to prepare for national dissemination and implementation of collaborative care for depression. Methods An evidence-based quality improvement (EBQI process was used to develop an initial set of goals to prepare the VA for national dissemination and implementation of collaborative care. The resulting product of the EBQI process is referred to herein as a "National Dissemination Plan" (NDP. EBQI participants included: a researchers with expertise on the collaborative care model for depression, clinical quality improvement, and implementation science, and b VA clinical and administrative leaders with experience and expertise on how to adapt research evidence to organizational needs, resources and capacity. Based on EBQI participant feedback, drafts of the NDP were revised and refined over multiple iterations before a final version was approved by MH-QUERI leadership. 'Action Teams' were created to address each goal. A formative evaluation framework and related tools were developed to document processes, monitor progress, and identify and act upon barriers and facilitators in addressing NDP goals. Results The National Dissemination Plan suggests that effectively disseminating collaborative care for depression in the VA will likely require attention to: Guidelines and Quality Indicators (4 goals, Training in Clinical Processes and Evidence-based Quality Improvement (6 goals, Marketing (7 goals, and Informatics Support (1 goal. Action Teams are using the NDP as a blueprint for developing infrastructure to support system-wide adoption and sustained implementation of

  6. Mental health treatment associated with community-based depression screening: considerations for planning multidisciplinary collaborative care.

    Science.gov (United States)

    Winchester, Bruce R; Watkins, Sarah C; Brahm, Nancy C; Harrison, Donald L; Miller, Michael J

    2013-06-01

    antidepressant prescribing and referral for behavioral health care. It is critical for policy planners to recognize changes in follow-up depression care when implementing screening programs to ensure adequate capacity. Pharmacists are poised to assume a role in collaborative depression care, particularly with antidepressant medication therapy management.

  7. Collaborative care for depression in general practice: study protocol for a randomised controlled trial.

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    Brinck-Claussen, Ursula Ødum; Curth, Nadja Kehler; Davidsen, Annette Sofie; Mikkelsen, John Hagel; Lau, Marianne Engelbrecht; Lundsteen, Merete; Csillag, Claudio; Christensen, Kaj Sparle; Hjorthøj, Carsten; Nordentoft, Merete; Eplov, Lene Falgaard

    2017-07-21

    Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish context. We therefore developed a model for CC (the Collabri model) to treat people with depression in general practice in Denmark. Since systematic identification of patients is an "active ingredient" in CC and some literature suggests case finding as the best alternative to standard detection, the two detection methods are examined as part of the study. The aim is to investigate if treatment according to the Collabri model has an effect on depression symptoms when provided to people with depression in general practice in Denmark, and to examine if case finding is a better method to detect depression in general practice than standard detection. The trial is a cluster-randomised, clinical superiority trial investigating the effect of treatment according to the Collabri model for CC, compared to treatment as usual for 480 participants diagnosed with depression in general practice in the Capital Region of Denmark. The primary outcome is depression symptoms (Beck's Depression Inventory (BDI-II)) after 6 months. Secondary outcomes include depression symptoms (BDI-II) after 15 months, anxiety symptoms (Beck's Anxiety Inventory (BAI)), level of functioning (Global Assessment of Function (GAF)) and psychological stress (Symptom Checklist-90-Revised (SCL-90-R)). In addition, case finding (with the recommended screening tool Major Depression Inventory (MDI)) and standard detection of depression is examined in a cluster-randomized controlled design. Here, the primary outcome is the positive predictive value of referral diagnosis. If the Collabri model is shown to be superior to treatment as usual, the study will contribute with important knowledge on how to improve treatment of depression in

  8. [Primary care and mental health care collaboration in patients with depression: Evaluation of a pilot experience].

    Science.gov (United States)

    Calderón, Carlos; Balagué, Laura; Iruin, Álvaro; Retolaza, Ander; Belaunzaran, Jon; Basterrechea, Javier; Mosquera, Isabel

    2016-01-01

    To implement and assess a collaborative experience between Primary Care (PC) and Mental Health (MH) in order to improve the care of patients with depression. Pilot collaborative project from a participatory action research approach during 2013. Basque Country. Osakidetza (Basque Health Service). Bizkaia and Gipuzkoa. The study included 207 professionals from general practice, nursing, psychiatry, psychiatric nursing, psychology and social work of 9 health centres and 6 mental health centres of Osakidetza. Shared design and development of four axes of intervention: 1) Communication and knowledge between PC and MH professionals, 2) Improvement of diagnostic coding and referral of patients, 3) Training programmes with meetings and common Clinical Practice Guidelines, and 4) Evaluation. Intervention and control questionnaires to professionals of the centres on the knowledge and satisfaction in the PC-MH relationship, joint training activities, and assessment of the experience. Osakidetza registers of prevalences, referrals and treatments. Follow-up meetings. Improvement in the 4 axes of intervention in the participant centres compared with the controls. Identification of factors to be considered in the development and sustainability of PC-MH collaborative care. The pilot experience confirms that collaborative projects promoted by PC and MH can improve depression care and the satisfaction of professionals. They are complex projects that need simultaneous interventions adjusted to the particularities of the health services. Multidisciplinary and continuous participation and management and information system support are necessary for their implementation. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  9. The Bypassing the Blues treatment protocol: stepped collaborative care for treating post-CABG depression.

    Science.gov (United States)

    Rollman, Bruce L; Belnap, Bea Herbeck; LeMenager, Michelle S; Mazumdar, Sati; Schulberg, Herbert C; Reynolds, Charles F

    2009-02-01

    To present the design of the Bypassing the Blues (BtB) study to examine the impact of a collaborative care strategy for treating depression among patients with cardiac disease. Coronary artery bypass graft (CABG) surgery is one of the most common and costly medical procedures performed in the US. Up to half of post-CABG patients report depressive symptoms, and they are more likely to experience poorer health-related quality of life (HRQoL), worse functional status, continued chest pains, and higher risk of cardiovascular morbidity independent of cardiac status, medical comorbidity, and the extent of bypass surgery. BtB was designed to enroll 450 post-CABG patients from eight Pittsburgh-area hospitals including: (1) 300 patients who expressed mood symptoms preceding discharge and at 2 weeks post hospitalization (Patient Health Questionnaire (PHQ-9) >or=10); and (2) 150 patients who served as nondepressed controls (PHQ-9 Depressed patients were randomized to either an 8-month course of nurse-delivered telephone-based collaborative care supervised by a psychiatrist and primary care expert, or to their physicians' "usual care." The primary hypothesis will test whether the intervention can produce an effect size of >or=0.5 improvement in HRQoL at 8 months post CABG, as measured by the SF-36 Mental Component Summary score. Secondary hypotheses will examine the impact of our intervention on mood symptoms, cardiovascular morbidity, employment, health services utilization, and treatment costs. Not applicable. This effectiveness trial will provide crucial information on the impact of a widely generalizable evidence-based collaborative care strategy for treating depressed patients with cardiac disease.

  10. An Academic-Marketing Collaborative to Promote Depression Care: A Tale of Two Cultures

    Science.gov (United States)

    Kravitz, Richard L.; Epstein, Ronald M.; Bell, Robert A.; Rochlen, Aaron B.; Duberstein, Paul; Riby, Caroline H.; Caccamo, Anthony F.; Slee, Christina K.; Cipri, Camille S.; Paterniti, Debora A.

    2011-01-01

    Objectives Commercial advertising and patient education have separate theoretical underpinnings, approaches, and practitioners. This paper aims to describe a collaboration between academic researchers and a marketing firm working to produce demographically targeted public service anouncements (PSAs) designed to enhance depression care-seeking in primary care. Methods An interdisciplinary group of academic researcherss contracted with a marketing firm in Rochester, NY to produce PSAs that would help patients with depressive symptoms engage more effectively with their primary care physicians (PCPs). The researchers brought perspectives derived from clinical experience and the social sciences and conducted empirical research using focus groups, conjoint analysis, and a population-based survey. Results were shared with the marketing firm, which produced four PSA variants targeted to gender and socioeconomic position. Results There was no simple, one-to-one relationship between research results and the form, content, or style of the PSAs. Instead, empirical findings served as a springboard for discussion and kept the creative process tethered to the experiences, attitudes, and opinions of actual patients. Reflecting research findings highlighting patients’ struggles to recognize, label, and disclose depressive symptoms, the marketing firm generated communication objectives that emphasized: a) educating the patient to consider and investigate the possibility of depression; b) creating the belief that the PCP is interested in discussing depression and capable of offering helpful treatment; and c) modelling different ways of communicating with physicians about depression. Before production, PSA prototypes were vetted with additional focus groups. The winning prototype, “Faces,” involved a multi-ethnic montage of formerly depressed persons talking about how depression affected them and how they improved with treatment, punctuated by a physician who provided clinical

  11. An academic-marketing collaborative to promote depression care: a tale of two cultures.

    Science.gov (United States)

    Kravitz, Richard L; Epstein, Ronald M; Bell, Robert A; Rochlen, Aaron B; Duberstein, Paul; Riby, Caroline H; Caccamo, Anthony F; Slee, Christina K; Cipri, Camille S; Paterniti, Debora A

    2013-03-01

    Commercial advertising and patient education have separate theoretical underpinnings, approaches, and practitioners. This paper aims to describe a collaboration between academic researchers and a marketing firm working to produce demographically targeted public service anouncements (PSAs) designed to enhance depression care-seeking in primary care. An interdisciplinary group of academic researchers contracted with a marketing firm in Rochester, NY to produce PSAs that would help patients with depressive symptoms engage more effectively with their primary care physicians (PCPs). The researchers brought perspectives derived from clinical experience and the social sciences and conducted empirical research using focus groups, conjoint analysis, and a population-based survey. Results were shared with the marketing firm, which produced four PSA variants targeted to gender and socioeconomic position. There was no simple, one-to-one relationship between research results and the form, content, or style of the PSAs. Instead, empirical findings served as a springboard for discussion and kept the creative process tethered to the experiences, attitudes, and opinions of actual patients. Reflecting research findings highlighting patients' struggles to recognize, label, and disclose depressive symptoms, the marketing firm generated communication objectives that emphasized: (a) educating the patient to consider and investigate the possibility of depression; (b) creating the belief that the PCP is interested in discussing depression and capable of offering helpful treatment; and (c) modelling different ways of communicating with physicians about depression. Before production, PSA prototypes were vetted with additional focus groups. The winning prototype, "Faces," involved a multi-ethnic montage of formerly depressed persons talking about how depression affected them and how they improved with treatment, punctuated by a physician who provided clinical information. A member of the

  12. Implementation of collaborative depression management at community-based primary care clinics: an evaluation.

    Science.gov (United States)

    Bauer, Amy M; Azzone, Vanessa; Goldman, Howard H; Alexander, Laurie; Unützer, Jürgen; Coleman-Beattie, Brenda; Frank, Richard G

    2011-09-01

    This study evaluated a large demonstration project of collaborative care of depression at community health centers by examining the role of clinic site on two measures of quality care (early follow-up and appropriate pharmacotherapy) and on improvement of symptoms (score on Patient Health Questionnaire-9 reduced by 50% or ≤ 5). A quasi-experimental study examined data on the treatment of 2,821 patients aged 18 and older with depression symptoms between 2006 and 2009 at six community health organizations selected in a competitive process to implement a model of collaborative care. The model's key elements were use of a Web-based disease registry to track patients, care management to support primary care providers and offer proactive follow-up of patients, and organized psychiatric consultation. Across all sites, a plurality of patients achieved meaningful improvement in depression, and in many sites, improvement occurred rapidly. After adjustment for patient characteristics, multivariate logistic regression models revealed significant differences across clinics in the probability of receiving early follow-up (range .34-.88) or appropriate pharmacotherapy (range .27-.69) and in experiencing improvement (.36 to .84). Similarly, after adjustment for patient characteristics, Cox proportional hazards models revealed that time elapsed between first evaluation and the occurrence of improvement differed significantly across clinics (pquality indicators and outcomes. Sites that performed better on quality indicators had better outcomes, and the differences were not attributable to patients' characteristics.

  13. Breakthroughs in statistics

    CERN Document Server

    Johnson, Norman

    This is author-approved bcc: This is the third volume of a collection of seminal papers in the statistical sciences written during the past 110 years. These papers have each had an outstanding influence on the development of statistical theory and practice over the last century. Each paper is preceded by an introduction written by an authority in the field providing background information and assessing its influence. Volume III concerntrates on articles from the 1980's while including some earlier articles not included in Volume I and II. Samuel Kotz is Professor of Statistics in the College of Business and Management at the University of Maryland. Norman L. Johnson is Professor Emeritus of Statistics at the University of North Carolina. Also available: Breakthroughs in Statistics Volume I: Foundations and Basic Theory Samuel Kotz and Norman L. Johnson, Editors 1993. 631 pp. Softcover. ISBN 0-387-94037-5 Breakthroughs in Statistics Volume II: Methodology and Distribution Samuel Kotz and Norman L. Johnson, Edi...

  14. Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory.

    Science.gov (United States)

    Coupe, Nia; Anderson, Emma; Gask, Linda; Sykes, Paul; Richards, David A; Chew-Graham, Carolyn

    2014-05-01

    Collaborative care (CC) is an organisational framework which facilitates the delivery of a mental health intervention to patients by case managers in collaboration with more senior health professionals (supervisors and GPs), and is effective for the management of depression in primary care. However, there remains limited evidence on how to successfully implement this collaborative approach in UK primary care. This study aimed to explore to what extent CC impacts on professional working relationships, and if CC for depression could be implemented as routine in the primary care setting. This qualitative study explored perspectives of the 6 case managers (CMs), 5 supervisors (trial research team members) and 15 general practitioners (GPs) from practices participating in a randomised controlled trial of CC for depression. Interviews were transcribed verbatim and data was analysed using a two-step approach using an initial thematic analysis, and a secondary analysis using the Normalisation Process Theory concepts of coherence, cognitive participation, collective action and reflexive monitoring with respect to the implementation of CC in primary care. Supervisors and CMs demonstrated coherence in their understanding of CC, and consequently reported good levels of cognitive participation and collective action regarding delivering and supervising the intervention. GPs interviewed showed limited understanding of the CC framework, and reported limited collaboration with CMs: barriers to collaboration were identified. All participants identified the potential or experienced benefits of a collaborative approach to depression management and were able to discuss ways in which collaboration can be facilitated. Primary care professionals in this study valued the potential for collaboration, but GPs' understanding of CC and organisational barriers hindered opportunities for communication. Further work is needed to address these organisational barriers in order to facilitate

  15. Interdisciplinary Team Collaboration during Discharge of Depressed Older Persons: A Norwegian Qualitative Implementation Study

    Directory of Open Access Journals (Sweden)

    Anne Lise Holm

    2013-01-01

    Full Text Available In order to deliver effective care, it is necessary to organise interdisciplinary activities for older persons who suffer from depressive disorders. This paper evaluated the interdisciplinary team members’ perceptions of cooperation in the discharge planning of depressed older persons based on the Chronic Care Model (CCM. A qualitative implementation design was used, data were collected by means of multistage focus groups, and a thematic analysis was performed. Three themes emerged: lack of effective team leadership in the community, the need to change the delivery system, and enhancing self-management support for depressed older persons as well as the participation of their families. It was concluded that nurse managers must find ways of supporting the depressed older persons by better structuring the care, increasing cooperation with organisational leadership, and creating an environment characterised by trust and mutual respect. Distrust can have serious implications for discharge planning collaboration. The development of a common vision of transparency in the organization is important as is a policy of change among leadership and in clinical practice.

  16. Enablers and barriers to implementing collaborative care for anxiety and depression

    DEFF Research Database (Denmark)

    Overbeck, Gritt; Davidsen, Annette Sofie; Kousgaard, Marius Brostrøm

    2016-01-01

    shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing...... employed the normalization process theory (NPT). RESULTS: We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care...... collaborative care interventions: effective educational programs, especially for care managers; issues of reimbursement in relation to primary care providers; good systems for communication and monitoring; and promoting face-to-face interaction between care managers and physicians, preferably through co...

  17. Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis.

    Science.gov (United States)

    Thota, Anilkrishna B; Sipe, Theresa Ann; Byard, Guthrie J; Zometa, Carlos S; Hahn, Robert A; McKnight-Eily, Lela R; Chapman, Daniel P; Abraido-Lanza, Ana F; Pearson, Jane L; Anderson, Clinton W; Gelenberg, Alan J; Hennessy, Kevin D; Duffy, Farifteh F; Vernon-Smiley, Mary E; Nease, Donald E; Williams, Samantha P

    2012-05-01

    To improve the quality of depression management, collaborative care models have been developed from the Chronic Care Model over the past 20 years. Collaborative care is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists. In addition to case management support, primary care providers receive consultation and decision support from mental health specialists (i.e., psychiatrists and psychologists). This collaboration is designed to (1) improve routine screening and diagnosis of depressive disorders; (2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and (3) improve clinical and community support for active client/patient engagement in treatment goal-setting and self-management. A team of subject matter experts in mental health, representing various agencies and institutions, conceptualized and conducted a systematic review and meta-analysis on collaborative care for improving the management of depressive disorders. This team worked under the guidance of the Community Preventive Services Task Force, a nonfederal, independent, volunteer body of public health and prevention experts. Community Guide systematic review methods were used to identify, evaluate, and analyze available evidence. An earlier systematic review with 37 RCTs of collaborative care studies published through 2004 found evidence of effectiveness of these models in improving depression outcomes. An additional 32 studies of collaborative care models conducted between 2004 and 2009 were found for this current review and analyzed. The results from the meta-analyses suggest robust evidence of effectiveness of collaborative care in improving depression symptoms (standardized mean difference [SMD]=0.34); adherence to treatment (OR=2.22); response to treatment (OR=1.78); remission of symptoms (OR=1.74); recovery from symptoms (OR=1.75); quality of

  18. Ten Main Technological Breakthroughs of CNPC in 2009

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ Breakthrough in systematic technology for exploration of Qikou oil-enriched depression in Bohai Bay Basin Qikou oil-enriched depression is one of the largest depressions of the Tertiary deposit in Bohai Bay Basin.The oil and gas exploration of this area faces a number of bottlenecks,such as a large proportion of negative structures,complicated distribution of sedimentary sand bodies and diversified types of oil and gas reservoirs.

  19. The Impact of Posttraumatic Stress Disorder on the 6-Month Outcomes in Collaborative Care Management for Depression.

    Science.gov (United States)

    Angstman, Kurt B; Marcelin, Alberto; Gonzalez, Cesar A; Kaufman, Tara K; Maxson, Julie A; Williams, Mark D

    2016-07-01

    Posttraumatic stress disorder (PTSD) has symptoms that exist along a spectrum that includes depression and the 2 disorders may coexist. Collaborative care management (CCM) has been successfully used in outpatient mental health management (especially depression and anxiety) with favorable outcomes. Despite this, there exist limited data on clinical impact of a diagnosis of PTSD on depression outcomes in CCM. The present study used a retrospective cohort design to examine the association of PTSD with depression outcomes among 2121 adult patients involved in CCM in a primary care setting. Using standardized self-report measures, baseline depression scores and 6-month outcome scores were evaluated. Seventy-six patients had a diagnosis of PTSD documented in their electronic medical record. Patients with PTSD reported more severe depressive symptoms at baseline (Patient Health Questionnaire-9 score of 17.9 vs 15.4, P depressive symptoms at 6 months after CCM. When coexisting with depression, a diagnosis of PTSD was associated with worse depression outcomes, when managed with CCM in primary care. Opportunities still exist for more aggressive management of depression in these patients to help improve remission as well as reduce persistent depressive symptoms. © The Author(s) 2016.

  20. Parents' experiences of collaboration between welfare professionals regarding children with anxiety or depression - an explorative study

    Directory of Open Access Journals (Sweden)

    Catharina Widmark

    2013-10-01

    Full Text Available Introduction: Well-functioning collaboration between professionals in the welfare sector has a strong influence on the contact with parents of children and adolescents with mental illness, and it is a precondition for the availability of support for these parents. This paper reports how such parents experience collaboration between professionals in mental health care, social services, and schools.Methods: Data were collected by in-depth interviews with seven parents of children and adolescents diagnosed with anxiety and depression. The families were selected from the Child and Adolescent Mental Health (CAMH patient records kept by the Stockholm County Council (Sweden, and they all lived in a catchment area for CAMH outpatient services in Stockholm.Results and discussion: We conclude that when the encounter between parents and professionals is characterized by structure and trust, it is supportive and serves as a holding environment. Coordination and communication links are needed in the collaboration between the professionals, along with appropriately scheduled and well-performed network meetings to create structure in the parent-professional encounter. Indeed, establishment of trust in this interaction is promoted if individual professionals are available, provide the parents with adequate information, are skilled, and show empathy and commitment. 

  1. Parents' experiences of collaboration between welfare professionals regarding children with anxiety or depression - an explorative study

    Directory of Open Access Journals (Sweden)

    Catharina Widmark

    2013-10-01

    Full Text Available Introduction: Well-functioning collaboration between professionals in the welfare sector has a strong influence on the contact with parents of children and adolescents with mental illness, and it is a precondition for the availability of support for these parents. This paper reports how such parents experience collaboration between professionals in mental health care, social services, and schools. Methods: Data were collected by in-depth interviews with seven parents of children and adolescents diagnosed with anxiety and depression. The families were selected from the Child and Adolescent Mental Health (CAMH patient records kept by the Stockholm County Council (Sweden, and they all lived in a catchment area for CAMH outpatient services in Stockholm. Results and discussion: We conclude that when the encounter between parents and professionals is characterized by structure' and trust', it is supportive and serves as a holding environment'. Coordination and communication links are needed 'in the collaboration between the professionals, along with appropriately scheduled and well-performed network meetings 'to create structure in the parent-professional encounter. Indeed, establishment of trust in this interaction is promoted if individual professionals are available, provide the parents with adequate information, are skilled, and show empathy and commitment. 

  2. Collaboration

    Science.gov (United States)

    King, Michelle L.

    2010-01-01

    This article explores collaboration between library media educators and regular classroom teachers. The article focuses on the context of the issue, positions on the issue, the impact of collaboration, and how to implement effective collaboration into the school system. Various books and professional journals are used to support conclusions…

  3. Reconsidering the definition of Major Depression based on Collaborative Psychiatric Epidemiology Surveys.

    Science.gov (United States)

    Rosenström, Tom; Jokela, Markus

    2017-01-01

    Diagnostic definitions for depressive disorders remain a debated topic, despite their central role in clinical practice and research. We use both recent evidence and nationally representative data to derive an empirically-based modification of DSM-IV/-5 Major Depressive Disorder (MDD). A modified MDD diagnosis was derived by analyzing data from Collaborative Psychiatric Epidemiology Surveys, a multistage probability sample of adults (n=20 013; age ≥ 18 years) in coterminous USA, Alaska and Hawaii. The old and the newly suggested MDD definitions were compared for their associated disability (WHO Disability Assessment Schedule and number of disability days in past month), suicide attempt, and other covariates. Our data-driven definition for major depression was "lack of interest to all or most things" plus four other symptoms from the set {weight gain, weight loss, insomnia, psychomotor retardation, fatigue, feelings of worthlessness, diminished ability to think/concentrate, suicidal ideation/attempt}. The new definition captured all the disability implied by MDD and excluded cases that showed no greater disability than the general population nor increased risk of suicide attempts. The lifetime prevalence of the new diagnosis was 14.7% (95% CI=14-15.4%) of the population, slightly less than for the old definition (16.4%; CI=15.4-17.3%). Only conservative modifications of MDD could be studied, because of restrictions in the symptom data. With only small adjusting, the new definition for major depression may be more clinically relevant than the old one, and could serve as a conservative replacement for the old definition. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Impact of collaborative care for depression on clinical, functional, and work outcomes: a practice-based evaluation.

    Science.gov (United States)

    Shippee, Nathan D; Shah, Nilay D; Angstman, Kurt B; DeJesus, Ramona S; Wilkinson, John M; Bruce, Steven M; Williams, Mark D

    2013-01-01

    The impact of collaborative care (CC) on depression and work productivity in routine, nonresearch primary care settings remains unclear due to limited evidence. This prospective study examined depression and work outcomes (eg, absenteeism, presenteeism) for 165 individuals in CC for depression versus 211 patients in practice as usual in a multisite primary care practice. CC predicted greater adjusted 6-month improvements in treatment response, remission, and absenteeism versus practice as usual. Response/remission increased productivity overall. CC increased clinical and work improvements in a nonresearch care setting. Insurers and employers should consider CC's work benefits in developing payment structures.

  5. A Remote Collaborative Care Program for Patients with Depression Living in Rural Areas: Open-Label Trial.

    Science.gov (United States)

    Rojas, Graciela; Guajardo, Viviana; Martínez, Pablo; Castro, Ariel; Fritsch, Rosemarie; Moessner, Markus; Bauer, Stephanie

    2018-04-30

    In the treatment of depression, primary care teams have an essential role, but they are most effective when inserted into a collaborative care model for disease management. In rural areas, the shortage of specialized mental health resources may hamper management of depressed patients. The aim was to test the feasibility, acceptability, and effectiveness of a remote collaborative care program for patients with depression living in rural areas. In a nonrandomized, open-label (blinded outcome assessor), two-arm clinical trial, physicians from 15 rural community hospitals recruited 250 patients aged 18 to 70 years with a major depressive episode (DSM-IV criteria). Patients were assigned to the remote collaborative care program (n=111) or to usual care (n=139). The remote collaborative care program used Web-based shared clinical records between rural primary care teams and a specialized/centralized mental health team, telephone monitoring of patients, and remote supervision by psychiatrists through the Web-based shared clinical records and/or telephone. Depressive symptoms, health-related quality of life, service use, and patient satisfaction were measured 3 and 6 months after baseline assessment. Six-month follow-up assessments were completed by 84.4% (221/250) of patients. The remote collaborative care program achieved higher user satisfaction (odds ratio [OR] 1.94, 95% CI 1.25-3.00) and better treatment adherence rates (OR 1.81, 95% CI 1.02-3.19) at 6 months compared to usual care. There were no statically significant differences in depressive symptoms between the remote collaborative care program and usual care. Significant differences between groups in favor of remote collaborative care program were observed at 3 months for mental health-related quality of life (beta 3.11, 95% CI 0.19-6.02). Higher rates of treatment adherence in the remote collaborative care program suggest that technology-assisted interventions may help rural primary care teams in the management

  6. Case Study of Resilient Baton Rouge: Applying Depression Collaborative Care and Community Planning to Disaster Recovery

    Directory of Open Access Journals (Sweden)

    Robin Keegan

    2018-06-01

    Full Text Available Background: Addressing behavioral health impacts of major disasters is a priority of increasing national attention, but there are limited examples of implementation strategies to guide new disaster responses. We provide a case study of an effort being applied in response to the 2016 Great Flood in Baton Rouge. Methods: Resilient Baton Rouge was designed to support recovery after major flooding by building local capacity to implement an expanded model of depression collaborative care for adults, coupled with identifying and responding to local priorities and assets for recovery. For a descriptive, initial evaluation, we coupled analysis of documents and process notes with descriptive surveys of participants in initial training and orientation, including preliminary comparisons among licensed and non-licensed participants to identify training priorities. Results: We expanded local behavioral health service delivery capacity through subgrants to four agencies, provision of training tailored to licensed and non-licensed providers and development of advisory councils and partnerships with grassroots and government agencies. We also undertook initial efforts to enhance national collaboration around post-disaster resilience. Conclusion: Our partnered processes and lessons learned may be applicable to other communities that aim to promote resilience, as well as planning for and responding to post-disaster behavioral health needs.

  7. Cost Effectiveness of On-site versus Off-site Depression Collaborative Care in Rural Federally Qualified Health Centers

    Science.gov (United States)

    Pyne, Jeffrey M.; Fortney, John C.; Mouden, Sip; Lu, Liya; Hudson, Teresa J; Mittal, Dinesh

    2018-01-01

    Objective Collaborative care for depression is effective and cost-effective in primary care settings. However, there is minimal evidence to inform the choice of on-site versus off-site models. This study examined the cost-effectiveness of on-site practice-based collaborative care (PBCC) versus off-site telemedicine-based collaborative care (TBCC) for depression in Federally Qualified Health Centers (FQHCs). Methods Multi-site randomized pragmatic comparative cost-effectiveness trial. 19,285 patients were screened for depression, 14.8% (n=2,863) screened positive (PHQ9 ≥10) and 364 were enrolled. Telephone interview data were collected at baseline, 6-, 12-, and 18-months. Base case analysis used Arkansas FQHC healthcare costs and secondary analysis used national cost estimates. Effectiveness measures were depression-free days and quality-adjusted life years (QALYs) derived from depression-free days, Medical Outcomes Study SF-12, and Quality of Well Being scale (QWB). Nonparametric bootstrap with replacement methods were used to generate an empirical joint distribution of incremental costs and QALYs and acceptability curves. Results Mean base case FQHC incremental cost-effectiveness ratio (ICER) using depression-free days was $10.78/depression-free day. Mean base case ICERs using QALYs ranged from $14,754/QALY (depression-free day QALY) to $37,261/QALY (QWB QALY). Mean secondary national ICER using depression-free days was $8.43/depression-free day and using QALYs ranged from $11,532/QALY (depression-free day QALY) to $29,234/QALY (QWB QALY). Conclusions These results support the cost-effectiveness of the TBCC intervention in medically underserved primary care settings. Results can inform the decision about whether to insource (make) or outsource (buy) depression care management in the FQHC setting within the current context of Patient-Centered Medical Home, value-based purchasing, and potential bundled payments for depression care. The www.clinicaltrials.gov # for

  8. Cost-utility of collaborative care for major depressive disorder in primary care in the Netherlands.

    Science.gov (United States)

    Goorden, Maartje; Huijbregts, Klaas M L; van Marwijk, Harm W J; Beekman, Aartjan T F; van der Feltz-Cornelis, Christina M; Hakkaart-van Roijen, Leona

    2015-10-01

    Major depression is a great burden on society, as it is associated with high disability/costs. The aim of this study was to evaluate the cost-utility of Collaborative Care (CC) for major depressive disorder compared to Care As Usual (CAU) in a primary health care setting from a societal perspective. A cluster randomized controlled trial was conducted, including 93 patients that were identified by screening (45-CC, 48-CAU). Another 57 patients were identified by the GP (56-CC, 1-CAU). The outcome measures were TiC-P, SF-HQL and EQ-5D, respectively measuring health care utilization, production losses and general health related quality of life at baseline three, six, nine and twelve months. A cost-utility analysis was performed for patients included by screening and a sensitivity analysis was done by also including patients identified by the GP. The average annual total costs was €1131 (95% C.I., €-3158 to €750) lower for CC compared to CAU. The average quality of life years (QALYs) gained was 0.02 (95% C.I., -0.004 to 0.04) higher for CC, so CC was dominant from a societal perspective. Taking a health care perspective, CC was less cost-effective due to higher costs, €1173 (95% C.I., €-216 to €2726), of CC compared to CAU which led to an ICER of 53,717 Euro/QALY. The sensitivity analysis showed dominance of CC. The cost-utility analysis from a societal perspective showed that CC was dominant to CAU. CC may be a promising treatment for depression in the primary care setting. Further research should explore the cost-effectiveness of long-term CC. Netherlands Trial Register ISRCTN15266438. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Impact of Personality Disorder Cluster on Depression Outcomes Within Collaborative Care Management Model of Care.

    Science.gov (United States)

    George, Merit P; Garrison, Gregory M; Merten, Zachary; Heredia, Dagoberto; Gonzales, Cesar; Angstman, Kurt B

    2018-01-01

    Previous studies have suggested that having a comorbid personality disorder (PD) along with major depression is associated with poorer depression outcomes relative to those without comorbid PD. However, few studies have examined the influence of specific PD cluster types. The purpose of the current study is to compare depression outcomes between cluster A, cluster B, and cluster C PD patients treated within a collaborative care management (CCM), relative to CCM patients without a PD diagnosis. The overarching goal was to identify cluster types that might confer a worse clinical prognosis. This retrospective chart review study examined 2826 adult patients with depression enrolled in CCM. The cohort was divided into 4 groups based on the presence of a comorbid PD diagnosis (cluster A/nonspecified, cluster B, cluster C, or no PD). Baseline clinical and demographic variables, along with 6-month follow-up Patient Health Questionnaire-9 (PHQ-9) scores were obtained for all groups. Depression remission was defined as a PHQ-9 score cluster A or nonspecified PD diagnosis, 122 patients (4.3%) had a cluster B diagnosis, 35 patients (1.2%) had a cluster C diagnosis, and 2610 patients (92.4%) did not have any PD diagnosis. The presence of a cluster A/nonspecified PD diagnosis was associated with a 62% lower likelihood of remission at 6 months (AOR = 0.38; 95% CI 0.20-0.70). The presence of a cluster B PD diagnosis was associated with a 71% lower likelihood of remission at 6 months (AOR = 0.29; 95% CI 0.18-0.47). Conversely, having a cluster C diagnosis was not associated with a significantly lower likelihood of remission at 6 months (AOR = 0.83; 95% CI 0.42-1.65). Increased odds of having PDS at 6-month follow-up were seen with cluster A/nonspecified PD patients (AOR = 3.35; 95% CI 1.92-5.84) as well as cluster B patients (AOR = 3.66; 95% CI 2.45-5.47). However, cluster C patents did not have significantly increased odds of experiencing persistent depressive symptoms at 6-month

  10. Improving the quality of depression and pain care in multiple sclerosis using collaborative care: The MS-care trial protocol.

    Science.gov (United States)

    Ehde, Dawn M; Alschuler, Kevin N; Sullivan, Mark D; Molton, Ivan P; Ciol, Marcia A; Bombardier, Charles H; Curran, Mary C; Gertz, Kevin J; Wundes, Annette; Fann, Jesse R

    2018-01-01

    Evidence-based pharmacological and behavioral interventions are often underutilized or inaccessible to persons with multiple sclerosis (MS) who have chronic pain and/or depression. Collaborative care is an evidence-based patient-centered, integrated, system-level approach to improving the quality and outcomes of depression care. We describe the development of and randomized controlled trial testing a novel intervention, MS Care, which uses a collaborative care model to improve the care of depression and chronic pain in a MS specialty care setting. We describe a 16-week randomized controlled trial comparing the MS Care collaborative care intervention to usual care in an outpatient MS specialty center. Eligible participants with chronic pain of at least moderate intensity (≥3/10) and/or major depressive disorder are randomly assigned to MS Care or usual care. MS Care utilizes a care manager to implement and coordinate guideline-based medical and behavioral treatments with the patient, clinic providers, and pain/depression treatment experts. We will compare outcomes at post-treatment and 6-month follow up. We hypothesize that participants randomly assigned to MS Care will demonstrate significantly greater control of both pain and depression at post-treatment (primary endpoint) relative to those assigned to usual care. Secondary analyses will examine quality of care, patient satisfaction, adherence to MS care, and quality of life. Study findings will aid patients, clinicians, healthcare system leaders, and policy makers in making decisions about effective care for pain and depression in MS healthcare systems. (PCORI- IH-1304-6379; clinicaltrials.gov: NCT02137044). This trial is registered at ClinicalTrials.gov, protocol NCT02137044. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model.

    Science.gov (United States)

    Luck, Jeff; Hagigi, Fred; Parker, Louise E; Yano, Elizabeth M; Rubenstein, Lisa V; Kirchner, JoAnn E

    2009-09-28

    Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems.

  12. A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model

    Science.gov (United States)

    2009-01-01

    Abstract Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. PMID:19785754

  13. Evaluation of the effect of collaborative care on depression, anxiety and stress of patients after coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Rezapour Parastoo

    2016-08-01

    Full Text Available Background and Objective: Coronary artery disease and its associated treatment interventions such as angioplasty can lead to emotional problems, including depression, anxiety, and stress, in patients and might have adverse effects on the recovery process. This study aimed to evaluate the effect of collaborative care model on depression, anxiety, and stress in patients after coronary angioplasty. Materials and Methods: This clinical trial was conducted on 50 patients undergoing coronary angioplasty, who were referred to intensive care unit and surgical ward of one of the hospitals of Isfahan, Iran, in 2015. Samples were selected through randomized convenience sampling and were divided into intervention and control group (n=25 for each group. Collaborative care model, consisting of four stages of motivation, preparation, engagement, and evaluation, was implemented for the intervention group through five 45-60 minute sessions and a three-month telephone follow-up. Data was collected using depression, anxiety, and stress scale (DASS-42 before and one month after the intervention from both groups. Data were analyzed using descriptive statistics, Chi-square, as well as independent and paired t-tests in SPSS, version 18. Results: In this study, mean score of depression was significantly decreased in the intervention group after the implementation of collaborative model (from 31.6±3.7 to 6.3±5.03 (P <0.001, and mean anxiety and stress scores were reduced from 32.6±3.04 and 32.2±3.3 to 6.2±4.1 and 8.5±4.8, respectively (P<0.001. In this regard, a significant difference was observed between the intervention and control groups (P<0.001. Conclusion: Implementation of collaborative care could be associated with lower depression, anxiety, and stress in patients after coronary angioplasty. Therefore, its application is recommended as an effective method for such patients.

  14. Cost-effectiveness of collaborative care for the treatment of depressive disorders in primary care: a systematic review.

    Directory of Open Access Journals (Sweden)

    Thomas Grochtdreis

    Full Text Available For the treatment of depressive disorders, the framework of collaborative care has been recommended, which showed improved outcomes in the primary care sector. Yet, an earlier literature review did not find sufficient evidence to draw robust conclusions on the cost-effectiveness of collaborative care.To systematically review studies on the cost-effectiveness of collaborative care, compared with usual care for the treatment of patients with depressive disorders in primary care.A systematic literature search in major databases was conducted. Risk of bias was assessed using the Cochrane Collaboration's tool. Methodological quality of the articles was assessed using the Consensus on Health Economic Criteria (CHEC list. To ensure comparability across studies, cost data were inflated to the year 2012 using country-specific gross domestic product inflation rates, and were adjusted to international dollars using purchasing power parities (PPP.In total, 19 cost-effectiveness analyses were reviewed. The included studies had sample sizes between n = 65 to n = 1,801, and time horizons between six to 24 months. Between 42% and 89% of the CHEC quality criteria were fulfilled, and in only one study no risk of bias was identified. A societal perspective was used by five studies. Incremental costs per depression-free day ranged from dominance to US$PPP 64.89, and incremental costs per QALY from dominance to US$PPP 874,562.Despite our review improved the comparability of study results, cost-effectiveness of collaborative care compared with usual care for the treatment of patients with depressive disorders in primary care is ambiguous depending on willingness to pay. A still considerable uncertainty, due to inconsistent methodological quality and results among included studies, suggests further cost-effectiveness analyses using QALYs as effect measures and a time horizon of at least 1 year.

  15. Creating breakthroughs at 3M.

    Science.gov (United States)

    von Hippel, E; Thomke, S; Sonnack, M

    1999-01-01

    Most senior managers want their product development teams to create break-throughs--new products that will allow their companies to grow rapidly and maintain high margins. But more often they get incremental improvements to existing products. That's partly because companies must compete in the short term. Searching for breakthroughs is expensive and time consuming; line extensions can help the bottom line immediately. In addition, developers simply don't know how to achieve breakthroughs, and there is usually no system in place to guide them. By the mid-1990s, the lack of such a system was a problem even for an innovative company like 3M. Then a project team in 3M's Medical-Surgical Markets Division became acquainted with a method for developing breakthrough products: the lead user process. The process is based on the fact that many commercially important products are initially thought of and even prototyped by "lead users"--companies, organizations, or individuals that are well ahead of market trends. Their needs are so far beyond those of the average user that lead users create innovations on their own that may later contribute to commercially attractive breakthroughs. The lead user process transforms the job of inventing breakthroughs into a systematic task of identifying lead users and learning from them. The authors explain the process and how the 3M project team successfully navigated through it. In the end, the team proposed three major new product lines and a change in the division's strategy that has led to the development of breakthrough products. And now several more divisions are using the process to break away from incrementalism.

  16. A Randomized Trial of Collaborative Care for Perinatal Depression in Socioeconomically Disadvantaged Women: The Impact of Comorbid Posttraumatic Stress Disorder.

    Science.gov (United States)

    Grote, Nancy K; Katon, Wayne J; Russo, Joan E; Lohr, Mary Jane; Curran, Mary; Galvin, Erin; Carson, Kathy

    2016-11-01

    The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus). A multisite randomized controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System, July 2009-January 2014. Pregnant women were recruited who met criteria for a probable diagnosis of major depressive disorder (MDD) on the Patient Health Questionnaire-9 and/or dysthymia on the MINI-International Neuropsychiatric Interview (5.0.0). The primary outcome was depression severity at 3-, 6-, 12-and 18-month follow-ups; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care. Sixty-five percent of the sample of 164 met criteria for probable comorbid PTSD. The treatment effect was significantly associated with PTSD status in a group-by-PTSD severity interaction, controlling for baseline depression severity (Wald χ²₁ = 4.52, P = .03). Over the 18-month follow-up, those with comorbid PTSD in MOMCare (n = 48), versus MSS-Plus (n = 58), showed greater improvement in depression severity (Wald χ²₁ = 8.51, P depression response (Wald χ²₁ = 4.13, P depression care had a greater impact on perinatal depressive outcomes for socioeconomically disadvantaged women with comorbid PTSD than for those without PTSD. Findings suggest that a stepped care treatment model for high-risk pregnant women with both MDD and PTSD could be integrated into public health systems in

  17. Characteristics of effective collaborative care for treatment of depression: a systematic review and meta-regression of 74 randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Peter A Coventry

    Full Text Available Collaborative care is a complex intervention based on chronic disease management models and is effective in the management of depression. However, there is still uncertainty about which components of collaborative care are effective. We used meta-regression to identify factors in collaborative care associated with improvement in patient outcomes (depressive symptoms and the process of care (use of anti-depressant medication.Systematic review with meta-regression. The Cochrane Collaboration Depression, Anxiety and Neurosis Group trials registers were searched from inception to 9th February 2012. An update was run in the CENTRAL trials database on 29th December 2013. Inclusion criteria were: randomised controlled trials of collaborative care for adults ≥18 years with a primary diagnosis of depression or mixed anxiety and depressive disorder. Random effects meta-regression was used to estimate regression coefficients with 95% confidence intervals (CIs between study level covariates and depressive symptoms and relative risk (95% CI and anti-depressant use. The association between anti-depressant use and improvement in depression was also explored. Seventy four trials were identified (85 comparisons, across 21,345 participants. Collaborative care that included psychological interventions predicted improvement in depression (β coefficient -0.11, 95% CI -0.20 to -0.01, p = 0.03. Systematic identification of patients (relative risk 1.43, 95% CI 1.12 to 1.81, p = 0.004 and the presence of a chronic physical condition (relative risk 1.32, 95% CI 1.05 to 1.65, p = 0.02 predicted use of anti-depressant medication.Trials of collaborative care that included psychological treatment, with or without anti-depressant medication, appeared to improve depression more than those without psychological treatment. Trials that used systematic methods to identify patients with depression and also trials that included patients with a chronic physical

  18. A stepped-wedge evaluation of an initiative to spread the collaborative care model for depression in primary care.

    Science.gov (United States)

    Solberg, Leif I; Crain, A Lauren; Maciosek, Michael V; Unützer, Jürgen; Ohnsorg, Kris A; Beck, Arne; Rubenstein, Lisa; Whitebird, Robin R; Rossom, Rebecca C; Pietruszewski, Pamela B; Crabtree, Benjamin F; Joslyn, Kenneth; Van de Ven, Andrew; Glasgow, Russell E

    2015-09-01

    Scale-up and spread of evidence-based practices is one of the most important challenges facing health care. We tested whether a statewide initiative, Depression Improvement Across Minnesota-Offering a New Direction (DIAMOND), to implement the collaborative care model for depression in 75 primary care clinics resulted in patient outcome improvements corresponding to those reported in randomized controlled trials. Health plans provided a new monthly payment to participating clinics after a 6-month intensive training program with ongoing data submission, networking, and consultation. Implementation was staggered, with 5 sequences of 10 to 40 clinics every 6 months. Payers provided weekly contact information for members from participating clinics who were filling antidepressant prescriptions, and we conducted baseline and 6-month surveys of 1,578 patients about their care and outcomes. There were 466 patients in DIAMOND clinics who received usual care before implementation (UCB), 559 who received usual care in DIAMOND clinics after implementation (UCA), 245 who received DIAMOND care after implementation (DCA), and 308 who received usual care in comparison clinics (UC). Patients who received DIAMOND care after implementation reported more collaborative care depression services than the 3 comparison groups (10.9 vs 6.4-6.7, on a scale of 0 of 14, where higher numbers indicate more services; P <.001) and more satisfaction with their care (4.0 vs 3.4 on a scale 1 to 5, in which higher scores indicate higher satisfaction; P ≤.001). Depression remission rates, however, were not significantly different among the 4 groups (36.4% DCA vs 35.8% UCB, 35.0% UCA, 33.9% UC; P = .94). Despite the incentive of a supporting payment change and intensive training and support for clinics volunteering to participate, no difference in depression outcomes was documented. Specific unmeasured actions present in trials but not present in these clinics may be critical for successful outcome

  19. Symptom specificity in the acute treatment of Major Depressive Disorder: a re-analysis of the treatment of depression collaborative research program.

    Science.gov (United States)

    Stewart, Jeremy G; Harkness, Kate L

    2012-03-01

    Antidepressant medications, Cognitive-Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are equally efficacious in the acute treatment of Major Depressive Disorder (MDD). Nevertheless, remission rates remain unacceptably low. Examining the differential time course of remission of specific symptom clusters across treatments may provide a basis for assigning patients to treatments that have the highest chance of being effective. This study re-analyzed data from the NIMH Treatment of Depression Collaborative Research Project (TDCRP), which included 250 adult outpatients with MDD randomized to 16 weeks of CBT, IPT, imipramine+clinical management (IMI-CM), or pill placebo (PLA-CM). We derived four symptom factors from the 23-item Hamilton Depression Rating Scale, and three symptom factors from the Beck Depression Inventory. Within-subject hierarchical regression models were specified to examine the linear and quadratic patterns of symptom remission over five assessment points. IMI-CM produced a more rapid rate of remission than CBT or IPT for both the somatic/vegetative and cognitive-affective symptoms of MDD. There were no statistically significant differences in the rates of improvement of any of the symptom factors between the IMI-CM and PLA-CM groups. Some core symptoms of depression were excluded due to low factor loadings. Past research has argued that the CBT arm in the TDCRP may have been weak. We failed to find evidence that treatments act preferentially on specific symptom clusters. Therefore, the symptoms of MDD may be inter-dependent when it comes to their courses of remission in treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. [Major breakthroughs in the medical treatment

    DEFF Research Database (Denmark)

    Kirk, O.; Gerstoft, J.; Lundgren, J.D.

    2009-01-01

    The introduction of antiretroviral combination therapy for patients with HIV infection is described as an example of a breakthrough within the field of medical treatment. The background for the breakthrough and the phases thereof are described and for comparison, the circumstances of major breakt...... breakthroughs within other medical specialities are mentioned Udgivelsesdato: 2009/3/2......The introduction of antiretroviral combination therapy for patients with HIV infection is described as an example of a breakthrough within the field of medical treatment. The background for the breakthrough and the phases thereof are described and for comparison, the circumstances of major...

  1. Aostra claims major oilsands breakthrough

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    This paper reports that Alberta Oil Sands Technology and Research Authority (Aostra) has completed a horizontal well in-situ steam injection project it calls a major breakthrough in commercially producing bitumen from the bast Athabasca oilsands deposit in Alberta. Aostra the its $71 million (Canadian) proof of concept pilot underground test facility (UTF) near Fort McMurray, achieved a 60% bitumen recovery rate, compared with less than 20% recovery typically achieved with Alberta bitumen. More than 100,000 bbl of bitumen was produced during the project

  2. A target-driven collaborative care model for Major Depressive Disorder is effective in primary care in the Netherlands. A randomized clinical trial from the depression initiative.

    Science.gov (United States)

    Huijbregts, Klaas M L; de Jong, Fransina J; van Marwijk, Harm W J; Beekman, Aartjan T F; Adèr, Herman J; Hakkaart-van Roijen, Leona; Unützer, Jürgen; van der Feltz-Cornelis, Christina M

    2013-04-25

    Practice variation in the primary care treatment of depression may be considerable in the Netherlands, due to relatively small and unregulated practices. We adapted the collaborative care model for the treatment of Major Depressive Disorder (MDD) to accommodate existing practice variation and tested whether this had added value over Care as Usual (CAU). A cluster randomized controlled trial was conducted to compare an adapted target driven collaborative care model with Care as Usual (CAU). Randomization was at the level of 18 (sub)urban primary care centers. The care manager and GP were supported by a web-based tracking and decision aid system that advised targeted treatment actions to achieve rapid response and if possible remission, and that warned the consultant psychiatrist if such treatment advice was not followed up. Eligible patients had a score of 10 or higher on the PHQ9, and met diagnostic criteria for major depression at the subsequent MINI Neuropsychiatric interview. A total of 93 patients were identified by screening. They received either collaborative care (CC) or CAU. Another 56 patients received collaborative care after identification by the GP. The outcome measures were response to treatment (50% or greater reduction of the PHQ9-total score from baseline) at three, six, nine and twelve months, and remission (a score of 0-4 on the PHQ9 at follow-up). Treatment response and remission in CAU were low. Collaborative care was more effective on achieving treatment response than CAU at three months for the total group of patients who received collaborative care [OR 5.2 ((1.41-16.09), NNT 2] and at nine months [OR 5.6 ((1.40-22.58)), NNT 3]. The effect was not statistically significant at 6 and 12 months. A relatively high percentage of patients (36.5%) did not return one or more follow-up questionnaires. There was no evidence for selective non response. Our adapted target driven CC was considerably more effective than CAU for MDD in primary care in the

  3. Depression

    Science.gov (United States)

    ... in the winter. Depression is one part of bipolar disorder. There are effective treatments for depression, including antidepressants, talk therapy, or both. NIH: National Institute of Mental Health

  4. Recurring Utterances - Targeting a Breakthrough

    Directory of Open Access Journals (Sweden)

    Jacqueline Stark

    2014-05-01

    The most interesting phenomenon is KB’s production of words from former sessions indicating that they are still ‘active’ and the production of completely novel incorrect words. The observable features indicate that immediate auditory processing is possible in the form of repeating target words. However, as soon as KB must retrieve information from the (semantic lexicon, even after being able to correctly ‘repeat’ the target word several times, he responds with a RU, perseveration, or paraphasia. Several of his productions can be characterized as aphasic confabulations which stem from a memory gap. Thus, although KB’s language impairment is severe, his responses across time indicate that step-by-step a breakthrough is being made.

  5. Depression

    Science.gov (United States)

    ... reasons why a woman may have depression: Family history . Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression. Brain changes. The brains of people ...

  6. Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Beekman Aartjan TF

    2007-02-01

    Full Text Available Abstract Background Depressive disorder is one of the most common disorders, and is highly prevalent in chronically ill patients. The presence of comorbid depression has a negative influence on quality of life, health care costs, self-care, morbidity, and mortality. Early diagnosis and well-organized treatment of depression has a positive influence on these aspects. Earlier research in the USA has reported good results with regard to the treatment of depression with a collaborative care approach and an antidepressant algorithm. In the UK 'Problem Solving Treatment' has proved to be feasible. However, in the general hospital setting this approach has not yet been evaluated. Methods/Design CC: DIM (Collaborative Care: Depression Initiative in the Medical setting is a two-armed randomised controlled trial with randomisation at patient level. The aim of the trial is to evaluate the treatment of depressive disorder in general hospitals in the Netherlands based on a collaborative care framework, including contracting, 'Problem Solving Treatment', antidepressant algorithm, and manual-guided self-help. 126 outpatients with diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular diseases will be randomised to either the intervention group or the control group. Patients will be included if they have been diagnosed with moderate to severe depression, based on the DSM-IV criteria in a two-step screening method. The intervention group will receive treatment based on the collaborative care approach; the control group will receive 'care as usual'. Baseline and follow-up measurements (after 3, 6, 9, and 12 months will be performed by means of questionnaires. The primary outcome measure is severity of depressive symptoms, as measured with the PHQ-9. The secondary outcome measure is the cost-effectiveness of these treatments according to the TiC-P, the EuroQol and the SF-36. Discussion Earlier research has indicated that depressive disorder is

  7. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

    The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued......, that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression...

  8. Depressants

    Science.gov (United States)

    ... For Teens / Depressants Print en español Depresores del sistema nervioso What They Are: Tranquilizers and other depressants ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  9. Depression

    DEFF Research Database (Denmark)

    Cizza, G; Ravn, Pernille; Chrousos, G P

    2001-01-01

    Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Nevertheless, these studies reveal...... a strong association between depression and osteoporosis. Endocrine factors such as depression-induced hypersecretion of corticotropin-releasing hormone and hypercortisolism, hypogonadism, growth hormone deficiency and increased concentration of circulating interleukin 6, might play a crucial role...... in the bone loss observed in subjects suffering from major depression....

  10. Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

    Science.gov (United States)

    Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

    2013-09-20

    Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about

  11. Tsetse Fly Genome Breakthrough Brings Hope for African Farmers

    International Nuclear Information System (INIS)

    2014-01-01

    Scientists have cracked the genetic code of the bloodsucking tsetse fly, prompting hope that the breakthrough will help future efforts to control one of the most devastating livestock diseases in sub-Saharan Africa spread by the insect. The tsetse genome was sequenced and annotated during a 10-year international collaborative effort that involved the Insect Pest Control Laboratory run jointly by the United Nations Food and Agriculture Organization (FAO) and the International Atomic Energy Agency (IAEA) in Vienna. The achievement allows scientists to better study the fly's genes and their functions, knowledge that should open the door for researching ways to control the insect

  12. Remote Collaborative Depression Care Program for Adolescents in Araucanía Region, Chile: Randomized Controlled Trial

    Science.gov (United States)

    Martínez, Pablo; Zitko, Pedro; Irarrázaval, Matías; Luttges, Carolina; Araya, Ricardo

    2018-01-01

    Background Despite evidence on efficacious interventions, a great proportion of depressed adolescents do not receive evidence-based treatment and have no access to specialized mental health care. Remote collaborative depression care (RCDC) may help to reduce the gap between needs and specialized mental health services. Objective The objective of this study was to assess the feasibility, acceptability, and effectiveness of an RCDC intervention for adolescents with major depressive disorder (MDD) living in the Araucanía Region, Chile. Methods A cluster randomized, assessor-blind trial was carried out at 16 primary care centers in the Araucanía Region, Chile. Before randomization, all participating primary care teams were trained in clinical guidelines for the treatment of adolescent depression. Adolescents (N=143; 13-19 years) with MDD were recruited. The intervention group (RCDC, N=65) received a 3-month RCDC treatment that included continuous remote supervision by psychiatrists located in Santiago, Chile’s capital city, through shared electronic health records (SEHR) and phone patient monitoring. The control group (enhanced usual care or EUC; N=78) received EUC by clinicians who were encouraged to follow clinical guidelines. Recruitment and response rates and the use of the SEHR system were registered; patient adherence and satisfaction with the treatment and clinician satisfaction with RCDC were assessed at 12-week follow-up; and depressive symptoms and health-related quality of life (HRQoL) were evaluated at baseline and 12-weeks follow-up. Results More than 60.3% (143/237) of the original estimated sample size was recruited, and a response rate of 90.9% (130/143) was achieved at 12-week follow-up. A mean (SD) of 3.5 (4.0) messages per patient were written on the SEHR system by primary care teams. A third of the patients showed an optimal adherence to psychopharmacological treatment, and adolescents in the RCDC intervention group were more satisfied with

  13. [Breakthrough cancer pain in the elderly].

    Science.gov (United States)

    Cabezón-Gutiérrez, Luis; Viloria-Jiménez, María Aurora; Pérez-Cajaraville, Juan; Álamo-González, Cecilio; López-Trigo, José Antonio; Gil-Gregorio, Pedro

    Breakthrough pain is defined as an acute exacerbation of pain with rapid onset, short duration and moderate or high intensity, which occurs spontaneously or in connection with a predictable or unpredictable event despite there being stabilised and controlled baseline pain. However, there are doubts about the definition, terminology, epidemiology, and assessment of breakthrough pain, with no clear answers or consensus, especially in the elderly population. This non-systematic review summarises the most important aspects of breakthrough pain in the elderly, based on the limited publications there are in that population group. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Depression

    DEFF Research Database (Denmark)

    Pouwer, Frans

    2017-01-01

    There is ample evidence that depression is000  a common comorbid health issue in people with type 1 or type 2 diabetes. Reviews have also concluded that depression in diabetes is associated with higher HbA1c levels, less optimal self-care behaviours, lower quality of life, incident vascular...... complications and higher mortality rates. However, longitudinal studies into the course of depression in people with type 1 diabetes remain scarce. In this issue of Diabetologia, Kampling and colleagues (doi: 10.1007/s00125-016-4123-0 ) report the 5 year trajectories of depression in adults with newly diagnosed...... type 1 diabetes (mean age, 28 years). Their baseline results showed that shortly after the diagnosis of type 1 diabetes a major depressive episode was diagnosed in approximately 6% of participants, while 8% suffered from an anxiety disorder. The longitudinal depression data showed that, in a 5 year...

  15. Innovation Impact: Breakthrough Research Results (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2013-07-01

    The Innovation Impact brochure captures key breakthrough results across NREL's primary areas of renewable energy and energy efficiency research: solar, wind, bioenergy, transportation, buildings, analysis, and manufacturing technologies.

  16. The Breakthrough Behind the Chevy Volt Battery

    Science.gov (United States)

    Lerner, Louise

    2011-03-28

    A revolutionary breakthrough cathode for lithium-ion batteries—the kind in your cell phone, laptop and new hybrid cars—makes them last longer, run more safely and perform better than batteries currently on the market.

  17. Researchers Realize Major Breakthrough in Understanding Endometriosis

    Science.gov (United States)

    ... 16, 2014 Researchers Realize Major Breakthrough in Understanding Endometriosis For a disease that affects an estimated 6 ... 10% of women, surprisingly little is known about endometriosis — a disorder that causes uterine tissue to grow ...

  18. The new ABCs of research: achieving breakthrough collaborations

    National Research Council Canada - National Science Library

    Shneiderman, Ben

    2016-01-01

    ..., they can produce the advances that will enhance the lives of many people. These inspirational research leaders will break free from traditional thinking, disciplinary boundaries, and narrow aspirations...

  19. Cost-Effectiveness of a Collaborative Care Depression and Anxiety Treatment Program in Patients with Acute Cardiac Illness.

    Science.gov (United States)

    Celano, Christopher M; Healy, Brian; Suarez, Laura; Levy, Douglas E; Mastromauro, Carol; Januzzi, James L; Huffman, Jeff C

    2016-01-01

    To use data from a randomized trial to determine the cost-effectiveness of a collaborative care (CC) depression and anxiety treatment program and to assess effects of the CC program on health care utilization. The CC intervention's impact on health-related quality of life, depression-free days (DFDs), and anxiety-free days (AFDs) over the 24-week postdischarge period was calculated and compared with the enhanced usual care (EUC) condition using independent samples t tests and random-effects regression models. Costs for both the CC and EUC conditions were calculated on the basis of staff time, overhead expenses, and treatment materials. Using this information, incremental cost-effectiveness ratios were calculated. A cost-effectiveness acceptability plot was created using nonparametric bootstrapping with 10,000 replications, and the likelihood of the CC intervention's cost-effectiveness was assessed using standard cutoffs. As a secondary analysis, we determined whether the CC intervention led to reductions in postdischarge health care utilization and costs. The CC intervention was more costly than the EUC intervention ($209.86 vs. $34.59; z = -11.71; P < 0.001), but was associated with significantly greater increases in quality-adjusted life-years (t = -2.49; P = 0.01) and DFDs (t = -2.13; P = 0.03), but not AFDs (t = -1.92; P = 0.057). This translated into an incremental cost-effectiveness ratio of $3337.06 per quality-adjusted life-year saved, $13.36 per DFD, and $13.74 per AFD. Compared with the EUC intervention, the CC intervention was also associated with fewer emergency department visits but no differences in overall costs. This CC intervention was associated with clinically relevant improvements, was cost-effective, and was associated with fewer emergency department visits in the 24 weeks after discharge. Copyright © 2016. Published by Elsevier Inc.

  20. Depression

    DEFF Research Database (Denmark)

    Johansen, Jon O. J.

    2013-01-01

    Nyhederne er fulde af historier om depression. Overskrifter som: ’Danskerne propper sig med lykkepiller’ eller ‘depression er stadigvæk tabu’ går tit igen i dagspressen. Men hvor er nuancerne, og hvorfor gider vi læse de samme historier igen og igen? Måske er det fordi, vores egne forestillinger er...

  1. How to revive breakthrough innovation in the pharmaceutical industry.

    Science.gov (United States)

    Munos, Bernard H; Chin, William W

    2011-06-29

    Over the past 20 years, pharmaceutical companies have implemented conservative management practices to improve the predictability of therapeutics discovery and success rates of drug candidates. This approach has often yielded compounds that are only marginally better than existing therapies, yet require larger, longer, and more complex trials. To fund them, companies have shifted resources away from drug discovery to late clinical development; this has hurt innovation and amplified the crisis brought by the expiration of patents on many best-selling drugs. Here, we argue that more breakthrough therapeutics will reach patients only if the industry ceases to pursue "safe" incremental innovation, re-engages in high-risk discovery research, and adopts collaborative innovation models that allow sharing of knowledge and costs among collaborators.

  2. The Clinical Research Center for Depression Study: Baseline Characteristics of a Korean Long-Term Hospital-Based Observational Collaborative Prospective Cohort Study

    Science.gov (United States)

    Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo

    2011-01-01

    Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Social and Occupational Functioning Assessment Scale, Beck Depression Inventory-Second Edition, Scale for Suicide Ideation, and World Health Organization Quality of Life assessment instruments-abbreviated version. Also, personal histories of medical and psychiatric illnesses and the range of socio-epidemiologic and clinical data were collected from each participant. Results One thousand one hundred eighty three participants were recruited from 18 hospitals. The mean age of the participants was 47.9±15.9 year-old, 74.4% were female, 82.9% had been diagnosed of major depressive disorder, 40.9% were experiencing their first depressive episode, and 21.4% had a past history of suicide attempts. The majority (85.3%) of the participants were moderately to severely ill. The average HDRS-17 was 19.8±6.1. Significant gender differences at baseline were shown in age, education, marriage, employment, religion, and first depressive episode. Conclusion The baseline findings in the CRESCEND study showed some different characteristics of depression in Korea, suggesting a possibility of ethnic and cultural factors in depression. PMID:21519530

  3. CASPER plus (CollAborative care in Screen-Positive EldeRs with major depressive disorder): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Overend, Karen; Lewis, Helen; Bailey, Della; Bosanquet, Kate; Chew-Graham, Carolyn; Ekers, David; Gascoyne, Samantha; Hems, Deborah; Holmes, John; Keding, Ada; McMillan, Dean; Meer, Shaista; Meredith, Jodi; Mitchell, Natasha; Nutbrown, Sarah; Parrott, Steve; Richards, David; Traviss, Gemma; Trépel, Dominic; Woodhouse, Rebecca; Gilbody, Simon

    2014-11-19

    Depression accounts for the greatest disease burden of all mental health disorders, contributes heavily to healthcare costs, and by 2020 is set to become the second largest cause of global disability. Although 10% to 16% of people aged 65 years and over are likely to experience depressive symptoms, the condition is under-diagnosed and often inadequately treated in primary care. Later-life depression is associated with chronic illness and disability, cognitive impairment and social isolation. With a progressively ageing population it becomes increasingly important to refine strategies to identity and manage depression in older people. Currently, management may be limited to the prescription of antidepressants where there may be poor concordance; older people may lack awareness of psychosocial interventions and general practitioners may neglect to offer this treatment option. CASPER Plus is a multi-centre, randomised controlled trial of a collaborative care intervention for individuals aged 65 years and over experiencing moderate to severe depression. Selected practices in the North of England identify potentially eligible patients and invite them to participate in the study. A diagnostic interview is carried out and participants with major depressive disorder are randomised to either collaborative care or usual care. The recruitment target is 450 participants. The intervention, behavioural activation and medication management in a collaborative care framework, has been adapted to meet the complex needs of older people. It is delivered over eight to 10 weekly sessions by a case manager liaising with general practitioners. The trial aims to evaluate the clinical and cost effectiveness of collaborative care in addition to usual GP care versus usual GP care alone. The primary clinical outcome, depression severity, will be measured with the Patient Health Questionnaire-9 (PHQ-9) at baseline, 4, 12 and 18 months. Cost effectiveness analysis will assess health

  4. Creative Management as a Strategy for Breakthrough Innovation. Lessons from Basic Research Projects of Japanese Companies.

    Science.gov (United States)

    Lee, K. T.

    1997-01-01

    Japanese science/technology policies emphasize creative research management for strengthening breakthrough innovation. Key lessons include the following: cultivation of creative researchers, clear strategic directions, systematic teamwork and collaboration, focus on strategic industrial relevance, balance between autonomy and control, and the need…

  5. Cost-effectiveness of collaborative care including PST and an antidepressant treatment algorithm for the treatment of major depressive disorder in primary care; a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Beekman Aartjan TF

    2007-03-01

    Full Text Available Abstract Background Depressive disorder is currently one of the most burdensome disorders worldwide. Evidence-based treatments for depressive disorder are already available, but these are used insufficiently, and with less positive results than possible. Earlier research in the USA has shown good results in the treatment of depressive disorder based on a collaborative care approach with Problem Solving Treatment and an antidepressant treatment algorithm, and research in the UK has also shown good results with Problem Solving Treatment. These treatment strategies may also work very well in the Netherlands too, even though health care systems differ between countries. Methods/design This study is a two-armed randomised clinical trial, with randomization on patient-level. The aim of the trial is to evaluate the treatment of depressive disorder in primary care in the Netherlands by means of an adapted collaborative care framework, including contracting and adherence-improving strategies, combined with Problem Solving Treatment and antidepressant medication according to a treatment algorithm. Forty general practices will be randomised to either the intervention group or the control group. Included will be patients who are diagnosed with moderate to severe depression, based on DSM-IV criteria, and stratified according to comorbid chronic physical illness. Patients in the intervention group will receive treatment based on the collaborative care approach, and patients in the control group will receive care as usual. Baseline measurements and follow up measures (3, 6, 9 and 12 months are assessed using questionnaires and an interview. The primary outcome measure is severity of depressive symptoms, according to the PHQ9. Secondary outcome measures are remission as measured with the PHQ9 and the IDS-SR, and cost-effectiveness measured with the TiC-P, the EQ-5D and the SF-36. Discussion In this study, an American model to enhance care for patients with a

  6. CollAborative care for Screen-Positive EldeRs with major depression (CASPER plus): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness.

    Science.gov (United States)

    Bosanquet, Katharine; Adamson, Joy; Atherton, Katie; Bailey, Della; Baxter, Catherine; Beresford-Dent, Jules; Birtwistle, Jacqueline; Chew-Graham, Carolyn; Clare, Emily; Delgadillo, Jaime; Ekers, David; Foster, Deborah; Gabe, Rhian; Gascoyne, Samantha; Haley, Lesley; Hamilton, Jahnese; Hargate, Rebecca; Hewitt, Catherine; Holmes, John; Keding, Ada; Lewis, Helen; McMillan, Dean; Meer, Shaista; Mitchell, Natasha; Nutbrown, Sarah; Overend, Karen; Parrott, Steve; Pervin, Jodi; Richards, David A; Spilsbury, Karen; Torgerson, David; Traviss-Turner, Gemma; Trépel, Dominic; Woodhouse, Rebecca; Gilbody, Simon

    2017-11-01

    Depression in older adults is common and is associated with poor quality of life, increased morbidity and early mortality, and increased health and social care use. Collaborative care, a low-intensity intervention for depression that is shown to be effective in working-age adults, has not yet been evaluated in older people with depression who are managed in UK primary care. The CollAborative care for Screen-Positive EldeRs (CASPER) plus trial fills the evidence gap identified by the most recent guidelines on depression management. To establish the clinical effectiveness and cost-effectiveness of collaborative care for older adults with major depressive disorder in primary care. A pragmatic, multicentred, two-arm, parallel, individually randomised controlled trial with embedded qualitative study. Participants were automatically randomised by computer, by the York Trials Unit Randomisation Service, on a 1 : 1 basis using simple unstratified randomisation after informed consent and baseline measures were collected. Blinding was not possible. Sixty-nine general practices in the north of England. A total of 485 participants aged ≥ 65 years with major depressive disorder. A low-intensity intervention of collaborative care, including behavioural activation, delivered by a case manager for an average of six sessions over 7-8 weeks, alongside usual general practitioner (GP) care. The control arm received only usual GP care. The primary outcome measure was Patient Health Questionnaire-9 items score at 4 months post randomisation. Secondary outcome measures included depression severity and caseness at 12 and 18 months, the EuroQol-5 Dimensions, Short Form questionnaire-12 items, Patient Health Questionnaire-15 items, Generalised Anxiety Disorder-7 items, Connor-Davidson Resilience Scale-2 items, a medication questionnaire, objective data and adverse events. Participants were followed up at 12 and 18 months. In total, 485 participants were randomised (collaborative

  7. Rapid learning: a breakthrough agenda.

    Science.gov (United States)

    Etheredge, Lynn M

    2014-07-01

    A "rapid-learning health system" was proposed in a 2007 thematic issue of Health Affairs. The system was envisioned as one that uses evidence-based medicine to quickly determine the best possible treatments for patients. It does so by drawing on electronic health records and the power of big data to access large volumes of information from a variety of sources at high speed. The foundation for a rapid-learning health system was laid during 2007-13 by workshops, policy papers, large public investments in databases and research programs, and developing learning systems. Challenges now include implementing a new clinical research system with several hundred million patients, modernizing clinical trials and registries, devising and funding research on national priorities, and analyzing genetic and other factors that influence diseases and responses to treatment. Next steps also should aim to improve comparative effectiveness research; build on investments in health information technology to standardize handling of genetic information and support information exchange through apps and software modules; and develop new tools, data, and information for clinical decision support. Further advances will require commitment, leadership, and public-private and global collaboration. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Controlled trial of a collaborative primary care team model for patients with diabetes and depression: Rationale and design for a comprehensive evaluation

    Directory of Open Access Journals (Sweden)

    Johnson Jeffrey A

    2012-08-01

    Full Text Available Abstract Background When depression accompanies diabetes, it complicates treatment, portends worse outcomes and increases health care costs. A collaborative care case-management model, previously tested in an urban managed care organization in the US, achieved significant reduction of depressive symptoms, improved diabetes disease control and patient-reported outcomes, and saved money. While impressive, these findings need to be replicated and extended to other healthcare settings. Our objective is to comprehensively evaluate a collaborative care model for comorbid depression and type 2 diabetes within a Canadian primary care setting. Methods/design We initiated the TeamCare model in four Primary Care Networks in Northern Alberta. The intervention involves a nurse care manager guiding patient-centered care with family physicians and consultant physician specialists to monitor progress and develop tailored care plans. Patients eligible for the intervention will be identified using the Patient Health Questionnaire-9 as a screen for depressive symptoms. Care managers will then guide patients through three phases: 1 improving depressive symptoms, 2 improving blood glucose, blood pressure and cholesterol, and 3 improving lifestyle behaviors. We will employ the RE-AIM framework for a comprehensive and mixed-methods approach to our evaluation. Effectiveness will be assessed using a controlled “on-off” trial design, whereby eligible patients would be alternately enrolled in the TeamCare intervention or usual care on a monthly basis. All patients will be assessed at baseline, 6 and 12 months. Our primary analyses will be based on changes in two outcomes: depressive symptoms, and a multivariable, scaled marginal model for the combined outcome of global disease control (i.e., A1c, systolic blood pressure, LDL cholesterol. Our planned enrolment of 168 patients will provide greater than 80% power to observe clinically important improvements in all

  9. Flipped Instruction: Breakthroughs in Research and Practice

    Science.gov (United States)

    IGI Global, 2017

    2017-01-01

    The integration of technology into modern classrooms has enhanced learning opportunities for students. With increased access to educational content, students gain a better understanding of the concepts being taught. "Flipped Instruction: Breakthroughs in Research and Practice" is a comprehensive reference source for the latest scholarly…

  10. Exploring the Market for Breakthrough Technologies

    NARCIS (Netherlands)

    Ortt, J. Roland; Langley, David J.; Pals, Nico

    In this article, the gap between futures research (long term) and market research (short term) is closed in two ways. Firstly, by describing methods of market exploration that can be used earlier on in the process of development and diffusion of breakthrough technologies, so market research can be

  11. Exploring the Market for Breakthrough Technologies

    NARCIS (Netherlands)

    Ortt, J. Roland; Langley, David J.; Pals, Nico

    2007-01-01

    In this article, the gap between futures research (long term) and market research (short term) is closed in two ways. Firstly, by describing methods of market exploration that can be used earlier on in the process of development and diffusion of breakthrough technologies, so market research can be

  12. The Breakthrough Listen Search for Intelligent Life

    Science.gov (United States)

    Croft, Steve; Siemion, Andrew; De Boer, David; Enriquez, J. Emilio; Foster, Griffin; Gajjar, Vishal; Hellbourg, Greg; Hickish, Jack; Isaacson, Howard; Lebofsky, Matt; MacMahon, David; Price, Daniel; Werthimer, Dan

    2018-01-01

    The $100M, 10-year philanthropic "Breakthrough Listen" project is driving an unprecedented expansion of the search for intelligent life beyond Earth. Modern instruments allow ever larger regions of parameter space (luminosity function, duty cycle, beaming fraction, frequency coverage) to be explored, which is enabling us to place meaningful physical limits on the prevalence of transmitting civilizations. Data volumes are huge, and preclude long-term storage of the raw data products, so real-time and machine learning processing techniques must be employed to identify candidate signals as well as simultaneously classifying interfering sources. However, the Galaxy is now known to be a target-rich environment, teeming with habitable planets.Data from Breakthrough Listen can also be used by researchers in other areas of astronomy to study pulsars, fast radio bursts, and a range of other science targets. Breakthrough Listen is already underway in the optical and radio bands, and is also engaging with facilities across the world, including Square Kilometer Array precursors and pathfinders. I will give an overview of the technology, science goals, data products, and roadmap of Breakthrough Listen, as we attempt to answer one of humanity's oldest questions: Are we alone?

  13. Evaluating Nanoparticle Breakthrough during Drinking Water Treatment

    Science.gov (United States)

    Chalew, Talia E. Abbott; Ajmani, Gaurav S.; Huang, Haiou

    2013-01-01

    Background: Use of engineered nanoparticles (NPs) in consumer products is resulting in NPs in drinking water sources. Subsequent NP breakthrough into treated drinking water is a potential exposure route and human health threat. Objectives: In this study we investigated the breakthrough of common NPs—silver (Ag), titanium dioxide (TiO2), and zinc oxide (ZnO)—into finished drinking water following conventional and advanced treatment. Methods: NPs were spiked into five experimental waters: groundwater, surface water, synthetic freshwater, synthetic freshwater containing natural organic matter, and tertiary wastewater effluent. Bench-scale coagulation/flocculation/sedimentation simulated conventional treatment, and microfiltration (MF) and ultrafiltration (UF) simulated advanced treatment. We monitored breakthrough of NPs into treated water by turbidity removal and inductively coupled plasma–mass spectrometry (ICP-MS). Results: Conventional treatment resulted in 2–20%, 3–8%, and 48–99% of Ag, TiO2, and ZnO NPs, respectively, or their dissolved ions remaining in finished water. Breakthrough following MF was 1–45% for Ag, 0–44% for TiO2, and 36–83% for ZnO. With UF, NP breakthrough was 0–2%, 0–4%, and 2–96% for Ag, TiO2, and ZnO, respectively. Variability was dependent on NP stability, with less breakthrough of aggregated NPs compared with stable NPs and dissolved NP ions. Conclusions: Although a majority of aggregated or stable NPs were removed by simulated conventional and advanced treatment, NP metals were detectable in finished water. As environmental NP concentrations increase, we need to consider NPs as emerging drinking water contaminants and determine appropriate drinking water treatment processes to fully remove NPs in order to reduce their potential harmful health outcomes. Citation: Abbott Chalew TE, Ajmani GS, Huang H, Schwab KJ. 2013. Evaluating nanoparticle breakthrough during drinking water treatment. Environ Health Perspect 121

  14. What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model

    Directory of Open Access Journals (Sweden)

    Lankshear Annette J

    2010-02-01

    Full Text Available Abstract Background There is a considerable evidence base for 'collaborative care' as a method to improve quality of care for depression, but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model (NPM to inform the process of implementation of collaborative care in both a future full-scale trial, and the wider health economy. Methods Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression. Results Findings are presented as they relate to the four factors of the NPM (interactional workability, relational integration, skill-set workability, and contextual integration and a number of necessary tasks are identified. Using the model, it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However, additional insights were gained from the post-trial interview participants who, unlike those interviewed before the trial, had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so. Conclusions The NPM provides a useful structure for both guiding and analysing the process by which an intervention is optimized for testing in a larger scale trial or for subsequent full-scale implementation.

  15. What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model.

    Science.gov (United States)

    Gask, Linda; Bower, Peter; Lovell, Karina; Escott, Diane; Archer, Janine; Gilbody, Simon; Lankshear, Annette J; Simpson, Angela E; Richards, David A

    2010-02-10

    There is a considerable evidence base for 'collaborative care' as a method to improve quality of care for depression, but an acknowledged gap between efficacy and implementation. This study utilises the Normalisation Process Model (NPM) to inform the process of implementation of collaborative care in both a future full-scale trial, and the wider health economy. Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression. Findings are presented as they relate to the four factors of the NPM (interactional workability, relational integration, skill-set workability, and contextual integration) and a number of necessary tasks are identified. Using the model, it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However, additional insights were gained from the post-trial interview participants who, unlike those interviewed before the trial, had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so. The NPM provides a useful structure for both guiding and analysing the process by which an intervention is optimized for testing in a larger scale trial or for subsequent full-scale implementation.

  16. The TrueBlue study: Is practice nurse-led collaborative care effective in the management of depression for patients with heart disease or diabetes?

    Directory of Open Access Journals (Sweden)

    Coates Michael

    2009-06-01

    Full Text Available Abstract Background In the presence of type 2 diabetes (T2DM or coronary heart disease (CHD, depression is under diagnosed and under treated despite being associated with worse clinical outcomes. Our earlier pilot study demonstrated that it was feasible, acceptable and affordable for practice nurses to extend their role to include screening for and monitoring of depression alongside biological and lifestyle risk factors. The current study will compare the clinical outcomes of our model of practice nurse-led collaborative care with usual care for patients with depression and T2DM or CHD. Methods This is a cluster-randomised intervention trial. Eighteen general practices from regional and metropolitan areas agreed to join this study, and were allocated randomly to an intervention or control group. We aim to recruit 50 patients with co-morbid depression and diabetes or heart disease from each of these practices. In the intervention group, practice nurses (PNs will be trained for their enhanced roles in this nurse-led collaborative care study. Patients will be invited to attend a practice nurse consultation every 3 months prior to seeing their usual general practitioner. The PN will assess psychological, physiological and lifestyle parameters then work with the patient to set management goals. The outcome of this assessment will form the basis of a GP Management Plan document. In the control group, the patients will continue to receive their usual care for the first six months of the study before the PNs undergo the training and switch to the intervention protocol. The primary clinical outcome will be a reduction in the depression score. The study will also measure the impact on physiological measures, quality of life and on patient attitude to health care delivered by practice nurses. Conclusion The strength of this programme is that it provides a sustainable model of chronic disease management with monitoring and self-management assistance for

  17. Initial Severity and Differential Treatment Outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

    Science.gov (United States)

    Elkin, Irene; And Others

    1995-01-01

    Random regression models were used to investigate the role of initial severity in the outcome of four treatments for major depression: cognitive behavioral therapy, interpersonal psychotherapy, imipramine plus clinical management, and placebo plus clinical management. Initial severity of depression and impairment of functioning significantly…

  18. Exploration of the Pathways to Delinquency for Female Adolescents with Depression: Implications for Cross-Systems Collaboration and Counseling

    Science.gov (United States)

    Mellin, Elizabeth A.; Fang, Hong-Ning

    2010-01-01

    This study found that lack of involvement in prosocial institutions, affiliation with other troubled youth, and indifference regarding personal safety partially mediate the relationship between depression and delinquency among justice-involved female adolescents. The results suggest that depression may not be the primary conduit to delinquency.…

  19. Association Between Chronic Physical Conditions and the Effectiveness of Collaborative Care for Depression : An Individual Participant Data Meta-analysis

    NARCIS (Netherlands)

    Panagioti, Maria; Bower, Peter; Kontopantelis, Evangelos; Lovell, Karina; Gilbody, Simon; Waheed, Waquas; Dickens, Chris; Archer, Janine; Simon, Gregory; Ell, Kathleen; Huffman, Jeff C.; Richards, David A.; van der Feltz-Cornelis, Christina; Adler, David A.; Bruce, Martha; Buszewicz, Marta; Cole, Martin G.; Davidson, Karina W.; de Jonge, Peter; Gensichen, Jochen; Huijbregts, Klaas; Menchetti, Marco; Patel, Vikram; Rollman, Bruce; Shaffer, Jonathan; Zijlstra-Vlasveld, Moniek C.; Coventry, Peter A.

    IMPORTANCE Collaborative care is an intensive care model involving several health care professionals working together, typically a physician, a case manager, and a mental health professional. Meta-analyses of aggregate data have shown that collaborative care is particularly effective in people with

  20. Breakthrough Propulsion Physics Project: Project Management Methods

    Science.gov (United States)

    Millis, Marc G.

    2004-01-01

    To leap past the limitations of existing propulsion, the NASA Breakthrough Propulsion Physics (BPP) Project seeks further advancements in physics from which new propulsion methods can eventually be derived. Three visionary breakthroughs are sought: (1) propulsion that requires no propellant, (2) propulsion that circumvents existing speed limits, and (3) breakthrough methods of energy production to power such devices. Because these propulsion goals are presumably far from fruition, a special emphasis is to identify credible research that will make measurable progress toward these goals in the near-term. The management techniques to address this challenge are presented, with a special emphasis on the process used to review, prioritize, and select research tasks. This selection process includes these key features: (a) research tasks are constrained to only address the immediate unknowns, curious effects or critical issues, (b) reliability of assertions is more important than the implications of the assertions, which includes the practice where the reviewers judge credibility rather than feasibility, and (c) total scores are obtained by multiplying the criteria scores rather than by adding. Lessons learned and revisions planned are discussed.

  1. New analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program: do different treatments reflect different processes?

    Science.gov (United States)

    Herbert, Gregory L; Callahan, Jennifer; Ruggero, Camilo J; Murrell, Amy R

    2013-01-01

    To determine whether or not different therapies have distinct patterns of change, it is useful to investigate not only the end result of psychotherapy (outcome) but also the processes by which outcomes are attained. The present study subjected data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program to survival analyses to examine whether the process of psychotherapy, as conceptualized by the phase model, differed between psychotherapy treatment approaches. Few differences in terms of progression through phases of psychotherapy were identified between cognitive behavior therapy and interpersonal therapy. Additionally, results indicate that phases of psychotherapy may not represent discrete, sequentially invariant processes.

  2. Multidisciplinary Collaborative Care for Depressive Disorder in the Occupational Health Setting: design of a randomised controlled trial and cost-effectiveness study

    Directory of Open Access Journals (Sweden)

    Beekman Aartjan TF

    2008-05-01

    Full Text Available Abstract Background Major depressive disorder (MDD has major consequences for both patients and society, particularly in terms of needlessly long sick leave and reduced functioning. Although evidence-based treatments for MDD are available, they show disappointing results when implemented in daily practice. A focus on work is also lacking in the treatment of depressive disorder as well as communication of general practitioners (GPs and other health care professionals with occupational physicians (OPs. The OP may play a more important role in the recovery of patients with MDD. Purpose of the present study is to tackle these obstacles by applying a collaborative care model, which has proven to be effective in the USA, with a focus on return to work (RTW. From a societal perspective, the (costeffectiveness of this collaborative care treatment, as a way of transmural care, will be evaluated in depressed patients on sick leave in the occupational health setting. Methods/Design A randomised controlled trial in which the treatment of MDD in the occupational health setting will be evaluated in the Netherlands. A transmural collaborative care model, including Problem Solving Treatment (PST, a workplace intervention, antidepressant medication and manual guided self-help will be compared with care as usual (CAU. 126 Patients with MDD on sick leave between 4 and 12 weeks will be included in the study. Care in the intervention group will be provided by a multidisciplinary team of a trained OP-care manager and a consultant psychiatrist. The treatment is separated from the sickness certification. Data will be collected by means of questionnaires at baseline and at 3, 6, 9 and 12 months after baseline. Primary outcome measure is reduction of depressive symptoms, secondary outcome measure is time to RTW, tertiary outcome measure is the cost effectiveness. Discussion The high burden of MDD and the high level of sickness absence among people with MDD contribute to

  3. Collaborative care intervention targeting violence risk behaviors, substance use, and posttraumatic stress and depressive symptoms in injured adolescents: a randomized clinical trial.

    Science.gov (United States)

    Zatzick, Douglas; Russo, Joan; Lord, Sarah Peregrine; Varley, Christopher; Wang, Jin; Berliner, Lucy; Jurkovich, Gregory; Whiteside, Lauren K; O'Connor, Stephen; Rivara, Frederick P

    2014-06-01

    Violence and injury risk behaviors, alcohol and drug use problems, and posttraumatic stress disorder (PTSD) and depressive symptoms occur frequently among adolescents presenting to acute care medical settings after traumatic physical injury. To test the effectiveness of a stepped collaborative care intervention targeting this constellation of risk behaviors and symptoms in randomly sampled hospitalized adolescents with and without traumatic brain injury. A pragmatic randomized clinical trial was conducted at a single US level I trauma center. Participants included 120 adolescents aged 12 to 18 years randomized to intervention (n = 59) and control (n = 61) conditions. Stepped collaborative care intervention included motivational interviewing elements targeting risk behaviors and substance use as well as medication and cognitive behavioral therapy elements targeting PTSD and depressive symptoms. Adolescents were assessed at baseline before randomization and 2, 5, and 12 months after injury hospitalization. Standardized instruments were used to assess violence risk behaviors, alcohol and drug use, and PTSD and depressive symptoms. The investigation attained more than 95% adolescent follow-up at each assessment point. At baseline, approximately one-third of the participants endorsed the violence risk behavior of carrying a weapon. Regression analyses demonstrated that intervention patients experienced significant reductions in weapon carrying compared with controls during the year after injury (group × time effect, F3,344 = 3.0; P = .03). At 12 months after the injury, 4 (7.3%) intervention patients vs 13 (21.3%) control patients reported currently carrying a weapon (relative risk, 0.31; 95% CI, 0.11-0.90). The intervention was equally effective in reducing the risk of weapon carrying among injured adolescents with and without traumatic brain injury. Other treatment targets, including alcohol and drug use problems and high levels of PTSD and

  4. Breakthrough at NIF 'unlikely' in 2010

    Science.gov (United States)

    Harris, Margaret

    2010-05-01

    Hopes of reaching a milestone in fusion research by the end of 2010 have dimmed following a US government report that plays down the chances of an early breakthrough and sharply criticizes management of the 4bn National Ignition Facility (NIF). In the report, officials from the Government Accountability Office (GAO) state that ignition - fusion's "break-even" point - is "unlikely" to occur at the laser-fusion lab this year and that "significant scientific and technical challenges" could delay or even prevent the facility from achieving ignition by 2012.

  5. Collaborative care for depression and anxiety disorders in patients with recent cardiac events: the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial.

    Science.gov (United States)

    Huffman, Jeff C; Mastromauro, Carol A; Beach, Scott R; Celano, Christopher M; DuBois, Christina M; Healy, Brian C; Suarez, Laura; Rollman, Bruce L; Januzzi, James L

    2014-06-01

    Depression and anxiety are associated with adverse cardiovascular outcomes in patients with recent acute cardiac events. There has been minimal study of collaborative care (CC) management models for mental health disorders in high-risk cardiac inpatients, and no prior CC intervention has simultaneously managed depression and anxiety disorders. To determine the impact of a low-intensity CC intervention for depression, generalized anxiety disorder, and panic disorder among patients hospitalized for an acute cardiac illness. Single-blind randomized clinical trial, with study assessors blind to group assignment, from September 2010 through July 2013 of 183 patients admitted to inpatient cardiac units in an urban academic general hospital for acute coronary syndrome, arrhythmia, or heart failure and found to have clinical depression, generalized anxiety disorder, or panic disorder on structured assessment. Participants were randomized to 24 weeks of a low-intensity telephone-based multicomponent CC intervention targeting depression and anxiety disorders (n = 92) or to enhanced usual care (serial notification of primary medical providers; n = 91). The CC intervention used a social work care manager to coordinate assessment and stepped care of psychiatric conditions and to provide support and therapeutic interventions as appropriate. Improvement in mental health-related quality of life (Short Form-12 Mental Component Score [SF-12 MCS]) at 24 weeks, compared between groups using a random-effects model in an intent-to-treat analysis. Patients randomized to CC had significantly greater estimated mean improvements in SF-12 MCS at 24 weeks (11.21 points [from 34.21 to 45.42] in the CC group vs 5.53 points [from 36.30 to 41.83] in the control group; estimated mean difference, 5.68 points [95% CI, 2.14-9.22]; P = .002; effect size, 0.61). Patients receiving CC also had significant improvements in depressive symptoms and general functioning, and higher rates of

  6. Implementation of a collaborative care model for the treatment of depression and anxiety in a community health center: results from a qualitative case study

    Directory of Open Access Journals (Sweden)

    Eghaneyan BH

    2014-11-01

    Full Text Available Brittany H Eghaneyan,1 Katherine Sanchez,2 Diane B Mitschke2 1Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; 2School of Social Work, The University of Texas at Arlington, Arlington, TX, USA Background: The collaborative care model is a systematic approach to the treatment of depression and anxiety in primary care settings that involves the integration of care managers and consultant psychiatrists, with primary care physician oversight, to more proactively manage mental disorders as chronic diseases, rather than treating acute symptoms. While collaborative care has been shown to be more effective than usual primary care in improving depression outcomes in a number of studies, less is known about the factors that support the translation of this evidence-based intervention to real-world program implementation. The purpose of this case study was to examine the implementation of a collaborative care model in a community based primary care clinic that primarily serves a low-income, uninsured Latino population, in order to better understand the interdisciplinary relationships and the specific elements that might facilitate broader implementation. Methods: An embedded single-case study design was chosen in order to thoroughly examine the components of one of several programs within a single organization. The main unit of analysis was semi-structured interviews that were conducted with seven clinical and administrative staff members. A grounded theory approach was used to analyze the interviews. Line-by-line initial coding resulted in over 150 initial codes, which were clustered together to rebuild the data into preliminary categories and then divided into four final categories, or main themes. Results: Four unique themes about how the implementation of a collaborative care model worked in this setting emerged from the interviews: organizational change, communication, processes and outcomes of the program, and barriers to

  7. Collaborative care management effectively promotes self-management: patient evaluation of care management for depression in primary care.

    Science.gov (United States)

    DeJesus, Ramona S; Howell, Lisa; Williams, Mark; Hathaway, Julie; Vickers, Kristin S

    2014-03-01

    Chronic disease management in the primary care setting increasingly involves self-management support from a nurse care manager. Prior research had shown patient acceptance and willingness to work with care managers. This survey study evaluated patient-perceived satisfaction with care management and patient opinions on the effectiveness of care management in promoting self-management. Qualitative and quantitative survey responses were collected from 125 patients (79% female; average age 46; 94% Caucasian) enrolled in care management for depression. Qualitative responses were coded with methods of content analysis by 2 independent analysts. Patients were satisfied with depression care management. Patients felt that care management improved their treatment above and beyond other aspects of their depression treatment (mean score, 6.7 [SD, 2]; 10 = Very much), increased their understanding of depression self-management (mean score, 7.2 [SD, 2]; 10 = Very much), and increased the frequency of self-management goal setting (mean score, 6.9 [SD, 3]; 10 = Very much). Predominant qualitative themes emphasized that patients value emotional, motivational, and relational aspects of the care manager relationship. Patients viewed care managers as caring and supportive, helpful in creating accountability for patients and knowledgeable in the area of depression care. Care managers empower patients to take on an active role in depression self-management. Some logistical challenges associated with a telephonic intervention are described. Care manager training should include communication and motivation strategies, specifically self-management education, as these strategies are valued by patients. Barriers to care management, such as scheduling telephone calls, should be addressed in future care management implementation and study.

  8. Spatially varying dispersion to model breakthrough curves.

    Science.gov (United States)

    Li, Guangquan

    2011-01-01

    Often the water flowing in a karst conduit is a combination of contaminated water entering at a sinkhole and cleaner water released from the limestone matrix. Transport processes in the conduit are controlled by advection, mixing (dilution and dispersion), and retention-release. In this article, a karst transport model considering advection, spatially varying dispersion, and dilution (from matrix seepage) is developed. Two approximate Green's functions are obtained using transformation of variables, respectively, for the initial-value problem and for the boundary-value problem. A numerical example illustrates that mixing associated with strong spatially varying conduit dispersion can cause strong skewness and long tailing in spring breakthrough curves. Comparison of the predicted breakthrough curve against that measured from a dye-tracing experiment between Ames Sink and Indian Spring, Northwest Florida, shows that the conduit dispersivity can be as large as 400 m. Such a large number is believed to imply strong solute interaction between the conduit and the matrix and/or multiple flow paths in a conduit network. It is concluded that Taylor dispersion is not dominant in transport in a karst conduit, and the complicated retention-release process between mobile- and immobile waters may be described by strong spatially varying conduit dispersion. Copyright © 2010 The Author(s). Journal compilation © 2010 National Ground Water Association.

  9. Development and assessment of an active strategy for the implementation of a collaborative care approach for depression in primary care (the INDI·i project).

    Science.gov (United States)

    Aragonès, Enric; Palao, Diego; López-Cortacans, Germán; Caballero, Antonia; Cardoner, Narcís; Casaus, Pilar; Cavero, Myriam; Monreal, José Antonio; Pérez-Sola, Víctor; Cirera, Miquel; Loren, Maite; Bellerino, Eva; Tomé-Pires, Catarina; Palacios, Laura

    2017-12-13

    Primary care is the principal clinical setting for the management of depression. However, significant shortcomings have been detected in its diagnosis and clinical management, as well as in patient outcomes. We developed the INDI collaborative care model to improve the management of depression in primary care. This intervention has been favorably evaluated in terms of clinical efficacy and cost-effectiveness in a clinical trial. Our aim is to bring this intervention from the scientific context into clinical practice. Objective: To test for the feasibility and impact of a strategy for implementing the INDI model for depression in primary care. A quasi-experiment conducted in primary care. Several areas will be established to implement the new program and other, comparable areas will serve as control group. The study constitutes the preliminary phase preceding generalization of the model in the Catalan public healthcare system. The target population of the intervention are patients with major depression. The implementation strategy will also involve healthcare professionals, primary care centers, as well as management departments and the healthcare organization itself in the geographical areas where the study will be conducted: Camp de Tarragona and Vallès Occidental (Catalonia). The INDI model is a program for improving the management of depression involving clinical, instructional, and organizational interventions including the participation of nurses as care managers, the efficacy and efficiency of which has been proven in a clinical trial. We will design an active implementation strategy for this model based on the PARIHS (Promoting Action on Research Implementation in Health Services) framework. Qualitative and quantitative measures will be used to evaluate variables related to the successful implementation of the model: acceptability, utility, penetration, sustainability, and clinical impact. This project tests the transferability of a healthcare intervention

  10. 50 Breakthroughs by America's National Labs

    Science.gov (United States)

    2011-01-01

    America's National Laboratory system has been changing and improving the lives of millions for more than 80 years. Born at a time of great societal need, this network of Department of Energy Laboratories has now grown into 17 facilities, working together as engines of prosperity and invention. As this list of 50 Breakthroughs attests, National Laboratory discoveries have spawned industries, saved lives, generated new products, fired the imagination, and helped to reveal the secrets of the universe. Rooted in the need to be the best and bring the best, America's National Laboratories have put an American stamp on the past century of science. With equal ingenuity and tenacity, they are now engaged in winning the future.

  11. Breakthroughs in neuroactive steroid drug discovery.

    Science.gov (United States)

    Blanco, Maria-Jesus; La, Daniel; Coughlin, Quinn; Newman, Caitlin A; Griffin, Andrew M; Harrison, Boyd L; Salituro, Francesco G

    2018-01-15

    Endogenous and synthetic neuroactive steroids (NASs) or neurosteroids are effective modulators of multiple signaling pathways including receptors for the γ-aminobutyric acid A (GABA A ) and glutamate, in particular N-methyl-d-aspartate (NMDA). These receptors are the major inhibitory and excitatory neurotransmitters in the central nervous system (CNS), and there is growing evidence suggesting that dysregulation of neurosteroid production plays a role in numerous neurological disorders. The significant unmet medical need for treatment of CNS disorders has increased the interest for these types of compounds. In this review, we highlight recent progress in the clinical development of NAS drug candidates, in addition to preclinical breakthroughs in the identification of novel NASs, mainly for GABA A and NMDA receptor modulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Controlled Nucleosynthesis Breakthroughs in Experiment and Theory

    CERN Document Server

    Adamenko, Stanislav; Merwe, Alwyn

    2007-01-01

    This book ushers in a new era of experimental and theoretical investigations into collective processes, structure formation, and self-organization of nuclear matter. It reports the results of experiments wherein for the first time the nuclei constituting our world (those displayed in Mendeleev's table as well as the super-heavy ones) have been artificially created. Pioneering breakthroughs are described, achieved at the "Proton-21" Laboratory, Kiev, Ukraine, in a variety of new physical and technological directions. A detailed description of the main experiments, their analyses, and the interpretation of copious experimental data are given, along with the methodology governing key measurements and the processing algorithms of the data that empirically confirm the occurrence of macroscopic self-organizing processes leading to the nuclear transformations of various materials. The basic concepts underlying the initiation of self-sustaining collective processes that result in the formation of nuclear structures a...

  13. Comparative effect of collaborative care, pain medication, and duloxetine in the treatment of major depressive disorder and comorbid (Sub)chronic pain: Results of an exploratory randomized, placebo-controlled, multicenter trial (CC:PAINDIP)

    NARCIS (Netherlands)

    de Heer, Eric W.; Dekker, Jack; Beekman, Aartjan T.F.; van Marwijk, Harm W.J.; Holwerda, Tjalling J.; Bet, Pierre M.; Roth, Joost; Timmerman, Lotte; van der Feltz-Cornelis, Christina M.

    2018-01-01

    Objective: Evidence exists for the efficacy of collaborative care (CC) for major depressive disorder (MDD), for the efficacy of the consequent use of pain medication against pain, and for the efficacy of duloxetine against both MDD and neuropathic pain. Their relative effectiveness in comorbid MDD

  14. Breakdown Breakthrough: NREL Finds Easier Ways to Deconstruct Biomass |

    Science.gov (United States)

    News | NREL Breakdown Breakthrough: NREL Finds Easier Ways to Deconstruct Biomass Breakdown Breakthrough: NREL Finds Easier Ways to Deconstruct Biomass May 22, 2018 Roman Brunecky (left), Yannick Bomble soften biomass. Photo by Dennis Schroeder, NREL If there's an easier, more efficient method, science will

  15. Breakthrough Listen - A New Search for Life in the Universe

    Science.gov (United States)

    Worden, Pete

    On July 20, 2015 Yuri Milner and Stephen Hawking announced a new set of scientific initiatives - a SETI search called Breakthrough Listen and a contest to devise potential messages in response to a detection entitled Breakthrough Message. These are the first of several privately-funded Breakthrough Initiatives, designed to answer the fundamental science questions surrounding the origin, extent and nature of life in the universe. The initiatives are managed by the Breakthrough Prize Foundation. With Breakthrough Listen, Radio SETI observations have begun at the Green Bank Radio Telescope (GBT) and optical SETI at the Lick Observatory Automated Planet Finder (APF). Observations will soon commence at the CSIRO Parkes Radio Telescope. Other SETI instruments and observations are under consideration. In addition, several other initiatives are under development including an expanded search for life in the universe.

  16. Inertial frames and breakthrough propulsion physics

    Science.gov (United States)

    Millis, Marc G.

    2017-09-01

    The term ;Breakthrough Propulsion Physics; comes from the NASA project by that name which examined non-rocket space drives, gravity control, and faster-than-light travel. The focus here is on space drives and the related unsolved physics of inertial frames. A ;space drive; is a generic term encompassing any concept for using as-yet undiscovered physics to move a spacecraft instead of existing rockets, sails, or tethers. The collective state of the art spans mostly steps 1-3 of the scientific method: defining the problem, collecting data, and forming hypotheses. The key issues include (1) conservation of momentum, (2) absence of obvious reaction mass, and (3) the net-external thrusting requirement. Relevant open problems in physics include: (1) the sources and mechanisms of inertial frames, (2) coupling of gravitation to the other fundamental forces, and (3) the nature of the quantum vacuum. Rather than following the assumption that inertial frames are an immutable, intrinsic property of space, this paper revisits Mach's Principle, where it is posited that inertia is relative to the distant surrounding matter. This perspective allows conjectures that a space drive could impart reaction forces to that matter, via some as-yet undiscovered interaction with the inertial frame properties of space. Thought experiments are offered to begin a process to derive new hypotheses. It is unknown if this line of inquiry will be fruitful, but it is hoped that, by revisiting unsolved physics from a propulsion point of view, new insights will be gained.

  17. Effectiveness and cost-effectiveness of transmural collaborative care with consultation letter (TCCCL) and duloxetine for major depressive disorder (MDD) and (sub)chronic pain in collaboration with primary care: design of a randomized placebo-controlled multi-Centre trial: TCC:PAINDIP.

    Science.gov (United States)

    de Heer, Eric W; Dekker, Jack; van Eck van der Sluijs, Jonna F; Beekman, Aartjan Tf; van Marwijk, Harm Wj; Holwerda, Tjalling J; Bet, Pierre M; Roth, Joost; Hakkaart-Van Roijen, Leona; Ringoir, Lianne; Kat, Fiona; van der Feltz-Cornelis, Christina M

    2013-05-24

    The comorbidity of pain and depression is associated with high disease burden for patients in terms of disability, wellbeing, and use of medical care. Patients with major and minor depression often present themselves with pain to a general practitioner and recognition of depression in such cases is low, but evolving. Also, physical symptoms, including pain, in major depressive disorder, predict a poorer response to treatment. A multi-faceted, patient-tailored treatment programme, like collaborative care, is promising. However, treatment of chronic pain conditions in depressive patients has, so far, received limited attention in research. Cost effectiveness of an integrated approach of pain in depressed patients has not been studied. This study is a placebo controlled double blind, three armed randomized multi centre trial. Patients with (sub)chronic pain and a depressive disorder are randomized to either a) collaborative care with duloxetine, b) collaborative care with placebo or c) duloxetine alone. 189 completers are needed to attain sufficient power to show a clinically significant effect of 0.6 SD on the primary outcome measures (PHQ-9 score). Data on depression, anxiety, mental and physical health, medication adherence, medication tolerability, quality of life, patient-doctor relationship, coping, health resource use and productivity will be collected at baseline and after three, six, nine and twelve months. This study enables us to show the value of a closely monitored integrated treatment model above usual pharmacological treatment. Furthermore, a comparison with a placebo arm enables us to evaluate effectiveness of duloxetine in this population in a real life setting. Also, this study will provide evidence-based treatments and tools for their implementation in practice. This will facilitate generalization and implementation of results of this study. Moreover, patients included in this study are screened for pain symptoms, differentiating between nociceptive

  18. Building breakthrough businesses within established organizations.

    Science.gov (United States)

    Govindarajan, Vijay; Trimble, Chris

    2005-05-01

    Many companies assume that once they've launched a major innovation, growth will soon follow. It's not that simple. High-potential new businesses within established companies face stiff headwinds well after their inception. That's why a company's emphasis must shift: from ideas to execution and from leadership excellence to organizational excellence. The authors spent five years chronicling new businesses at the New York Times Company, Analog Devices, Corning, Hasbro, and other organizations. They found that a breakthrough new business (referred to as NewCo) rarely coexists gracefully with the established business in the company (called CoreCo). The unnatural combination creates three specific challenges--forgetting, borrowing, and learning--that NewCo must meet in order to survive and grow. NewCo must first forget some of what made CoreCo successful. NewCo and CoreCo have elemental differences, so NewCo must leave behind CoreCo's notions about what skills and competencies are most valuable. NewCo must also borrow some of CoreCo's assets--usually in one or two key areas that will give NewCo a crucial competitive advantage. Incremental cost reductions, for example, are never a sufficient justification for borrowing. Finally, NewCo must be prepared to learn some things from scratch. Because strategic experiments are highly uncertain endeavors, NewCo will face several critical unknowns. The more rapidly it can resolve those unknowns--that is, the faster it can learn--the sooner it will zero in on a winning business model or exit a hopeless situation. Managers can accelerate this learning by planning more simply and more often and by comparing predicted and actual trends.

  19. The United States: breakthroughs and waste.

    Science.gov (United States)

    Reinhardt, U E

    1992-01-01

    The health system of the United States is in a paradoxical position. At its best, the system is a magnet for those seeking the latest technical breakthroughs. It can offer that excellence because there have never been effective financial constraints on the imagination; the system has become a major economic frontier, at which professional and other entrepreneurs successfully seek their fortune. At the same time, the system is leaving increasing numbers of Americans frustrated and disillusioned. It is beset by excess capacity in many areas, is needlessly expensive, and often bestows unnecessary health services. Yet only the experts are aware of these flaws; most Americans still express high satisfaction with the quality of the services they receive from their doctors and hospitals. The public's major misgivings arise over the awkward and inequitable way in which American health care is financed. The typical private health insurance policy, for example, is tied to a particular job. If the job is lost, so is the health insurance. Furthermore, these policies are priced on actuarially "fair" principles, so sick individuals are forced to pay higher insurance premiums than relatively healthy ones and chronically ill persons often cannot obtain health insurance coverage at any price. Although there are public programs to catch many persons not privately insured, the coverage tends to be insufficiently extensive and deep. Some 35 million Americans, mostly poor, have no health insurance whatsoever. Unfortunately, at this time there is no political force in the United States strong enough to reform the American health system toward greater social equity and economic efficiency, whereas there are numerous groups powerful enough to block whatever reform might harm their own narrow economic interests. Other nations can learn from America's clinical and organizational innovations in health care delivery. They can also learn what not to do by studying the unseemly way in which

  20. Teens Engaged in Collaborative Health: The Feasibility and Acceptability of an Online Skill-Building Intervention for Adolescents at Risk for Depression.

    Science.gov (United States)

    Lattie, Emily G; Ho, Joyce; Sargent, Elizabeth; Tomasino, Kathryn N; Smith, J D; Brown, C Hendricks; Mohr, David C

    2017-06-01

    There is an ongoing need for effective and accessible preventive interventions for adolescent depression and substance abuse. This paper reports on a field trial of an online indicated preventive intervention, ProjectTECH, which is based on cognitive-behavioral therapy (CBT) techniques. The study aims to gather information about the feasibility and acceptability of this program. Secondary aims of this study were to examine the impact of the program on depression symptoms, perceived stress, positive affect, and substance use and to compare differences between groups that were led by a peer versus those that were led by a licensed clinician. High school students (n = 39) were recruited primarily through social media advertisements, and assigned to four groups of 8-12 individuals to collaboratively participate in an 8 week peer network-based online preventive intervention which were led by a trained peer guide or a licensed clinician. Participants were provided with didactic lessons, CBT-based mood management tools, and peer networking features, and completed quantitative and qualitative feedback at baseline, midpoint, end of intervention, and 1 month follow up. The program attracted and retained users primarily from social media and was used frequently by many of the participants (system login M = 25.62, SD = 16.58). Participants rated the program as usable, and offered several suggestions for improving the program, including allowing for further personalization by the individual user, and including more prompts to engage with the social network. From baseline to end of intervention, significant decreases were observed in depressive symptoms and perceived stress ( p 's power to detect group differences, no consistent differences were observed between participants in a peer-led group and those in a clinician-led group. Results of this study indicates that ProjectTECH, an indicated preventive intervention for high school-aged adolescents, demonstrates both feasibility

  1. A Breakthrough for Strengthening Tusi Studies

    Institute of Scientific and Technical Information of China (English)

    Li Liangpin; Peng Furong

    2016-01-01

    Following the inscription of China’s Tusi ( native officials ) relics onto the list of world cultural heritage in 2015 , Tusi studies has already become a current topic. However, if we ignored the numerous and complicated historical events, the tremendous amount of historical materials and cases with different characteristics, it is difficult to realize a theoretical breakthrough and academic in-novation. Hence, if the academic world intends to find a new breakthrough in Tusi studies, enough attention should be given to the analysis of past e-vents, digging out historical materials, and case studies—only by which can Tusi studies be strengthened. 1 . Analysis of past events Scholarly research of the Tusi in the past has paid more attention to the system, culture ,and ap-plication of Tusi relics for inscription onto the list of world cultural heritage, but has ignored analysis of significant events. Due to the influence of the political right, economic benefit, and cultural in-filtration, there had always been competition be-tween the central government and the Tusi regime during the Yuan, Ming and Qing dynasties. When some conflicts could not be resolved through nego-tiation, large-scale events or battles were the re-sult. Judging from current studies on every small or large battle between the central government and a Tusi regime, we can see that scholars always focus their studies on the background, process, result, historical influence and related evaluations. Up to now, no scholars have written a monograph of these big events closely related to the Tusi, which is doubtlessly a pity when it comes to Tusi studies. We think that three issues should be noticed while analyzing big events related to the Tusi:1 ) taking the overall situation into consideration; 2 ) having theoretical sight; and 3 ) having a theoretical awareness. 2 . Uncovering historical materials The historical materials are especially impor-tant for the study of the Tusi system or Tusi issues

  2. Managing Conversations: The Medium for Achieving "Breakthrough" Results.

    Science.gov (United States)

    Bolton, Robert

    1998-01-01

    Unlike traditional management development, use of conversations in coaching high-performance work teams addresses core processes of speaking and listening. Management of conversations aims to create learning that will lead to breakthroughs in team performance. (SK)

  3. Long-term cost-effectiveness of collaborative care (vs usual care) for people with depression and comorbid diabetes or cardiovascular disease: a Markov model informed by the COINCIDE randomised controlled trial.

    Science.gov (United States)

    Camacho, Elizabeth M; Ntais, Dionysios; Coventry, Peter; Bower, Peter; Lovell, Karina; Chew-Graham, Carolyn; Baguley, Clare; Gask, Linda; Dickens, Chris; Davies, Linda M

    2016-10-07

    To evaluate the long-term cost-effectiveness of collaborative care (vs usual care) for treating depression in patients with diabetes and/or coronary heart disease (CHD). 36 primary care general practices in North West England. 387 participants completed baseline assessment (collaborative care: 191; usual care: 196) and full or partial 4-month follow-up data were captured for 350 (collaborative care: 170; usual care: 180). 62% of participants were male, 14% were non-white. Participants were aged ≥18 years, listed on a Quality and Outcomes Framework register for CHD and/or type 1 or 2 diabetes mellitus, with persistent depressive symptoms. Patients with psychosis or type I/II bipolar disorder, actively suicidal, in receipt of services for substance misuse, or already in receipt of psychological therapy for depression were excluded. Collaborative care consisted of evidence-based low-intensity psychological treatments, delivered over 3 months and case management by a practice nurse and a Psychological Well Being Practitioner. As planned, the primary measure of cost-effectiveness was the incremental cost-effectiveness ratio (cost per quality-adjusted life year (QALY)). A Markov model was constructed to extrapolate the trial results from short-term to long-term (24 months). The mean cost per participant of collaborative care was £317 (95% CI 284 to 350). Over 24 months, it was estimated that collaborative care was associated with greater healthcare usage costs (net cost £674 (95% CI -30 953 to 38 853)) and QALYs (net QALY gain 0.04 (95% CI -0.46 to 0.54)) than usual care, resulting in a cost per QALY gained of £16 123, and a likelihood of being cost-effective of 0.54 (willingness to pay threshold of £20 000). Collaborative care is a potentially cost-effective long-term treatment for depression in patients with comorbid physical and mental illness. The estimated cost per QALY gained was below the threshold recommended by English decision

  4. PREFACE: Inverse Problems in Applied Sciences—towards breakthrough

    Science.gov (United States)

    Cheng, Jin; Iso, Yuusuke; Nakamura, Gen; Yamamoto, Masahiro

    2007-06-01

    These are the proceedings of the international conference `Inverse Problems in Applied Sciences—towards breakthrough' which was held at Hokkaido University, Sapporo, Japan on 3-7 July 2006 (http://coe.math.sci.hokudai.ac.jp/sympo/inverse/). There were 88 presentations and more than 100 participants, and we are proud to say that the conference was very successful. Nowadays, many new activities on inverse problems are flourishing at many centers of research around the world, and the conference has successfully gathered a world-wide variety of researchers. We believe that this volume contains not only main papers, but also conveys the general status of current research into inverse problems. This conference was the third biennial international conference on inverse problems, the core of which is the Pan-Pacific Asian area. The purpose of this series of conferences is to establish and develop constant international collaboration, especially among the Pan-Pacific Asian countries, and to lead the organization of activities concerning inverse problems centered in East Asia. The first conference was held at City University of Hong Kong in January 2002 and the second was held at Fudan University in June 2004. Following the preceding two successes, the third conference was organized in order to extend the scope of activities and build useful bridges to the next conference in Seoul in 2008. Therefore this third biennial conference was intended not only to establish collaboration and links between researchers in Asia and leading researchers worldwide in inverse problems but also to nurture interdisciplinary collaboration in theoretical fields such as mathematics, applied fields and evolving aspects of inverse problems. For these purposes, we organized tutorial lectures, serial lectures and a panel discussion as well as conference research presentations. This volume contains three lecture notes from the tutorial and serial lectures, and 22 papers. Especially at this

  5. Aldosterone breakthrough during aliskiren, valsartan, and combination (aliskiren + valsartan) therapy.

    Science.gov (United States)

    Bomback, Andrew S; Rekhtman, Yelena; Klemmer, Philip J; Canetta, Pietro A; Radhakrishnan, Jai; Appel, Gerald B

    2012-01-01

    Aldosterone levels increase in 30%-40% of patients on angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers over the long term. This "aldosterone breakthrough" may carry important clinical consequences given aldosterone's nonepithelial, pro-fibrotic actions. The renin inhibitor, aliskiren, by suppressing the renin-angiotensin-aldosterone system (RAAS) proximally, may limit breakthrough compared to conventional RAAS blockade. This open-label study (NCT01129557) randomized subjects to aliskiren 300 mg daily (A), valsartan 320 mg daily (V), or aliskiren 150 mg + valsartan 160 mg daily (A+V) for 9 months. Eligible subjects had proteinuria >300 mg/day, estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m(2), and systolic blood pressure (BP) >130 or diastolic BP >80 mm Hg. Serum and 24-hour urine aldosterone (indexed to 24-hour urine Na) were checked before initiation of therapy and at 3, 6, and 9 months. Aldosterone breakthrough was defined as a sustained increase from baseline aldosterone by study end. The study was intended to enroll 120 subjects but was terminated early by the sponsor. We present here the results of 33 subjects who completed the protocol, of which 12 were randomized to A, 11 were randomized to V, and 10 were randomized to A+V. Mean baseline eGFR was 75.5 (±23.3) mL/min/1.73 m(2); baseline proteinuria was 3104 (±2943) mg/day; and baseline BP was 134.7 (±10.5)/84.8 (±8.4) mm Hg. Three (27%) subjects on V, three (25%) subjects on A, and three (30%) subjects on A+V had aldosterone breakthrough. Mean proteinuria reduction was 31% from baseline in all subjects: 30% in subjects with breakthrough vs. 32% in subjects without breakthrough. Mean BP reduction was 11.0/8.8 mm Hg in all subjects: 8.4/6.1 mm Hg in subjects with breakthrough vs. 12.0/9.8 mm Hg in subjects without breakthrough. Aliskiren, alone or in combination with valsartan, did not reduce the incidence of aldosterone breakthrough in subjects with hypertension

  6. High-pressure gas-breakthrough apparatus and a procedure for determining the gas-breakthrough pressure of compacted clay

    International Nuclear Information System (INIS)

    Hume, H.B.

    1997-08-01

    Gas may be produced in a nuclear fuel waste disposal vault. Given that the vault will be sealed with clay-based materials, the fate of the gas is uncertain. Therefore, an instrument was previously built to measure the pressure required to pass gas through compacted clay materials (a gas-breakthrough apparatus). However, the 10 MPa pressure limit of the apparatus was insufficient to test compacted buffer material at the density proposed in the Canadian concept for nuclear fuel waste disposal. Therefore, a high-pressure (50 Wa) gas-breakthrough apparatus was designed, constructed and installed. This report describes the components of the apparatus and the materials and procedures that are used for the gas-breakthrough tests. (author)

  7. Major depression

    Science.gov (United States)

    Depression - major; Depression - clinical; Clinical depression; Unipolar depression; Major depressive disorder ... providers do not know the exact causes of depression. It is believed that chemical changes in the ...

  8. A Blueprint for Collaborative Lawmaking

    Directory of Open Access Journals (Sweden)

    Miki Kashtan

    2016-03-01

    Full Text Available Miki Kashtan, a consultant at the Center for Efficient Collaboration, describes how her Convergent Facilitation method of collaborative decision-making brought together contentiously divided stakeholders in an effort to redraft child custody legislation in Minnesota, resulting in a near-unanimous new bill that completely changes the approach to child custody. This breakthrough surprised many. It depended on reframing the goals of the legislative effort to find legislation that all could wholeheartedly embrace, based on what mattered to all parties. A commitment to those goals carried the group through two years of an intensive and yet non-adversarial process.

  9. Foreknowledge of breakthroughs science and technology foresight, and the early identification of areas of breakthrough

    International Nuclear Information System (INIS)

    Papon, P.

    2010-01-01

    The progress of science and technology has been so rapid in the last few decades that it receives especial attention in forecasting and foresight exercises. But, because they are too greatly in thrall to the dominant paradigms and hence favour a linear perspective, the experts who deal with these questions pay more attention to the future of technologies than to scientific advances and revolutions. The bulk of their work consists, then, in anticipating, by various different methods (Delphi surveys, Road-maps, etc.), at what date a particular technology might be available (without, however, always correctly gauging the conditions for its social appropriation or the applications to which it might be put). In this article, Pierre Papon expounds a much more original and promising approach for attempting to anticipate the discoveries that are likely radically to transform the fields of scientific knowledge by investigating the phenomena that may potentially lead to fundamental revolutions. After reminding us of the premonitory thinking of a number of authors - in the fields, for example, of genetics and computer science -, he endeavors to describe some of the dominant paradigms, particularly in quantum physics and molecular biology. In this way, he shows the advances they have made possible, and also their limitations, and explores what new scientific leaps forward might occur, bringing radically new technological breakthroughs between now and 2050. Papon reminds us, at the same time that, 'as science is not something isolated within society'; it has a duty to contribute to meeting the great challenges that face us - of work, health, nutrition and sustainable development, particularly where energy and climate are concerned. He therefore examines the ways in which future scientific and technological advances might provide solutions and how important it might be to 'translate the questions society poses into scientific questions'. He thus argues implicitly for strategic

  10. Direct Breakthrough Curve Prediction From Statistics of Heterogeneous Conductivity Fields

    Science.gov (United States)

    Hansen, Scott K.; Haslauer, Claus P.; Cirpka, Olaf A.; Vesselinov, Velimir V.

    2018-01-01

    This paper presents a methodology to predict the shape of solute breakthrough curves in heterogeneous aquifers at early times and/or under high degrees of heterogeneity, both cases in which the classical macrodispersion theory may not be applicable. The methodology relies on the observation that breakthrough curves in heterogeneous media are generally well described by lognormal distributions, and mean breakthrough times can be predicted analytically. The log-variance of solute arrival is thus sufficient to completely specify the breakthrough curves, and this is calibrated as a function of aquifer heterogeneity and dimensionless distance from a source plane by means of Monte Carlo analysis and statistical regression. Using the ensemble of simulated groundwater flow and solute transport realizations employed to calibrate the predictive regression, reliability estimates for the prediction are also developed. Additional theoretical contributions include heuristics for the time until an effective macrodispersion coefficient becomes applicable, and also an expression for its magnitude that applies in highly heterogeneous systems. It is seen that the results here represent a way to derive continuous time random walk transition distributions from physical considerations rather than from empirical field calibration.

  11. Husserl's Illumination of the Breakthrough of Logical Investigations

    African Journals Online (AJOL)

    denise

    the example Husserl offers of the room where the lights go off in order to illuminate the breakthrough for ... correspondence theory of truth, and his main concern seems to be to ..... The advantage of Husserl's example is that it tries to situate the ...

  12. Application of the rainfall infiltration breakthrough (RIB) model for ...

    African Journals Online (AJOL)

    Application of the rainfall infiltration breakthrough (RIB) model for groundwater recharge estimation in west coastal South Africa. ... the data from Oudebosch with different rainfall and groundwater abstraction inputs are simulated to explore individual effects on water levels as well as recharge rate estimated on a daily basis.

  13. A European survey of oncology nurse breakthrough cancer pain practices

    NARCIS (Netherlands)

    Rustoen, Tone; Geerling, Jenske I.; Pappa, Theodora; Rundstrom, Carina; Weisse, Isolde; Williams, Sian C.; Zavratnik, Bostjan; Kongsgaard, Ulf E.; Wengstrom, Yvonne

    Purpose of the research: Breakthrough cancer pain (BTCP) is a prevalent type of pain in which the nurse can play an important role in improving patients' pain symptoms and overall well-being. Nurses' experience with BTCP (number of patients, and estimates of severity and frequency), the treatment of

  14. Dissolved CO2 Increases Breakthrough Porosity in Natural Porous Materials.

    Science.gov (United States)

    Yang, Y; Bruns, S; Stipp, S L S; Sørensen, H O

    2017-07-18

    When reactive fluids flow through a dissolving porous medium, conductive channels form, leading to fluid breakthrough. This phenomenon is caused by the reactive infiltration instability and is important in geologic carbon storage where the dissolution of CO 2 in flowing water increases fluid acidity. Using numerical simulations with high resolution digital models of North Sea chalk, we show that the breakthrough porosity is an important indicator of dissolution pattern. Dissolution patterns reflect the balance between the demand and supply of cumulative surface. The demand is determined by the reactive fluid composition while the supply relies on the flow field and the rock's microstructure. We tested three model scenarios and found that aqueous CO 2 dissolves porous media homogeneously, leading to large breakthrough porosity. In contrast, solutions without CO 2 develop elongated convective channels known as wormholes, with low breakthrough porosity. These different patterns are explained by the different apparent solubility of calcite in free drift systems. Our results indicate that CO 2 increases the reactive subvolume of porous media and reduces the amount of solid residual before reactive fluid can be fully channelized. Consequently, dissolved CO 2 may enhance contaminant mobilization near injection wellbores, undermine the mechanical sustainability of formation rocks and increase the likelihood of buoyance driven leakage through carbonate rich caprocks.

  15. Collaboration 'Engineerability'

    NARCIS (Netherlands)

    Kolfschoten, Gwendolyn L.; de Vreede, Gert-Jan; Briggs, Robert O.; Sol, Henk G.

    Collaboration Engineering is an approach to create sustained collaboration support by designing collaborative work practices for high-value recurring tasks, and transferring those designs to practitioners to execute for themselves without ongoing support from collaboration professionals. A key

  16. Modeling dust growth in protoplanetary disks: The breakthrough case

    Science.gov (United States)

    Drążkowska, J.; Windmark, F.; Dullemond, C. P.

    2014-07-01

    Context. Dust coagulation in protoplanetary disks is one of the initial steps toward planet formation. Simple toy models are often not sufficient to cover the complexity of the coagulation process, and a number of numerical approaches are therefore used, among which integration of the Smoluchowski equation and various versions of the Monte Carlo algorithm are the most popular. Aims: Recent progress in understanding the processes involved in dust coagulation have caused a need for benchmarking and comparison of various physical aspects of the coagulation process. In this paper, we directly compare the Smoluchowski and Monte Carlo approaches to show their advantages and disadvantages. Methods: We focus on the mechanism of planetesimal formation via sweep-up growth, which is a new and important aspect of the current planet formation theory. We use realistic test cases that implement a distribution in dust collision velocities. This allows a single collision between two grains to have a wide range of possible outcomes but also requires a very high numerical accuracy. Results: For most coagulation problems, we find a general agreement between the two approaches. However, for the sweep-up growth driven by the "lucky" breakthrough mechanism, the methods exhibit very different resolution dependencies. With too few mass bins, the Smoluchowski algorithm tends to overestimate the growth rate and the probability of breakthrough. The Monte Carlo method is less dependent on the number of particles in the growth timescale aspect but tends to underestimate the breakthrough chance due to its limited dynamic mass range. Conclusions: We find that the Smoluchowski approach, which is generally better for the breakthrough studies, is sensitive to low mass resolutions in the high-mass, low-number tail that is important in this scenario. To study the low number density features, a new modulation function has to be introduced to the interaction probabilities. As the minimum resolution

  17. Do It Yourself (DIY) Earth Science Collaboratories Using Best Practices and Breakthrough Technologies

    Science.gov (United States)

    Stephan, E.

    2017-12-01

    The objective of published earth science study data results and literature on the Web should be to provide a means to integrate discoverable science resources through an open collaborative-Web. At the core of any open science collaborative infrastructure is the ability to discover, manage and ultimately use relevant data accessible to the collaboration. Equally important are the relationships between people, applications, services, and publications, which capture critical contextual knowledge that enable their effective use. While contributions of either irreproducible or costly data can be a great asset the inability of users being able to use the data intelligently or make sense of it, makes these investments not usable. An ability to describe ad-hoc discoverable usage methodologies, provide feedback to data producers, and identify and cite data in a systematic way by leveraging existing Web-enabled off the shelf technology is needed. Fortunately many break-through advancements in data publication best practices and government, open source, and commercial investments support consumers who can provide feedback, share experiences, and contribute back to the earth science ecosystem.

  18. Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries.

    Science.gov (United States)

    Lloyd, C E; Nouwen, A; Sartorius, N; Ahmed, H U; Alvarez, A; Bahendeka, S; Basangwa, D; Bobrov, A E; Boden, S; Bulgari, V; Burti, L; Chaturvedi, S K; Cimino, L C; Gaebel, W; de Girolamo, G; Gondek, T M; de Braude, M Guinzbourg; Guntupalli, A; Heinze, M G; Ji, L; Hong, X; Khan, A; Kiejna, A; Kokoszka, A; Kamala, T; Lalic, N M; Lecic Tosevski, D; Mankovsky, B; Li, M; Musau, A; Müssig, K; Ndetei, D; Rabbani, G; Srikanta, S S; Starostina, E G; Shevchuk, M; Taj, R; Vukovic, O; Wölwer, W; Xin, Y

    2018-06-01

    To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes. © 2018 Diabetes UK.

  19. Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care.

    Science.gov (United States)

    Bellos, Stefanos; Skapinakis, Petros; Rai, Dheeraj; Zitko, Pedro; Araya, Ricardo; Lewis, Glyn; Lionis, Christos; Mavreas, Venetsanos

    2013-12-15

    Alcohol consumption is associated with several complications of both physical and mental health. Light or moderate alcohol consumption may have beneficial effects on physical or mental health but this effect is still controversial and research in the mental health field is relatively scarce. Our aim was to investigate the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety in a large international primary care sample. The sample consisted of 5438 primary care attenders from 14 countries who participated in the WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT) and the mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). Light to moderate alcohol consumption was associated with a lower prevalence of depression and generalized anxiety disorder compared to abstinence while excessive alcohol consumption was associated with a higher prevalence of depression. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables, including the presence of chronic disease and the current physical status of participants and was evident in different drinking cultures. The study confirms that excessive drinking is associated with an increased prevalence of depression, but also raises the possibility that light/moderate drinking may be associated with a reduced prevalence of both depression and anxiety. Any causal interpretation of this association is difficult in the context of this cross-sectional study and further longitudinal studies are needed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. A review on Anticipated Breakthrough Technologies of 21st Century

    OpenAIRE

    Aithal P. S.; Shubhrajyotsna Aithal

    2016-01-01

    This review discuss strategic management of thirteen most anticipated possible technology breakthroughs of 21st century which are substantially affect the life style of living beings in the world like (1) Nanotechnology-based human life comfort, (2) High speed computation through optical computers, (3) Embedded Intelligence, (4) HIV Antivirus, (5) Pseudo Senses - Sensation of existence through virtual reality and through artificial environment, (6) Off Planet Production in micro-gravity, (7) ...

  1. Breakthrough innovations : The impact of foreign acquisition of knowledge

    OpenAIRE

    Tojeiro Rivero, Damián; Moreno Serrano, Rosina; Badillo Enciso, Erika Raquel

    2016-01-01

    Based on the Spanish Technological Innovation Panel, this paper explores the role of R+D offshoring on innovation performance from 2004 to 2013. Specifically, we focus our attention on the impact of different types of offshoring governance models on the profitability of developing breakthrough innovations. Using a novel methodology for panel data sets, we control for the heterogeneity of firms as well as for the sample selection and endogeneity. Our study provides evidence that firms developi...

  2. New AIDA-2020 call for breakthrough detector technologies

    CERN Multimedia

    2016-01-01

    Physicists, engineers, and industry will be interested in a new proof-of-concept fund for breakthrough projects from the general field of detector development and testing.   Launched in the framework of the European project AIDA-2020, this open call will provide up to 200k€ of seed funding to support innovative and societal applications with a focus on industry-oriented applications. The deadline for applying is 20 October 2016. More information here.

  3. Methodology for Examining Potential Technology Breakthroughs for Mitigating CO2 and Application to Centralized Solar Photovoltaics

    Science.gov (United States)

    Aggressive reductions in US greenhouse gas emissions will require radical changes in how society generates and uses energy. Technological breakthroughs will be necessary if we are to make this transition cost effectively. With limited resources, understanding the breakthrough pot...

  4. The SolarPACES strategy for the solar thermal breakthrough

    Energy Technology Data Exchange (ETDEWEB)

    Burch, G.D. [U.S. Department of Energy, Washington, DC (United States)

    1997-12-31

    Our national solar thermal research programs and our combined efforts conducted through IEA/SolarPACES have brought about many breakthroughs in the development of solar thermal technology. We have components and systems that are much more efficient, much more reliable, and can be built much more cost-efficiently than just a few years ago. As our technology development proceeds, we undoubtedly will continue to make significant progress, breakthroughs in fact, in all these areas - progress that will bring us even closer to economic parity with more conventional forms of energy. And while this progress is absolutely necessary, the question is whether it will be enough to allow solar thermal to break into the mainstream of global energy supply. Our new IEA/SolarPACES strategy, crafted and approved over the course of the past year, has recognized the changes we must face and given us license to begin to make those changes. We must begin addressing financial hurdles, work to create a more favorable regulatory and tax environment, support development of international partnerships, and expand the visibility and excitement of solar thermal technology to achieve the final breakthroughs we need to allow solar thermal energy to live up to its vast potential. (orig./AKF)

  5. The prevalence and illness characteristics of DSM-5-defined "mixed feature specifier" in adults with major depressive disorder and bipolar disorder: Results from the International Mood Disorders Collaborative Project.

    Science.gov (United States)

    McIntyre, Roger S; Soczynska, Joanna K; Cha, Danielle S; Woldeyohannes, Hanna O; Dale, Roman S; Alsuwaidan, Mohammad T; Gallaugher, Laura Ashley; Mansur, Rodrigo B; Muzina, David J; Carvalho, Andre; Kennedy, Sidney H

    2015-02-01

    A substantial proportion of individuals with mood disorders present with sub-syndromal hypo/manic features. The objective of this analysis was to evaluate the prevalence and illness characteristics of the Diagnostic and Statistical Manual Version-5 (DSM-5) - defined mixed features specifier (MFS) in adults with major depressive disorder (MDD) and bipolar disorder (BD). Data from participants who met criteria for a current mood episode as part of MDD (n=506) or BD (BD-I: n=216, BD-II: n=130) were included in this post-hoc analysis. All participants were enrolled in the International Mood Disorders Collaborative Project (IMDCP): a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto and the Cleveland Clinic, Cleveland, Ohio. Mixed features specifier was operationalized as a score ≥ 1 on 3 or more select items on the Young Mania Rating Scale (YMRS) or ≥ 1 on 3 select items of the Montgomery Åsberg Depression Rating Scale (MADRS) or Hamilton Depression Rating Scale (HAMD-17) during an index major depressive episode (MDE) or hypo/manic episode, respectively. A total of 26.0% (n=149), 34.0% (n=65), and 33.8% (n=49) of individuals met criteria for MFS during an index MDE as part of MDD, BD-I and BD-II, respectively. Mixed features specifier during a hypo/manic episode was identified in 20.4% (n=52) and 5.1% (n=8) in BD-I and BD-II participants, respectively. Individuals with MDE-MFS as part of BD or MDD exhibited a more severe depressive phenotype (p=0.0002 and pdefined MFS is common during an MDE as part of MDD and BD. The presence of MFS identifies a subgroup of individuals with greater illness complexity and possibly a higher rate of cardiovascular comorbidity. The results herein underscore the common occurrence of MFS in adults with either BD or MDD. Moreover, the results of our analysis indicate that adults with mood disorders and MFS have distinct clinical characteristics and comorbidity patterns. Copyright

  6. Multidisciplinary collaborative care for depressive disorder in the occupational health setting: design of a randomised controlled trial and cost-effectiveness study

    NARCIS (Netherlands)

    Vlasveld, M.C.; Anema, J.R.; Beekman, A.T.F.; van Mechelen, W.; Hoedeman, R.; van Marwijk, H.W.J.; Rutten, F.F.H.; Hakkaart-van Roijen, L.H.; van der Feltz-Cornelis, C.M.

    2008-01-01

    Background. Major depressive disorder (MDD) has major consequences for both patients and society, particularly in terms of needlessly long sick leave and reduced functioning. Although evidence-based treatments for MDD are available, they show disappointing results when implemented in daily practice.

  7. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... generally miserable or unhappy without really knowing why. Depression symptoms in children and teens Common signs and ... in normal activities, and avoidance of social interaction. Depression symptoms in older adults Depression is not a ...

  8. Generating breakthrough new product ideas feeding the innovation funnel

    CERN Document Server

    Cooper, Robert

    2007-01-01

    Senior executives are experiencing a shortage of game-changing ideas that drive growth. This book explains how to feed the innovation funnel with a steady stream of breakthrough new product ideas, providing numerous examples of the methods, approaches and techniques used by leading companies such as Motorola and Procter & Gamble. Learn more about the impact you can make by leveraging an innovation strategy, voice-of-customer research, external ideas via open innovation, employees? creative talent and fundamental research. Establish a proactive Discovery Stage that focuses on the drivers of innovation performance to transform your organization into an innovation machine.

  9. Mini-columns for Conducting Breakthrough Experiments. Design and Construction

    Energy Technology Data Exchange (ETDEWEB)

    Dittrich, Timothy M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reimus, Paul William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Ware, Stuart Douglas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-06-11

    Experiments with moderately and strongly sorbing radionuclides (i.e., U, Cs, Am) have shown that sorption between experimental solutions and traditional column materials must be accounted for to accurately determine stationary phase or porous media sorption properties (i.e., sorption site density, sorption site reaction rate coefficients, and partition coefficients or Kd values). This report details the materials and construction of mini-columns for use in breakthrough columns to allow for accurate measurement and modeling of sorption parameters. Material selection, construction techniques, wet packing of columns, tubing connections, and lessons learned are addressed.

  10. The next breakthrough in phonon-mediated superconductivity

    International Nuclear Information System (INIS)

    Pickett, W.E.

    2008-01-01

    If history teaches us anything, it is that the next breakthrough in superconductivity will not be the result of surveying the history of past breakthroughs, as they have almost always been a matter of serendipity resulting from undirected exploration into new materials. Still, there is reason to reflect on recent advances, work toward higher T c of even an incremental nature, and recognize that it is important to explore avenues currently believed to be unpromising even as we attempt to be rational. In this paper we look at two remarkable new unusually high temperature superconductors (UHTS), MgB 2 with T c = 40 K and (in less detail) high pressure Li with T c = 20 K, with the aim of reducing their unexpected achievements to a simple and clear understanding. We also consider briefly other UHTS systems that provide still unresolved puzzles; these materials include mostly layered structures, and several with strongly bonded C-C or B-C substructures. What may be possible in phonon-coupled superconductivity is reconsidered in the light of the discussion

  11. (Mis)understanding Science: The Problem with Scientific Breakthroughs.

    Science.gov (United States)

    Evans, James P

    2016-09-01

    On Saturday morning, February 28, 1953, the mystery of heredity appeared secure. Humans hadn't the faintest idea of how genetic information was transmitted-how the uncanny resemblance between mother and daughter, grandfather and grandson was conveyed across generations. Yet, by that Saturday afternoon, two individuals, James Watson and Francis Crick, had glimpsed the solution to these mysteries. The story of Watson and Crick's great triumph has been told and retold and has rightly entered the pantheon of scientific legend. But Watson and Crick's breakthrough was just that: a rupture and dramatic discontinuity in human knowledge that solved a deep mystery, the likes of which occurs, perhaps, a couple of times each century. And that's the problem. The story is just so good and so irresistible that it has misled generations of scientists about what to expect regarding a life in science. And more damaging, the resulting breakthrough mentality misleads the public, the media, and society's decision-makers about how science really works, all to the detriment of scientific progress and our society's well-being. © 2016 The Hastings Center.

  12. Turning Regenerative Medicine Breakthrough Ideas and Innovations into Commercial Products.

    Science.gov (United States)

    Bayon, Yves; Vertès, Alain A; Ronfard, Vincent; Culme-Seymour, Emily; Mason, Chris; Stroemer, Paul; Najimi, Mustapha; Sokal, Etienne; Wilson, Clayton; Barone, Joe; Aras, Rahul; Chiesi, Andrea

    2015-12-01

    The TERMIS-Europe (EU) Industry committee intended to address the two main critical issues in the clinical/commercial translation of Advanced Therapeutic Medicine Products (ATMP): (1) entrepreneurial exploitation of breakthrough ideas and innovations, and (2) regulatory market approval. Since January 2012, more than 12,000 publications related to regenerative medicine and tissue engineering have been accepted for publications, reflecting the intense academic research activity in this field. The TERMIS-EU 2014 Industry Symposium provided a reflection on the management of innovation and technological breakthroughs in biotechnology first proposed to contextualize the key development milestones and constraints of allocation of financial resources, in the development life-cycle of radical innovation projects. This was illustrated with the biofuels story, sharing similarities with regenerative medicine. The transition was then ensured by an overview of the key identified challenges facing the commercialization of cell therapy products as ATMP examples. Real cases and testimonies were then provided by a palette of medical technologies and regenerative medicine companies from their commercial development of cell and gene therapy products. Although the commercial development of ATMP is still at the proof-of-concept stage due to technology risks, changing policies, changing markets, and management changes, the sector is highly dynamic with a number of explored therapeutic approaches, developed by using a large diversity of business models, both proposed by the experience, pitfalls, and successes of regenerative medicine pioneers, and adapted to the constraint resource allocation and environment in radical innovation projects.

  13. Collaborative Economy

    DEFF Research Database (Denmark)

    collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...... localities of tourism Greg Richards 11.Collaborative economy and destination marketing organizations: A systems approach Jonathan Day 12.Working within the Collaborative Tourist Economy: The complex crafting of work and meaning Jane Widtfeldt Meged and Mathilde Dissing Christensen PART - III Encounters...

  14. Collaborative Economy

    DEFF Research Database (Denmark)

    that are emerging from them, and how governments are responding to these new challenges. In doing so, the book provides both theoretical and practical insights into the future of tourism in a world that is, paradoxically, becoming both increasingly collaborative and individualized. Table of Contents Preface 1.The...... collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...

  15. Working Collaboratively

    DEFF Research Database (Denmark)

    Holder, Anna; Lovett, George

    2009-01-01

    identified as a transformative global force of the last decade, most notably in knowledge and information publishing, communication and creation. This paper presents a structured conversation on changing understandings of collaboration, and the realities of collaborative methodology in architectural work...

  16. Is a Breakthrough on Climate Change Governance on the Horizon?

    DEFF Research Database (Denmark)

    Figueroa, Maria Josefina

    The recently released Fifth Assessment report of the IPCC has highlighted again with unprecedented scope and insight the urgency of addressing climate change. The international community has pledged to devise the next international agreement on climate change by 2015, while the EU and in particular...... the Scandinavian countries have forged ahead advancing a variety of policies to respond to climate change. Similarly, regions, municipalities, and private actors across the world are also contributing to climate governance. This paper asks whether the world is reaching a tipping point where a breakthrough...... on climate change governance is near?. The answer is approached by contrasting the governance model within which the IPCC operates and the conditions of policy and governance interaction toward the more scientific foundations laid out by IPCC, with the range of multilateral climate governance...

  17. Comparative Effect of Collaborative Care, Pain Medication, and Duloxetine in the Treatment of Major Depressive Disorder and Comorbid (SubChronic Pain: Results of an Exploratory Randomized, Placebo-Controlled, Multicenter Trial (CC:PAINDIP

    Directory of Open Access Journals (Sweden)

    Eric W. de Heer

    2018-04-01

    Full Text Available ObjectiveEvidence exists for the efficacy of collaborative care (CC for major depressive disorder (MDD, for the efficacy of the consequent use of pain medication against pain, and for the efficacy of duloxetine against both MDD and neuropathic pain. Their relative effectiveness in comorbid MDD and pain has never been established so far. This study explores the effectiveness of CC with pain medication and duloxetine, and CC with pain medication and placebo, compared with duloxetine alone, on depressive and pain symptoms. This study was prematurely terminated because of massive reorganizations and reimbursement changes in mental health care in the Netherlands during the study period and is therefore of exploratory nature.MethodsThree-armed, randomized, multicenter, placebo-controlled trial at three specialized mental health outpatient clinics with patients who screened positive for MDD. Interventions lasted 12 weeks. Pain medication was administered according to an algorithm that avoids opiate prescription as much as possible, where paracetamol, COX inhibitors, and pregabalin are offered as steps before opiates are considered. Patients who did not show up for three or more sessions were registered as non-compliant. Explorative, intention-to-treat and per protocol, multilevel regression analyses were performed. The trial is listed in the trial registration (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1089; NTR number: NTR1089.ResultsSixty patients completed the study. Patients in all treatment groups reported significantly less depressive and pain symptoms after 12 weeks. CC with placebo condition showed the fastest decrease in depressive symptoms compared with the duloxetine alone group (b = −0.78; p = 0.01. Non-compliant patients (n = 31 did not improve over the 12-week period, in contrast to compliant patients (n = 29. Pain outcomes did not differ between the three groups.ConclusionIn MDD and pain, patient

  18. What is depression?

    DEFF Research Database (Denmark)

    Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

    2014-01-01

    of depression is insufficient and a collaborative care (CC) model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed......The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners' (GPs') treatment...... to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views...

  19. Depression - resources

    Science.gov (United States)

    Resources - depression ... Depression is a medical condition. If you think you may be depressed, see a health care provider. ... following organizations are good sources of information on depression : American Psychological Association -- www.apa.org/topics/depression/ ...

  20. The Breakthrough Listen Initiative and the Future of the Search for Intelligent Life

    Science.gov (United States)

    Enriquez, J. Emilio; Siemion, Andrew; Croft, Steve; Hellbourg, Greg; Lebofsky, Matt; MacMahon, David; Price, Danny; DeBoer, David; Werthimer, Dan

    2017-05-01

    Unprecedented recent results in the fields of exoplanets and astrobiology have dramatically increased the interest in the potential existence of intelligent life elsewhere in the galaxy. Additionally, the capabilities of modern Searches for Extraterrestrial Intelligence (SETI) have increased tremendously. Much of this improvement is due to the ongoing development of wide bandwidth radio instruments and the Moore's Law increase in computing power over the previous decades. Together, these instrumentation improvements allow for narrow band signal searches of billions of frequency channels at once.The Breakthrough Listen Initiative (BL) was launched on July 20, 2015 at the Royal Society in London, UK with the goal to conduct the most comprehensive and sensitive search for advanced life in humanity's history. Here we detail important milestones achieved during the first year and a half of the program. We describe the key BL SETI surveys and briefly describe current facilities, including the Green Bank Telescope, the Automated Planet Finder and the Parkes Observatory. We also mention the ongoing and potential collaborations focused on complementary sciences, these include pulse searches of pulsars and FRBs, as well as astrophysically powered radio emission from stars targeted by our program.We conclude with a brief view towards future SETI searches with upcoming next-generation radio facilities such as SKA and ngVLA.

  1. CMS Collaboration

    International Nuclear Information System (INIS)

    Faridah Mohammad Idris; Wan Ahmad Tajuddin Wan Abdullah; Zainol Abidin Ibrahim

    2013-01-01

    Full-text: CMS Collaboration is an international scientific collaboration located at European Organization for Nuclear Research (CERN), Switzerland, dedicated in carried out research on experimental particle physics. Consisting of 179 institutions from 41 countries from all around the word, CMS Collaboration host a general purpose detector for example the Compact Muon Solenoid (CMS) for members in CMS Collaboration to conduct experiment from the collision of two proton beams accelerated to a speed of 8 TeV in the LHC ring. In this paper, we described how the CMS detector is used by the scientist in CMS Collaboration to reconstruct the most basic building of matter. (author)

  2. THE ARTHRITIS AND MUSCULOSKELETAL QUALITY IMPROVEMENT PROGRAM (AMQUIP: A BREAKTHROUGH SERIES METHODOLOGY PROJECT

    Directory of Open Access Journals (Sweden)

    MASTURA I

    2008-01-01

    Full Text Available The Australian government had funded the National Primary Care Collaborative (NPCC program with funding of $14.6 million over three years. One of the pilots project was the Arthritis and Musculoskeletal Quality Improvement Program (AMQuIP.The study aims to optimize general practitioners (GPs management of patients with osteoarthritis (OA of the hip and knee by identifying gaps between their current practice and best practice. The Breakthrough Series Collaborative methodology with several Plan-Do-Study-Act (PDSA cycles was employed. Participants comprises of 12 GPs/practices from two Victorian Divisions of general Practice (one rural, one metropolitan with 10 patients per GP/practice. GPs/practices attended an orientation and three learning workshops and a videoconference. GPs/practices completed PDSA cycles between workshop and reported results at workshops. GPs/practices reported use of guidelines, change in patient management and change in practice management/systems. All recruited patients completed the SF-12v2 Health Survey and WOMAC OA Index Questionnaire twice. Follow up activities including focus groups and face-to-face interviews were held six months after the final workshop. All GPs/practices used the guidelines/key messages, introduced “new” management strategies to patients, and made positive changes to their practice management/systems. Patient reported positive changes and outcomes. By using a structured methodology and evidence-based guidelines/key messages; GPs can introduce new patient management strategies, and by identifying gaps in practice management systems, positive changes can be achieved.

  3. 75 Breakthroughs by the U.S. Department of Energy's National Laboratories; Breakthroughs 2017

    Energy Technology Data Exchange (ETDEWEB)

    None

    2017-01-01

    Born at a time when the world faced a dire threat, the National Laboratory System protects America through science and technology. For more than 75 years, the Department of Energy’s national laboratories have solved important problems in science, energy and national security. Partnering with industry and academia, the laboratories also drive innovation to advance economic competitiveness and ensure our nation’s future prosperity. Over the years, America's National Laboratories have been changing and improving the lives of millions of people and this expertise continues to keep our nation at the forefront of science and technology in a rapidly changing world. This network of Department of Energy Laboratories has grown into 17 facilities across the country. As this list of breakthroughs attests, Laboratory discoveries have spawned industries, saved lives, generated new products, fired the imagination and helped to reveal the secrets of the universe.

  4. Collaborative Economy

    DEFF Research Database (Denmark)

    collaborative economy and tourism Dianne Dredge and Szilvia Gyimóthy PART I - Theoretical explorations 2.Definitions and mapping the landscape in the collaborative economy Szilvia Gyimóthy and Dianne Dredge 3.Business models of the collaborative economy Szilvia Gyimóthy 4.Responsibility and care...... and similar phenomena are among these collective innovations in tourism that are shaking the very bedrock of an industrial system that has been traditionally sustained along commercial value chains. To date there has been very little investigation of these trends, which have been inspired by, amongst other...... in the collaborative economy Dianne Dredge 5.Networked cultures in the collaborative economy Szilvia Gyimóthy 6.Policy and regulatory perspectives in the collaborative economy Dianne Dredge PART II - Disruptions, innovations and transformations 7.Regulating innovation in the collaborative economy: An examination...

  5. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... your mood. Chronic pain causes a number of problems that can lead to depression, such as trouble sleeping and stress. Disabling pain can cause low self-esteem due to work, legal or financial issues. Depression ...

  6. Collaboration and E-collaboration

    DEFF Research Database (Denmark)

    Razmerita, Liana; Kirchner, Kathrin

    2015-01-01

    Understanding student’s perception of collaboration and how collaboration is supported by ICT is important for its efficient use in the classroom. This article aims to investigate how students perceive collaboration and how they use new technologies in collaborative group work. Furthermore......, it tries to measure the impact of technology on students’ satisfaction with collaboration outcomes. In particular, the study aims to address the following research questions: Which demographic information (e.g. gender and place of origin) is significant for collaboration and ecollaboration? and Which...... are the perceived factors that influence the students’ group performance? The findings of this study emphasize that there are gender and cultural differences with respect to the perception of e-collaboration. Furthermore, the article summarizes in a model the most significant factors influencing group performance....

  7. The New Three Rs: Research, Reading, and Results. Breakthrough to Literacy[TM].

    Science.gov (United States)

    McGraw-Hill Companies, New York, NY. Educational and Professional Publishing Group.

    Research in school districts throughout the United States shows that children who use "Breakthrough to Literacy" achieve significant and lasting improvement in their reading skills. At virtually every site studied where implementation criteria were met, children who participated in "Breakthrough" demonstrated marked increases…

  8. Alternative sample-introduction technique to avoid breakthrough in gradient-elution liquid chromatography of polymers

    NARCIS (Netherlands)

    Reingruber, E.; Bedani, F.; Buchberger, W.; Schoenmakers, P.

    2010-01-01

    Gradient-elution liquid chromatography (GELC) is a powerful tool for the characterization of synthetic polymers. However, gradient-elution chromatograms often suffer from breakthrough phenomena. Breakthrough can be averted by using a sample solvent as weak as the mobile phase. However, this approach

  9. Collaborative experience

    DEFF Research Database (Denmark)

    Mortensen, Thomas Bøtker

    -Doerr, 1996) and has been shown to have a positive effect to the outcome of collaborative R&D (Sampson, 2005). Anand & Khanna (2000), furthermore, hypothesized that research joint ventures are more ambiguous than marketing joint ventures and even more the licensing and showed that the effect of collaborative......Literature review: Collaborative experience has been shown to have a positive effect on the collaborative outcome in general (Anand & Khanna, 2000; Kale, Dyer & Singh, 2002). Furthermore, it has been linked to the ability to exploit the network of the firm for learning (Powell, Koput and Smith...... experience was largest the higher the hypothesized ambiguity. Theoretically contribution: This research project aims at contributing to existing literature by arguing, that collaborative experience is a moderating variable which moderates the effects on collaborative outcome from the level of complexity...

  10. Parameterizing the Spatial Markov Model From Breakthrough Curve Data Alone

    Science.gov (United States)

    Sherman, Thomas; Fakhari, Abbas; Miller, Savannah; Singha, Kamini; Bolster, Diogo

    2017-12-01

    The spatial Markov model (SMM) is an upscaled Lagrangian model that effectively captures anomalous transport across a diverse range of hydrologic systems. The distinct feature of the SMM relative to other random walk models is that successive steps are correlated. To date, with some notable exceptions, the model has primarily been applied to data from high-resolution numerical simulations and correlation effects have been measured from simulated particle trajectories. In real systems such knowledge is practically unattainable and the best one might hope for is breakthrough curves (BTCs) at successive downstream locations. We introduce a novel methodology to quantify velocity correlation from BTC data alone. By discretizing two measured BTCs into a set of arrival times and developing an inverse model, we estimate velocity correlation, thereby enabling parameterization of the SMM in studies where detailed Lagrangian velocity statistics are unavailable. The proposed methodology is applied to two synthetic numerical problems, where we measure all details and thus test the veracity of the approach by comparison of estimated parameters with known simulated values. Our results suggest that our estimated transition probabilities agree with simulated values and using the SMM with this estimated parameterization accurately predicts BTCs downstream. Our methodology naturally allows for estimates of uncertainty by calculating lower and upper bounds of velocity correlation, enabling prediction of a range of BTCs. The measured BTCs fall within the range of predicted BTCs. This novel method to parameterize the SMM from BTC data alone is quite parsimonious, thereby widening the SMM's practical applicability.

  11. Beyond the traditional definition of breakthrough pain: an observational study.

    Science.gov (United States)

    Gatti, Antonio; Gentili, Marta; Iorno, Vittorio; Mammucari, Massimo; Tufaro, Giuseppe; Lazzari, Marzia; Sabato, Alessandro Fabrizio

    2013-03-01

    Breakthrough pain (BTP) is traditionally defined as a transitory pain flare in opioid-treated patients with chronic background pain. This definition has, however, been challenged in recent years. This study aimed to analyze BTP prevalence in different pain conditions. This was a prospective, non-interventional, observational study conducted from June to September 2011 in two Italian pain treatment reference centres. Consecutive patients aged >18 years with oncological or non-oncological pain were eligible for this study; background pain was acute/ subacute (3 months). The characteristics of pain were evaluated by means of a structured interview by physicians, and patients were asked to complete a dedicated clinical study form. The following outcomes were assessed: chronic pain duration (in patients with chronic pain), BTP prevalence, and number and severity of daily BTP episodes. All outcomes were assessed in four populations of patients with: (a) chronic oncological pain; (b) chronic non-oncological pain; (c) non-chronic oncological pain; (d) non-chronic non-oncological pain. The correlation between BTP and gender was also investigated. Of 1,270 patients with chronic pain, 1,086 had non-oncological pain (85.5%). Most patients (68.6%) with non-oncological pain were female (P = 0.001). Pain duration was significantly longer in non-oncological pain versus oncological pain groups (P = 0.002). BTP prevalence was lower in non-oncological patients (P definition. BTP frequency and severity is similar in oncological and non-oncological pain.

  12. Soil homogeneity evaluation by radionuclide tracer breakthrough curve interpretation

    International Nuclear Information System (INIS)

    Brenizer, J.S. Jr.; Jarrett, A.R.; Jester, W.A.

    1980-01-01

    Increasing concern about the environmental impact of hazardous waste disposal has made site evaluation and site selection difficult and expensive. Pollutants, assumed to be absorbed by the soil immediately surrounding the burial trench, have been detected far from sites. Discrepancies between predicted migration distances based on indirect methods such as laboratory and computer modeling and those observed at the field site are often significant. The homogeneity of subsurface media, often assumed in laboratory and modeling studies, is seldom found in the field. The use of tracers to determine the flow characteristics of a potential disposal site involves time and expense, but offers a direct evaluation of solute transport and eliminates the assumptions inherent in indirect methods. Current modeling of solute transport in nonhomogeneous porous media is limited by the quantification of input parameters. Several general models can predict solute transport in saturated-unsaturated media from low-level disposal sites if the hydraulic characteristics and chemical reactions expected in each unique water-solute-media system can be defined. The objective of this research was to develop a method of evaluating potential shallow-land burial waste disposal sites by interpreting tracer breakthrough curve structure with respect to the hydrologic properties of the media at the potential disposal site. This methodology will be helpful in evaluating the potential performance of many types of shallow-land waste burial sites such as low-level radioactive waste disposal, surface disposal of flyash, chemical waste disposal, waste sedimentation ponds, and sanitary landfills

  13. From Islamicizing the Sciences to Strategizing for Muslims’ Scientific Breakthrough

    Directory of Open Access Journals (Sweden)

    RAFIU IBRAHIM ADEBAYO

    2015-06-01

    Full Text Available At inception, science and religion were seen as poles apart and so science was vehemently kicked against by religious leaders. Islam later came to bridge the gap between religion and science only to be later hijacked by the Western world and so science was rewritten from a purely materialist point of view; hence, experts in modern science became over-confident and arrogant to have relegated religion to the lowest ebb and looked down upon any knowledge which could not be scientifically proved. However attempts are being made to reconcile religion and science by Muslim reformers. These attempts are not without their shortcomings, hence the need for Islamization of the sciences for them to conform to the Islamic principle of unity of knowledge. However, the present researcher feels that there should be a step forward from the contemporary approaches to Islamicizing the sciences in form of colouring the Western scientific discoveries Islam, to making their own scientific breakthroughs, the type which immortalized Muslim scientists of the Islam’s golden ages. Without this, Muslims will continue to be mere consumers of the Western products. The strategy for the Ummah to achieve this is suggested in this paper.

  14. Breakthrough characteristics of gas absorption in a packed column

    International Nuclear Information System (INIS)

    Shitanda, Shoji; Fukada, Satoshi; Koto, Kenji; Mitsuishi, Nobuo

    1979-01-01

    In nuclear industries, the operations to collect or recover various radioactive and non-radioactive gases with a number of absorption or adsorption reagents are practically utilized or planned. Specifically in the operations of recovering hydrogen isotopes, the direct collecting method with active metals such as uranium, zirconium (Zr) and yttrium is watched with keen interest. In this study, the capability of recovering hydrogen by means of Zr was investigated through the estimation of rate-determining step, by flowing the gas mixture of hydrogen and argon after activating metallic Zr under the condition of high temperature and high vacuum, and by determining overall mass transfer coefficient from the absorption breakthrough curves. The details of a packed column and the flowsheet are also described, and the deterioration of Zr powder is considered. That is, the diffusion speed and absorbing reaction speed of hydrogen in Zr particles are supposed to be slow and dominant in mass transfer speed. Further, since gas mixture does not simply diffuse in Zr particles, but the reaction plane seems to move toward the center from the surface in the case of Zr, different from general adsorbents, the moving speed seems to give large effect on the rate-determining step. It is ensured that the hydrogen absorption with Zr powder is so active that hydrogen in gas flow can easily be recovered, and its separation from other gases can be effectively carried out by the desorption of hydrogen from Zr powder by heating it in vacuum. (Wakatsuki, Y.)

  15. Funding breakthrough therapies: A systematic review and recommendation.

    Science.gov (United States)

    Hanna, E; Toumi, M; Dussart, C; Borissov, B; Dabbous, O; Badora, K; Auquier, P

    2018-03-01

    Advanced therapy medicinal products (ATMPs) are innovative therapies likely associated with high prices. Payers need guidance to create a balance between ensuring patient access to breakthrough therapies and maintaining the financial sustainability of the healthcare system. The aims of this study were to identify, define, classify and compare the approaches to funding high-cost medicines proposed in the literature, to analyze their appropriateness for ATMP funding and to suggest an optimal funding model for ATMPs. Forty-eight articles suggesting new funding models for innovative high-cost therapies were identified. The models were classified into 3 groups: financial agreement, health outcomes-based agreement and healthcoin. Financial agreement encompassed: discounts, rebates, price and volume caps, price-volume agreements, loans, cost-plus price, intellectual-based payment and fund-based payment. Health outcomes-based agreements were defined as agreements between manufacturers and payers based on drug performance, and were divided into performance-based payment and coverage with evidence development. Healthcoin described a new suggested tradeable currency used to assign monetary value to incremental outcomes. With a large number of ATMPs in development, it is time for stakeholders to start thinking about new pathways and funding strategies for these innovative high-cost therapies. An "ATMP-specific fund" may constitute a reasonable solution to ensure rapid patient access to innovation without threatening the sustainability of the health care system. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. How Students Combine Resources to Make Conceptual Breakthroughs

    Science.gov (United States)

    Richards, A. J.; Jones, Darrick C.; Etkina, Eugenia

    2018-04-01

    We use the framework of cognitive resources to investigate how students construct understanding of a complex physics topic, namely, a photovoltaic cell. By observing students as they learn about how a solar cell functions, we identified over 60 distinct resources that learners may activate while thinking about photovoltaic cells. We classify these resources into three main types: phenomenological primitives, conceptual resources, and epistemological resources. Furthermore, we found a pattern that suggests that when students make conceptual breakthroughs they may be more likely to activate combinations of resources of different types in concert, especially if a resource from each of the three categories is used. This pattern suggests that physics instructors should encourage students to activate multiple types of prior knowledge during the learning process. This can result from instructors deliberately and explicitly connecting new knowledge to students' prior experience both in and outside the formal physics classroom, as well as allowing students to reflect metacognitively on how the new knowledge fits into their existing understanding of the natural world.

  17. Recent breakthroughs on C-2U: Norman’s legacy

    Energy Technology Data Exchange (ETDEWEB)

    Binderbauer, M. W.; Tajima, T.; Tuszewski, M.; Smirnov, A.; Gota, H.; Garate, E.; Barnes, D.; Deng, B. H.; Trask, E.; Yang, X.; Putvinski, S.; Andow, R.; Bolte, N.; Bui, D. Q.; Ceccherini, F.; Clary, R.; Cheung, A. H.; Conroy, K. D.; Dettrick, S. A.; Douglass, J. D. [Tri Alpha Energy, Inc., P.O. Box 7010, Rancho Santa Margarita, CA 92688 (United States); and others

    2016-03-25

    Conventional field-reversed configurations (FRC) face notable stability and confinement concerns, which can be ameliorated by introducing and maintaining a significant fast ion population in the system. This is the conjecture first introduced by Norman Rostoker multiple decades ago and adopted as the central design tenet in Tri Alpha Energy’s advanced beam driven FRC concept. In fact, studying the physics of such neutral beam (NB) driven FRCs over the past decade, considerable improvements were made in confinement and stability. Next to NB injection, the addition of axially streaming plasma guns, magnetic end plugs, as well as advanced surface conditioning lead to dramatic reductions in turbulence driven losses and greatly improved stability. In turn, fast ion confinement improved significantly and allowed for the build-up of a dominant fast particle population. This recently led to the breakthrough of sustaining an advanced beam driven FRC, thereby demonstrating successful maintenance of trapped magnetic flux, plasma dimensions and total pressure inventory for times much longer than all characteristic system time scales and only limited by hardware and electric supply constraints.

  18. Clean Energy Innovation: Sources of Technical and Commercial Breakthroughs

    Energy Technology Data Exchange (ETDEWEB)

    Perry, T. D., IV; Miller, M.; Fleming, L.; Younge, K.; Newcomb, J.

    2011-03-01

    Low-carbon energy innovation is essential to combat climate change, promote economic competitiveness, and achieve energy security. Using U.S. patent data and additional patent-relevant data collected from the Internet, we map the landscape of low-carbon energy innovation in the United States since 1975. We isolate 10,603 renewable and 10,442 traditional energy patents and develop a database that characterizes proxy measures for technical and commercial impact, as measured by patent citations and Web presence, respectively. Regression models and multivariate simulations are used to compare the social, institutional, and geographic drivers of breakthrough clean energy innovation. Results indicate statistically significant effects of social, institutional, and geographic variables on technical and commercial impacts of patents and unique innovation trends between different energy technologies. We observe important differences between patent citations and Web presence of licensed and unlicensed patents, indicating the potential utility of using screened Web hits as a measure of commercial importance. We offer hypotheses for these revealed differences and suggest a research agenda with which to test these hypotheses. These preliminary findings indicate that leveraging empirical insights to better target research expenditures would augment the speed and scale of innovation and deployment of clean energy technologies.

  19. Parameterizing the Spatial Markov Model from Breakthrough Curve Data Alone

    Science.gov (United States)

    Sherman, T.; Bolster, D.; Fakhari, A.; Miller, S.; Singha, K.

    2017-12-01

    The spatial Markov model (SMM) uses a correlated random walk and has been shown to effectively capture anomalous transport in porous media systems; in the SMM, particles' future trajectories are correlated to their current velocity. It is common practice to use a priori Lagrangian velocity statistics obtained from high resolution simulations to determine a distribution of transition probabilities (correlation) between velocity classes that govern predicted transport behavior; however, this approach is computationally cumbersome. Here, we introduce a methodology to quantify velocity correlation from Breakthrough (BTC) curve data alone; discretizing two measured BTCs into a set of arrival times and reverse engineering the rules of the SMM allows for prediction of velocity correlation, thereby enabling parameterization of the SMM in studies where Lagrangian velocity statistics are not available. The introduced methodology is applied to estimate velocity correlation from BTCs measured in high resolution simulations, thus allowing for a comparison of estimated parameters with known simulated values. Results show 1) estimated transition probabilities agree with simulated values and 2) using the SMM with estimated parameterization accurately predicts BTCs downstream. Additionally, we include uncertainty measurements by calculating lower and upper estimates of velocity correlation, which allow for prediction of a range of BTCs. The simulated BTCs fall in the range of predicted BTCs. This research proposes a novel method to parameterize the SMM from BTC data alone, thereby reducing the SMM's computational costs and widening its applicability.

  20. Collaborative Hierarchy.

    Science.gov (United States)

    Maris, Mariann

    The University of Wisconsin-Milwaukee writing program is collaborative, not divisionary, as some, such as Jeanne Gunner, have suggested. Three terms are useful in understanding the relationships and ethics governing operations at Wisconsin-Milwaukee: (1) authority and collaboration; (2) hierarchical difference; (3) professional respect.…

  1. Collaborative Prototyping

    DEFF Research Database (Denmark)

    Bogers, Marcel; Horst, Willem

    2014-01-01

    of the prototyping process, the actual prototype was used as a tool for communication or development, thus serving as a platform for the cross-fertilization of knowledge. In this way, collaborative prototyping leads to a better balance between functionality and usability; it translates usability problems into design......This paper presents an inductive study that shows how collaborative prototyping across functional, hierarchical, and organizational boundaries can improve the overall prototyping process. Our combined action research and case study approach provides new insights into how collaborative prototyping...... can provide a platform for prototype-driven problem solving in early new product development (NPD). Our findings have important implications for how to facilitate multistakeholder collaboration in prototyping and problem solving, and more generally for how to organize collaborative and open innovation...

  2. The 2001 HBR list. Breakthrough ideas for today's business agenda.

    Science.gov (United States)

    2001-04-01

    Business is shaped by ideas. But how do you separate enduring ideas from passing fancies? In this, the first edition of the annual HBR List, our editors spotlight five break-through ideas that are truly shaping the future of business. EVEN A GREAT BUSINESS MODEL IS NOT ENOUGH: The rise and fall of dot-coms left markets reeling and CEOs scratching their heads. The most important lesson of the debacle: squishy thinking about "business models" is no substitute for a distinctive strategy. CHANGE IS CHANGING: In recent years, pundits have urged executives to incite revolutions within their companies. But a growing group of experts now suggests that the best companies actually evolve through incremental change--change that builds on rather than subverts their heritage. EGO MAKES THE LEADER: By looking deeply into executives' psyches, we are beginning to unlock the enigma of leadership. While there will never be a single recipe for successful corporate stewardship, an understanding of the human ego can shed light on leadership's most fundamental components. ONLY CONNECT: In business organizations, what's really important about people is not their individual skills but the relationships they form with one another. By investing in "social capital," companies can often push their performance to a whole new level. THE BIOLOGY CENTURY DAWNS: In the twentieth century, product innovations tended to spring from physics. But in the new century, biology may be the central source of innovation. From genomics to biomimicry, the study of life promises to change what companies sell and even how they operate.

  3. Observational study to analyze patterns of treatment of breakthrough dyspnea in cancer patients in clinical practice.

    Science.gov (United States)

    Cabezón-Gutiérrez, Luis; Delgado-Mingorance, Ignacio; Nabal-Vicuña, María; Jiménez-López, Antonio Javier; Cabezón-Álvarez, Ana; Soler-López, Begoña

    2018-06-12

    Although breakthrough dyspnea is very frequent in cancer patients, there are no precise recommendations for treating it. The main objective of this study was to analyze what treatments are used in clinical practice for the management of breakthrough dyspnea in cancer patients in Spain and the secondary objectives were to describe the characteristics of cancer patients with breakthrough dyspnea and the attributes of the disorder. Cancer patients over 18 years of age, with breakthrough dyspnea and a Karnofsky performance score of ≥30, who were treated at departments of oncology in institutes across Spain were included in this cross-sectional observational study. The characteristics of breakthrough dyspnea, history of treatment, anthropometric variables, Mahler dyspnea index, Borg scale, Edmonton Symptoms Assessment Scale, and patient satisfaction with current breakthrough dyspnea treatment were assessed. The mean age of the 149 included patients was 66 years (95% confidence interval: 64.3 to 67.9), and 53 were females (35.6%). The mean breakthrough dyspnea intensity was 5.85 (95% confidence interval 5.48 to 6.22, Borg scale). A total of 55.1% of the first-choice treatments consisted of opioids, followed by oxygen (17.3%). A total of 119 patients (79.9%) received monotherapy for breakthrough dyspnea. Patients presenting with basal dyspnea received oxygen in a greater proportion of cases (21.1% vs 7.4%; p = 0.07). Patients with predictable dyspnea received a greater proportion of opioids (70.9% vs 44.4%; p = 0.01). Opioids constitute first-line therapy for breakthrough dyspnea in routine clinical practice, though the scientific evidence supporting their use is scarce. Further information derived from controlled clinical trials is needed regarding the comparative efficacy of the different treatments in order to justify their use.

  4. Collaborative Consumption

    DEFF Research Database (Denmark)

    Gjerdrum Pedersen, Esben Rahbek; Netter, Sarah

    2015-01-01

    Purpose – The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach – The analysis is based on a multiple-case study of Scandinavian fashion libraries – a new...... to the new phenomenon of fashion libraries and does not cover other types of collaborative consumption within the fashion industry (Swap-parties, etc.). Originality/value – The paper is one of the first attempts to examine new business models of collaborative consumption in general and the fashion library...... concept in particular. The study contributes to the discussions of whether and how fashion sharing and collaboration holds promise as a viable business model and as a means to promote sustainability....

  5. Collaborative Consumption

    DEFF Research Database (Denmark)

    Gjerdrum Pedersen, Esben Rahbek; Netter, Sarah

    Purpose: The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach: The analysis is based on a multiple-­‐‑case study of Scandinavian fashion libraries – a new...... to the new phenomenon of fashion libraries and does not cover other types of collaborative consumption within the fashion industry (Swap-­‐‑parties, etc.). Originality/value: The paper is one of the first attempts to examine new business models of collaborative consumption in general and the fashion library...... concept in particular. The study contributes to the discussions of whether and how fashion sharing and collaboration holds promise as a viable business model and as a means to promote sustainability....

  6. Cost-utility of collaborative care for the treatment of comorbid major depressive disorder in outpatients with chronic physical conditions. A randomized controlled trial in the general hospital setting (CC-DIM

    Directory of Open Access Journals (Sweden)

    Goorden M

    2017-07-01

    Full Text Available Maartje Goorden,1 Christina M van der Feltz-Cornelis,2,3 Kirsten M van Steenbergen-Weijenburg,4 Eva K Horn,5 Aartjan TF Beekman,6,7 Leona Hakkaart-van Roijen1 1Institute of Health Policy and Management (iBMG/Institute for Medical Technology Assessment (iMTA, Erasmus University Rotterdam, Rotterdam, 2Tranzo Department, Tilburg University, 3Clinical Centre of Excellence for Body, Mind and Health, GGzBreburg, Tilburg, 4Trimbos Instituut, Utrecht, 5Viersprong Institute for Studies on Personality Disorders, Halsteren, 6Department of Psychiatry, 7EMGO+ Research Institute VUmc, VU University Medical Centre, Amsterdam, the Netherlands Purpose: Major depressive disorder (MDD is highly prevalent in patients with a chronic physical condition, and this comorbidity has a negative influence on quality of life, health care costs, self-care, morbidity, and mortality. Research has shown that collaborative care (CC may be a cost-effective treatment. However, its cost-effectiveness in this patient group has not yet been established. Therefore, the aim of this study was to evaluate the cost-utility of CC for the treatment of comorbid MDD in chronically ill patients in the outpatient general hospital setting. The study was conducted from a health care and societal perspective.Patients and methods: In this randomized controlled trial, 81 patients with moderate-to-severe MDD were included; 42 were randomly assigned to the CC group and 39 to the care as usual (CAU group. We applied the TiC-P, short-form Health-Related Quality of Life questionnaire, and EuroQol EQ-5D 3 level version, measuring the use of health care, informal care, and household work, respectively, at baseline and at 3, 6, 9, and 12 months follow-up.Results: The mean annual direct medical costs in the CC group were €6,718 (95% confidence interval [CI]: 3,541 to 10,680 compared to €4,582 (95% CI: 2,782 to 6,740 in the CAU group. The average quality-adjusted life years (QALYs gained were 0.07 higher

  7. Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes–2

    Directory of Open Access Journals (Sweden)

    Diego Muñoz-Torrero

    2017-12-01

    Full Text Available Breakthroughs in Medicinal Chemistry: New Targets and Mechanisms, New Drugs, New Hopes is a series of Editorials, which are published on a biannual basis by the Editorial Board of the Medicinal Chemistry section of the journal Molecules [...

  8. Use of pulsed-neutron capture logs to identify steam breakthrough

    International Nuclear Information System (INIS)

    Masse, P.J.; Gosney, T.C.; Long, D.L.

    1991-01-01

    This paper reports on identification of steam-breakthrough zones in a stacked sand/shale sequence with variable lateral continuity which is difficult. Such identification, however, would allow the modification of field operations to enhance recovery through improved vertical sweep and heat injection. Twenty pulsed-neutron capture (PNC) logs were run to identify the steam-breakthrough zone(s) in a seven-pattern area of Mobil's Middle expansion (MIDX) Steamflood Project in the South Belridge field. These PNC data were combined with data from recent replacement wells and a detailed geologic analysis. Evaluation of this combined information allowed identification of potential steam-breakthrough zone(s), and operations were modified to reduce and eliminate steam breakthrough

  9. Statistical characteristics of breakthrough discoveries in science using the metaphor of black and white swans

    Science.gov (United States)

    Zeng, Carl J.; Qi, Eric P.; Li, Simon S.; Stanley, H. Eugene; Ye, Fred Y.

    2017-12-01

    A publication that reports a breakthrough discovery in a particular scientific field is referred to as a ;black swan;, and the most highly-cited papers previously published in the same field ;white swans;. Important scientific progress occurs when ;white swans; meet a ;black swan;, and the citation patterns of the ;white swans; change. This metaphor combines scientific discoveries and scientometric data and suggests that breakthrough scientific discoveries are either ;black swans; or ;grey-black swans;.

  10. The management of breakthrough cancer pain--educational needs a European nursing survey.

    Science.gov (United States)

    Wengström, Y; Rundström, C; Geerling, J; Pappa, T; Weisse, I; Williams, S C; Zavratnik, B; Rustøen, T

    2014-01-01

    Poorly managed cancer pain is well known to profoundly impact the patient's daily life and interfere with quality of life. Nurses who cared for patients with cancer from 12 European countries participated in a survey of breakthrough cancer pain practice. The purpose was to investigate how nurses assess breakthrough cancer pain, use of standardised tools, confidence in supporting patients and awareness of medications. Responses from 1241 participants showed country variations. The majority of the sample was female, Germany had the highest proportion of male nurses (21.0%), followed by Greece (15.8%). A significantly larger proportion of nurses with longer experience and more education (78.8%) used a comprehensive definition of breakthrough cancer pain. Significant variations in training were found; 71% of Finnish nurses had received training compared with 6% of Greek nurses. Training and using a standardised assessment tool was associated with a significant increase in the nurses' perceived ability to distinguish between breakthrough and background pain. Nurses in countries with the highest proportion of training were most confident in supporting patients. In conclusion, there still exists problems with effective management of patients' breakthrough cancer pain, continuing inability to define the difference between background and breakthrough cancer pain leads to poor treatment. © 2013 John Wiley & Sons Ltd.

  11. Prediction of ion-exchange column breakthrough curves by constant-pattern wave approach.

    Science.gov (United States)

    Lee, I-Hsien; Kuan, Yu-Chung; Chern, Jia-Ming

    2008-03-21

    The release of heavy metals from industrial wastewaters represents one of major threats to environment. Compared with chemical precipitation method, fixed-bed ion-exchange process can effectively remove heavy metals from wastewaters and generate no hazardous sludge. In order to design and operate fixed-bed ion-exchange processes successfully, it is very important to understand the column dynamics. In this study, the column experiments for Cu2+/H+, Zn2+/H+, and Cd2+/H+ systems using Amberlite IR-120 were performed to measure the breakthrough curves under varying operating conditions. The experimental results showed that total cation concentration in the mobile-phase played a key role on the breakthrough curves; a higher feed concentration resulted in an earlier breakthrough. Furthermore, the column dynamics was also predicted by self-sharpening and constant-pattern wave models. The self-sharpening wave model assuming local ion-exchange equilibrium could provide a simple and quick estimation for the breakthrough volume, but the predicted breakthrough curves did not match the experimental data very well. On the contrary, the constant-pattern wave model using a constant driving force model for finite ion-exchange rate provided a better fit to the experimental data. The obtained liquid-phase mass transfer coefficient was correlated to the flow velocity and other operating parameters; the breakthrough curves under varying operating conditions could thus be predicted by the constant-pattern wave model using the correlation.

  12. Depressive Disorders in Primary Health Care

    OpenAIRE

    Vuorilehto, Maria

    2008-01-01

    The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

  13. The solarPACES strategy for the solar thermal breakthrough

    International Nuclear Information System (INIS)

    Burch, G.D.; Grasse, W.

    1997-01-01

    IEA(International Energy Agency)/SolarPACES(Solar Power and Chemical Energy systems)represents a world wide coalition for information sharing and collaboration on applications of concentrated solar energy. The current SolarPACES community has built up solar thermal system know-how over 15 years, is operating the three main solar test centres in the world. Its main activities are in the following four fields: solar thermal electric power systems, solar chemistry, solar technology and advanced applications and non-technical activities. The article presents the talk on the strategy of solarPACES given at the International Workshop on applied solar energy held in Tashkent(Uzbekistan) in June 1997. (A.A.D.)

  14. Collaborative Economy

    DEFF Research Database (Denmark)

    things, de-industrialization processes and post-capitalist forms of production and consumption, postmaterialism, the rise of the third sector and collaborative governance. Addressing that gap, this book explores the character, depth and breadth of these disruptions, the creative opportunities for tourism...... that are emerging from them, and how governments are responding to these new challenges. In doing so, the book provides both theoretical and practical insights into the future of tourism in a world that is, paradoxically, becoming both increasingly collaborative and individualized. Table of Contents Preface 1.The......This book employs an interdisciplinary, cross-sectoral lens to explore the collaborative dynamics that are currently disrupting, re-creating and transforming the production and consumption of tourism. House swapping, ridesharing, voluntourism, couchsurfing, dinner hosting, social enterprise...

  15. Computer model predicting breakthrough febrile urinary tract infection in children with primary vesicoureteral reflux.

    Science.gov (United States)

    Arlen, Angela M; Alexander, Siobhan E; Wald, Moshe; Cooper, Christopher S

    2016-10-01

    Factors influencing the decision to surgically correct vesicoureteral reflux (VUR) include risk of breakthrough febrile urinary tract infection (fUTI) or renal scarring, and decreased likelihood of spontaneous resolution. Improved identification of children at risk for recurrent fUTI may impact management decisions, and allow for more individualized VUR management. We have developed and investigated the accuracy of a multivariable computational model to predict probability of breakthrough fUTI in children with primary VUR. Children with primary VUR and detailed clinical and voiding cystourethrogram (VCUG) data were identified. Patient demographics, VCUG findings including grade, laterality, and bladder volume at onset of VUR, UTI history, presence of bladder-bowel dysfunction (BBD), and breakthrough fUTI were assessed. The VCUG dataset was randomized into a training set of 288 with a separate representational cross-validation set of 96. Various model types and architectures were investigated using neUROn++, a set of C++ programs. Two hundred fifty-five children (208 girls, 47 boys) diagnosed with primary VUR at a mean age of 3.1 years (±2.6) met all inclusion criteria. A total 384 VCUGs were analyzed. Median follow-up was 24 months (interquartile range 12-52 months). Sixty-eight children (26.7%) experienced 90 breakthrough fUTI events. Dilating VUR, reflux occurring at low bladder volumes, BBD, and history of multiple infections/fUTI were associated with breakthrough fUTI (Table). A 2-hidden node neural network model had the best fit with a receiver operating characteristic curve area of 0.755 for predicting breakthrough fUTI. The risk of recurrent febrile infections, renal parenchymal scarring, and likelihood of spontaneous resolution, as well as parental preference all influence management of primary VUR. The genesis of UTI is multifactorial, making precise prediction of an individual child's risk of breakthrough fUTI challenging. Demonstrated risk factors for

  16. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    The thesis data have been collected in the EU-sponsored project: Collaborative Improvement Tool for the Extended Manufacturing Enterprise, CO-IMPROVE. In this project four universities (Denmark, Ireland, Italy, and The Netherlands), two software vendors (Greece and Sweden) and three companies...... (Denmark, Italy and The Netherlands) each with three to five suppliers were involved. The CO-IMPROVE project and the thesis is based on “action research” and “action learning”. The main aim of the whole project is through actual involvement and actions make the researchers, companies and selected suppliers...... learn how to improve operations in (hopefully) a win-win like manner through collaboration....

  17. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    -organisational continuous improvement of their performance, relative to that of other EMEs. Developing a collaborative improvement relationship between companies is a protracted and complex process and, according to some surveys, the failure rate is as low as one to three. This failure rate is affected by a whole range...... of factors. The research presented in this thesis was aimed at identifying these factors and investigating their interplay and influence on the progress and success of the development of the collaborative improvement. This thesis presents our findings regarding the factors found, their interplay...

  18. Caregiver Depression

    Science.gov (United States)

    ... will not sell or share your name. Caregiver Depression Tweet Bookmark this page | Email | Print Many caregivers ... depression See your doctor Treatment Coping Symptoms of depression Caregiving is hard — and can lead to feelings ...

  19. Depression FAQs

    Science.gov (United States)

    Depression affects about 15 million American adults every year. Women are more likely to get depression than men. In general, about one out of every four women will get depression at some point in her life.

  20. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  1. Predicting the Risk of Breakthrough Urinary Tract Infections: Primary Vesicoureteral Reflux.

    Science.gov (United States)

    Hidas, Guy; Billimek, John; Nam, Alexander; Soltani, Tandis; Kelly, Maryellen S; Selby, Blake; Dorgalli, Crystal; Wehbi, Elias; McAleer, Irene; McLorie, Gordon; Greenfield, Sheldon; Kaplan, Sherrie H; Khoury, Antoine E

    2015-11-01

    We constructed a risk prediction instrument stratifying patients with primary vesicoureteral reflux into groups according to their 2-year probability of breakthrough urinary tract infection. Demographic and clinical information was retrospectively collected in children diagnosed with primary vesicoureteral reflux and followed for 2 years. Bivariate and binary logistic regression analyses were performed to identify factors associated with breakthrough urinary tract infection. The final regression model was used to compute an estimation of the 2-year probability of breakthrough urinary tract infection for each subject. Accuracy of the binary classifier for breakthrough urinary tract infection was evaluated using receiver operator curve analysis. Three distinct risk groups were identified. The model was then validated in a prospective cohort. A total of 252 bivariate analyses showed that high grade (IV or V) vesicoureteral reflux (OR 9.4, 95% CI 3.8-23.5, p urinary tract infection (OR 5.3, 95% CI 1.1-24.7, p = 0.034) and female gender (OR 2.6, 95% CI 0.097-7.11, p urinary tract infection. Subgroup analysis revealed bladder and bowel dysfunction was a significant risk factor more pronounced in low grade (I to III) vesicoureteral reflux (OR 2.8, p = 0.018). The estimation model was applied for prospective validation, which demonstrated predicted vs actual 2-year breakthrough urinary tract infection rates of 19% vs 21%. Stratifying the patients into 3 risk groups based on parameters in the risk model showed 2-year risk for breakthrough urinary tract infection was 8.6%, 26.0% and 62.5% in the low, intermediate and high risk groups, respectively. This proposed risk stratification and probability model allows prediction of 2-year risk of patient breakthrough urinary tract infection to better inform parents of possible outcomes and treatment strategies. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

  2. Contested collaboration

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.

    1995-01-01

    . The model describes design phases, roles, themes, and intergroup communication networks as they evolve throughout the design process and characterizes design as a process of "contested collaboration". It is a first step towards a predictive design model that suggests strategies which may help participants...

  3. Timeline Collaboration

    DEFF Research Database (Denmark)

    Bohøj, Morten; Borchorst, Nikolaj Gandrup; Bouvin, Niels Olof

    2010-01-01

    This paper explores timelines as a web-based tool for collaboration between citizens and municipal caseworkers. The paper takes its outset in a case study of planning and control of parental leave; a process that may involve surprisingly many actors. As part of the case study, a web-based timeline...

  4. Collaborative Appropriation

    DEFF Research Database (Denmark)

    Muller, Michael; Neureiter, Katja; Verdezoto, Nervo

    2016-01-01

    Previous workshops and papers have examined how individual users adopt and adapt technologies to meet their own local needs, by “completing design through use.” However, there has been little systematic study of how groups of people engage collaboratively in these activities. This workshop opens ...

  5. Collaborative Design

    Science.gov (United States)

    Broderick, Debora

    2014-01-01

    This practitioner research study investigates the power of multimodal texts within a real-world context and argues that a participatory culture focused on literary arts offers marginalized high school students opportunities for collaborative design and authoring. Additionally, this article invites educators to rethink the at-risk label. This…

  6. The Breakthrough Listen Search for Intelligent Life: the first SETI results and other future science.

    Science.gov (United States)

    Enriquez, J. Emilio; Breakthrough Listen Team

    2018-01-01

    The Breakthrough Listen (BL) Initiative is the largest campaign in human history on the search for extraterrestrial intelligence. The work presented here is the first BL search for engineered signals. This comprises a sample of 692 nearby stars within 50 pc. We used the Green Bank Telescope (GBT) to conduct observations over 1.1-1.9 GHz (L-band). Our observing strategy allows us to reject most of the detected signals as terrestrial interference. During the analysis, eleven stars show events that passed our thresholding algorithm, but detailed analysis of their properties indicates they are consistent with known examples of anthropogenic radio frequency interference. This small number of false positives and their understood properties give confidence on the techniques used for this search. We conclude that, at the time of our observations none of the observed systems host high-duty-cycle radio transmitters emitting at the observed frequencies with an EIRP of 10^13 W, readily achievable by our own civilization.We can place limits on the presence of engineered signals from putative extraterrestrial civilizations inhabiting the environs of the target stars. Our results suggest that fewer than ~0.1% of the stellar systems within 50 pc possess the type of transmitters searched in this survey. This work provides the most stringent limit on the number of low power radio transmitters around nearby stars to date. We explored several metics to compare our results to previous SETI efforts. We developed a new figure-of-merit that can encompass a wider set of parameters and can be used on future SETI experiments for a meaningful comparison.We note that the current BL state-of-the-art digital backend installed at the Green Bank Observatory is the fastest ever used for a SETI experiment by a factor of a few. Here we will describe the potential use of the BL backend by other groups on complementary science, as well as a mention the ongoing and potential collaborations focused in

  7. Collaborative Consumption

    OpenAIRE

    Rahbek Gjerdrum Pedersen, Esben; Netter, Sarah

    2013-01-01

    Purpose: The purpose of this paper is to explore barriers and opportunities for business models based on the ideas of collaborative consumption within the fashion industry. Design/methodology/approach: The analysis is based on a multiple-­‐‑case study of Scandinavian fashion libraries – a new, clothes-­‐‑sharing concept that has emerged as a fashion niche within the last decade. Findings: It is concluded that fashion libraries offers interesting perspectives, e.g. by allow...

  8. Collaborative sketching

    DEFF Research Database (Denmark)

    Johansson, Martin Wetterstrand

    2006-01-01

    Sketching is a most central activity with in most design projects. But what happens if we adopt the ideas of collaborative design and invite participants that are not trained to sketch in to the design process, how can they participate in this central activity? This paper offers an introduction to...... the design material has been used to co- author possible futures within the scope of design sessions....

  9. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings - Report from the World Health Organization collaborative study on Psychological Problems in General Health Care

    NARCIS (Netherlands)

    Gater, R; Tansella, M; Korten, A; Tiemens, BG; Mavreas, VG; Olatawura, MO

    Background: Understanding the relevance of biological and social factors to sex differences in the prevalence and detection of depressive and anxiety disorders has been impaired by the lack of standardized research methods across cultures. Method: Prevalence rates of depressive and anxiety disorders

  10. Modeling Breakthrough Curves of Citric Acid Adsorption onto Anionic Resins in an Aqueous Solution

    Directory of Open Access Journals (Sweden)

    Sohrabali Ghorbanian

    2015-01-01

    Full Text Available Breakthrough curves for citric acid adsorption from aqueous solution onto ion-exchange resin at 20, 35, and 55°C have been investigated. To predict breakthrough curves, three mathematical models have been analyzed based on the values of the least square method parameters, Durbin-Watson test, and mean relative percent error and, finally, appropriate models have been achieved. Models are in good agreement with experimental data based on the results. To examine models reliabilities and accuracy, models have been compared by various breakthrough curve data obtained by other investigators. The results show appropriate agreement and in some cases regression errors have been reduced to less than 1.0 percent.

  11. Liquid water breakthrough location distances on a gas diffusion layer of polymer electrolyte membrane fuel cells

    Science.gov (United States)

    Yu, Junliang; Froning, Dieter; Reimer, Uwe; Lehnert, Werner

    2018-06-01

    The lattice Boltzmann method is adopted to simulate the three dimensional dynamic process of liquid water breaking through the gas diffusion layer (GDL) in the polymer electrolyte membrane fuel cell. 22 micro-structures of Toray GDL are built based on a stochastic geometry model. It is found that more than one breakthrough locations are formed randomly on the GDL surface. Breakthrough location distance (BLD) are analyzed statistically in two ways. The distribution is evaluated statistically by the Lilliefors test. It is concluded that the BLD can be described by the normal distribution with certain statistic characteristics. Information of the shortest neighbor breakthrough location distance can be the input modeling setups on the cell-scale simulations in the field of fuel cell simulation.

  12. Breakthrough properties of chloride ions in columns of lead phosphate hydroxide

    International Nuclear Information System (INIS)

    Akiba, Kenichi; Hashimoto, Hiroyuki; Mimura, Hitoshi; Shindo, Manabu.

    1994-01-01

    Breakthrough properties of chloride ion (Cl - ) have been studied by using columns packed with a granular anion-exchanger of lead phosphate hydroxide (Pb 10 (PO 4 ) 6 (OH) 2 , IXE-1000G). The column utilization of the ratio of breakthrough capacity to total capacity increased with decreasing particle size and increasing temperature. The collection of Cl - from a simulated waste solution was improved by the addition of cation-exchange to IXE-1000G; the adsorption capacity of the column of IXE-1000G/IXE-300G (Sb type cation-exchanger) was over 0.16 mmol Cl - /g, yielding a relatively high column utilization of 75%. (author)

  13. Coupling gravity, electromagnetism and space-time for space propulsion breakthroughs

    Science.gov (United States)

    Millis, Marc G.

    1994-01-01

    spaceflight would be revolutionized if it were possible to propel a spacecraft without rockets using the coupling between gravity, electromagnetism, and space-time (hence called 'space coupling propulsion'). New theories and observations about the properties of space are emerging which offer new approaches to consider this breakthrough possibility. To guide the search, evaluation, and application of these emerging possibilities, a variety of hypothetical space coupling propulsion mechanisms are presented to highlight the issues that would have to be satisfied to enable such breakthroughs. A brief introduction of the emerging opportunities is also presented.

  14. Collaborative Care

    OpenAIRE

    Schuyler, Dean

    2005-01-01

    本書を著したHornbyは英国のソーシャルワーカーである。彼女は1983年に「Collaboration in social work(Journal of social work practice,1.1)」を発表し、ソーシャルワークでの職種間の連携の重要性について報告している。さらに1993年に発刊した本書では、同一機関内の人間関係 ...

  15. First case of breakthrough pneumonia due to Aspergillus nomius in a patient with acute myeloid leukemia.

    Science.gov (United States)

    Caira, Morena; Posteraro, Brunella; Sanguinetti, Maurizio; de Carolis, Elena; Leone, Giuseppe; Pagano, Livio

    2012-10-01

    We report the first known case of a breakthrough pulmonary infection caused by Aspergillus nomius in an acute myeloid leukemia patient receiving caspofungin therapy. The isolate was identified using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and sequencing-based methods. The organism was found to be fully susceptible, in vitro, to echinocandin antifungal agents.

  16. Efficacy and safety of tramadol/acetaminophen in the treatment of breakthrough pain in cancer patients

    International Nuclear Information System (INIS)

    Ming-Lin Ho; Chih-Yuan Chung

    2010-01-01

    We evaluated the analgesic efficacy and safety of tramadol 37.5 mg/acetaminophen 325 mg combination tablet, for the treatment of breakthrough pain in cancer patients. This study was conducted at Changhua Christian Hospital, Changhua, Taiwan from January 2006 to February 2007. The single-center and open-label study enrolled 59 opioid-treated cancer patients with at least moderate breakthrough pain (visual analog scale [VAS] score >/=40mm on a 100-mm scale). The efficacy measures included VAS scores and adverse effect assessment 10, 30, and 60 minutes after the administration of tramadol/acetaminophen. Visual analog scale score at time of pain relief was reported. The mean VAS score when the breakthrough pain episode began (0 minute) was 77.8. Analysis showed significant better mean pain VAS scores at 10, 30, and 60 minutes after the administration of tramadol/acetaminophen (p Tramadol/acetaminophen might be efficacious and safe in the treatment of breakthrough pain in cancer (Author).

  17. Efficacy and safety of tramadol/acetaminophen in the treatment of breakthrough pain in cancer patients.

    Science.gov (United States)

    Ho, Ming-Lin; Chung, Chih-Yuan; Wang, Chuan-Cheng; Lin, Hsuan-Yu; Hsu, Nicholas C; Chang, Cheng-Shyong

    2010-12-01

    We evaluated the analgesic efficacy and safety of tramadol 37.5 mg/acetaminophen 325 mg combination tablet, for the treatment of breakthrough pain in cancer patients. This study was conducted at Changhua Christian Hospital, Changhua, Taiwan from January 2006 to February 2007. The single-center and open-label study enrolled 59 opioid-treated cancer patients with at least moderate breakthrough pain (visual analog scale [VAS] score ≥40mm on a 100-mm scale). The efficacy measures included VAS scores and adverse effect assessment 10, 30, and 60 minutes after the administration of tramadol/acetaminophen. Visual analog scale score at time of pain relief was reported. The mean VAS score when the breakthrough pain episode began (0 minute) was 77.8. Analysis showed significant better mean pain VAS scores at 10, 30, and 60 minutes after the administration of tramadol/acetaminophen (p≤0.001 versus 0 min for all 3 time points). The mean time to pain relief was 597.2 seconds and the mean VAS score at time of relief was 43.4. The effective rates, defined by more than 30% reduction of the VAS score, after 10 minutes of administration was 74.6%, 30 minutes 86.4%, and one hour 94.9% (p≤0.001 versus 0 minute for all 3 time points). Two cases of drowsiness were reported. Tramadol/acetaminophen might be efficacious and safe in the treatment of breakthrough pain in cancer.

  18. [Parahisian atrial tachycardia or atrioventricular nodal reentrant tachycardia with tendon of Todaro breakthrough?].

    Science.gov (United States)

    Orczykowski, Michał; Jaworska-Wilczyńska, Maria; Urbanek, Piotr; Bodalski, Robert; Derejko, Paweł; Gajek, Jacek; Hryniewiecki, Tomasz; Szumowski, Lukasz; Walczak, Franciszek

    2010-08-01

    We present a case of a 61 year-old woman with tachycardia originating close to the His bundle where radiofrequency (RF) ablation may bear potential risk of atrioventricular (AV) block. In this case report we discuss the possibility of a AV nodal reciprocating tachycardia with tendon of Todaro breakthrough. Patient was safely and effectively treated with RF catheter ablation.

  19. Collaborative Environments. Considerations Concerning Some Collaborative Systems

    Directory of Open Access Journals (Sweden)

    Mihaela I. MUNTEAN

    2009-01-01

    Full Text Available It is obvious, that all collaborative environments (workgroups, communities of practice, collaborative enterprises are based on knowledge and between collaboration and knowledge management there is a strong interdependence. The evolution of information systems in these collaborative environments led to the sudden necessity to adopt, for maintaining the virtual activities and processes, the latest technologies/systems, which are capable to support integrated collaboration in business services. In these environments, portal-based IT platforms will integrate multi-agent collaborative systems, collaborative tools, different enterprise applications and other useful information systems.

  20. Effect of temperature on the breakthrough of a charcoal tube during vinyl chloride monomer sampling.

    Science.gov (United States)

    Roh, J; Park, Y J; Kim, C N; Lim, N G; Lee, S H; Song, J S; Won, J U; Talaska, G

    2000-01-01

    This study evaluated the effects of temperature on breakthrough of two standard collection media at various concentrations during vinyl chloride monomer (VCM) sampling. The National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) methods were evaluated. To determine whether breakthrough of VCM would occur at the extremes of exposure and temperature that might be encountered in some workplaces, air samples containing 4 ppm (10.24 mg/m3), 8 ppm (20.45 mg/m3), 16 ppm (40.98 mg/m3), and 32 ppm (81.80 mg/m3) of VCM were collected at temperatures of 4, 22, and 40 degrees C. Five liters of air was sampled at the rate of 0.05 L/min for 100 min using the activated charcoal tube recommended by NIOSH. A second tube was added to the sampling train to collect any VCM that might not have been absorbed in the first tube. To collect VCM air samples by the OSHA method, two carbon molecular sieve tubes were connected serially and 3 L of air was sampled at the rate of 0.05 L/min for 60 min. A gas chromatograph with a flame ionization detector and ultra 2 capillary column was used to analyze VCM. Significant breakthrough was found when sampling at higher temperatures with the NIOSH method. No breakthrough was found when samples were collected using the OSHA media at different temperatures and concentrations. Therefore, under hot ambient conditions (>22 degrees C), the possibility of breakthrough should be considered when sampling VCM by the NIOSH method.

  1. Distal Ureteral Diameter Ratio is Predictive of Breakthrough Febrile Urinary Tract Infection.

    Science.gov (United States)

    Arlen, Angela M; Leong, Traci; Guidos, P Joseph; Alexander, Siobhan E; Cooper, Christopher S

    2017-12-01

    Distal ureteral diameter ratio is an objective measure that is prognostic of spontaneous resolution of vesicoureteral reflux. Along with likelihood of resolution, improved identification of children at risk for recurrent febrile urinary tract infections may impact management decisions. We evaluated the usefulness of ureteral diameter ratio as a predictive factor for breakthrough febrile urinary tract infections. Children with primary vesicoureteral reflux and detailed voiding cystourethrogram were identified. Ureteral diameter ratio was computed by measuring largest ureteral diameter within the pelvis and dividing by the distance between L1 and L3 vertebral bodies. Demographics, vesicoureteral reflux grade, laterality, presence/absence of bladder-bowel dysfunction, and ureteral diameter ratio were tested in univariate and multivariable analyses. Primary outcome was breakthrough febrile urinary tract infections. We analyzed 112 girls and 28 boys with a mean ± SD age of 2.5 ± 2.3 years at diagnosis. Vesicoureteral reflux was grade 1 to 2 in 64 patients (45.7%), grade 3 in 50 (35.7%), grade 4 in 16 (11.4%) and grade 5 in 10 (7.2%). Mean ± SD followup was 3.2 ± 2.7 years. A total of 40 children (28.6%) experienced breakthrough febrile urinary tract infections. Ureteral diameter ratio was significantly greater in children with (0.36) vs without (0.25) breakthrough febrile infections (p = 0.004). Controlling for vesicoureteral reflux grade, every 0.1 U increase in ureteral diameter ratio resulted in 1.7 times increased odds of breakthrough infection (95% CI 1.24 to 2.26, p urinary tract infections independent of reflux grade. Ureteral diameter ratio provides valuable prognostic information about risk of recurrent pyelonephritis and may assist with clinical decision-making. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  2. A survey of Canadian cancer patients' perspectives on the characteristics and treatment of breakthrough pain.

    Science.gov (United States)

    Bedard, Gillian; Hawley, Philippa; Zhang, Liying; Slaven, Marissa; Gagnon, Pierre; Bisland, Stuart; Bennett, Margaret; Tardif, Francois; Chow, Edward

    2013-09-01

    Breakthrough pain is defined as a transient exacerbation of pain that occurs spontaneously or in response to a trigger despite stable and controlled background pain. The purpose of this study was to explore Canadian patients' awareness of and experience with breakthrough pain in cancer (BTPc). Four Canadian cancer centers participated in a non-interventional survey recruiting cancer patients who experienced breakthrough pain. These patients were asked about their pain, its impact on functioning, current management and interest in new treatments of BTPc. Ninety-four Canadian cancer patients participated in this study, with 96% stating that cancer pain impacted their daily living with over half unable to go to work or shopping. Fifty percent of patients said that an episode of BTPc lasted greater than 60 minutes, with the pain score being on average 7.8/10, impacting normal work (7.2/10) and general activity (7.1/10). Only 35% of patients were very satisfied with the speed of relief of their medications. Those who did not take their breakthrough pain medication for every episode stated that was because the pain was not always severe (37%), or they were afraid of becoming tolerant (23%) or addicted (12%). Patients stated that the most important features of a new treatment for BTPc were the ability to relieve pain completely (47%), and quickly (43%). Patients expressed willingness to try transmucosal products (80%) or nasal products (59%). Breakthrough cancer pain in Canadian cancer patients greatly impacts their daily lives. There is room for improvement in the management of BTPc, and the majority of patients would be willing to try new treatments.

  3. Depression (PDQ)

    Science.gov (United States)

    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... that may also cause depression. There are many medical conditions that can cause depression. Medical conditions that ...

  4. Postpartum Depression

    Science.gov (United States)

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  5. Depression Treatment

    Science.gov (United States)

    ... 3286 After hours (404) 639-2888 Contact Media Depression Treatment Recommend on Facebook Tweet Share Compartir On ... How Do I Know if I Am Experiencing Depression? The following questions may help you determine if ...

  6. Collaborative innovation

    DEFF Research Database (Denmark)

    Torfing, Jacob; Sørensen, Eva; Hartley, Jean

    2013-01-01

    , which emphasizes market competition; the neo-Weberian state, which emphasizes organizational entrepreneurship; and collaborative governance, which emphasizes multiactor engagement across organizations in the private, public, and nonprofit sectors. The authors conclude that the choice of strategies......-driven private sector is more innovative than the public sector by showing that both sectors have a number of drivers of as well as barriers to innovation, some of which are similar, while others are sector specific. The article then systematically analyzes three strategies for innovation: New Public Management......There are growing pressures for the public sector to be more innovative but considerable disagreement about how to achieve it. This article uses institutional and organizational analysis to compare three major public innovation strategies. The article confronts the myth that the market...

  7. Choreographing Partnerships within an Organizational Structure of Accountability: Maryland State Department of Education's Shift from Compliance Monitor to Breakthrough Partner

    Science.gov (United States)

    Strickling, Laura Rutter; Doneker, Karen Lee

    2014-01-01

    Drawing upon data from twenty-five interviews, this paper examines how the Maryland State Department of Education's Cross-functional Team navigates its changing role from compliance monitor to breakthrough partner in terms of discourse, time, and flexibility, as it carries out the work of the Breakthrough Center. It also examines how the role of…

  8. Teen Depression

    Science.gov (United States)

    What is depression in teens? Teen depression is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. It is ... trouble focusing and have no motivation or energy. Depression can make you feel like it is hard ...

  9. Enhanced care for depression : Review

    NARCIS (Netherlands)

    Beekman, A.J.; van der Feltz-Cornelis, C.M.; van Marwijk, H.W.J.

    2013-01-01

    Purpose of review: The purpose of this study is to review recent evidence of the effects of enhanced depression care, focusing (1) on symptomatic, functional and economic outcomes and (2) across different countries, (3) ethnic groups and (4) settings. Recent findings: Collaborative care is currently

  10. Gas breakthrough and emission through unsaturated compacted clay in landfill final cover

    International Nuclear Information System (INIS)

    Ng, C.W.W.; Chen, Z.K.; Coo, J.L.; Chen, R.; Zhou, C.

    2015-01-01

    Highlights: • Explore feasibility of unsaturated clay as a gas barrier in landfill cover. • Gas breakthrough pressure increases with clay thickness and degree of saturation. • Gas emission rate decreases with clay thickness and degree of saturation. • A 0.6 m-thick clay layer may be sufficient to meet gas emission rate limit. - Abstract: Determination of gas transport parameters in compacted clay plays a vital role for evaluating the effectiveness of soil barriers. The gas breakthrough pressure has been widely studied for saturated swelling clay buffer commonly used in high-level radioactive waste disposal facility where the generated gas pressure is very high (in the order of MPa). However, compacted clay in landfill cover is usually unsaturated and the generated landfill gas pressure is normally low (typically less than 10 kPa). Furthermore, effects of clay thickness and degree of saturation on gas breakthrough and emission rate in the context of unsaturated landfill cover has not been quantitatively investigated in previous studies. The feasibility of using unsaturated compacted clay as gas barrier in landfill covers is thus worthwhile to be explored over a wide range of landfill gas pressures under various degrees of saturation and clay thicknesses. In this study, to evaluate the effectiveness of unsaturated compacted clay to minimize gas emission, one-dimensional soil column tests were carried out on unsaturated compacted clay to determine gas breakthrough pressures at ultimate limit state (high pressure range) and gas emission rates at serviceability limit state (low pressure range). Various degrees of saturation and thicknesses of unsaturated clay sample were considered. Moreover, numerical simulations were carried out using a coupled gas–water flow finite element program (CODE-BRIGHT) to better understand the experimental results by extending the clay thickness and varying the degree of saturation to a broader range that is typical at different

  11. Gas breakthrough and emission through unsaturated compacted clay in landfill final cover

    Energy Technology Data Exchange (ETDEWEB)

    Ng, C.W.W.; Chen, Z.K.; Coo, J.L. [Department of Civil and Environmental Engineering, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon (Hong Kong); Chen, R., E-mail: chenrui1005@hotmail.com [Shenzhen Key Laboratory of Urban and Civil Engineering for Disaster Prevention and Mitigation, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen 518055 (China); Zhou, C. [Department of Civil and Environmental Engineering, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon (Hong Kong)

    2015-10-15

    Highlights: • Explore feasibility of unsaturated clay as a gas barrier in landfill cover. • Gas breakthrough pressure increases with clay thickness and degree of saturation. • Gas emission rate decreases with clay thickness and degree of saturation. • A 0.6 m-thick clay layer may be sufficient to meet gas emission rate limit. - Abstract: Determination of gas transport parameters in compacted clay plays a vital role for evaluating the effectiveness of soil barriers. The gas breakthrough pressure has been widely studied for saturated swelling clay buffer commonly used in high-level radioactive waste disposal facility where the generated gas pressure is very high (in the order of MPa). However, compacted clay in landfill cover is usually unsaturated and the generated landfill gas pressure is normally low (typically less than 10 kPa). Furthermore, effects of clay thickness and degree of saturation on gas breakthrough and emission rate in the context of unsaturated landfill cover has not been quantitatively investigated in previous studies. The feasibility of using unsaturated compacted clay as gas barrier in landfill covers is thus worthwhile to be explored over a wide range of landfill gas pressures under various degrees of saturation and clay thicknesses. In this study, to evaluate the effectiveness of unsaturated compacted clay to minimize gas emission, one-dimensional soil column tests were carried out on unsaturated compacted clay to determine gas breakthrough pressures at ultimate limit state (high pressure range) and gas emission rates at serviceability limit state (low pressure range). Various degrees of saturation and thicknesses of unsaturated clay sample were considered. Moreover, numerical simulations were carried out using a coupled gas–water flow finite element program (CODE-BRIGHT) to better understand the experimental results by extending the clay thickness and varying the degree of saturation to a broader range that is typical at different

  12. Collaborative information seeking

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2008-01-01

    Since common ground is pivotal to collaboration, this paper proposes to define collaborative information seeking as the combined activity of information seeking and collaborative grounding. While information-seeking activities are necessary for collaborating actors to acquire new information......, the activities involved in information seeking are often performed by varying subgroups of actors. Consequently, collaborative grounding is necessary to share information among collaborating actors and, thereby, establish and maintain the common ground necessary for their collaborative work. By focusing...... on the collaborative level, collaborative information seeking aims to avoid both individual reductionism and group reductionism, while at the same time recognizing that only some information and understanding need be shared....

  13. Mathematical models applied to the Cr(III) and Cr(VI) breakthrough curves.

    Science.gov (United States)

    Ramirez C, Margarita; Pereira da Silva, Mônica; Ferreira L, Selma G; Vasco E, Oscar

    2007-07-19

    Trivalent and hexavalent chromium continuous biosorption was studied using residual brewer Saccharomyces cerevisiae immobilized in volcanic rock. The columns used in the process had a diameter of 4.5 cm and a length of 140 cm, working at an inlet flow rate of 15 mL/min. Breakthrough curves were used to study the yeast biosorption behavior in the process. The saturation time (ts) was 21 and 45 h for Cr(III) and Cr(VI), respectively, and a breakthrough time (tb) of 4 h for Cr(III) and 5 h for Cr(VI). The uptake capacity of the biosorbent for Cr(III) and Cr(VI) were 48 and 60 mg/g, respectively. Two non-diffusional mathematical models with parameters t0 and sigma were used to adjust the experimental data obtained. Microsoft Excel tools were used for the mathematical solution of the two parameters used.

  14. Electrical breakthrough effect for end pointing in 90 and 45 nm node circuit edit

    International Nuclear Information System (INIS)

    Liu, Kun; Soskov, Alex; Scipioni, Larry; Bassom, Neil; Sijbrandij, Sybren; Smith, Gerald

    2006-01-01

    The interaction between high-energy Ga + ions and condensed matter is studied for circuit edit applications. A new 'electrical breakthrough effect' due to charging of, and Ga + penetration/doping into, dielectrics is discovered. This new effect is proposed for end pointing in 90 and 45 nm node circuit edits where integrated circuit device dimensions are of a few hundred nanometers. This new end point approach is very sensitive, reliable, and precise. Most importantly, it is not sensitive to device dimensions. A series of circuit edits involving milling holes of high aspect ratio (5-30) and small cross-section area (0.01-0.25 μm 2 ) on real chips has been successfully performed using the electrical breakthrough effect as the end point method

  15. Breakthrough of toluene vapours in granular activated carbon filled packed bed reactor

    International Nuclear Information System (INIS)

    Mohan, N.; Kannan, G.K.; Upendra, S.; Subha, R.; Kumar, N.S.

    2009-01-01

    The objective of this research was to determine the toluene removal efficiency and breakthrough time using commercially available coconut shell-based granular activated carbon in packed bed reactor. To study the effect of toluene removal and break point time of the granular activated carbon (GAC), the parameters studied were bed lengths (2, 3, and 4 cm), concentrations (5, 10, and 15 mg l -1 ) and flow rates (20, 40, and 60 ml/min). The maximum percentage removal of 90% was achieved and the maximum carbon capacity for 5 mg l -1 of toluene, 60 ml/min flow rate and 3 cm bed length shows 607.14 mg/g. The results of dynamic adsorption in a packed bed were consistent with those of equilibrium adsorption by gravimetric method. The breakthrough time and quantity shows that GAC with appropriate surface area can be utilized for air cleaning filters. The result shows that the physisorption plays main role in toluene removal.

  16. Breakthrough on technical and vocational education of Taiwan: Take Oriental Institute of Technology as an example

    Science.gov (United States)

    Chang, Horng-jinh; Wang, Whe-min

    2017-06-01

    Taiwan's economic strength has changed drastically in the past decade because of political and economic reasons; however, in order to cope with international environment, higher education must increase its breakthrough to meet the needs of enterprises. School curriculum also has to be timely changes and adjustments. This study will analyze school learning in several directions, use questionnaire to investigate students' learning stress, to find out where students' pressure lie. Also, outsourcing employers' satisfaction survey to find out what do enterprises wants to solve with the drop problem between school and enterprise. Taking Oriental Institute of Technology (OIT) as an example; over the past ten years, OIT has used overseas internships to help students overcome learning difficulties. Overseas practice courses include Penang Malaysia and Suzhou China had gained tremendous breakthrough.

  17. Collaboration rules.

    Science.gov (United States)

    Evans, Philip; Wolf, Bob

    2005-01-01

    Corporate leaders seeking to boost growth, learning, and innovation may find the answer in a surprising place: the Linux open-source software community. Linux is developed by an essentially volunteer, self-organizing community of thousands of programmers. Most leaders would sell their grandmothers for workforces that collaborate as efficiently, frictionlessly, and creatively as the self-styled Linux hackers. But Linux is software, and software is hardly a model for mainstream business. The authors have, nonetheless, found surprising parallels between the anarchistic, caffeinated, hirsute world of Linux hackers and the disciplined, tea-sipping, clean-cut world of Toyota engineering. Specifically, Toyota and Linux operate by rules that blend the self-organizing advantages of markets with the low transaction costs of hierarchies. In place of markets' cash and contracts and hierarchies' authority are rules about how individuals and groups work together (with rigorous discipline); how they communicate (widely and with granularity); and how leaders guide them toward a common goal (through example). Those rules, augmented by simple communication technologies and a lack of legal barriers to sharing information, create rich common knowledge, the ability to organize teams modularly, extraordinary motivation, and high levels of trust, which radically lowers transaction costs. Low transaction costs, in turn, make it profitable for organizations to perform more and smaller transactions--and so increase the pace and flexibility typical of high-performance organizations. Once the system achieves critical mass, it feeds on itself. The larger the system, the more broadly shared the knowledge, language, and work style. The greater individuals' reputational capital, the louder the applause and the stronger the motivation. The success of Linux is evidence of the power of that virtuous circle. Toyota's success is evidence that it is also powerful in conventional companies.

  18. Onset of disability in depressed and non-depressed primary care patients

    NARCIS (Netherlands)

    Ormel, J; Vonkorff, M; Oldehinkel, AJ; Simon, G; Tiemens, BG; Ustun, TB

    Background. While cross-sectional and longitudinal studies have consistently found depressive illness and disability to be related, understanding whether depression leads to subsequent onset of disability is limited. Methods. In the context of the multi-centre international WHO Collaborative Study

  19. Ordovician gas exploration breakthrough in the Gucheng lower uplift of the Tarim Basin and its enlightenment

    Directory of Open Access Journals (Sweden)

    Wang Zhaoming

    2014-10-01

    Full Text Available A steady high yield natural gas flow was tapped in the Ordovician strata of Well Gucheng 6 drilled in the Gucheng lower uplift in the Tarim Basin in 2012, marking the discovery of another carbonate gas exploration field after the other two fields in the middle and northern Tarim Basin (the so called Tazhong and Tabei in the industry. The exploration in the Gucheng lower uplift has experienced three stages: the first stage, marine facies clastic exploration from 1995 to 2003, focusing on the Devonian Donghe sandstone lithologic traps, the Silurian overlapping lithologic traps, and the Upper Ordovician shelf slope turbidites; the second stage focusing on the reef shoal carbonate reservoirs from 2003 to 2006, during which oil and gas were first discovered in Well Gucheng 4; the third stage can be divided into two periods, in the first period, deeper insight into interbed karstification reservoir exploration, intense research on tricky seismic issues, selection of favorable zones, and 3D seismic deployment in advance laid a robust foundation for breakthroughs in oil and gas exploration; and during 2009–2012, through an in-depth investigation, Well Gucheng 6 was drilled, bringing about the major breakthrough in oil and gas exploration in this study area. This success proves that the Lower Paleozoic carbonate rocks in the Gucheng area have good geological conditions and broad prospect for oil and gas exploration, which give us enlightenment in three aspects: a. new insight into geologic understanding is the prerequisite of exploration breakthrough; b. addressing bottleneck technologies, and acquiring 3D seismic data are the guarantees of exploration breakthrough; and c. emancipation of mind and persistent exploration are key to the findings in new domains.

  20. Comprehensive sieve analysis of breakthrough HIV-1 sequences in the RV144 vaccine efficacy trial.

    Science.gov (United States)

    Edlefsen, Paul T; Rolland, Morgane; Hertz, Tomer; Tovanabutra, Sodsai; Gartland, Andrew J; deCamp, Allan C; Magaret, Craig A; Ahmed, Hasan; Gottardo, Raphael; Juraska, Michal; McCoy, Connor; Larsen, Brendan B; Sanders-Buell, Eric; Carrico, Chris; Menis, Sergey; Kijak, Gustavo H; Bose, Meera; Arroyo, Miguel A; O'Connell, Robert J; Nitayaphan, Sorachai; Pitisuttithum, Punnee; Kaewkungwal, Jaranit; Rerks-Ngarm, Supachai; Robb, Merlin L; Kirys, Tatsiana; Georgiev, Ivelin S; Kwong, Peter D; Scheffler, Konrad; Pond, Sergei L Kosakovsky; Carlson, Jonathan M; Michael, Nelson L; Schief, William R; Mullins, James I; Kim, Jerome H; Gilbert, Peter B

    2015-02-01

    The RV144 clinical trial showed the partial efficacy of a vaccine regimen with an estimated vaccine efficacy (VE) of 31% for protecting low-risk Thai volunteers against acquisition of HIV-1. The impact of vaccine-induced immune responses can be investigated through sieve analysis of HIV-1 breakthrough infections (infected vaccine and placebo recipients). A V1/V2-targeted comparison of the genomes of HIV-1 breakthrough viruses identified two V2 amino acid sites that differed between the vaccine and placebo groups. Here we extended the V1/V2 analysis to the entire HIV-1 genome using an array of methods based on individual sites, k-mers and genes/proteins. We identified 56 amino acid sites or "signatures" and 119 k-mers that differed between the vaccine and placebo groups. Of those, 19 sites and 38 k-mers were located in the regions comprising the RV144 vaccine (Env-gp120, Gag, and Pro). The nine signature sites in Env-gp120 were significantly enriched for known antibody-associated sites (p = 0.0021). In particular, site 317 in the third variable loop (V3) overlapped with a hotspot of antibody recognition, and sites 369 and 424 were linked to CD4 binding site neutralization. The identified signature sites significantly covaried with other sites across the genome (mean = 32.1) more than did non-signature sites (mean = 0.9) (p analysis of the breakthrough infections in the RV144 trial, this work describes a set of statistical methods and tools applicable to analysis of breakthrough infection genomes in general vaccine efficacy trials for diverse pathogens.

  1. The Effect of Velocity Correlation on the Spatial Evolution of Breakthrough Curves in Heterogeneous Media

    Science.gov (United States)

    Massoudieh, A.; Dentz, M.; Le Borgne, T.

    2017-12-01

    In heterogeneous media, the velocity distribution and the spatial correlation structure of velocity for solute particles determine the breakthrough curves and how they evolve as one moves away from the solute source. The ability to predict such evolution can help relating the spatio-statistical hydraulic properties of the media to the transport behavior and travel time distributions. While commonly used non-local transport models such as anomalous dispersion and classical continuous time random walk (CTRW) can reproduce breakthrough curve successfully by adjusting the model parameter values, they lack the ability to relate model parameters to the spatio-statistical properties of the media. This in turns limits the transferability of these models. In the research to be presented, we express concentration or flux of solutes as a distribution over their velocity. We then derive an integrodifferential equation that governs the evolution of the particle distribution over velocity at given times and locations for a particle ensemble, based on a presumed velocity correlation structure and an ergodic cross-sectional velocity distribution. This way, the spatial evolution of breakthrough curves away from the source is predicted based on cross-sectional velocity distribution and the connectivity, which is expressed by the velocity transition probability density. The transition probability is specified via a copula function that can help construct a joint distribution with a given correlation and given marginal velocities. Using this approach, we analyze the breakthrough curves depending on the velocity distribution and correlation properties. The model shows how the solute transport behavior evolves from ballistic transport at small spatial scales to Fickian dispersion at large length scales relative to the velocity correlation length.

  2. Managing collaborative design

    NARCIS (Netherlands)

    Sebastian, R.

    2007-01-01

    Collaborative design has been emerging in building projects everywhere. The more complex a building project becomes, the closer and more intensive collaboration between the design actors is required. This research focuses on collaborative design in the conceptual architecture design phase,

  3. Collaborative networks: Reference modeling

    NARCIS (Netherlands)

    Camarinha-Matos, L.M.; Afsarmanesh, H.

    2008-01-01

    Collaborative Networks: Reference Modeling works to establish a theoretical foundation for Collaborative Networks. Particular emphasis is put on modeling multiple facets of collaborative networks and establishing a comprehensive modeling framework that captures and structures diverse perspectives of

  4. [Breakthrough pain treatment with sublingual fentanyl in patients with chronic cutaneous ulcers].

    Science.gov (United States)

    Domingo-Triadó, V; López Alarcón, M D; Villegas Estévez, F; Alba Moratillas, C; Massa Domínguez, B; Palomares Payá, F; Mínguez Martí, A; Debón Vicent, L

    2014-10-01

    The aim of the study was to assess the efficacy and safety of opioids in the management of pain in those patients with chronic cutaneous ulcers and breakthrough/incidental pain. An open-label, multicentre, prospective, uncontrolled study was conducted in the pain and ulcer units of 5 hospitals across the Comunidad Valenciana. Eligibility criteria were baseline pain 4 in the visual analogue scale or breakthrough procedural pain 4. Exclusion criteria were cognitive impairment, opioid intolerance, or patient refusal to provide informed consent. The protocol scheduled 5 controls: baseline (enrolment), 15 days, one month, 2 months, and 3 months. The main outcome measure of the study was the visual analogue scale score during rest, movement and procedures. Opioids were administered for release of the baseline pain, and sublingual fentanyl for breakthrough pain. A total of 32 patients (86.5%) completed the study. Baseline pain achieved a mean improvement of 3.6 visual analogue scale points (SD 2.3), movement pain improved by 3.9 points (SD 2.5) and procedural pain improved by 4.5 points (SD 2.8), and the mean pain intensity improvement was statistically significant from the first control and at all controls thereafter (PDolor. Published by Elsevier España. All rights reserved.

  5. Breakthrough analysis for water disinfection using silver nanoparticles coated resin beads in fixed-bed column

    International Nuclear Information System (INIS)

    Mthombeni, Nomcebo H.; Mpenyana-Monyatsi, Lizzy; Onyango, Maurice S.; Momba, Maggie N.B.

    2012-01-01

    Highlights: ► Performance of silver nanoparticles coated resin in water disinfection is presented. ► Sigmoidal models are used to describe breakthrough curves. ► The performance of the media in water disinfection is affected by process variables. ► Test with environmental water shows the media is effective in water disinfection. - Abstract: This study demonstrates the use of silver nanoparticles coated resin beads in deactivating microbes in drinking water in a column filtration system. The coated resin beads are characterized using X-ray diffraction (XRD), Fourier transform infra-red (FT-IR), scanning electron microscope (SEM), transmission electron microscope (TEM) and energy dispersive spectroscopy (EDS) to confirm the functional groups, morphology and the presence of silver nanoparticles on the surface of the resin. The performance of the coated resin is evaluated as a function of bed mass, initial bacterial concentration and flow rate using Escherichia coli as model microbial contaminant in water. The survival curves of E. coli are expressed as breakthrough curves (BTCs), which are modeled using sigmoidal regression equations to obtain relevant rate parameters. The number of bed volumes processed at breakthrough point and capacity of the bed are used as performance indicators. Results show that performance increases with a decrease in initial bacterial concentration, an increase in flow rate and an increase in bed mass.

  6. Peak and Tail Scaling of Breakthrough Curves in Hydrologic Tracer Tests

    Science.gov (United States)

    Aquino, T.; Aubeneau, A. F.; Bolster, D.

    2014-12-01

    Power law tails, a marked signature of anomalous transport, have been observed in solute breakthrough curves time and time again in a variety of hydrologic settings, including in streams. However, due to the low concentrations at which they occur they are notoriously difficult to measure with confidence. This leads us to ask if there are other associated signatures of anomalous transport that can be sought. We develop a general stochastic transport framework and derive an asymptotic relation between the tail scaling of a breakthrough curve for a conservative tracer at a fixed downstream position and the scaling of the peak concentration of breakthrough curves as a function of downstream position, demonstrating that they provide equivalent information. We then quantify the relevant spatiotemporal scales for the emergence of this asymptotic regime, where the relationship holds, in the context of a very simple model that represents transport in an idealized river. We validate our results using random walk simulations. The potential experimental benefits and limitations of these findings are discussed.

  7. Breakthrough revisited: investigating the requirements for growth of dust beyond the bouncing barrier

    Science.gov (United States)

    Booth, Richard A.; Meru, Farzana; Lee, Man Hoi; Clarke, Cathie J.

    2018-03-01

    For grain growth to proceed effectively and lead to planet formation, a number of barriers to growth must be overcome. One such barrier, relevant for compact grains in the inner regions of the disc, is the `bouncing barrier' in which large grains (˜mm size) tend to bounce off each other rather than sticking. However, by maintaining a population of small grains, it has been suggested that cm-size particles may grow rapidly by sweeping up these small grains. We present the first numerically resolved investigation into the conditions under which grains may be lucky enough to grow beyond the bouncing barrier by a series of rare collisions leading to growth (so-called `breakthrough'). Our models support previous results, and show that in simple models breakthrough requires the mass ratio at which high-velocity collisions transition to growth instead of causing fragmentation to be low, ϕ ≲ 50. However, in models that take into account the dependence of the fragmentation threshold on mass ratio, we find that breakthrough occurs more readily, even if mass transfer is relatively inefficient. This suggests that bouncing may only slow down growth, rather than preventing growth beyond a threshold barrier. However, even when growth beyond the bouncing barrier is possible, radial drift will usually prevent growth to arbitrarily large sizes.

  8. Offering Global Collaboration Services beyond CERN and HEP

    CERN Document Server

    Fernandes, J; Baron, T

    2015-01-01

    The CERN IT department has built over the years a performant and integrated ecosystem of collaboration tools, from videoconference and webcast services to event management software. These services have been designed and evolved in very close collaboration with the various communities surrounding the laboratory and have been massively adopted by CERN users. To cope with this very heavy usage, global infrastructures have been deployed which take full advantage of CERN's international and global nature. If these services and tools are instrumental in enabling the worldwide collaboration which generates major HEP breakthroughs, they would certainly also benefit other sectors of science in which globalization has already taken place. Some of these services are driven by commercial software (Vidyo or Wowza for example), some others have been developed internally and have already been made available to the world as Open Source Software in line with CERN's spirit and mission. Indico for example is now installed in 10...

  9. ACTIVE MARKETING STRATEGY IN THE EDUCATION MARKET:BREAKTHROUGH POSITIONING STRATEGY IN PROMOTING UNIVERSITY’S INNOVATIONS

    OpenAIRE

    Pashkus N.A; Pashkus V.

    2013-01-01

    The article discusses the possibility of using active marketing strategies for promoting the results of university’s innovations. Benefits, that can be obtained by university through its strategy of breakthrough positioning explored

  10. Depressive Disorders

    Science.gov (United States)

    Brown, Jacqueline A.; Russell, Samantha; Rasor, Kaitlin

    2017-01-01

    Depression is among the most common mental disorders in the United States. Its diagnosis is often related to impairment of functioning across several domains, including how an individual thinks, feels, and participates in daily activities. Although depression has a relatively high prevalence among adults, the rate is alarmingly higher among…

  11. Postpartum Depression

    Science.gov (United States)

    ... professionals for help. With support and treatment, new mothers with depression can go on to be healthy, happy parents. ... or two, talk to your doctor. A new mother who feels like giving up, who feels that life is not ... depression can last for several months or even longer ...

  12. Collaboration enhances later individual memory for emotional material.

    Science.gov (United States)

    Bärthel, Gwennis A; Wessel, Ineke; Huntjens, Rafaële J C; Verwoerd, Johan

    2017-05-01

    Research on collaborative remembering suggests that collaboration hampers group memory (i.e., collaborative inhibition), yet enhances later individual memory. Studies examining collaborative effects on memory for emotional stimuli are scarce, especially concerning later individual memory. In the present study, female undergraduates watched an emotional movie and recalled it either collaboratively (n = 60) or individually (n = 60), followed by an individual free recall test and a recognition test. We replicated the standard collaborative inhibition effect. Further, in line with the literature, the collaborative condition displayed better post-collaborative individual memory. More importantly, in post-collaborative free recall, the centrality of the information to the movie plot did not play an important role. Recognition rendered slightly different results. Although collaboration rendered more correct recognition for more central details, it did not enhance recognition of background details. Secondly, the collaborative and individual conditions did not differ with respect to overlap of unique correct items in free recall. Yet, during recognition former collaborators more unanimously endorsed correct answers, as well as errors. Finally, extraversion, neuroticism, social anxiety, and depressive symptoms did not moderate the influence of collaboration on memory. Implications for the fields of forensic and clinical psychology are discussed.

  13. Breakthrough Aspergillus fumigatus and Candida albicans double infection during caspofungin treatment

    DEFF Research Database (Denmark)

    Arendrup, Maiken Cavling; Garcia-Effron, Guillermo; Buzina, Walter

    2009-01-01

    Caspofungin is used for the treatment of acute invasive candidiasis and as salvage treatment for invasive aspergillosis. We report characteristics of isolates of Candida albicans and Aspergillus fumigatus detected in a patient with breakthrough infection complicating severe gastrointestinal surgery...... without FSK1 resistance mutations in liver and lung tissues. Breakthrough disseminated aspergillosis and candidiasis developed despite an absence of characteristic FKS1 resistance mutations in the Aspergillus isolates. EUCAST and CLSI methodology did not separate the candin-resistant clinical isolate from...

  14. Making synthetic mudstone: Parametric resedimentation studies at high effective stress to determine controls on breakthrough pressure and permeability

    Science.gov (United States)

    Guiltinan, E. J.; Cardenas, M. B.; Cockrell, L.; Espinoza, N.

    2017-12-01

    The geologic sequestration of CO2 is widely considered a potential solution for decreasing anthropogenic atmospheric CO2 emissions. As CO2 rises buoyantly within a reservoir it pools beneath a caprock and a pressure is exerted upon the pores of the caprock proportionally to the height of the pool. The breakthrough pressure is the point at which CO2 begins to flow freely across the caprock. Understanding the mineralogical and grain size controls on breakthrough pressure is important for screening the security of CO2 sequestration sites. However, breakthrough pressure and permeability measurements on caprocks are difficult to conduct in a systematic manner given the variability in and heterogeneity of naturally occurring mudstones and shales causing significant noise and scatter in the literature. Recent work has even revealed the ability for CO2 to pass through thin shale beds at relatively low pressures. To broaden the understanding of shale breakthrough and permeability, we developed an approach that allows for the creation of resedimented mudstones at high effective stresses. Resedimented samples also include calcium carbonate cement. Using this technique, we explore the controls on entry pressure, breakthrough pressure, and permeability of synthetic mudstones. Understanding the effect of mineralogy and grain size on the permeability and breakthrough pressure of mudstones at reservoir stresses will help in the selection and uncertainty quantification of secure CO2 storage sites.

  15. Depressive realism and clinical depression.

    Science.gov (United States)

    Carson, Richard C; Hollon, Steven D; Shelton, Richard C

    2010-04-01

    Depressive realism suggests that depressed individuals make more accurate judgments of control than their nondepressed counterparts. However, most studies demonstrating this phenomenon were conducted in nonclinical samples. In this study, psychiatric patients who met criteria for major depressive disorder underestimated control in a contingent situation and were consistently more negative in their judgments than were nondepressed controls. Depressed patients were less likely than their nondepressed counterparts to overestimate control in a noncontingent situation, but largely because they perceived receiving less reinforcement. Depressed patients were no more likely to use the appropriate logical heuristic to generate their judgments of control than their nondepressed counterparts and each appeared to rely on different primitive heuristics. Depressed patients were consistently more negative than their nondepressed counterparts and when they did appear to be more "accurate" in their judgments of control (as in the noncontingent situation) it was largely because they applied the wrong heuristic to less accurate information. These findings do not support the notion of depressive realism and suggest that depressed patients distort their judgments in a characteristically negative fashion. 2009 Elsevier Ltd. All rights reserved.

  16. Depression in the Workplace

    Science.gov (United States)

    ... You are here Home » Depression In The Workplace Depression In The Workplace Clinical depression has become one ... will die by suicide vi . Employees' Attitudes Towards Depression Often times a depressed employee will not seek ...

  17. Genetics Home Reference: depression

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Depression Depression Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Depression (also known as major depression or major depressive ...

  18. Procedure and accuracy in the Eurotunnel breakthrough. Vorgehensweise und Genauigkeit beim Durchschlag des Eurotunnels

    Energy Technology Data Exchange (ETDEWEB)

    Korittke, N. (DMT-Gesellschaft fuer Forschung und Pruefung mbH, Essen (Germany, F.R.). Inst. fuer Lagerstaette und Vermessung (ILV))

    1991-02-14

    After a construction time of about 2.5 years the first link was made in the Eurotunnel between France and England, viz. the service tunnel, on 1 December 1990. Thanks to the accurate Gyromat measurements of the Institute for Mineral Deposits and Surveying of the Deutsche Montan Technologie (DMT) a transverse deviation of only 361 mm, a longitudinal deviation of 69 mm and a vertical deviation of 58 mm were determined in the breakthrough of the 22.3 and 15.6 km long tunnel sections. (orig.).

  19. Epicardial Breakthrough Waves During Sinus Rhythm: Depiction of the Arrhythmogenic Substrate?

    Science.gov (United States)

    Mouws, Elisabeth M J P; Lanters, Eva A H; Teuwen, Christophe P; van der Does, Lisette J M E; Kik, Charles; Knops, Paul; Bekkers, Jos A; Bogers, Ad J J C; de Groot, Natasja M S

    2017-09-01

    Epicardial breakthrough waves (EBW) during atrial fibrillation are important elements of the arrhythmogenic substrate and result from endo-epicardial asynchrony, which also occurs to some degree during sinus rhythm (SR). We examined the incidence and characteristics of EBW during SR and its possible value in the detection of the arrhythmogenic substrate associated with atrial fibrillation. Intraoperative epicardial mapping (interelectrode distances 2 mm) of the right atrium, Bachmann's bundle, the left atrioventricular groove, and the pulmonary vein area was performed during SR in 381 patients (289 male, 67±10 years) with ischemic or valvular heart disease. EBW were referred to as sinus node breakthrough waves if they were the earliest right atrial activated site. A total of 218 EBW and 57 sinus node breakthrough waves were observed in 168 patients (44%). EBW mostly occurred at right atrium (N=105, 48%) and left atrioventricular groove (N=67, 31%), followed by Bachmann's bundle (N=27, 12%) and pulmonary vein area (N=19, 9%; P <0.001). EBW occurred most often in ischemic heart disease patients (N=114, 49%) compared with (ischemic and) valvular heart disease patients (N=26, 17%; P <0.001). EBW electrograms most often consisted of double and fractionated potentials (N=137, 63%). In case of single potentials, an R wave was observed in 88% (N=71) of EBW, as opposed to 21% of sinus node breakthrough waves (N=5; P <0.001). Fractionated EBW potentials were more often observed at the right atrium and Bachmann's bundle ( P <0.001). During SR, EBW are present in over a third of patients, particularly in thicker parts of the atrial wall. Features of SR EBW indicate that muscular connections between endo- and epicardium underlie EBW and that a slight degree of endo-epicardial asynchrony required for EBW to occur is already present in some areas during SR. Hence, an anatomic substrate is present, which may enhance the occurrence of EBW during atrial fibrillation, thereby

  20. Comprehensive sieve analysis of breakthrough HIV-1 sequences in the RV144 vaccine efficacy trial.

    Directory of Open Access Journals (Sweden)

    Paul T Edlefsen

    2015-02-01

    Full Text Available The RV144 clinical trial showed the partial efficacy of a vaccine regimen with an estimated vaccine efficacy (VE of 31% for protecting low-risk Thai volunteers against acquisition of HIV-1. The impact of vaccine-induced immune responses can be investigated through sieve analysis of HIV-1 breakthrough infections (infected vaccine and placebo recipients. A V1/V2-targeted comparison of the genomes of HIV-1 breakthrough viruses identified two V2 amino acid sites that differed between the vaccine and placebo groups. Here we extended the V1/V2 analysis to the entire HIV-1 genome using an array of methods based on individual sites, k-mers and genes/proteins. We identified 56 amino acid sites or "signatures" and 119 k-mers that differed between the vaccine and placebo groups. Of those, 19 sites and 38 k-mers were located in the regions comprising the RV144 vaccine (Env-gp120, Gag, and Pro. The nine signature sites in Env-gp120 were significantly enriched for known antibody-associated sites (p = 0.0021. In particular, site 317 in the third variable loop (V3 overlapped with a hotspot of antibody recognition, and sites 369 and 424 were linked to CD4 binding site neutralization. The identified signature sites significantly covaried with other sites across the genome (mean = 32.1 more than did non-signature sites (mean = 0.9 (p < 0.0001, suggesting functional and/or structural relevance of the signature sites. Since signature sites were not preferentially restricted to the vaccine immunogens and because most of the associations were insignificant following correction for multiple testing, we predict that few of the genetic differences are strongly linked to the RV144 vaccine-induced immune pressure. In addition to presenting results of the first complete-genome analysis of the breakthrough infections in the RV144 trial, this work describes a set of statistical methods and tools applicable to analysis of breakthrough infection genomes in general vaccine

  1. So That's How! 2007 Microsoft® Office System Timesavers, Breakthroughs, & Everyday Genius

    CERN Document Server

    Archilla, Evan

    2009-01-01

    Turn your productivity drains into productivity gains! With this practical (and fun) guide, you'll discover the best ways to tackle your daily work with the 2007 Microsoft Office system. The authors have taught thousands of people to get better results with less effort. Now these efficiency experts let you steal from their "tip jar" full of timesaving shortcuts and other brilliant ideas. You'll explore what's new in your favorite Microsoft Office programs-and transform the way you work. Get timesavers, breakthroughs, & everyday genius to: Take control of your inbox, calendar, and everyday in

  2. The Impact of Breakthrough Therapy Designation on Development Strategies and Timelines for Nononcology Drugs and Vaccines.

    Science.gov (United States)

    Poirier, A F; Murphy, W R

    2016-12-01

    The US Food and Drug Administration (FDA) Safety and Innovation Act (FDASIA, 2012) introduced the Breakthrough Therapy Designation (BTD), a new tool to expedite development of medicines to treat serious or life-threatening diseases. The majority of BTDs have gone to oncology drugs, and a recent publication by Shea et al. 1 reviewed the impact of BTD on oncology drug development. This article reviews the impact of BTD on development strategies and timelines for nononcology drugs. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  3. Postpartum Depression

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne

    Background: In three academic articles, this PhD thesis investigates maternal postpartum depression (PPD) as a risk factor for the infant-mother attachment and infant development. Previous studies have been contradictory with respect to the question of whether PPD can have long term effects...... on offspring. This may be due to not differing between when PPD is only occurring in the postpartum period and when effects are also due to ongoing or recurrent depression. However, it may also be due to viewing maternal depression as a unitary construct, and not considering underlying maternal psychological...... difficulties which may moderate potential adverse effects. The present thesis investigates two potential maternal moderators of risk:. Comorbid personality disorder and adult attachment insecurity. Moreover, the question of early environmental effects of PPD versus effects of later or ongoing depression...

  4. Effect of Relative Humidity on Adsorption Breakthrough of CO2 on Activated Carbon Fibers

    Directory of Open Access Journals (Sweden)

    Yu-Chun Chiang

    2017-11-01

    Full Text Available Microporous activated carbon fibers (ACFs were developed for CO2 capture based on potassium hydroxide (KOH activation and tetraethylenepentamine (TEPA amination. The material properties of the modified ACFs were characterized using several techniques. The adsorption breakthrough curves of CO2 were measured and the effect of relative humidity in the carrier gas was determined. The KOH activation at high temperature generated additional pore networks and the intercalation of metallic K into the carbon matrix, leading to the production of mesopore and micropore volumes and providing access to the active sites in the micropores. However, this treatment also resulted in the loss of nitrogen functionalities. The TEPA amination has successfully introduced nitrogen functionalities onto the fiber surface, but its long-chain structure blocked parts of the micropores and, thus, made the available surface area and pore volume limited. Introduction of the power of time into the Wheeler equation was required to fit the data well. The relative humidity within the studied range had almost no effects on the breakthrough curves. It was expected that the concentration of CO2 was high enough so that the impact on CO2 adsorption capacity lessened due to increased relative humidity.

  5. Breakthrough indicator for aromatic VOCs using needle trap samplers for activated carbon adsorbent.

    Science.gov (United States)

    Cheng, Wen-Hsi; Jiang, Jia-Rong; Huang, Yi-Ning; Huang, Shiun-Chian; Yu, Yan-Pin

    2012-08-01

    Internal circulation cabinets equipped with granular activated carbon (GAC) for adsorbing volatile organic compounds (VOCs) are widely used to store bottles containing organic solvents in universities, colleges, and hospital laboratories throughout Taiwan. This work evaluates the VOC adsorption capacities of GAC using various adsorption times for gas stream mixtures of 100 ppm toluene and 100 ppm o-xylene. Additionally, needle trap sampling (NTS) technology was used to indicate the time for renewing the GAC to avoid VOC breakthrough from adsorbents. Experimental results demonstrate that the proposed models can linearly express toluene and o-xylene adsorption capacities as the natural logarithm of adsorption time (ln(t)) and can accurately simulate the equilibrium adsorption capacities (Qe, g VOCs/g GAC) for gaseous toluene and o-xylene. The NTS, packed with 60-80 mesh divinylbenzene (DVB) particles, was compared in terms of extraction efficiency by simultaneously using the 75-microm Carboxen/polydimethylsiloxane-solid-phase microextraction (Carboxen/PDMS-SPME) fiber for time-weighted average (TWA) sampling, and experimental results indicated that the packed DVB-NTS achieved higher toluene extraction rates. Additionally, the NTS installed in the outlet air stream for adsorbing toluene and o-xylene exhausted through GAC accurately indicated toluene and o-xylene breakthrough times of 4700-5000 min. The GAC-NTS operational instructions to indicate the replacing time of adsorbent in the internal circulation cabinets are also included in this paper.

  6. Proposal to realize a cost breakthrough in carbon-13 production by photochemical separation

    International Nuclear Information System (INIS)

    Marling, J.B.

    1979-10-01

    A cost breakthrough can now be made in photochemical production of the rare stable isotope carbon-13. This cost breakthrough is achieved by CO 2 laser infrared multiple-photon dissociation of any of several halocarbons (Freon derivatives) such as CF 3 Cl, CF 3 Br, or CF 2 Cl 2 . The single-step carbon-13 enrichment factor for this process is approximately 50, yielding 30% pure C-13 in one step, or up to 97% pure C-13 in two steps. A three-fold carbon-13 cost reduction to below $20/gram is expected to be achieved in a small laboratory-scale demonstration facility capable of producing 4 to 8 kg/year of carbon-13, using presently available pulsed CO 2 TEA lasers at an average power level of 50 watts. Personnel costs dominate the attainable C-13 production costs in a small photochemical enrichment facility. A price reduction to $2/gm carbon-13 is feasible at carbon-13 production levels of 100 to 1000 kg/year, dominated by the Freon raw material costs

  7. Collaborative Contracting in Projects

    NARCIS (Netherlands)

    Suprapto, M.

    2016-01-01

    Project practitioners have increasingly recognized the importance of collaborative relationships to ensure successful executions of projects. However, the ability to sustain and consistenly drive real collaborative attitudes and behavior for achieving the desired outcomes remains of enduring

  8. Global Collaborative STEM Education

    Science.gov (United States)

    Meabh Kelly, Susan; Smith, Walter

    2016-04-01

    Global Collaborative STEM Education, as the name suggests, simultaneously supports two sets of knowledge and skills. The first set is STEM -- science, technology, engineering and math. The other set of content knowledge and skills is that of global collaboration. Successful global partnerships require awareness of one's own culture, the biases embedded within that culture, as well as developing awareness of the collaborators' culture. Workforce skills fostered include open-mindedness, perseverance when faced with obstacles, and resourceful use of technological "bridges" to facilitate and sustain communication. In respect for the 2016 GIFT Workshop focus, Global Collaborative STEM Education projects dedicated to astronomy research will be presented. The projects represent different benchmarks within the Global Collaborative STEM Education continuum, culminating in an astronomy research experience that fully reflects how the global STEM workforce collaborates. To facilitate wider engagement in Global Collaborative STEM Education, project summaries, classroom resources and contact information for established international collaborative astronomy research projects will be disseminated.

  9. Experiences of Collaborative Research

    Science.gov (United States)

    Kahneman, Daniel

    2003-01-01

    The author's personal history of the research that led to his recognition in economics is described, focusing on the process of collaboration and on the experience of controversy. The author's collaboration with Amos Tversky dealt with 3 major topics: judgment under uncertainty, decision making, and framing effects. A subsequent collaboration,…

  10. Trust repertoires for collaboration

    DEFF Research Database (Denmark)

    Fuglsang, Lars

    This case study analyses the role of trust in a public private innovation network that involved a private consultancy company as a facilitator. We know that collaboration is a important for innovation, and that collaboration across organizational boundaries is not a trivial issue. But we know very...... little about how such processes develop and how trust, understood as “confident positive expectations” (Lewicki et al. 1998) to collaborative activities, arises out of collaboration. The paper contributes by showing how trust and collaboration are intertwined. The main finding is that a facilitator can...

  11. Breakthrough curve of H/sub 2/-Ti-sponge adsorption system

    Energy Technology Data Exchange (ETDEWEB)

    Yasufuku, K [Kawasaki Heavy Industries Ltd., Kobe (Japan)

    1977-11-01

    Experimental work concerning H/sub 2/-Ti-sponge adsorption system has been undertaken at Kawasaki Heavy Industry Co. to obtain necessary data for the design of hydrogen removal tower (Ti-sponge trap) to be used as an purification component of a VHTR plant. In this study, the effects of equilibrium curve, H/sub 2/ inlet concentration, and the ratio of the solid-side capacity factor to the gas-side capacity factor on the breakthrough curve were investigated. The Freundlich's equation with the diffusion model of Carter et al. was numerically solved by the Crank-Nicholson method, and the results of calculations are presented. The flow diagram and the photographs of the facilities for He gas purification experiments are also presented.

  12. Central Hyperexcitability in Chronic Musculoskeletal Pain: A Conceptual Breakthrough with Multiple Clinical Implications

    Directory of Open Access Journals (Sweden)

    Jan Lidbeck

    2002-01-01

    Full Text Available Recent investigations of dysfunctional pain processing in the central nervous system have contributed much knowledge about the development of chronic musculoskeletal pain. Many common chronic musculoskeletal pain syndromes - including regional myofascial pain syndromes, whiplash pain syndromes, refractory work-related neck-shoulder pain, certain types of chronic low back pain, fibromyalgia and others - may essentially be explained by abnormalities in central pain modulation. The growing awareness of dysfunctional central pain modulation may be a conceptual breakthrough leading to a better understanding of common chronic pain disorders. A new paradigm will have multiple clinical implications, including re-evaluation of clinical practice routines and rehabilitation methods, and will focus on controversial issues of medicolegal concern. The concept of dysfunctional central pain processing will also necessitate a mechanism-based classification of pain for the selection of individual treatment and rehabilitation programs for subgroups of patients with chronic musculoskeletal pain due to different pathophysiological mechanisms.

  13. Fentanyl sublingual spray for breakthrough cancer pain in patients receiving transdermal fentanyl.

    Science.gov (United States)

    Alberts, David S; Smith, Christina Cognata; Parikh, Neha; Rauck, Richard L

    2016-10-01

    To investigate the relationship between effective fentanyl sublingual spray (FSS) doses for breakthrough cancer pain (BTCP) and around-the-clock (ATC) transdermal fentanyl patch (TFP). Adults tolerating ATC opioids received open-label FSS for 26 days, followed by a 26-day double-blind phase for patients achieving an effective dose (100-1600 µg). Out of 50 patients on ATC TFP at baseline, 32 (64%) achieved an effective dose. FSS effective dose moderately correlated with mean TFP dose (r = 0.4; p = 0.03). Patient satisfaction increased during the study. Common adverse event included nausea (9%) and peripheral edema (9%). FSS can be safely titrated to an effective dose for BTCP in patients receiving ATC TFP as chronic cancer pain medication. ClinicalTrials.gov identifier: NCT00538850.

  14. Scientific breakthroughs necessary for the commercial success of renewable energy (Invited)

    Science.gov (United States)

    Sharp, J.

    2010-12-01

    In recent years the wind energy industry has grown at an unprecedented rate, and in certain regions has attained significant penetration into the power infrastructure. This growth has been both a result of, and a precursor to, significant advances in the science and business of wind energy. But as a result of this growth and increasing penetration, further advances and breakthroughs will become increasingly important. These advances will be required in a number of different aspects of wind energy, including: resource assessment, operations and performance analysis, forecasting, and the impacts of increased wind energy development. Resource assessment has benefited from the development of tools specifically designed for this purpose. Despite this, the atmosphere is often portrayed in an extremely simplified manner by these tools. New methodologies should rely upon more sophisticated application of the physics of fluid flows. There will need to be an increasing reliance and acceptance of improved measurement techniques (remote sensing, volume rather than point measurements, etc), and more sophisticated and higher-resolution numerical methods for micrositing. The goals of resource assessment will have to include a better understanding of the variability and forecastability of potential sites. Operational and performance analysis are vital to quantifying how well all aspects of the business are being carried out. Operational wind farms generate large amounts of meteorological and mechanical data. Data mining and detailed analysis of this data has proven to be invaluable to shed light upon poorly understood aspects of the science and industry. Future analysis will need to be even more rigorous and creative. Worthy topics of study include the impact of turbine wakes upon downstream turbine performance, how to utilize operational data to improve resource assessment and forecasting, and what the impacts of large-scale wind energy development might be. Forecasting is an

  15. Ovarian stem cells and neo-oogenesis: A breakthrough in reproductive biology research

    Directory of Open Access Journals (Sweden)

    S Mooyottu1

    2011-04-01

    Full Text Available The concept of ovarian stem cells which can replenish the ovarian reserve in postnatal mammalian females is a revolutionary breakthrough in reproductive biology. This idea overturned the central dogma existed in female reproductive physiology. Contradicting the popular belief that oogenesis does not occur in post natal life, researchers proved the existence of putative stem cells in ovary, which can supply functional follicles in post natal ovaries. Even though the idea of neo-oogenesis in postnatal ovaries in normal conditions is controversial, the isolation and manipulation of ovarian stem cells have got tremendous application in medical, veterinary and animal production fields. [Veterinary World 2011; 4(2.000: 89-91

  16. From Bottleneck to Breakthrough: Urbanization and the Future of Biodiversity Conservation.

    Science.gov (United States)

    Sanderson, Eric W; Walston, Joseph; Robinson, John G

    2018-06-01

    For the first time in the Anthropocene, the global demographic and economic trends that have resulted in unprecedented destruction of the environment are now creating the necessary conditions for a possible renaissance of nature. Drawing reasonable inferences from current patterns, we can predict that 100 years from now, the Earth could be inhabited by between 6 and 8 billion people, with very few remaining in extreme poverty, most living in towns and cities, and nearly all participating in a technologically driven, interconnected market economy. Building on the scholarship of others in demography, economics, sociology, and conservation biology, here, we articulate a theory of social-environmental change that describes the simultaneous and interacting effects of urban lifestyles on fertility, poverty alleviation, and ideation. By recognizing the shifting dynamics of these macrodrivers, conservation practice has the potential to transform itself from a discipline managing declines ("bottleneck") to a transformative movement of recovery ("breakthrough").

  17. Marketization of Collective-owned Rural Land: A Breakthrough in Shenzhen, China

    Directory of Open Access Journals (Sweden)

    Yonghua Zou

    2014-12-01

    Full Text Available This study focuses on analyzing the ongoing land policy reform that allows collective-owned rural land transactions in the open market in Shenzhen, China. Employing a case study method, we investigate this land policy evolution through description and contextual analysis. We argue that the existing dual-track land administration system, within which the state administers market transactions, has contributed to numerous social problems, such as urban land scarcity, inefficiency of land resource allocation, and exacerbated social injustice. Following the recent actions of the central government, a collective-owned rural land parcel in Shenzhen was officially transferred in November 2013, an action viewed as a landmark step in reforming the current dual-track land system. Though the generalization of Shenzhen’s experiment nationwide faces significant barriers, Shenzhen’s breakthrough in liberalization of the rural land market indicates that China is moving toward a potential new round of land policy revolution.

  18. Solar Spicules: Prospects for Breakthroughs in Understanding with Solar-B

    Science.gov (United States)

    Sterling, A.

    Spicules densely populate the lower solar atmosphere; any image or movie of the chromosphere shows a plethora of them or their "cousins," such as mottles or fibrils. Yet despite several decades of effort we still do not know the mechanism that generates them, or how important their contribution is to the material and energy balance of the overall solar atmosphere. Solar-B will provide exciting new chromospheric observations at high time- and spatial-resolution, along with associated quality magnetic field data, that promise to open doors to revolutionary breakthroughs in spicule research. In this presentation we will review the current observational and theoretical status of spicule studies, and discuss prospects for advances in spicule understanding during the Solar-B era.

  19. Plastic fracture instability analysis of wall breakthrough in a circumferentially cracked pipe subjected to bending loads

    International Nuclear Information System (INIS)

    Zahoor, A.; Kanninen, M.F.

    1981-01-01

    A method of analyzing internal surface circumferential cracks in ductile reactor piping is presented. The method utilizes an alternate but equivalent definition of the J-integral based on nonlinear structural compliance. The analysis is valid for situations where the cross section containing the crack is fully yielded. Results are obtained for radial and circumferential crack growth for pipes subjected to bending. The stability of radial crack growth (wall breakthrough) is assessed using the J-integral-based tearing modulus approach. The analysis is shown to be in agreement with experimental results on the stability of surface crack growth in Type 304 stainless stee pipes. Example quantitative results for fracture instability assessments for nuclear piping are presented. 23 refs

  20. Plastic fracture instability analysis of wall breakthrough in a circumferentially cracked pipe subjected to bending loads

    Energy Technology Data Exchange (ETDEWEB)

    Zahoor, A.; Kanninen, M.F.

    1981-07-01

    A method of analyzing internal surface circumferential cracks in ductile reactor piping is presented. The method utilizes an alternate but equivalent definition of the J-integral based on nonlinear structural compliance. The analysis is valid for situations where the cross section containing the crack is fully yielded. Results are obtained for radial and circumferential crack growth for pipes subjected to bending. The stability of radial crack growth (wall breakthrough) is assessed using the J-integral-based tearing modulus approach. The analysis is shown to be in agreement with experimental results on the stability of surface crack growth in Type 304 stainless stee pipes. Example quantitative results for fracture instability assessments for nuclear piping are presented. 23 refs.

  1. Posterior reversible encephalopathy syndrome and acute post-streptococcal glomerulonephritis mimicking breakthrough seizures

    Directory of Open Access Journals (Sweden)

    Kamille Abdool

    2015-05-01

    Full Text Available We report the case of a 14-year-old boy with a past history of primary generalized seizures, who had been seizure-free for 2 years on sodium valproate and presented with generalized tonic clonic seizures suggestive of breakthrough seizures. Examination revealed hypertension, impetiginous lesions of the lower limbs, microscopic hematuria, elevated antistreptolysin O titre and low complement levels consistent with acute post-streptococcal glomerulonephritis. Cranial magnetic resonance imaging (MRI demonstrated changes consistent with posterior reversible encephalopathy syndrome. Hypertension was controlled with intravenous nitroglycerin followed by oral captopril and amlodipine. Brain MRI changes returned normal within 2 weeks. The nephritis went in to remission within 2 months and after 8 months the patient has been seizure free again. Posterior reversible encephalopathy syndrome appeared to have neither short nor intermediate effect on seizure control in this patient. The relationship between posterior reversible encephalopathy syndrome and seizures is reviewed.

  2. Supply chain optimization: a practitioner's perspective on the next logistics breakthrough.

    Science.gov (United States)

    Schlegel, G L

    2000-08-01

    The objective of this paper is to profile a practitioner's perspective on supply chain optimization and highlight the critical elements of this potential new logistics breakthrough idea. The introduction will briefly describe the existing distribution network, and business environment. This will include operational statistics, manufacturing software, and hardware configurations. The first segment will cover the critical success factors or foundations elements that are prerequisites for success. The second segment will give you a glimpse of a "working game plan" for successful migration to supply chain optimization. The final segment will briefly profile "bottom-line" benefits to be derived from the use of supply chain optimization as a strategy, tactical tool, and competitive advantage.

  3. Collaborative Data Mining

    Science.gov (United States)

    Moyle, Steve

    Collaborative Data Mining is a setting where the Data Mining effort is distributed to multiple collaborating agents - human or software. The objective of the collaborative Data Mining effort is to produce solutions to the tackled Data Mining problem which are considered better by some metric, with respect to those solutions that would have been achieved by individual, non-collaborating agents. The solutions require evaluation, comparison, and approaches for combination. Collaboration requires communication, and implies some form of community. The human form of collaboration is a social task. Organizing communities in an effective manner is non-trivial and often requires well defined roles and processes. Data Mining, too, benefits from a standard process. This chapter explores the standard Data Mining process CRISP-DM utilized in a collaborative setting.

  4. On the late-time behavior of tracer test breakthrough curves

    Energy Technology Data Exchange (ETDEWEB)

    HAGGERTY, ROY; MCKENNA, SEAN A; MEIGS, LUCY C

    2000-06-12

    The authors investigated the late-time (asymptotic) behavior of tracer test breakthrough curves (BTCs) with rate-limited mass transfer (e.g., in dual or multi-porosity systems) and found that the late-time concentration, c, is given by the simple expression: c = t{sub ad} (c{sub 0}g {minus} m{sub 0}{partial_derivative}g/{partial_derivative}t), for t >> t{sub ad} and t{sub a} >> t{sub ad} where t{sub ad} is the advection time, c{sub 0} is the initial concentration in the medium, m{sub 0} is the 0th moment of the injection pulse; and t{sub a} is the mean residence time in the immobile domain (i.e., the characteristic mass transfer time). The function g is proportional to the residence time distribution in the immobile domain, the authors tabulate g for many geometries, including several distributed (multirate) models of mass transfer. Using this expression they examine the behavior of late-time concentration for a number of mass transfer models. One key results is that if rate-limited mass transfer causes the BTC to behave as a power-law at late-time (i.e., c {approximately} t{sup {minus}k}), then the underlying density function of rate coefficients must also be a power-law with the form a{sup k{minus}}, as a {r_arrow}0. This is true for both density functions of first-order and diffusion rate coefficients. BTCs with k < 3 persisting to the end of the experiment indicate a mean residence time longer than the experiment and possibly infinite, and also suggest an effective rate coefficient that is either undefined or changes as a function of observation time. They apply their analysis to breakthrough curves from Single-Well Injection-Withdrawal tests at the Waste Isolation Pilot Plant, New Mexico.

  5. Accuracy of a Diagnostic Algorithm to Diagnose Breakthrough Cancer Pain as Compared With Clinical Assessment.

    Science.gov (United States)

    Webber, Katherine; Davies, Andrew N; Cowie, Martin R

    2015-10-01

    Breakthrough cancer pain (BTCP) is a heterogeneous condition, and there are no internationally agreed standardized criteria to diagnose it. There are published algorithms to assist with diagnosis, but these differ in content. There are no comparative data to support use. To compare the diagnostic ability of a simple algorithm against a comprehensive clinical assessment to diagnose BTCP and to assess if verbal rating descriptors can adequately discriminate controlled background pain. Patients with cancer pain completed a three-step algorithm with a researcher to determine if they had controlled background pain and BTCP. This was followed by a detailed pain consultation with a clinical specialist who was blinded to the algorithm results and determined an independent pain diagnosis. The sensitivity, specificity, and positive and negative predictive values were calculated for the condition of BTCP. Further analysis determined which verbal pain severity descriptors corresponded with the condition of controlled background pain. The algorithm had a sensitivity of 0.54 and a specificity of 0.76 in the identification of BTCP. The positive predictive value was 0.7, and the negative predictive value was 0.62. The sensitivity of a background pain severity rating of mild or less to accurately categorize controlled background pain was 0.69 compared with 0.97 for severity of moderate or less; however, this was balanced by a higher specificity rating for mild or less, 0.78 compared with 0.2. The diagnostic breakthrough pain algorithm had a good positive predictive value but limited sensitivity using a cutoff score of "mild" to define controlled background pain. When the cutoff level was changed to moderate, the sensitivity increased, but specificity reduced. A comprehensive clinical assessment remains the preferred method to diagnose BTCP. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  6. Accord on “Fire and Building Safety in Bangladesh”: A Breakthrough Agreement?

    Directory of Open Access Journals (Sweden)

    Zillur Rahman

    2014-03-01

    Full Text Available This discussion aims to review the emergence of the “Accord on Fire and Building Safety in Bangladesh” signed on May 13, 2013, and evaluate if it is an international agreement “breakthrough”. The Accord is signed not only by the global clothing brands and national garment unions but also by international trade union organizations, which is a new development. This raises a question: could this agreement set a new international negotiating precedence in industrial relations between transnational corporations and international trade union organizations? In Bangladesh, globalization has played an important role for booming garment industries. Yet, lack of workers’ rights, weak safety situations, and poor working conditions have continuously been reported. Local and international solidarity movements and garment workers’ welfare associations have been emphasizing workers’ rights and better and safer working environments in workplaces since the beginning of the 1990s. However, their voices were not highly considered even there were some initiatives. Following the ‘Rana Plaza’ garment factory building collapse in April 2013, one of the world’s worst industrial accidents, with more than 1,100 dead workers, some strong measures have been taken—one of these, signing the ‘Accord on Fire and Building Safety in Bangladesh’. This is a strong achievement of a long struggle to take collective action for improving the safety in garment factories in Bangladesh. Although the Accord is understood as a game changer or breakthrough in relation to national and international agreements, do we really know yet if it is a breakthrough or not when it comes to its implementation?

  7. Photogravimagnetic assists of light sails: a mixed blessing for Breakthrough Starshot?

    Science.gov (United States)

    Forgan, Duncan H.; Heller, René; Hippke, Michael

    2018-03-01

    Upon entering a star system, light sails are subject to both gravitational forces and radiation pressure, and can use both in concert to modify their trajectory. Moreover, stars possess significant magnetic fields, and if the sail is in any way charged, it will feel the Lorentz force also. We investigate the dynamics of so-called `photogravimagnetic assists' of sailcraft around α Centauri A, a potential first destination en route to Proxima Centauri (the goal of the Breakthrough Starshot programme). We find that a 10-m2 sail with a charge-to-mass ratio of around 10 μC g-1 or higher will need to take account of magnetic field effects during orbital manoeuvres. The magnetic field can provide an extra source of deceleration and deflection, and allow capture on to closer orbits around a target star. However, flipping the sign of the sailcraft's charge can radically change resulting trajectories, resulting in complex loop-de-loops around magnetic field lines and essentially random ejection from the star system. Even on well-behaved trajectories, the field can generate off-axis deflections at α Centauri that, while minor, can result in very poor targeting of the final destination (Proxima) post-assist. Fortunately for Breakthrough Starshot, nanosails are less prone to charging en route than their heavier counterparts, but can still accrue relatively high charge at both the origin and destination, when travelling at low speeds. Photogravimagnetic assists are highly non-trivial, and require careful course correction to mitigate against unwanted changes in trajectory.

  8. Aldosterone breakthrough with benazepril in furosemide-activated renin-angiotensin-aldosterone system in normal dogs.

    Science.gov (United States)

    Lantis, A C; Ames, M K; Atkins, C E; DeFrancesco, T C; Keene, B W; Werre, S R

    2015-02-01

    Pilot studies in our laboratory revealed that furosemide-induced renin-angiotensin-aldosterone system (RAAS) activation was not attenuated by the subsequent co-administration of benazepril. This study was designed to evaluate the effect of benazepril on angiotensin-converting enzyme (ACE) activity and furosemide-induced circulating RAAS activation. Our hypothesis was that benazepril suppression of ACE activity would not suppress furosemide-induced circulating RAAS activation, indicated by urinary aldosterone concentration. Ten healthy hound dogs were used in this study. The effect of furosemide (2 mg/kg p.o., q12h; Group F; n = 5) and furosemide plus benazepril (1 mg/kg p.o., q24h; Group FB; n = 5) on circulating RAAS was determined by plasma ACE activity, 4-6 h posttreatment, and urinary aldosterone to creatinine ratio (UAldo:C) on days -1, -2, 1, 3, and 7. There was a significant increase in the average UAldo:C (μg/g) after the administration of furosemide (Group F baseline [average of days -1 and -2] UAldo:C = 0.41, SD 0.15; day 1 UAldo:C = 1.1, SD 0.56; day 3 UAldo:C = 0.85, SD 0.50; day 7 UAldo:C = 1.1, SD 0.80, P Benazepril suppressed ACE activity (U/L) in Group FB (Group FB baseline ACE = 16.4, SD 4.2; day 1 ACE = 3.5, SD 1.4; day 3 ACE = 1.6, SD 1.3; day 7 ACE = 1.4, SD 1.4, P Benazepril decreased plasma ACE activity but did not prevent furosemide-induced RAAS activation, indicating aldosterone breakthrough (escape). This is particularly noteworthy in that breakthrough is observed at the time of initiation of RAAS suppression, as opposed to developing after months of therapy. © 2014 John Wiley & Sons Ltd.

  9. Breakthrough and prospect of shale gas exploration and development in China

    Directory of Open Access Journals (Sweden)

    Dazhong Dong

    2016-01-01

    Full Text Available In the past five years, shale gas exploration and development has grown in a leaping-forward way in China. Following USA and Canada, China is now the third country where industrial shale gas production is realized, with the cumulative production exceeding 60 × 108 m3 until the end of 2015. In this paper, the main achievements of shale gas exploration and development in China in recent years were reviewed and the future development prospect was analyzed. It is pointed out that shale gas exploration and development in China is, on the whole, still at its early stage. Especially, marine shale gas in the Sichuan Basin has dominated the recent exploration and development. For the realization of shale gas scale development in China, one key point lies in the breakthrough and industrial production of transitional facies and continental facies shale gas. Low–moderate yield of shale gas wells is the normal in China, so it is crucial to develop key exploration and development technologies. Especially, strictly controlling single well investment and significantly reducing cost are the important means to increase shale gas exploration and development benefits. And finally, suggestions were proposed in five aspects. First, continuously strengthen theoretical and technical researches, actively carry out appraisal on shale gas “sweet spots”, and gradually accumulate development basis. Second, stress on primary evaluation of exploration and development, highlight the effective implementation of shale gas resources, and control the rhythm of appraisal drilling and productivity construction. Third, highlight fine description and evaluation of shale gas reservoirs and increase the overall development level. Fourth, intensify the research on exploration and development technologies in order to stand out simple and practical technologies with low costs. And fifth, summarize the experiences in fast growth of shale gas exploration and development, highlight

  10. Tsetse Fly Genome Breakthrough: The FAO and IAEA Crack the Code

    International Nuclear Information System (INIS)

    Dixit, Aabha

    2014-01-01

    With the breakthrough in sequencing the genome of the tsetse fly species Glossina morsitans in April 2014, another milestone has been achieved in helping to solve a problem that has had horrendous ramifications for Africa. Finding a solution to the havoc created by tsetse flies to livestock has been a major challenge for the combined scientific efforts of the IAEA and the Food and Agriculture Organization of the United Nations (FAO), as well as for the World Health Organization (WHO), which has focused on combating human sleeping sickness. Joint research over the past decades to block the spread of severe infection from tsetse flies resulted in the introduction by the FAO and IAEA of the environmentally friendly sterile insect technique (SIT), a biologically-based method for the management of key insect pests of agricultural, medical and veterinary importance. A form of insect birth control, the SIT involves releasing mass-bred male flies that have been sterilized by low doses of radiation into infested areas, where they mate with wild females. These do not produce offspring and, as a result, the technique can suppress and, if applied systematically on an area-wide basis, eventually eradicate populations of wild flies. The newly acquired knowledge of the tsetse fly genome provides a wealth of information for the improvement of the entire SIT package and can help unravel interactions between tsetse flies, symbionts and trypanosomes. The decoding of the genome was detailed in a press release issued by the IAEA on 24 April 2014 entitled Tsetse Fly Genome Breakthrough Brings Hope for African Farmers. Tsetse flies were successfully eradicated in 1997 from the Tanzanian island of Zanzibar using the SIT. Ethiopia and Senegal are making significant progress in infested areas with the same method. The FAO and IAEA are helping 14 countries control tsetse populations through applying area-wide integrated pest management approaches

  11. Depression and Multiple Sclerosis

    Science.gov (United States)

    ... Symptoms Depression Share this page Facebook Twitter Email Depression Depression Fatigue Walking (Gait) Difficulties Numbness or Tingling ... away from addictive substances such as alcohol. Clinical depression It’s important to distinguish between mild, everyday “blues” — ...

  12. Depression in Older Adults

    Science.gov (United States)

    ... here Home » Depression In Older Adults: More Facts Depression In Older Adults: More Facts Depression affects more ... combination of both. [8] Older Adult Attitudes Toward Depression: According to a Mental Health America survey [9] ...

  13. Older Adults and Depression

    Science.gov (United States)

    ... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...

  14. Depression and Caregiving

    Science.gov (United States)

    ... FCA - A A + A You are here Home Depression and Caregiving Order this publication Printer-friendly version ... a more serious depression over time. Symptoms of Depression People experience depression in different ways. Some may ...

  15. Depression and Suicide Risk

    Science.gov (United States)

    ... due to another medical disorder Relationship Between Depression & Suicide: 1. Depression is the psychiatric diagnosis most commonly associated with ... of patients with treated depression eventually die by suicide. xiv 4. Depression is present in at least 50 percent of ...

  16. Postpartum Depression

    Science.gov (United States)

    ... or guilty. These emotions can affect a woman’s self-esteem and how she deals with stress. Fatigue—Many ... FAQs Exercise After Pregnancy (FAQ131) Depression (FAQ106) Patient Education FAQs Resources & Publications Committee Opinions Practice Bulletins Patient ...

  17. Virtual Breakthrough Series, Part 1: Preventing Catheter-Associated Urinary Tract Infection and Hospital-Acquired Pressure Ulcers in the Veterans Health Administration.

    Science.gov (United States)

    Zubkoff, Lisa; Neily, Julia; King, Beth J; Dellefield, Mary Ellen; Krein, Sarah; Young-Xu, Yinong; Boar, Shoshana; Mills, Peter D

    2016-11-01

    In 2014 the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help VHA facilities prevent hospital-acquired conditions: catheter-associated urinary tract infection (CAUTI) and hospital-acquired pressure ulcers (HAPUs). During the prework phase, participating facilities assembled a multidisciplinary team, assessed their current system for CAUTI or HAPU prevention, and examined baseline data to set improvement aims. The action phase consisted of educational conference calls, coaching, and monthly team reports. Learning was conducted via phone, web-based options, and e-mail. The CAUTI bundle focused on four key principles: (1) avoidance of indwelling urinary catheters, (2) proper insertion technique, (3) proper catheter maintenance, and (4) timely removal of the indwelling catheter. The HAPU bundle focused on assessment and inspection, pressure-relieving surfaces, turning and repositioning, incontinence management, and nutrition/hydration assessment and intervention. For the 18 participating units, the mean aggregated CAUTI rate decreased from 2.37 during the prework phase to 1.06 per 1,000 catheter-days during the action (implementation) phase (p model for implementing a virtual model for improvement. Copyright 2016 The Joint Commission.

  18. Collaborative research: Accomplishments & potential

    Science.gov (United States)

    Katsouyanni, Klea

    2008-01-01

    Although a substantial part of scientific research is collaborative and increasing globalization will probably lead to its increase, very few studies actually investigate the advantages, disadvantages, experiences and lessons learned from collaboration. In environmental epidemiology interdisciplinary collaboration is essential and the contrasting geographical patterns in exposure and disease make multi-location projects essential. This paper is based on a presentation given at the Annual Conference of the International Society for Environmental Epidemiology, Paris 2006, and is attempting to initiate a discussion on a framework for studying collaborative research. A review of the relevant literature showed that indeed collaborative research is rising, in some countries with impressive rates. However, there are substantial differences between countries in their outlook, need and respect for collaboration. In many situations collaborative publications receive more citations than those based on national authorship. The European Union is the most important host of collaborative research, mainly driven by the European Commission through the Framework Programmes. A critical assessment of the tools and trends of collaborative networks under FP6, showed that there was a need for a critical revision, which led to changes in FP7. In conclusion, it is useful to study the characteristics of collaborative research and set targets for the future. The added value for science and for the researchers involved may be assessed. The motivation for collaboration could be increased in the more developed countries. Particular ways to increase the efficiency and interaction in interdisciplinary and intercultural collaboration may be developed. We can work towards "the principles of collaborative research" in Environmental Epidemiology. PMID:18208596

  19. Collaboration across the Arctic

    DEFF Research Database (Denmark)

    Huppert, Verena Gisela; Chuffart, Romain François R.

    2017-01-01

    The Arctic is witnessing the rise of a new paradigm caused by an increase in pan-Arctic collaborations which co-exist with the region’s traditional linkages with the South. Using an analysis of concrete examples of regional collaborations in the Arctic today in the fields of education, health...... and infrastructure, this paper questions whether pan-Arctic collaborations in the Arctic are more viable than North-South collaborations, and explores the reasons behind and the foreseeable consequences of such collaborations. It shows that the newly emerging East-West paradigm operates at the same time...... as the traditional North-South paradigm, with no signs of the East-West paradigm being more viable in the foreseeable future. However, pan-Arctic collaboration, both due to pragmatic reasons and an increased awareness of similarities, is likely to increase in the future. The increased regionalization process...

  20. Professional Learning and Collaboration

    OpenAIRE

    Greer, Janet Agnes

    2012-01-01

    The American education system must utilize collaboration to meet the challenges and demands our culture poses for schools. Deeply rooted processes and structures favor teaching and learning in isolation and hinder the shift to a more collaborative paradigm. Professional learning communities (PLCs) support continuous teacher learning, improved efficacy, and program implementation. The PLC provides the framework for the development and enhancement of teacher collaboration and teacher collaborat...

  1. Managing collaborative design

    OpenAIRE

    Sebastian, R.

    2007-01-01

    Collaborative design has been emerging in building projects everywhere. The more complex a building project becomes, the closer and more intensive collaboration between the design actors is required. This research focuses on collaborative design in the conceptual architecture design phase, especially during the elaboration of the masterplan and the development of the preliminary building designs. This research is descriptive and has two aims. First, it aims at describing the characteristics a...

  2. Opposing incentives for collaboration

    DEFF Research Database (Denmark)

    Dorch, Bertil F.; Wien, Charlotte; Larsen, Asger Væring

    , and gives a bonus for publications done through inter-institutionary collaboration. Credits given to universities are fractionalized between the participating universities. So far credits are not assigned to the individual authors but only to their institutions. However, it turns out that research...... collaboration is associated with a higher number of citations than single authorship which may present the author with two opposing incentives for research collaboration....

  3. Application of the rainfall infiltration breakthrough (RIB) model for groundwater recharge estimation in west coastal South Africa

    CSIR Research Space (South Africa)

    Sun, X

    2013-04-01

    Full Text Available level fluctuations (WLF) on a monthly basis was proposed in the rainfall infiltration breakthrough (RIB) model for the purpose of groundwater recharge estimation. In this paper, the physical meaning of parameters in the CRD and previous RIB models...

  4. Geopolitics of Quantum Buddhism: Our Pre-Hydrocarbon Tao Future (No Breakthrough at the Rio+20 Summit)

    Science.gov (United States)

    Bajrektarevic, Anis

    2013-01-01

    From Rio to Rio with Kyoto, Copenhagen and Durban in between, the conclusion remains the same: we fundamentally disagree on realities of this planet and the ways we can address them. A decisive breakthrough would necessitate both wider contexts and a larger participatory base so as to identify problems, formulate policies, and broaden and…

  5. The Collaborative Future

    Directory of Open Access Journals (Sweden)

    Thomas Marlowe

    2011-10-01

    Full Text Available Collaboration has become an important goal in modern ventures, across the spectrum of commercial, social, and intellectual activities, sometimes as a mediating factor, and sometimes as a driving, foundational principle. Research, development, social programs, and ongoing ventures of all sorts benefit from interactions between teams, groups, and organizations, across intellectual disciplines and across facets and features of the inquiry, product, entity, or activity under consideration. We present a survey of the state of collaboration and collaborative enterprise, in the context of papers and presentations at the International Symposium on Collaborative Enterprises 2011 (CENT 2011, and the extended papers appearing in this special issue.

  6. Commemorating Misadventures, Celebrating Collaborations

    Centers for Disease Control (CDC) Podcasts

    Byron Breedlove, Managing Editor of Emerging Infectious Diseases journal, reads his February 2018 cover essay, "Commemorating Misadventures, Celebrating Collaborations" and discusses a sketch by Picasso and zoonoses.

  7. Collaborative Service Arrangements

    DEFF Research Database (Denmark)

    J. May, Peter; Winter, Søren

    While much of prior research on collaboration addresses the service delivery network as a whole, we address collaborative relationships between one type of organization—municipal employment services—and a range of governmental and non-governmental partners for employment services in Denmark....... Municipalities differ in the type, degree, and character of collaboration with these partners. As others have found in prior research, we find that organizational benefits, trust, and a variety of contextual factors help shape the extent of collaboration. But, the relevance of these and problem-solving benefits...

  8. Busted Butte Phase 2: Introduction and Analytical Modeling of Nonreactive Tracer and Lithium Breakthrough

    International Nuclear Information System (INIS)

    Turin, H.J.; Soll, W.E.

    2002-01-01

    The Busted Butte Unsaturated-Zone Transport Test Facility is located approximately 8 km southeast of Yucca Mountain, and was designed to address uncertainties associated with flow and transport in the UZ site-process models for Yucca Mountain. Busted Butte Phase 2 consisted of a 10m x 10m x 7m test block. From July 1988 through October 2000, complex tracer mixtures were injected continuously at 77 discrete points located along eight parallel 10-m boreholes arranged in two horizontal planes. In August 1999, iodide was added to the tracer mixture to explore the effects of initial hydraulic transients. During the course of the experiment, porewater samples were collected at regular intervals using sorbing-paper collection pads, emplaced into fifteen horizontal and inclined 10-m collection boreholes, oriented perpendicular to the injection boreholes. Potential travel distances ranged from 20 cm to over 500 cm. Nonreactive tracer and weakly sorbing lithium breakthrough was observed at most of the collection points during the injection period. Following termination of injection, approximately 800 rock samples were collected using overcore and mineback techniques, and analyzed for tracer concentration. Rock analyses are discussed in a subsequent paper. To complement complex 3-dimensional finite-element modeling of the entire block, bromide, iodide, and lithium breakthrough onto the collection pads has been modeled with CXTFIT. This simple 1-dimensional analytical code uses a non-linear curve-fitting routine to estimate transport parameters including apparent velocity, dispersivity, and field retardation factors. Preliminary results show that: (1) Bromide and iodide behaved similarly, despite the fact that bromide was injected in a strongly transient flow field, while iodide injection began after flow had approached steady state conditions. (2) With the exception of the closest collection points, tracer velocities remained relatively constant, indicating that transport was

  9. Recent breakthroughs and themes in hydrology, from climate to the water-food-energy nexus

    Science.gov (United States)

    Montanari, A.

    2017-12-01

    The last decades marked a significant change in geosciences. Increasing communication, observations, computing capabilities and opportunities to make dissemination stimulated a rapid increase of the number of publications and scientific forums. On the one hand this development is undoubtedly positive. In fact, it provides more and more opportunities to young and experienced scientists to elaborate innovative ideas and to establish cooperation. On the other hand, the proliferation of information, communication and publications makes the identification of key ideas and contributions definitely more challenging. Notwithstanding the above development, Water Resources Research (WRR) provides an ideal perspective to elaborate a picture of recent breakthroughs in hydrology. In fact, despite the increasing number of submissions and the progress of time, WRR kept a rigorous attitude to assess manuscripts by evaluating their relevance to emerging environmental and societal challenges.To get a long term perspective of breakthroughs in hydrology, it is interesting to compare the two anniversary special sections published so far in WRR, namely, the 50th anniversary special section "Legacy and perspectives for the science of hydrology", and "Trends and Directions in Hydrology", that was edited by Steven Burges in 1986 to celebrate the 20th anniversary of the journal. The above comparison highlights that the traditional break-up of hydrology into sub-disciplines, each focusing on separate components of the water cycle, has given way to a more interconnected, interdisciplinary research on a wide range of spatial and temporal scales, and interactions between water, society, earth and biological systems.This talk will present a voyage through the WRR history to highlight recent advances and topical themes. An attempt to develop a vision for the future of WRR and hydrology will be presented. Water will become more and more the regulator of social dynamics, including economy, politics

  10. Predicting trace organic compound breakthrough in granular activated carbon using fluorescence and UV absorbance as surrogates.

    Science.gov (United States)

    Anumol, Tarun; Sgroi, Massimiliano; Park, Minkyu; Roccaro, Paolo; Snyder, Shane A

    2015-06-01

    This study investigated the applicability of bulk organic parameters like dissolved organic carbon (DOC), UV absorbance at 254 nm (UV254), and total fluorescence (TF) to act as surrogates in predicting trace organic compound (TOrC) removal by granular activated carbon in water reuse applications. Using rapid small-scale column testing, empirical linear correlations for thirteen TOrCs were determined with DOC, UV254, and TF in four wastewater effluents. Linear correlations (R(2) > 0.7) were obtained for eight TOrCs in each water quality in the UV254 model, while ten TOrCs had R(2) > 0.7 in the TF model. Conversely, DOC was shown to be a poor surrogate for TOrC breakthrough prediction. When the data from all four water qualities was combined, good linear correlations were still obtained with TF having higher R(2) than UV254 especially for TOrCs with log Dow>1. Excellent linear relationship (R(2) > 0.9) between log Dow and the removal of TOrC at 0% surrogate removal (y-intercept) were obtained for the five neutral TOrCs tested in this study. Positively charged TOrCs had enhanced removals due to electrostatic interactions with negatively charged GAC that caused them to deviate from removals that would be expected with their log Dow. Application of the empirical linear correlation models to full-scale samples provided good results for six of seven TOrCs (except meprobamate) tested when comparing predicted TOrC removal by UV254 and TF with actual removals for GAC in all the five samples tested. Surrogate predictions using UV254 and TF provide valuable tools for rapid or on-line monitoring of GAC performance and can result in cost savings by extended GAC run times as compared to using DOC breakthrough to trigger regeneration or replacement. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. FRB121102: First detection across 5 - 8 GHz and spectral properties from the Breakthrough Listen instrument

    Science.gov (United States)

    Gajjar, Vishal; Siemion, Andrew; MacMohan, David; Croft, Steve; Hellbourg, Greg; Isaacson, Howard; Enriquez, J. Emilio; Price, Daniel; Lebofsky, Matt; De Boer, David; Werthimer, Dan; Hickish, Jack; Brinkman, Casey; Chatterjee, Shami; Ransom, Scott M.; Law, Casey; Hessels, Jason W. T.; Cordes, Jim; Spitler, Laura; Lynch, Ryan; McLaughlin, Maura; Scholz, Paul; Marcote, Benito; Bower, Geoffrey C.; Tendulkar, Shriharsh

    2018-01-01

    Fast Radio Bursts (FRBs) are some of the most energetic and enigmatic events in the Universe. The origin of these sources is among the most challenging questions of modern-day astrophysics. Thus, it is imperative to understand the properties of these bursts across a range of radio frequencies. Among the known FRBs, FRB121102 is the only source known to show repeated bursts [Spitler et al., Nature, 531, 7593 202-205, 2016], which can allow a detailed investigation of various origin models. In August 2017, we initiated a campaign observing FRB 121102 using the Breakthrough Listen Digital Backend with the C-band receiver at the Robert C. Byrd Green Bank Telescope (GBT). We recorded baseband voltage data across 5.4 GHz of bandwidth, completely covering the C-band receiver's nominal 4-8 GHz band [MacMahon et al. arXiv:1707.06024v2]. The recorded data were searched for dispersed pulses consistent with the known dispersion measure of FRB 121102 (557 pc cm-3) using high-speed GPU software tools. We detected 21 bursts above our detection threshold of 6 sigmas in the first 60-minutes, out of which 18 occurred in the first 30-minutes only. To our knowledge, this is the highest event rate seen for FRB121102 at any observing frequency. These observations are the highest frequency and widest bandwidth detection of bursts from FRB 121102 (or any other FRB) obtained to-date. We note that individual bursts show marked changes in spectral extent ranging from hundreds of MHz to several GHz. We have used high frequency dynamic spectra of these bursts to estimate the characteristic scintillation bandwidth and correlation time-scale. We also found distinctive temporal structures, separated by a few milliseconds, in three of the strongest bursts, with each sub-structure exhibiting varied spectral features. We will discuss our findings and how these detections of FRB 121102 around 8 GHz opens up a new regime in scrutinizing various origin models. We will also highlight the unique

  12. Often Difficult--But Worth It. Collaboration among Professionals.

    Science.gov (United States)

    Walker, Joyce A.

    1988-01-01

    A joint effort between the Minnesota Extension Service and University of Minnesota School of Medicine produced a community-based research and educational program on stress, depression, and suicide prevention. The Teens in Distress program represents a successful collaborative effort and illustrates the potential problems when Extension…

  13. Collaboration in teacher teams

    NARCIS (Netherlands)

    Brouwer, P.

    2011-01-01

    In order to deal with innovations and the associated complexity of work, ongoing collaboration between teachers has become more important in secondary education. Teacher collaboration is one of the factors that contribute to the successful implementation of innovations in secondary schools. However,

  14. Enabling distributed collaborative science

    DEFF Research Database (Denmark)

    Hudson, T.; Sonnenwald, Diane H.; Maglaughlin, K.

    2000-01-01

    To enable collaboration over distance, a collaborative environment that uses a specialized scientific instrument called a nanoManipulator is evaluated. The nanoManipulator incorporates visualization and force feedback technology to allow scientists to see, feel, and modify biological samples bein...

  15. Solo Librarians Working Collaboratively

    Science.gov (United States)

    Nickel, Robbie

    2011-01-01

    The Elko County School District in Nevada has elementary school librarians that are "solo" librarians. Over the last several years they have worked to collaborate on meeting monthly--even though the district covers 17,100 square miles--and on providing professional development face to face and online. Sharing and collaboration help them…

  16. Collaborating with Rising Stars

    DEFF Research Database (Denmark)

    Andersen, Kristina Vaarst; Mors, Marie Louise; Jeppesen, Jacob

    2018-01-01

    Status provides preferential access to resources, as well as favorable judgment, which in turn may lead to increases in performance. Prior work has established that such benefits even spill over between collaboration partners, thus allowing collaboration partners of high status individuals to bas...

  17. Negotiating Collaborative Governance Designs

    DEFF Research Database (Denmark)

    Plotnikof, Mie

    2017-01-01

    This chapter addresses the design and implementation issues of collaborative governance, a public management practice aimed at involving stakeholders in problem-solving and public innovation.......This chapter addresses the design and implementation issues of collaborative governance, a public management practice aimed at involving stakeholders in problem-solving and public innovation....

  18. Enhancing performance through collaboration

    International Nuclear Information System (INIS)

    Froats, J.

    2010-01-01

    This presentation examines how co-operation and collaboration are keys to high performing organizations and attempts to provoke some thinking about how one can improve the game to meet the challenges of today. The presentation discusses the origins of the belief system and gives examples of the benefits of collaborative approaches.

  19. Collaborative Car Pooling System

    OpenAIRE

    João Ferreira; Paulo Trigo; Porfírio Filipe

    2009-01-01

    This paper describes the architecture for a collaborative Car Pooling System based on a credits mechanism to motivate the cooperation among users. Users can spend the accumulated credits on parking facilities. For this, we propose a business model to support the collaboration between a car pooling system and parking facilities. The Portuguese Lisbon-s Metropolitan area is used as application scenario.

  20. Emergent Collaboration on Twitter

    DEFF Research Database (Denmark)

    Lundgaard, Daniel; Razmerita, Liana; Tan, Chee-Wee

    2018-01-01

    This paper explores the organizing elements that foster emergent collaboration within large-scale communities on online social platforms like Twitter. This study is based on a case study of the #BlackLivesMatter social movement and draws on organizing dynamics and online social network literature...... foster emergent collaboration in social movements using Twitter....

  1. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions.

    Science.gov (United States)

    Adimoelja, A

    2000-01-01

    Traditional herbs have been a revolutionary breakthrough in the management of erectile dysfunction and have become known world-wide as an 'instant' treatment. The modern view of the management of erectile dysfunction subscribes to a single etiology, i.e. the mechanism of erection. A large number of pharmacological agents are orally consumed and vasoactive agents inserted intraurethrally or injected intrapenially to regain good erection. Modern phytochemicals have developed from traditional herbs. Phytochemicals focus their mechanism of healing action to the root cause, i.e. the inability to control the proper function of the whole body system. Hence phytochemicals manage erectile dysfunction in the frame of sexual dysfunction as a whole entity. Protodioscin is a phytochemical agent derived from Tribulus terrestris L plant, which has been clinically proven to improve sexual desire and enhance erection via the conversion of protodioscine to DHEA (De-Hydro-Epi-Androsterone). Preliminary observations suggest that Tribulus terrestris L grown on different soils does not consistently produce the active component Protodioscin. Further photochemical studies of many other herbal plants are needed to explain the inconsistent results found with other herbal plants, such as in diversities of Ginseng, Eurycoma longifolia, Pimpinella pruacen, Muara puama, Ginkgo biloba, Yohimbe etc.

  2. Stem cell-derived kidney cells and organoids: Recent breakthroughs and emerging applications.

    Science.gov (United States)

    Chuah, Jacqueline Kai Chin; Zink, Daniele

    The global rise in the numbers of kidney patients and the shortage in transplantable organs have led to an increasing interest in kidney-specific regenerative therapies, renal disease modelling and bioartificial kidneys. Sources for large quantities of high-quality renal cells and tissues would be required, also for applications in in vitro platforms for compound safety and efficacy screening. Stem cell-based approaches for the generation of renal-like cells and tissues would be most attractive, but such methods were not available until recently. This situation has drastically changed since 2013, and various protocols for the generation of renal-like cells and precursors from pluripotent stem cells (PSC) have been established. The most recent breakthroughs were related to the establishment of various protocols for the generation of PSC-derived kidney organoids. In combination with recent advances in genome editing, bioprinting and the establishment of predictive renal screening platforms this results in exciting new possibilities. This review will give a comprehensive overview over current PSC-based protocols for the generation of renal-like cells, precursors and organoids, and their current and potential applications in regenerative medicine, compound screening, disease modelling and bioartificial organs. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol.

    Science.gov (United States)

    Jingu, Akiko; Fukuda, Junya; Taketomi-Takahashi, Ayako; Tsushima, Yoshito

    2014-10-06

    Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR).The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. The protocol was applied to a total of 252 examinations (153 patients, ages 15-87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma.

  4. Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol

    International Nuclear Information System (INIS)

    Jingu, Akiko; Fukuda, Junya; Taketomi-Takahashi, Ayako; Tsushima, Yoshito

    2014-01-01

    Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR). The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. The protocol was applied to a total of 252 examinations (153 patients, ages 15–87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma

  5. Computational tools for Breakthrough Propulsion Physics: State of the art and future prospects

    International Nuclear Information System (INIS)

    Maccone, Claudio

    2000-01-01

    To address problems in Breakthrough Propulsion Physics (BPP) one needs sheer computing capabilities. This is because General Relativity and Quantum Field Theory are so mathematically sophisticated that the amount of analytical calculations is prohibitive and one can hardly do all of them by hand. In this paper we make a comparative review of the main tensor calculus capabilities of the three most advanced and commercially available 'symbolic manipulator' codes: Macsyma, Maple V and Mathematica. We also point out that currently one faces such a variety of different conventions in tensor calculus that it is difficult or impossible to compare results obtained by different scholars in General Relativity and Quantum Field Theory. Mathematical physicists, experimental physicists and engineers have each their own way of customizing tensors, especially by using the different metric signatures, different metric determinant signs, different definitions of the basic Riemann and Ricci tensors, and by adopting different systems of physical units. This chaos greatly hampers progress toward the chief NASA BPP goal: the design of the NASA Warp Drive. It is thus concluded that NASA should put order by establishing international standards in symbolic tensor calculus and enforcing anyone working in BPP to adopt these NASA BPP Standards

  6. Tracking tracer breakthrough in the hyporheic zone using time‐lapse DC resistivity, Crabby Creek, Pennsylvania

    Science.gov (United States)

    Nyquist, Jonathan E.; Toran, Laura; Fang, Allison C.; Ryan, Robert J.; Rosenberry, Donald O.

    2010-01-01

    Characterization of the hyporheic zone is of critical importance for understanding stream ecology, contaminant transport, and groundwater‐surface water interaction. A salt water tracer test was used to probe the hyporheic zone of a recently re‐engineered portion of Crabby Creek, a stream located near Philadelphia, PA. The tracer solution was tracked through a 13.5 meter segment of the stream using both a network of 25 wells sampled every 5–15 minutes and time‐lapse electrical resistivity tomographs collected every 11 minutes for six hours, with additional tomographs collected every 100 minutes for an additional 16 hours. The comparison of tracer monitoring methods is of keen interest because tracer tests are one of the few techniques available for characterizing this dynamic zone, and logistically it is far easier to collect resistivity tomographs than to install and monitor a dense network of wells. Our results show that resistivity monitoring captured the essential shape of the breakthrough curve and may indicate portions of the stream where the tracer lingered in the hyporheic zone. Time‐lapse resistivity measurements, however, represent time averages over the period required to collect a tomographic data set, and spatial averages over a volume larger than captured by a well sample. Smoothing by the resistivity data inversion algorithm further blurs the resulting tomograph; consequently resistivity monitoring underestimates the degree of fine‐scale heterogeneity in the hyporheic zone.

  7. Point Climat no. 33 'International Climate Negotiations - COP 19: do not underestimate the MRV breakthrough'

    International Nuclear Information System (INIS)

    Dupont, Marion; Morel, Romain; Bellassen, Valentin; Deheza, Mariana

    2013-01-01

    Among the publications of CDC Climat Research, 'Climate Briefs' presents, in a few pages, hot topics in climate change policy. This issue addresses the following points: For those who expect 'binding' emission reductions targets in the future international climate agreement to be signed in Paris in 2015, the Warsaw Conference (November 11 to 23, 2013) yielded as much progress as it could. That means little beyond a timetable. However, for those who consider the UNFCCC as the depository of common tools on the monitoring, reporting and verification (MRV) of emissions, actions and financing, Warsaw represents a major breakthrough. For the first time, developing countries - at least those wishing to access climate finance for forests - will abide by MRV procedures similar to those governing the greenhouse gas inventories of industrialized countries. Forestry may be seen as a first sectoral NAMA, and it would be difficult to ignore the Warsaw decisions for the future definition of MRV procedures of NAMAs. In spite of the establishment of the Warsaw International Mechanism for Loss and Damage, low outputs on other issues show that achieving an agreement at COP 21 will require significant political progress during the next 15 months

  8. Engineering excellence in breakthrough biomedical technologies: bioengineering at the University of California, Riverside.

    Science.gov (United States)

    Schultz, Jane S; Rodgers, V G J

    2012-07-01

    The Department of Bioengineering at the University of California, Riverside (UCR), was established in 2006 and is the youngest department in the Bourns College of Engineering. It is an interdisciplinary research engine that builds strength from highly recognized experts in biochemistry, biophysics, biology, and engineering, focusing on common critical themes. The range of faculty research interests is notable for its diversity, from the basic cell biology through cell function to the physiology of the whole organism, each directed at breakthroughs in biomedical devices for measurement and therapy. The department forges future leaders in bioengineering, mirroring the field in being energetic, interdisciplinary, and fast moving at the frontiers of biomedical discoveries. Our educational programs combine a solid foundation in bio logical sciences and engineering, diverse communication skills, and training in the most advanced quantitative bioengineering research. Bioengineering at UCR also includes the Bioengineering Interdepartmental Graduate (BIG) program. With its slogan Start-Grow-Be-BIG, it is already recognized for its many accomplishments, including being third in the nation in 2011 for bioengineering students receiving National Science Foundation graduate research fellowships as well as being one of the most ethnically inclusive programs in the nation.

  9. Familial concordance for age at natural menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Morris, Danielle H; Jones, Michael E; Schoemaker, Minouk J; Ashworth, Alan; Swerdlow, Anthony J

    2011-09-01

    Existing estimates of the heritability of menopause age have a wide range. Furthermore, few studies have analyzed to what extent familial similarities might reflect shared environment, rather than shared genes. We therefore analyzed familial concordance for age at natural menopause and the effects of shared genetic and environmental factors on this concordance. Participants were 2,060 individuals comprising first-degree relatives, aged 31 to 90 years, and participating in the UK Breakthrough Generations Study. Menopause data were collected using a self-administered questionnaire and analyzed using logistic regression and variance-components models. Women were at an increased risk of early menopause (≤45 y) if their mother (odds ratio, 6.2; P menopause. Likewise, women had an increased risk of late menopause (≥54 y) if their relative had had a late menopause (mother: odds ratio, 6.1; P menopause age attributed to environmental factors shared by sisters. We confirm that early menopause aggregates within families and show, for the first time, that there is also strong familial concordance for late menopause. Both genes and shared environment were the source of variation in menopause age. Past heritability estimates have not accounted for shared environment, and thus, the effect of genetic variants on menopause age may previously have been overestimated.

  10. Exploring the role of lipids in intercellular conduits: breakthroughs in the pipeline

    Directory of Open Access Journals (Sweden)

    Elise eDelage

    2013-12-01

    Full Text Available It has been known for more than a century that most of the plant cells are connected to their neighbors through membranous pores perforating the cell wall, namely plasmodesmata (PDs. The recent discovery of tunneling nanotubes (TNTs, thin membrane bridges established between distant mammalian cells, suggests that intercellular communication mediated through cytoplasmic continuity could be a conserved feature of eukaryotic organisms. Although TNTs differ from PDs in their formation and architecture, both are characterized by a continuity of the plasma membrane between two cells, delimiting a nanotubular channel supported by actin-based cytoskeleton. Due to this unusual membrane organization, lipids are likely to play critical roles in the formation and stability of intercellular conduits like TNTs and PDs, but also in regulating the transfer through these structures. While it is crucial for a better understanding of those fascinating communication highways, the study of TNT lipid composition and dynamics turned out to be extremely challenging. The present review aims to give an overview of the recent findings in this context. We will also discuss some of the promising imaging approaches, which might be the key for future breakthroughs in the field and could also benefit the research on PDs.

  11. Laboratory investigation and simulation of breakthrough curves in karst conduits with pools

    Science.gov (United States)

    Zhao, Xiaoer; Chang, Yong; Wu, Jichun; Peng, Fu

    2017-12-01

    A series of laboratory experiments are performed under various hydrological conditions to analyze the effect of pools in pipes on breakthrough curves (BTCs). The BTCs are generated after instantaneous injections of NaCl tracer solution. In order to test the feasibility of reproducing the BTCs and obtain transport parameters, three modeling approaches have been applied: the equilibrium model, the linear graphical method and the two-region nonequilibrium model. The investigation results show that pools induce tailing of the BTCs, and the shapes of BTCs depend on pool geometries and hydrological conditions. The simulations reveal that the two-region nonequilibrium model yields the best fits to experimental BTCs because the model can describe the transient storage in pools by the partition coefficient and the mass transfer coefficient. The model parameters indicate that pools produce high dispersion. The increased tailing occurs mainly because the partition coefficient decreases, as the number of pools increases. When comparing the tracer BTCs obtained using the two types of pools with the same size, the more appreciable BTC tails that occur for symmetrical pools likely result mainly from the less intense exchange between the water in the pools and the water in the pipe, because the partition coefficients for the two types of pools are virtually identical. Dispersivity values decrease as flow rates increase; however, the trend in dispersion is not clear. The reduced tailing is attributed to a decrease in immobile water with increasing flow rate. It provides evidence for hydrodynamically controlled tailing effects.

  12. Making Breakthroughs in the Turbulent Decade: China's Space Technology During the Cultural Revolution.

    Science.gov (United States)

    Li, Chengzhi; Zhang, Dehui; Hu, Danian

    2017-09-01

    This article discusses why Chinese space programs were able to develop to the extent they did during the turbulent decade of the Cultural Revolution (1966-1976). It first introduces briefly what China had accomplished in rocket and missile technology before the Cultural Revolution, including the establishment of a system for research and manufacturing, breakthroughs in rocket technology, and programs for future development. It then analyzes the harmful impacts of the Cultural Revolution on Chinese space programs by examining activities of contemporary mass factions in the Seventh Ministry of Machinery Industry. In the third section, this article presents the important developments of Chinese space programs during the Cultural Revolution and explores briefly the significance of these developments for the future and overall progress in space technology. Finally, it discusses the reasons for the series of developments of Chinese space technology during the Cultural Revolution. This article concludes that, although the Cultural Revolution generated certain harmful impacts on the development of Chinese space technology, the Chinese essentially accomplished their scheduled objectives in their space program, both because of the great support of top Chinese leaders, including the officially disgraced Lin Biao and the Gang of Four, and due to the implementation of many effective special measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Mathematical modeling and experimental breakthrough curves of carbon dioxide adsorption on metal organic framework CPM-5.

    Science.gov (United States)

    Sabouni, Rana; Kazemian, Hossein; Rohani, Sohrab

    2013-08-20

    It is essential to capture carbon dioxide from flue gas because it is considered one of the main causes of global warming. Several materials and different methods have been reported for CO2 capturing including adsorption onto zeolites and porous membranes, as well as absorption in amine solutions. All such methods require high energy input and high cost. A new class of porous materials called Metal Organic Frameworks (MOFs) exhibited excellent performance in extracting carbon dioxide from a gas mixture. In this study, the breakthrough curves for the adsorption of carbon dioxide on CPM-5 (crystalline porous materials) were obtained experimentally and theoretically using a laboratory-scale fixed-bed column at different experimental conditions such as feed flow rate, adsorption temperature, and feed concentration. It was found that the CPM-5 has a dynamic CO2 adsorption capacity of 11.9 wt % (2.7 mmol/g) (corresponding to 8 mL/min, 298 K, and 25% v/v CO2). The tested CPM-5 showed an outstanding adsorption equilibrium capacity (e.g., 2.3 mmol/g (10.2 wt %) at 298 K) compared to other adsorbents, which can be considered as an attractive adsorbent for separation of CO2 from flue gas.

  14. Collaborative Policy Innovation

    DEFF Research Database (Denmark)

    Sørensen, Eva; Boch Waldorff, Susanne

    2014-01-01

    Governments all over the Western world currently face wicked problems that call for policy innovation. A new strand of research in public innovation points to collaboration between public authorities and relevant and affected stakeholders as an important driver of public innovation. A case study...... of collaborative policy innovation in the area of mental health care in Denmark indicates that collaboration can contribute to qualify the politicians’ understanding of wicked policy problems, and to fostering new creative policy solutions. The study also shows, however, that the new problem understandings...... and policy ideas produced in collaborative governance arenas are not diffused to the formal political institutions of representative democracy because the participating politicians only to a limited extent function as boundary spanners between the collaborative governance arena and the decision making arenas...

  15. Nurse-patient collaboration

    DEFF Research Database (Denmark)

    Sørensen, Dorthe; Frederiksen, Kirsten; Groefte, Thorbjoern

    2013-01-01

    Objectives: This paper provides a theoretical account of nurses’ collaboration with patients with chronic obstructive pulmonary disease during non-invasive ventilation treatment in hospital. Background: Despite strong evidence for the effect of non-invasive ventilation treatment, success remains...... a huge challenge. Nurse-patient collaboration may be vital for treatment tolerance and success. A better understanding of how nurses and patients collaborate during non-invasive ventilation may therefore contribute to improvement in treatment success. Design: A constant comparative classical grounded...... at three intensive care units and one general respiratory ward in Denmark. Results: Succeeding emerged as the nurses’ main concern in the nurse-patient collaboration during non-invasive ventilation treatment. Four collaborative typologies emerged as processing their main concern: (1) twofold oriented...

  16. Electronic Collaboration Logbook

    International Nuclear Information System (INIS)

    Gysin, Suzanne; Mandrichenko, Igor; Podstavkov, Vladimir; Vittone, Margherita

    2012-01-01

    In HEP, scientific research is performed by large collaborations of organizations and individuals. The logbook of a scientific collaboration is an important part of the collaboration record. Often it contains experimental data. At Fermi National Accelerator Laboratory (FNAL), we developed an Electronic Collaboration Logbook (ECL) application, which is used by about 20 different collaborations, experiments and groups at FNAL. The ECL is the latest iteration of the project formerly known as the Control Room Logbook (CRL). We have been working on mobile (IOS and Android) clients for the ECL. We will present the history, current status and future plans of the project, as well as design, implementation and support solutions made by the project.

  17. Writing as collaborative inquiry

    DEFF Research Database (Denmark)

    Frølunde, Lisbeth; Pedersen, Christina Hee; Novak, Martin

    2015-01-01

    involved in collaborative knowledge production across difference (including age, professional position, life situation, nation). We tell about our experiences with how collaboration can lead toward re-invention of our research practices and methods, as well as our own subjectivities, through involvement......In our presentation we strive to disturb and unravel the romantic discourses of collaboration, dialogue and empowerment in relation to qualitative inquiry. For more than two years we (five Danish and Czech researchers) have been exploring the complex obstructions, difficulties and potentials...... in the not-yet-known. Over the years, we have shared and analyzed personal stories about our collaborative experiences in an on-going reflective learning process. We draw on writing methodologies, including memory-work (Haug, Davies) and collaborative writing such as by Wyatt, Gale, Gannon & Davies. Our...

  18. Helping your teen with depression

    Science.gov (United States)

    Teen depression - helping; Teen depression - talk therapy; Teen depression - medicine ... teen the most. The most effective treatments for depression are: Talk therapy Antidepressant medicines If your teen ...

  19. Theoretical foundations for collaboration engineering

    NARCIS (Netherlands)

    Kolfschoten, G.L.

    2007-01-01

    Collaboration is often presented as the solution to numerous problems in business and society. However, collaboration is challenging, and collaboration support is not an off-the-shelf-product. This research offers theoretical foundations for Collaboration Engineering. Collaboration Engineering is an

  20. Energy Efficiency Collaboratives

    Energy Technology Data Exchange (ETDEWEB)

    Li, Michael [US Department of Energy, Washington, DC (United States); Bryson, Joe [US Environmental Protection Agency, Washington, DC (United States)

    2015-09-01

    Collaboratives for energy efficiency have a long and successful history and are currently used, in some form, in more than half of the states. Historically, many state utility commissions have used some form of collaborative group process to resolve complex issues that emerge during a rate proceeding. Rather than debate the issues through the formality of a commission proceeding, disagreeing parties are sent to discuss issues in a less-formal setting and bring back resolutions to the commission. Energy efficiency collaboratives take this concept and apply it specifically to energy efficiency programs—often in anticipation of future issues as opposed to reacting to a present disagreement. Energy efficiency collaboratives can operate long term and can address the full suite of issues associated with designing, implementing, and improving energy efficiency programs. Collaboratives can be useful to gather stakeholder input on changing program budgets and program changes in response to performance or market shifts, as well as to provide continuity while regulators come and go, identify additional energy efficiency opportunities and innovations, assess the role of energy efficiency in new regulatory contexts, and draw on lessons learned and best practices from a diverse group. Details about specific collaboratives in the United States are in the appendix to this guide. Collectively, they demonstrate the value of collaborative stakeholder processes in producing successful energy efficiency programs.

  1. Assessing Online Collaborative Discourse.

    Science.gov (United States)

    Breen, Henny

    2015-01-01

    This qualitative study using transcript analysis was undertaken to clarify the value of Harasim's Online Collaborative Learning Theory as a way to assess the collaborative process within nursing education. The theory incorporated three phases: (a) idea generating; (b) idea organizing; and (c) intellectual convergence. The transcripts of asynchronous discussions from a 2-week module about disaster nursing using a virtual community were analyzed and formed the data for this study. This study supports the use of Online Collaborative Learning Theory as a framework for assessing online collaborative discourse. Individual or group outcomes were required for the students to move through all three phases of the theory. The phases of the Online Collaborative Learning Theory could be used to evaluate the student's ability to collaborate. It is recommended that group process skills, which have more to do with interpersonal skills, be evaluated separately from collaborative learning, which has more to do with cognitive skills. Both are required for practicing nurses. When evaluated separately, the student learning needs are more clearly delineated. © 2014 Wiley Periodicals, Inc.

  2. Collaborative quality improvement.

    Science.gov (United States)

    Luckenbaugh, Amy N; Miller, David C; Ghani, Khurshid R

    2017-07-01

    Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care. Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes. The largest regional collaborative in urology is the Michigan Urological Surgery Improvement Collaborative (MUSIC). Recent efforts by this group have been focused at understanding variation in care, improving patient selection for treatment, reducing treatment morbidity and measuring and optimizing technical skill. The American Urological Association has also recently launched a national quality registry (AQUA), with an initial focus on prostate cancer care. By understanding factors that result in exemplary performance, quality improvement collaboratives are able to develop best practices around areas of care with high variation that have the potential to improve outcomes and reduce costs. These developments have been made possible by the unique model offered by the collaborative structure with the goal of improving patient care at a population level.

  3. Designing collaborative policy innovation

    DEFF Research Database (Denmark)

    Agger, Annika; Sørensen, Eva

    2014-01-01

    Recent approaches to enhancing public innovation suffer from two shortcomings: They overemphasize competition as a driver of innovation and overlook the fact that public sector innovation involves policy innovation as well as service innovation. Drawing on governance research and innovation theory......, the chapter investigates the extent to which and how collaboration between politicians and relevant stakeholders can spur the formulation, implementation and diffusion of new innovative policies. A case study of a process of collaborative policy innovation in a Danish municipality shows that collaborative...... policy arenas do contribute to policy innovation but also that the degree to which they do so depends on the institutional design of these arenas....

  4. Comprehensive multiplatform collaboration

    Science.gov (United States)

    Singh, Kundan; Wu, Xiaotao; Lennox, Jonathan; Schulzrinne, Henning G.

    2003-12-01

    We describe the architecture and implementation of our comprehensive multi-platform collaboration framework known as Columbia InterNet Extensible Multimedia Architecture (CINEMA). It provides a distributed architecture for collaboration using synchronous communications like multimedia conferencing, instant messaging, shared web-browsing, and asynchronous communications like discussion forums, shared files, voice and video mails. It allows seamless integration with various communication means like telephones, IP phones, web and electronic mail. In addition, it provides value-added services such as call handling based on location information and presence status. The paper discusses the media services needed for collaborative environment, the components provided by CINEMA and the interaction among those components.

  5. Collaboration in experiential therapy.

    Science.gov (United States)

    Berdondini, Lucia; Elliott, Robert; Shearer, Joan

    2012-02-01

    We offer a view of the nature and role of client-therapist collaboration in experiential psychotherapy, focusing on Gestalt and emotion-focused therapy (EFT). We distinguish between the necessary condition of mutual trust (the emotional bond between client and therapist) and effective collaboration (regarding the goals and tasks of therapy). Using a case study of experiential therapy for social anxiety, we illustrate how the development of collaboration can be both complex and pivotal for therapeutic success, and how it can involve client and therapist encountering one another through taking risks by openly and nonjudgementally disclosing difficult experiences in order to enrich and advance the work. © 2012 Wiley Periodicals, Inc.

  6. Collaborative Video Sketching

    DEFF Research Database (Denmark)

    Henningsen, Birgitte; Gundersen, Peter Bukovica; Hautopp, Heidi

    2017-01-01

    This paper introduces to what we define as a collaborative video sketching process. This process links various sketching techniques with digital storytelling approaches and creative reflection processes in video productions. Traditionally, sketching has been used by designers across various...... findings: 1) They are based on a collaborative approach. 2) The sketches act as a mean to externalizing hypotheses and assumptions among the participants. Based on our analysis we present an overview of factors involved in collaborative video sketching and shows how the factors relate to steps, where...... the participants: shape, record, review and edit their work, leading the participants to new insights about their work....

  7. Sensemaking in collaborative networks

    DEFF Research Database (Denmark)

    Peronard, Jean-Paul; Brix, Jacob

    2018-01-01

    be redesigned to strengthen the collaboration between companies. To enable this discussion we delve into the sensemaking literature and theory from loosely coupled systems. Our discussion leads to the development of the Balanced Activity System (BAS) model. The paper’s key contribution is the prescriptive BAS......The purpose of the study is to advance research on open business models as activity systems (Zott and Amit, 2010) in collaborative networks. We utilize Bradley’s (1995) theory of exchange behavior to discuss how new joint activities can be explored as well as how existing activities can...... model that can be used strategically in collaborative networks to redesign or create new joint activities....

  8. Budget impact analysis of the fentanyl buccal tablet for treatment of breakthrough cancer pain

    Directory of Open Access Journals (Sweden)

    Darbà J

    2013-12-01

    Full Text Available Josep Darbà,1 Lisette Kaskens,2 Rainel Sánchez-de la Rosa31University of Barcelona, Barcelona, 2BCN Health Economics and Outcomes Research SL, Barcelona, 3Medical and HEOR Department, TEVA Pharmaceutical Industries Ltd, Madrid, SpainBackground: The purpose of this study was to assess the economic impact of the fentanyl buccal tablet for the management of breakthrough cancer pain (BTcP in Spain.Methods: A 4-year budget impact model was developed for the period 2012–2015 for patients with BTcP from the perspective of the Spanish National Health System. BTcP products included in this model were rapid-onset opioids containing fentanyl (buccal, sublingual, or nasal transmucosal. Prevalence data on cancer, BTcP, opioid use, and number of BTcP episodes were obtained from the literature. Input data on health care resources associated with opioid use and opioid-induced side effects were obtained by consulting experts in oncology from different Spanish hospitals. Resources used included drugs, medical and emergency visits, other nonpharmacologic treatments, and treatment of opioid-induced side effects. Unit costs were obtained from the literature, and a 3% discount rate was applied to costs. Based on the unit costs for drugs and health care resources, the annual BTcP treatment costs per patient associated with each fentanyl product were determined to estimate the overall budget impact based on the total treatment population and the percentage of drug utilization associated with each product. One-way sensitivity analyses were conducted to test the robustness of the model.Results: Patients treated with oral opioids for BTcP were estimated at 23,291 in 2012, with an increase up to 23,413 in 2015. The average annual budget savings, with an increase of fentanyl buccal tablets, fentanyl sublingual tablets, and intranasal fentanyl spray, and a decrease in oral transmucosal fentanyl citrate, was estimated at €2.6 million, which represents a 0.5% decrease in

  9. Postpartum Depression - Multiple Languages

    Science.gov (United States)

    ... Русский (Russian) Bilingual PDF Health Information Translations Postpartum Depression - English PDF Postpartum Depression - Русский (Russian) PDF Postpartum Depression - English MP3 ...

  10. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

  11. Recognizing teen depression

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000648.htm Recognizing teen depression To use the sharing features on this page, ... life. Be Aware of the Risk for Teen Depression Your teen is more at risk for depression ...

  12. Sadness and Depression

    Science.gov (United States)

    ... Videos for Educators Search English Español Sadness and Depression KidsHealth / For Kids / Sadness and Depression Print en ... big difference in your life. When Sadness Is Depression When you're in a sad mood, it ...

  13. Postpartum Depression Facts

    Science.gov (United States)

    ... Where can I find more information? Share Postpartum Depression Facts Download PDF Download ePub Download Mobi Order ... for herself or her family. What is postpartum depression? Postpartum depression is a mood disorder that can ...

  14. Depression and College Students

    Science.gov (United States)

    ... depression and other mental health issues? Reference Share Depression and College Students Download PDF Download ePub Order ... Answers to college students’ frequently asked questions about depression Feeling moody, sad, or grouchy? Who doesn’t ...

  15. Watch out for the blue circle: a breakthrough in family planning promotional strategy.

    Science.gov (United States)

    Sumarsono

    1989-07-01

    Realizing the potential of commercial marketing in changing the attitude and behavior of the target audience in the early years of the 4th 5-year development plan, the National Family Planning Program tried to develop new ventures in communicating the concept of the small family norm to the people. The condom was chosen as the 1st product to be sold through the social marketing project because male awareness about family planning was still low. Based on audience research, the pricing, packaging, and branding of the product was developed. The most accepted brand name was Dua Lima because it has a neutral meaning, is easily remembered, and can be described in sign language. The last reason is very important because most consumers have difficulty communicating about condoms in the sales outlet. Social marketing has proved effective because of strong public relations activities and the involvement of formal and informal leaders. This experiment has convinced family planning management that social marketing is workable for promoting the small family norm. In 1987, under the new program of self-sufficiency in family planning, the private sector is invited to participate by providing family planning services for target audiences, using the principles of self-sufficiency and self-support. There are 2 principal activities; 1) the IEC campaign, and 2) product (contraceptive) selling. IEC activities include a media campaign public relations work. Product selling is done through commercial channels such as pharmaceutical firms, drug stores, private doctors, and midwives. It was decided that the campaign would be aided by a name and logo. The blue circle was chosen because it is unique, communicative, and simple. The social marketing of contraceptives in Indonesia can be considered a breakthrough in communication strategy for a national development program.

  16. Common genetic variants are significant risk factors for early menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Murray, Anna; Bennett, Claire E; Perry, John R B; Weedon, Michael N; Jacobs, Patricia A; Morris, Danielle H; Orr, Nicholas; Schoemaker, Minouk J; Jones, Michael; Ashworth, Alan; Swerdlow, Anthony J

    2011-01-01

    Women become infertile approximately 10 years before menopause, and as more women delay childbirth into their 30s, the number of women who experience infertility is likely to increase. Tests that predict the timing of menopause would allow women to make informed reproductive decisions. Current predictors are only effective just prior to menopause, and there are no long-range indicators. Age at menopause and early menopause (EM) are highly heritable, suggesting a genetic aetiology. Recent genome-wide scans have identified four loci associated with variation in the age of normal menopause (40-60 years). We aimed to determine whether theses loci are also risk factors for EM. We tested the four menopause-associated genetic variants in a cohort of approximately 2000 women with menopause≤45 years from the Breakthrough Generations Study (BGS). All four variants significantly increased the odds of having EM. Comparing the 4.5% of individuals with the lowest number of risk alleles (two or three) with the 3.0% with the highest number (eight risk alleles), the odds ratio was 4.1 (95% CI 2.4-7.1, P=4.0×10(-7)). In combination, the four variants discriminated EM cases with a receiver operator characteristic area under the curve of 0.6. Four common genetic variants identified by genome-wide association studies, had a significant impact on the odds of having EM in an independent cohort from the BGS. The discriminative power is still limited, but as more variants are discovered they may be useful for predicting reproductive lifespan.

  17. Ionic Liquids: Breakthrough Absorption Technology for Post-Combustion CO{sub 2} Capture

    Energy Technology Data Exchange (ETDEWEB)

    Maginn, Edward

    2012-09-30

    This is the final report for DE-FC26-07NT43091 Ionic Liquids: Breakthrough Absorption Technology for Post-Combustion CO{sub 2} Capture. A detailed summary is provided of the ionic liquid (IL) discovery process, synthesis and testing results, process / systems modeling, lab-scale operational testing, corrosion testing and commercialization possibilities. The work resulted in the discovery of a new class of ionic liquids (ILs) that efficiently react with CO{sub 2} in a 1:1 stoichiometry with no water present and no increase in viscosity. The enthalpy of reaction was tuned to optimize process economics. The IL was found to have excellent corrosion behavior with and without CO{sub 2} present. In lab-scale tests, the IL was able to effectively remove CO{sub 2} from a simulated flue gas stream, although mass transfer was slower than with aqueous monoethanolamine (MEA) due to higher viscosities. The non-volatile nature of the solvent and its high thermal stability, however, make it an intriguing option. An independent systems analysis indicates that the economics of using the best IL discovered to date (NDIL0157), are at least comparable to and potentially slightly better than - the Fluor Econamine FG PlusTM process (DOE Case 12). Further work should be directed at improving mass transfer / lowering viscosity and developing commercial synthesis routes to make these ILs at scale in an inexpensive manner. Demonstration of the process at larger scales is also warranted, as is the exploration of other process configurations that leverage the anhydrous nature of the solvent and its extremely low volatility.

  18. The effect of vapor polarity and boiling point on breakthrough for binary mixtures on respirator carbon.

    Science.gov (United States)

    Robbins, C A; Breysse, P N

    1996-08-01

    This research evaluated the effect of the polarity of a second vapor on the adsorption of a polar and a nonpolar vapor using the Wheeler model. To examine the effect of polarity, it was also necessary to observe the effect of component boiling point. The 1% breakthrough time (1% tb), kinetic adsorption capacity (W(e)), and rate constant (kv) of the Wheeler model were determined for vapor challenges on carbon beds for both p-xylene and pyrrole (referred to as test vapors) individually, and in equimolar binary mixtures with the polar and nonpolar vapors toluene, p-fluorotoluene, o-dichlorobenzene, and p-dichlorobenzene (referred to as probe vapors). Probe vapor polarity (0 to 2.5 Debye) did not systematically alter the 1% tb, W(e), or kv of the test vapors. The 1% tb and W(e) for test vapors in binary mixtures can be estimated reasonably well, using the Wheeler model, from single-vapor data (1% tb +/- 30%, W(e) +/- 20%). The test vapor 1% tb depended mainly on total vapor concentration in both single and binary systems. W(e) was proportional to test vapor fractional molar concentration (mole fraction) in mixtures. The kv for p-xylene was significantly different (p boiling point; however, these differences were apparently of limited importance in estimating 1% tb for the range of boiling points tested (111 to 180 degrees C). Although the polarity and boiling point of chemicals in the range tested are not practically important in predicting 1% tb with the Wheeler model, an effect due to probe boiling point is suggested, and tests with chemicals of more widely ranging boiling point are warranted. Since the 1% tb, and thus, respirator service life, depends mainly on total vapor concentration, these data underscore the importance of taking into account the presence of other vapors when estimating respirator service life for a vapor in a mixture.

  19. Relativistic generalization of the incentive trap of interstellar travel with application to Breakthrough Starshot

    Science.gov (United States)

    Heller, René

    2017-09-01

    As new concepts of sending interstellar spacecraft to the nearest stars are now being investigated by various research teams, crucial questions about the timing of such a vast financial and labour investment arise. If humanity could build high-speed interstellar lightsails and reach α Centauri 20 yr after launch, would it be better to wait a few years, then take advantage of further technology improvements and arrive earlier despite waiting? The risk of being overtaken by a future, faster probe has been described earlier as the incentive trap. Based on 211 yr of historical data, we find that the speed growth of artificial vehicles, from steam-driven locomotives to Voyager 1, is much faster than previously believed, about 4.72 per cent annually or a doubling every 15 yr. We derive the mathematical framework to calculate the minimum of the wait time to launch t plus travel time τ(t) and extend it into the relativistic regime. We show that the t + τ(t) minimum disappears for nearby targets. There is no use of waiting once we can reach an object within about 20 yr of travel, irrespective of the actual speed. In terms of speed, the t + τ(t) minimum for a travel to α Centauri occurs at 19.6 per cent the speed of light (c), in agreement with the 20 per cent c proposed by the Breakthrough Starshot initiative. If interstellar travel at 20 per cent c could be achieved within 45 yr from today and the kinetic energy be increased at a rate consistent with the historical record, then humans can reach the 10 most nearby stars within 100 yr from today.

  20. Breakthrough in current-in-plane tunneling measurement precision by application of multi-variable fitting algorithm

    DEFF Research Database (Denmark)

    Cagliani, Alberto; Østerberg, Frederik Westergaard; Hansen, Ole

    2017-01-01

    We present a breakthrough in micro-four-point probe (M4PP) metrology to substantially improve precision of transmission line (transfer length) type measurements by application of advanced electrode position correction. In particular, we demonstrate this methodology for the M4PP current-in-plane t......We present a breakthrough in micro-four-point probe (M4PP) metrology to substantially improve precision of transmission line (transfer length) type measurements by application of advanced electrode position correction. In particular, we demonstrate this methodology for the M4PP current......-in-plane tunneling (CIPT) technique. The CIPT method has been a crucial tool in the development of magnetic tunnel junction (MTJ) stacks suitable for magnetic random-access memories for more than a decade. On two MTJ stacks, the measurement precision of resistance-area product and tunneling magnetoresistance...

  1. Collaborative Learning in the Cloud

    DEFF Research Database (Denmark)

    Kirchner, Kathrin; Razmerita, Liana

    2015-01-01

    This present study aims to investigate how students perceive collaboration and identifies associated technologies used to collaborate. In particular we aim to address the following research questions: What are the factors that impact satisfaction with collaboration? How do these factors differ in...... in different collaborative settings? Based on data from 75 students from Denmark and Germany, the article identifies collaborative practices and factors that impact positively and negatively satisfaction with collaboration....

  2. Stanford test called a net breakthrough - data sent at 3,500 times the speed of broadband

    CERN Multimedia

    2003-01-01

    Researchers at a Stanford University-affiliated research center have found a way to send data across the Internet more than 3,500 times faster than the typical broadband connection. The technical breakthrough set an Internet speed record too fast to be of use with present-day computers but could open the way for scientists to share and ship massive databases around the world, according to the researchers.

  3. Closed-flow column experiments—Insights into solute transport provided by a damped oscillating breakthrough behavior

    Science.gov (United States)

    Ritschel, Thomas; Totsche, Kai Uwe

    2016-03-01

    Transport studies that employ column experiments in closed-flow mode complement classical approaches by providing new characteristic features observed in the solute breakthrough and equilibrium between liquid and solid phase. Specific to the closed-flow mode is the recirculation of the effluent to the inflow via a mixing vessel. Depending on the ratio of volumes of mixing vessel and water-filled pore space, a damped oscillating solute concentration emerges in the effluent and mixing vessel. The oscillation characteristics, e.g., frequency, amplitude, and damping, allow for the investigation of solute transport in a similar fashion as known for classical open-flow column experiments. However, the closed loop conserves substances released during transport within the system. In this way, solute and porous medium can equilibrate with respect to physicochemical conditions. With this paper, the features emerging in the breakthrough curves of saturated column experiments run in closed-flow mode and methods of evaluation are illustrated under experimental boundary conditions forcing the appearance of oscillations. We demonstrate that the effective pore water volume and the pumping rate can be determined from a conservative tracer breakthrough curve uniquely. In this way, external preconditioning of the material, e.g., drying, can be avoided. A reactive breakthrough experiment revealed a significant increase in the pore water pH value as a consequence of the closed loop. These results highlight the specific impact of the closed mass balance. Furthermore, the basis for the modeling of closed-flow experiments is given by the derivation of constitutive equations and numerical implementation, validated with the presented experiments.

  4. Collaborative engagement experiment

    Science.gov (United States)

    Mullens, Katherine; Troyer, Bradley; Wade, Robert; Skibba, Brian; Dunn, Michael

    2006-05-01

    Unmanned ground and air systems operating in collaboration have the potential to provide future Joint Forces a significant capability for operations in complex terrain. Collaborative Engagement Experiment (CEE) is a consolidation of separate Air Force, Army and Navy collaborative efforts within the Joint Robotics Program (JRP) to provide a picture of the future of unmanned warfare. The Air Force Research Laboratory (AFRL), Material and Manufacturing Directorate, Aerospace Expeditionary Force Division, Force Protection Branch (AFRL/MLQF), The Army Aviation and Missile Research, Development and Engineering Center (AMRDEC) Joint Technology Center (JTC)/Systems Integration Laboratory (SIL), and the Space and Naval Warfare Systems Center - San Diego (SSC San Diego) are conducting technical research and proof of principle experiments for an envisioned operational concept for extended range, three dimensional, collaborative operations between unmanned systems, with enhanced situational awareness for lethal operations in complex terrain. This paper describes the work by these organizations to date and outlines some of the plans for future work.

  5. Collaborative Learning through Teletutorials.

    Science.gov (United States)

    Idrus, Rozhan

    1993-01-01

    Describes the use of audiographic teleconferencing for distance education courses for adult higher education at the Universiti Sains Malaysia. Telecommunications is discussed, and a collaborative learning strategy is explained that emphasizes the student-teacher relationship. (Contains 18 references.) (LRW)

  6. Collaborative Knowledge Management

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... collaboration of knowledge. The organizational structures and ... enables organizations to see the collective knowledge as a base element of ..... requirements for communication across different equipment and applications by ...

  7. Collaborative Communities of Firms

    DEFF Research Database (Denmark)

    2011-01-01

    and developing strategic initiatives that aid the community as a whole. We discuss the facilitator role of the shared services provider, contrasting it with the coordinator role found in other multi-firm organizations, and we show how shared services providers function by describing three examples...... is an organizational model called the collaborative community of firms. This chapter addresses an important organizational role in a collaborative community, that of the shared services provider. The shared services provider acts as a facilitator in the community, helping member firms collaborate with one another...... of collaborative communities of firms from different sectors: the U.S.-based Blade.org and two Denmark-based communities, the Kalundborg Industrial Symbiosis and MG50. Implications for the theory and practice of organization design are discussed....

  8. Drivers of Collaborative Advantage

    DEFF Research Database (Denmark)

    Weihe, Gudrid

    processes and behavioural dimensions is practically non-existent. This article tries to remedy the current gap in the literature by reviewing research findings on interfirm collaboration (alliances). On that basis a conceptual framework for analyzing partnership processes is developed. Finally......, the antecedents of collaborative advantage are theoretically examined, and the organizational competences contributing to collaborative success are identified. The conclusion is that operational processes and social dynamics are vital drivers of collaborative advantage. Another significant conclusion...... is that public management research can benefit from drawing upon existing alliance research. Alliance scholars have during the past couple of decades accumulated an impressive amount of knowledge on different aspects of inter-firm cooperation, and therefore the learning potential for public management scholars...

  9. Collaboration in scientific practice

    DEFF Research Database (Denmark)

    Wagenknecht, Susann

    2014-01-01

    This monograph investigates the collaborative creation of scientific knowledge in research groups. To do so, I combine philosophical analysis with a first-hand comparative case study of two research groups in experimental science. Qualitative data are gained through observation and interviews......, and I combine empirical insights with existing approaches to knowledge creation in philosophy of science and social epistemology. On the basis of my empirically-grounded analysis I make several conceptual contributions. I study scientific collaboration as the interaction of scientists within research...... to their publication. Specifically, I suggest epistemic difference and the porosity of social structure as two conceptual leitmotifs in the study of group collaboration. With epistemic difference, I emphasize the value of socio-cognitive heterogeneity in group collaboration. With porosity, I underline the fact...

  10. EPA Collaboration with Israel

    Science.gov (United States)

    The United States and Israel focus on scientific and technical collaboration to protect the environment, by exchanging scientific and technical information, arranging visits of scientific personnel, cooperating in scientific symposia and workshops, etc.

  11. Providers’ perspectives on collaboration

    Directory of Open Access Journals (Sweden)

    Patricia Bruner

    2011-08-01

    Full Text Available Objective: Changes in models of health care are required to better meet the needs of diverse, underserved patient populations. Collaboration among providers is one way to promote accessible, comprehensive and continuous care in healthcare organizations. This paper describes the quantitative findings from two time points that examined providers' views of collaboration among a sample of diverse personnel (e.g. clinical nurses, social workers, dental providers, mental health providers, clerical staff, medical assistants, public health staff, and administrators within a federally qualified nurse managed health care centre in the United States. Methods: The quantitative arm of a mixed-method study is presented in this paper. Two instruments, the Collaboration and Satisfaction About Care Decisions Scale and the University of the West of England Interprofessional Questionnaire (comprised of 4 subscales-Communication and Teamwork Scale, Interprofessional Learning Scale, Interprofessional Interaction Scale, and Interprofessional Relationships Scale were administered to providers at baseline and three to eight months following six same discipline focus group discussions on collaboration, in order to evaluate whether participating in the focus group discussions changed providers' views of collaboration. A summary of the focus group data which were published elsewhere is additionally summarized to help provide insight to the quantitative findings. Thirty-nine staff participated. Results: Paired t-tests revealed that only one scale out of the five, Collaboration and Satisfaction About Care Decisions Scale (33.97 at time one and 37.45 at time two, significantly and positively changed after the focus group discussion (p=0.046. Providers' views on collaboration ranged from positive to moderate views of collaboration; most measures revealed a non-significant improvement after the focus group discussions. Staff with some graduate school reported the greatest

  12. Providers’ perspectives on collaboration

    Directory of Open Access Journals (Sweden)

    Patricia Bruner

    2011-08-01

    Full Text Available Objective: Changes in models of health care are required to better meet the needs of diverse, underserved patient populations. Collaboration among providers is one way to promote accessible, comprehensive and continuous care in healthcare organizations. This paper describes the quantitative findings from two time points that examined providers' views of collaboration among a sample of diverse personnel (e.g. clinical nurses, social workers, dental providers, mental health providers, clerical staff, medical assistants, public health staff, and administrators within a federally qualified nurse managed health care centre in the United States.Methods: The quantitative arm of a mixed-method study is presented in this paper. Two instruments, the Collaboration and Satisfaction About Care Decisions Scale and the University of the West of England Interprofessional Questionnaire (comprised of 4 subscales-Communication and Teamwork Scale, Interprofessional Learning Scale, Interprofessional Interaction Scale, and Interprofessional Relationships Scale were administered to providers at baseline and three to eight months following six same discipline focus group discussions on collaboration, in order to evaluate whether participating in the focus group discussions changed providers' views of collaboration. A summary of the focus group data which were published elsewhere is additionally summarized to help provide insight to the quantitative findings. Thirty-nine staff participated.Results: Paired t-tests revealed that only one scale out of the five, Collaboration and Satisfaction About Care Decisions Scale (33.97 at time one and 37.45 at time two, significantly and positively changed after the focus group discussion (p=0.046. Providers' views on collaboration ranged from positive to moderate views of collaboration; most measures revealed a non-significant improvement after the focus group discussions. Staff with some graduate school reported the greatest

  13. Silence in Intercultural Collaboration

    NARCIS (Netherlands)

    Verouden, Nick W.; Sanden, Van der Maarten C.A.; Aarts, Noelle

    2018-01-01

    China is widely recognized as a significant scientific partner for Western universities. Given that many Western universities are now operating in the Chinese context, this study investigates the everyday conversations in which international partnerships are collaboratively developed and

  14. Indico: CERN Collaboration Hub

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    Indico development is also moving towards a broader collaboration where other institutes, hosting their own Indico instance, can contribute to the project in order make it a better and more complete tool.

  15. Electronic Collaboration Logbook

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    At FNAL, we developed an Electronic Collaboration Logbook (ECL) application which is used by about 20 different collaborations, experiments and groups at FNAL. ECL is the latest iteration of the project formerly known as Control Room Logbook (CRL). We have been working on mobile (IOS and Android) clients for ECL. We will present history, current status and future plans of the project, as well as design, implementation and support solutions made by the project.

  16. Embarrassing To Collaborate

    DEFF Research Database (Denmark)

    Mitchell, Robb

    This position paper briefly outlines my interest in embarrassment– principally in relation to experiments provoking collaborative encounters in contexts that range from urban spaces to art galleries, and from music events to industrial innovation workshops.......This position paper briefly outlines my interest in embarrassment– principally in relation to experiments provoking collaborative encounters in contexts that range from urban spaces to art galleries, and from music events to industrial innovation workshops....

  17. Collaboration Between Multistakeholder Standards

    DEFF Research Database (Denmark)

    Rasche, Andreas; Maclean, Camilla

    Public interest in corporate social responsibility (CSR) has resulted in a wide variety of multistakeholder CSR standards in which companies can choose to participate. While such standards reflect collaborative governance arrangements between public and private actors, the market for corporate...... responsibility is unlikely to support a great variety of partly competing and overlapping standards. Increased collaboration between these standards would enhance both their impact and their adoption by firms. This report examines the nature, benefits, and shortcomings of existing multistakeholder standards...

  18. Staging Collaborative Innovation Processes

    DEFF Research Database (Denmark)

    Pedersen, Signe; Clausen, Christian

    Organisations are currently challenged by demands for increased collaborative innovation internally as well as with external and new entities - e.g. across the value chain. The authors seek to develop new approaches to managing collaborative innovative processes in the context of open innovation ...... the diverse matters of concern into a coherent product or service concept, and 2) in the same process move these diverse holders of the matters of concern into a translated actor network which carry or support the concept.......Organisations are currently challenged by demands for increased collaborative innovation internally as well as with external and new entities - e.g. across the value chain. The authors seek to develop new approaches to managing collaborative innovative processes in the context of open innovation...... and public private innovation partnerships. Based on a case study of a collaborative design process in a large electronics company the paper points to the key importance of staging and navigation of collaborative innovation process. Staging and navigation is presented as a combined activity: 1) to translate...

  19. Collaborations in fusion research

    International Nuclear Information System (INIS)

    Barnes, D.; Davis, S.; Roney, P.

    1995-01-01

    This paper reviews current experimental collaborative efforts in the fusion community and extrapolates to operational scenarios for the Tokamak Physics Experiment (TPX) and the International Thermonuclear Experimental Reactor (ITER). Current requirements, available technologies and tools, and problems, issues and concerns are discussed. This paper specifically focuses on the issues that apply to experimental operational collaborations. Special requirements for other types of collaborations, such as theoretical or design and construction efforts, will not be addressed. Our current collaborative efforts have been highly successful, even though the tools in use will be viewed as primitive by tomorrow's standards. An overview of the tools and technologies in today's collaborations can be found in the first section of this paper. The next generation of fusion devices will not be primarily institutionally based, but will be national (TPX) and international (ITER) in funding, management, operation and in ownership of scientific results. The TPX will present the initial challenge of real-time remotely distributed experimental data analysis for a steady state device. The ITER will present new challenges with the possibility of several remote control rooms all participating in the real-time operation of the experimental device. A view to the future of remote collaborations is provided in the second section of this paper

  20. TU-E-211-01: Establishing Multidisciplinary Collaboration as a Medical Physicist.

    Science.gov (United States)

    Xing, L; Fraass, B; Ford, E; Chang, S

    2012-06-01

    Many medical physicists are scientists at heart and their career fulfillment includes a balance of clinical service and research development. Multidisciplinary collaboration is a great way for the medical physicists to advance science and technology of our fields and the fields of our collaborators. Cross-pollination among scientists of different fields has been the key for some of the most significant breakthroughs in science and medicine and produced some of the most rewarding experiences for the individuals involved. However, medical physicists face unique challenges in establishing multidisciplinary collaboration because our time and resources for research are often quite limited compared to basic scientists. Yet we medical physicists are uniquely positioned and have a tremendous opportunity to create/contribute to multidisciplinary research: our fields are already multidisciplinary in nature and hospital environment is problem rich. How do we establish and carry out research collaboration with scientists of other fields? How to balance research with your higher priority clinical service? How do you find the right multidisciplinary collaboration in your own environment? We will discuss the challenges, provide real exemplary solutions to the above questions, and offer advise to medical physicists who are interested in starting or improving their multidisciplinary collaboration. There are different kinds of multidisciplinary collaborations a medical physicist can create and participate at different involvement levels. Multidisciplinary collaboration is not for every medical physicist but for those who seek and devote time to it, the experience can be truly rewarding and the impact can be enormous. 1. Learn the types of multidisciplinary collaboration medical physicists can created/participated 2. Learn the approaches and strategies to develop collaborations with scientists and professional of other fields3. Understand the challenges and different approaches to

  1. Bladder volume at onset of vesicoureteral reflux is an independent risk factor for breakthrough febrile urinary tract infection.

    Science.gov (United States)

    Alexander, Siobhan E; Arlen, Angela M; Storm, Douglas W; Kieran, Kathleen; Cooper, Christopher S

    2015-04-01

    Improved identification of children with vesicoureteral reflux at risk for recurrent febrile urinary tract infection may impact management decisions. We hypothesized that reflux occurring earlier during bladder filling increases the duration of exposure of the kidneys to bacteria, and, therefore, increases the risk of pyelonephritis. Children with vesicoureteral reflux and detailed voiding cystourethrogram data were identified. Bladder volume at onset of reflux was normalized for age. Demographics, reflux grade, laterality, presence/absence of bladder-bowel dysfunction and breakthrough febrile urinary tract infections were assessed. Median followup was 24 months (IQR 12 to 52). A total of 208 girls and 47 boys were analyzed with a mean ± SD age at diagnosis of 3.1 ± 2.6 years. On univariate analysis history of febrile urinary tract infection (HR 2.17, 95% CI 1.33-2.85, p = 0.01), dilating vesicoureteral reflux (HR 1.6, 95% CI 1.05-2.42, p = 0.03) and bladder-bowel dysfunction (HR 1.66, 95% CI 0.99-2.75, p = 0.05) were associated with an increased risk of breakthrough febrile urinary tract infection. Median bladder volume at onset of reflux in children with breakthrough febrile urinary tract infection was significantly less (33.1%) than in those without infection (49.5%, p = 0.003). Reflux onset at 35% predicted bladder capacity or less was associated with a significantly increased risk of breakthrough febrile urinary tract infection on multivariate analysis (HR 1.58, 95% CI 1.05-2.38, p = 0.03). Children with early filling vesicoureteral reflux are at increased risk for breakthrough febrile urinary tract infection independent of reflux grade. Bladder volume at onset of reflux should be recorded during cystograms since it provides additional prognostic information about the risk of pyelonephritis and resolution, and may assist with counseling and clinical decision making. Copyright © 2015 American Urological Association Education and Research, Inc. Published by

  2. Collaborative engagement experiment (CEE)

    Science.gov (United States)

    Wade, Robert L.; Reames, Joseph M.

    2005-05-01

    Unmanned ground and air systems operating in collaboration have the potential to provide future Joint Forces a significant capability for operations in complex terrain. Ground and air collaborative engagements potentially offer force conservation, perform timely acquisition and dissemination of essential combat information, and can eliminate high value and time critical targets. These engagements can also add considerably to force survivability by reducing soldier and equipment exposure during critical operations. The Office of the Secretary of Defense, Joint Robotics Program (JRP) sponsored Collaborative Engagement Experiment (CEE) is a consolidation of separate Air Force, Army and Navy collaborative efforts to provide a Joint capability. The Air Force Research Laboratory (AFRL), Material and Manufacturing Directorate, Aerospace Expeditionary Force Division, Force Protection Branch (AFRLMLQF), The Army Aviation and Missile Research, Development and Engineering Center (AMRDEC) Joint Technology Center (JTC)/Systems Integration Laboratory (SIL), and the Space and Naval Warfare Systems Center-San Diego (SSC San Diego) are conducting technical research and proof of principle for an envisioned operational concept for extended range, three dimensional, collaborative operations between unmanned systems, with enhanced situational awareness for lethal operations in complex terrain. This program will assess information requirements and conduct experiments to identify and resolve technical risks for collaborative engagements using Unmanned Ground Vehicles (UGVs) and Unmanned Aerial Vehicles (UAVs). It will research, develop and physically integrate multiple unmanned systems and conduct live collaborative experiments. Modeling and Simulation systems will be upgraded to reflect engineering fidelity levels to greater understand technical challenges to operate as a team. This paper will provide an update of a multi-year program and will concentrate primarily on the JTC

  3. Correlations between plasma endothelin-1 levels and breakthrough pain in patients with cancer

    Directory of Open Access Journals (Sweden)

    Yan XB

    2015-12-01

    Full Text Available Xue-bin Yan, Tuo-chao Peng, Dong Huang Department of Anesthesiologist, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, People’s Republic of China Abstract: Endothelin-1 (ET-1 may be involved in driving pain in patients with advanced cancer. However, a few studies focus on the role of ET-1 in breakthrough pain (BP. The aim of this pivotal study was to explore the correlation between the plasma (ET-1 level and BP intensity. A total of 40 patients were enrolled in the study, and they were divided into two groups: BP group and non-BP group. Moreover, 20 healthy adults were used as the normal control group. Pain intensity was measured using visual analog scale (VAS scores of 1–10. Plasma ET-1 levels were detected by an ET radioimmunoassay kit. Subsequently, the correlation of ET-1 level with the VAS score and cancer types was analyzed by Pearson’s correlation coefficient. The plasma ET-1 level in the BP group (35.31±8.02 pg/mL was higher than that in the non-BP group (29.51±6.78 pg/mL and the normal control group (24.77±10.10 pg/mL, P<0.05. In addition, the VAS score in the BP group (7.45±0.82 was higher than that in the non-BP group (2.80±1.23, P<0.05. The plasma ET-1 level was positively correlated with the VAS score of the BP group (Pearson’s r=0.42. There was no significant correlation between the plasma ET-1 level and VAS score of the non-BP group (Pearson’s r=–0.22 or/and cancer types (P>0.05. The elevated plasma ET-1 levels were positively related to BP, and targeting ET-1 may provide a novel pain-reducing therapeutic treatment in BP. Keywords: visual analog scale, correlation, cancer types, background pain

  4. Aldosterone breakthrough in dogs with naturally occurring myxomatous mitral valve disease.

    Science.gov (United States)

    Ames, M K; Atkins, C E; Eriksson, A; Hess, A M

    2017-06-01

    Aldosterone breakthrough (ABT) is the condition in which angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers fail to effectively suppress the activity of the renin angiotensin aldosterone system. The objective of this study was to determine if ABT occurs in dogs with naturally occurring myxomatous mitral valve disease receiving an ACEI, using the urine aldosterone to creatinine ratio (UAldo:C) as a measure of renin angiotensin aldosterone system activation. This study includes 39 dogs with myxomatous mitral valve disease. A UAldo:C cut-off definition (derived from a normal population of healthy, adult, and client-owned dogs) was used to determine the prevalence of ABT in this population. Spearman analysis and univariate logistic regression were used to evaluate the relationship between UAldo:C and ABT (yes/no) and eight variables (age, serum K + concentration, serum creatinine concentration, ACEI therapy duration and ACEI dosage, furosemide therapy duration and furosemide dosage, and urine sample storage time). Finally, the UAldo:C in dogs receiving spironolactone, as part congestive heart failure (CHF) therapy, was compared to dogs with CHF that were not receiving spironolactone. The prevalence of ABT was 32% in dogs with CHF and 30% in dogs without CHF. There was no relationship between either the UAldo:C or the likelihood of ABT and the eight variables. Therapy with spironolactone lead to a significant elevation of the UAldo:C. Using the UAldo:C and a relatively stringent definition of ABT, it appears that incomplete RAAS blockade is common in dogs with MMVD receiving an ACEI. The prevalence of ABT in this canine population mirrors that reported in humans. While the mechanism of ABT is likely multifactorial and still poorly understood, the proven existence of ABT in dogs offers the potential to improve the prognosis for MMVD with the addition of a mineralocorticoid receptor blocker to current therapeutic regimens

  5. Reputational Information and Strategic Collaboration

    DEFF Research Database (Denmark)

    Andersen, Poul Houman; Bendix, Henrik B.

    1998-01-01

    What types of information do decision-makers use when deciding on collaboration? What are the role of reputational information in relation to decisions on collaboration......What types of information do decision-makers use when deciding on collaboration? What are the role of reputational information in relation to decisions on collaboration...

  6. Distance collaborations with industry

    Energy Technology Data Exchange (ETDEWEB)

    Peskin, A.; Swyler, K.

    1998-06-01

    The college industry relationship has been identified as a key policy issue in Engineering Education. Collaborations between academic institutions and the industrial sector have a long history and a bright future. For Engineering and Engineering Technology programs in particular, industry has played a crucial role in many areas including advisement, financial support, and practical training of both faculty and students. Among the most important and intimate interactions are collaborative projects and formal cooperative education arrangements. Most recently, such collaborations have taken on a new dimension, as advances in technology have made possible meaningful technical collaboration at a distance. There are several obvious technology areas that have contributed significantly to this trend. Foremost is the ubiquitous presence of the Internet. Perhaps almost as important are advances in computer based imaging. Because visual images offer a compelling user experience, it affords greater knowledge transfer efficiency than other modes of delivery. Furthermore, the quality of the image appears to have a strongly correlated effect on insight. A good visualization facility offers both a means for communication and a shared information space for the subjects, which are among the essential features of both peer collaboration and distance learning.

  7. COLLABORATION BOARD (CB55)

    CERN Multimedia

    B. Cousins

    Open Access Publication Policy ATLAS had recently issued a short statement in support of open access publishing. The mood of the discussions in the December CMS Collaboration Board had appeared to be in favour and so it was being proposed that CMS issue the same statement as that made by ATLAS (the statement is attached to the agenda of this meeting). The Collaboration Board agreed. Election of the Chair of the Collaboration Board Following the agreement to shorten the terms of both the Spokesperson and the Collaboration Board Chair, and to introduce a longer overlap period between the election and the start of the term, the election for the next Collaboration Board Chair was due in December 2007. If the old standard schedule specified in the Constitution were adapted to this date, then the Board should be informed at the present meeting that the election was being prepared. However, it was felt that the experience of the previous year's election of the Spokesperson had shown that it would be desirable to...

  8. Depression After Heart Attack

    Science.gov (United States)

    ... Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health? There is some good news here. Depression is ... Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health? What Can I Do About the Depression I’ ...

  9. Ketamine Metabolites for the Treatment of Depression and Pain | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Institute on Aging, Laboratory of Clinical Investigation, is seeking parties interested in collaborative research to co-develop ketamine metabolites for the treatment of different forms of depression and for alleviating pain.

  10. Managing collaborative innovation networks

    DEFF Research Database (Denmark)

    Stevens, Vidar; Agger, Annika

    2017-01-01

    Collaborative innovation networks are increasingly used as vehicles for fostering innovative policy solutions. However, scholars have noted that the extent to which collaborative networks can actually contribute to the development of innovative policy solutions depends on how they are managed...... a Flemish administrative network to develop a radical new Spatial Planning Policy Plan. This study shows that the best way to manage collaborative innovation networks is not to press directly for results, but take the time to invest in relationship-building and together agree on a planning and clear process...... steps. Such a management approach allows actors to get to know each other and from thereon expand, with more background and appreciation for the others’ goals, behaviors, and intentions, their group activities concerning the formulation of a radical and innovative policy plan....

  11. Innovation and network collaboration

    DEFF Research Database (Denmark)

    Kesting, Peter; Müller, Sabine; Jørgensen, Frances

    2011-01-01

    Research suggests that small and medium-sized enterprises (SMEs) can benefit from network collaboration by enhancing opportunities for innovation. Managing the necessary collaboration to benefit from network participation may however be particularly challenging for SMEs due to their size...... and their inherent shortage of resources. In this paper, we propose that human resource management (HRM) practices may provide a means by which SMEs can increase their innovation capacity through network collaboration. Following a brief presentation of the relevant literature on networks, and innovation in networks...... in particular, and HRM, we analyse and evaluate the potential applicability of existing models for supporting innovation in SMEs participating in networks. Finally, we propose several lines of inquiry arising from our analysis that provide directions for future research....

  12. Securing collaborative environments

    Energy Technology Data Exchange (ETDEWEB)

    Agarwal, Deborah [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Jackson, Keith [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, Mary [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2002-05-16

    The diverse set of organizations and software components involved in a typical collaboratory make providing a seamless security solution difficult. In addition, the users need support for a broad range of frequency and locations for access to the collaboratory. A collaboratory security solution needs to be robust enough to ensure that valid participants are not denied access because of its failure. There are many tools that can be applied to the task of securing collaborative environments and these include public key infrastructure, secure sockets layer, Kerberos, virtual and real private networks, grid security infrastructure, and username/password. A combination of these mechanisms can provide effective secure collaboration capabilities. In this paper, we discuss the requirements of typical collaboratories and some proposals for applying various security mechanisms to collaborative environments.

  13. Intercultural Collaboration Stories

    DEFF Research Database (Denmark)

    Gertsen, Martine Cardel; Søderberg, Anne-Marie

    2011-01-01

    The objective of this article is to show how narrative methods provide useful tools for international business research. We do this by presenting a study of stories told about the collaboration between a Danish expatriate manager and his Chinese CEO in the Shanghai subsidiary of an MNE. First, we...... to elucidate intercultural collaboration processes by analyzing how each member of a dyad of interacting managers narrates the same chain of events. We show how the narratological concepts of peripeteia and anagnorisis are well suited to identifying focal points in their stories: situations where change...... follows their recognizing new dimensions of their conflicts, eventually furthering their collaboration. We explain how Greimas's actantial model is valuable when mapping differences between and changes in the narrators’ projects, alliances and oppositions in the course of their interaction. Thus, we make...

  14. Playful Collaboration (or Not)

    DEFF Research Database (Denmark)

    Bogers, Marcel

    2011-01-01

    This paper explores how games and play, which are deeply rooted in human beings as a way to learn and interact, can be used to teach certain concepts and practices related to open collaborative innovation. We discuss how playing games can be a source of creativity, imagination and fun, while it can...... also be conducive to deep learning. As such, a game can engage different dimensions of learning and embed elements of active, collaborative, cooperative and problem-based learning. Building on this logic, we present an exploratory case study of the use of a particular board game in a class of a course...... collaboration at the cost of individual performance and possible long-term collective performance as well....

  15. Collaborative Economy and Tourism

    DEFF Research Database (Denmark)

    Dredge, Dianne; Gyimóthy, Szilvia

    2017-01-01

    The digital collaborative economy is one of the most fascinating developments to have claimed our attention in the last decade. Not only does it defy clear definition, but its historical links back to non-monetised sharing and gift economies and its contemporary foundations in monetising idling...... or spare capacity make it difficult to theorise. In this chapter, we lay the foundation for a social science approach to the exploration of the collaborative economy and its relationship with tourism. We argue that “collaborative” and “economy” should be conceptualised in a broad and inclusive manner...... in order to avoid narrow theorisations and blinkered accounts that focus only on digitally-mediated, monetised transactions. A balance between individual and collective dimensions of the collaborative economy is also necessary if we are to understand its societal implications....

  16. The collaboration imperative.

    Science.gov (United States)

    Nidumolu, Ram; Ellison, Jib; Whalen, John; Billman, Erin

    2014-04-01

    Addressing global sustainability challenges--including climate change, resource depletion, and ecosystem loss--is beyond the individual capabilities of even the largest companies. To tackle these threats, and unleash new value, companies and other stakeholders must collaborate in new ways that treat fragile and complex ecosystems as a whole. In this article, the authors draw on cases including the Latin American Water Funds Partnership, the Sustainable Apparel Coalition (led by Nike, Patagonia, and Walmart), and Action to Accelerate Recycling (a partnership between Alcoa, consumer packaged goods companies, and local governments, among others) to describe four new collaboration models that create shared value and address environmental protection across the value stream. Optimal collaborations focus on improving either business processes or outcomes. They start with a small group of key organizations, bring in project management expertise, link self-interest to shared interest, encourage productive competition, create quick wins, and, above all, build and maintain trust.

  17. Depression associated with dementia.

    Science.gov (United States)

    Gutzmann, H; Qazi, A

    2015-06-01

    Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression is frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients and the severity of psychopathological and neurological impairments increases with increasing severity of depression. Depressive symptoms may be both a risk factor for, as well as a prodrome of dementia. Major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults. Treating depression is therefore a key clinical priority to improve the quality of life both of people with dementia as well as their carergivers. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate depression and dementia. In cases of severe depression or depression not able to be managed through nonpharmacological means, antidepressant therapy should be considered.

  18. Communication and collaboration technologies.

    Science.gov (United States)

    Cheeseman, Susan E

    2012-01-01

    This is the third in a series of columns exploring health information technology (HIT) in the neonatal intensive care unit (NICU). The first column provided background information on the implementation of information technology throughout the health care delivery system, as well as the requisite informatics competencies needed for nurses to fully engage in the digital era of health care. The second column focused on information and resources to master basic computer competencies described by the TIGER initiative (Technology Informatics Guiding Education Reform) as learning about computers, computer networks, and the transfer of data.1 This column will provide additional information related to basic computer competencies, focusing on communication and collaboration technologies. Computers and the Internet have transformed the way we communicate and collaborate. Electronic communication is the ability to exchange information through the use of computer equipment and software.2 Broadly defined, any technology that facilitates linking one or more individuals together is a collaborative tool. Collaboration using technology encompasses an extensive range of applications that enable groups of individuals to work together including e-mail, instant messaging (IM ), and several web applications collectively referred to as Web 2.0 technologies. The term Web 2.0 refers to web applications where users interact and collaborate with each other in a collective exchange of ideas generating content in a virtual community. Examples of Web 2.0 technologies include social networking sites, blogs, wikis, video sharing sites, and mashups. Many organizations are developing collaborative strategies and tools for employees to connect and interact using web-based social media technologies.3.

  19. Explaining variation in perceived team effectiveness: results from eleven quality improvement collaboratives.

    Science.gov (United States)

    Strating, Mathilde M H; Nieboer, Anna P

    2013-06-01

    Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Evidence underlying the effectiveness of quality improvement collaboratives is inconclusive and few studies investigated determinants of implementation success. Moreover, most evaluation studies on quality improvement collaboratives are based on one specific topic or quality problem, making it hard to compare across collaboratives addressing different topics. A multiple-case cross-sectional study. Quality improvement teams in 11 quality improvement collaboratives focusing on 11 different topics. Team members received a postal questionnaire at the end of each collaborative. Of the 283 improvement teams, 151 project leaders and 362 team members returned the questionnaire. Analysis of variance revealed that teams varied widely on perceived effectiveness. Especially, members in the Prevention of Malnutrition and Prevention of Medication Errors collaboratives perceived a higher effectiveness than other groups. Multilevel regression analyses showed that educational level of professionals, innovation attributes, organisational support, innovative culture and commitment to change were all significant predictors of perceived effectiveness. In total, 27·9% of the individual-level variance, 57·6% of the team-level variance and 80% of the collaborative-level variance could be explained. The innovation's attributes, organisational support, an innovative team culture and professionals' commitment to change are instrumental to perceived effectiveness. The results support the notion that a layered approach is necessary to achieve improvements in quality of care and provides further insight in the determinants of success of quality improvement collaboratives. Understanding which factors enhance the impact of quality improvement initiatives can help professionals to achieve

  20. Playful Collaboration (Or Not)

    DEFF Research Database (Denmark)

    Bogers, Marcel; Sproedt, Henrik

    2012-01-01

    This article explores how playing games can be used to teach intangible social interaction across boundaries, in particular within open collaborative innovation. We present an exploratory case study of how students learned from playing a board game in a graduate course of the international...... and interdisciplinary Innovation and Business master's program in Denmark. We identify several important themes related to the process of learning through playing and the social dynamics of open collaborative innovation, while we also highlight possible caveats of “playing” and practicing open innovation. Our findings...

  1. Organizing for Asymmetric Collaboration

    DEFF Research Database (Denmark)

    Nielsen, Jørn Flohr; Sørensen, Henrik B.

      The vision of new organizational forms consists of less-organized networks and alliances between organizations, in which collaborative capabilities are assumed to be crucial (Miles et al., 2005). The path to such new forms may go through fragile cooperative efforts. Despite the good will of many...... complexity to already complex models, we claim that our approach has practical implications: it offers rather simple diagnostic cues to change agents that are coping with the barriers to management and collaboration among loosely coupled units....

  2. Collaboratively Constructed Contradictory Accounts

    DEFF Research Database (Denmark)

    Tunby Gulbrandsen, Ib; Just, Sine Nørholm

    2013-01-01

    Based on a mixed-method case study of online communication about the Danish pharmaceutical company Novo Nordisk, this article argues that online communication plays out as a centrifugal narration process with centripetal consequences. Through a content analysis of communication about Novo Nordisk...... the theoretical and methodological implications of the empirical findings. It is argued that although the findings are not in themselves surprising, they adequately reflect that online meaning formation is, indeed, a collaborative process in which centrifugal forces have centripetal consequences. Furthermore......, the findings suggest that the chosen mixed-method case study successfully navigates the dilemma of studying online collaborative processes through the traces they leave behind....

  3. Personalized medicine in Alzheimer's disease and depression.

    Science.gov (United States)

    Souslova, Tatiana; Marple, Teresa C; Spiekerman, A Michael; Mohammad, Amin A

    2013-11-01

    Latest research in the mental health field brings new hope to patients and promises to revolutionize the field of psychiatry. Personalized pharmacogenetic tests that aid in diagnosis and treatment choice are now becoming available for clinical practice. Amyloid beta peptide biomarkers in the cerebrospinal fluid of patients with Alzheimer's disease are now available. For the first time, radiologists are able to visualize amyloid plaques specific to Alzheimer's disease in live patients using Positron Emission Tomography-based tests approved by the FDA. A novel blood-based assay has been developed to aid in the diagnosis of depression based on activation of the HPA axis, metabolic, inflammatory and neurochemical pathways. Serotonin reuptake inhibitors have shown increased remission rates in specific ethnic subgroups and Cytochrome P450 gene polymorphisms can predict antidepressant tolerability. The latest research will help to eradicate "trial and error" prescription, ushering in the most personalized medicine to date. Like all major medical breakthroughs, integration of new algorithms and technologies requires sound science and time. But for many mentally ill patients, diagnosis and effective therapy cannot happen fast enough. This review will describe the newest diagnostic tests, treatments and clinical studies for the diagnosis and treatment of Alzheimer's disease and unipolar, major depressive disorder. © 2013 Elsevier Inc. All rights reserved.

  4. Depression and anxiety in patients with COPD

    Directory of Open Access Journals (Sweden)

    Abebaw M. Yohannes

    2014-09-01

    Full Text Available Under-recognised and untreated depression and anxiety symptoms have deleterious effects on physical functioning and social interaction increasing fatigue and healthcare utilisation in patients with chronic obstructive pulmonary disease (COPD. Depression and anxiety are challenging to identify and treat because their symptoms often overlap with those of COPD. The cause(s of depression and anxiety symptoms are multifactorial and include behavioural, social and biological factors. Less than one-third of COPD patients with comorbid depression or anxiety symptoms are receiving appropriate treatment. Factors that contribute to the lack of provision of treatment are varied, they include patient perceived barriers, for example lack of knowledge and reluctance to receive antidepressant drug therapy; poor treatment compliance and lack of a standardised diagnostic approach; and scarcity of adequate resources for mental health treatment. The evidence for the efficacy of antidepressant drug therapy in patients with COPD with comorbid depression and anxiety is inconclusive. There are some promising findings regarding pulmonary rehabilitation, psychological therapy and the collaborative care model in reducing depression and anxiety symptoms in patients with COPD, but these findings are limited by short-term follow-up periods. Further work is required to examine the efficacy of these interventions in randomised controlled trials with larger samples and long-term follow-up.

  5. Reproducing tailing in breakthrough curves: Are statistical models equally representative and predictive?

    Science.gov (United States)

    Pedretti, Daniele; Bianchi, Marco

    2018-03-01

    Breakthrough curves (BTCs) observed during tracer tests in highly heterogeneous aquifers display strong tailing. Power laws are popular models for both the empirical fitting of these curves, and the prediction of transport using upscaling models based on best-fitted estimated parameters (e.g. the power law slope or exponent). The predictive capacity of power law based upscaling models can be however questioned due to the difficulties to link model parameters with the aquifers' physical properties. This work analyzes two aspects that can limit the use of power laws as effective predictive tools: (a) the implication of statistical subsampling, which often renders power laws undistinguishable from other heavily tailed distributions, such as the logarithmic (LOG); (b) the difficulties to reconcile fitting parameters obtained from models with different formulations, such as the presence of a late-time cutoff in the power law model. Two rigorous and systematic stochastic analyses, one based on benchmark distributions and the other on BTCs obtained from transport simulations, are considered. It is found that a power law model without cutoff (PL) results in best-fitted exponents (αPL) falling in the range of typical experimental values reported in the literature (1.5 tailing becomes heavier. Strong fluctuations occur when the number of samples is limited, due to the effects of subsampling. On the other hand, when the power law model embeds a cutoff (PLCO), the best-fitted exponent (αCO) is insensitive to the degree of tailing and to the effects of subsampling and tends to a constant αCO ≈ 1. In the PLCO model, the cutoff rate (λ) is the parameter that fully reproduces the persistence of the tailing and is shown to be inversely correlated to the LOG scale parameter (i.e. with the skewness of the distribution). The theoretical results are consistent with the fitting analysis of a tracer test performed during the MADE-5 experiment. It is shown that a simple

  6. Capacitive Sensors and Breakthrough Curves in Automated Irrigation for Water and Soil Conservation

    Science.gov (United States)

    Fahmy Hussein, Mohamed

    2016-04-01

    when such sensors are used in farmers' fields. The second procedure was Breakthrough Curve (BTC) lab-method to follow the fate of chemical composition of water draining out of Ca-saturated soil columns and Exchangeable Sodium Percent, ESP, in soil materials under saturated-flow. The work was run on five packed soil-columns under hydraulic-gradient of about 6 in fine-grained soil materials (Nile clay-sediments) wetted with five NaCl aqueous solutions (10, 25, 50, 75 and 100 mEq/l). The results revealed the removal of 40 to 80% of sodium from irrigation water after 6 to 8 pore volumes flowed out in about 12 hours with the highest removal from the most dilute solution. Rapid increase of ESP was observed when the inlet solution had moderate to high TDS whereas the dilute solution (10 mEq/l) has resulted in no soil chemical degradation. The results were extrapolated to field situation and showed that Nile clayey soil would never get sodic (ESP>15) when wetted with high quality water regardless the water application duration whereas only 1-4 year of irrigation with moderate to poor-quality water (as takes place under perennial irrigation) would result in ESP increase to 15 and much higher values. A secondary but important outcome of BTC experiments was that marginal sediments could be used in multi-column cells (6 to 8 columns) to improve water-quality through removal of Na+ ions from water, whereas anions could be removed by positively-charged resins and the cells could be recycled in a proposed prototype scheme.

  7. The best news for LPG in Denmark is diesel conversion breakthrough

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Throughout Scandanavia, taxes seem to drive the marketplace. Governments do not want to encourage consumption of alcoholic beverages, so they tax them heavily, thereby actually discouraging their use. Using the same means, they dictate the fate of the various fuels. Taxes have depressed propane's use to a large extent; today it is priced at three times natural gas, with the result that it accounts for only 0.5%-0.7% of total energy consumption. But, this paper reports on a potential new star that has appeared on the horizon, as participants in the People-to-People sojourn to Scandanavia last August learned. It's a program of converting diesel buses to propane, and officials of the company that is marketing it, Skibby Motor A/S, are so confident of its success that they have already begun a campaign of introducing it to the U.S

  8. Experimental investigation of the impact of compound-specific dispersion and electrostatic interactions on transient transport and solute breakthrough

    Science.gov (United States)

    Muniruzzaman, Muhammad; Rolle, Massimo

    2017-02-01

    This study investigates the effects of compound-specific diffusion/dispersion and electrochemical migration on transient solute transport in saturated porous media. We conducted laboratory bench-scale experiments, under advection-dominated regimes (seepage velocity: 0.5, 5, 25 m/d), in a quasi two-dimensional flow-through setup using pulse injection of multiple tracers (both uncharged and ionic species). Extensive sampling and measurement of solutes' concentrations (˜1500 samples; >3000 measurements) were performed at the outlet of the flow-through setup, at high spatial and temporal resolution. The experimental results show that compound-specific effects and charge-induced Coulombic interactions are important not only at low velocities and/or for steady state plumes but also for transient transport under high flow velocities. Such effects can lead to a remarkably different behavior of measured breakthrough curves also at very high Péclet numbers. To quantitatively interpret the experimental results, we used four modeling approaches: classical advection-dispersion equation (ADE), continuous time random walk (CTRW), dual-domain mass transfer model (DDMT), and a multicomponent ionic dispersion model. The latter is based on the multicomponent formulation of coupled diffusive/dispersive fluxes and was used to describe and explain the electrostatic effects of charged species. Furthermore, we determined experimentally the temporal profiles of the flux-related dilution index. This metric of mixing, used in connection with the traditional solute breakthrough curves, proved to be useful to correctly distinguish between plume spreading and mixing, particularly for the cases in which the sole analysis of integrated concentration breakthrough curves may lead to erroneous interpretation of plume dilution.

  9. Clinical and Microbiological Characteristics of Breakthrough Candidemia in Allogeneic Hematopoietic Stem Cell Transplant Recipients in a Japanese Hospital

    Science.gov (United States)

    Kimura, Muneyoshi; Yamamoto, Hisashi; Asano-Mori, Yuki; Nakamura, Shigeki; Yamagoe, Satoshi; Ohno, Hideaki; Miyazaki, Yoshitsugu; Abe, Masahiro; Yuasa, Mitsuhiro; Kaji, Daisuke; Kageyama, Kosei; Nishida, Aya; Ishiwata, Kazuya; Takagi, Shinsuke; Yamamoto, Go; Uchida, Naoyuki; Izutsu, Koji; Wake, Atsushi; Taniguchi, Shuichi; Yoneyama, Akiko

    2017-01-01

    ABSTRACT Few data on breakthrough candidemia (BC), defined as candidemia that develops on administration of antifungal agents (AFAs), in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are available. The medical and microbiological records of recipients of an allo-HSCT obtained between December 2008 and December 2014 were reviewed. Of 768 allo-HSCT cases, 26 developed BC. Among the 26 causative strains, 22 strains were stored and identified by sequencing. The following species were isolated: Candida parapsilosis (9 strains), C. glabrata (4 strains), C. guilliermondii (3 strains), and other Candida species (6 strains). The AFAs being used when BC developed were micafungin (17 cases), liposomal amphotericin B (5 cases), itraconazole (2 cases), and voriconazole (2 cases). All 17 cases who developed BC during micafungin administration were administered 150 mg/day of micafungin. The susceptibilities of the causative Candida species to the administered AFAs when breakthrough occurred ranged from susceptible to resistant. Especially, 85% of the Candida species that caused BC during micafungin administration were susceptible to micafungin. Additionally, 75% of the strains were wild type for susceptibility to the administered AFAs when breakthrough occurred. Systemic steroid administration and a longer severe neutropenic phase (≥5 days) were independent risk factors for BC (P = 0.016 and P = 0.015, respectively). BC developed in allo-HSCT recipients even when they received a sufficient dose of AFA, including micafungin, to which the causative Candida species were susceptible and/or had wild-type susceptibility in vitro. Systemic steroid administration and a longer severe neutropenic phase were host-based factors associated with BC. PMID:28115352

  10. Development of the breastfeeding quality improvement in hospitals learning collaborative in New York state.

    Science.gov (United States)

    Fitzpatrick, Eileen; Dennison, Barbara A; Welge, Sara Bonam; Hisgen, Stephanie; Boyce, Patricia Simino; Waniewski, Patricia A

    2013-06-01

    Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.

  11. The Cochrane collaboration

    NARCIS (Netherlands)

    Scholten, R. J. P. M.; Clarke, M.; Hetherington, J.

    2005-01-01

    The Cochrane Collaboration is an international, not-for-profit organisation that aims to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health-care interventions. Cochrane systematic reviews

  12. Strategic importance of collaboration

    Energy Technology Data Exchange (ETDEWEB)

    Miller, K.A. [NB Power, Fredericton, New Brunswick (Canada)

    2015-07-01

    In the nuclear industry there is a need to collaborate because of aging equipment, aging people that contribute to dilution of expertise, obsolesce and advances in codes and standards. In the longer term there is a need to focus on operational issues, sustain our suppliers and expertise as well as improve and sustain performance.

  13. Strategic importance of collaboration

    International Nuclear Information System (INIS)

    Miller, K.A.

    2015-01-01

    In the nuclear industry there is a need to collaborate because of aging equipment, aging people that contribute to dilution of expertise, obsolesce and advances in codes and standards. In the longer term there is a need to focus on operational issues, sustain our suppliers and expertise as well as improve and sustain performance.

  14. When industry & academia collaborate

    NARCIS (Netherlands)

    Kopczak, L.R.; Fransoo, J.C.

    1999-01-01

    Innovative "project-based courses" are bringing the business and academic worlds together to advance global supply chain management. By collaborating with universities to solve specific supply chain problems, companies not only benefit from the infusion of new ideas, but also gain access to a pool

  15. INTERNATIONAL COLLABORATION: Panelling

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    At the meeting of the International Committee for Future Accelerators (ICFA), in Geneva in July, Chairman A.N. Skrinsky of Novosibirsk reviewed ICFA progress, particularly the activities of the specialist Panels which pursue specific Committee objectives in guiding worldwide collaboration in high energy physics

  16. Preparing for Collaborative Working.

    Science.gov (United States)

    David, Rachel; Smith, Beryl

    1987-01-01

    Interdisciplinary collaboration with other professionals was the theme of a preservice training activity in England in which 18 students enrolled in a teacher training program for learning difficulties were paired with students of speech and language pathology to observe, discuss, and assess a severely disabled child in the school setting. (JW)

  17. Beyond Collaborative Services

    DEFF Research Database (Denmark)

    Seravalli, Anna; Agger Eriksen, Mette

    2017-01-01

    between the designer and various other stakeholders. To navigate this rich complexity, we propose the two notions of commons and infrastructuring, and we do that by re ecting on the case of designing a makerspace, Fabriken, a sharing-based collaborative service. We use the notion of commons as a framework...

  18. INTERNATIONAL COLLABORATION: Panelling

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1991-10-15

    At the meeting of the International Committee for Future Accelerators (ICFA), in Geneva in July, Chairman A.N. Skrinsky of Novosibirsk reviewed ICFA progress, particularly the activities of the specialist Panels which pursue specific Committee objectives in guiding worldwide collaboration in high energy physics.

  19. Understanding collaborative design

    NARCIS (Netherlands)

    Kleinsmann, M.S.

    2006-01-01

    Fast product follow-ups and increasing customer demands have changed product design from a rather unstructured process, into a systematic activity. Nowadays, both companies and researchers have developed the organizational aspects of integrated product design. However, attention to the collaborative

  20. Collaboration and Networking

    NARCIS (Netherlands)

    Husson, O.; Manten-Horst, E.; Graaf, W.T.A. van der

    2016-01-01

    Awareness of the need for collaboration across pediatric and adult cancer to care for adolescents and young adults (AYAs) arose from the recognition of the unique characteristics of AYAs with cancer. Neither pediatric nor adult oncology hospital departments are able to provide age-appropriate care

  1. Collaborative engineering experiences

    NARCIS (Netherlands)

    Ir. Peter van Kollenburg; Dr. Ir. P. Mulders; Ir. Dick van Schenk Brill; Dr. Ir. G. Schouten; Dr. J. Ochs

    2000-01-01

    In the fall of 1999, an international integrated product development pilot project based on collaborative engineering was started with team members in two international teams from the United States, The Netherlands and Germany. Team members interacted using various Internet capabilities, including,

  2. Collaboration in Print

    DEFF Research Database (Denmark)

    Lund, Joachim

    2012-01-01

    During the Second World War, Germany's National Socialist regime mobilized German universities in order to support the war efforts through academic collaboration and a number of publications that were meant to legitimize Germany's territorial ambitions. The rector of the University of Kiel, Dr Paul...

  3. Collaboration in Augmented Reality

    NARCIS (Netherlands)

    Lukosch, S.; Billinghurst, M.; Alem, L.; Kiyokawa, K.

    2015-01-01

    Augmented Reality (AR) is a technology that allows users to view and interact in real time with virtual images seamlessly superimposed over the real world. AR systems can be used to create unique collaborative experiences. For example, co-located users can see shared 3D virtual objects that they

  4. Collaborating for Impact

    Science.gov (United States)

    Dobrzeniecki, Aimee; Poole, Ken; Troppe, Mark

    2006-01-01

    Collaborating to define clear roles, responsibilities, and expectations can help a college and its partners avoid misunderstandings and "turf" problems. In this article, the authors describe vital partnerships between community colleges and economic development organizations to foster economic growth. The authors also share some lessons…

  5. The Promise of Collaboration

    Science.gov (United States)

    Bauml, Michelle

    2016-01-01

    Whether a teacher loves it or dreads it, lesson planning is a crucial step in the teaching process. Done effectively, collaborative lesson planning--in which teachers work together to design lessons--leads to increased professional learning, higher job satisfaction for teachers, and better lesson plans. The process poses challenges for both…

  6. Dynamic adsorption of CO2/N2 on cation-exchanged chabazite SSZ-13: A breakthrough analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bower, Jamey K.; Barpaga, Dushyant; Prodinger, Sebastian; Krishna, Rajamani; Schaef, Herbert T.; McGrail, Bernard P.; Derewinski, Miroslaw A.; Motkuri, Radha K.

    2018-04-17

    Alkali exchanged SSZ-13 adsorbents were investigated for their applicability in separating N2 from CO2 in flue gas streams using a dynamic breakthrough method. In contrast to IAST calculations based on equilibrium isotherms, K+ exchanged SSZ-13 was found to yield the best N2 productivity under dynamic conditions where diffusion properties play a significant role. This was attributed to the selective, partial blockage of access to the CHA cavities enhancing the separation potential in a 15/85 CO2/N2 binary gas mixture.

  7. Breakthrough of the Nordic Bronze Age: Transcultural warriorhood and a Carpathian crossroad in the 16th century BC

    DEFF Research Database (Denmark)

    Vandkilde, Helle

    2014-01-01

    The breakthrough of the Nordic Bronze Age (NBA) c. 1600 bc as a koiné within Bronze Age Europe can be historically linked to the Carpathian Basin. Nordic distinctiveness entailed an entanglement of cosmology and warriorhood, albeit represented through different media in the hotspot zone (bronze) ...... momentous creativity that drew upon Carpathian originals, contacts and a pool of Carpathian ideas, but ultimately drawing on emergent Mycenaean hegemonies in the Aegean. This provided the incentive for a cosmology-rooted resource from which the NBA could take its starting point....

  8. Effect of CH4 on the CO2 breakthrough pressure and permeability of partially saturated low-permeability sandstone in the Ordos Basin, China

    Science.gov (United States)

    Zhao, Yan; Yu, Qingchun

    2018-01-01

    The behavior of CO2 that coexists with CH4 and the effect of CH4 on the CO2 stream need to be deeply analyzed and studied, especially in the presence of water. Our previous studies investigated the breakthrough pressure and permeability of pure CO2 in five partially saturated low-permeability sandstone core samples from the Ordos Basin, and we concluded that rocks with a small pore size and low permeability show considerable sealing capacity even under unsaturated conditions. In this paper, we selected three of these samples for CO2-CH4 gas-mixture breakthrough experiments under various degrees of water saturation. The breakthrough experiments were performed by increasing the gas pressure step by step until breakthrough occurred. Then, the effluent gas mixture was collected for chromatographic partitioning analysis. The results indicate that CH4 significantly affects the breakthrough pressure and permeability of CO2. The presence of CH4 in the gas mixture increases the interfacial tension and, thus, the breakthrough pressure. Therefore, the injected gas mixture that contains the highest (lowest) mole fraction of CH4 results in the largest (smallest) breakthrough pressure. The permeability of the gas mixture is greater than that for pure CO2 because of CH4, and the effective permeability decreases with increased breakthrough pressure. Chromatographic partitioning of the effluent mixture gases indicates that CH4 breaks through ahead of CO2 as a result of its weaker solubility in water. Correlations are established between (1) the breakthrough pressure and water saturation, (2) the effective permeability and water saturation, (3) the breakthrough pressure and effective permeability, and (4) the mole fraction of CO2/CH4 in the effluent mixture gases and water saturation. These results deepen our understanding of the multi-phase flow behavior in the porous media under unsaturated conditions, which have implications for formulating emergency response plans for gas

  9. Effectiveness of Pranayama on Depression in Elderly

    Directory of Open Access Journals (Sweden)

    Kannan K

    2015-01-01

    Full Text Available The knowledge of Pranayama in elderly is very important in day to day life. In case of mental health problem like depression, the availability of the source of Complementary and Alternative Medicine (CAM like Pranayama helps to decrease depression. The aim of the review is to discuss the articles pertaining to pranayama on depression in elderly including both quantitative and qualitative studies published and unpublished and to review the related studies and other articles regarding effectiveness of pranayama on depression in elderly. The review was based on the studies conducted globally. Systematic searches were conducted on a range of databases, citations were sought from relevant reviews and several websites were also included in the search, including those of MIND and the Mental Health Foundation. MEDline, EMBASE, and PsycINFO were searched for studies published from 2000 January to December 2013. Five independent reviewers assessed the eligibility of each report based on predefined inclusion criteria (study design and measure of depression. Individual effect sizes were standardized. Results of 87 abstracts reviewed, 7 results were not Randomized Controlled Trial (RCT, 36 Studies were excluded due to their intervention and other problems, 25 Studies were excluded due to their outcomes, 2 dissertations was excluded, 17 Full Text articles were assessed for eligibility, Exclusion of study reports through full text screening n=8 duplicated: editorial review article: 3 Did not meet inclusion criteria: 4 Incomplete information: 9 studies met inclusion criteria and were included for final review. Heterogeneity between studies was not explained by age or sex, but could be partly explained by the types of depression and assessments. Collaborative care interventions are more effective for depression in older people than usual care and are also of high value. Pranayama are effective component with depression.

  10. The Breakthrough Listen Search for Intelligent Life: A Wideband Data Recorder System for the Robert C. Byrd Green Bank Telescope

    Science.gov (United States)

    MacMahon, David H. E.; Price, Danny C.; Lebofsky, Matthew; Siemion, Andrew P. V.; Croft, Steve; DeBoer, David; Enriquez, J. Emilio; Gajjar, Vishal; Hellbourg, Gregory; Isaacson, Howard; Werthimer, Dan; Abdurashidova, Zuhra; Bloss, Marty; Brandt, Joe; Creager, Ramon; Ford, John; Lynch, Ryan S.; Maddalena, Ronald J.; McCullough, Randy; Ray, Jason; Whitehead, Mark; Woody, Dave

    2018-04-01

    The Breakthrough Listen Initiative is undertaking a comprehensive search for radio and optical signatures from extraterrestrial civilizations. An integral component of the project is the design and implementation of wide-bandwidth data recorder and signal processing systems. The capabilities of these systems, particularly at radio frequencies, directly determine survey speed; further, given a fixed observing time and spectral coverage, they determine sensitivity as well. Here, we detail the Breakthrough Listen wide-bandwidth data recording system deployed at the 100 m aperture Robert C. Byrd Green Bank Telescope. The system digitizes up to 6 GHz of bandwidth at 8 bits for both polarizations, storing the resultant 24 GB s‑1 of data to disk. This system is among the highest data rate baseband recording systems in use in radio astronomy. A future system expansion will double recording capacity, to achieve a total Nyquist bandwidth of 12 GHz in two polarizations. In this paper, we present details of the system architecture, along with salient configuration and disk-write optimizations used to achieve high-throughput data capture on commodity compute servers and consumer-class hard disk drives.

  11. Offering Global Collaboration Services beyond CERN and HEP

    Science.gov (United States)

    Fernandes, J.; Ferreira, P.; Baron, T.

    2015-12-01

    The CERN IT department has built over the years a performant and integrated ecosystem of collaboration tools, from videoconference and webcast services to event management software. These services have been designed and evolved in very close collaboration with the various communities surrounding the laboratory and have been massively adopted by CERN users. To cope with this very heavy usage, global infrastructures have been deployed which take full advantage of CERN's international and global nature. If these services and tools are instrumental in enabling the worldwide collaboration which generates major HEP breakthroughs, they would certainly also benefit other sectors of science in which globalization has already taken place. Some of these services are driven by commercial software (Vidyo or Wowza for example), some others have been developed internally and have already been made available to the world as Open Source Software in line with CERN's spirit and mission. Indico for example is now installed in 100+ institutes worldwide. But providing the software is often not enough and institutes, collaborations and project teams do not always possess the expertise, or human or material resources that are needed to set up and maintain such services. Regional and national institutions have to answer needs, which are growingly global and often contradict their operational capabilities or organizational mandate and so are looking at existing worldwide service offers such as CERN's. We believe that the accumulated experience obtained through the operation of a large scale worldwide collaboration service combined with CERN's global network and its recently- deployed Agile Infrastructure would allow the Organization to set up and operate collaborative services, such as Indico and Vidyo, at a much larger scale and on behalf of worldwide research and education institutions and thus answer these pressing demands while optimizing resources at a global level. Such services would

  12. Petroleum R and D collaboration

    International Nuclear Information System (INIS)

    Kerr, R.

    1995-01-01

    Conditions for collaboration in research and development (R and D) were developed based on a decision-tree analysis. A key requirement for effective R and D collaboration was stated to be the company's ability to internalize a significant portion of the benefits. This was seen as the principal factor that determined good collaborators and good industries for collaboration. It was noted that collaboration benefits can also be improved through R and D exchanges in collaborative associations. Simple decision-tree analysis tended to understate the advantages of collaboration. Portfolio risk reduction and inter-project synergies were significant additional advantages. Collaborative R and D was said to be the preferred route for the development of a broad base of petroleum-related technologies. 5 tabs., 2 figs

  13. The collaborative Economy and Tourism

    DEFF Research Database (Denmark)

    Dredge, Dianne; Gyimóthy, Szilvia

    2015-01-01

    House swapping, ridesharing, voluntourism, couchsurfing, dinner hosting and similar innovations epitomize the collaborative economy. The rise of the collaborative economy, also known as collaborative consumption, the sharing economy and peer-to-peer consumption, has been fuelled by a range of soc...... for a balanced assessment of such claims. Highlighting these claims allows us to pursue a more reflective research agenda and leads to a more informed, evidence-based assessment of the collaborative economy and tourism.......House swapping, ridesharing, voluntourism, couchsurfing, dinner hosting and similar innovations epitomize the collaborative economy. The rise of the collaborative economy, also known as collaborative consumption, the sharing economy and peer-to-peer consumption, has been fuelled by a range...... experiences; and higher levels of consumer risk-taking balanced against mechanisms such as peer-to-peer feedback designed to engender trust between producers and consumers. This paper explores and critically assesses the collaborative economy and its implications for tourism industrial systems. It achieves...

  14. Silence in Interdisciplinary Research Collaboration

    NARCIS (Netherlands)

    Verouden, Nick W.; Sanden, van der Maarten C.A.; Aarts, Noelle

    2016-01-01

    Solving publicly important issues asks for the development of socio-technical approaches, which demands collaboration between researchers with different perspectives, values, and interests. In these complex interdisciplinary collaborations, the course of communication is of utmost importance,

  15. Collaborations in Open Learning Environments

    NARCIS (Netherlands)

    Spoelstra, Howard

    2015-01-01

    This thesis researches automated services for professionals aiming at starting collaborative learning projects in open learning environments, such as MOOCs. It investigates the theoretical backgrounds of team formation for collaborative learning. Based on the outcomes, a model is developed

  16. Collaborative Knowledge Production

    DEFF Research Database (Denmark)

    Olesen, Birgitte Ravn

    2014-01-01

    In this article, the author reflects on the conditions for working with collaborative research in current academic settings. On the basis of reflections on goals, challenges and results of earlier projects, the author looks into how economic and political shifts and transformations in work have...... changed the conditions for shared knowledge production with the institutionalization of neo-liberal discourse of the knowledge economy as managerial regimes. She questions if context-specific enactments of the discourse of participation can be handled, when neoliberal managerial regimes guide research...... activities and other working practices and the identities of academics and other professionals who are inscribed as subjects in these regimes. The conclusion is, that we have to look for cracks in the wall and insist on collaborative research because it is it the process of “being in relation that forms...

  17. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper

    2015-01-01

    Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the collaborat......Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept...... of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...

  18. The Collaborative Economy

    DEFF Research Database (Denmark)

    Avital, Michel; Andersson, Magnus; Nickerson, Jeffrey

    2014-01-01

    An economy based on the exchange of capital, assets and services between individuals has grown significantly, spurred by proliferation of internet-based platforms that allow people to share underutilized resources and trade with reasonably low transaction costs. The movement toward this economy...... of “sharing” translates into market efficiencies that bear new products, reframe established services, have positive environmental effects, and may generate overall economic growth. This emerging paradigm, entitled the collaborative economy, is disruptive to the conventional company-driven economic paradigm...... as evidenced by the large number of peer-to-peer based services that have captured impressive market shares sectors ranging from transportation and hospitality to banking and risk capital. The panel explores economic, social, and technological implications of the collaborative economy, how digital technologies...

  19. Making Collaborative Innovation Accountable

    DEFF Research Database (Denmark)

    Sørensen, Eva

    The public sector is increasingly expected to be innovative, but the prize for a more innovative public sector might be that it becomes difficult to hold public authorities to account for their actions. The article explores the tensions between innovative and accountable governance, describes...... the foundation for these tensions in different accountability models, and suggest directions to take in analyzing the accountability of collaborative innovation processes....

  20. Enhancing Collaborative Healthcare Synergy

    OpenAIRE

    Noran , Ovidiu

    2013-01-01

    Part 15: Stimulating Collaborative Relationships; International audience; Worldwide, the constant ageing of the population brings significant challenges to the traditional style of health care systems. Rapidly spreading pandemics triggered by new disease strains, increased population mobility and displacements fuelled by conflict and climate change add another dimension to the health care predicament. In this context, proper cooperation and interoperability of the participants in the healthca...

  1. Collaboration in Performing Arts

    OpenAIRE

    Langeveld, Cees; Belme, D.; Koppenberg, T.

    2014-01-01

    markdownabstract__Abstract__ As a result of declining government support, performing arts organisations (PAOs) face increased challenges and difficulties in the sector. They attempt to develop new ways of generating income and seek new models of organising the production and presentation of performing arts. Hereby, we can think of collaboration and integration as horizontal and vertical within the production chain of performing arts. There are various reasons for cultural organisations to dec...

  2. Teacher and Student Perceptions on High School Science Flipped Classrooms: Educational Breakthrough or Media Hype?

    Science.gov (United States)

    Hunley, Rebecca C.

    For years educators have struggled to ensure students meet the rigors of state mandated tests. Challenges that often impede student success are student absences, school closings due to weather, and remediation for students who need additional help while advanced students can move ahead. Many educators, especially secondary math and science teachers, have responded to these issues by implementing a teaching strategy called the flipped classroom where students view lectures, power points, or podcasts outside of school and class time shifts to allow opportunities for collaborative learning. The purpose of this research was to evaluate teacher and student perceptions of high school flipped science classrooms. A qualitative phenomenological study was conducted to observe 3 high school science teachers from Georgia, North Carolina, and Tennessee selected through purposeful sampling who have used the flipped classroom method for a minimum of 2 years. Analysis of data from an online survey, direct observation, teacher interviews, and student focus groups helped to identify challenges and benefits of this teaching and learning strategy. Findings indicated that teachers find the flipped classroom beneficial to build student relationships but requires a significant amount of time to develop. Mixed student reactions revealed benefits of a flipped classroom as a successful learning tool for current and future endeavors for college or career preparation.

  3. Behandlingsresistent depression kan behandles

    DEFF Research Database (Denmark)

    Vinberg, Maj; Levinsen, Mette Frandsen; Kessing, Lars Vedel

    2011-01-01

    Depression is considered resistant when two treatment attempts with antidepressants from different classes fail to produce significant clinical improvement. In cases of treatment-resistant depression, it is recommended to reevaluate the diagnosis, clarify comorbidity, substance abuse and lack of ...

  4. Learning about depression

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000325.htm Learning about depression To use the sharing features on this page, ... trigger or reason. What are the Signs of Depression? You may notice some or all of the ...

  5. Signs of Depression

    Science.gov (United States)

    Everyone has down days and times when they feel sad. But depression is more than feeling sad or having a bad day. You may have depression if you feel sad every day (or most days) for at least two weeks.

  6. Men and Depression

    Science.gov (United States)

    ... crisis? For More Information Reprints Share Men and Depression Download PDF Download ePub Order a free hardcopy ... affects a large number of men. What is depression? Everyone feels sad or irritable and has trouble ...

  7. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  8. Depression - stopping your medicines

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features ... prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are ...

  9. Depression Disturbs Germany

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The suicide of Robert Enke,the goalkeeper of the Germany national football team who had battled depression for years,stunned the country and cast depression into the national spotlight as a disturbing disease.

  10. Collaborative Information Technologies

    Science.gov (United States)

    Meyer, William; Casper, Thomas

    1999-11-01

    Significant effort has been expended to provide infrastructure and to facilitate the remote collaborations within the fusion community and out. Through the Office of Fusion Energy Science Information Technology Initiative, communication technologies utilized by the fusion community are being improved. The initial thrust of the initiative has been collaborative seminars and meetings. Under the initiative 23 sites, both laboratory and university, were provided with hardware required to remotely view, or project, documents being presented. The hardware is capable of delivering documents to a web browser, or to compatible hardware, over ESNET in an access controlled manner. The ability also exists for documents to originate from virtually any of the collaborating sites. In addition, RealNetwork servers are being tested to provide audio and/or video, in a non-interactive environment with MBONE providing two-way interaction where needed. Additional effort is directed at remote distributed computing, file systems, security, and standard data storage and retrieval methods. This work supported by DoE contract No. W-7405-ENG-48

  11. Preventing Depression in Adults With Subthreshold Depression

    DEFF Research Database (Denmark)

    Buntrock, Claudia; Berking, Matthias; Smit, Filip

    2017-01-01

    -based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs......BACKGROUND: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. OBJECTIVE: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD......) in people with subthreshold depression (sD). METHODS: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web...

  12. Manipulation Robustness of Collaborative Filtering

    OpenAIRE

    Benjamin Van Roy; Xiang Yan

    2010-01-01

    A collaborative filtering system recommends to users products that similar users like. Collaborative filtering systems influence purchase decisions and hence have become targets of manipulation by unscrupulous vendors. We demonstrate that nearest neighbors algorithms, which are widely used in commercial systems, are highly susceptible to manipulation and introduce new collaborative filtering algorithms that are relatively robust.

  13. Security for ICT collaboration tools

    NARCIS (Netherlands)

    Broenink, E.G.; Kleinhuis, G.; Fransen, F.

    2010-01-01

    In order for collaboration tools to be productive in an operational setting, an information base that is shared across the collaborating parties is needed. Therefore, a lot of research is done for tooling to create such a common information base in a collaboration tool. However, security is often

  14. Security for ICT collaboration tools

    NARCIS (Netherlands)

    Broenink, E.G.; Kleinhuis, G.; Fransen, F.

    2011-01-01

    In order for collaboration tools to be productive in an operational setting, an information base that is shared across the collaborating parties is needed. Therefore, a lot of research is done for tooling to create such a common information base in a collaboration tool. However, security is often

  15. Understanding Nomadic Collaborative Learning Groups

    Science.gov (United States)

    Ryberg, Thomas; Davidsen, Jacob; Hodgson, Vivien

    2018-01-01

    The paper builds on the work of Rossitto "et al." on collaborative nomadic work to develop three categories of practice of nomadic collaborative learning groups. Our study is based on interviews, workshops and observations of two undergraduate student's group practices engaged in self-organised, long-term collaborations within the frame…

  16. International collaborations through the internet

    DEFF Research Database (Denmark)

    Olson, Gary M.; David, Paul A.; Eksteen, Johan

    2007-01-01

    The past decade has seen remarkable advances in the availability of tools to support scientific collaboration at a distance. This is especially good news for international collaborations, where in the past constraints on collocation and travel have made such collaborations a major challenge. The ...

  17. Realities of Supply Chain Collaboration

    NARCIS (Netherlands)

    Kampstra, R.P.; Ashayeri, J.; Gattorna, J.

    2006-01-01

    Successful supply chain collaboration (SCC) practices are rather exceptional, yet collaboration is believed to be the single most pressing need in supply chain management.In this paper we discuss the realities of SCC, present prerequisites for the collaboration process, indicate where the process

  18. Method of treating depression

    Science.gov (United States)

    Henn, Fritz [East Patchogue, NY

    2012-01-24

    Methods for treatment of depression-related mood disorders in mammals, particularly humans are disclosed. The methods of the invention include administration of compounds capable of enhancing glutamate transporter activity in the brain of mammals suffering from depression. ATP-sensitive K.sup.+ channel openers and .beta.-lactam antibiotics are used to enhance glutamate transport and to treat depression-related mood disorders and depressive symptoms.

  19. Strategic Nuclear Research Collaboration - FY99 Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    T. J. Leahy

    1999-07-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) has created the Strategic Nuclear Research Collaboration. The SNRC brings together some of America's finest laboratory and university nuclear researchers in a carefully focused research program intended to produce ''breakthrough'' solutions to the difficult issues of nuclear economics, safety, non-proliferation, and nuclear waste. This integrated program aims to address obstacles that stand in the way of nuclear power development in the US These include fuel cycle concerns related to waste and proliferation, the need for more efficient regulatory practices, and the high cost of constructing and operating nuclear power plants. Funded at an FY99 level of $2.58M, the SNRC is focusing the efforts of scientists and engineers from the INEEL and the Massachusetts Institute of Technology to solve complex nuclear energy challenges in a carefully chosen, integrated portfolio of research topics. The result of this collaboration will be research that serves as a catalyst for future direct-funded nuclear research and technology development and which preserves and enhances the INEEL's role as America's leading national laboratory for nuclear power research. In its first year, the SNRC has focused on four research projects each of which address one or more of the four issues facing further nuclear power development (economics, safety, waste disposition and proliferation-resistance). This Annual Report describes technical work and accomplishments during the first year of the SNRC's existence.

  20. Therapeutics of postpartum depression.

    Science.gov (United States)

    Thomson, Michael; Sharma, Verinder

    2017-05-01

    Postpartum depression is a prevalent disorder affecting many women of reproductive age. Despite increasing public awareness, it is frequently underdiagnosed and undertreated leading to significant maternal morbidity and adverse child outcomes. When identified, postpartum depression is usually treated as major depressive disorder. Many studies have identified the postpartum as a period of high risk for first presentations and relapses of bipolar disorder. Areas covered: This article reviews the acute and prophylactic treatment of postpartum major depressive disorder, bipolar depression and major depressive disorder with mixed features. The safety of antidepressant and mood stabilizing medications in pregnancy and breastfeeding will also be reviewed. Expert commentary: Differentiating postpartum major depressive disorder and postpartum bipolar depression can be difficult given their clinical similarities but accurate identification is vital for initiating proper treatment. Antidepressants are the mainstay of drug treatment for postpartum major depressive disorder, yet randomized controlled trials have shown conflicting results. A paucity of evidence exists for the effectiveness of antidepressant prophylaxis in the prevention of recurrences of major depressive disorder. Mood stabilizing medications reduce the risk of postpartum bipolar depression relapse but no randomized controlled trials have examined their use in the acute or prophylactic treatment of postpartum bipolar depression.

  1. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Meyers, B S; Flint, A J

    Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number...... of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD....

  2. Depression (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Depression KidsHealth / For Parents / Depression What's in this article? ... Ways to Help Print en español Depresión About Depression It's normal for kids to feel sad, down, ...

  3. Handling Depression | Smokefree 60+

    Science.gov (United States)

    Everyone feels blue now and then. It's a part of life. But if your feelings last more than few days and interfere with your normal daily activities, you may be suffering from depression. On this page: Symptoms of depression Who gets depressed and why?

  4. Depression (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Depression KidsHealth / For Teens / Depression What's in this article? ... Yourself Print en español Depresión Regular Sadness vs. Depression It's natural to feel sad, down, or discouraged ...

  5. Management of co-morbidity of depression and chronic non ...

    African Journals Online (AJOL)

    Methods: The study used an action research design involving a research team of 14 health care professionals to collaboratively identify existing protocols or interventions for managing co-morbidity of depression and NCDs in Rwanda. Focus group discussion using a structured interview guide was used to collect qualitative ...

  6. Granular activated carbon adsorption of organic micro-pollutants in drinking water and treated wastewater--Aligning breakthrough curves and capacities.

    Science.gov (United States)

    Zietzschmann, Frederik; Stützer, Christian; Jekel, Martin

    2016-04-01

    Small-scale granular activated carbon (GAC) tests for the adsorption of organic micro-pollutants (OMP) were conducted with drinking water and wastewater treatment plant (WWTP) effluent. In both waters, three influent OMP concentration levels were tested. As long as the influent OMP concentrations are below certain thresholds, the relative breakthrough behavior is not impacted in the respective water. Accordingly, the GAC capacity for OMP is directly proportional to the influent OMP concentration in the corresponding water. The differences between the OMP breakthrough curves in drinking water and WWTP effluent can be attributed to the concentrations of the low molecular weight acid and neutral (LMW) organics of the waters. Presenting the relative OMP concentrations (c/c0) over the specific throughput of the LMW organics (mg LMW organics/g GAC), the OMP breakthrough curves in drinking water and WWTP effluent superimpose each other. This superimposition can be further increased if the UV absorbance at 254 nm (UV254) of the LMW organics is considered. In contrast, using the specific throughput of the dissolved organic carbon (DOC) did not suffice to obtain superimposed breakthrough curves. Thus, the LMW organics are the major water constituent impacting OMP adsorption onto GAC. The results demonstrate that knowing the influent OMP and LMW organics concentrations (and UV254) of different waters, the OMP breakthroughs and GAC capacities corresponding to any water can be applied to all other waters. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. A symptom profile of depression among Asian Americans: is there evidence for differential item functioning of depressive symptoms?

    Science.gov (United States)

    Kalibatseva, Z; Leong, F T L; Ham, E H

    2014-09-01

    Theoretical and clinical publications suggest the existence of cultural differences in the expression and experience of depression. Measurement non-equivalence remains a potential methodological explanation for the lower prevalence of depression among Asian Americans compared to European Americans. This study compared DSM-IV depressive symptoms among Asian Americans and European Americans using secondary data analysis of the Collaborative Psychiatric Epidemiology Surveys (CPES). The Composite International Diagnostic Interview (CIDI) was used for the assessment of depressive symptoms. Of the entire sample, 310 Asian Americans and 1974 European Americans reported depressive symptoms and were included in the analyses. Measurement variance was examined with an item response theory differential item functioning (IRT DIF) analysis. χ2 analyses indicated that, compared to Asian Americans, European American participants more frequently endorsed affective symptoms such as 'feeling depressed', 'feeling discouraged' and 'cried more often'. The IRT analysis detected DIF for four out of the 15 depression symptom items. At equal levels of depression, Asian Americans endorsed feeling worthless and appetite changes more easily than European Americans, and European Americans endorsed feeling nervous and crying more often than Asian Americans. Asian Americans did not seem to over-report somatic symptoms; however, European Americans seemed to report more affective symptoms than Asian Americans. The results suggest that there was measurement variance in a few of the depression items.

  8. Collaborative care in real-world settings: barriers and opportunities for sustainability

    Directory of Open Access Journals (Sweden)

    Sanchez K

    2017-01-01

    Full Text Available Katherine Sanchez1,2 1School of Social Work, The University of Texas at Arlington, Arlington, 2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA Abstract: Patient-centered care and self-management of chronic disease are optimally characterized by distinct adjunct services such as education, and support for the behavioral and psychosocial elements of managing disease. The collaborative care model for the treatment of depression and anxiety in primary care includes the integration of a behavioral health specialist, in collaboration with the primary care provider, and psychiatric consultation to effectively screen and treat common mental health problems. Dissemination and sustainability of the model have encountered numerous barriers across systems of care. This article represents a discussion of the key barriers to collaborative care and offers a discussion of opportunities for dissemination and sustainability of the model. Keywords: collaborative care, barriers, depression, anxiety, patient preferences

  9. Collision Welding of Dissimilar Materials by Vaporizing Foil Actuator: A Breakthrough Technology for Dissimilar Metal Joining

    Energy Technology Data Exchange (ETDEWEB)

    Daehn, Glenn S. [The Ohio State Univ., Columbus, OH (United States). Dept. of Materials Science and Engineering; Vivek, Anupam [The Ohio State Univ., Columbus, OH (United States). Dept. of Materials Science and Engineering; Liu, Bert C. [The Ohio State Univ., Columbus, OH (United States). Dept. of Materials Science and Engineering

    2016-09-30

    This work demonstrated and further developed Vaporizing Foil Actuator Welding (VFAW) as a viable technique for dissimilar-metal joining for automotive lightweighting applications. VFAW is a novel impact welding technology, which uses the pressure developed from electrically-assisted rapid vaporization of a thin aluminum foil (the consumable) to launch and ultimately collide two of more pieces of metal to create a solid-state bond between them. 18 dissimilar combinations of automotive alloys from the steel, aluminum and magnesium alloy classes were screened for weldability and characterized by metallography of weld cross sections, corrosion testing, and mechanical testing. Most combinations, especially a good number of Al/Fe pairs, were welded successfully. VFAW was even able to weld combinations of very high strength materials such as 5000 and 6000 series aluminum alloys to boron and dual phase steels, which is difficult to impossible by other joining techniques such as resistance spot welding, friction stir welding, or riveting. When mechanically tested, the samples routinely failed in a base metal rather than along the weld interface, showing that the weld was stronger than either of the base metals. As for corrosion performance, a polymer-based protective coating was used to successfully combat galvanic corrosion of 5 Al/Fe pairs through a month-long exposure to warm salt fog. In addition to the technical capabilities, VFAW also consumes little energy compared to conventional welding techniques and requires relatively light, flexible tooling. Given the technical and economic advantages, VFAW can be a very competitive joining technology for automotive lightweighting. The success of this project and related activities has resulted in substantial interest not only within the research community but also various levels of automotive supply chain, which are collaborating to bring this technology to commercial use.

  10. Can formal collaborative methodologies improve quality in primary health care in New Zealand? Insights from the EQUIPPED Auckland Collaborative.

    Science.gov (United States)

    Palmer, Celia; Bycroft, Janine; Healey, Kate; Field, Adrian; Ghafel, Mazin

    2012-12-01

    Auckland District Health Board was one of four District Health Boards to trial the Breakthrough Series (BTS) methodology to improve the management of long-term conditions in New Zealand, with support from the Ministry of Health. To improve clinical outcomes, facilitate planned care and promote quality improvement within participating practices in Auckland. Implementation of the Collaborative followed the improvement model / Institute for Healthcare Improvement methodology. Three topic areas were selected: system redesign, cardio-vascular disease/diabetes, and self-management support. An expert advisory group and the Improvement Foundation Australia helped guide project development and implementation. Primary Health Organisation facilitators were trained in the methodology and 15 practice teams participated in the three learning workshops and action periods over 12 months. An independent evaluation study using both quantitative and qualitative methods was conducted. Improvements were recorded in cardiovascular disease risk assessment, practice-level systems of care, self-management systems and follow-up and coordination for patients. Qualitative research found improvements in coordination and teamwork, knowledge of practice populations and understanding of managing long-term conditions. The Collaborative process delivered some real improvements in the systems of care for people with long-term conditions and a change in culture among participating practices. The findings suggest that by strengthening facilitation processes, improving access to comprehensive population audit tools and lengthening the time frame, the process has the potential to make significant improvements in practice. Other organisations should consider this approach when investigating quality improvement programmes.

  11. The novel composite mechanism of ammonium molybdophosphate loaded on silica matrix and its ion exchange breakthrough curves for cesium

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Hao [State Key Laboratory Cultivation Base for Nonmetal Composites and Functional Materials, Southwest University of Science and Technology, Mianyang 621010 (China); Li, Yuxiang, E-mail: superfigure@163.com [State Key Laboratory Cultivation Base for Nonmetal Composites and Functional Materials, Southwest University of Science and Technology, Mianyang 621010 (China); School of Materials Science and Engineering, Southwest University of Science and Technology, Mianyang 621010 (China); National Defense Key Discipline Laboratory for Nuclear Wastes and Environmental Safety, Southwest University of Science and Technology, Mianyang 621010 (China); Wu, Lang [State Key Laboratory Cultivation Base for Nonmetal Composites and Functional Materials, Southwest University of Science and Technology, Mianyang 621010 (China); Ma, Xue [School of Materials Science and Engineering, Southwest University of Science and Technology, Mianyang 621010 (China)

    2017-02-15

    Highlights: • The granular composites were fabricated by the sequential annealing mechanism. • The method controls the porous characteristics and stable structure of materials. • The breakthrough curve of Cs{sup +} follows the Thomas model with a high removal rate. • It is a probable for SM-AMP20 to recycle Cs{sup +} using an eluent of 2–3 mol/L NH{sub 4}NO{sub 3}. - Abstract: Long-lived {sup 137}Cs (over 30 years), a byproduct of the spent fuel fission processes, comprises the majority of high-level and prolific heat-generating waste in downstream processing. This study reports a novel sequential annealing mechanism with cross-linked network of polyvinyl alcohol, fabricating the composite of ammonium molybdophosphate loaded on silica matrix (SM-AMP20, 20 wt% AMP) as an excellent granular ion exchanger for removal Cs{sup +}. When the matrix is remarkably sequential annealed, well-dispersed SM-AMP20 particles are formed by firmly anchoring themselves on controlling the porous characteristics and stable structure. The material crystallizes in the complex cubic space group Pn-3m with cell parameters of crystalline AMP formation. The breakthrough curve of Cs{sup +} by SM-AMP20 follows the Thomas model with a high removal rate of 88.23% (∼10 mg/L of Cs{sup +}) and breakthrough time as high as 26 h (flow rate Q ≈ 2.5 mL/min and bed height Z ≈ 11 cm) at neutral pH. We also report on sorbents that could efficiently remove Cs{sup +} ions from complex solutions containing different competitive cations (Na{sup +}, Al{sup 3+}, Fe{sup 3+}, and Ni{sup 2+}, respectively) in large excess. Furthermore, this study shows that there is a probability for SM-AMP20 to recycle cesium using an eluent of 2–3 mol/L NH{sub 4}NO{sub 3} solution.

  12. Virologic breakthrough in a patient with chronic hepatitis B by combination treatment with tenofovir disoproxil fumarate and entecavir

    Directory of Open Access Journals (Sweden)

    Suzuki F

    2014-06-01

    Full Text Available Fumitaka Suzuki,1,2 Hitomi Sezaki,1 Norio Akuta,1 Yoshiyuki Suzuki,1 Yusuke Kawamura,1 Tetsuya Hosaka,1 Masahiro Kobayashi,1 Satoshi Saitoh,1 Yasuji Arase,1 Kenji Ikeda,1 Mariko Kobayashi,3 Sachiyo Watahiki,3 Rie Mineta,3 Yukiko Suzuki,3 Hiromitsu Kumada1 1Department of Hepatology, Toranomon Hospital, Tokyo, Japan; 2Okinaka Memorial Institute for Medical Research, Tokyo, Japan; 3Research Institute for Hepatology, Toranomon Branch Hospital, Kawasaki, Japan Abstract: Tenofovir disoproxil fumarate (TDF is widely used to treat hepatitis B virus (HBV patients in the USA and Europe. No confirmed report of resistance selection during treatment with TDF in treatment-naïve and nucleoside/nucleotide analog-treated chronic hepatitis B patients has yet been reported. Here, we report for the first time a patient with chronic hepatitis B and cirrhosis who emerged with virologic breakthrough during combination therapy with TDF and entecavir (ETV, against ETV-resistant virus. A 51-year-old Japanese woman with hepatitis B e-antigen (HBeAg, whose genotype was C, received ETV monotherapy continuously followed by TDF and ETV combination therapy, because her HBV DNA levels had been >3.5 log copies/mL. At the start of combination therapy, amino acid substitutions of the reverse transcriptase (rt gene, rtL180M, rtT184I/M, and rtM204V, were detected. After this, serum HBV DNA decreased to less than 2.1 log copies/mL and remained at this level until 31 months of combination therapy, when it again began to increase. Amino acid substitutions of rtL180M, rtS202G, and rtM204V emerged and were associated with an increase in serum HBV DNA at virologic breakthrough. Long-term therapy with TDF against the ETV-resistant virus has the potential to induce virologic breakthrough and resistance, and careful follow-up should be carried out. Keywords: hepatitis B virus, resistant

  13. From GRID to gridlock: the relationship between scientific biomedical breakthroughs and HIV/AIDS policy in the US Congress.

    Science.gov (United States)

    Platt, Matthew B; Platt, Manu O

    2013-11-27

    From the travel ban on people living with HIV (PLHIV) to resistance to needle exchange programmes, there are many examples where policy responses to HIV/AIDS in the United States seem divorced from behavioural, public health and sociological evidence. At its root, however, the unknowns about HIV/AIDS lie at biomedical science, and scientific researchers have made tremendous progress over the past 30 years of the epidemic by using antiretroviral therapy to increase the life expectancy of PLHIV almost to the same level as non-infected individuals; but a relationship between biomedical science discoveries and congressional responses to HIV/AIDS has not been studied. Using quantitative approaches, we directly examine the hypothesis that progress in HIV/AIDS biomedical science discoveries would have a correlative relationship with congressional response to HIV/AIDS from 1981 to 2010. This study used original data on every bill introduced, hearing held and law passed by the US Congress relating to HIV/AIDS over 30 years (1981-2010). We combined congressional data with the most cited and impactful biomedical research scientific publications over the same time period as a metric of biomedical science breakthroughs. Correlations between congressional policy and biomedical research were then analyzed at the aggregate and individual levels. Biomedical research advancements helped shape both the level and content of bill sponsorship on HIV/AIDS, but they had no effect on other stages of the legislative process. Examination of the content of bills and biomedical research indicated that science helped transform HIV/AIDS bill sponsorship from a niche concern of liberal Democrats to a bipartisan coalition when Republicans became the majority party. The trade-off for that expansion has been an emphasis on the global epidemic to the detriment of domestic policies and programmes. Breakthroughs in biomedical science did associate with the number and types of HIV/AIDS bills introduced

  14. Collaborative exams: Cheating? Or learning?

    Science.gov (United States)

    Jang, Hyewon; Lasry, Nathaniel; Miller, Kelly; Mazur, Eric

    2017-03-01

    Virtually all human activity involves collaboration, and yet, collaboration during an examination is typically considered cheating. Collaborative assessments have not been widely adopted because of the perceived lack of individual accountability and the notion that collaboration during assessments simply causes propagation of correct answers. Hence, collaboration could help weaker students without providing much benefit to stronger students. In this paper, we examine student performance in open-ended, two-stage collaborative assessments comprised of an individually accountable round followed by an automatically scored, collaborative round. We show that collaboration entails more than just propagation of correct answers. We find greater rates of correct answers after collaboration for all students, including the strongest members of a team. We also find that half of teams that begin without a correct answer to propagate still obtain the correct answer in the collaborative round. Our findings, combined with the convenience of automatic feedback and grading of open-ended questions, provide a strong argument for adopting collaborative assessments as an integral part of education.

  15. State Technologies Advancement Collaborative

    Energy Technology Data Exchange (ETDEWEB)

    David S. Terry

    2012-01-30

    The U. S. Department of Energy (DOE), National Association of State Energy Officials (NASEO), and Association of State Energy Research and Technology Transfer Institutions (ASERTTI) signed an intergovernmental agreement on November 14, 2002, that allowed states and territories and the Federal Government to better collaborate on energy research, development, demonstration and deployment (RDD&D) projects. The agreement established the State Technologies Advancement Collaborative (STAC) which allowed the states and DOE to move RDD&D forward using an innovative competitive project selection and funding process. A cooperative agreement between DOE and NASEO served as the contracting instrument for this innovative federal-state partnership obligating funds from DOE's Office of Energy Efficiency and Renewable Energy and Office of Fossil Energy to plan, fund, and implement RDD&D projects that were consistent with the common priorities of the states and DOE. DOE's Golden Field Office provided Federal oversight and guidance for the STAC cooperative agreement. The STAC program was built on the foundation of prior Federal-State efforts to collaborate on and engage in joint planning for RDD&D. Although STAC builds on existing, successful programs, it is important to note that it was not intended to replace other successful joint DOE/State initiatives such as the State Energy Program or EERE Special Projects. Overall the STAC process was used to fund, through three competitive solicitations, 35 successful multi-state research, development, deployment, and demonstration projects with an overall average non-federal cost share of 43%. Twenty-two states were awarded at least one prime contract, and organizations in all 50 states and some territories were involved as subcontractors in at least one STAC project. Projects were funded in seven program areas: (1) Building Technologies, (2) Industrial Technologies, (3) Transportation Technologies, (4) Distributed Energy

  16. Collaboration or contestation?

    DEFF Research Database (Denmark)

    Middleton, Geoff; Evans, Adam Brian; Henderson, Hannah

    2016-01-01

    -agency approach. The strength of health promotion initiatives relies on formed ‘coalitions’ or partnerships and the subsequent collaboration in the design, delivery and administration of the programme’s multiple components. Advantages of partnership are the pooling of resources, avoiding duplication...... to the development, implementation and evaluation of such programmes (Middleton et al., 2014, Kleij et al., 2015). This includes leadership issues, competing agendas and priorities, the unwieldy nature of large multi-agency networks and the complexities around making a sustained impact. Those involved...

  17. Advances in Collaborative Filtering

    Science.gov (United States)

    Koren, Yehuda; Bell, Robert

    The collaborative filtering (CF) approach to recommenders has recently enjoyed much interest and progress. The fact that it played a central role within the recently completed Netflix competition has contributed to its popularity. This chapter surveys the recent progress in the field. Matrix factorization techniques, which became a first choice for implementing CF, are described together with recent innovations. We also describe several extensions that bring competitive accuracy into neighborhood methods, which used to dominate the field. The chapter demonstrates how to utilize temporal models and implicit feedback to extend models accuracy. In passing, we include detailed descriptions of some the central methods developed for tackling the challenge of the Netflix Prize competition.

  18. Collaborative form(s)

    DEFF Research Database (Denmark)

    Gunn, Wendy

    anthropology engages groups of people within collaborative, interdisciplinary, inter-organizational design processes and co-analytic activities vs. the individual anthropologist conducting studies of people. In doing anthropology by means of design as Gatt and Ingold (2013) have shown, design is considered...... the process of research rather than its object. In its temporal orientation, anthropology by means of design moves, ‘…forward with people in tandem with their desires and aspirations rather than going back over times passed’ (ibid 2013: 141). Doing design by means of anthropology takes as its most fundamental...

  19. The Efficient Windows Collaborative

    Energy Technology Data Exchange (ETDEWEB)

    Petermann, Nils

    2006-03-31

    The Efficient Windows Collaborative (EWC) is a coalition of manufacturers, component suppliers, government agencies, research institutions, and others who partner to expand the market for energy efficient window products. Funded through a cooperative agreement with the U.S. Department of Energy, the EWC provides education, communication and outreach in order to transform the residential window market to 70% energy efficient products by 2005. Implementation of the EWC is managed by the Alliance to Save Energy, with support from the University of Minnesota and Lawrence Berkeley National Laboratory.

  20. Collaborative Communities of Firms

    DEFF Research Database (Denmark)

    Bøllingtoft, Anne; Müller, Sabine; Ulhøi, John Parm

    2011-01-01

    and developing strategic initiatives that aid the community as a whole. We discuss the facilitator role of the shared services provider, contrasting it with the coordinator role found in other multi-firm organizations, and we show how shared services providers function by describing three examples...... of collaborative communities of firms from different sectors: the U.S.-based Blade.org and two Denmark-based communities, the Kalundborg Industrial Symbiosis and MG50. Implications for the theory and practice of organization design are discussed....

  1. Significant breakthroughs in monitoring networks of the volcanological and seismological French observatories

    Science.gov (United States)

    lemarchand, A.; Francois, B.; Bouin, M.; Brenguier, F.; Clouard, V.; Di Muro, A.; Ferrazzini, V.; Shapiro, N.; Staudacher, T.; Kowalski, P.; Agrinier, P.

    2013-12-01

    Others authors: S. Tait (1), D. Amorese (4,1), JB de Chabalier (1), A. Anglade (4,1), P. Kowalski (5,1),the teams in the IPGP Volcanological and Seismological observatories In the last few years, French West Indies observatories, in collaboration with the Seismic Research Center (University of West Indies-Trinidad), have modernized the Lesser Antilles Arc seismic and deformation monitoring network. 16 new permanent stations have been installed to strengthen and expand its detection capabilities. The global network of the IPGP-SRC consortium is now composed of 21 modernized stations, all equipped with broadband seismometers, strong motion sensors, GNSS sensors and satellite communication for real-time data transfer to the observatories of Trinidad (SRC), Guadeloupe (OVSG), Martinique (OVSM). To improve the sensitivity and reduce ambient noise, special efforts were made to enhance the design of the seismic vault and the original Stuttgart shielding (D. Kurrle R. Widmer-Schnidrig, 2005) of the broadband seismometers (240 and 120 sec). This renewed network feeds the Caribbean Tsunami Warning System supported by UNESCO and establishes a monitoring tool that produces high quality data for studying subduction and volcanism interactions in the Lesser Antilles arc. Since 2010, the UnderVolc research program has been an opportunity to reinforce the existing volcanic seismic network of Piton de la Fournaise on La Réunion Island (Indian Ocean). 20 broadband seismometers, 20 short-period sensors, and 26 GNSS receivers now cover the volcano. The program successfully developed many new data treatment tools. They have proven to be well-adapted for monitoring volcanic activity such as the tracking of seismic velocity changes inferred from seismic noise, or the injection of dike and the resulting deformations. This upgrade has now established the monitoring network of La Réunion hot spot to high quality standards which will foster the scientific attractiveness of OVPF-IPGP. During

  2. Multi-centre European study of breakthrough cancer pain: pain characteristics and patient perceptions of current and potential management strategies

    DEFF Research Database (Denmark)

    Davies, Andrew; Zeppetella, Giovambattista; Andersen, Steen

    2011-01-01

    This study involved 320 cancer patients from four Northern European countries. Patients with breakthrough pain were questioned about the characteristics of their pain, the current management of their pain, and the acceptability/utility of alternative routes of administration. The median number...... of episodes was 3/day. Forty-four percent patients reported incident-type pain, 39% spontaneous-type pain, and 17% a combination of these pains. The median duration was 60 min, and the median time to peak intensity was 15 min. Three percent patients reported "mild" pain, 37% "moderate" pain, and 60% "severe......" pain. Ninety percent patients stated that the pain interfered with their daily activities. All patients were using opioids as rescue medication (mainly oral morphine/oxycodone), whilst 28% patients were using non-opioids, and 50% patients were using non-pharmacological interventions. Only 55% patients...

  3. Breakthrough in current-in-plane tunneling measurement precision by application of multi-variable fitting algorithm.

    Science.gov (United States)

    Cagliani, Alberto; Østerberg, Frederik W; Hansen, Ole; Shiv, Lior; Nielsen, Peter F; Petersen, Dirch H

    2017-09-01

    We present a breakthrough in micro-four-point probe (M4PP) metrology to substantially improve precision of transmission line (transfer length) type measurements by application of advanced electrode position correction. In particular, we demonstrate this methodology for the M4PP current-in-plane tunneling (CIPT) technique. The CIPT method has been a crucial tool in the development of magnetic tunnel junction (MTJ) stacks suitable for magnetic random-access memories for more than a decade. On two MTJ stacks, the measurement precision of resistance-area product and tunneling magnetoresistance was improved by up to a factor of 3.5 and the measurement reproducibility by up to a factor of 17, thanks to our improved position correction technique.

  4. Depression in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Badema Čengić

    2010-04-01

    Full Text Available Depression is the most frequent psychological complication of haemodialysis (HD patients (pts and has been associated with impaired Quality of Life (QoL. The aim of our study was to investigate the prevalence of depression in HD pts in relation to sociodemographic factors and the relationship between depression and QoL.200 pts from Clinic for haemodialysis in Sarajevo, B&H were participating in the study. Mean age was S7,26±13,78 years and mean HD duration was 64’26±58,18 months. From the test material we applied BDI and SF-36.51% of our pts have shown depression (BDI>11 in various degrees (30%-mild depression, 8,5%-moderate depression and 12,5%-severe depression. As we could expect, the most emphasized symptoms of depression were somatic symptoms. 55,5% of pts have shown QoL lower then average. Sociodemographic data such as gender, marital status and HD duration did not influence significantly on pt’s QoL and occurrence of depression (p>0,05. As the age of the pts increased, level of depression increased too and QoL significantly decreased (p<0,05. Employed pts have shown significantly better QoL and lower level of depression in relation to unemployed pts (p<0,05. As the educational level of pts increased, QoL increased too and level of depression significantly decreased (p<0,05. Pts in 1st HD shift were significantly more depressed and have significantly worse mental health in compare to pts in 3rd HD shift (p<0,05. Our results showed a high prevalence of depressive symptoms among the study group that was linked to trend of poor QoL.

  5. An evaluation of total disintegration time for three different doses of sublingual fentanyl tablets in patients with breakthrough pain.

    Science.gov (United States)

    Nalamachu, Srinivas

    2013-12-01

    Breakthrough pain is common among patients with cancer and presents challenges to effective pain management. Breakthrough pain is characterized by rapid onset, severe intensity, and duration typically lasting disintegration time of three different doses of sublingual fentanyl tablets in opioid-tolerant patients. This was a single-center, non-randomized, open-label study. Opioid-tolerant adult patients (N = 30) with chronic pain were assigned to one of three dose groups and self-administered a single 100, 200, or 300 μg sublingual fentanyl tablet (Abstral(®), Galena Biopharma, Portland, OR, USA). Time to complete disintegration was measured by each patient with a stopwatch and independently verified by study personnel. Disintegration time (mean ± SD) for sublingual fentanyl tablets (all doses) was 88.2 ± 55.1 s. Mean disintegration times tended to be slightly longer for the 200 μg (96.7 ± 57.9 s) and 300 μg doses (98.6 ± 64.8 s) compared to the 100 μg dose (69.5 ± 40.5 s). Differences were not statistically significant. Disintegration time was not significantly different between men and women and was not affected by age. Sublingual fentanyl tablets dissolved rapidly (average time <2 min) in all patients, with the higher doses taking slightly more time to dissolve.

  6. Significant breakthrough in proprietary deepwater natural gas exploration in the northern South China Sea and its inspiration

    Directory of Open Access Journals (Sweden)

    Yuhong Xie

    2014-12-01

    Full Text Available In 2014, Zhanjiang Branch of CNOOC Limited obtained high oil and gas flows (160 × 104 m3/d in Well LS 17-2-1 in northern South China Sea. The tested formation is the Neogene Upper Miocene Huangliu Fm. This is the first self-explored natural gas field in deep water area in China. Exploration in this area underwent three periods: (1 Reconnaissance exploration period (before 2002: Limited by techniques, the major exploration was in shallow water areas; (2 Foreign cooperative exploration period (2002–2012: As the discovered reserve scale was small, and there is no economic benefit, the partners successively gave up their exploration equities in the deep water area of western South China Sea; however, the high quality source rocks and reservoirs were confirmed in the deep water area of the South China Sea, revealing the mask of hydrocarbon exploration in this region; (3 Self-exploration period (since 2013: Relying on national science and technology major projects and its scientific research and production, Zhanjiang Company of CNOOC conducted several scientific researches on seismic data acquisition and processing, high-quality reservoir distribution, key factors for hydrocarbon accumulation in deep water areas, optimized and confirmed Lingshui 17-2 structure as the first drilling target, and obtained significant exploration breakthrough. Lingshui 17-2 structure is located in the Ledong-Lingshui section of the Central Canyon. Its major target layer is the Huangliu Fm. Its total thickness is over 150 m, with sandstone ratio of 75.4%, maximum single layer thickness of 52 m, porosity ranging 30.0%–33.7% (31.5% averagely, permeability ranging 293–2512 mD (633 mD averagely, belonging to reservoir with ultrahigh porosity and high-ultrahigh permeability. The exploration breakthrough in Lingshui 17-2 shows the giant potentiality of hydrocarbon exploration in this deep water area.

  7. Use of tigecycline for the management of Clostridium difficile colitis in oncology patients and case series of breakthrough infections.

    Science.gov (United States)

    Brinda, B J; Pasikhova, Y; Quilitz, R E; Thai, C M; Greene, J N

    2017-04-01

    Clostridium difficile infection (CDI) is the most frequent cause of nosocomial diarrhoea in adults. Cancer patients, in particular, are at a higher risk for CDI. Limited clinical data exist regarding the use of tigecycline for the treatment of CDI, especially in patients with oncologic and haematologic malignancies. To characterize the use of tigecycline for treatment of CDI in oncology patients at an academic cancer centre. This was a retrospective, single-centre, single-arm, chart review evaluating the use of tigecycline for the management of CDI in oncology patients at an academic cancer centre. The median age of CDI diagnosis in this patient group (N=66) was 65 years (range: 16-84) and the majority of patients had solid tumour malignancies. Fifty-six percent of patients had severe CDI, 70.3% of which were classified as having severe complicated disease. The median time to initiation of tigecycline therapy was 2 days (mean: 3.83) and the median number of tigecycline doses was 13 (range: 1-50). Twelve non-CDI breakthrough infections were observed, and four patients developed CDI while receiving tigecycline for non-CDI indications. The rate of death was 18% and the recurrence rate was 15.2%. Tigecycline did not lead to overt benefits in outcomes of oncology patients with CDI when compared to historical data. In addition, several breakthrough CDIs were observed in patients who received the drug for a non-CDI indication. Further prospective research is needed to validate the use of tigecycline for management of CDI. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. Development of techniques for rapid analysis of 90Sr breakthrough and 90Y activity from a 90Sr-90Y generator

    International Nuclear Information System (INIS)

    Chism, S.E.; Goodwin, D.A.; Meares, C.F.

    1986-01-01

    Recently there has been interest in labelling monoclonal antibodies with therapeutic amounts of a pure beta emitting isotope. 90 Y offers many desirable features and may be conveniently and economically obtained from a 90 Sr- 90 Y generator. A potential hazard with this system is breakthrough of the parent 90 Sr which has a half life of 28 years and is an extremely toxic bone seeking isotope. Therefore it is essential that the daughter be completely separated from its parent. We have devised two simple techniques which allow us to monitor rapidly the amount of 90 Sr breakthrough and quantitate the 90 Y activity over a 5 log range. (author)

  9. A neighbourly collaboration

    CERN Multimedia

    Corinne Pralavorio

    2014-01-01

    CERN and its host territories in France have created a new partnership aimed at reinforcing and making permanent numerous projects for the people who live in the region.   Over the last four years, CERN has developed a number of initiatives with its partners in Geneva and neighbouring France. To formalise and improve the structure of this collaboration, CERN, the French government, the Conseil général de l’Ain and the Communauté de communes du Pays de Gex have recently formed a quadripartite partnership. The CERN Director-General has been appointed Chair of the committee leading the partnership for this year. “Due to its geographical location, activities and aims, CERN has always placed great emphasis on dialogue with its neighbours,” explains Friedemann Eder, Head of the Relations with the Host States Service.  “The current Director-General wanted to boost dialogue and collaboration – an aim that the auth...

  10. Globally Collaborative Experiential Learning

    Directory of Open Access Journals (Sweden)

    Takeshi UTSUMI

    2005-07-01

    Full Text Available ABSTRACT The Global University System (GUS [Utsumi, et al, 2003] is a worldwide initiative to create advanced telecommunications infrastructure for access to educational resources across national and cultural boundaries for global peace. GUS aims to create a worldwide consortium of universities to provide the underdeveloped world with access to 21st Century education via broadband Internet technologies. The aim is to achieve “education and healthcare for all,” anywhere, anytime and at any pace. The GUS works in the major regions of the globe with partnerships of higher education and healthcare institutions. Learners in these regions will be able to take their courses from member institutions around the world to receive a GUS degree. These learners and their professors from partner institutions will also form a global forum for exchange of ideas and information and for conducting collaborative research and development with emerging global GRID computer network technology. Globally Collaborative Environmental Peace Gaming (GCEPG project [Utsumi, 2003] with a globally distributed computer simulation system, focusing on the issue of environment and sustainable development in developing countries, is to train would-be decision-makers in crisis management, conflict resolution, and negotiation techniques basing on “facts and figures.” The GUS will supply game players from around the world.

  11. A collaborative adventure

    CERN Multimedia

    2014-01-01

    At the start of a new year, I’d like to wish all of you and your families a happy, successful and peaceful 2014. It’s a year that holds particular significance for CERN, as on 29 September it will be 60 years since the Organization was founded.   As CERN turns 60, it is still going strong, maintaining its underlying attraction of international collaboration for basic science. Since its foundation in 1954, it has grown steadily and this year begins well as we welcome a new Member State, Israel. CERN and Israel already have a long history of mutual collaboration and now we can look forward to increasingly fruitful scientific cooperation. Israel’s accession brings the total number of Member States to 21, and other countries are in the stages leading up to becoming Members or Associates, while still others are expressing interest. CERN is becoming a global success, while retaining its original, European flavour. This year’s events for the 60th anniversary ...

  12. Does major depression result in lasting personality change?

    Science.gov (United States)

    Shea, M T; Leon, A C; Mueller, T I; Solomon, D A; Warshaw, M G; Keller, M B

    1996-11-01

    Individuals with a history of depression are characterized by high levels of certain personality traits, particularly neuroticism, introversion, and interpersonal dependency. The authors examined the "scar hypothesis," i.e., the possibility that episodes of major depression result in lasting personality changes that persist beyond recovery from the depression. A large sample of first-degree relatives, spouses, and comparison subjects ascertained in connection with the proband sample from the National Institute of Mental Health Collaborative Program on the Psychobiology of Depression were assessed at two points in time separated by an interval of 6 years. Subjects with a prospectively observed first episode of major depression during the interval were compared with subjects remaining well in terms of change from time 1 to time 2 in self-reported personality traits. All subjects studied were well (had no mental disorders) at the time of both assessments. There was no evidence of negative change from premorbid to postmorbid assessment in any of the personality traits for subjects with a prospectively observed first episode of major depression during the interval. The results suggested a possible association of number and length of episodes with increased levels of emotional reliance and introversion, respectively. The findings suggest that self-reported personality traits do not change after a typical episode of major depression. Future studies are needed to determine whether such change occurs following more severe, chronic, or recurrent episodes of depression.

  13. Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.

    Science.gov (United States)

    Llewellyn-Jones, R H; Baikie, K A; Smithers, H; Cohen, J; Snowdon, J; Tennant, C C

    1999-09-11

    To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Population of residential facility in Sydney living in self care units and hostels. 220 depressed residents aged >/=65 without severe cognitive impairment. The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Geriatric depression scale. Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents.

  14. Comparison of depression symptoms between primary depression and secondary-to-schizophrenia depression.

    Science.gov (United States)

    Rahim, Twana; Rashid, Roshe

    2017-11-01

    This study exclusively aimed to clinically assess which symptom pattern discriminates primary depression from depression-secondary to-schizophrenia. A total of 98 patients with primary depression and 71 patients with secondary-to-schizophrenia depression were assessed for identifying the clinical phenomena of depression. Diagnosis of schizophrenia was confirmed by Mini International Neuropsychiatric Interview. Each participant was, however, assessed by Patient Health Questionnaire-9 as well as Calgary Depression Scale for Schizophrenia (CDSS) for possible concurrent depressive symptoms. Depressed mood, loss of interest, reduced energy and pathological guilt were more common in primary depression, whereas sleep disturbance and guilty ideas of reference were more amounting towards the diagnosis of depression secondary-to-schizophrenia. It is clinically hard to differentiate primary from secondary-to-schizophrenia depression, especially in the absence of obvious psychotic symptoms. However, the classical symptoms of depression like subjective depressed mood, anhedonia, reduced energy and pathological guilt are more prominent in the primary depression.

  15. Stakeholder collaboration and heritage management

    OpenAIRE

    Aas, C.; Ladkin, Adele; Fletcher, John

    2005-01-01

    This article examines a collaborative approach to the relationship between heritage management and tourism development in Luang Prabang, Laos. The purpose is to examine stakeholder collaboration and management roles, heritage tourism development, as well as the interdependence of the heritage conservation and tourism relationship. The research examines a UNESCO/Norwegian government project, which aiming to promote collaboration between heritage conservation and tourism through stakeholder inv...

  16. Formation of a collaborative society

    OpenAIRE

    Buřita, Ladislav; Ondryhal, Vojtěch

    2014-01-01

    The MilUNI knowledge portal, based on the knowledge base developed in ATOM software has been created at the authors' workplace with the aim to form a collaborative society of military universities. The analysis of the collaborative society concept is presented. The description of the MilUNI project is included. Some areas for university cooperation are proposed, as well as the measures facilitating the formation and development of the collaborative society.

  17. Coordination theory and collaboration technology

    CERN Document Server

    Olson, Gary M; Smith, John B

    2001-01-01

    The National Science Foundation funded the first Coordination Theory and Collaboration Technology initiative to look at systems that support collaborations in business and elsewhere. This book explores the global revolution in human interconnectedness. It will discuss the various collaborative workgroups and their use in technology. The initiative focuses on processes of coordination and cooperation among autonomous units in human systems, in computer and communication systems, and in hybrid organizations of both systems. This initiative is motivated by three scientific issues which have been

  18. Collaborate, compete and share

    Science.gov (United States)

    Pugliese, Emanuele; Castellano, Claudio; Marsili, Matteo; Pietronero, Luciano

    2009-02-01

    We introduce and study a model of an interacting population of agents who collaborate in groups which compete for limited resources. Groups are formed by random matching agents and their worth is determined by the sum of the efforts deployed by agents in group formation. Agents, on their side, have to share their effort between contributing to their group’s chances to outcompete other groups and resource sharing among partners, when the group is successful. A simple implementation of this strategic interaction gives rise to static and evolutionary properties with a very rich phenomenology. A robust emerging feature is the separation of the population between agents who invest mainly in the success of their group and agents who concentrate in getting the largest share of their group’s profits.

  19. Depression, diet and exercise.

    Science.gov (United States)

    Jacka, Felice N; Berk, Michael

    2013-09-16

    Unhealthy lifestyle behaviour is driving an increase in the burden of chronic non-communicable diseases worldwide. Recent evidence suggests that poor diet and a lack of exercise contribute to the genesis and course of depression. While studies examining dietary improvement as a treatment strategy in depression are lacking, epidemiological evidence clearly points to diet quality being of importance to the risk of depression. Exercise has been shown to be an effective treatment strategy for depression, but this is not reflected in treatment guidelines, and increased physical activity is not routinely encouraged when managing depression in clinical practice. Recommendations regarding dietary improvement, increases in physical activity and smoking cessation should be routinely given to patients with depression. Specialised and detailed advice may not be necessary. Recommendations should focus on following national guidelines for healthy eating and physical activity.

  20. Standardization of depression measurement

    DEFF Research Database (Denmark)

    Wahl, Inka; Löwe, Bernd; Bjørner, Jakob

    2014-01-01

    OBJECTIVES: To provide a standardized metric for the assessment of depression severity to enable comparability among results of established depression measures. STUDY DESIGN AND SETTING: A common metric for 11 depression questionnaires was developed applying item response theory (IRT) methods. Data...... of 33,844 adults were used for secondary analysis including routine assessments of 23,817 in- and outpatients with mental and/or medical conditions (46% with depressive disorders) and a general population sample of 10,027 randomly selected participants from three representative German household surveys....... RESULTS: A standardized metric for depression severity was defined by 143 items, and scores were normed to a general population mean of 50 (standard deviation = 10) for easy interpretability. It covers the entire range of depression severity assessed by established instruments. The metric allows...