WorldWideScience

Sample records for CBT training supervision structure governance

  1. Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision.

    Science.gov (United States)

    Rakovshik, Sarah G; McManus, Freda; Vazquez-Montes, Maria; Muse, Kate; Ougrin, Dennis

    2016-03-01

    To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to IBT programs may not be an effective method of disseminating CBT to routine clinical practice. (c) 2016 APA, all rights reserved).

  2. "Is supervision necessary? Examining the effects of Internet-based CBT training with and without supervision": Correction to Rakovshik et al. (2016).

    Science.gov (United States)

    2016-12-01

    Reports an error in "Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision" by Sarah G. Rakovshik, Freda McManus, Maria Vazquez-Montes, Kate Muse and Dennis Ougrin ( Journal of Consulting and Clinical Psychology , 2016[Mar], Vol 84[3], 191-199). In the article, the department and affiliation were misspelled for author Kate Muse. The department and affiliation should have read Psychology Department, University of Worcester. All versions of this article has been corrected. (The following abstract of the original article appeared in record 2016-03513-001.) Objective: To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to

  3. Psychotherapy and Cognitive Behavioral Therapy Supervision in Danish Psychiatry: Training the Next Generation of Psychiatrists.

    Science.gov (United States)

    Schmidt, Lasse M; Foli-Andersen, Nina J

    2017-02-01

    Psychotherapy training is mandatory for physicians to qualify as psychiatrists in Denmark. Evidence for the effectiveness of psychotherapy has increased, and psychotherapy is increasingly included in international treatment guidelines. The authors investigated how psychiatrists in training in Denmark evaluate the opportunities to practice psychotherapy in their training and the quality of the supervision they receive in psychotherapy training, particularly for cognitive behavioral therapy (CBT). The authors conducted a survey regarding psychotherapy training and CBT supervision among psychiatrists in training at Danish psychiatric specialist training courses. They investigated respondents' interest and experience in psychotherapy and respondents' views on the relevance and feasibility of performing psychotherapy and receiving supervision in their psychiatry training. Eighty-eight percent of the psychiatrists in training found psychotherapy to be a relevant part of their training; however, 77 % found it difficult to find time to practice psychotherapy and 44 % felt that practicing psychotherapy was a strain on their employer. Thirty-six percent and 53 %, respectively, had difficulties securing psychodynamic and CBT supervision. In CBT supervision, more than 60 % reported supervision that appeared to be below the expected CBT supervision standard and often so much below it might not qualify as CBT supervision. There is a need to focus on how to better integrate psychotherapy and supervision in the Danish psychiatric training program. Good CBT supervision may be lacking, and a way to ensure high-quality supervision is required.

  4. Acquiring and refining CBT skills and competencies: which training methods are perceived to be most effective?

    Science.gov (United States)

    Bennett-Levy, James; McManus, Freda; Westling, Bengt E; Fennell, Melanie

    2009-10-01

    A theoretical and empirical base for CBT training and supervision has started to emerge. Increasingly sophisticated maps of CBT therapist competencies have recently been developed, and there is evidence that CBT training and supervision can produce enhancement of CBT skills. However, the evidence base suggesting which specific training techniques are most effective for the development of CBT competencies is lacking. This paper addresses the question: What training or supervision methods are perceived by experienced therapists to be most effective for training CBT competencies? 120 experienced CBT therapists rated which training or supervision methods in their experience had been most effective in enhancing different types of therapy-relevant knowledge or skills. In line with the main prediction, it was found that different training methods were perceived to be differentially effective. For instance, reading, lectures/talks and modelling were perceived to be most useful for the acquisition of declarative knowledge, while enactive learning strategies (role-play, self-experiential work), together with modelling and reflective practice, were perceived to be most effective in enhancing procedural skills. Self-experiential work and reflective practice were seen as particularly helpful in improving reflective capability and interpersonal skills. The study provides a framework for thinking about the acquisition and refinement of therapist skills that may help trainers, supervisors and clinicians target their learning objectives with the most effective training strategies.

  5. The Perceived Effectiveness of Supervision In Cognitive Behavioral Therapy Training

    Directory of Open Access Journals (Sweden)

    Erkan Kuru

    2016-12-01

    Full Text Available Psychotherapy is a general name for the problem solving techniques to address mental disorders or struggles through verbal interaction. Cognitive Behavioral Therapy (CBT is one of the leading approaches in psychotherapy field. The first aim of this study; to evaluate the contribution of theoretical and supervision trainings perceived by mental health professionals to their CBT skills and personal development. The second one was to evaluate the CBT training process in psychotherapy training. To this end, 54 mental health professionals who agree to participate the study were given questionnaires each consisting of 18 items. This questionnaire was created by three supervisors who have been certified by the Academy of Cognitive Therapy (ACT. Mean duration of work as a mental health professional were 7.6 years. Mean duration of using psychotherapy in their clinical practice were 4,8 years. Mean duration of application of CBT as a psychotherapy modality were 3,2 years. Mean durations of theoretical and supervision trainings the participants had participated were 55,4 hours and 69,1 respectively. Seventy-nine point six of the participants reported that the theoretical training had contributed to their CBT practice at “quite” to “too much” levels. Fifty-nine point two of the participants reported that the same training contributed to their personal development at “quiet” to “too much” levels. For the supervision traning these perceived contributions were 92,6 % and 70,4% respectively. That the therapists reported high degree of satisfaction with the theoretical and supervision trainings they need to accomplish is promising about the psychotherapy training in Turkey. Besides, results of this study suggests that although theoretical training is of perceived value, supervision has been perceived as had given extra contribution. [JCBPR 2016; 5(3.000: 119-124

  6. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2016-10-29

    clinician applicants occurred. b. SP baseline interviews with eligible clinicians occurred. c. Automated random assignment of participants with Completed SP...intervention without web-centered supervision and a wait-list control with regard to improvements in two CBT-based skill areas (behavioral task...Secondary Aim #1: To compare improvements in knowledge and attitudes following internet- based training with or without web-centered supervision and

  7. What IAPT CBT High-Intensity Trainees Do After Training.

    Science.gov (United States)

    Liness, Sheena; Lea, Susan; Nestler, Steffen; Parker, Hannah; Clark, David M

    2017-01-01

    The UK Department of Health Improving Access to Psychological Therapies (IAPT) initiative set out to train a large number of therapists in cognitive behaviour therapies (CBT) for depression and anxiety disorders. Little is currently known about the retention of IAPT CBT trainees, or the use of CBT skills acquired on the course in the workplace after training has finished. This study set out to conduct a follow-up survey of past CBT trainees on the IAPT High Intensity CBT Course at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), one of the largest IAPT High Intensity courses in the UK. Past trainees (n = 212) across 6 cohorts (2008-2014 intakes) were contacted and invited to participate in a follow-up survey. A response rate of 92.5% (n = 196) was achieved. The vast majority of IAPT trainees continue to work in IAPT services posttraining (79%) and to practise CBT as their main therapy modality (94%); 61% have become CBT supervisors. A minority (23%) have progressed to other senior roles in the services. Shortcomings are reported in the use of out-of-office CBT interventions, the use of disorder-specific outcome measures and therapy recordings to inform therapy and supervision. Past trainees stay working in IAPT services and continue to use CBT methods taught on the course. Some NICE recommended treatment procedures that are likely to facilitate patients' recovery are not being routinely implemented across IAPT services. The results have implications for the continued roll out of the IAPT programme, and other future large scale training initiatives.

  8. An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario

    Science.gov (United States)

    Manassis, Katharina; Ickowicz, Abel; Picard, Erin; Antle, Beverley; McNeill, Ted; Chahauver, Anu; Mendlowitz, Sandra; Monga, Suneeta; Adler-Nevo, Gili

    2009-01-01

    Objective: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by…

  9. The Constraints of Ghanaian Polytechnics in Adopting Competency Based Training (CBT): The Case of a Pilot-Tested Programme

    Science.gov (United States)

    Alhassan, Munkaila; Habib, Abdallah Mohammed

    2016-01-01

    Polytechnics in Ghana view Competency Based Training (CBT) as a major intervention to the perennial constraints confronting its education and training. On the basis of this, and by government policy, a pilot programme of CBT was instituted in all the 10 polytechnics of Ghana, and was pilot tested in, at least, one department. Agricultural…

  10. The CBT Advisor: An Expert System Program for Making Decisions about CBT.

    Science.gov (United States)

    Kearsley, Greg

    1985-01-01

    Discusses structure, credibility, and use of the Computer Based Training (CBT) Advisor, an expert system designed to help managers make judgements about course selection, system selection, cost/benefits, development effort, and probable success of CBT projects. (MBR)

  11. How Supervisees on a Foundation Course in CBT Perceive a Supervision Session and what they Bring Forward to the Next Therapy Session.

    Science.gov (United States)

    Törnquist, Anna; Rakovshik, Sarah; Carlsson, Jan; Norberg, Joakim

    2018-05-01

    There is limited research into the effect of supervision in cognitive behavioural therapy (CBT) from the supervisees' perspective. The aim of the study was to acquire knowledge from the supervisees' perspective as to what in particular in the supervision process contributes to the therapy process. Fourteen supervisees on a foundation course participated in the study. A qualitative approach was used with thematic analysis of the participants' written diaries after supervision and therapy sessions. Analyses of supervisees' experiences suggested that a variety of therapeutic interventions were easier to implement if one had the supervisor's support and felt free to decide if and when the suggested interventions could best be implemented. Evaluation in the form of positive feedback from the supervisor indicating that the supervisee was 'doing the right thing' was perceived to be important. A unifying theme when supervisees felt they were not getting anything out of the supervision was that the supervisees did not have a supervision question. The results of this research suggest that the supervisor's support during training is perceived to be important for the supervisee. Receiving positive feedback from one's supervisor in an evaluation is perceived to have a great impact on whether the therapist implements the suggested therapeutic interventions discussed in the previous supervision.

  12. Enhancing Technical and Vocational Education and Training (TVET) in Nigeria for Sustainable Development: Competency-Based Training (CBT) Approach

    Science.gov (United States)

    Okoye, K. R. E.; Michael, Ofonmbuk Isaac

    2015-01-01

    This paper attempts to examine the concept of Competency-Based Training (CBT) as a veritable mode of delivery of Technical and Vocational Education and Training (TVET) and at the same time highlights some of the strengths and weaknesses of implementing competency-base training. The characteristics, principles and benefits of CBT were also x-rayed.…

  13. 48 CFR 836.572 - Government supervision.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Government supervision. 836.572 Section 836.572 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 836.572 Government supervision. The contracting officer shal...

  14. Studi evaluasi penerapan Community Based Tourism (CBT sebagai pendukung agrowisata berkelanjutan

    Directory of Open Access Journals (Sweden)

    Sri Endah Nurhidayati

    2015-01-01

    Full Text Available The role of government in the development of Community Based Tourism (CBT is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1 describe the government's perception of the  Community Based Tourism (CBT development, (2 identifying government policies to support the Community Based Tourism (CBT implementation in Batu City, East Java, and (3 describe the constraints that occur in the implementation of Community based Tourism (CBT in Batu City, East Java. This study uses qualitative approach by analyzing critical reality, being constructed locally and specifically. The study was conducted in Batu City, East Java. Perceptions of government on the implementation of community-based tourism reflected the mindset of the individual. The community-based tourism development in Batu city is considered the same as rural tourism development. The Government supervise the development of tourism products, especially the tourist village. To support the existence of a tourist village Department of Tourism and Creative Economy   help develop and market promotion. Barriers to the implementation of community-based tourism development with regard to the internal aspects of the government: the quality of human resources decision makers in the Batu Government do not possess educational background of tourism, government people less creative design programs and somewhat forced, the lack of trust the government to local communities, government is not able to map the condition social community related to the system's internal decision-making in the community that are less able to intervene in all components of society, a narrow understanding of CBT, and yet solid government policy coordination between stakeholders. While the external barriers are lack of insight into the

  15. Evaluation of a Trauma-Focused CBT Training Programme for IAPT services.

    Science.gov (United States)

    Murray, Hannah

    2017-09-01

    Therapists in Improving Access to Psychological Therapies (IAPT) services are often expected to treat complex presentations of post-traumatic stress disorder (PTSD), such as individuals with multiple, prolonged or early life trauma histories and significant co-morbidity, for which they have received minimal training. Although high recovery rates for PTSD have been demonstrated in randomized controlled trials, these are not always replicated in routine practice, suggesting that training interventions are required to fill the research-practice gap. This study investigated the outcomes of a therapist training programme on treating PTSD with trauma-focused cognitive behavioural therapy (TF-CBT). Twenty therapists from ten IAPT services participated in the training, which consisted of workshops, webinars and consultation sessions over a 6-month period. Feedback indicated that participants found the training highly acceptable. PTSD knowledge and self- and supervisor-rated competence on TF-CBT measures improved following the training and improvements were maintained a year later. Client outcomes on a PTSD measure improved following the training. Participants reported attempts to disseminate learning from the course back to their teams. The findings indicate that the training programme was successful in improving TF-CBT knowledge, skills and outcomes for IAPT therapists. Tentative support for training 'trauma experts' within IAPT services was found, although institutional constraints and staff turnover may limit the sustainability of the model.

  16. Advanced Music Therapy Supervision Training

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2009-01-01

    supervision training excerpts live in the workshop will be offered. The workshop will include demonstrating a variety of supervision methods and techniques used in A) post graduate music therapy training programs b) a variety of work contexts such as psychiatry and somatic music psychotherapy. The workshop......The presentation will illustrate training models in supervision for experienced music therapists where transference/counter transference issues are in focus. Musical, verbal and body related tools will be illustrated from supervision practice by the presenters. A possibility to experience small...

  17. Enduring Effects of a Computer-Assisted Training Program For Cognitive Behavioral Therapy: A six-month follow-up of CBT4CBT*

    Science.gov (United States)

    Carroll, Kathleen M.; Ball, Samuel A.; Martino, Steve; Nich, Charla; Babuscio, Theresa A.; Rounsaville, Bruce J.

    2009-01-01

    Objectives To evaluate the durability of effects of a computer assisted version of cognitive behavioral therapy (CBT) as treatment for substance dependence through a 6 month follow-up. Methods Following a randomized clinical trial in which 73 individuals seeking outpatient treatment for substance dependence in an outpatient community setting were randomized to either standard treatment-as-usual (TAU) or TAU with 8 weeks of biweekly access to computer-based training for CBT (CBT4CBT), participants were interviewed one, three, and six months after the termination of study treatments. Results Sixty of the 73 participants were reached for follow-up (82%); follow up rates and availability of data were comparable across treatment conditions. Random regression analyses of use across time indicated significant differences between groups, such that those assigned to TAU increased their drug use across time while those assigned to CBT4CBT tended to improve slightly. The durability of the CBT4CBT effect remained even after controlling for treatment retention, treatment substance use outcomes, and exposure to other treatment during the follow-up period. Conclusions Computerized CBT4CBT appears to have both short-term and enduring effects on drug use. PMID:19041197

  18. The efficiency of government supervision

    International Nuclear Information System (INIS)

    Paetzold, H.

    1992-01-01

    In 1970, fires as events initiating plant failure were included in the accident analyses of nuclear power plant design concepts. In the meantime, they have been expressed in more precise terms and incorporated into the bodies of nuclear technical rules and regulations. Following a suggestion by the Baden-Wuerttemberg State Ministry for the Environment, the efficiency of government supervision has been examined for the example of fire protection measures or the site of Phillipsburg with one BWR and one PWR plant in operation. The result of the examination indicated that pragmatic approaches and the establishment of key areas of supervision could further enhance the efficiency of government supervision under Section 19 of the German Atomic Energy Act and achieve improvements in plant safety. (orig.) [de

  19. 48 CFR 852.236-78 - Government supervision.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Government supervision. 852.236-78 Section 852.236-78 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of Provisions and Clauses 852.236-78 Government supervision. As prescribed in...

  20. Task sharing in rural Haiti: Qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers

    Science.gov (United States)

    McLean, Kristen E; Kaiser, Bonnie N; Hagaman, Ashley K; Wagenaar, Bradley H; Therosme, Tatiana P; Kohrt, Brandon A

    2015-01-01

    Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery, and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased confidence regarding utilising skills, and career advancement. Qualitative findings support the added value of apprenticeship according to trainees. PMID:26190953

  1. 25 CFR 213.43 - Relinquishment of Government supervision.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Relinquishment of Government supervision. 213.43 Section 213.43 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF RESTRICTED LANDS OF MEMBERS OF FIVE CIVILIZED TRIBES, OKLAHOMA, FOR MINING Removal of Restrictions § 213.43 Relinquishment of Government supervision....

  2. Training community matrons in basic cognitive behavioural therapy-based techniques for patients with COPD.

    Science.gov (United States)

    Barker, David; Davies, Caroline; Dixon, Brendan; Hodgson, Amanda; Reay, Simon; Barclay, Nicola

    2014-06-01

    People with chronic obstructive pulmonary disease (COPD) experience anxiety and depression with a higher prevalence than the general population. Despite this, they are under-represented in mental health services on a national scale, but do regularly have contact with health-care professionals such as community matrons. We aimed to explore the process of CBT-based skills supervision and the practical implications for community matrons using CBT-based techniques with COPD clients as part of their standard practice. Twenty community matrons took part in a 2-day CBT-based skills training programme. Measurements of their knowledge and understanding of CBT-based skills were taken before and following the training. Additionally, they completed written feedback relating to the training. They were then supervised by CBT therapists for 6 months. Written feedback was obtained following this and some supervisors participated in a 1-hour focus group to discuss the process. Community matrons' knowledge and understanding of CBT-based techniques significantly improved following training, although findings did indicate that merely training did not always seamlessly translate into effective practice. Supervisor feedback suggested that it would be beneficial for community matrons to share positive practice of their use of basic CBT-based techniques among peers to maximise the perceived value of this approach.

  3. Defeating abusive supervision: Training supervisors to support subordinates.

    Science.gov (United States)

    Gonzalez-Morales, M Gloria; Kernan, Mary C; Becker, Thomas E; Eisenberger, Robert

    2018-04-01

    Although much is known about the antecedents and consequences of abusive supervision, scant attention has been paid to investigating procedures to reduce its frequency. We conducted a quasiexperiment to examine the effects of supervisor support training on subordinate perceptions of abusive supervision and supervisor support. Supervisors (n = 23) in 4 restaurants were trained in 4 supportive supervision strategies (benevolence, sincerity, fairness, and experiential processing) during 4 2-hr sessions over a period of 2 months. We compared perceived supervisor support and abusive supervision before and 9 months after training for 208 employees whose supervisors received support training and 241 employees in 4 similar control restaurants. Compared to employees in the control restaurants, employees whose supervisors received the support training reported higher levels of perceived supervisor support and less abusive supervision. These findings suggest that a relatively brief training program can help managers become more supportive and less abusive. Theoretical and practical implications for effectively managing abusive supervision are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  4. Competence feedback improves CBT competence in trainee therapists: A randomized controlled pilot study.

    Science.gov (United States)

    Weck, Florian; Kaufmann, Yvonne M; Höfling, Volkmar

    2017-07-01

    The development and improvement of therapeutic competencies are central aims in psychotherapy training; however, little is known about which training interventions are suitable for the improvement of competencies. In the current pilot study, the efficacy of feedback regarding therapeutic competencies was investigated in cognitive behavioural therapy (CBT). Totally 19 trainee therapists and 19 patients were allocated randomly to a competence feedback group (CFG) or control group (CG). Two experienced clinicians and feedback providers who were blind to the treatment conditions independently evaluated therapeutic competencies on the Cognitive Therapy Scale at five treatment times (i.e., at Sessions 1, 5, 9, 13, and 17). Whereas CFG and CG included regular supervision, only therapists in the CFG additionally received written qualitative and quantitative feedback regarding their demonstrated competencies in conducting CBT during treatment. We found a significant Time × Group interaction effect (η² = .09), which indicates a larger competence increase in the CFG in comparison to the CG. Competence feedback was demonstrated to be suitable for the improvement of therapeutic competencies in CBT. These findings may have important implications for psychotherapy training, clinical practice, and psychotherapy research. However, further research is necessary to ensure the replicability and generalizability of the findings.

  5. Engagement in Trauma-Specific CBT for Youth Post-9/11

    Science.gov (United States)

    Rodriguez, James; Hoagwood, Kimberly Eaton; Gopalan, Geetha; Olin, Serene; McKay, Mary M.; Marcus, Sue M.; Radigan, Marleen; Chung, Michelle; Legerski, Joanna

    2013-01-01

    Treatment participation was examined among youth enrolled in an evaluation of cognitive behavioral therapy (CBT) for trauma following the 9/11 World Trade Center disaster. Staff at nine agencies serving a predominantly low-income, ethnically diverse population were trained to deliver CBT and structured engagement strategies. A total of 445 youth…

  6. Integrating Research, Theory-Building, Training, and Practice in CBT Group Therapy for Children and Adolescents with anxiety

    DEFF Research Database (Denmark)

    Thastum, Mikael

    This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents. The res......This presentation will describe how the model developed in Esben Hougaard's Adult CBT Therapy Program at Aarhus University - which integrates research, theory-building, training, and practice - has beenadapted to work with children and adolescents with anxiety disorders and their parents....... The resulting Youth CBT Therapy Program at Aarhus is organized around a short-term, 10-session, evidence-based, manualized, family-based, cognitive behavioral therapy (CBT) group program, called "Cool Kids" for children and "Chilled Adolescents" for adolescents, and derived from Ronald Rapee's work in Australia....... A distinctive aspect of the work of the Youth CBT Therapy Program is their incorporation of a case-study perspective into a series of group designs, including:(a) a randomized treatment vs. waitlist-control efficacy study (n=120); (b) an open, naturalistic effectiveness study of the program in two mental health...

  7. CBT competence in novice therapists improves anxiety outcomes.

    Science.gov (United States)

    Brown, Lily A; Craske, Michelle G; Glenn, Daniel E; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy; Bystritsky, Alexander; Welch, Stacy S; Campbell-Sills, Laura; Lang, Ariel; Roy-Byrne, Peter; Rose, Raphael D

    2013-02-01

    This study explores the relationships between therapist variables (cognitive behavioral therapy [CBT] competence, and CBT adherence) and clinical outcomes of computer-assisted CBT for anxiety disorders delivered by novice therapists in a primary care setting. Participants were recruited for a randomized controlled trial of evidence-based treatment, including computer-assisted CBT, versus treatment as usual. Therapists (anxiety clinical specialists; ACSs) were nonexpert clinicians, many of whom had no prior experience in delivering psychotherapy (and in particular, very little experience with CBT). Trained raters reviewed randomly selected treatment sessions from 176 participants and rated therapists on measures of CBT competence and CBT adherence. Patients were assessed at baseline and at 6-, 12-, and 18-month follow-ups on measures of anxiety, depression, and functioning, and an average Reliable Change Index was calculated as a composite measure of outcome. CBT competence and CBT adherence were entered as predictors of outcome, after controlling for baseline covariates. Higher CBT competence was associated with better clinical outcomes whereas CBT adherence was not. Also, CBT competence was inversely correlated with years of clinical experience and trended (not significantly, though) down as the study progressed. CBT adherence was inversely correlated with therapist tenure in the study. Therapist competence was related to improved clinical outcomes when CBT for anxiety disorders was delivered by novice clinicians with technology assistance. The results highlight the value of the initial training for novice therapists as well as booster training to limit declines in therapist adherence. © 2012 Wiley Periodicals, Inc.

  8. Can Competency-Based Training Fly?: An Overview of Key Issues for "Ab Initio" Pilot Training

    Science.gov (United States)

    Franks, Peter; Hay, Stephen; Mavin, Tim

    2014-01-01

    Competency-based training (CBT) for pilots was formally introduced in 1999 by the Civil Aviation Safety Authority (CASA) for training leading to the issue of aeroplane private and commercial pilot licences. This initiative followed the Australian government's introduction of CBT policy for vocational and workplace training in the late 1980's.…

  9. Computer-based training (CBT) intervention reduces workplace violence and harassment for homecare workers.

    Science.gov (United States)

    Glass, Nancy; Hanson, Ginger C; Anger, W Kent; Laharnar, Naima; Campbell, Jacquelyn C; Weinstein, Marc; Perrin, Nancy

    2017-07-01

    The study examines the effectiveness of a workplace violence and harassment prevention and response program with female homecare workers in a consumer driven model of care. Homecare workers were randomized to either; computer based training (CBT only) or computer-based training with homecare worker peer facilitation (CBT + peer). Participants completed measures on confidence, incidents of violence, and harassment, health and work outcomes at baseline, 3, 6 months post-baseline. Homecare workers reported improved confidence to prevent and respond to workplace violence and harassment and a reduction in incidents of workplace violence and harassment in both groups at 6-month follow-up. A decrease in negative health and work outcomes associated with violence and harassment were not reported in the groups. CBT alone or with trained peer facilitation with homecare workers can increase confidence and reduce incidents of workplace violence and harassment in a consumer-driven model of care. © 2017 Wiley Periodicals, Inc.

  10. Computer-assisted delivery of cognitive-behavioral therapy for addiction: a randomized trial of CBT4CBT.

    Science.gov (United States)

    Carroll, Kathleen M; Ball, Samuel A; Martino, Steve; Nich, Charla; Babuscio, Theresa A; Nuro, Kathryn F; Gordon, Melissa A; Portnoy, Galina A; Rounsaville, Bruce J

    2008-07-01

    This study evaluated the efficacy of a computer-based version of cognitive-behavioral therapy (CBT) for substance dependence. This was a randomized clinical trial in which 77 individuals seeking treatment for substance dependence at an outpatient community setting were randomly assigned to standard treatment or standard treatment with biweekly access to computer-based training in CBT (CBT4CBT) skills. Treatment retention and data availability were comparable across the treatment conditions. Participants assigned to the CBT4CBT condition submitted significantly more urine specimens that were negative for any type of drugs and tended to have longer continuous periods of abstinence during treatment. The CBT4CBT program was positively evaluated by participants. In the CBT4CBT condition, outcome was more strongly associated with treatment engagement than in treatment as usual; furthermore, completion of homework assignments in CBT4CBT was significantly correlated with outcome and a significant predictor of treatment involvement. These data suggest that CBT4CBT is an effective adjunct to standard outpatient treatment for substance dependence and may provide an important means of making CBT, an empirically validated treatment, more broadly available.

  11. New developments in technology-assisted supervision and training: a practical overview.

    Science.gov (United States)

    Rousmaniere, Tony; Abbass, Allan; Frederickson, Jon

    2014-11-01

    Clinical supervision and training are now widely available online. In this article, three of the most accessible and widely adopted new developments in clinical supervision and training technology are described: Videoconference supervision, cloud-based file sharing software, and clinical outcome tracking software. Partial transcripts from two online supervision sessions are provided as examples of videoconference-based supervision. The benefits and limitations of technology in supervision and training are discussed, with an emphasis on supervision process, ethics, privacy, and security. Recommendations for supervision practice are made, including methods to enhance experiential learning, the supervisory working alliance, and online security. © 2014 Wiley Periodicals, Inc.

  12. A semi-supervised learning approach for RNA secondary structure prediction.

    Science.gov (United States)

    Yonemoto, Haruka; Asai, Kiyoshi; Hamada, Michiaki

    2015-08-01

    RNA secondary structure prediction is a key technology in RNA bioinformatics. Most algorithms for RNA secondary structure prediction use probabilistic models, in which the model parameters are trained with reliable RNA secondary structures. Because of the difficulty of determining RNA secondary structures by experimental procedures, such as NMR or X-ray crystal structural analyses, there are still many RNA sequences that could be useful for training whose secondary structures have not been experimentally determined. In this paper, we introduce a novel semi-supervised learning approach for training parameters in a probabilistic model of RNA secondary structures in which we employ not only RNA sequences with annotated secondary structures but also ones with unknown secondary structures. Our model is based on a hybrid of generative (stochastic context-free grammars) and discriminative models (conditional random fields) that has been successfully applied to natural language processing. Computational experiments indicate that the accuracy of secondary structure prediction is improved by incorporating RNA sequences with unknown secondary structures into training. To our knowledge, this is the first study of a semi-supervised learning approach for RNA secondary structure prediction. This technique will be useful when the number of reliable structures is limited. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Does training frequency and supervision affect compliance, performance and muscular health?

    DEFF Research Database (Denmark)

    Dalager, Tina; Bredahl, Thomas G V; Pedersen, Mogens Theisen

    2015-01-01

    The aim was to determine the effect of one weekly hour of specific strength training within working hours, performed with the same total training volume but with different training frequencies and durations, or with different levels of supervision, on compliance, muscle health and performance......, behavior and work performance. In total, 573 office workers were cluster-randomized to: 1WS: one 60-min supervised session/week, 3WS: three 20-min supervised sessions/week, 9WS: nine 7-min supervised sessions/week, 3MS: three 20-min sessions/week with minimal supervision, or REF: a reference group without...... training. Outcomes were diary-based compliance, total training volume, muscle performance and questionnaire-based health, behavior and work performance. Comparisons were made among the WS training groups and between 3WS and 3MS. If no difference, training groups were collapsed (TG) and compared with REF...

  14. The supervisor as gender analyst: feminist perspectives on group supervision and training.

    Science.gov (United States)

    Schoenholtz-Read, J

    1996-10-01

    Supervision and training groups have advantages over dyadic supervision and training that include factors to promote group learning and interaction within a sociocultural context. This article focuses on the gender aspects of group supervision and training. It provides a review of feminist theoretical developments and presents their application to group supervision and training in the form of eight guidelines that are illustrated by clinical examples.

  15. Development and Validation of the Negative Attitudes towards CBT Scale.

    Science.gov (United States)

    Parker, Zachary J; Waller, Glenn

    2017-11-01

    Clinicians commonly fail to use cognitive behavioural therapy (CBT) adequately, but the reasons for such omissions are not well understood. The objective of this study was to create and validate a measure to assess clinicians' attitudes towards CBT - the Negative Attitudes towards CBT Scale (NACS). The participants were 204 clinicians from various mental healthcare fields. Each completed the NACS, measures of anxiety and self-esteem, and a measure of therapists' use of CBT and non-CBT techniques and their confidence in using those techniques. Exploratory factor analysis was used to determine the factor structure of the NACS, and scale internal consistency was tested. A single, 16-item scale emerged from the factor analysis of the NACS, and that scale had good internal consistency. Clinicians' negative attitudes and their anxiety had different patterns of association with the use of CBT and other therapeutic techniques. The findings suggest that clinicians' attitudes and emotions each need to be considered when understanding why many clinicians fail to deliver the optimum version of evidence-based CBT. They also suggest that training effective CBT clinicians might depend on understanding and targeting such internal states.

  16. Modernization of personnel training

    International Nuclear Information System (INIS)

    Haferburg, M.; Rehn, H.

    1997-01-01

    Personnel training in German nuclear power plants adheres to high standards complying with government regulations. The development of PC technology allows the introduction of new training methods, e.g. computer based training (CBT), as well as their integration into existing systems. In Germany, the operators of nuclear power plants have developed their own computer based standards with a screen design, a hardware platform and an assessment standard. 25% of the theoretical training of the shift personnel is covered by CBT. The CBT-Programmes offer multimedia features: videos, photographs, sound, graphs and switching diagrams of existing systems, practice oriented simulations and 3-D animations. Interaction is the most important attribute of an efficient self-learning-programme. A typical example of such an appropriate theme is the CBT-Lesson ''Pressure Surges in Pipes and Components of Power Plants''. (author)

  17. ADMINISTRATIVE SUPERVISION OF LOCAL SELF-GOVERNMENT IN THE BALTIC STATES: A COMPARATIVE VIEW

    Directory of Open Access Journals (Sweden)

    VIOLETA KIURIENÉ

    2015-12-01

    Full Text Available The article analyses models of administrative supervision of local self-government in the Baltic States (Latvia, Lithuania, Estonia highlighting the advantages and disadvantages of these models. The research done in this article defines the theoretical concept of administrative supervision of local self-government; gives an overview of the legislative framework underpining the key administrative supervision bodies of local self-government in the Baltic States; discusses the issue of legal regulation and the present state of administrative supervision over local self-government units in the Baltic States; gives some theoretical and practical suggestions to develop this field in the Baltic States.The research methods employed in preparation of this article are theoretical methods of analysis of scientific literature and sources, legal acts and documents as well as comparative and logical analysis, induction and generalisation. Three Baltic States similar in their area, number of inhabitants, and governmental peculiarities have been chosen for the analysis.

  18. Effectiveness of cognitive behaviour therapy for treatment-resistant depression with psychiatric comorbidity: comparison of individual versus group CBT in an interdisciplinary rehabilitation setting.

    Science.gov (United States)

    Hauksson, Pétur; Ingibergsdóttir, Sylvía; Gunnarsdóttir, Thórunn; Jónsdóttir, Inga Hrefna

    2017-08-01

    Cognitive behaviour therapy (CBT) has been shown to be effective, yet there is a paucity of research on the differential effectiveness of individual and group CBT for adults with treatment-resistant depression with psychiatric comorbidity. To investigate the effectiveness of individual and group CBT for inpatients, in an interdisciplinary rehabilitation setting; the extent of psychiatric comorbidity; and who benefits the most from group CBT. All patients (n = 181) received 6 weeks of rehabilitation (treatment as usual, TAU). In addition, they were randomly allocated to group CBT (n = 86) or individual CBT (n = 59) combined with TAU, or TAU only (n = 36). All CBT therapists were part of an interdisciplinary team, had at least 1-year CBT training, and attended weekly supervision. The same CBT manual was used for individual and group therapy, providing 12 sessions, two per week. Groups had 12-15 participants and two therapists in each session. Individual CBT was superior in efficacy to group CBT and TAU, with a large within-subject effect size (ES = 2.10). Group CBT was not superior to TAU. The benefits of treatment decreased over time, but remained large at 18-month follow-up for individual CBT (ES = 1.02), and medium for group CBT (ES = 0.46) and TAU (ES = 0.60). Individual CBT was an effective addition to TAU and showed significant improvements in symptom severity post-treatment and at 18-month follow-up. Disorder severity and comorbidity may have decreased effectiveness of group therapy primarily aimed at depression.

  19. A qualitative investigation of the nature of "informal supervision" among therapists in training.

    Science.gov (United States)

    Coren, Sidney; Farber, Barry A

    2017-11-29

    This study investigated how, when, why, and with whom therapists in training utilize "informal supervision"-that is, engage individuals who are not their formally assigned supervisors in significant conversations about their clinical work. Participants were 16 doctoral trainees in clinical and counseling psychology programs. Semi-structured interviews were conducted and analyzed using the Consensual Qualitative Research (CQR) method. Seven domains emerged from the analysis, indicating that, in general, participants believe that informal and formal supervision offer many of the same benefits, including validation, support, and reassurance; freedom and safety to discuss doubts, anxieties, strong personal reactions to patients, clinical mistakes and challenges; and alternative approaches to clinical interventions. However, several differences also emerged between these modes of learning-for example, formal supervision is seen as more focused on didactics per se ("what to do"), whereas informal supervision is seen as providing more of a "holding environment." Overall, the findings of this study suggest that informal supervision is an important and valuable adjunctive practice by which clinical trainees augment their professional competencies. Recommendations are proposed for clinical practice and training, including the need to further specify the ethical boundaries of this unique and essentially unregulated type of supervision.

  20. Isocyanate toughening of pCBT/organoclay nanocomposites with exfoliated structure and enhanced mechanical properties

    Directory of Open Access Journals (Sweden)

    T. Abt

    2014-12-01

    Full Text Available Cyclic butylene terephthalate (CBT® is an interesting matrix material for the preparation of nanocomposites due to its very low, water-like melt viscosity which favours clay exfoliation. Nevertheless, polymerized CBT (pCBT is inherently brittle. This paper reports the preparation of isocyanate-toughened nanocomposites made from CBT and organo-modified montmorillonite. The role of the organoclay as reinforcement and the polymeric isocyanate (PMDI as toughening agent on the properties of pCBT was studied. The organoclay increased the stiffness and strength by up to 20% whereas the PMDI improved the deformation behaviour. However, the PMDI did not affect the degree of clay dispersion or exfoliation and flocculated-intercalated structures were observed. The compatibility between the pCBT matrix and clay was further increased by preparing PMDI-tethered intercalated organoclay. The modified organoclay then exfoliated during ring-opening polymerization and yielded true pCBT/clay nanocomposites. This work demonstrates that reactive chain extension of CBT with a polyfunctional isocyanate is an effective method to obtain toughened pCBT nanocomposites. Moreover, isocyanates can enhance the compatibility between pCBT and nanofiller as well as the degree of exfoliation.

  1. Studi Evaluasi Penerapan Community Based Tourism (CBT) Sebagai Pendukung Agrowisata Berkelanjutan

    OpenAIRE

    Nurhidayati, Sri Endah

    2015-01-01

    The role of government in the development of Community Based Tourism (CBT) is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1) describe the government's perception of the Community Based Tourism (CBT) development, (2) identifying government policies to support the Community Based Tourism...

  2. Studi evaluasi penerapan Community Based Tourism (CBT) sebagai pendukung agrowisata berkelanjutan

    OpenAIRE

    Sri Endah Nurhidayati

    2015-01-01

    The role of government in the development of Community Based Tourism (CBT) is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1) describe the government's perception of the  Community Based Tourism (CBT) development, (2) identifying government policies to support the Community Based Tourism...

  3. To evaluate if increased supervision and support of South African Government health workers' home visits improves maternal and child outcomes: study protocol for a randomized control trial.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Le Roux, Karl; Le Roux, Ingrid M; Christodoulou, Joan; Laurenzi, Christina; Mbewu, Nokwanele; Tomlinson, Mark

    2017-08-07

    Concurrent epidemics of HIV, depression, alcohol abuse, and partner violence threaten maternal and child health (MCH) in South Africa. Although home visiting has been repeatedly demonstrated efficacious in research evaluations, efficacy disappears when programs are scaled broadly. In this cluster randomized controlled trial (RCT), we examine whether the benefits of ongoing accountability and supervision within an existing government funded and implemented community health workers (CHW) home visiting program ensure the effectiveness of home visiting. In the deeply rural, Eastern Cape of South Africa, CHW will be hired by the government and will be initially trained by the Philani Programme to conduct home visits with all pregnant mothers and their children until the children are 2 years old. Eight clinics will be randomized to receive either (1) the Accountable Care Condition in which additional monitoring and accountability systems that Philani routinely uses are implemented (4 clinics, 16 CHW, 450 households); or (2) a Standard Care Condition of initial Philani training, but with supervision and monitoring being delivered by local government structures and systems (4 clinics, 21 CHW, 450 households). In the Accountable Care Condition areas, the CHW's mobile phone reports, which are time-location stamped, will be monitored and data-informed supervision will be provided, as well as monitoring growth, medical adherence, mental health, and alcohol use outcomes. Interviewers will independently assess outcomes at pregnancy at 3, 6, 15, and 24 months post-birth. The primary outcome will be a composite score of documenting maternal HIV/TB testing, linkage to care, treatment adherence and retention, as well as child physical growth, cognitive functioning, and child behavior and developmental milestones. The proposed cluster RCT will evaluate whether routinely implementing supervision and accountability procedures and monitoring CHWs' over time will improve MCH outcomes

  4. Twelve tips on how to set up postgraduate training via remote clinical supervision

    DEFF Research Database (Denmark)

    Wearne, Susan; Dornan, Tim; Teunissen, Pim W.

    2013-01-01

    Doctors-in-training can now be supervised remotely by specialist clinicians using information and communication technology. This provides an intermediate stage of professional development between on-site supervision and independent medical practice. Remote supervision could increase training capa...

  5. Urgency of Community Supervision Organization by Government

    Directory of Open Access Journals (Sweden)

    Catur Wibowo Budi Santoso

    2015-03-01

    Full Text Available Urgency Surveillance Study of Social Organization aims to describe the reality of the problems in the a real of Social Organization; describe the implementation of the role of government (including local government in controlling the Social Organization; and provider recommendations on matters that need to be regulated in the draft regulations on the supervision of organizations. This study used a qualitative approach, with the aim that can be obtained in-depth and complete information about matters relating to the existence and dynamics in regional organizations. The study results presented can be: that on the one hand the existence of organizations that do not contribute little in development, but on the other hand there are many community organizations that act an archaic and disturbing in society; for the entire operational provisions for the implementation of Social Organization must be available; things that need to be arranged substantially in the surveillance by the government.

  6. Enhancing Self-Practice/Self-Reflection (SP/SR) approach to cognitive behaviour training through the use of reflective blogs.

    Science.gov (United States)

    Farrand, Paul; Perry, Jon; Linsley, Sue

    2010-07-01

    Self-Practice/Self-Reflection (SP/SR) is increasingly beginning to feature as a central component of CBT training programmes (Bennett-Levy et al., 2001). Programmes including a reflective element, however, are not unproblematic and it has been documented that simply setting time aside for reflection does not necessarily result in trainees using such time to reflect. Such limitations may be overcome by including a requirement to post reflections on reflective blogs. To examine the effect that a requirement to contribute to a reflective blog had upon a SP/SR approach to CBT training. A focus group methodology was adopted with data analyzed using a general inductive qualitative approach. The requirement to use blogs to reflect upon the self-practice of CBT techniques enhanced SP/SR, established a learning community, and improved course supervision, although some technical difficulties arose. Consideration should be given towards using reflective blogs to support a SP/SR approach to CBT training. Benefits afforded by the use of reflective blogs further establish SP/SR as a valid and flexible training approach.

  7. The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review.

    Science.gov (United States)

    Alfonsson, Sven; Parling, Thomas; Spännargård, Åsa; Andersson, Gerhard; Lundgren, Tobias

    2018-05-01

    Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists' competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists' competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists' competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.

  8. Pervasive Sound Sensing: A Weakly Supervised Training Approach.

    Science.gov (United States)

    Kelly, Daniel; Caulfield, Brian

    2016-01-01

    Modern smartphones present an ideal device for pervasive sensing of human behavior. Microphones have the potential to reveal key information about a person's behavior. However, they have been utilized to a significantly lesser extent than other smartphone sensors in the context of human behavior sensing. We postulate that, in order for microphones to be useful in behavior sensing applications, the analysis techniques must be flexible and allow easy modification of the types of sounds to be sensed. A simplification of the training data collection process could allow a more flexible sound classification framework. We hypothesize that detailed training, a prerequisite for the majority of sound sensing techniques, is not necessary and that a significantly less detailed and time consuming data collection process can be carried out, allowing even a nonexpert to conduct the collection, labeling, and training process. To test this hypothesis, we implement a diverse density-based multiple instance learning framework, to identify a target sound, and a bag trimming algorithm, which, using the target sound, automatically segments weakly labeled sound clips to construct an accurate training set. Experiments reveal that our hypothesis is a valid one and results show that classifiers, trained using the automatically segmented training sets, were able to accurately classify unseen sound samples with accuracies comparable to supervised classifiers, achieving an average F -measure of 0.969 and 0.87 for two weakly supervised datasets.

  9. The Spiritual Genogram in Training and Supervision.

    Science.gov (United States)

    Frame, Marsha Wiggins

    2001-01-01

    Describes the spiritual genogram, a blueprint of family members' multigenerational religious and spiritual affiliations, events, and conflicts. Used as a tool in both training and supervision, the spiritual genogram enables students and supervisees to make sense of their own religious and spiritual heritage and to explore the ways in which their…

  10. The effectiveness of internet cognitive behaviour therapy (iCBT for social anxiety disorder across two routine practice pathways

    Directory of Open Access Journals (Sweden)

    Alishia D. Williams

    2014-10-01

    Full Text Available Social anxiety disorder (SAD is a common, chronic and disabling mental disorder. Cognitive Behaviour Therapy (CBT is a highly effective treatment of SAD and internet CBT (iCBT offers a cost-effective and convenient alternative to face to face approaches, with high fidelity and demonstrated efficacy. The aim of the current paper was to evaluate the effectiveness of an iCBT programme for SAD (The This Way Up Clinic Shyness Programme when delivered in routine practice through two different pathways. Patients in the prescription pathway (Study 1, N = 368, 50% female, mean age = 34 were ‘prescribed’ the Shyness Programme by a registered practitioner of the This Way Up Clinic who supervised their progress throughout the programme. Patients in the referral pathway (Study 2, N = 192, 50% female, mean age = 36 were referred to the This Way Up Clinic and supervised by a specialist CBT clinician at the clinic. Intention-to-treat marginal model analyses demonstrated significant reductions in primary outcomes of social anxiety symptoms (Mini-SPIN and psychological distress (K10, corresponding to large effect sizes (Cohen's d = .82–1.09, 95% CIs .59–1.31 and secondary outcomes of impairment (WHODAS-II and depressive symptoms (PHQ9, corresponding to small effect sizes (Cohen's d = .36–.46, 95% CIs .19–.68 for patients in both pathways. Results provide evidence of the effectiveness of iCBT for social anxiety disorder when delivered in routine practice.

  11. Learning outcomes using video in supervision and peer feedback during clinical skills training

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; Toftgård, Rie Castella; Nørgaard, Cita

    supervision of clinical skills (formative assessment). Demonstrations of these principles will be presented as video podcasts during the session. The learning outcomes of video supervision and peer-feedback were assessed in an online questionnaire survey. Results Results of the supervision showed large self......Objective New technology and learning principles were introduced in a clinical skills training laboratory (iLab). The intension was to move from apprenticeship to active learning principles including peer feedback and supervision using video. The objective of this study was to evaluate student...... learning outcomes in a manual skills training subject using video during feedback and supervision. Methods The iLab classroom was designed to fit four principles of teaching using video. Two of these principles were (a) group work using peer-feedback on videos produced by the students and, (b) video...

  12. Informal sources of supervision in clinical training.

    Science.gov (United States)

    Farber, Barry A; Hazanov, Valery

    2014-11-01

    Although formal, assigned supervision is a potent source of learning and guidance for psychotherapy trainees, many beginning psychotherapists use other, informal sources of supervision or consultation for advice and support. Results of an online survey of beginning trainees (N = 146) indicate that other than their formally assigned supervisor, trainees most often consult with colleagues in their program, their own psychotherapist, and their significant other; that they're most likely to seek these other sources of help when they're feeling stuck or feel they've made a clinical mistake; that they do so because they need extra reassurance and suggestions; that they feel the advice given from these sources is helpful; and that they don't especially regret sharing this information. Several case examples are used to illustrate these points. Discussing clinical material with informal sources is, apparently, a great deal more common than typically acknowledged, and as such, has implications for training programs (including discussions of ethics) and formal supervision. © 2014 Wiley Periodicals, Inc.

  13. Transfer of communication skills training from workshop to workplace: the impact of clinical supervision.

    Science.gov (United States)

    Heaven, Cathy; Clegg, Jenny; Maguire, Peter

    2006-03-01

    Recent studies have recognised that the communication skills learned in the training environment are not always transferred back into the clinical setting. This paper reports a study which investigated the potential of clinical supervision in enhancing the transfer process. A randomised controlled trial was conducted involving 61 clinical nurse specialists. All attended a 3-day communication skills training workshop. Twenty-nine were then randomised to 4 weeks of clinical supervision, aimed at facilitating transfer of newly acquired skills into practice. Assessments, using real and simulated patients, were carried out before the course, immediately after the supervision period and 3 months later. Interviews were rated objectively using the Medical Interview Aural Rating Scale (MIARS) to assess nurses' ability to use key skills, respond to patient cues and identify patient concerns. Assessments with simulated patients showed that the training programme was extremely effective in changing competence in all three key areas. However, only those who experienced supervision showed any evidence of transfer. Improvements were found in the supervised groups' use of open questions, negotiation and psychological exploration. Whilst neither group facilitated more disclosure of cues or concerns, those in the experimental group responded more effectively to the cues disclosed, reduced their distancing behaviour and increasing their exploration of cues. The study has shown that whilst training enhances skills, without intervention, it may have little effect on clinical practice. The potential role of clinical supervision as one way of enhancing the clinical effectiveness of communication skills training programmes has been demonstrated. PRACTISE IMPLICATIONS: This study raises questions about the effectiveness of training programmes which do not incorporate a transfer element, and provides evidence to support the need for clinical supervision for clinical nurse specialist.

  14. A Novel Semi-Supervised Electronic Nose Learning Technique: M-Training

    Directory of Open Access Journals (Sweden)

    Pengfei Jia

    2016-03-01

    Full Text Available When an electronic nose (E-nose is used to distinguish different kinds of gases, the label information of the target gas could be lost due to some fault of the operators or some other reason, although this is not expected. Another fact is that the cost of getting the labeled samples is usually higher than for unlabeled ones. In most cases, the classification accuracy of an E-nose trained using labeled samples is higher than that of the E-nose trained by unlabeled ones, so gases without label information should not be used to train an E-nose, however, this wastes resources and can even delay the progress of research. In this work a novel multi-class semi-supervised learning technique called M-training is proposed to train E-noses with both labeled and unlabeled samples. We employ M-training to train the E-nose which is used to distinguish three indoor pollutant gases (benzene, toluene and formaldehyde. Data processing results prove that the classification accuracy of E-nose trained by semi-supervised techniques (tri-training and M-training is higher than that of an E-nose trained only with labeled samples, and the performance of M-training is better than that of tri-training because more base classifiers can be employed by M-training.

  15. Predicting protein complexes using a supervised learning method combined with local structural information.

    Science.gov (United States)

    Dong, Yadong; Sun, Yongqi; Qin, Chao

    2018-01-01

    The existing protein complex detection methods can be broadly divided into two categories: unsupervised and supervised learning methods. Most of the unsupervised learning methods assume that protein complexes are in dense regions of protein-protein interaction (PPI) networks even though many true complexes are not dense subgraphs. Supervised learning methods utilize the informative properties of known complexes; they often extract features from existing complexes and then use the features to train a classification model. The trained model is used to guide the search process for new complexes. However, insufficient extracted features, noise in the PPI data and the incompleteness of complex data make the classification model imprecise. Consequently, the classification model is not sufficient for guiding the detection of complexes. Therefore, we propose a new robust score function that combines the classification model with local structural information. Based on the score function, we provide a search method that works both forwards and backwards. The results from experiments on six benchmark PPI datasets and three protein complex datasets show that our approach can achieve better performance compared with the state-of-the-art supervised, semi-supervised and unsupervised methods for protein complex detection, occasionally significantly outperforming such methods.

  16. Supervised Exercise Training Counterbalances the Adverse Effects of Insulin Therapy in Overweight/Obese Subjects With Type 2 Diabetes

    OpenAIRE

    Balducci, Stefano; Zanuso, Silvano; Cardelli, Patrizia; Salerno, Gerardo; Fallucca, Sara; Nicolucci, Antonio; Pugliese, Giuseppe

    2011-01-01

    OBJECTIVE To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES). RESEARCH DESIGN AND METHODS The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory paramete...

  17. Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

    Science.gov (United States)

    Barnett, Jeffrey E

    2011-06-01

    Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided.

  18. Training system of knowledge society

    International Nuclear Information System (INIS)

    Ceclan, M.; Ionescu, T.B.; Ceclan, Rodica Elena; Tatar, Florin; Tiron, C.; Georgescu, Luisa Maria

    2005-01-01

    Full text: The paper aims at presenting the results of Cernavoda NPP Training Department modernization project. In order to achieve a training system of knowledge society in the first stage of the project a Computer Based Training (CBT) or E-Learning platform and several CBT objects/courses were worked out. The conceived E-Learning solution is called CBT Center and it is a complete system offering a variety of teaching and learning services to its users. CBT and/or E-Learning always mean two things: a software platform and content authoring. Ideally, a software platform should be able to import any type of flat documentation and integrate it into a structured database which keeps track of pedagogically meaningful information like the student's progress in studying materials, tests and quiz, marks, etc. At the same time, the materials, the study and the tests have to be organized around certain objectives which play the role of guidelines during the entire educational activity. An example of such a course which has been successfully integrated into CBT Center is the 'Thermodynamics'. CBT technology implementation at NPP Cernavoda Training Department has brought several advantages: the technology improves overall communication between all individuals which are part of the educational process; there is no space problem any more; students can access training materials from their own desk using the NPP intranet; the logistics problem will decrease, while more and more disciplines will be transformed as CBT objects. (authors)

  19. A Conceptual Design Model for CBT Development: A NATO Case Study

    Science.gov (United States)

    Kok, Ayse

    2014-01-01

    CBT (computer-based training) can benefit from the modern multimedia tools combined with network capabilities to overcame traditional education. The objective of this paper is focused on CBT development to improve strategic decision-making with regard to air command and control system for NATO staff in virtual environment. A conceptual design for…

  20. Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial.

    Science.gov (United States)

    Dalager, Tina; Bredahl, Thomas G V; Pedersen, Mogens T; Boyle, Eleanor; Andersen, Lars L; Sjøgaard, Gisela

    2015-10-01

    The aim was to determine the effect of one weekly hour of specific strength training within working hours, performed with the same total training volume but with different training frequencies and durations, or with different levels of supervision, on compliance, muscle health and performance, behavior and work performance. In total, 573 office workers were cluster-randomized to: 1 WS: one 60-min supervised session/week, 3 WS: three 20-min supervised sessions/week, 9 WS: nine 7-min supervised sessions/week, 3 MS: three 20-min sessions/week with minimal supervision, or REF: a reference group without training. Outcomes were diary-based compliance, total training volume, muscle performance and questionnaire-based health, behavior and work performance. Comparisons were made among the WS training groups and between 3 WS and 3 MS. If no difference, training groups were collapsed (TG) and compared with REF. Results demonstrated similar degrees of compliance, mean(range) of 39(33-44)%, and total training volume, 13.266(11.977-15.096)kg. Musculoskeletal pain in neck and shoulders were reduced with approx. 50% in TG, which was significant compared with REF. Only the training groups improved significantly their muscle strength 8(4-13)% and endurance 27(12-37)%, both being significant compared with REF. No change in workability, productivity or self-rated health was demonstrated. Secondary analysis showed exercise self-efficacy to be a significant predictor of compliance. Regardless of training schedule and supervision, similar degrees of compliance were shown together with reduced musculoskeletal pain and improved muscle performance. These findings provide evidence that a great degree of flexibility is legitimate for companies in planning future implementation of physical exercise programs at the workplace. ClinicalTrials.gov, number NCT01027390. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Reflections on the supervised relationship and interaction in nursing clinical training

    Directory of Open Access Journals (Sweden)

    Inês Alves da Rocha e Silva Rocha

    2013-05-01

    Full Text Available This reflection fits into the area of Clinical Supervision in Nursing focusing on relationships that the student develops during clinical training. It seems that in clinical training the student not only learns but also consolidates verbal, procedural and attitudinal contents. The relationship established with peers, teachers and tutors will contribute to their professional identity. It is underlined the importance of the contribution of clinical supervision for the development of a reflective thinking in students in Portugal, as highlighted here, which influences the changes in nursing practices, as well as ensuring the quality and safety of the care provided. The characteristics that the tutor must have to improve the development of the students are also explained as well as the possible solutions for the existing limitations of clinical training contexts.

  2. Knowledge society training system

    International Nuclear Information System (INIS)

    Ceclan, Mihail; Ionescu, Tudor Basarab; Ceclan, Rodica Elena; Tatar, Florin; Tiron, Cristian; Georgescu, Luisa Maria

    2005-01-01

    The paper aims to present the results of the Cernavoda NPP Training Department modernization project. In order to achieve a knowledge society training system, in the first stage of the project a Computer Based Training (CBT) or E-Learning software platform and several CBT objects/courses have been implemented. The conceived solution is called CBTCenter which is a complete E-Learning and CBT system, offering a variety of teaching and learning tools and services to its users. CBT and/or E-Learning always mean two things: a software platform and content authoring. Ideally, a software platform should be able to import any type of flat documentation and integrate it into a structured database which keeps track of pedagogically meaningful information like the student's progress in studying materials, tests and quizzes, grades, etc. At the same time, the materials, the study and the tests have to be organized around certain objectives which play the role of guidelines during the entire educational activity. An example of such a course which has been successfully integrated into CBTCenter is Labour safety - code name BB-001. The implementation of the CBT technology at NPP Cernavoda Training Department has brought several advantages: the technology improves overall communication between all individuals which take part in the educational process; the classroom space problem has been considerably reduced; students can access training materials from their own desk using the NPP intranet; the logistics problems will decrease with the conversion of more and more conventional courses and materials into CBT objects/courses. (authors)

  3. Adapting CBT for traumatized refugees and ethnic minority patients: examples from culturally adapted CBT (CA-CBT).

    Science.gov (United States)

    Hinton, Devon E; Rivera, Edwin I; Hofmann, Stefan G; Barlow, David H; Otto, Michael W

    2012-04-01

    In this article, we illustrate how cognitive behavioral therapy (CBT) can be adapted for the treatment of PTSD among traumatized refugees and ethnic minority populations, providing examples from our treatment, culturally adapted CBT, or CA-CBT. CA-CBT has a unique approach to exposure (typical exposure is poorly tolerated in these groups), emphasizes the treatment of somatic sensations (a particularly salient part of the presentation of PTSD in these groups), and addresses comorbid anxiety disorders and anger. To accomplish these treatment goals, CA-CBT emphasizes emotion exposure and emotion regulation techniques such as meditation and aims to promote emotional and psychological flexibility. We describe 12 key aspects of adapting CA-CBT that make it a culturally sensitive treatment of traumatized refugee and ethnic minority populations. We discuss three models that guide our treatment and that can be used to design culturally sensitive treatments: (a) the panic attack-PTSD model to illustrate the many processes that generate PTSD in these populations, highlighting the role of arousal and somatic symptoms; (b) the arousal triad to demonstrate how somatic symptoms are produced and the importance of targeting comorbid anxiety conditions and psychopathological processes; and (c) the multisystem network (MSN) model of emotional state to reveal how some of our therapeutic techniques (e.g., body-focused techniques: bodily stretching paired with self-statements) bring about psychological flexibility and improvement.

  4. Providing effective supervision in clinical neuropsychology.

    Science.gov (United States)

    Stucky, Kirk J; Bush, Shane; Donders, Jacobus

    2010-01-01

    A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology.

  5. Long-Term Effects of CBT on Social Impairment in Adolescents with ASD

    Science.gov (United States)

    Maddox, Brenna B.; Miyazaki, Yasuo; White, Susan W.

    2017-01-01

    Anxiety interventions involving social skills training and CBT for youth with ASD have shown promise, but few studies have examined the effects on social functioning or the maintenance of treatment gains. This study evaluated change in social skills during a randomized controlled trial of CBT and during the 1-year follow-up for 25 adolescents with…

  6. CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia.

    Science.gov (United States)

    Kuhn, Eric; Weiss, Brandon J; Taylor, Katherine L; Hoffman, Julia E; Ramsey, Kelly M; Manber, Rachel; Gehrman, Philip; Crowley, Jill J; Ruzek, Josef I; Trockel, Mickey

    2016-04-15

    This paper describes CBT-I Coach, a patient-facing smartphone app designed to enhance cognitive behavioral therapy for insomnia (CBT-I). It presents findings of two surveys of U.S. Department of Veterans Affairs (VA) CBT-I trained clinicians regarding their perceptions of CBT-I Coach before it was released (n = 138) and use of it two years after it was released (n = 176). VA-trained CBT-I clinicians completed web-based surveys before and two years after CBT-I Coach was publicly released. Prior to CBT-I Coach release, clinicians reported that it was moderately to very likely that the app could improve care and a majority (87.0%) intended to use it if it were available. Intention to use the app was predicted by smartphone ownership (β = 0.116, p CBT-I practices (β = 0.286, p CBT-I Coach became available, 59.9% of participants reported using it with patients and had favorable impressions of its impact on homework adherence and outcomes. Findings suggest that before release, CBT-I Coach was perceived to have potential to enhance CBT-I and address common adherence issues and clinicians would use it. These results are reinforced by findings two years after it was released suggesting robust uptake and favorable perceptions of its value. © 2016 American Academy of Sleep Medicine.

  7. A semi-supervised classification algorithm using the TAD-derived background as training data

    Science.gov (United States)

    Fan, Lei; Ambeau, Brittany; Messinger, David W.

    2013-05-01

    In general, spectral image classification algorithms fall into one of two categories: supervised and unsupervised. In unsupervised approaches, the algorithm automatically identifies clusters in the data without a priori information about those clusters (except perhaps the expected number of them). Supervised approaches require an analyst to identify training data to learn the characteristics of the clusters such that they can then classify all other pixels into one of the pre-defined groups. The classification algorithm presented here is a semi-supervised approach based on the Topological Anomaly Detection (TAD) algorithm. The TAD algorithm defines background components based on a mutual k-Nearest Neighbor graph model of the data, along with a spectral connected components analysis. Here, the largest components produced by TAD are used as regions of interest (ROI's),or training data for a supervised classification scheme. By combining those ROI's with a Gaussian Maximum Likelihood (GML) or a Minimum Distance to the Mean (MDM) algorithm, we are able to achieve a semi supervised classification method. We test this classification algorithm against data collected by the HyMAP sensor over the Cooke City, MT area and University of Pavia scene.

  8. The role of supervision in the training of behavior therapists: Case study

    Directory of Open Access Journals (Sweden)

    Raquel Martins Sartori

    2014-08-01

    Full Text Available The therapeutic process therapist requires skills that go beyond the theoretical and technical knowledge, the therapeutic relationship is a prerequisite for the success of behavioral psychotherapy variable. Supervision of clinical care is a fundamental skill development of the future therapist educational resource as well as to increase the supply conditions of a more appropriate psychotherapeutic customer service. The article reports on supervisory experience in the first client of a therapist in training showed behavioral patterns of aggression. The default client produced in therapist behaviors and feelings that hindered progress and therapeutic success. Supervision thus occupied a role in analyzing and modeling the behavior therapist as a strategy to increase the chances of success of the case. As a result of the strategies adopted in supervision, there were changes in the pattern of interaction between therapist and client training with his progress in the case.

  9. Blended CBT versus face-to-face CBT: a randomised non-inferiority trial.

    Science.gov (United States)

    Mathiasen, Kim; Andersen, Tonny E; Riper, Heleen; Kleiboer, Annet A M; Roessler, Kirsten K

    2016-12-05

    Internet based cognitive behavioural therapy (iCBT) has been demonstrated to be cost- and clinically effective. There is a need, however, for increased therapist contact for some patient groups. Combining iCBT with traditional face-to-face (ftf) consultations in a blended format (B-CBT) may produce a new treatment format with multiple benefits from both traditional CBT and iCBT such as individual adaptation, lower costs than traditional therapy, wide geographical and temporal availability, and possibly lower threshold to implementation. The primary aim of the present study is to compare directly the clinical effectiveness of B-CBT with face-to-face CBT for adult major depressive disorder. The study is designed as a two arm randomised controlled non-inferiority trial comparing blended CBT for adult depression with treatment as usual (TAU). In the blended condition six sessions of ftf CBT is alternated with six to eight online modules (NoDep). TAU is defined as 12 sessions of ftf CBT. The primary outcome is symptomatic change of depressive symptoms on the patient-health questionnaire (PHQ-9). Additionally, the study will include an economic evaluation. All participants must be 18 years of age or older and meet the diagnostic criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental disorders 4th edition. Participants are randomised on an individual level by a researcher not involved in the project. The primary outcome is analysed by regressing the three-month follow-up PHQ-9 data on the baseline PHQ-9 score and a treatment group indicator using ancova. A sample size of 130 in two balanced groups will yield a power of at least 80% to detect standardised mean differences above 0.5 on a normally distributed variable. This study design will compare B-CBT and ftf CBT in a concise and direct manner with only a minimal of the variance explained by differences in therapeutic content. On the other hand, while situated in routine care

  10. Cognitive bias modification versus CBT in reducing adolescent social anxiety: a randomized controlled trial.

    Science.gov (United States)

    Sportel, B Esther; de Hullu, Eva; de Jong, Peter J; Nauta, Maaike H

    2013-01-01

    Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n = 86) was compared to a school-based cognitive behavioral group training (CBT; n = 84) and a control group (n = 70) in reducing symptoms of social and test anxiety in high socially and/or test anxious adolescents aged 13-15 years. Participants (n = 240) were randomized at school level over the three conditions. CBM consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive automatic threat-related associations. TrialRegister.nl NTR965.

  11. Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Lacroix, André; Hortobágyi, Tibor; Beurskens, Rainer; Granacher, Urs

    2017-11-01

    Balance and resistance training can improve healthy older adults' balance and muscle strength. Delivering such exercise programs at home without supervision may facilitate participation for older adults because they do not have to leave their homes. To date, no systematic literature analysis has been conducted to determine if supervision affects the effectiveness of these programs to improve healthy older adults' balance and muscle strength/power. The objective of this systematic review and meta-analysis was to quantify the effectiveness of supervised vs. unsupervised balance and/or resistance training programs on measures of balance and muscle strength/power in healthy older adults. In addition, the impact of supervision on training-induced adaptive processes was evaluated in the form of dose-response relationships by analyzing randomized controlled trials that compared supervised with unsupervised trials. A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SportDiscus to detect articles examining the role of supervision in balance and/or resistance training in older adults. The initially identified 6041 articles were systematically screened. Studies were included if they examined balance and/or resistance training in adults aged ≥65 years with no relevant diseases and registered at least one behavioral balance (e.g., time during single leg stance) and/or muscle strength/power outcome (e.g., time for 5-Times-Chair-Rise-Test). Finally, 11 studies were eligible for inclusion in this meta-analysis. Weighted mean standardized mean differences between subjects (SMD bs ) of supervised vs. unsupervised balance/resistance training studies were calculated. The included studies were coded for the following variables: number of participants, sex, age, number and type of interventions, type of balance/strength tests, and change (%) from pre- to post-intervention values. Additionally, we coded training according

  12. Computer based training: Technology and trends

    International Nuclear Information System (INIS)

    O'Neal, A.F.

    1986-01-01

    Computer Based Training (CBT) offers great potential for revolutionizing the training environment. Tremendous advances in computer cost performance, instructional design science, and authoring systems have combined to put CBT within the reach of all. The ability of today's CBT systems to implement powerful training strategies, simulate complex processes and systems, and individualize and control the training process make it certain that CBT will now, at long last, live up to its potential. This paper reviews the major technologies and trends involved and offers some suggestions for getting started in CBT

  13. Clinician Perceptions Related to the Use of the CBT-I Coach Mobile App.

    Science.gov (United States)

    Miller, Katherine E; Kuhn, Eric; Owen, Jason E; Taylor, Katherine; Yu, Jessica S; Weiss, Brandon J; Crowley, Jill J; Trockel, Mickey

    2017-11-09

    Clinicians' perceptions of CBT-I Coach, a patient-facing mobile app for cognitive-behavioral therapy for insomnia (CBT-I), are critical to its adoption and integration into practice. Diffusion of innovations theory emphasizes the influence of perceptions, including the relative advantage to current practice, the compatibility to clinicians' needs, the complexity, the innovation's trialability, and observability. This study intended to evaluate the use and perceptions of CBT-I Coach among Veterans Affairs (VA)-trained CBT-I clinicians. Clinicians (N = 108) were surveyed about their use, feedback, and perceptions of CBT-I Coach a year after the app became available. Overall perceptions of CBT-I Coach were favorable. Fifty percent of clinicians reported using CBT-I Coach, with 98% intending to continue use. The app was perceived to increase sleep diary completion and homework compliance. Clinicians viewed the app as providing accessibility to helpful tools and improving patient engagement. Of those not using the app, 83% endorsed intention to use it. Reasons for nonuse were lack of patient access to smart phones, not being aware of the app, not having time to learn it, and inability to directly access app data. Those who reported using CBT-I Coach had more favorable perceptions across all constructs (p CBT-I Coach, as well as study if reported benefits can be evidenced more directly.

  14. Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder

    DEFF Research Database (Denmark)

    Arnfred, Sidse Marie Hemmingsen; Aharoni, Ruth; Pedersen, Morten Hvenegaard

    2017-01-01

    Background: Transdiagnostic Cognitive Behavior Therapy (TCBT) manuals delivered in individual format have been reported to be just as effective as traditional diagnosis specific CBT manuals. We have translated and modified the “The Unified Protocol for Transdiagnostic Treatment of Emotional...... Disorders” (UP-CBT) for group delivery in Mental Health Service (MHS), and shown effects comparable to traditional CBT in a naturalistic study. As the use of one manual instead of several diagnosis-specific manuals could simplify logistics, reduce waiting time, and increase therapist expertise compared...... to diagnosis specific CBT, we aim to test the relative efficacy of group UP-CBT and diagnosis specific group CBT. Methods/design: The study is a partially blinded, pragmatic, non-inferiority, parallel, multi-center randomized controlled trial (RCT) of UP-CBT vs diagnosis specific CBT for Unipolar Depression...

  15. Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation.

    Science.gov (United States)

    Hinton, Devon E; Hofmann, Stefan G; Rivera, Edwin; Otto, Michael W; Pollack, Mark H

    2011-04-01

    We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen's d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Training Level, Acculturation, Role Ambiguity, and Multicultural Discussions in Training and Supervising International Counseling Students in the United States

    Science.gov (United States)

    Ng, Kok-Mun; Smith, Shannon D.

    2012-01-01

    This research partially replicated Nilsson and Anderson's "Professional Psychology: Research and Practice" (2004) study on training and supervising international students. It investigated the relationships among international counseling students' training level, acculturation, supervisory working alliance (SWA), counseling self-efficacy (COSE),…

  17. Cultivating Self-Awareness in Counselors-in-Training through Group Supervision

    Science.gov (United States)

    Del Moro, Ronald R.

    2012-01-01

    This study investigated processes, strategies, and frameworks that took place during group supervision classes, which best cultivate the self-awareness of Mental Health and Marriage and Family Counselors-in-Training (CITs). It was designed to explore factors across multiple theoretical models, which contributed to the cultivation of self-awareness…

  18. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2013-10-01

    behavioral therapy (CBT) interventions have been shown to be effective in alleviating symptoms of Post - Traumatic Stress Disorder ( PTSD ) and related... traumatic stress disorder treatment providers: design and methods for a randomized, prospective intervention study. Implement Sci, 7, 43. doi: 10.1186...Friedman, M. J., Young-Xu, Y., & Stevens, S. P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder

  19. Costs and cost-effectiveness of family CBT versus individual CBT in clinically anxious children

    NARCIS (Netherlands)

    Bodden, D.H.M.; Dirksen, C.D.; Bögels, S.M.; Nauta, M.H.; de Haan, E.; Ringrose, J.; Appelboom, C.; Brinkman, A.G.; Appelboom-Geerts, K.C.M.M.J.

    2008-01-01

    The objective of this study was to investigate the cost-effectiveness of family cognitive-behavioral therapy (CBT) compared with individual CBT in children with anxiety disorders. Clinically anxious children (aged 8—18 years) referred for treatment were randomly assigned to family or individual CBT

  20. Internet and video technology in psychotherapy supervision and training.

    Science.gov (United States)

    Wolf, Abraham W

    2011-06-01

    The seven articles in this special section on the use of Internet and video technology represent the latest growth on one branch of the increasingly prolific and differentiated work in the technology of psychotherapy. In addition to the work presented here on video and the Internet applications to supervision and training, information technology is changing the field of psychotherapy through computer assisted therapies and virtual reality interventions.

  1. A 10-session cognitive-behavioral therapy (CBT-T) for eating disorders: Outcomes from a case series of nonunderweight adult patients.

    Science.gov (United States)

    Waller, Glenn; Tatham, Madeleine; Turner, Hannah; Mountford, Victoria A; Bennetts, Alison; Bramwell, Kate; Dodd, Julie; Ingram, Lauren

    2018-03-01

    Existing forms of evidence-based cognitive behavior therapy for eating disorders (CBT-ED) are relatively effective for nonunderweight cases. However, they are also expensive compared to CBT for other disorders. This study reports the first outcomes for a shorter, 10-session form of CBT-ED (CBT-T) for such cases, designed to be less demanding of resources. A case series of 106 nonunderweight eating disordered cases were considered for this effectiveness study. A protocolized 10-session version of CBT-ED was delivered by clinical assistants, under supervision. Measures assessed eating attitudes and behaviors, anxiety, depression, personality pathology, and the working alliance. Intention-to-treat analyses were used. Suitability, acceptability, working alliance ratings, and retention were all positive. Outcomes by the end of therapy and at three-month follow-up were positive for all symptoms, with levels of change, abstinence and remission that were comparable to those from effectiveness studies of longer forms of CBT. Higher levels of pretreatment anxiety predicted retention in treatment, but no factors predicted poorer response. Early change in eating attitudes and the working alliance were the strongest predictors of a positive response. This 10-session form of CBT-ED for nonunderweight eating disorders performed at a level that is comparable to versions of CBT-ED that are twice as long, despite being delivered by nonspecialist therapists. Replication and longer-term follow-ups are needed to ensure retained effects. However, CBT-T has promise as a therapy for use in a range of healthcare settings, to enhance access to treatment for such eating disorders. © 2018 Wiley Periodicals, Inc.

  2. Analysis list: cbt [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available cbt Larvae + dm3 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/target/cbt.1.tsv ht...tp://dbarchive.biosciencedbc.jp/kyushu-u/dm3/target/cbt.5.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/target/cbt....10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/colo/cbt.Larvae.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/colo/Larvae.gml ...

  3. Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder.

    Science.gov (United States)

    van Apeldoorn, F J; Stant, A D; van Hout, W J P J; Mersch, P P A; den Boer, J A

    2014-04-01

    The objective of this study was to assess the cost-effectiveness of three empirically supported treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both (CBT+SSRI). Cost-effectiveness was examined based on the data from a multicenter randomized controlled trial. The Hamilton Anxiety Rating Scale was selected as a primary health outcome measure. Data on costs from a societal perspective (i.e., direct medical, direct non-medical, and indirect non-medical costs) were collected in the study sample (N=150) throughout a 24-month period in which patients received active treatment during the first twelve months and were seen twice for follow-up in the next twelve months. Total costs were largely influenced by costs of the interventions and productivity losses. The mean total societal costs were lower for CBT as compared to SSRI and CBT+SSRI. Costs of medication use were substantial for both SSRI and CBT+SSRI. When examining the balance between costs and health outcomes, both CBT and CBT+SSRI led to more positive outcomes than SSRI. Cognitive behavioral therapy is associated with the lowest societal costs. Cognitive behavioral therapy and CBT+SSRI are more cost-effective treatments for panic disorder with or without agoraphobia as compared to SSRI only. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. SUPERVISED PHYSICAL TRAINING IMPROVES FINE MOTOR SKILLS OF 5-YEAR-OLD CHILDREN

    Directory of Open Access Journals (Sweden)

    Yugang Qi

    Full Text Available ABSTRACT Introduction: Fine motor skills are important for children not only in the activities of daily living, but also for learning activities. In the present study, the effects of supervised physical training were investigated in normal children. Objective: To evaluate the effects of supervised training by combining full-body exercise and the eye-hand coordination activities to improve fine motor skills in a group of five-year-old normal children. Methods: Fifty-two children were selected and randomized in exercise and control groups. The exercise group participated in three 30-minute training sessions per week for 24 weeks. Results: The fine motor skills and hand grip strength of the exercise group were significantly increased, while there was no significant change in the control group during the experimental period. Conclusion: The results indicate that the current exercise training program is effective and can be applied to 5-year-old normal children to improve their fine motor skills. In addition, this program has simple physical activities that are appropriate to the physical and mental level of child development. The 30-minute training session would be easily implemented in the kindergarten program. Level of Evidence I; High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

  5. Randomized controlled trial of parent-enhanced CBT compared with individual CBT for obsessive-compulsive disorder in young people.

    Science.gov (United States)

    Reynolds, Shirley A; Clark, Sarah; Smith, Holly; Langdon, Peter E; Payne, Ruth; Bowers, Gemma; Norton, Elisabeth; McIlwham, Harriet

    2013-12-01

    Obsessive-compulsive disorder (OCD) in young people can be effectively treated with Cognitive Behavior Therapy (CBT). Practice guidelines in the United Kingdom recommend that CBT be delivered with parental or family involvement; however, there is no evidence from randomized trials that this enhances effectiveness. The aim of this trial was to assess if CBT with high parental involvement was more effective than CBT with low parental involvement (individual CBT) in reducing symptoms of OCD. Fifty young people ages 12-17 years with OCD were randomly allocated to individual CBT or parent-enhanced CBT. In parent-enhanced CBT parents attended all treatment sessions; in individual CBT, parents attended only Sessions 1, 7, and the final session. Participants received up to 14 sessions of CBT. Data were analyzed using intent-to-treat and per-protocol methods. The primary outcome measure was the Children's Yale-Brown Obsessive Compulsion Scale (Scahill et al., 1997). Both forms of CBT significantly reduced symptoms of OCD and anxiety. Change in OCD symptoms was maintained at 6 months. Per-protocol analysis suggested that parent-enhanced CBT may be associated with significantly larger reductions in anxiety symptoms. High and low parental involvement in CBT for OCD in young people were both effective, and there was no evidence that 1 method of delivery was superior on the primary outcome measure. However, this study was small. Future trials should be adequately powered and examine interactions with the age of the young person and comorbid anxiety disorders.

  6. Isocyanate toughened pCBT: Reactive blending and tensile properties

    Directory of Open Access Journals (Sweden)

    T. Abt

    2013-02-01

    Full Text Available Cyclic butylene terephthalate oligomers (CBT were reacted in a ring-opening polymerization with three types of isocyanates: a bifunctional aromatic type, a bifunctional aliphatic type and a polymeric aromatic isocyanate. All reactions took place in a batch mixer. The use of 0.5 to 1 wt% isocyanate led to a dramatic increase in elongation at break of polymerized cyclic butylene terephthalate (pCBT, from 8 to above 100%. The stiffness and strength of the modified pCBT, however, were found to slightly decrease. Proton nuclear magnetic resonance (NMR analysis shows that the formation of thermally stable amide groups is the dominant chain extension reaction mechanism. Gel content measurements suggest a linear structure for samples containing bifunctional isocyanates while pCBT modified with polyfunctional isocyanate exhibited some gel formation at higher isocyanate content. Melting and crystallization temperatures as well as degree of crystallinity were found to decrease with increasing isocyanate content. No phase separation was detected by scanning electron microscopy (SEM analysis. Moreover, a high degree of polymerization is deduced due to the absence of CBT oligomer crystals.

  7. Is immediate adjunctive CBT more beneficial than delayed CBT in treating depression?: A Pilot Study.

    Science.gov (United States)

    Rizvi, Sakina J; Zaretsky, Ari; Schaffer, Ayal; Levitt, Anthony

    2015-03-01

    Cognitive-behavioral therapy (CBT) is an efficacious first-line therapy for patients with major depressive disorder (MDD). Due to the limited accessibility of CBT, long wait lists result in delayed treatment, which may affect treatment outcomes. The goal of this pilot study was to obtain preliminary data from a randomized controlled trial to determine whether delayed CBT reduces the effectiveness of the therapy compared to immediate CBT in patients with MDD receiving pharmacotherapy. Patients were randomized to receive immediate CBT (n=18) or to begin CBT after 6 months (n=20) and received 14 weekly sessions, followed by two additional booster sessions. During the active treatment months, patients in the immediate group demonstrated reductions in scores on the Beck Depression Inventory II (BDI-II) that were similar to those in the delayed CBT group. However, when the analysis was performed using only data from patients in the delayed group who were still in a depressive episode, there was an overall greater decrease in BDI-II scores in the immediate group vs. the delayed group over the active treatment months, but not specifically at the 6-month endpoint. These findings suggest delays in depression treatment, similar to what occurs with real-world wait list times, may not have a significant impact on the effectiveness of CBT in patients who are already receiving treatment as usual. However, such delays may affect the effectiveness of CBT in those patients who remain depressed during the time delay. A larger trial is necessary to confirm these findings. (Journal of Psychiatric Practice 2015;21:107-113).

  8. International Doctoral Students in Counselor Education: Coping Strategies in Supervision Training

    Science.gov (United States)

    Woo, Hongryun; Jang, Yoo Jin; Henfield, Malik S.

    2015-01-01

    This study explores 8 international doctoral students' perceptions of coping strategies used in supervision training in counselor education programs. Using human agency as a conceptual framework, the authors found 3 categories: (a) personal and professional self-directed strategies as personal agency, (b) support and care from mentors as proxy…

  9. Supervision of the thermal performance of heat exchanger trains

    Energy Technology Data Exchange (ETDEWEB)

    Negrao, C.O.R.; Tonin, P.C.; Madi, M. [Federal University of Technology Parana UTFPR, Post-graduate Program in Mechanical and Materials Engineering PPGEM, Thermal Science Laboratory LACIT, Av. Sete de Setembro, 3165, CEP 80230-901, Curitiba, Parana (Brazil)

    2007-02-15

    In oil refining, heat exchanger networks are employed to recover heat and therefore save energy of the plant. However, many heat exchangers in crude oil pre-heat trains are under high risk of fouling. Under fouling conditions, the thermal performance of heat exchangers is continuously reduced and its supervision becomes an important task. The large number of heat exchangers in pre-heat trains and the change of operation conditions and feedstock charges make the daily supervision a difficult task. This work applies an approach to follow the performance of heat exchangers [M.A.S. Jeronimo, L.F. Melo, A.S. Braga, P.J.B.F. Ferreira, C. Martins, Monitoring the thermal efficiency of fouled heat exchangers - A simplified method, Experimental Thermal and Fluid Science 14 (1997) 455-463] and extends it to monitor the whole train. The approach is based on the comparison of measured and predicted heat exchanger effectiveness. The measured value is computed from the four inlet and outlet temperatures of a heat exchanger unit. The predicted clean and dirty values of effectiveness are calculated from classical literature relations as a function of NTU and of heat capacity ratio (R). NTU and R are continuously adjusted according to mass flow rate changes. An index of fouling is defined for the whole network and the results show the performance degradation of the network with time. The work also suggests that Jeronimo's index of fouling can be used to estimate the fouling thermal resistance of heat exchangers. (author)

  10. Short- and long-term effectiveness of a supervised training program in spirometry use for primary care professionals.

    Science.gov (United States)

    Represas-Represas, Cristina; Botana-Rial, Maribel; Leiro-Fernández, Virginia; González-Silva, Ana Isabel; García-Martínez, Ana; Fernández-Villar, Alberto

    2013-09-01

    Despite the importance of spirometry, its use and quality are limited in the Primary Care setting. There are few accredited training programs that have demonstrated improvement in the quality of spirometric studies. In this paper, we analyze the short- and long-term effectiveness of a supervised training program for performing and interpreting spirometries. Ours is an intervention study with before and after measurements. The target population included teams of physicians and nursing staff at 26 health-care centers in the area of Vigo (Galicia, Spain). The structured training program involved 2 theoretical and practical training sessions (that were 2months apart), an intermediate period of 30 supervised spirometries performed in the respective centers and weekly e-mail exercises. Effectiveness was evaluated using exercises at the beginning (test 1) and the end (test 2) of the 1st day, 2nd day (test 3) and one year later (test 4), as well as the analysis of spirometries done in month1, month2 and one year later. Participants also completed a survey about their satisfaction. 74 participants initiated the program; 72 completed the program, but only 45 participated in the one-year evaluation. Mean test scores were: 4.1±1.9 on test 1; 7.5±1.6 on test 2; 8.9±1.3 on test 3, and 8.8±1.4 on test 4. During month1, the percentage of correctly done/interpreted tests was 71%, in month two it was 91% and after one year it was 83% (Ptraining program based on theoretical and practical workshops and a supervised follow-up of spirometries significantly improved the ability of Primary Care professionals to carry out and interpret spirometric testing, although the quality of the tests diminished over time. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  11. Medical-pedagogical supervisions for sportsmen short-trek in a period of еducational and trainings employments

    Directory of Open Access Journals (Sweden)

    Zaycev V.P.

    2010-04-01

    Full Text Available The results of inspection of sportsmen are generalized. 8 highly skilled sportsmen were inspected. A method is presented medical-pedagogical supervisions. Age of sportsmen: 16-18 years - 2 sportsmen, 19-20 years - 3 sportsmen, 22-25 years - 3 sportsmen. The results of the use of clinical inspection and visual supervisions are rotined. Frequency of heart-throbs and arteriotony is certain. Information of pulsator is resulted, functional tests and tests, dynamometer. For renewal of organism after educational and training employment employment it is recommended to accept water procedures, vitaminized food, autogenic training, active and passive rest.

  12. Supervised exercise training counterbalances the adverse effects of insulin therapy in overweight/obese subjects with type 2 diabetes.

    Science.gov (United States)

    Balducci, Stefano; Zanuso, Silvano; Cardelli, Patrizia; Salerno, Gerardo; Fallucca, Sara; Nicolucci, Antonio; Pugliese, Giuseppe

    2012-01-01

    To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES). The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory parameters were assessed at baseline and at the end of the study. The volume of physical activity was significantly higher in the EXE versus the CON group. Values for hemoglobin A(1c), BMI, waist circumference, high-sensitivity C-reactive protein, blood pressure, LDL cholesterol, and the coronary heart disease risk score were significantly reduced only in the EXE group. No major adverse events were observed. In insulin-treated subjects with type 2 diabetes, supervised exercise is safe and effective in improving glycemic control and markers of adiposity and inflammation, thus counterbalancing the adverse effects of insulin on these parameters.

  13. Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects.

    Science.gov (United States)

    Youssef, Enas Fawzy; Shanb, Alsayed Abd Elhameed

    2016-11-01

    Aging is associated with a progressive decline in physical capabilities and a disturbance of both postural control and daily living activities. The aim of this study was to evaluate the effects of supervised versus home exercise programs on muscle strength, balance and functional activities in older participants. Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35-45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG). The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs ( P training programs significantly increased balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants.

  14. Wibangbe: the making of a documentary about the training and supervision of traditional birth attendants in Zaire.

    Science.gov (United States)

    Vansintejan, G A; Glaser, W A

    1988-01-01

    During the 1980's in Karawa, Northwestern Zaire, a motion picture was produced which showed the interaction of the modern and traditional systems. The maternity center of the Karawa hospital was central to this effort. Traditional birth attendants (TBAs) became leading participants. Locally trained midwives were key trainers. The training and supervision programs had been ongoing for 2 years when Karawa was chosen as the movie site in 1986. The script was written by a midwife who had trained trainers of TBAs and TBAs themselves. All the steps in the selection, training, supervision, and supplying of TBAs in Karawa and its neighboring villages are included in the script. A Zairian team shot the script. The 5-member crew were employees of the Office Zairois de la Radio-Television (OZRT), the country's official television, radio, and film service. "Wibange" has separate sound tracks in French and English. Costs of the movie were met by contributions from both the US Agency for International Development and from Zaire. "Wibange--Traditional Birth Attendants: Their Training and Supervision" was developed in New York City. There are 2 final productions, a French and an English version. Running time is 23 minutes.

  15. Semi-supervised adaptation in ssvep-based brain-computer interface using tri-training

    DEFF Research Database (Denmark)

    Bender, Thomas; Kjaer, Troels W.; Thomsen, Carsten E.

    2013-01-01

    This paper presents a novel and computationally simple tri-training based semi-supervised steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI). It is implemented with autocorrelation-based features and a Naïve-Bayes classifier (NBC). The system uses nine characters...

  16. Evaluation of the Sustainability and Clinical Outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a Child Protection Center

    Science.gov (United States)

    Kolko, David J.; Iselin, Anne-Marie R.; Gully, Kevin J.

    2011-01-01

    This paper examines the sustainability and outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) as delivered by practitioners in a community-based child protection program who had received training in the model several years earlier. Formerly described as Abuse-Focused CBT, AF-CBT is an evidence-based treatment (EBT) for…

  17. Hypermedia for Training: A Software and Instructional Engineering Model.

    Science.gov (United States)

    Cortinovis, Renato

    1992-01-01

    Presents an engineering environment oriented to the development of hypermedia applications for training. Training trends are described; requirements for a computer-based training (CBT) strategy are outlined; a hypermedia course structure is examined; microinstructional events (MIEs) are explained; and technology requirements and selection are…

  18. Competency in integrative psychotherapy: perspectives on training and supervision.

    Science.gov (United States)

    Boswell, James F; Nelson, Dana L; Nordberg, Samuel S; McAleavey, Andrew A; Castonguay, Louis G

    2010-03-01

    Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology and health care service delivery. Aspects of integrative psychotherapy competency may differ from competency in other psychotherapy orientations, although convergence is more often the case. Despite the potential differences, there exist very few formal training programs or guidelines to systematically guide clinicians in developing a competent integrative practice. This paper attempts to distill the essential elements of competent integrative psychotherapy practice and focuses on how these might be developed in training and supervision. We address most of these complex issues from a specific integrative perspective: principle-based assimilative integration. PsycINFO Database Record (c) 2010 APA, all rights reserved

  19. Improving Banking Supervision

    OpenAIRE

    Mayes, David G.

    1998-01-01

    This paper explains how banking supervision within the EU, and in Finland in particular, can be improved by the implementation of greater market discipline and related changes. Although existing EU law, institutions, market structures and practices of corporate governance restrict the scope for change, substantial improvements can be introduced now while there is a window of opportunity for change. The economy is growing H5ly and the consequences of the banking crises of the early 1990s have ...

  20. Effectiveness and cost effectiveness of cognitive behavioral therapy (CBT) in clinically depressed adolescents: individual CBT versus treatment as usual (TAU).

    Science.gov (United States)

    Stikkelbroek, Yvonne; Bodden, Denise Hm; Deković, Maja; van Baar, Anneloes L

    2013-11-21

    Depressive disorders occur in 2 to 5% of the adolescents and are associated with a high burden of disease, a high risk of recurrence and a heightened risk for development of other problems, like suicide attempts. The effectiveness of cognitive behaviour therapy (CBT), cost-effectiveness of this treatment and the costs of illness of clinical depression in adolescents are still unclear. Although several Randomized Controlled Trials (RCT) have been conducted to establish the efficacy of CBT, the effectiveness has not been established yet. Aim of this study is to conduct a RCT to test the effectiveness of CBT and to establish the cost-effectiveness of CBT under rigorous conditions within routine care provided by professionals already working in mental health institutions. CBT is investigated with a multi-site, RCT using block randomisation. The targeted population is 140 clinically referred depressed adolescents aged 12 to 21 years old. Adolescents are randomly assigned to the experimental (N = 70, CBT) or control condition (N = 70, TAU). Four assessments (pre, post, follow up at 6 and 12 months) and two mediator assessments during treatment are conducted. Primary outcome measure is depression diagnosis based on a semi-structured interview namely the K-SADS-PL. Secondary outcome measures include depressive symptoms, severity and improvement of the depression, global functioning, quality of life, suicide risk, comorbidity, alcohol and drug use, parental depression and psychopathology, parenting and conflicts. Costs and treatment characteristics will also be assessed. Furthermore, moderator and mediator analyses will be conducted. This trial will be the first to compare CBT with TAU under rigorous conditions within routine care and with a complex sample. Furthermore, cost-effectiveness of treatment and cost-of-illness of clinical depression are established which will provide new insights on depression as a disorder and its treatment. Dutch Trial register number

  1. Supervised Learning for Visual Pattern Classification

    Science.gov (United States)

    Zheng, Nanning; Xue, Jianru

    This chapter presents an overview of the topics and major ideas of supervised learning for visual pattern classification. Two prevalent algorithms, i.e., the support vector machine (SVM) and the boosting algorithm, are briefly introduced. SVMs and boosting algorithms are two hot topics of recent research in supervised learning. SVMs improve the generalization of the learning machine by implementing the rule of structural risk minimization (SRM). It exhibits good generalization even when little training data are available for machine training. The boosting algorithm can boost a weak classifier to a strong classifier by means of the so-called classifier combination. This algorithm provides a general way for producing a classifier with high generalization capability from a great number of weak classifiers.

  2. Weighting training images by maximizing distribution similarity for supervised segmentation across scanners

    DEFF Research Database (Denmark)

    van Opbroek, Annegreet; Vernooij, Meike W; Ikram, M.Arfan

    2015-01-01

    Many automatic segmentation methods are based on supervised machine learning. Such methods have proven to perform well, on the condition that they are trained on a sufficiently large manually labeled training set that is representative of the images to segment. However, due to differences between...... scanners, scanning parameters, and patients such a training set may be difficult to obtain. We present a transfer-learning approach to segmentation by multi-feature voxelwise classification. The presented method can be trained using a heterogeneous set of training images that may be obtained with different...... scanners than the target image. In our approach each training image is given a weight based on the distribution of its voxels in the feature space. These image weights are chosen as to minimize the difference between the weighted probability density function (PDF) of the voxels of the training images...

  3. Self-supervised Chinese ontology learning from online encyclopedias.

    Science.gov (United States)

    Hu, Fanghuai; Shao, Zhiqing; Ruan, Tong

    2014-01-01

    Constructing ontology manually is a time-consuming, error-prone, and tedious task. We present SSCO, a self-supervised learning based chinese ontology, which contains about 255 thousand concepts, 5 million entities, and 40 million facts. We explore the three largest online Chinese encyclopedias for ontology learning and describe how to transfer the structured knowledge in encyclopedias, including article titles, category labels, redirection pages, taxonomy systems, and InfoBox modules, into ontological form. In order to avoid the errors in encyclopedias and enrich the learnt ontology, we also apply some machine learning based methods. First, we proof that the self-supervised machine learning method is practicable in Chinese relation extraction (at least for synonymy and hyponymy) statistically and experimentally and train some self-supervised models (SVMs and CRFs) for synonymy extraction, concept-subconcept relation extraction, and concept-instance relation extraction; the advantages of our methods are that all training examples are automatically generated from the structural information of encyclopedias and a few general heuristic rules. Finally, we evaluate SSCO in two aspects, scale and precision; manual evaluation results show that the ontology has excellent precision, and high coverage is concluded by comparing SSCO with other famous ontologies and knowledge bases; the experiment results also indicate that the self-supervised models obviously enrich SSCO.

  4. Artificial neural network classification using a minimal training set - Comparison to conventional supervised classification

    Science.gov (United States)

    Hepner, George F.; Logan, Thomas; Ritter, Niles; Bryant, Nevin

    1990-01-01

    Recent research has shown an artificial neural network (ANN) to be capable of pattern recognition and the classification of image data. This paper examines the potential for the application of neural network computing to satellite image processing. A second objective is to provide a preliminary comparison and ANN classification. An artificial neural network can be trained to do land-cover classification of satellite imagery using selected sites representative of each class in a manner similar to conventional supervised classification. One of the major problems associated with recognition and classifications of pattern from remotely sensed data is the time and cost of developing a set of training sites. This reseach compares the use of an ANN back propagation classification procedure with a conventional supervised maximum likelihood classification procedure using a minimal training set. When using a minimal training set, the neural network is able to provide a land-cover classification superior to the classification derived from the conventional classification procedure. This research is the foundation for developing application parameters for further prototyping of software and hardware implementations for artificial neural networks in satellite image and geographic information processing.

  5. Implementing effect of energy efficiency supervision system for government office buildings and large-scale public buildings in China

    International Nuclear Information System (INIS)

    Zhao Jing; Wu Yong; Zhu Neng

    2009-01-01

    The Chinese central government released a document to initiate a task of energy efficiency supervision system construction for government office buildings and large-scale public buildings in 2007, which marks the overall start of existing buildings energy efficiency management in China with the government office buildings and large-scale public buildings as a breakthrough. This paper focused on the implementing effect in the demonstration region all over China for less than one year, firstly introduced the target and path of energy efficiency supervision system, then described the achievements and problems during the implementing process in the first demonstration provinces and cities. A certain data from the energy efficiency public notice in some typical demonstration provinces and cities were analyzed statistically. It can be concluded that different functional buildings have different energy consumption and the average energy consumption of large-scale public buildings is too high in China compared with the common public buildings and residential buildings. The obstacles need to be overcome afterward were summarized and the prospects for the future work were also put forward in the end.

  6. Implementing effect of energy efficiency supervision system for government office buildings and large-scale public buildings in China

    Energy Technology Data Exchange (ETDEWEB)

    Zhao Jing [School of Environmental Science and Engineering, Tianjin University, Tianjin 300072 (China)], E-mail: zhaojing@tju.edu.cn; Wu Yong [Department of Science and Technology, Ministry of Housing and Urban-Rural Development of the People' s Republic of China, Beijing 100835 (China); Zhu Neng [School of Environmental Science and Engineering, Tianjin University, Tianjin 300072 (China)

    2009-06-15

    The Chinese central government released a document to initiate a task of energy efficiency supervision system construction for government office buildings and large-scale public buildings in 2007, which marks the overall start of existing buildings energy efficiency management in China with the government office buildings and large-scale public buildings as a breakthrough. This paper focused on the implementing effect in the demonstration region all over China for less than one year, firstly introduced the target and path of energy efficiency supervision system, then described the achievements and problems during the implementing process in the first demonstration provinces and cities. A certain data from the energy efficiency public notice in some typical demonstration provinces and cities were analyzed statistically. It can be concluded that different functional buildings have different energy consumption and the average energy consumption of large-scale public buildings is too high in China compared with the common public buildings and residential buildings. The obstacles need to be overcome afterward were summarized and the prospects for the future work were also put forward in the end.

  7. Implementing effect of energy efficiency supervision system for government office buildings and large-scale public buildings in China

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Jing; Zhu, Neng [School of Environmental Science and Engineering, Tianjin University, Tianjin 300072 (China); Wu, Yong [Department of Science and Technology, Ministry of Housing and Urban-Rural Development of the People' s Republic of China, Beijing 100835 (China)

    2009-06-15

    The Chinese central government released a document to initiate a task of energy efficiency supervision system construction for government office buildings and large-scale public buildings in 2007, which marks the overall start of existing buildings energy efficiency management in China with the government office buildings and large-scale public buildings as a breakthrough. This paper focused on the implementing effect in the demonstration region all over China for less than one year, firstly introduced the target and path of energy efficiency supervision system, then described the achievements and problems during the implementing process in the first demonstration provinces and cities. A certain data from the energy efficiency public notice in some typical demonstration provinces and cities were analyzed statistically. It can be concluded that different functional buildings have different energy consumption and the average energy consumption of large-scale public buildings is too high in China compared with the common public buildings and residential buildings. The obstacles need to be overcome afterward were summarized and the prospects for the future work were also put forward in the end. (author)

  8. Effect of training supervision on effectiveness of strength training for reducing neck/shoulder pain and headache in office workers

    DEFF Research Database (Denmark)

    Gram, Bibi; Andersen, Christoffer; Zebis, Mette Kreutzfeldt

    2014-01-01

    Objective. To investigate the effect of workplace neck/shoulder strength training with and without regular supervision on neck/shoulder pain and headache among office workers. Method. A 20-week cluster randomized controlled trial among 351 office workers was randomized into three groups: two trai...

  9. Skærpet bevidsthed om supervision

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2002-01-01

    This article presents a historical survey of the initiatives which have taken place in european music therapy towards developing a deeper consciousness about supervision. Supervision as a disciplin in music therapy training, as a maintenance of music therapy profession and as a postgraduate...... training for examined music therapists. Definitions are presented and methods developed by working groups in european music therapy supervision are presented....

  10. A Training Intervention for Supervisors to Support a Work-Life Policy Implementation

    Science.gov (United States)

    Laharnar, Naima; Glass, Nancy; Perrin, Nancy; Hanson, Ginger; Kent Anger, W.

    2013-01-01

    Background Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. Methods The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. Results More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. Conclusion CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA. PMID:24106648

  11. Semi-supervised sparse coding

    KAUST Repository

    Wang, Jim Jing-Yan; Gao, Xin

    2014-01-01

    Sparse coding approximates the data sample as a sparse linear combination of some basic codewords and uses the sparse codes as new presentations. In this paper, we investigate learning discriminative sparse codes by sparse coding in a semi-supervised manner, where only a few training samples are labeled. By using the manifold structure spanned by the data set of both labeled and unlabeled samples and the constraints provided by the labels of the labeled samples, we learn the variable class labels for all the samples. Furthermore, to improve the discriminative ability of the learned sparse codes, we assume that the class labels could be predicted from the sparse codes directly using a linear classifier. By solving the codebook, sparse codes, class labels and classifier parameters simultaneously in a unified objective function, we develop a semi-supervised sparse coding algorithm. Experiments on two real-world pattern recognition problems demonstrate the advantage of the proposed methods over supervised sparse coding methods on partially labeled data sets.

  12. Semi-supervised sparse coding

    KAUST Repository

    Wang, Jim Jing-Yan

    2014-07-06

    Sparse coding approximates the data sample as a sparse linear combination of some basic codewords and uses the sparse codes as new presentations. In this paper, we investigate learning discriminative sparse codes by sparse coding in a semi-supervised manner, where only a few training samples are labeled. By using the manifold structure spanned by the data set of both labeled and unlabeled samples and the constraints provided by the labels of the labeled samples, we learn the variable class labels for all the samples. Furthermore, to improve the discriminative ability of the learned sparse codes, we assume that the class labels could be predicted from the sparse codes directly using a linear classifier. By solving the codebook, sparse codes, class labels and classifier parameters simultaneously in a unified objective function, we develop a semi-supervised sparse coding algorithm. Experiments on two real-world pattern recognition problems demonstrate the advantage of the proposed methods over supervised sparse coding methods on partially labeled data sets.

  13. Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa.

    Science.gov (United States)

    Leslie, Hannah H; Gage, Anna; Nsona, Humphreys; Hirschhorn, Lisa R; Kruk, Margaret E

    2016-09-01

    In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce. We used nationally representative surveys of health systems in seven countries in sub-Saharan Africa to examine the association of in-service training and supervision with provider quality in antenatal and sick child care. The results of our analysis showed that observed quality of care was poor, with fewer than half of evidence-based actions completed by health workers, on average. In-service training and supervision were associated with quality of sick child care; they were associated with quality of antenatal care only when provided jointly. All associations were modest-at most, improvements related to interventions were equivalent to 2 additional provider actions out of the 18-40 actions expected per visit. In-service training and supportive supervision as delivered were not sufficient to meaningfully improve the quality of care in these countries. Greater attention to the quality of health professional education and national health system performance will be required to provide the standard of health care that patients deserve. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Psychotherapy Training: Residents' Perceptions and Experiences.

    Science.gov (United States)

    Kovach, Jessica G; Dubin, William R; Combs, Christopher J

    2015-10-01

    This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

  15. Implementing a sustainable clinical supervision model for Isles nurses in Orkney.

    Science.gov (United States)

    Hall, Ian

    2018-03-02

    The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from 'carrot' to 'stick'. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision. The survey found that 55% provide supervision and 40% receive it. Health board encouragement of its use was found to be disappointingly low at 40%. The INOC nurses were surveyed about the new peer-support (restorative) model, which relies on video-conference contact to allow face to face interaction between isolated isles nurses. Feedback prompted a review of clinical supervision pairings, and the frequency and methods of meeting. The need for supervisor training led to agreement with the Remote and Rural Health Education Alliance to provide relevant support. The perceived benefits of supervision included increased support and reflection, and improved relationships with isolated colleagues.

  16. Oceans apart, yet connected: Findings from a qualitative study on professional supervision in rural and remote allied health services.

    Science.gov (United States)

    Ducat, Wendy; Martin, Priya; Kumar, Saravana; Burge, Vanessa; Abernathy, LuJuana

    2016-02-01

    Improving the quality and safety of health care in Australia is imperative to ensure the right treatment is delivered to the right person at the right time. Achieving this requires appropriate clinical governance and support for health professionals, including professional supervision. This study investigates the usefulness and effectiveness of and barriers to supervision in rural and remote Queensland. As part of the evaluation of the Allied Health Rural and Remote Training and Support program, a qualitative descriptive study was conducted involving semi-structured interviews with 42 rural or remote allied health professionals, nine operational managers and four supervisors. The interviews explored perspectives on their supervision arrangements, including the perceived usefulness, effect on practice and barriers. Themes of reduced isolation; enhanced professional enthusiasm, growth and commitment to the organisation; enhanced clinical skills, knowledge and confidence; and enhanced patient safety were identified as perceived outcomes of professional supervision. Time, technology and organisational factors were identified as potential facilitators as well as potential barriers to effective supervision. This research provides current evidence on the impact of professional supervision in rural and remote Queensland. A multidimensional model of organisational factors associated with effective supervision in rural and remote settings is proposed identifying positive supervision culture and a good supervisor-supervisee fit as key factors associated with effective arrangements. © 2015 Commonwealth of Australia. Australian Journal of Rural Health published by Wiley Publishing Asia Pty Ltd. on behalf of National Rural Health Alliance Inc.

  17. The Art and Skill of Delivering Culturally Responsive TF-CBT in Tanzania and Kenya

    Science.gov (United States)

    Kava, Christine M.; Akiba, Christopher F.; Lucid, Leah; Dorsey, Shannon

    2016-01-01

    Objective This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known how about western-developed EBTs are delivered in a culturally responsive manner. Method Semistructured qualitative interviews were conducted with 12 TF-CBT lay counselors involved in a large randomized controlled trial of TF-CBT in Kenya and Tanzania. An inductive approach was used to analyze the data. Results Lay counselors described the importance of being responsive to TF-CBT participants’ customs, beliefs, and socioeconomic conditions and highlighted the value of TF-CBT for their community. They also discussed the importance of partnering with other organizations to address unmet socioeconomic needs. Conclusion The findings from this study provide support for the acceptability and appropriateness of TF-CBT as a treatment approach for improving child mental health. Having a better understanding of the strategies used by lay counselors to ensure that treatment is relevant to the cultural and socioeconomic context of participants can help to inform the implementation of future EBTs. PMID:27414470

  18. Clinical Supervision in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2011-01-01

    Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...

  19. Mr. Traore introduces team supervision. Case scenarios for training and group discussion.

    Science.gov (United States)

    1993-01-01

    This supplement to "The Family Planning Manager" presents a case example and five case discussion questions to illustrate the concept of team supervision. In contrast to traditional supervision, where an emphasis is placed on inspection and the uncovering of deficiencies, team supervision uses a facilitative, advocacy-oriented approach. Problem-solving and decision-making responsibilities are assumed by the clinic staff, who identify and analyze problems in group meetings. Thus, the focus shifts from assessing individual performance to evaluating how well they meet clinic objectives as a team. In the team meetings, the visiting supervisor asks the team as a whole to analyze clinic problems and ensures that all staff members are aware of the significance of their contributions. The supervisor also clarifies the division of labor required for implementing solutions and performance standards. Staff are asked if they have concerns they would like communicated to the next organizational level. The supervisory report of the visit can serve as a guide for implementing the recommendations. This approach may require that supervisors and clinic managers receive training in problem solving, motivating staff, team building, and providing constructive feedback.

  20. The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, Peter Bo; Bogh, Søren B; Kierkegaard, Signe

    2017-01-01

    OBJECTIVE: To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. DESIGN: Single blinded, randomized clinical trial. SETTING: Surgery, progressive resistance training and testing was carried out...

  1. Group Supervision in Psychotherapy. Main Findings from a Swedish Research Project on Psychotherapy Supervision in a Group Format

    Science.gov (United States)

    Ogren, Marie-Louise; Sundin, Eva C.

    2009-01-01

    Psychotherapy supervision is considered crucial for psychotherapists in training. During the last decades, group supervision has been a frequently used format in many countries. Until recently, very few studies had evaluated the small-group format for training of beginner psychotherapists and psychotherapy supervisors. This article aims to…

  2. DOE contractor radiation safety CBT [computer based training] course

    International Nuclear Information System (INIS)

    Gardner, P.R.

    1986-01-01

    Westinghouse Hanford Company developed a generic Radiation Worker safety CBT course for Department of Energy contractors. Task analysis concentrated on actual and potential tasks and included visits to fourteen different contractor sites. Team Design and Prototype verification formed the major portion of the development phase. Lesson entry was accomplished using the WISE author system from WICAT Systems, Inc. The course features graded task simulations for both Pretest and Final; fourteen Topics in five Lessons, each Topic keyed to ''Critical Acts'' and Questions in the Pretest and Final; Automatic, Intensive, and Manual modes of instruction available for each Lesson; Practical Problems and Sample Questions associated with each Topic; and provisions for local configuration in several areas. The course is deliverable on IBM PC compatible equipment. 2 refs

  3. Gymnasium-based unsupervised exercise maintains benefits in oxygen uptake kinetics obtained following supervised training in type 2 diabetes.

    Science.gov (United States)

    Macananey, Oscar; O'Shea, Donal; Warmington, Stuart A; Green, Simon; Egaña, Mikel

    2012-08-01

    Supervised exercise (SE) in patients with type 2 diabetes improves oxygen uptake kinetics at the onset of exercise. Maintenance of these improvements, however, has not been examined when supervision is removed. We explored if potential improvements in oxygen uptake kinetics following a 12-week SE that combined aerobic and resistance training were maintained after a subsequent 12-week unsupervised exercise (UE). The involvement of cardiac output (CO) in these improvements was also tested. Nineteen volunteers with type 2 diabetes were recruited. Oxygen uptake kinetics and CO (inert gas rebreathing) responses to constant-load cycling at 50% ventilatory threshold (V(T)), 80% V(T), and mid-point between V(T) and peak workload (50% Δ) were examined at baseline (on 2 occasions) and following each 12-week training period. Participants decided to exercise at a local gymnasium during the UE. Thirteen subjects completed all the interventions. The time constant of phase 2 of oxygen uptake was significantly faster (p exercise maintained benefits in oxygen uptake kinetics obtained during a supervised exercise in subjects with diabetes, and these benefits were associated with a faster dynamic response of heart rate after training.

  4. Parental Involvement in CBT for Anxiety-Disordered Youth Revisited: Family CBT Outperforms Child CBT in the Long Term for Children With Comorbid ADHD Symptoms.

    Science.gov (United States)

    Maric, Marija; van Steensel, Francisca J A; Bögels, Susan M

    2018-03-01

    The objective of this study was to examine the efficacy of child cognitive-behavioral therapy (CCBT) versus family CBT (FCBT) in anxiety-disordered youth with high and low comorbid ADHD symptoms. Youth with anxiety disorders ( n = 123, aged 8-18) were classified in four groups according to (a) the type of CBT received (child vs. family) and (b) their comorbid ADHD symptoms, measured with the Child Behavior Checklist (CBCL) Attention Problems syndrome scale level (normal vs. [sub]clinical). Severity of anxiety disorders was assessed with Anxiety Disorders Interview Schedule-Child and Parent (ADIS-C/P) version and anxiety symptoms via a 71-item anxiety symptom questionnaire, the Screen for Child Anxiety and Related Emotional Disorders (SCARED-71), before and after CBT, and at 3 months and 1-year follow-ups. Based on the severity of anxiety disorders, children with high ADHD symptoms profit more from FCBT than CCBT in the long term. For children low on ADHD symptoms, and for anxiety symptoms and attention problems, no differences between CCBT and FCBT occurred. Family involvement seems a valuable addition to CBT for children with comorbid anxiety and ADHD symptoms.

  5. A SURVEY OF SEMI-SUPERVISED LEARNING

    OpenAIRE

    Amrita Sadarangani *, Dr. Anjali Jivani

    2016-01-01

    Semi Supervised Learning involves using both labeled and unlabeled data to train a classifier or for clustering. Semi supervised learning finds usage in many applications, since labeled data can be hard to find in many cases. Currently, a lot of research is being conducted in this area. This paper discusses the different algorithms of semi supervised learning and then their advantages and limitations are compared. The differences between supervised classification and semi-supervised classific...

  6. Educational Supervision Appropriate for Psychiatry Trainee's Needs

    Science.gov (United States)

    Rele, Kiran; Tarrant, C. Jane

    2010-01-01

    Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…

  7. Optimistic semi-supervised least squares classification

    DEFF Research Database (Denmark)

    Krijthe, Jesse H.; Loog, Marco

    2017-01-01

    The goal of semi-supervised learning is to improve supervised classifiers by using additional unlabeled training examples. In this work we study a simple self-learning approach to semi-supervised learning applied to the least squares classifier. We show that a soft-label and a hard-label variant ...

  8. A Study of Supervision of China's Commercial Banks from the Perspective of the Trinity-Characteristics of Bank Supervision System

    Institute of Scientific and Technical Information of China (English)

    LV Jianglin; HUANG Guang

    2015-01-01

    Based on the theoretical analysis,this paper applies the entropy method to establish a comprehensive index system for the evaluation of the overall level of risk control and comprehensive efficiency of the supervision of China's commercial banks.Considering the trinity-characteristics of bank supervision system consisting of the People's Bank of China(PBC),the CBRC and the financial offices of local governments,the following conclusions have been drawn:the amount of penalties on banking illegal transactions is not correlated with the supervision efficiency of China's commercial banks;the capital adequacy ratio,the loan to deposit ratio,the percentage point of the non-performing loan rate of urban commercial banks higher than that of the national joint-stock banks are negatively correlated with the supervision efficiency of China 's commercial banks;the total asset variation of the PBC and the different loan balance in local and foreign currency of the banks are positively correlated with the supervision efficiency of China's commercial banks,but the effect is minor.Therefore,China should give the capital adequacy ratio a full play in the bank supervision,accelerate the construction of supervision information system and improve the supervision function of the local governments.

  9. A Pilot Test of the Additive Benefits of Physical Exercise to CBT for OCD.

    Science.gov (United States)

    Rector, Neil A; Richter, Margaret A; Lerman, Bethany; Regev, Rotem

    2015-01-01

    The majority of "responders" to first-line cognitive-behavioural therapy (CBT) and pharmacological treatments for obsessive-compulsive disorder (OCD) are left with residual symptoms that are clinically relevant and disabling. Therefore, there is pressing need for widely accessible efficacious alternative and/or adjunctive treatments for OCD. Accumulating evidence suggests that physical exercise may be one such intervention in the mood and anxiety disorders broadly, although we are aware of only two positive small-scale pilot studies that have tested its clinical benefits in OCD. This pilot study aimed to test the feasibility and preliminary efficacy of adding a structured physical exercise programme to CBT for OCD. A standard CBT group was delivered concurrently with a 12-week customized exercise programme to 11 participants. The exercise regimen was individualized for each participant based on peak heart rate measured using an incremental maximal exercise test. Reports of exercise adherence across the 12-week regimen exceeded 80%. A paired-samples t-test indicated very large treatment effects in Yale-Brown Obsessive-Compulsive Scale scores from pre- to post-treatment in CBT group cohorts led by expert CBT OCD specialists (d = 2.55) and junior CBT clinician non-OCD specialists (d = 2.12). These treatment effects are very large and exceed effects typically observed with individual and group-based CBT for OCD based on leading meta-analytic reviews, as well as previously obtained treatment effects for CBT using the same recruitment protocol without exercise. As such, this pilot work demonstrates the feasibility and significant potential clinical utility of a 12-week aerobic exercise programme delivered in conjunction with CBT for OCD.

  10. Academic Writing in Reflexive Professional Writing: Citations of Scientific Literature in Supervised Pre-Service Training Reports

    Directory of Open Access Journals (Sweden)

    Lívia Chaves de Melo

    2013-06-01

    Full Text Available In this paper we investigate citation practices of scientific literature in reflexive writing from the genre of supervised pre-service training report produced by pre-service teachers enrolled in the mandatory pre-service training subject of English Language Teaching, at an undergraduate language teaching course. The aim of this research is to analyze how these pre-services teacher represent themselves based on citation practices of scientific literature, and characterize some of the functions deployed by the citations in the reflexive writing emerging in the academic sphere. We use the dialogic approach to language from Bakhtinian studies as a theoretical base, as well as theoretical and methodological contributions regarding types of sequences and of discourse proposed by Adam and Bronckart. The results of this research show that the practice of citation of scientific literature is an invocation of authority as a form of erudition, amplification and ornamentation of the discourse produced. This practice can also guide pedagogical action developed by pre-service teachers in their supervised training.

  11. Using clinical supervision to improve the quality and safety of patient care: a response to Berwick and Francis.

    Science.gov (United States)

    Tomlinson, Jonathon

    2015-06-11

    After widely publicised investigations into excess patient deaths at Mid Staffordshire hospital the UK government commissioned reports from Robert Francis QC and Professor Don Berwick. Among their recommendations to improve the quality and safety of patient care were lifelong learning, professional support and 'just culture'. Clinical supervision is in an excellent position to support these activities but opportunities are in danger of being squeezed out by regulatory and managerial demands. Doctors who have completed their training are responsible for complex professional judgements for which narrative supervision is particularly helpful. With reference to the literature and my own practice I propose that all practicing clinicians should have regular clinical supervision. Clinical supervision has patient-safety and the quality of patient care as its primary purposes. After training is completed, doctors may practice for the rest of their career without any clinical supervision, the implication being that the difficulties dealt with in clinical supervision are no longer difficulties, or are better dealt with some other way. Clinical supervision is sufficiently flexible to be adapted to the needs of experienced clinicians as its forms can be varied, though its functions remain focused on patient safety, good quality clinical care and professional wellbeing. The evidence linking clinical supervision to the quality and safety of patient care reveals that supervision is most effective when its educational and supportive functions are separated from its managerial and evaluative functions. Among supervision's different forms, narrative-based-supervision is particularly useful as it has been developed for clinicians who have completed their training. It provides ways to explore the complexity of clinical judgements and encourages doctors to question one another's authority in a supportive culture. To be successful, supervision should also be professionally led and

  12. Evaluation of Semi-supervised Learning for Classification of Protein Crystallization Imagery.

    Science.gov (United States)

    Sigdel, Madhav; Dinç, İmren; Dinç, Semih; Sigdel, Madhu S; Pusey, Marc L; Aygün, Ramazan S

    2014-03-01

    In this paper, we investigate the performance of two wrapper methods for semi-supervised learning algorithms for classification of protein crystallization images with limited labeled images. Firstly, we evaluate the performance of semi-supervised approach using self-training with naïve Bayesian (NB) and sequential minimum optimization (SMO) as the base classifiers. The confidence values returned by these classifiers are used to select high confident predictions to be used for self-training. Secondly, we analyze the performance of Yet Another Two Stage Idea (YATSI) semi-supervised learning using NB, SMO, multilayer perceptron (MLP), J48 and random forest (RF) classifiers. These results are compared with the basic supervised learning using the same training sets. We perform our experiments on a dataset consisting of 2250 protein crystallization images for different proportions of training and test data. Our results indicate that NB and SMO using both self-training and YATSI semi-supervised approaches improve accuracies with respect to supervised learning. On the other hand, MLP, J48 and RF perform better using basic supervised learning. Overall, random forest classifier yields the best accuracy with supervised learning for our dataset.

  13. Computerised CBT for depressed adolescents: Randomised controlled trial.

    Science.gov (United States)

    Smith, Patrick; Scott, Rebecca; Eshkevari, Ertimiss; Jatta, Fatoumata; Leigh, Eleanor; Harris, Victoria; Robinson, Alex; Abeles, Paul; Proudfoot, Judy; Verduyn, Chrissie; Yule, William

    2015-10-01

    Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Multicultural Supervision: What Difference Does Difference Make?

    Science.gov (United States)

    Eklund, Katie; Aros-O'Malley, Megan; Murrieta, Imelda

    2014-01-01

    Multicultural sensitivity and competency represent critical components to contemporary practice and supervision in school psychology. Internship and supervision experiences are a capstone experience for many new school psychologists; however, few receive formal training and supervision in multicultural competencies. As an increased number of…

  15. Cognitive Behavioral Training and Education for Spaceflight Operations

    Science.gov (United States)

    Moonmaw, Ronald

    2011-01-01

    Cognitive behavioral-training (CBT) is an evidence-based practice commonly used to help treat insomnia, and is part of NASA's countermeasure regimen for Fatigue Management. CBT addresses the life style and habits of individuals that are maladaptive to managing stress and fatigue. This includes addressing learned behavioral responses that may cause stress and lead to an increased sense of fatigue. While the initial cause of onset of fatigue in the individual may be no longer present, the perception and engrained anticipation of fatigue persist and cause an exaggerated state of tension. CBT combined with relaxation training allows the individual to unlearn the maladaptive beliefs and behaviors and replace them with routines and techniques that allow cognitive restructuring and resultant relief from stress. CBT allows for elimination in individuals of unwanted ruminating thoughts and anticipatory anxiety by, for example, training the individuals to practice stressful situations in a relaxed state. As a result of CBT, relaxation can be accomplished in many ways, such as progressive muscle relaxation, meditation and guided imagery. CBT is not therapy, but rather the synthesis of behavioral countermeasures. CBT utilizes progressive relaxation as a means of reinforcing educational and cognitive countermeasures. These countermeasures include: masking, elimination of distracting thoughts, anxiety control, split attention, cognitive restructuring and other advanced psychological techniques.

  16. Effects of cancer rehabilitation on problem-solving, anxiety and depression : a RCT comparing physical and cognitive-behavioural training versus physical training

    NARCIS (Netherlands)

    Korstjens, Irene; Mesters, Ilse; May, Anne M; van Weert, Ellen; van den Hout, Johanna H C; Ros, Wynand; Hoekstra-Weebers, Josette E H M; van der Schans, Cees; van den Borne, Bart

    2011-01-01

    We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

  17. Effects of cancer rehabilitation on problem-solving, anxiety and depression : A RCT comparing physical and cognitive-behavioural training versus physical training

    NARCIS (Netherlands)

    Korstjens, Irene; Mesters, Ilse; May, Anne M.; van Weert, Ellen; van den Hout, Johanna H. C.; Ros, Wynand; Hoekstra-Weebers, Josette E. H. M.; van der Schans, Cees P.; van den Borne, Bart

    2011-01-01

    We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

  18. Quasi-supervised scoring of human sleep in polysomnograms using augmented input variables.

    Science.gov (United States)

    Yaghouby, Farid; Sunderam, Sridhar

    2015-04-01

    The limitations of manual sleep scoring make computerized methods highly desirable. Scoring errors can arise from human rater uncertainty or inter-rater variability. Sleep scoring algorithms either come as supervised classifiers that need scored samples of each state to be trained, or as unsupervised classifiers that use heuristics or structural clues in unscored data to define states. We propose a quasi-supervised classifier that models observations in an unsupervised manner but mimics a human rater wherever training scores are available. EEG, EMG, and EOG features were extracted in 30s epochs from human-scored polysomnograms recorded from 42 healthy human subjects (18-79 years) and archived in an anonymized, publicly accessible database. Hypnograms were modified so that: 1. Some states are scored but not others; 2. Samples of all states are scored but not for transitional epochs; and 3. Two raters with 67% agreement are simulated. A framework for quasi-supervised classification was devised in which unsupervised statistical models-specifically Gaussian mixtures and hidden Markov models--are estimated from unlabeled training data, but the training samples are augmented with variables whose values depend on available scores. Classifiers were fitted to signal features incorporating partial scores, and used to predict scores for complete recordings. Performance was assessed using Cohen's Κ statistic. The quasi-supervised classifier performed significantly better than an unsupervised model and sometimes as well as a completely supervised model despite receiving only partial scores. The quasi-supervised algorithm addresses the need for classifiers that mimic scoring patterns of human raters while compensating for their limitations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Supervised pelvic floor muscle training versus attention-control massage treatment in patients with faecal incontinence

    DEFF Research Database (Denmark)

    Ussing, Anja; Dahn, Inge; Due, Ulla

    2017-01-01

    supplements is recommended as first-line treatment for faecal incontinence. Despite this, the effect of pelvic floor muscle training for faecal incontinence is unclear. No previous trials have investigated the efficacy of supervised pelvic floor muscle training in combination with conservative treatment...... treatment and conservative treatment. The primary outcome is participants' rating of symptom changes after 16 weeks of treatment using the Patient Global Impression of Improvement Scale. Secondary outcomes are the Vaizey Incontinence Score, the Fecal Incontinence Severity Index, the Fecal Incontinence...

  20. Complexity in Vocational Education and Training Governance

    Science.gov (United States)

    Oliver, Damian

    2010-01-01

    Complexity is a feature common to all vocational education and training (VET) governance arrangements, due to the wide range of students VET systems caters for, and the number of stakeholders involved in both decision making and funding and financing. In this article, Pierre and Peter's framework of governance is used to examine complexity in VET…

  1. Extended apprenticeship learning in doctoral training and supervision - moving beyond 'cookbook recipes'

    DEFF Research Database (Denmark)

    Tanggaard, Lene; Wegener, Charlotte

    An apprenticeship perspective on learning in academia sheds light on the potential for mutual learning and production, and also reveals the diverse range of learning resources beyond the formal novice-–expert relationship. Although apprenticeship is a well-known concept in educational research......, in this case apprenticeship offers an innovative perspective on future practice and research in academia allowing more students access to high high-quality research training and giving supervisors a chance to combine their own research with their supervision obligations....

  2. Legislation and supervision

    International Nuclear Information System (INIS)

    1998-01-01

    In this part next aspects are described: (1) Legislative and supervision-related framework (reviews of structure of supervisory bodies; legislation; state supervision in the nuclear safety area, and state supervision in the area of health protection against radiation are given); (2) Operator's responsibility

  3. Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT) for anxiety disorders in youth: Psychometric properties.

    Science.gov (United States)

    Bjaastad, Jon Fauskanger; Haugland, Bente Storm Mowatt; Fjermestad, Krister W; Torsheim, Torbjørn; Havik, Odd E; Heiervang, Einar R; Öst, Lars-Göran

    2016-08-01

    The aim of the present study was to evaluate the psychometric properties of the Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT). The CAS-CBT is an 11-item scale developed to measure adherence and competence in cognitive-behavioral therapy (CBT) for anxiety disorders in youth. A total of 181 videotapes from the treatment sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014) comprising youth (N = 182, M age = 11.5 years, SD = 2.1, range 8-15 years, 53% girls, 90.7% Caucasian) with mixed anxiety disorders were assessed with the CAS-CBT to investigate interitem correlations, internal consistency, and factor structure. Internal consistency was good (Cronbach's alpha = .87). Factor analysis suggested a 2-factor solution with Factor 1 representing CBT structure and session goals (explaining 46.9% of the variance) and Factor 2 representing process and relational skills (explaining 19.7% of the variance). The sum-score for adherence and competence was strongly intercorrelated, r = .79, p .40, n = 10 videotapes) and also good to excellent interrater reliability when compared to expert raters (ICC = .83 for adherence and .64 for competence, n = 26 videotapes). High rater stability was also found (n = 15 videotapes). The findings suggest that the CAS-CBT is a reliable measure of adherence and competence in manualized CBT for anxiety disorders in youth. Further research is needed to investigate the validity of the scale and psychometric properties when used with other treatment programs, disorders and treatment formats. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. QUEST: Eliminating Online Supervised Learning for Efficient Classification Algorithms.

    Science.gov (United States)

    Zwartjes, Ardjan; Havinga, Paul J M; Smit, Gerard J M; Hurink, Johann L

    2016-10-01

    In this work, we introduce QUEST (QUantile Estimation after Supervised Training), an adaptive classification algorithm for Wireless Sensor Networks (WSNs) that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting raw sensor data puts high demands on the battery, reducing network life time. By merely transmitting partial results or classifications based on the sampled data, the amount of traffic on the network can be significantly reduced. Such classifications can be made by learning based algorithms using sampled data. An important issue, however, is the training phase of these learning based algorithms. Training a deployed sensor network requires a lot of communication and an impractical amount of human involvement. QUEST is a hybrid algorithm that combines supervised learning in a controlled environment with unsupervised learning on the location of deployment. Using the SITEX02 dataset, we demonstrate that the presented solution works with a performance penalty of less than 10% in 90% of the tests. Under some circumstances, it even outperforms a network of classifiers completely trained with supervised learning. As a result, the need for on-site supervised learning and communication for training is completely eliminated by our solution.

  5. Meaning Of The Term "Corruption Offense" As A Feature Of The Public Prosecutor's Supervision Over The Legislation On The Corruption Counteraction In The Municipal Governments Execution

    Directory of Open Access Journals (Sweden)

    Kseniya D. Okuneva

    2014-12-01

    Full Text Available In the present article theoretical and practical aspects of the corruption offense definition, which are being characteristic features of the methodology of prosecutorial supervision over the legislation on counteraction to corruption in local government are analyzed. Federal Law of Jan. 17, 1992 No. 2202-1 "On the Procuracy of the Russian Federation" (Article 21 establishes the public prosecutor's supervision over the legislation on combating corruption in local government execution, which is a special sub-cluster. On general terms of theoretical techniques of the prosecutor's supervision, taking into account its specific and complex nature of corruption prosecutors based activities in this area. Author emphasizes attention on characteristics of the corruption offense, as well as aspects of legal responsibility, which lie in the fact that it is applied in accordance with law to offender as measures of state coercion of personal, financial or organizational nature for the offense committed; responsibilities of the person, who committed the offense, to be subject to measures of state coercion. In the conclusion author notes that specifics of corruption offenses that are subject of prosecutorial supervision over the execution of legislation on combating corruption in local government is determined by the special status of the offense subjects, as well as the content of legal prohibitions and legal responsibilities in the field of ​​anti-corruption at the municipal level.

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

    Science.gov (United States)

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

    2010-02-01

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

  7. Speech reconstruction using a deep partially supervised neural network.

    Science.gov (United States)

    McLoughlin, Ian; Li, Jingjie; Song, Yan; Sharifzadeh, Hamid R

    2017-08-01

    Statistical speech reconstruction for larynx-related dysphonia has achieved good performance using Gaussian mixture models and, more recently, restricted Boltzmann machine arrays; however, deep neural network (DNN)-based systems have been hampered by the limited amount of training data available from individual voice-loss patients. The authors propose a novel DNN structure that allows a partially supervised training approach on spectral features from smaller data sets, yielding very good results compared with the current state-of-the-art.

  8. Cliché, Gossip, and Anecdote as Supervision Training

    Science.gov (United States)

    Grealy, Liam

    2016-01-01

    This article expands on a co-authored project with Timothy Laurie on the practices and ethics of higher degree research (HDR) supervision (or advising): "What does good HDR supervision look like?" in contemporary universities. It connects that project with scholarship on the relevance of "common sense" to questions of…

  9. SemiBoost: boosting for semi-supervised learning.

    Science.gov (United States)

    Mallapragada, Pavan Kumar; Jin, Rong; Jain, Anil K; Liu, Yi

    2009-11-01

    Semi-supervised learning has attracted a significant amount of attention in pattern recognition and machine learning. Most previous studies have focused on designing special algorithms to effectively exploit the unlabeled data in conjunction with labeled data. Our goal is to improve the classification accuracy of any given supervised learning algorithm by using the available unlabeled examples. We call this as the Semi-supervised improvement problem, to distinguish the proposed approach from the existing approaches. We design a metasemi-supervised learning algorithm that wraps around the underlying supervised algorithm and improves its performance using unlabeled data. This problem is particularly important when we need to train a supervised learning algorithm with a limited number of labeled examples and a multitude of unlabeled examples. We present a boosting framework for semi-supervised learning, termed as SemiBoost. The key advantages of the proposed semi-supervised learning approach are: 1) performance improvement of any supervised learning algorithm with a multitude of unlabeled data, 2) efficient computation by the iterative boosting algorithm, and 3) exploiting both manifold and cluster assumption in training classification models. An empirical study on 16 different data sets and text categorization demonstrates that the proposed framework improves the performance of several commonly used supervised learning algorithms, given a large number of unlabeled examples. We also show that the performance of the proposed algorithm, SemiBoost, is comparable to the state-of-the-art semi-supervised learning algorithms.

  10. Computer-Based Training at a Military Medical Center: Understanding Decreased Participation in Training among Staff and Ways to Improve Completion Rates

    Science.gov (United States)

    Lavender, Julie

    2013-01-01

    Military health care facilities make extensive use of computer-based training (CBT) for both clinical and non-clinical staff. Despite evidence identifying various factors that may impact CBT, the problem is unclear as to what factors specifically influence employee participation in computer-based training. The purpose of this mixed method case…

  11. Panel: Governance in Open Source Projects and Communities

    Science.gov (United States)

    Bolici, Francesco; de Laat, Paul; Ljungberg, Jan; Pontiggia, Andrea; Rossi Lamastra, Cristina

    “Although considerable research has been devoted to the growth and expansion of open source communities and the comparison between the efficiency of corporate structures and community structures in the field of software development, rather less attention has been paid to their governance structures (control, monitoring, supervision)” (Lattemann and Stieglitz 2005).

  12. 46 CFR 131.420 - Manning and supervision.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Manning and supervision. 131.420 Section 131.420 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS OPERATIONS Sufficiency and Supervision of Crew of Survival Craft § 131.420 Manning and supervision. (a) There must be enough trained persons aboard each survival craf...

  13. Supervision for School Psychologists in Training: Developing a Framework from Empirical Findings

    Science.gov (United States)

    Gibbs, Simon; Atkinson, Cathy; Woods, Kevin; Bond, Caroline; Hill, Vivian; Howe, Julia; Morris, Sue

    2016-01-01

    Similar to other professional disciplines, the importance of supervision within school psychology has attracted considerable attention within recent years. Despite this, systematic review of current literature reveals a dearth of empirical literature proposing underlying theoretical structures. This study extends recent qualitative research by…

  14. CBT for children with depressive symptoms: a meta-analysis.

    Science.gov (United States)

    Arnberg, Alexandra; Ost, Lars-Göran

    2014-01-01

    Pediatric depression entails a higher risk for psychiatric disorders, somatic complaints, suicide, and functional impairment later in life. Cognitive behavior therapy (CBT) is recommended for the treatment of depression in children, yet research is based primarily on adolescents. The present meta-analysis investigated the efficacy of CBT in children aged 8-12 years with regard to depressive symptoms. We included randomized controlled trials of CBT with participants who had an average age of  ≤ 12 years and were diagnosed with either depression or reported elevated depressive symptoms. The search resulted in 10 randomized controlled trials with 267 participants in intervention and 256 in comparison groups. The mean age of participants was 10.5 years. The weighted between-group effect size for CBT was moderate, Cohen's d = 0.66. CBT outperformed both attention placebo and wait-list, although there was a significant heterogeneity among studies with regard to effect sizes. The weighted within-group effect size for CBT was large, d = 1.02. Earlier publication year, older participants, and more treatment sessions were associated with a larger effect size. In conclusion, the efficacy of CBT in the treatment of pediatric depression symptoms was supported. Differences in efficacy, methodological shortcomings, and lack of follow-up data limit the present study and indicate areas in need of improvement.

  15. Financial Stability and Central Bank Governance

    NARCIS (Netherlands)

    Koetter, Michael; Roszbach, Kasper; Spagnolo, Giancarlo

    2014-01-01

    The financial crisis has ignited a debate about the appropriate objectives and the governance structure of Central Banks. We use novel survey data to investigate the relation between these traits and banking system stability focusing in particular on their role in micro-prudential supervision. We

  16. QUEST: Eliminating Online Supervised Learning for Efficient Classification Algorithms

    Directory of Open Access Journals (Sweden)

    Ardjan Zwartjes

    2016-10-01

    Full Text Available In this work, we introduce QUEST (QUantile Estimation after Supervised Training, an adaptive classification algorithm for Wireless Sensor Networks (WSNs that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting raw sensor data puts high demands on the battery, reducing network life time. By merely transmitting partial results or classifications based on the sampled data, the amount of traffic on the network can be significantly reduced. Such classifications can be made by learning based algorithms using sampled data. An important issue, however, is the training phase of these learning based algorithms. Training a deployed sensor network requires a lot of communication and an impractical amount of human involvement. QUEST is a hybrid algorithm that combines supervised learning in a controlled environment with unsupervised learning on the location of deployment. Using the SITEX02 dataset, we demonstrate that the presented solution works with a performance penalty of less than 10% in 90% of the tests. Under some circumstances, it even outperforms a network of classifiers completely trained with supervised learning. As a result, the need for on-site supervised learning and communication for training is completely eliminated by our solution.

  17. Educational Technology and Distance Supervision in Counselor Education

    Science.gov (United States)

    Carlisle, Robert Milton; Hays, Danica G.; Pribesh, Shana L.; Wood, Chris T.

    2017-01-01

    The authors used a nonexperimental descriptive design to examine the prevalence of distance supervision in counselor education programs, educational technology used in supervision, training on technology in supervision, and participants' (N = 673) perceptions of legal and ethical compliance. Program policies are recommended to guide the training…

  18. The Effects of Skill Training on Social Workers' Professional Competences in Norway: Results of a Cluster-Randomised Study

    Science.gov (United States)

    Malmberg-Heimonen, Ira; Natland, Sidsel; Tøge, Anne Grete; Hansen, Helle Cathrine

    2016-01-01

    Using a cluster-randomised design, this study analyses the effects of a government-administered skill training programme for social workers in Norway. The training programme aims to improve social workers' professional competences by enhancing and systematising follow-up work directed towards longer-term unemployed clients in the following areas: encountering the user, system-oriented efforts and administrative work. The main tools and techniques of the programme are based on motivational interviewing and appreciative inquiry. The data comprise responses to baseline and eighteen-month follow-up questionnaires administered to all social workers (n = 99) in eighteen participating Labour and Welfare offices randomised into experimental and control groups. The findings indicate that the skill training programme positively affected the social workers' evaluations of their professional competences and quality of work supervision received. The acquisition and mastering of combinations of specific tools and techniques, a comprehensive supervision structure and the opportunity to adapt the learned skills to local conditions were important in explaining the results. PMID:27559232

  19. The Application of Artificial Intelligence Principles to Teaching and Training

    Science.gov (United States)

    Shaw, Keith

    2008-01-01

    This paper compares and contrasts the use of AI principles in industrial training with more normal computer-based training (CBT) approaches. A number of applications of CBT are illustrated (for example simulations, tutorial presentations, fault diagnosis, management games, industrial relations exercises) and compared with an alternative approach…

  20. Treatment outcomes using CBT-IA with Internet-addicted patients.

    Science.gov (United States)

    Young, Kimberly S

    2013-12-01

    Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. RESULTS showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. RESULTS found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.

  1. Clinical Supervision of International Supervisees: Suggestions for Multicultural Supervision

    Science.gov (United States)

    Lee, Ahram

    2018-01-01

    An increase of international students in various settings has been noted in a range of disciplines including counseling and other mental health professions. The author examined the literature on international counseling students related to their experiences in counseling training, particularly in supervision. From the counseling literature, five…

  2. The Efficacy of Internet-Based Mindfulness Training and Cognitive-Behavioral Training With Telephone Support in the Enhancement of Mental Health Among College Students and Young Working Adults: Randomized Controlled Trial.

    Science.gov (United States)

    Mak, Winnie Ws; Chio, Floria Hn; Chan, Amy Ty; Lui, Wacy Ws; Wu, Ellery Ky

    2017-03-22

    College students and working adults are particularly vulnerable to stress and other mental health problems, and mental health promotion and prevention are needed to promote their mental health. In recent decades, mindfulness-based training has demonstrated to be efficacious in treating physical and psychological conditions. The aim of our study was to examine the efficacy of an Internet-based mindfulness training program (iMIND) in comparison with the well-established Internet-based cognitive-behavioral training program (iCBT) in promoting mental health among college students and young working adults. This study was a 2-arm, unblinded, randomized controlled trial comparing iMIND with iCBT. Participants were recruited online and offline via mass emails, advertisements in newspapers and magazines, announcement and leaflets in primary care clinics, and social networking sites. Eligible participants were randomized into either the iMIND (n=604) or the iCBT (n=651) condition. Participants received 8 Web-based sessions with information and exercises related to mindfulness or cognitive-behavioral principles. Telephone or email support was provided by trained first tier supporters who were supervised by the study's research team. Primary outcomes included mental and physical health-related measures, which were self-assessed online at preprogram, postprogram, and 3-month follow-up. Among the 1255 study participants, 213 and 127 completed the post- and 3-month follow-up assessment, respectively. Missing data were treated using restricted maximum likelihood estimation. Both iMIND (n=604) and iCBT (n=651) were efficacious in improving mental health, psychological distress, life satisfaction, sleep disturbance, and energy level. Both Internet-based mental health programs showed potential in improving the mental health from pre- to postassessment, and such improvement was sustained at the 3-month follow-up. The high attrition rate in this study suggests the need for refinement

  3. CBT Theory and Its Application: A School Phobic Kindergarten Case.

    Science.gov (United States)

    Sigmon, Scott B.

    Cognitive behavioral psychology is a new theoretical orientation and when applied in treatment it is known as cognitive behavior therapy (CBT). Theoretically CBT seeks primarily to change cognitions to alter behaviors and to modify cognitions to affect emotions. In general CBT is considered to be an information processing psychology because it…

  4. Cognitive Behavioral Therapy in Psychiatric Nursing in Japan

    Directory of Open Access Journals (Sweden)

    Naoki Yoshinaga

    2015-01-01

    Full Text Available Psychiatric nurses have played a significant role in disseminating cognitive behavioral therapy (CBT in Western countries; however, in Japan, the application, practice, efficiency, and quality control of CBT in the psychiatric nursing field are unclear. This study conducted a literature review to assess the current status of CBT practice and research in psychiatric nursing in Japan. Three English databases (MEDLINE, CINAHL, and PsycINFO and two Japanese databases (Ichushi-Web and CiNii were searched with predetermined keywords. Fifty-five articles met eligibility criteria: 46 case studies and 9 comparative studies. It was found that CBT took place primarily in inpatient settings and targeted schizophrenia and mood disorders. Although there were only a few comparative studies, each concluded that CBT was effective. However, CBT recipients and outcome measures were diverse, and nurses were not the only CBT practitioners in most reports. Only a few articles included the description of CBT training and supervision. This literature review clarified the current status of CBT in psychiatric nursing in Japan and identified important implications for future practice and research: performing CBT in a variety of settings and for a wide range of psychiatric disorders, conducting randomized controlled trials, and establishing pre- and postqualification training system.

  5. Supervised progressive cross-continuum strength training compared with usual care in older medical patients

    DEFF Research Database (Denmark)

    Pedersen, Mette Merete; Petersen, Janne; Beyer, Nina

    2016-01-01

    Background: Hospitalization in older adults is characterized by physical inactivity and a risk of losing function and independence. Systematic strength training can improve muscle strength and functional performance in older adults. Few studies have examined the effect of a program initiated during...... hospitalization and continued after discharge. We conducted a feasibility study prior to this trial and found a progression model for loaded sit-to-stands feasible in older medical patients. This study aims to determine whether a simple supervised strength training program for the lower extremities (based...... on the model), combined with post-training protein supplementation initiated during hospitalization and continued at home for 4 weeks, is superior to usual care on change in mobility 4 weeks after discharge in older medical patients. Methods: Eighty older medical patients (65 years or older) acutely admitted...

  6. Transfer learning improves supervised image segmentation across imaging protocols.

    Science.gov (United States)

    van Opbroek, Annegreet; Ikram, M Arfan; Vernooij, Meike W; de Bruijne, Marleen

    2015-05-01

    The variation between images obtained with different scanners or different imaging protocols presents a major challenge in automatic segmentation of biomedical images. This variation especially hampers the application of otherwise successful supervised-learning techniques which, in order to perform well, often require a large amount of labeled training data that is exactly representative of the target data. We therefore propose to use transfer learning for image segmentation. Transfer-learning techniques can cope with differences in distributions between training and target data, and therefore may improve performance over supervised learning for segmentation across scanners and scan protocols. We present four transfer classifiers that can train a classification scheme with only a small amount of representative training data, in addition to a larger amount of other training data with slightly different characteristics. The performance of the four transfer classifiers was compared to that of standard supervised classification on two magnetic resonance imaging brain-segmentation tasks with multi-site data: white matter, gray matter, and cerebrospinal fluid segmentation; and white-matter-/MS-lesion segmentation. The experiments showed that when there is only a small amount of representative training data available, transfer learning can greatly outperform common supervised-learning approaches, minimizing classification errors by up to 60%.

  7. Adult Attachment as a Moderator of Treatment Outcome for Generalized Anxiety Disorder: Comparison Between Cognitive–Behavioral Therapy (CBT) Plus Supportive Listening and CBT Plus Interpersonal and Emotional Processing Therapy

    Science.gov (United States)

    Newman, Michelle G.; Castonguay, Louis G.; Jacobson, Nicholas C.; Moore, Ginger A.

    2016-01-01

    Objective To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive–behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Method Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician’s Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Results Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. Conclusions When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment. PMID:26052875

  8. Adult attachment as a moderator of treatment outcome for generalized anxiety disorder: Comparison between cognitive-behavioral therapy (CBT) plus supportive listening and CBT plus interpersonal and emotional processing therapy.

    Science.gov (United States)

    Newman, Michelle G; Castonguay, Louis G; Jacobson, Nicholas C; Moore, Ginger A

    2015-10-01

    To determine whether baseline dimensions of adult insecure attachment (avoidant and anxious) moderated outcome in a secondary analysis of a randomized controlled trial comparing cognitive-behavioral therapy (CBT) plus supportive listening (CBT + SL) versus CBT plus interpersonal and emotional processing therapy (CBT + I/EP). Eighty-three participants diagnosed with generalized anxiety disorder (GAD) were recruited from the community and assigned randomly to CBT + SL (n = 40) or to CBT + I/EP (n = 43) within a study using an additive design. PhD-level psychologists treated participants. Blind assessors evaluated participants at pretreatment, posttreatment, 6-month, 12-month, and 2-year follow-up with a composite of self-report and assessor-rated GAD symptom measures (Penn State Worry Questionnaire, Hamilton Anxiety Rating Scale, Clinician's Severity Rating). Avoidant and anxious attachment were assessed using self-reported dismissing and angry states of mind, respectively, on the Perceptions of Adult Attachment Questionnaire. Consistent with our prediction, at all assessments higher levels of dismissing styles in those who received CBT + I/EP predicted greater change in GAD symptoms compared with those who received CBT + SL for whom dismissiveness was unrelated to the change. At postassessment, higher angry attachment was associated with less change in GAD symptoms for those receiving CBT + I/EP, compared with CBT + SL, for whom anger was unrelated to change in GAD symptoms. Pretreatment attachment-related anger failed to moderate outcome at other time points and therefore, these moderation effects were more short-lived than the ones for dismissing attachment. When compared with CBT + SL, CBT + I/EP may be better for individuals with GAD who have relatively higher dismissing styles of attachment. (c) 2015 APA, all rights reserved).

  9. Routine health information system utilization and factors associated thereof among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia.

    Science.gov (United States)

    Shiferaw, Atsede Mazengia; Zegeye, Dessalegn Tegabu; Assefa, Solomon; Yenit, Melaku Kindie

    2017-08-07

    Using reliable information from routine health information systems over time is an important aid to improving health outcomes, tackling disparities, enhancing efficiency, and encouraging innovation. In Ethiopia, routine health information utilization for enhancing performance is poor among health workers, especially at the peripheral levels of health facilities. Therefore, this study aimed to assess routine health information system utilization and associated factors among health workers at government health institutions in East Gojjam Zone, Northwest Ethiopia. An institution based cross-sectional study was conducted at government health institutions of East Gojjam Zone, Northwest Ethiopia from April to May, 2013. A total of 668 health workers were selected from government health institutions, using the cluster sampling technique. Data collected using a standard structured and self-administered questionnaire and an observational checklist were cleaned, coded, and entered into Epi-info version 3.5.3, and transferred into SPSS version 20 for further statistical analysis. Variables with a p-value of less than 0.05 at multiple logistic regression analysis were considered statistically significant factors for the utilization of routine health information systems. The study revealed that 45.8% of the health workers had a good level of routine health information utilization. HMIS training [AOR = 2.72, 95% CI: 1.60, 4.62], good data analysis skills [AOR = 6.40, 95%CI: 3.93, 10.37], supervision [AOR = 2.60, 95% CI: 1.42, 4.75], regular feedback [AOR = 2.20, 95% CI: 1.38, 3.51], and favorable attitude towards health information utilization [AOR = 2.85, 95% CI: 1.78, 4.54] were found significantly associated with a good level of routine health information utilization. More than half of the health workers working at government health institutions of East Gojjam were poor health information users compared with the findings of others studies. HMIS training, data

  10. Effects of a Supervised versus an Unsupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Lacroix, André; Kressig, Reto W; Muehlbauer, Thomas; Gschwind, Yves J; Pfenninger, Barbara; Bruegger, Othmar; Granacher, Urs

    2016-01-01

    Losses in lower extremity muscle strength/power, muscle mass and deficits in static and particularly dynamic balance due to aging are associated with impaired functional performance and an increased fall risk. It has been shown that the combination of balance and strength training (BST) mitigates these age-related deficits. However, it is unresolved whether supervised versus unsupervised BST is equally effective in improving muscle power and balance in older adults. This study examined the impact of a 12-week BST program followed by 12 weeks of detraining on measures of balance and muscle power in healthy older adults enrolled in supervised (SUP) or unsupervised (UNSUP) training. Sixty-six older adults (men: 25, women: 41; age 73 ± 4 years) were randomly assigned to a SUP group (2/week supervised training, 1/week unsupervised training; n = 22), an UNSUP group (3/week unsupervised training; n = 22) or a passive control group (CON; n = 22). Static (i.e., Romberg Test) and dynamic (i.e., 10-meter walk test) steady-state, proactive (i.e., Timed Up and Go Test, Functional Reach Test), and reactive balance (e.g., Push and Release Test), as well as lower extremity muscle power (i.e., Chair Stand Test; Stair Ascent and Descent Test) were tested before and after the active training phase as well as after detraining. Adherence rates to training were 92% for SUP and 97% for UNSUP. BST resulted in significant group × time interactions. Post hoc analyses showed, among others, significant training-related improvements for the Romberg Test, stride velocity, Timed Up and Go Test, and Chair Stand Test in favor of the SUP group. Following detraining, significantly enhanced performances (compared to baseline) were still present in 13 variables for the SUP group and in 10 variables for the UNSUP group. Twelve weeks of BST proved to be safe (no training-related injuries) and feasible (high attendance rates of >90%). Deficits of balance and lower extremity muscle power can be

  11. The effectiveness of banking supervision

    OpenAIRE

    Davis, EP; Obasi, U

    2009-01-01

    Banking supervision is an essential aspect of modern financial systems, seeking crucially to monitor risk-taking by banks so as to protect depositors, the government safety net and the economy as a whole against systemic bank failure and its consequences. In this context, this paper seeks to explore the relationship between risk indicators for individual banks and the different approaches to banking supervision adopted around the world. This is the first work to make use of the currently avai...

  12. Wellness Model of Supervision: A Comparative Analysis

    Science.gov (United States)

    Lenz, A. Stephen; Sangganjanavanich, Varunee Faii; Balkin, Richard S.; Oliver, Marvarene; Smith, Robert L.

    2012-01-01

    This quasi-experimental study compared the effectiveness of the Wellness Model of Supervision (WELMS; Lenz & Smith, 2010) with alternative supervision models for developing wellness constructs, total personal wellness, and helping skills among counselors-in-training. Participants were 32 master's-level counseling students completing their…

  13. A Comparison of Supervised Machine Learning Algorithms and Feature Vectors for MS Lesion Segmentation Using Multimodal Structural MRI

    Science.gov (United States)

    Sweeney, Elizabeth M.; Vogelstein, Joshua T.; Cuzzocreo, Jennifer L.; Calabresi, Peter A.; Reich, Daniel S.; Crainiceanu, Ciprian M.; Shinohara, Russell T.

    2014-01-01

    Machine learning is a popular method for mining and analyzing large collections of medical data. We focus on a particular problem from medical research, supervised multiple sclerosis (MS) lesion segmentation in structural magnetic resonance imaging (MRI). We examine the extent to which the choice of machine learning or classification algorithm and feature extraction function impacts the performance of lesion segmentation methods. As quantitative measures derived from structural MRI are important clinical tools for research into the pathophysiology and natural history of MS, the development of automated lesion segmentation methods is an active research field. Yet, little is known about what drives performance of these methods. We evaluate the performance of automated MS lesion segmentation methods, which consist of a supervised classification algorithm composed with a feature extraction function. These feature extraction functions act on the observed T1-weighted (T1-w), T2-weighted (T2-w) and fluid-attenuated inversion recovery (FLAIR) MRI voxel intensities. Each MRI study has a manual lesion segmentation that we use to train and validate the supervised classification algorithms. Our main finding is that the differences in predictive performance are due more to differences in the feature vectors, rather than the machine learning or classification algorithms. Features that incorporate information from neighboring voxels in the brain were found to increase performance substantially. For lesion segmentation, we conclude that it is better to use simple, interpretable, and fast algorithms, such as logistic regression, linear discriminant analysis, and quadratic discriminant analysis, and to develop the features to improve performance. PMID:24781953

  14. Incidental treatment effects of CBT on suicidal ideation and hopelessness.

    Science.gov (United States)

    Handley, Tonelle E; Kay-Lambkin, Frances J; Baker, Amanda L; Lewin, Terry J; Kelly, Brian J; Inder, Kerry J; Attia, John R; Kavanagh, David J

    2013-10-01

    Depression and alcohol misuse are among the most prevalent diagnoses in suicide fatalities. The risk posed by these disorders is exacerbated when they co-occur. Limited research has evaluated the effectiveness of common depression and alcohol treatments for the reduction of suicide vulnerability in individuals experiencing comorbidity. Participants with depressive symptoms and hazardous alcohol use were selected from two randomised controlled trials. They had received either a brief (1 session) intervention, or depression-focused cognitive behaviour therapy (CBT), alcohol-focused CBT, therapist-delivered integrated CBT, computer-delivered integrated CBT or person-centred therapy (PCT) over a 10-week period. Suicidal ideation, hopelessness, depression severity and alcohol consumption were assessed at baseline and 12-month follow-up. Three hundred three participants were assessed at baseline and 12 months. Both suicidal ideation and hopelessness were associated with higher severity of depressive symptoms, but not with alcohol consumption. Suicidal ideation did not improve significantly at follow-up, with no differences between treatment conditions. Improvements in hopelessness differed between treatment conditions; hopelessness improved more in the CBT conditions compared to PCT and in single-focused CBT compared to integrated CBT. Low retention rates may have impacted on the reliability of our findings. Combining data from two studies may have resulted in heterogeneity of samples between conditions. CBT appears to be associated with reductions in hopelessness in people with co-occurring depression and alcohol misuse, even when it is not the focus of treatment. Less consistent results were observed for suicidal ideation. Establishing specific procedures or therapeutic content for clinicians to monitor these outcomes may result in better management of individuals with higher vulnerability for suicide. © 2013 Elsevier B.V. All rights reserved.

  15. Educating Occupational Therapists in the Use of Theory and Evidence to Enhance Supervision Practice

    Directory of Open Access Journals (Sweden)

    Melanie J. Roberts

    2017-10-01

    Full Text Available This paper describes the implementation of a unique learning experience aimed at enhancing the quality of supervision practice in occupational therapy at the Gold Coast Hospital and Health Service. The package was designed by experienced occupational therapy educators based on adult, blended, and flipped learning approaches with content developed following administration of a standardized tool and semi-structured interviews. The learning package focused particularly on the logistics of supervision and the use of occupational therapy theory and evidence with supervision. The training for supervising therapists included a workshop and pre and post workshop learning activities. This collaborative research approach to designing and implementing a learning package as well as the specific content of the ongoing education opportunities could also be transferred to other services.

  16. Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function

    DEFF Research Database (Denmark)

    Stolberg, Charlotte Røn; Mundbjerg, Lene Hymøller; Funch-Jensen, Peter

    2018-01-01

    Background and aims: Obesity and physical inactivity are both associated with low-grade inflammation and endothelial dysfunction. Bariatric surgery improves markers of inflammation and endothelial function, but it is unknown if physical training after bariatric surgery can improve these markers...... even further. Therefore, we aimed to investigate the effects of Roux-en-Y gastric bypass (RYGB) followed by physical training on markers of low-grade inflammation and endothelial function. Methods: Sixty patients approved for RYGB underwent examinations pre-surgery, 6, 12, and 24 months post......-surgery. Six months post-surgery, they were randomized 1:1 to an intervention group or a control group. The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks. Fasting blood samples were analyzed for concentrations of interleukin 6 (IL-6...

  17. AI in Computer-Based Training

    Science.gov (United States)

    Camstra, Bert

    2008-01-01

    In this paper, intelligent approaches to CBT are put into several perspectives in an attempt to elucidate the concepts and give them a more realistic (and not only glamorous) footing. The role of expert systems in training is explored and possible routes towards intelligent CBT are outlined. [This paper was first published in "Interactive Learning…

  18. Processes of Change in CBT of Adolescent Depression: Review and Recommendations

    Science.gov (United States)

    Webb, Christian A.; Auerbach, Randy P.; DeRubeis, Robert J.

    2012-01-01

    A growing body of research supports the efficacy of cognitive-behavioral therapy (CBT) for adolescent depression. The mechanisms through which CBT exerts its beneficial effects on adolescent patients suffering from depression, however, remain unclear. The current article reviews the CBT for adolescent depression process literature. Our review…

  19. Nursing supervision for care comprehensiveness

    Directory of Open Access Journals (Sweden)

    Lucieli Dias Pedreschi Chaves

    Full Text Available ABSTRACT Objective: To reflect on nursing supervision as a management tool for care comprehensiveness by nurses, considering its potential and limits in the current scenario. Method: A reflective study based on discourse about nursing supervision, presenting theoretical and practical concepts and approaches. Results: Limits on the exercise of supervision are related to the organization of healthcare services based on the functional and clinical model of care, in addition to possible gaps in the nurse training process and work overload. Regarding the potential, researchers emphasize that supervision is a tool for coordinating care and management actions, which may favor care comprehensiveness, and stimulate positive attitudes toward cooperation and contribution within teams, co-responsibility, and educational development at work. Final considerations: Nursing supervision may help enhance care comprehensiveness by implying continuous reflection on including the dynamics of the healthcare work process and user needs in care networks.

  20. Projected estimators for robust semi-supervised classification

    DEFF Research Database (Denmark)

    Krijthe, Jesse H.; Loog, Marco

    2017-01-01

    For semi-supervised techniques to be applied safely in practice we at least want methods to outperform their supervised counterparts. We study this question for classification using the well-known quadratic surrogate loss function. Unlike other approaches to semi-supervised learning, the procedure...... specifically, we prove that, measured on the labeled and unlabeled training data, this semi-supervised procedure never gives a lower quadratic loss than the supervised alternative. To our knowledge this is the first approach that offers such strong, albeit conservative, guarantees for improvement over...... the supervised solution. The characteristics of our approach are explicated using benchmark datasets to further understand the similarities and differences between the quadratic loss criterion used in the theoretical results and the classification accuracy typically considered in practice....

  1. [Feedback on the training and supervision of student nurses].

    Science.gov (United States)

    Papas, Anne; Bourgois, Monique

    2015-03-01

    In order to harmonise the supervision of student nurses in the different departments of the same unit, a Parisian hospital team has created a working group. An IT tool for supervising the students to be used by the whole unit is also under development. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. 上市保险企业的融资方式与治理结构分析%Analysis on the Financial Mode and Governance Structure of Listed Insurance Companies

    Institute of Scientific and Technical Information of China (English)

    胡克松; 臧萌

    2017-01-01

    Different financing mode decides different capital structure,and it has important influence on corporate governance structure.Based on the theories of financing mode and corporate governance structure,by using the case analysis method,this paper analyses listed insurance companies' financing mode and corporate governance structure;and put forward the following suggestions:increase the proportion of endogenous financing and bond financing,and optimize external supervision environment and internal supervision mechanism.%公司的融资方式决定了公司的资本构成,并对公司治理结构产生重要影响.文章从融资方式与公司治理结构的相关理论入手,用案例分析方法对我国上市保险企业的融资方式和治理结构进行分析,进而提出以下建议:增加内源融资和债券融资的比例,优化外部监督环境和内部监督机制.

  3. Cross-Domain Semi-Supervised Learning Using Feature Formulation.

    Science.gov (United States)

    Xingquan Zhu

    2011-12-01

    Semi-Supervised Learning (SSL) traditionally makes use of unlabeled samples by including them into the training set through an automated labeling process. Such a primitive Semi-Supervised Learning (pSSL) approach suffers from a number of disadvantages including false labeling and incapable of utilizing out-of-domain samples. In this paper, we propose a formative Semi-Supervised Learning (fSSL) framework which explores hidden features between labeled and unlabeled samples to achieve semi-supervised learning. fSSL regards that both labeled and unlabeled samples are generated from some hidden concepts with labeling information partially observable for some samples. The key of the fSSL is to recover the hidden concepts, and take them as new features to link labeled and unlabeled samples for semi-supervised learning. Because unlabeled samples are only used to generate new features, but not to be explicitly included in the training set like pSSL does, fSSL overcomes the inherent disadvantages of the traditional pSSL methods, especially for samples not within the same domain as the labeled instances. Experimental results and comparisons demonstrate that fSSL significantly outperforms pSSL-based methods for both within-domain and cross-domain semi-supervised learning.

  4. Attachment as a predictor of non response to CBT treatment in children with anxiety disorders

    DEFF Research Database (Denmark)

    Walczak, Monika Anna; Esbjørn, Barbara Hoff; Breinholst, Sonja

    2017-01-01

    Children’s and parents’ attachment patterns have been linked with the presence of pediatric anxiety disorders. The present study examined the role of attachment in predicting cognitive behavior therapy (CBT) treatment outcomes. A total of 69 children aged 7–13 years were assessed using a semi......-structured interview, and treated with CBT. Differences between responders and nonresponders with regard to pretreatment characteristics were explored, and the predictive power of factors significantly different between groups was assessed using binominal logistic regression. Responders and nonresponders did...

  5. Discriminative Localization in CNNs for Weakly-Supervised Segmentation of Pulmonary Nodules.

    Science.gov (United States)

    Feng, Xinyang; Yang, Jie; Laine, Andrew F; Angelini, Elsa D

    2017-09-01

    Automated detection and segmentation of pulmonary nodules on lung computed tomography (CT) scans can facilitate early lung cancer diagnosis. Existing supervised approaches for automated nodule segmentation on CT scans require voxel-based annotations for training, which are labor- and time-consuming to obtain. In this work, we propose a weakly-supervised method that generates accurate voxel-level nodule segmentation trained with image-level labels only. By adapting a convolutional neural network (CNN) trained for image classification, our proposed method learns discriminative regions from the activation maps of convolution units at different scales, and identifies the true nodule location with a novel candidate-screening framework. Experimental results on the public LIDC-IDRI dataset demonstrate that, our weakly-supervised nodule segmentation framework achieves competitive performance compared to a fully-supervised CNN-based segmentation method.

  6. Current Risk Management Practices in Psychotherapy Supervision.

    Science.gov (United States)

    Mehrtens, Ilayna K; Crapanzano, Kathleen; Tynes, L Lee

    2017-12-01

    Psychotherapy competence is a core skill for psychiatry residents, and psychotherapy supervision is a time-honored approach to teaching this skill. To explore the current supervision practices of psychiatry training programs, a 24-item questionnaire was sent to all program directors of Accreditation Council for Graduate Medical Education (ACGME)-approved adult psychiatry programs. The questionnaire included items regarding adherence to recently proposed therapy supervision practices aimed at reducing potential liability risk. The results suggested that current therapy supervision practices do not include sufficient management of the potential liability involved in therapy supervision. Better protections for patients, residents, supervisors and the institutions would be possible with improved credentialing practices and better documentation of informed consent and supervision policies and procedures. © 2017 American Academy of Psychiatry and the Law.

  7. Genetic Counseling Supervisors' Self-Efficacy for Select Clinical Supervision Competencies.

    Science.gov (United States)

    Finley, Sabra Ledare; Veach, Pat McCarthy; MacFarlane, Ian M; LeRoy, Bonnie S; Callanan, Nancy

    2016-04-01

    Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors' perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0-100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants' self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student's report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.

  8. Nuclear supervision - Administration by the federal states on behalf of the Federal Government or direct federal administration? Evaluation from a practical point of view

    International Nuclear Information System (INIS)

    Cloosters, W.

    2005-01-01

    The organization of supervisory authorities under the Atomic Energy Act is not a new issue. In fact, it was discussed vehemently in the Federal Republic of Germany as far back as in the early fifties. Federal legislation in late 1959 decided to have the Atomic Energy Act executed in part under direct federal responsibility and, as far as the important supervision of the nuclear power plants operated in the Federal Republic of Germany was concerned, by the federal states on behalf of the federal government. Federal Minister for the Environment Trittin reopened the debate about the organization of nuclear administration by announcing his intention to transfer the supervision of nuclear power plants to direct federal administration. This announcement not only raises the question of legal permissibility of transferring nuclear power plant oversight to federal administration, but also requires a critical review, as presented in this article, of practical regulatory supervision to ensure safe operation of nuclear facilities. In this connection, both the actual content of supervisory activities and the way in which they are carried out must be examined in an effort to find an answer based on solid premises to the question raised above. For reasons explained in the contribution, oversight of nuclear power plants cannot be carried out as a centralized function. Instead, the legislative decision of 1959 in favor of the federal states exercising supervision on behalf of the federal government continues to be correct at the present stage also in the light of the steps initiated to opt out of the peaceful uses of nuclear power. (orig.)

  9. Yoga-enhanced cognitive behavioural therapy (Y-CBT) for anxiety management: a pilot study.

    Science.gov (United States)

    Khalsa, Manjit K; Greiner-Ferris, Julie M; Hofmann, Stefan G; Khalsa, Sat Bir S

    2015-01-01

    Cognitive behavioural therapy (CBT) is an effective treatment for generalized anxiety disorder, but there is still room for improvement. The aim of the present study was to examine the potential benefit of enriching CBT with kundalini yoga (Y-CBT). Participants consisted of treatment resistant clients at a community mental health clinic. A total of 32 participants enrolled in the study and 22 completed the programme. After the Y-CBT intervention, pre-post comparisons showed statistically significant improvements in state and trait anxiety, depression, panic, sleep and quality of life. Results from this preliminary study suggest that Y-CBT may have potential as a promising treatment for those suffering from generalized anxiety disorder. Yoga-enhanced cognitive behavioural therapy (Y-CBT) may be a promising new treatment for those suffering from generalized anxiety disorder. Y-CBT may also reduce depression in those suffering from generalized anxiety. Y-CBT may reduce depression and anxiety in a clinic population where clients suffer from multiple diagnoses including generalized anxiety disorder. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Supervised learning with restricted training sets: a generating functional analysis

    Energy Technology Data Exchange (ETDEWEB)

    Heimel, J.A.F.; Coolen, A.C.C. [Department of Mathematics, King' s College London, Strand, London (United Kingdom)

    2001-10-26

    We study the dynamics of supervised on-line learning of realizable tasks in feed-forward neural networks. We focus on the regime where the number of examples used for training is proportional to the number of input channels N. Using generating functional techniques from spin glass theory, we are able to average over the composition of the training set and transform the problem for N{yields}{infinity} to an effective single pattern system described completely by the student autocovariance, the student-teacher overlap and the student response function with exact closed equations. Our method applies to arbitrary learning rules, i.e., not necessarily of a gradient-descent type. The resulting exact macroscopic dynamical equations can be integrated without finite-size effects up to any degree of accuracy, but their main value is in providing an exact and simple starting point for analytical approximation schemes. Finally, we show how, in the region of absent anomalous response and using the hypothesis that (as in detailed balance systems) the short-time part of the various operators can be transformed away, one can describe the stationary state of the network successfully by a set of coupled equations involving only four scalar order parameters. (author)

  11. Determining effects of non-synonymous SNPs on protein-protein interactions using supervised and semi-supervised learning.

    Directory of Open Access Journals (Sweden)

    Nan Zhao

    2014-05-01

    Full Text Available Single nucleotide polymorphisms (SNPs are among the most common types of genetic variation in complex genetic disorders. A growing number of studies link the functional role of SNPs with the networks and pathways mediated by the disease-associated genes. For example, many non-synonymous missense SNPs (nsSNPs have been found near or inside the protein-protein interaction (PPI interfaces. Determining whether such nsSNP will disrupt or preserve a PPI is a challenging task to address, both experimentally and computationally. Here, we present this task as three related classification problems, and develop a new computational method, called the SNP-IN tool (non-synonymous SNP INteraction effect predictor. Our method predicts the effects of nsSNPs on PPIs, given the interaction's structure. It leverages supervised and semi-supervised feature-based classifiers, including our new Random Forest self-learning protocol. The classifiers are trained based on a dataset of comprehensive mutagenesis studies for 151 PPI complexes, with experimentally determined binding affinities of the mutant and wild-type interactions. Three classification problems were considered: (1 a 2-class problem (strengthening/weakening PPI mutations, (2 another 2-class problem (mutations that disrupt/preserve a PPI, and (3 a 3-class classification (detrimental/neutral/beneficial mutation effects. In total, 11 different supervised and semi-supervised classifiers were trained and assessed resulting in a promising performance, with the weighted f-measure ranging from 0.87 for Problem 1 to 0.70 for the most challenging Problem 3. By integrating prediction results of the 2-class classifiers into the 3-class classifier, we further improved its performance for Problem 3. To demonstrate the utility of SNP-IN tool, it was applied to study the nsSNP-induced rewiring of two disease-centered networks. The accurate and balanced performance of SNP-IN tool makes it readily available to study the

  12. Determining Effects of Non-synonymous SNPs on Protein-Protein Interactions using Supervised and Semi-supervised Learning

    Science.gov (United States)

    Zhao, Nan; Han, Jing Ginger; Shyu, Chi-Ren; Korkin, Dmitry

    2014-01-01

    Single nucleotide polymorphisms (SNPs) are among the most common types of genetic variation in complex genetic disorders. A growing number of studies link the functional role of SNPs with the networks and pathways mediated by the disease-associated genes. For example, many non-synonymous missense SNPs (nsSNPs) have been found near or inside the protein-protein interaction (PPI) interfaces. Determining whether such nsSNP will disrupt or preserve a PPI is a challenging task to address, both experimentally and computationally. Here, we present this task as three related classification problems, and develop a new computational method, called the SNP-IN tool (non-synonymous SNP INteraction effect predictor). Our method predicts the effects of nsSNPs on PPIs, given the interaction's structure. It leverages supervised and semi-supervised feature-based classifiers, including our new Random Forest self-learning protocol. The classifiers are trained based on a dataset of comprehensive mutagenesis studies for 151 PPI complexes, with experimentally determined binding affinities of the mutant and wild-type interactions. Three classification problems were considered: (1) a 2-class problem (strengthening/weakening PPI mutations), (2) another 2-class problem (mutations that disrupt/preserve a PPI), and (3) a 3-class classification (detrimental/neutral/beneficial mutation effects). In total, 11 different supervised and semi-supervised classifiers were trained and assessed resulting in a promising performance, with the weighted f-measure ranging from 0.87 for Problem 1 to 0.70 for the most challenging Problem 3. By integrating prediction results of the 2-class classifiers into the 3-class classifier, we further improved its performance for Problem 3. To demonstrate the utility of SNP-IN tool, it was applied to study the nsSNP-induced rewiring of two disease-centered networks. The accurate and balanced performance of SNP-IN tool makes it readily available to study the rewiring of

  13. The nature and structure of supervision in health visiting with victims of child sexual abuse.

    Science.gov (United States)

    Scott, L

    1999-03-01

    Part of a higher research degree to explore professional practice. To explore how health visitors work with victims of child sexual abuse and the supervision systems to support them. To seek the views and experiences of practising health visitors relating to complex care in order to consider the nature and structure of supervision. The research reported in this paper used a qualitative method of research and semi-structured interviews with practising health visitors of varying levels of experience in venues around England. Qualitative research enabled the exploration of experiences. Identification of the need for regular, structured, accountable opportunities in a 'private setting' to discuss whole caseload work and current practice issues. Supervision requires a structured, formalized process, in both regularity and content, as a means to explore and acknowledge work with increasingly complex care, to enable full discussion of whole caseloads. Supervision is demonstrated as a vehicle to enable the sharing of good practices and for weak practices to be identified and managed appropriately. Supervision seeks to fulfil the above whilst promoting a stimulating, learning experience, accommodating the notion that individuals learn at their own pace and bring a wealth of human experience to the service. The size of the study was dictated by the amount of time available within which to complete a research master's degree course primarily in the author's own time, over a 2-year period. The majority of participants volunteered their accounts in their own time. For others I obtained permission from their employers for them to participate once they approached me with an interest in being interviewed. This research provides a model of supervision based on practitioner views and experiences. The article highlights the value of research and evidence-based information to enhance practice accountability and the quality of care. Proactive risk management can safeguard the health

  14. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

    Science.gov (United States)

    Bosch-Capblanch, Xavier; Marceau, Claudine

    2014-12-01

    To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which

  15. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

    Science.gov (United States)

    Bosch–Capblanch, Xavier; Marceau, Claudine

    2014-01-01

    Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong

  16. [An exploratory study of 'blended' cognitive behavioural therapy (CBT) for patients with a panic disorder: results and patients' experiences].

    Science.gov (United States)

    Bruinsma, A; Kampman, M; Exterkate, C C; Hendriks, G J

    2016-01-01

    Digital technology (e-health or 'blended' care), combined with evidence-based face-to-face CBT, is becoming increasingly implemented into mental health care and is expected to result in improved effectiveness and efficiency. To explore the feasibility of blended CBT for patients with a panic disorder. Nine face-to-face sessions of blended CBT (n = 18), supplemented with the digital support of a tabletcomputer and three e-mail contacts, were compared with 12 weekly sessions of regular CBT (n = 18). Primary outcomes were panic frequency and avoidance behaviour; the secondary outcome was general functioning. Patients' experiences of the treatment were collected in the form of a structured interview. The effect sizes found in both the regular and the blended CBT were medium to high (Cohen's d 0.42-1.60). In both types of treatment there was a significant reduction in patients' symptoms. There were no big differences in patient satisfaction regarding the treatment received. The therapists registered 39 face-to-face minutes in the blended treatment but they registered in total 41 fewer face-to-face minutes; this represented a time reduction of 4%. Blended CBT with help of a tablet computer seems to be a suitable method for treating panic disorder psychologically, although the time saved is only moderate. Much more research is needed to ascertain the feasibility and the cost effectiveness of blended CBT.

  17. Clinical relevance of findings in trials of CBT for depression.

    Science.gov (United States)

    Lepping, P; Whittington, R; Sambhi, R S; Lane, S; Poole, R; Leucht, S; Cuijpers, P; McCabe, R; Waheed, W

    2017-09-01

    Cognitive behavioural therapy (CBT) is beneficial in depression. Symptom scores can be translated into Clinical Global Impression (CGI) scale scores to indicate clinical relevance. We aimed to assess the clinical relevance of findings of randomised controlled trials (RCTs) of CBT in depression. We identified RCTs of CBT that used the Hamilton Rating Scale for Depression (HAMD). HAMD scores were translated into Clinical Global Impression - Change scale (CGI-I) scores to measure clinical relevance. One hundred and seventy datasets from 82 studies were included. The mean percentage HAMD change for treatment arms was 53.66%, and 29.81% for control arms, a statistically significant difference. Combined active therapies showed the biggest improvement on CGI-I score, followed by CBT alone. All active treatments had better than expected HAMD percentage reduction and CGI-I scores. CBT has a clinically relevant effect in depression, with a notional CGI-I score of 2.2, indicating a significant clinical response. The non-specific or placebo effect of being in a psychotherapy trial was a 29% reduction of HAMD. Copyright © 2017. Published by Elsevier Masson SAS.

  18. [Can we do therapy without a therapist? Active components of computer-based CBT for depression].

    Science.gov (United States)

    Iakimova, G; Dimitrova, S; Burté, T

    2017-12-01

    Computer-delivered Cognitive Behavioral Therapies (C-CBT) are emerging as therapeutic techniques which contribute to overcome the barriers of health care access in adult populations with depression. The C-CBTs provide CBT techniques in a highly structured format comprising a number of educational lessons, homework, multimedia illustrations and supplementary materials via interactive computer interfaces. Programs are often administrated with a minimal or regular support provided by a clinician or a technician via email, telephone, online forums, or during face-to-face consultations. However, a lot of C-CBT is provided without any therapeutic support. Several reports showed that C-CBTs, both guided or unguided by a therapist, may be reliable and effective for patients with depression, and their use was recommended as part of the first step of the clinical care. The aim of the present qualitative review is to describe the operational format and functioning of five of the most cited unguided C-CBT programs for depression, to analyze their characteristics according to the CBT's principles, and to discuss the results of the randomized clinical trials (RCT) conducted to evaluate its effectiveness, adherence and user's experience. We analyzed five C-CBTs: Beating The Blues (BTB), MoodGYM, Sadness, Deprexis and Overcoming Depression on the Internet (ODIN) and 22 randomized controlled studies according to 5 dimensions: General characteristics; Methodology, structure and organization; Specific modules, themes and techniques: Clinical indications, recruitment mode, type of users with depression, type and mode of therapist's support, overall therapeutic effects, adherence and user's experience. The C-CBT have a secured free or pay-to-use access in different languages (English, German, Dutch, and Chinese) but not in French. The programs may be accessed at a medical center or at home via a CD-ROM or via an Internet connection. Some C-CBTs are very close to textual self

  19. Protocols and Results of Resident Neurosurgeon's Transfemoral Catheter Angiography Training Supervised by Neuroendovascular Specialists

    Science.gov (United States)

    Shin, Dong-Seong; Yeo, Dong-Kyu; Hwang, Sun-Chul; Park, Sukh-Que

    2013-01-01

    Objective Transfemoral catheter angiography (TFCA) is a basic procedure in neurovascular surgery with increasing importance in surgical and non-invasive treatments. Unfortunately, resident neurosurgeons have relatively few opportunities to perform TFCA in most institutions. We report a method developed in our hospital for training resident neurosurgeons to perform TFCA and evaluate the efficacy of this training. Methods From May 2011 to September 2011, a total of 112 consecutive patients underwent TFCA by one resident neurosurgeon supervised by two neuroendovascular specialists. Patients who underwent elective diagnostic procedures were included in this study. Patients who underwent endovascular treatment were excluded. Demographic data, indications for TFCA, side of approach, number of selected arteries, and complications were analyzed. Results This study included 64 males and 48 females with a mean age of 51.6 (12-81) years. All procedures were performed in the angiography suite. Common indications for procedures were as follows: stroke-induced symptoms in 61 patients (54.5%), Moyamoya disease and arteriovenous malformation in 13 patients (11.6%), and unruptured intracranial aneurysm in eight patients (7.1%). Right and left femoral puncture was performed in 98.2% and 1.8% of patients, respectively. A total of 465 selective angiographies were performed without complications. Angiographic examination was performed on 4.15 vessels per patient. Conclusion TFCA can be performed safely by resident neurosurgeons based on anatomical study and a meticulous protocol under the careful supervision of neuroendovascular specialists. PMID:24175020

  20. A Delphi Study and Initial Validation of Counselor Supervision Competencies

    Science.gov (United States)

    Neuer Colburn, Anita A.; Grothaus, Tim; Hays, Danica G.; Milliken, Tammi

    2016-01-01

    The authors addressed the lack of supervision training standards for doctoral counseling graduates by developing and validating an initial list of supervision competencies. They used content analysis, Delphi polling, and content validity methods to generate a list, vetted by 2 different panels of supervision experts, of 33 competencies grouped…

  1. CBT for Nightmares in OEF/OIF Veterans

    Science.gov (United States)

    2015-09-01

    205–12. 32. Nadorff MR, Nazem S, Fiske A. Insomnia symptoms, nightmares, and suicidal ideation in a college student sample. Sleep. 2011;34(1):93–8. 33...presentations:% Harb,’G.’C.’and’Gehrman,’P.’ (2014).’Treating% the%sleep%disturbance% in %Veterans%with% PTSD:% CBT% for% insomnia % and% imagery% rehearsal...and%CBT%for% insomnia %(CCBT3I)%alone,% in %reducing%nightmare%frequency% or%intensity%and%improving%global%sleep%quality% in %OEF/OIF%veterans%with%PTSD

  2. Nuclear safety culture and nuclear safety supervision

    International Nuclear Information System (INIS)

    Chai Jianshe

    2013-01-01

    In this paper, the author reviews systematically and summarizes up the development process and stage characteristics of nuclear safety culture, analysis the connotation and characteristics of nuclear safety culture, sums up the achievements of our country's nuclear safety supervision, dissects the challenges and problems of nuclear safety supervision. This thesis focused on the relationship between nuclear safety culture and nuclear safety supervision, they are essential differences, but there is a close relationship. Nuclear safety supervision needs to introduce some concepts of nuclear safety culture, lays emphasis on humanistic care and improves its level and efficiency. Nuclear safety supervision authorities must strengthen nuclear safety culture training, conduct the development of nuclear safety culture, make sure that nuclear safety culture can play significant roles. (author)

  3. Interactive, Computer-Based Training Program for Radiological Workers

    International Nuclear Information System (INIS)

    Trinoskey, P.A.; Camacho, P.I.; Wells, L.

    2000-01-01

    Lawrence Livermore National Laboratory (LLNL) is redesigning its Computer-Based Training (CBT) program for radiological workers. The redesign represents a major effort to produce a single, highly interactive and flexible CBT program that will meet the training needs of a wide range of radiological workers--from researchers and x-ray operators to individuals working in tritium, uranium, plutonium, and accelerator facilities. The new CBT program addresses the broad diversity of backgrounds found at a national laboratory. When a training audience is homogeneous in terms of education level and type of work performed, it is difficult to duplicate the effectiveness of a flexible, technically competent instructor who can tailor a course to the express needs and concerns of a course's participants. Unfortunately, such homogeneity is rare. At LLNL, they have a diverse workforce engaged in a wide range of radiological activities, from the fairly common to the quite exotic. As a result, the Laboratory must offer a wide variety of radiological worker courses. These include a general contamination-control course in addition to radioactive-material-handling courses for both low-level laboratory (i.e., bench-top) activities as well as high-level work in tritium, uranium, and plutonium facilities. They also offer training courses for employees who work with radiation-generating devices--x-ray, accelerator, and E-beam operators, for instance. However, even with the number and variety of courses the Laboratory offers, they are constrained by the diversity of backgrounds (i.e., knowledge and experience) of those to be trained. Moreover, time constraints often preclude in-depth coverage of site- and/or task-specific details. In response to this situation, several years ago LLNL began moving toward computer-based training for radiological workers. Today, that CBT effort includes a general radiological safety course developed by the Department of Energy's Hanford facility and a

  4. Coupled dimensionality reduction and classification for supervised and semi-supervised multilabel learning.

    Science.gov (United States)

    Gönen, Mehmet

    2014-03-01

    Coupled training of dimensionality reduction and classification is proposed previously to improve the prediction performance for single-label problems. Following this line of research, in this paper, we first introduce a novel Bayesian method that combines linear dimensionality reduction with linear binary classification for supervised multilabel learning and present a deterministic variational approximation algorithm to learn the proposed probabilistic model. We then extend the proposed method to find intrinsic dimensionality of the projected subspace using automatic relevance determination and to handle semi-supervised learning using a low-density assumption. We perform supervised learning experiments on four benchmark multilabel learning data sets by comparing our method with baseline linear dimensionality reduction algorithms. These experiments show that the proposed approach achieves good performance values in terms of hamming loss, average AUC, macro F 1 , and micro F 1 on held-out test data. The low-dimensional embeddings obtained by our method are also very useful for exploratory data analysis. We also show the effectiveness of our approach in finding intrinsic subspace dimensionality and semi-supervised learning tasks.

  5. Supervised exercise reduces cancer-related fatigue: a systematic review

    Directory of Open Access Journals (Sweden)

    José F Meneses-Echávez

    2015-01-01

    Full Text Available Question: Does supervised physical activity reduce cancer-related fatigue? Design: Systematic review with meta-analysis of randomised trials. Participants: People diagnosed with any type of cancer, without restriction to a particular stage of diagnosis or treatment. Intervention: Supervised physical activity interventions (eg, aerobic, resistance and stretching exercise, defined as any planned or structured body movement causing an increase in energy expenditure, designed to maintain or enhance health-related outcomes, and performed with systematic frequency, intensity and duration. Outcome measures: The primary outcome measure was fatigue. Secondary outcomes were physical and functional wellbeing assessed using the Functional Assessment of Cancer Therapy Fatigue Scale, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Piper Fatigue Scale, Schwartz Cancer Fatigue Scale and the Multidimensional Fatigue Inventory. Methodological quality, including risk of bias of the studies, was evaluated using the PEDro Scale. Results: Eleven studies involving 1530 participants were included in the review. The assessment of quality showed a mean score of 6.5 (SD 1.1, indicating a low overall risk of bias. The pooled effect on fatigue, calculated as a standardised mean difference (SMD using a random-effects model, was –1.69 (95% CI –2.99 to –0.39. Beneficial reductions in fatigue were also found with combined aerobic and resistance training with supervision (SMD = –0.41, 95% CI –0.70 to –0.13 and with combined aerobic, resistance and stretching training with supervision (SMD = –0.67, 95% CI –1.17 to –0.17. Conclusion: Supervised physical activity interventions reduce cancer-related fatigue. These findings suggest that combined aerobic and resistance exercise regimens with or without stretching should be included as part of rehabilitation programs for people who have been diagnosed with cancer

  6. Cognitive behavioural therapy (CBT – case studies

    Directory of Open Access Journals (Sweden)

    Martyna Głuszek-Osuch

    2016-04-01

    Full Text Available The objective of the present study is to further elucitate the specifics cognitive behavioural therapy (CBT based on the treatment of 2 patients. The theoretical background of the therapy is based on the idea that the learning processes determine behaviour (behavioural therapy, acquisition and consolidation of beliefs and view of the world (cognitive therapy. The CBT is short-term (usually 12–20 weekly sessions. It assumes close links between the patient’s thoughts (about self, the world and the future and his/her emotions, behaviour and physiology. The patient’s work in between sessions consists in observation of their own thoughts, behaviours, and emotions, and introduction of changes within the scope of their thoughts and behaviours. The goal of cognitive behavioural therapy is autonomy and independence of a patient, attainment of the patient’s objectives, and remedying the most important problems of the patient. The therapist should be active, warm and empathic. Cognitive behavioural therapy is structured and active. Between sessions, the patient receives homework assignments to complete. During therapy, information is collected by experiments and verification of hypotheses. It should be emphasized that for changes to occur in the process of psychotherapy it is necessary to establish a strong therapeutic alliance.

  7. An Evaluation of Trauma Focused Cognitive Behavioral Therapy for Children in Zambia

    Science.gov (United States)

    Murray, Laura K; Familiar, Itziar; Skavenski, Stephanie; Jere, Elizabeth; Cohen, Judy; Imasiku, Mwiya; Mayeya, John; Bass, Judith K; Bolton, Paul

    2013-01-01

    Objectives To monitor and evaluate the feasibility of implementing Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to address trauma and stress-related symptoms in orphans and vulnerable children (OVC) in Zambia as part of ongoing programming within a non-governmental organization (NGO). Methods As part of ongoing programming, voluntary care-workers administered locally validated assessments to identify children who met criteria for moderate to severe trauma symptomatology. Local lay counselors implemented TF-CBT with identified families, while participating in ongoing supervision. Fifty-eight children and adolescents aged 5–18 completed the TF-CBT treatment, with pre- and post-assessments. Results The mean number of traumas reported by the treatment completers (N=58) was 4.11. Post assessments showed significant reductions in severity of trauma symptoms (pintervention into programmatic services run by an NGO in low/middle resource countries. Results also support the effectiveness of implementation strategies such as task shifting, and the apprenticeship model of training and supervision. PMID:23768939

  8. Supervised pelvic floor muscle training versus attention-control massage treatment in patients with faecal incontinence: Statistical analysis plan for a randomised controlled trial.

    Science.gov (United States)

    Ussing, Anja; Dahn, Inge; Due, Ulla; Sørensen, Michael; Petersen, Janne; Bandholm, Thomas

    2017-12-01

    Faecal incontinence affects approximately 8-9% of the adult population. The condition is surrounded by taboo; it can have a devastating impact on quality of life and lead to major limitations in daily life. Pelvic floor muscle training in combination with information and fibre supplements is recommended as first-line treatment for faecal incontinence. Despite this, the effect of pelvic floor muscle training for faecal incontinence is unclear. No previous trials have investigated the efficacy of supervised pelvic floor muscle training in combination with conservative treatment and compared this to an attention-control massage treatment including conservative treatment. The aim of this trial is to investigate if 16 weeks of supervised pelvic floor muscle training in combination with conservative treatment is superior to attention-control massage treatment and conservative treatment in patients with faecal incontinence. Randomised, controlled, superiority trial with two parallel arms. 100 participants with faecal incontinence will be randomised to either (1) individually supervised pelvic floor muscle training and conservative treatment or (2) attention-control massage treatment and conservative treatment. The primary outcome is participants' rating of symptom changes after 16 weeks of treatment using the Patient Global Impression of Improvement Scale. Secondary outcomes are the Vaizey Incontinence Score, the Fecal Incontinence Severity Index, the Fecal Incontinence Quality of Life Scale, a 14-day bowel diary, anorectal manometry and rectal capacity measurements. Follow-up assessment at 36 months will be conducted. This paper describes and discusses the rationale, the methods and in particular the statistical analysis plan of this trial.

  9. The supervisions in the field develop nuclear professionals

    International Nuclear Information System (INIS)

    Fernandez de la Casa, M.; Buedo, J. L.; Gonzalez, F.

    2015-01-01

    In 2011 Cofrentes Nuclear Power Plants began a training program for improving the supervision of managers in the field: the effort done not only has improved the quality of supervisions but also has defined a way to reinforce behavior expectations of Cofrentes Nuclear Power Plant. (Author)

  10. Guidelines for the training, credentialing, use, and supervision of speech-language pathology assistants. Task Force on Support Personnel.

    Science.gov (United States)

    1996-01-01

    These guidelines are an official statement of the American Speech-Language-Hearing Association. They provide guidance on the training, credentialing, use, and supervision of one category of support personnel in speech-language pathology: speech-language pathology assistants. Guidelines are not official standards of the Association. They were developed by the Task Force on Support Personnel: Dennis J. Arnst, Kenneth D. Barker, Ann Olsen Bird, Sheila Bridges, Linda S. DeYoung, Katherine Formichella, Nena M. Germany, Gilbert C. Hanke, Ann M. Horton, DeAnne M. Owre, Sidney L. Ramsey, Cathy A. Runnels, Brenda Terrell, Gerry W. Werven, Denise West, Patricia A. Mercaitis (consultant), Lisa C. O'Connor (consultant), Frederick T. Spahr (coordinator), Diane Paul-Brown (associate coordinator), Ann L. Carey (Executive Board liaison). The 1994 guidelines supersede the 1981 guidelines entitled, "Guidelines for the Employment and Utilization of Supportive Personnel" (Asha, March 1981, 165-169). Refer to the 1995 position statement on the "Training, Credentialing, Use, and Supervision of Support Personnel in Speech-Language Pathology" (Asha, 37 [Suppl. 14], 21).

  11. Weakly supervised semantic segmentation using fore-background priors

    Science.gov (United States)

    Han, Zheng; Xiao, Zhitao; Yu, Mingjun

    2017-07-01

    Weakly-supervised semantic segmentation is a challenge in the field of computer vision. Most previous works utilize the labels of the whole training set and thereby need the construction of a relationship graph about image labels, thus result in expensive computation. In this study, we tackle this problem from a different perspective. We proposed a novel semantic segmentation algorithm based on background priors, which avoids the construction of a huge graph in whole training dataset. Specifically, a random forest classifier is obtained using weakly supervised training data .Then semantic texton forest (STF) feature is extracted from image superpixels. Finally, a CRF based optimization algorithm is proposed. The unary potential of CRF derived from the outputting probability of random forest classifier and the robust saliency map as background prior. Experiments on the MSRC21 dataset show that the new algorithm outperforms some previous influential weakly-supervised segmentation algorithms. Furthermore, the use of efficient decision forests classifier and parallel computing of saliency map significantly accelerates the implementation.

  12. QUEST : Eliminating online supervised learning for efficient classification algorithms

    NARCIS (Netherlands)

    Zwartjes, Ardjan; Havinga, Paul J.M.; Smit, Gerard J.M.; Hurink, Johann L.

    2016-01-01

    In this work, we introduce QUEST (QUantile Estimation after Supervised Training), an adaptive classification algorithm for Wireless Sensor Networks (WSNs) that eliminates the necessity for online supervised learning. Online processing is important for many sensor network applications. Transmitting

  13. Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder

    NARCIS (Netherlands)

    van Apeldoorn, F. J.; Stant, A. D.; van Hout, W. J. P. J.; Mersch, P. P. A.; den Boer, J. A.

    Objective The objective of this study was to assess the cost-effectiveness of three empirically supported treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both

  14. Semi-supervised prediction of gene regulatory networks using machine learning algorithms.

    Science.gov (United States)

    Patel, Nihir; Wang, Jason T L

    2015-10-01

    Use of computational methods to predict gene regulatory networks (GRNs) from gene expression data is a challenging task. Many studies have been conducted using unsupervised methods to fulfill the task; however, such methods usually yield low prediction accuracies due to the lack of training data. In this article, we propose semi-supervised methods for GRN prediction by utilizing two machine learning algorithms, namely, support vector machines (SVM) and random forests (RF). The semi-supervised methods make use of unlabelled data for training. We investigated inductive and transductive learning approaches, both of which adopt an iterative procedure to obtain reliable negative training data from the unlabelled data. We then applied our semi-supervised methods to gene expression data of Escherichia coli and Saccharomyces cerevisiae, and evaluated the performance of our methods using the expression data. Our analysis indicated that the transductive learning approach outperformed the inductive learning approach for both organisms. However, there was no conclusive difference identified in the performance of SVM and RF. Experimental results also showed that the proposed semi-supervised methods performed better than existing supervised methods for both organisms.

  15. LONGER-TERM EFFECTIVENESS OF CBT IN TREATMENT OF COMORBID AUD/MDD ADOLESCENTS.

    Science.gov (United States)

    Cornelius, Jack R; Douaihy, Antoine B; Kirisci, Levent; Daley, Dennis C

    2013-01-01

    Cognitive Behavioral Therapy (CBT) is a commonly used therapy among persons with major depressive disorder (MDD) and also among those with alcohol use disorders (AUD). However, less is known regarding the efficacy of CBT for treating persons with co-occurring disorders involving both MDD and an AUD. Studies assessing the efficacy of CBT in adolescent populations with co-occurring disorders are particularly sparse, especially studies designed to assess the potential longer-term efficacy of an acute phase trial of CBT therapy in that youthful comorbid population. We recently conducted a first acute phase treatment study involving comorbid AUD/MDD adolescents, which involved the medication fluoxetine as well as manualized CBT therapy. The results of that acute phase study suggested efficacy for CBT therapy but not for fluoxetine for treating the depressive symptoms and the excessive alcohol use of study subjects (Cornelius et al., 2009). The current chapter provides an assessment of the long-term efficacy of CBT for treating comorbid AUD/MDD adolescents, based on results from our own long-term (four-year) follow-up study, which was conducted following the completion of our recent acute phase treatment study. The results of the study suggest long-term efficacy for acute phase CBT/MET therapy for treating both the depressive symptoms and the excessive alcohol use of comorbid AUD/MDD adolescents, but demonstrate no evidence of long-term efficacy for fluoxetine for treating either the depressive symptoms or the excessive alcohol use of that population.

  16. Optimal training for emergency needle thoracostomy placement by prehospital personnel: didactic teaching versus a cadaver-based training program.

    Science.gov (United States)

    Grabo, Daniel; Inaba, Kenji; Hammer, Peter; Karamanos, Efstathios; Skiada, Dimitra; Martin, Matthew; Sullivan, Maura; Demetriades, Demetrios

    2014-09-01

    Tension pneumothorax can rapidly progress to cardiac arrest and death if not promptly recognized and appropriately treated. We sought to evaluate the effectiveness of traditional didactic slide-based lectures (SBLs) as compared with fresh tissue cadaver-based training (CBT) for placement of needle thoracostomy (NT). Forty randomly selected US Navy corpsmen were recruited to participate from incoming classes of the Navy Trauma Training Center at the LAC + USC Medical Center and were then randomized to one of two NT teaching methods. The following outcomes were compared between the two study arms: (1) time required to perform the procedure, (2) correct placement of the needle, and (3) magnitude of deviation from the correct position. During the study period, a total of 40 corpsmen were enrolled, 20 randomized to SBL and 20 to CBT arms. When outcomes were analyzed, time required to NT placement was not different between the two arms. Examination of the location of needle placement revealed marked differences between the two study groups. Only a minority of the SBL group (35%) placed the NT correctly in the second intercostal space. In comparison, the majority of corpsmen assigned to the CBT group demonstrated accurate placement in the second intercostal space (75%). In a CBT module, US Navy corpsmen were better trained to place NT accurately than their traditional didactic SBL counterparts. Further studies are indicated to identify the optimal components of effective simulation training for NT and other emergent interventions.

  17. Relation of management, supervision, and personnel practices to nuclear power plant safety

    International Nuclear Information System (INIS)

    Layton, W.L.; Turnage, J.J.

    1980-01-01

    The knowledge base of industrial/organization psychology suggests three major areas of research with important implications for nuclear power plant safety. These areas are: Management and Supervision: Personnel Selection, Training and Placement; and Organizational Climate. Evidence drawn from several Three Mile Island investigations confirms that organizational structure of plants and supervisory practices, the selection and training of personnel, and organizational climate are important factors. Difficulties in decision making and coordination of personnel are pinpointed. Deficiencies in training are highlighted and the climate of working atmosphere is discussed. These matters are related to nuclear power plant safety. Future research directions are presented

  18. CBT for Pediatric Migraine: A Qualitative Study of Patient and Parent Experience.

    Science.gov (United States)

    Kroon Van Diest, Ashley M; Ernst, Michelle M; Vaughn, Lisa; Slater, Shalonda; Powers, Scott W

    2018-03-08

    The goal of this study was to determine which cognitive behavioral therapy (CBT-HA) treatment components pediatric headache patient stakeholders would report to be most helpful and essential to reducing headache frequency and related disability to develop a streamlined, less burdensome treatment package that would be more accessible to patients and families. Pediatric migraine is a prevalent and disabling condition. CBT-HA has been shown to reduce headache frequency and related disability, but may not be readily available or accepted by many migraine sufferers due to treatment burden entailed. Research is needed to determine systematic ways of reducing barriers to CBT-HA. Qualitative interviews were conducted with 10 patients and 9 of their parents who had undergone CBT-HA. Interviews were analyzed using an inductive thematic analysis approach based upon modified grounded theory. Patients were 13-17.5 years of age (M = 15.4, SD = 1.63) and had undergone CBT-HA ∼1-2 years prior to participating in the study. Overall, patients and their parents reported that CBT-HA was helpful in reducing headache frequency and related disability. Although patients provided mixed reports on the effectiveness of different CBT-HA skills, the majority of patients indicated that the mind and body relaxation skills of CBT-HA (deep breathing, progressive muscle relaxation, and activity pacing in particular) were the most helpful and most frequently used skills. Patients and parents also generally reported that treatment was easy to learn, and noted at least some aspect of treatment was enjoyable. Results from these qualitative interviews indicate that mind and body CBT-HA relaxation skills emerged as popular and effective based on patient and parent report. Future research examining the effectiveness of streamlined pediatric migraine nonpharmacological interventions should include these patient-preferred skills. © 2018 American Headache Society.

  19. DuSK: A Dual Structure-preserving Kernel for Supervised Tensor Learning with Applications to Neuroimages.

    Science.gov (United States)

    He, Lifang; Kong, Xiangnan; Yu, Philip S; Ragin, Ann B; Hao, Zhifeng; Yang, Xiaowei

    With advances in data collection technologies, tensor data is assuming increasing prominence in many applications and the problem of supervised tensor learning has emerged as a topic of critical significance in the data mining and machine learning community. Conventional methods for supervised tensor learning mainly focus on learning kernels by flattening the tensor into vectors or matrices, however structural information within the tensors will be lost. In this paper, we introduce a new scheme to design structure-preserving kernels for supervised tensor learning. Specifically, we demonstrate how to leverage the naturally available structure within the tensorial representation to encode prior knowledge in the kernel. We proposed a tensor kernel that can preserve tensor structures based upon dual-tensorial mapping. The dual-tensorial mapping function can map each tensor instance in the input space to another tensor in the feature space while preserving the tensorial structure. Theoretically, our approach is an extension of the conventional kernels in the vector space to tensor space. We applied our novel kernel in conjunction with SVM to real-world tensor classification problems including brain fMRI classification for three different diseases ( i.e ., Alzheimer's disease, ADHD and brain damage by HIV). Extensive empirical studies demonstrate that our proposed approach can effectively boost tensor classification performances, particularly with small sample sizes.

  20. Supervised Balance Training and Wii Fit-Based Exercises Lower Falls Risk in Older Adults With Type 2 Diabetes.

    Science.gov (United States)

    Morrison, Steven; Simmons, Rachel; Colberg, Sheri R; Parson, Henri K; Vinik, Aaron I

    2018-02-01

    This study examined the benefits of and differences between 12 weeks of thrice-weekly supervised balance training and an unsupervised at-home balance activity (using the Nintendo Wii Fit) for improving balance and reaction time and lowering falls risk in older individuals with type 2 diabetes mellitus (T2DM). Before-after trial. University research laboratory, home environment. Sixty-five older adults with type 2 diabetes were recruited for this study. Participants were randomly allocated to either supervised balance training (mean age 67.8 ± 5.2) or unsupervised training using the Nintendo Wii Fit balance board (mean age 66.1 ± 5.6). The training period for both groups lasted for 12 weeks. Individuals were required to complete three 40-minute sessions per week for a total of 36 sessions. The primary outcome measure was falls risk, which was as derived from the physiological profile assessment. In addition, measures of simple reaction time, lower limb proprioception, postural sway, knee flexion, and knee extension strength were also collected. Persons also self-reported any falls in the previous 6 months. Both training programs resulted in a significant lowering of falls risk (P general balance ability. Interestingly, the reduced falls risk occurred without significant changes in leg strength, suggesting that interventions to reduce falls risk that target intrinsic risk factors related to balance control (over muscle strength) may have positive benefits for the older adult with T2DM at risk for falls. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  1. Computerised training improves cognitive performance in chronic pain: a participant-blinded randomised active-controlled trial with remote supervision.

    Science.gov (United States)

    Baker, Katharine S; Georgiou-Karistianis, Nellie; Lampit, Amit; Valenzuela, Michael; Gibson, Stephen J; Giummarra, Melita J

    2018-04-01

    Chronic pain is associated with reduced efficiency of cognitive performance, and few studies have investigated methods of remediation. We trialled a computerised cognitive training protocol to determine whether it could attenuate cognitive difficulties in a chronic pain sample. Thirty-nine adults with chronic pain (mean age = 43.3, 61.5% females) were randomised to an 8-week online course (3 sessions/week from home) of game-like cognitive training exercises, or an active control involving watching documentary videos. Participants received weekly supervision by video call. Primary outcomes were a global neurocognitive composite (tests of attention, speed, and executive function) and self-reported cognition. Secondary outcomes were pain (intensity; interference), mood symptoms (depression; anxiety), and coping with pain (catastrophising; self-efficacy). Thirty participants (15 training and 15 control) completed the trial. Mixed model intention-to-treat analyses revealed significant effects of training on the global neurocognitive composite (net effect size [ES] = 0.43, P = 0.017), driven by improved executive function performance (attention switching and working memory). The control group reported improvement in pain intensity (net ES = 0.65, P = 0.022). Both groups reported subjective improvements in cognition (ES = 0.28, P = 0.033) and catastrophising (ES = 0.55, P = 0.006). Depression, anxiety, self-efficacy, and pain interference showed no change in either group. This study provides preliminary evidence that supervised cognitive training may be a viable method for enhancing cognitive skills in persons with chronic pain, but transfer to functional and clinical outcomes remains to be demonstrated. Active control results suggest that activities perceived as relaxing or enjoyable contribute to improved perception of well-being. Weekly contact was pivotal to successful program completion.

  2. Training the Millennial learner through experiential evolutionary scaffolding: implications for clinical supervision in graduate education programs.

    Science.gov (United States)

    Venne, Vickie L; Coleman, Darrell

    2010-12-01

    They are the Millennials--Generation Y. Over the next few decades, they will be entering genetic counseling graduate training programs and the workforce. As a group, they are unlike previous youth generations in many ways, including the way they learn. Therefore, genetic counselors who teach and supervise need to understand the Millennials and explore new ways of teaching to ensure that the next cohort of genetic counselors has both skills and knowledge to represent our profession well. This paper will summarize the distinguishing traits of the Millennial generation as well as authentic learning and evolutionary scaffolding theories of learning that can enhance teaching and supervision. We will then use specific aspects of case preparation during clinical rotations to demonstrate how incorporating authentic learning theory into evolutionary scaffolding results in experiential evolutionary scaffolding, a method that potentially offers a more effective approach when teaching Millennials. We conclude with suggestions for future research.

  3. Clinical relevance of findings in trials of CBT for depression

    NARCIS (Netherlands)

    Lepping, P.; Whittington, R.; Sambhi, R.S.; Lane, S.; Poole, R.; Leucht, S.; Cuijpers, P.; McCabe, R.; Waheed, W.

    2017-01-01

    Cognitive behavioural therapy (CBT) is beneficial in depression. Symptom scores can be translated into Clinical Global Impression (CGI) scale scores to indicate clinical relevance. We aimed to assess the clinical relevance of findings of randomised controlled trials (RCTs) of CBT in depression. We

  4. Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Lacroix, Andre; Hortobagyi, Tibor; Beurskens, Rainer; Granacher, Urs

    Background Balance and resistance training can improve healthy older adults' balance and muscle strength. Delivering such exercise programs at home without supervision may facilitate participation for older adults because they do not have to leave their homes. To date, no systematic literature

  5. Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Lacroix, Andre; Hortobagyi, Tibor; Beurskens, Rainer; Granacher, Urs

    2017-01-01

    Background Balance and resistance training can improve healthy older adults' balance and muscle strength. Delivering such exercise programs at home without supervision may facilitate participation for older adults because they do not have to leave their homes. To date, no systematic literature

  6. Improving the Transportability of CBT for Internalizing Disorders in Children

    Science.gov (United States)

    Elkins, R. Meredith; McHugh, R. Kathryn; Santucci, Lauren C.; Barlow, David H.

    2011-01-01

    Research provides strong support for the efficacy and effectiveness of cognitive behavioral therapy (CBT) for the treatment of childhood internalizing disorders. Given evidence for limited dissemination and implementation of CBT outside of academic settings, efforts are underway to improve its transportability so that more children with mental…

  7. The Application of the Analytic Hierarchy Process and a New Correlation Algorithm to Urban Construction and Supervision Using Multi-Source Government Data in Tianjin

    Directory of Open Access Journals (Sweden)

    Shaoyi Wang

    2018-02-01

    Full Text Available As the era of big data approaches, big data has attracted increasing amounts of attention from researchers. Various types of studies have been conducted and these studies have focused particularly on the management, organization, and correlation of data and calculations using data. Most studies involving big data address applications in scientific, commercial, and ecological fields. However, the application of big data to government management is also needed. This paper examines the application of multi-source government data to urban construction and supervision in Tianjin, China. The analytic hierarchy process and a new approach called the correlation degree algorithm are introduced to calculate the degree of correlation between different approval items in one construction project and between different construction projects. The results show that more than 75% of the construction projects and their approval items are highly correlated. The results of this study suggest that most of the examined construction projects are well supervised, have relatively high probabilities of satisfying the relevant legal requirements, and observe their initial planning schemes.

  8. Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder: Study protocol for a pragmatic, multicenter non-inferiority randomized controlled trial.

    Science.gov (United States)

    Arnfred, Sidse M; Aharoni, Ruth; Hvenegaard, Morten; Poulsen, Stig; Bach, Bo; Arendt, Mikkel; Rosenberg, Nicole K; Reinholt, Nina

    2017-01-23

    Transdiagnostic Cognitive Behavior Therapy (TCBT) manuals delivered in individual format have been reported to be just as effective as traditional diagnosis specific CBT manuals. We have translated and modified the "The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders" (UP-CBT) for group delivery in Mental Health Service (MHS), and shown effects comparable to traditional CBT in a naturalistic study. As the use of one manual instead of several diagnosis-specific manuals could simplify logistics, reduce waiting time, and increase therapist expertise compared to diagnosis specific CBT, we aim to test the relative efficacy of group UP-CBT and diagnosis specific group CBT. The study is a partially blinded, pragmatic, non-inferiority, parallel, multi-center randomized controlled trial (RCT) of UP-CBT vs diagnosis specific CBT for Unipolar Depression, Social Anxiety Disorder and Agoraphobia/Panic Disorder. In total, 248 patients are recruited from three regional MHS centers across Denmark and included in two intervention arms. The primary outcome is patient-ratings of well-being (WHO Well-being Index, WHO-5), secondary outcomes include level of depressive and anxious symptoms, personality variables, emotion regulation, reflective functioning, and social adjustment. Assessments are conducted before and after therapy and at 6 months follow-up. Weekly patient-rated outcomes and group evaluations are collected for every session. Outcome assessors, blind to treatment allocation, will perform the observer-based symptom ratings, and fidelity assessors will monitor manual adherence. The current study will be the first RCT investigating the dissemination of the UP in a MHS setting, the UP delivered in groups, and with depressive patients included. Hence the results are expected to add substantially to the evidence base for rational group psychotherapy in MHS. The planned moderator and mediator analyses could spur new hypotheses about mechanisms of change in

  9. DuSK: A Dual Structure-preserving Kernel for Supervised Tensor Learning with Applications to Neuroimages

    Science.gov (United States)

    He, Lifang; Kong, Xiangnan; Yu, Philip S.; Ragin, Ann B.; Hao, Zhifeng; Yang, Xiaowei

    2015-01-01

    With advances in data collection technologies, tensor data is assuming increasing prominence in many applications and the problem of supervised tensor learning has emerged as a topic of critical significance in the data mining and machine learning community. Conventional methods for supervised tensor learning mainly focus on learning kernels by flattening the tensor into vectors or matrices, however structural information within the tensors will be lost. In this paper, we introduce a new scheme to design structure-preserving kernels for supervised tensor learning. Specifically, we demonstrate how to leverage the naturally available structure within the tensorial representation to encode prior knowledge in the kernel. We proposed a tensor kernel that can preserve tensor structures based upon dual-tensorial mapping. The dual-tensorial mapping function can map each tensor instance in the input space to another tensor in the feature space while preserving the tensorial structure. Theoretically, our approach is an extension of the conventional kernels in the vector space to tensor space. We applied our novel kernel in conjunction with SVM to real-world tensor classification problems including brain fMRI classification for three different diseases (i.e., Alzheimer's disease, ADHD and brain damage by HIV). Extensive empirical studies demonstrate that our proposed approach can effectively boost tensor classification performances, particularly with small sample sizes. PMID:25927014

  10. The efficacy of unsupervised home-based exercise regimens in comparison to supervised lab-based exercise training upon cardio-respiratory health facets

    OpenAIRE

    Blackwell, J.; Atherton, Philip J.; Smith, Kenneth; Doleman, Brett; Williams, John P.; Lund, Jonathan N.; Phillips, Bethan E.

    2017-01-01

    Abstract Supervised high?intensity interval training (HIIT) can rapidly improve cardiorespiratory fitness (CRF). However, the effectiveness of time?efficient unsupervised home?based interventions is unknown. Eighteen volunteers completed either: laboratory?HIIT (L?HIIT); home?HIIT (H?HIIT) or home?isometric hand?grip training (H?IHGT). CRF improved significantly in L?HIIT and H?HIIT groups, with blood pressure improvements in the H?IHGT group only. H?HIIT offers a practical, time?efficient ex...

  11. A worldview of the professional experiences and training needs of pediatric psycho-oncologists

    Science.gov (United States)

    Oppenheim, Daniel; Breyer, Joanna; Battles, Haven; Zadeh, Sima; Patenaude, Andrea Farkas

    2012-01-01

    BACKGROUND Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families. METHOD A survey was designed to assess training, work environment, theoretical orientation, services provided, sub-specialty areas or areas of special interest, satisfactions, challenges and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey. RESULTS 786 professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%) and siblings (25%). Therapies provided include CBT (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds report having appropriate supervision; 37% conduct research; only half feel their salary is appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research and ethics. CONCLUSIONS An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision and needs for additional, specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation. PMID:22461180

  12. German Training Revisited: An Appraisal of Corporatist Governance

    Science.gov (United States)

    Lange, Thomas

    2012-01-01

    Purpose: The aim of this paper is to re-examine the unique political economy of Germany's dual apprenticeship training model and its underlying philosophy of corporatist governance. It responds to recent arguments suggesting that Germany's collectivist skill regime is under threat, increasingly giving way to the introduction of…

  13. EU ECONOMIC GOVERNANCE REFORM: ARE WE AT A TURNING POINT?

    Directory of Open Access Journals (Sweden)

    Daniel Daianu

    2011-03-01

    Full Text Available The sovereign debt crisis is creating enormous anguish in the European Monetary Union (EMU. Not surprisingly, emergency measures continue to be used at a time when a sort of economic recovery seems to be underway. Against this background the European Council summit of last October considered a Task Force report with a telling name: "Strengthening economic governance in the EU". This document is to be examined in conjunction with the governance reform proposals issued by the European Commission at the end of September and related documents. For the depth of this financial crisis and the "Great Recession" have forced EU governments and EU institutions to take a hard look at the governance structure of the Union. But it would be wrong to say that this demarche is an attempt to explore a terra incognita. From the very beginning of the European Monetary Union (EMU there was some discomfort with its institutional underpinnings and there were misgivings regarding its optimality as a currency area. This explains why a train of thought underlines a political rationale, too, for the creation of the EMU. Likewise, criticism regarding the way regulation and supervision have been established in the Union is not of recent vintage. And insufficiencies of the Stability and Growth Pact (SGP, with almost all member states flouting its rules at various points in time, have been repeatedly pointed out. This said, however, the flaws of financial intermediation have been less tackled by policy-makers and central bankers for reasons which, partially, are to be found in a paradigm which has dominated economic thinking in recent decades. This paper focuses on roots of the huge strain in the EU (EMU and main policy issues ensuing from the current crisis. It also looks at the stake NMSs have in a reformed EU economic governance structure. The challenges for EU economic governance reform are to be seen from a broad perspective: the crisis of the financial intermediation

  14. Self-supervised, mobile-application based cognitive training of auditory attention: A behavioral and fMRI evaluation

    Directory of Open Access Journals (Sweden)

    Josef J. Bless

    2014-07-01

    Full Text Available Emerging evidence of the validity of collecting data in natural settings using smartphone applications has opened new possibilities for psychological assessment, treatment, and research. In this study we explored the feasibility and effectiveness of using a mobile application for self-supervised training of auditory attention. In addition, we investigated the neural underpinnings of the training procedure with functional magnetic resonance imaging (fMRI, as well as possible transfer effects to untrained cognitive interference tasks. Subjects in the training group performed the training task on an iPod touch two times a day (morning/evening for three weeks; subjects in the control group received no training, but were tested at the same time interval as the training group. Behavioral responses were measured before and after the training period in both groups, together with measures of task-related neural activations by fMRI. The results showed an expected performance increase after training that corresponded to activation decreases in brain regions associated with selective auditory processing (left posterior temporal gyrus and executive functions (right middle frontal gyrus, indicating more efficient processing in task-related neural networks after training. Our study suggests that cognitive training delivered via mobile applications is feasible and improves the ability to focus attention with corresponding effects on neural plasticity. Future research should focus on the clinical benefits of mobile cognitive training. Limitations of the study are discussed including reduced experimental control and lack of transfer effects.

  15. Online CBT Is Effective in Overcoming Cultural and Language Barriers in Patients With Depression.

    Science.gov (United States)

    Alavi, Nazanin; Hirji, Alyssa; Sutton, Chloe; Naeem, Farooq

    2016-01-01

    The goal of this study was to evaluate the efficacy of weekly email in delivering online cognitive behavioral therapy (CBT) to treat mild to moderately depressed individuals. The effectiveness of the online CBT was measured following treatment and then again at a 6-month follow-up and was compared with outcomes in a waitlist control group. Participants were recruited through announcements on psychology Web sites, Iranian organization Web sites, and weblogs and flyers. Ninety-three individuals who met inclusion criteria, including a score >18 on the Beck Depression Inventory (BDI), participated in the study, with 47 randomly assigned to the CBT group and 46 to the control group. The CBT group received 10 to 12 sessions of online CBT conducted by a psychiatrist and a psychiatry resident. Following completion of the CBT, a second BDI was sent to participants. Another BDI was then sent to participants 6 months after the completion of treatment. Email-based CBT significantly reduced BDI scores compared with results in a waitlist control group following 10 to 12 weeks of treatment and at 6-month follow-up. Email is a viable method for delivering CBT to individuals when face-to-face interaction is not possible. Limitations and future directions are discussed.

  16. Effectiveness of Modular CBT for Child Anxiety in Elementary Schools

    Science.gov (United States)

    Chiu, Angela W.; Langer, David A.; McLeod, Bryce D.; Har, Kim; Drahota, Amy; Galla, Brian M.; Jacobs, Jeffrey; Ifekwunigwe, Muriel; Wood, Jeffrey J.

    2013-01-01

    Most randomized controlled trials of cognitive-behavioral therapy (CBT) for children with anxiety disorders have evaluated treatment efficacy using recruited samples treated in research settings. Clinical trials in school settings are needed to determine if CBT can be effective when delivered in real world settings. This study evaluated a modular…

  17. Science-practice nexus for landslide surveying: technical training for local government units in Indonesia

    Science.gov (United States)

    Alam, A. L.; Hespiantoro, S.; Dyar, D.; Balzer, D.; Kuhn, D.; Torizin, J.; Fuchs, M.; Kastl, S.; Anhorn, J.

    2017-02-01

    The Indonesian archipelago is prone to various geological hazards on an almost day to day basis. In order to mitigate disaster risk and reduce losses, the government uses its unique setup of ministerial training institutions. The Centre for Development of Human Resources in Geology, Mineral and Coal offers different level of technical training to local governments in order to provide them with the necessary means to understand geological hazards, mitigate risks, and hence close the gap between local and national governments. One key factor has been the continuous incorporation of new scientific knowledge into their training curricula. The paper presents benefits and challenges of this science-practice nexus using the standardised landslide survey as one example where mobile technology has been introduced to the training just recently.

  18. What Communication Theories Can Teach the Designer of Computer-Based Training.

    Science.gov (United States)

    Larsen, Ronald E.

    1985-01-01

    Reviews characteristics of computer-based training (CBT) that make application of communication theories appropriate and presents principles from communication theory (e.g., general systems theory, symbolic interactionism, rule theories, and interpersonal communication theories) to illustrate how CBT developers can profitably apply them to…

  19. Examining adherence to components of cognitive-behavioral therapy for youth anxiety after training and consultation

    OpenAIRE

    Edmunds, Julie M.; Brodman, Douglas M.; Ringle, Vanesa A.; Read, Kendra L.; Kendall, Philip C.; Beidas, Rinad S.

    2016-01-01

    The present study examined 115 service providers’ adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety prior to training, post workshop training, and after three months of weekly consultation. Adherence was measured using a role-play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings following consultation. Findings indicated t...

  20. SECOND-STAGE TREATMENTS FOR RELATIVE NONRESPONDERS TO COGNITIVE BEHAVIORAL THERAPY (CBT) FOR PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA-CONTINUED CBT VERSUS SSRI: A RANDOMIZED CONTROLLED TRIAL.

    Science.gov (United States)

    Payne, Laura A; White, Kamila S; Gallagher, Matthew W; Woods, Scott W; Shear, M Katherine; Gorman, Jack M; Farchione, Todd J; Barlow, David H

    2016-05-01

    Cognitive behavioral therapy (CBT) and pharmacotherapy are efficacious for the short-term treatment of panic disorder. Less is known about the efficacy of these therapies for individuals who do not respond fully to short-term CBT. The current trial is a second-step stratified randomized design comparing two treatment conditions-selective serotonin reuptake inhibitor (SSRI; paroxetine or citalopram; n = 34) and continued CBT (n = 24)-in a sample of individuals classified as treatment nonresponders to an initial course of CBT for panic disorder. Participants were randomized to 3 months of treatment and then followed for an additional 9 months. Only treatment responders after 3 months were maintained on the treatment until 12-month follow-up. Data analysis focused on panic disorder symptoms and achievement of response status across the first 3 months of treatment. Final follow-up data are presented descriptively. Participants in the SSRI condition showed significantly lower panic disorder symptoms as compared to continued CBT at 3 months. Results were similar when excluding individuals with comorbid major depression or analyzing the entire intent-to-treat sample. Group differences disappeared during 9-month naturalistic follow-up, although there was significant attrition and use of nonstudy therapies in both arms. These data suggest greater improvement in panic disorder symptoms when switching to SSRI after failure to fully respond to an initial course of CBT. Future studies should further investigate relapse following treatment discontinuation for nonresponders who became responders. Clinicaltrials.gov Identifier: NCT00000368; https://clinicaltrials.gov/show/NCT00000368. © 2015 Wiley Periodicals, Inc.

  1. Feature-space transformation improves supervised segmentation across scanners

    DEFF Research Database (Denmark)

    van Opbroek, Annegreet; Achterberg, Hakim C.; de Bruijne, Marleen

    2015-01-01

    Image-segmentation techniques based on supervised classification generally perform well on the condition that training and test samples have the same feature distribution. However, if training and test images are acquired with different scanners or scanning parameters, their feature distributions...

  2. Correspondence Training: An Example of Rule-Governed Behavior?

    Science.gov (United States)

    Deacon, Joseph R.; Konarski, Edward A., Jr.

    1987-01-01

    Results of a study comparing the outcome of a reinforcement (do only) procedure with correspondence (say/do) training indicated no apparent differences in generalization between two groups of mentally retarded adults (N=12). Rule-governed behavior, rather than verbal regulation of behavior, may best account for behavior changes seen in…

  3. Effects of 12-week supervised treadmill training on spatio-temporal gait parameters in patients with claudication.

    Science.gov (United States)

    Konik, Anita; Kuklewicz, Stanisław; Rosłoniec, Ewelina; Zając, Marcin; Spannbauer, Anna; Nowobilski, Roman; Mika, Piotr

    2016-01-01

    The purpose of the study was to evaluate selected temporal and spatial gait parameters in patients with intermittent claudication after completion of 12-week supervised treadmill walking training. The study included 36 patients (26 males and 10 females) aged: mean 64 (SD 7.7) with intermittent claudication. All patients were tested on treadmill (Gait Trainer, Biodex). Before the programme and after its completion, the following gait biomechanical parameters were tested: step length (cm), step cycle (cycle/s), leg support time (%), coefficient of step variation (%) as well as pain-free walking time (PFWT) and maximal walking time (MWT) were measured. Training was conducted in accordance with the current TASC II guidelines. After 12 weeks of training, patients showed significant change in gait biomechanics consisting in decreased frequency of step cycle (p gait was more regular, which was expressed via statistically significant decrease of coefficient of variation (p 0.05). Twelve-week treadmill walking training programme may lead to significant improvement of temporal and spatial gait parameters in patients with intermittent claudication. Twelve-week treadmill walking training programme may lead to significant improvement of pain-free walking time and maximum walking time in patients with intermittent claudication.

  4. Nonparametric Mixture Models for Supervised Image Parcellation.

    Science.gov (United States)

    Sabuncu, Mert R; Yeo, B T Thomas; Van Leemput, Koen; Fischl, Bruce; Golland, Polina

    2009-09-01

    We present a nonparametric, probabilistic mixture model for the supervised parcellation of images. The proposed model yields segmentation algorithms conceptually similar to the recently developed label fusion methods, which register a new image with each training image separately. Segmentation is achieved via the fusion of transferred manual labels. We show that in our framework various settings of a model parameter yield algorithms that use image intensity information differently in determining the weight of a training subject during fusion. One particular setting computes a single, global weight per training subject, whereas another setting uses locally varying weights when fusing the training data. The proposed nonparametric parcellation approach capitalizes on recently developed fast and robust pairwise image alignment tools. The use of multiple registrations allows the algorithm to be robust to occasional registration failures. We report experiments on 39 volumetric brain MRI scans with expert manual labels for the white matter, cerebral cortex, ventricles and subcortical structures. The results demonstrate that the proposed nonparametric segmentation framework yields significantly better segmentation than state-of-the-art algorithms.

  5. An empirical study of ensemble-based semi-supervised learning approaches for imbalanced splice site datasets.

    Science.gov (United States)

    Stanescu, Ana; Caragea, Doina

    2015-01-01

    Recent biochemical advances have led to inexpensive, time-efficient production of massive volumes of raw genomic data. Traditional machine learning approaches to genome annotation typically rely on large amounts of labeled data. The process of labeling data can be expensive, as it requires domain knowledge and expert involvement. Semi-supervised learning approaches that can make use of unlabeled data, in addition to small amounts of labeled data, can help reduce the costs associated with labeling. In this context, we focus on the problem of predicting splice sites in a genome using semi-supervised learning approaches. This is a challenging problem, due to the highly imbalanced distribution of the data, i.e., small number of splice sites as compared to the number of non-splice sites. To address this challenge, we propose to use ensembles of semi-supervised classifiers, specifically self-training and co-training classifiers. Our experiments on five highly imbalanced splice site datasets, with positive to negative ratios of 1-to-99, showed that the ensemble-based semi-supervised approaches represent a good choice, even when the amount of labeled data consists of less than 1% of all training data. In particular, we found that ensembles of co-training and self-training classifiers that dynamically balance the set of labeled instances during the semi-supervised iterations show improvements over the corresponding supervised ensemble baselines. In the presence of limited amounts of labeled data, ensemble-based semi-supervised approaches can successfully leverage the unlabeled data to enhance supervised ensembles learned from highly imbalanced data distributions. Given that such distributions are common for many biological sequence classification problems, our work can be seen as a stepping stone towards more sophisticated ensemble-based approaches to biological sequence annotation in a semi-supervised framework.

  6. Effectiveness of group CBT in treating adolescents with depression symptoms: a critical review.

    Science.gov (United States)

    Nardi, Bernardo; Massei, Micaela; Arimatea, Emidio; Moltedo-Perfetti, Andrés

    2016-01-20

    Depression is among the most common psychological disorders of adolescents. Its management is based on pharmacological treatment, psychological therapy, or a combination thereof. Cognitive behavioral therapy (CBT) is the most extensively tested intervention for adolescent depression. A PubMed search was conducted for randomized controlled trials (RCT) of the efficacy of CBT in treating adolescents with depressive symptoms published in 2005-2015. Keywords were "cognitive behavioral therapy", "group therapy", "depression" and "adolescent". Of the 23 papers that were retrieved, only six met all inclusion criteria. Three of them reported a significant reduction in depressive symptom severity after either individual or group (G)-CBT compared with the control group, even with a small number of CBT sessions (six rather than 10-12), with a medium or medium-to-large effect size. One study reported improved self-awareness and a significantly greater increase in perceived friend social support compared with bibliotherapy and check with brochure. Two studies reported clinical symptom reduction without significant differences compared with the control group (activity contrast). This review highlighted primarily that very few RCT have applied CBT in adolescents; moreover, it confirmed the effectiveness of G-CBT, especially as psychotherapy, although it was not always superior to other interventions (e.g. other activities in prevention programs). Comparison showed that G-CBT and group interpersonal psychotherapy were both effective in reducing depressive symptoms. Successful G-CBT outcomes were related to the presence of peers, who were an important source of feedback and support to observe, learn, and practice new skills to manage depressive symptoms and improve social-relational skills.

  7. The role of CBT in explicit memory bias in bipolar I patients.

    Science.gov (United States)

    Docteur, Aurélie; Mirabel-Sarron, Christine; Guelfi, Julien-Daniel; Rouillon, Frédéric; Gorwood, Philip

    2013-09-01

    Cognitive and Behavioural Therapy (CBT) is widely used in bipolar disorder, but recent meta-analyses showed that its impact is either of limited effect or not significant for important aspects such as recurrence rate. A possible benefit of CBT could concern cognitive functions, known to be frequently impaired in patients with bipolar disorder. We analysed if the positive impact of 6 months group-CBT was associated with the improvement of a specific cognitive function, namely explicit memory, trying to disentangle if memory bias (i.e. different capacity according to the emotional valence of words to be recalled) was more improved than memory performance (i.e., total number of recalled words). Depressive, manic, anxiety symptoms and explicit memory for emotional words were initially assessed in 68 remitted bipolar I patients. Six months later, with an attrition rate of 16.2%, patients were re-assessed after CBT (N = 42) or as control condition (waiting list, N = 15). The expected impact of CBT was assessed through the improvement in the Dysfunctional Attitudes Scale. After CBT, an increase was observed for the number of neutral, positive and total words recalled, whereas the number of negative words recalled decreased. This increase was still significant when the improvement of dysfunctional attitudes and mood symptoms are taken into account. The small sample of control patients. CBT was effective, as it improved dysfunctional attitudes and reduced remaining symptoms, but also, and independently, it improved explicit memory performance while reducing memory bias in favour of negative words. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT.

    Science.gov (United States)

    Thase, Michael E; Wright, Jesse H; Eells, Tracy D; Barrett, Marna S; Wisniewski, Stephen R; Balasubramani, G K; McCrone, Paul; Brown, Gregory K

    2018-03-01

    The authors evaluated the efficacy and durability of a therapist-supported method for computer-assisted cognitive-behavioral therapy (CCBT) in comparison to standard cognitive-behavioral therapy (CBT). A total of 154 medication-free patients with major depressive disorder seeking treatment at two university clinics were randomly assigned to either 16 weeks of standard CBT (up to 20 sessions of 50 minutes each) or CCBT using the "Good Days Ahead" program. The amount of therapist time in CCBT was planned to be about one-third that in CBT. Outcomes were assessed by independent raters and self-report at baseline, at weeks 8 and 16, and at posttreatment months 3 and 6. The primary test of efficacy was noninferiority on the Hamilton Depression Rating Scale at week 16. Approximately 80% of the participants completed the 16-week protocol (79% in the CBT group and 82% in the CCBT group). CCBT met a priori criteria for noninferiority to conventional CBT at week 16. The groups did not differ significantly on any measure of psychopathology. Remission rates were similar for the two groups (intent-to-treat rates, 41.6% for the CBT group and 42.9% for the CCBT group). Both groups maintained improvements throughout the follow-up. The study findings indicate that a method of CCBT that blends Internet-delivered skill-building modules with about 5 hours of therapeutic contact was noninferior to a conventional course of CBT that provided over 8 additional hours of therapist contact. Future studies should focus on dissemination and optimizing therapist support methods to maximize the public health significance of CCBT.

  9. Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders: study protocol for a randomized controlled trial.

    Science.gov (United States)

    de Jong, Martie; Korrelboom, Kees; van der Meer, Iris; Deen, Mathijs; Hoek, Hans W; Spinhoven, Philip

    2016-12-03

    mediators of the effect of treatment. Also, an economic evaluation from a societal perspective will be undertaken. All relevant effects, direct and indirect costs will be included. Utility scores will measure the effects. Measurements will take place at pretreatment, 6 weeks, 20 weeks, 40 weeks and 80 weeks. This effectiveness study into CBT-E has the aim of broadening the scope and generalizability of former studies. If CBT-E appears to be at least as effective as traditional diagnosis-specific treatments for a broad range of ED patients, training in one protocol would be sufficient for clinicians to treat patients with different kinds of EDs. It gives the opportunity to offer treatment for a severe mental disorder with fewer resources, thereby increasing the accessibility of specialized care for patients with an ED. Netherlands Trial Register, NTR4485 . Registered on 2 April 2014.

  10. Evaluation of Two Mobile Health Apps in the Context of Smoking Cessation: Qualitative Study of Cognitive Behavioral Therapy (CBT) Versus Non-CBT-Based Digital Solutions

    Science.gov (United States)

    Amin, Nima; Chadha, Mehak; Jain, Minal; Karia, Kishan; Kothari, Varun; Patel, Tejus; Suseeharan, Melanie; Ahmed, Maroof; Sherwani, Yusuf; Siddiqui, Sarim; Lin, Yuting

    2018-01-01

    Background Mobile health (mHealth) apps can offer users numerous benefits, representing a feasible and acceptable means of administering health interventions such as cognitive behavioral therapy (CBT). CBT is commonly used in the treatment of mental health conditions, where it has a strong evidence base, suggesting that it represents an effective method to elicit health behavior change. More importantly, CBT has proved to be effective in smoking cessation, in the context of smoking-related costs to the National Health Service (NHS) having been estimated to be as high as £2.6bn in 2015. Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. Objective The objective of this study was, first, to explore participants’ perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. Methods A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Thematic analysis was carried out, and important themes were identified. Descriptive statistics regarding participants’ perceptions and health behavior in relation to smoking cessation are also provided. Results The thematic analysis resulted in five higher themes and several subthemes. Participants were generally more positive about Quit Genius’s features, as well as about its design and information engagement and quality. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using

  11. Leveraging routine clinical materials and mobile technology to assess CBT fidelity: the Innovative Methods to Assess Psychotherapy Practices (imAPP) study.

    Science.gov (United States)

    Wiltsey Stirman, Shannon; Marques, Luana; Creed, Torrey A; Gutner, Cassidy A; DeRubeis, Robert; Barnett, Paul G; Kuhn, Eric; Suvak, Michael; Owen, Jason; Vogt, Dawne; Jo, Booil; Schoenwald, Sonja; Johnson, Clara; Mallard, Kera; Beristianos, Matthew; La Bash, Heidi

    2018-05-22

    Identifying scalable strategies for assessing fidelity is a key challenge in implementation science. However, for psychosocial interventions, the existing, reliable ways to test treatment fidelity quality are often labor intensive, and less burdensome strategies may not reflect actual clinical practice. Cognitive behavioral therapies (CBTs) provide clinicians with a set of effective core elements to help treat a multitude of disorders, which, evidence suggests, need to be delivered with fidelity to maximize potential client impact. The current "gold standard" for rating CBTs is rating recordings of therapy sessions, which is extremely time-consuming and requires a substantial amount of initial training. Although CBTs can vary based on the target disorder, one common element employed in most CBTs is the use of worksheets to identify specific behaviors and thoughts that affect a client's ability to recover. The present study will develop and evaluate an innovative new approach to rate CBT fidelity, by developing a universal CBT scoring system based on worksheets completed in therapy sessions. To develop a scoring system for CBT worksheets, we will compile common CBT elements from a variety of CBT worksheets for a range of psychiatric disorders and create adherence and competence measures. We will collect archival worksheets from past studies to test the scoring system and assess test-retest reliability. To evaluate whether CBT worksheet scoring accurately reflects clinician fidelity, we will recruit clinicians who are engaged in a CBT for depression, anxiety, and/or posttraumatic stress disorder. Clinicians and clients will transmit routine therapy materials produced in session (e.g., worksheets, clinical notes, session recordings) to the study team after each session. We will compare observer-rated fidelity, clinical notes, and fidelity-rated worksheets to identify the most effective and efficient method to assess clinician fidelity. Clients will also be randomly

  12. Supervised spike-timing-dependent plasticity: a spatiotemporal neuronal learning rule for function approximation and decisions.

    Science.gov (United States)

    Franosch, Jan-Moritz P; Urban, Sebastian; van Hemmen, J Leo

    2013-12-01

    How can an animal learn from experience? How can it train sensors, such as the auditory or tactile system, based on other sensory input such as the visual system? Supervised spike-timing-dependent plasticity (supervised STDP) is a possible answer. Supervised STDP trains one modality using input from another one as "supervisor." Quite complex time-dependent relationships between the senses can be learned. Here we prove that under very general conditions, supervised STDP converges to a stable configuration of synaptic weights leading to a reconstruction of primary sensory input.

  13. The feasibility and effectiveness of Catch It, an innovative CBT smartphone app.

    Science.gov (United States)

    Kinderman, Peter; Hagan, Paul; King, Sophie; Bowman, James; Chahal, Jasprit; Gan, Li; McKnight, Rebecca; Waldon, Charlotte; Smith, Matthew; Gilbertson, John; Tai, Sara

    2016-05-01

    The widespread use of smartphones makes effective therapies such as cognitive-behavioural therapy (CBT) potentially accessible to large numbers of people. This paper reports the usage data of the first trial of Catch It, a new CBT smartphone app. Uptake and usage rates, fidelity of user responses to CBT principles, and impact on reported negative and positive moods were assessed. A relatively modest proportion of people chose to download the app. Once used, the app tended to be used more than once, and 84% of the user-generated content was consistent with the basic concepts of CBT. There were statistically significant reductions in negative mood intensity and increases in positive mood intensity. Smartphone apps have potential beneficial effects in mental health through the application of basic CBT principles. More research with randomised controlled trial designs should be conducted. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

  14. Paediatric trainee supervision: management changes and perceived education value.

    Science.gov (United States)

    van den Boom, Mirjam; Pinnock, Ralph; Weller, Jennifer; Reed, Peter; Shulruf, Boaz

    2012-07-01

    Supervision in postgraduate training is an under-researched area. We measured the amount, type and effect of supervision on patient care and perceived education value in a general paediatric service. We designed a structured observation form and questionnaire to document the type, duration and effect of supervision on patient management and perceived education value. Most supervision occurred without the paediatrician confirming the trainee's findings. Direct observation of the trainee was rare. Management was changed in 30% of patients seen on the inpatient ward round and in 42% of the patients discussed during the chart reviews but not seen by the paediatrician. Management was changed in 48% of the cases when the paediatrician saw the patient with the trainee in outpatients but in only 21% of patients when the patient was but not seen. Changes made to patient management, understanding and perceived education value, differed between inpatient and out patient settings. There was more impact when the paediatrician saw the patient with the trainee in outpatients; while for inpatients, the opposite was true. Trainees rated the value of the supervision more highly than their supervisors did. Trainees' comments on what they learnt from their supervisor related almost exclusively to clinical knowledge rather than professional behaviours. We observed little evidence of supervisors directly observing trainees and trainees learning professional behaviours. A review of supervisory practices to promote more effective learning is needed. Communicating to paediatricians the value their trainees place on their input could have a positive effect on their engagement in supervision. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. Combining Sedation and Cognitive Behavioural Therapy (CBT) to Overcome Dental Phobia: a Case Report.

    Science.gov (United States)

    Hare, Jennifer S J

    2017-01-01

    This case report presents a Cognitive Behavioural Therapy (CBT) intervention provided for a 63-year-old male, who had experienced dental phobia for over 50-years. This gentleman initially received intravenous sedation (IVS) for 5-years within a Specialist Sedation and Special Care dental department, before being referred for the long-term management of his dental phobia, within the embedded specialist Dental Health Psychology Service in a London Dental Hospital. This brief report will consider aspects of the CBT intervention delivered in relation to assessment, case conceptualisation, course of treatment and outcomes; reflecting on the complementary aspects of sedation and CBT. Learning points will be identified for the role of CBT or CBT-based techniques within dental anxiety management settings.

  16. Evaluation of the relative efficacy of a couple cognitive-behaviour therapy (CBT) for Premenstrual Disorders (PMDs), in comparison to one-to-one CBT and a wait list control: A randomized controlled trial.

    Science.gov (United States)

    Ussher, Jane M; Perz, Janette

    2017-01-01

    A randomised control trial (RCT) was conducted to examine the efficacy of couple-based cognitive behaviour therapy (CBT) for Premenstrual Disorders (PMDs), in comparison to one-to-one CBT and a wait-list control. Triangulation of quantitative and qualitative outcome measures evaluated changes pre-post intervention. Eighty three women were randomly allocated across three conditions, with 63 completing post-intervention measures, a retention rate of 76%. Repeated measures analysis of variance found a significant time by group interaction identifying that women in the two CBT conditions reported lower total premenstrual symptoms, emotional reactivity/mood, and premenstrual distress, in comparison to the wait list control. Significantly higher active behavioural coping post-intervention was found in the couple condition than in the one-to-one and wait list control groups. Qualitative analysis provided insight into the subjective experience of PMDs and participation in the intervention study. Across groups, women reported increased awareness and understanding of premenstrual change post-intervention. A larger proportion of women in the CBT conditions reported reduction in intensity and frequency of negative premenstrual emotional reactivity, increased communication and help-seeking, increased understanding and acceptance of embodied change, and the development of coping skills, post-intervention. Increased partner understanding and improved relationship post-intervention was reported by a greater proportion of participants in the CBT conditions, most markedly in the couple condition. These findings suggest that one-to-one and couple CBT interventions can significantly reduce women's premenstrual symptomatology and distress, and improve premenstrual coping. Couple based CBT interventions may have a greater positive impact upon behavioural coping and perceptions of relationship context and support. This suggests that CBT should be available for women reporting moderate

  17. Supervised and Unsupervised Classification for Pattern Recognition Purposes

    Directory of Open Access Journals (Sweden)

    Catalina COCIANU

    2006-01-01

    Full Text Available A cluster analysis task has to identify the grouping trends of data, to decide on the sound clusters as well as to validate somehow the resulted structure. The identification of the grouping tendency existing in a data collection assumes the selection of a framework stated in terms of a mathematical model allowing to express the similarity degree between couples of particular objects, quasi-metrics expressing the similarity between an object an a cluster and between clusters, respectively. In supervised classification, we are provided with a collection of preclassified patterns, and the problem is to label a newly encountered pattern. Typically, the given training patterns are used to learn the descriptions of classes which in turn are used to label a new pattern. The final section of the paper presents a new methodology for supervised learning based on PCA. The classes are represented in the measurement/feature space by a continuous repartitions

  18. Fully Decentralized Semi-supervised Learning via Privacy-preserving Matrix Completion.

    Science.gov (United States)

    Fierimonte, Roberto; Scardapane, Simone; Uncini, Aurelio; Panella, Massimo

    2016-08-26

    Distributed learning refers to the problem of inferring a function when the training data are distributed among different nodes. While significant work has been done in the contexts of supervised and unsupervised learning, the intermediate case of Semi-supervised learning in the distributed setting has received less attention. In this paper, we propose an algorithm for this class of problems, by extending the framework of manifold regularization. The main component of the proposed algorithm consists of a fully distributed computation of the adjacency matrix of the training patterns. To this end, we propose a novel algorithm for low-rank distributed matrix completion, based on the framework of diffusion adaptation. Overall, the distributed Semi-supervised algorithm is efficient and scalable, and it can preserve privacy by the inclusion of flexible privacy-preserving mechanisms for similarity computation. The experimental results and comparison on a wide range of standard Semi-supervised benchmarks validate our proposal.

  19. Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review.

    Science.gov (United States)

    Cunningham, Jasmyn E A; Shapiro, Colin M

    2018-03-01

    Major depressive disorder is one of the most commonly diagnosed psychiatric illnesses, and it has a profound negative impact on an individual's ability to function. Up to 90% of individuals suffering from depression also report sleep and circadian disruptions. If these disruptions are not effectively resolved over the course of treatment, the likelihood of relapse into depression is greatly increased. Cognitive Behavioural Therapy for Insomnia (CBT-I) has shown promise in treating these sleep and circadian disturbances associated with depression, and may be effective as a stand-alone treatment for depression. This may be particularly relevant in cases where antidepressant medications are not ideal (e.g. due to contraindications, cost, or treatment resistance). A systematic literature review was conducted of trials investigating the use of CBT-I to treat depression in adults. Therapy included in-person CBT-I, as well as telehealth and group CBT-I. CBT-I presents a promising treatment for depression comorbid with insomnia. In-person therapy has the most supporting evidence for its efficacy, though treatment effects may not be additive with those of antidepressant medications. Insomnia improvement due to CBT-I may mediate the improvement in depressive symptoms. There is less evidence for the use of telehealth, though a stepped-care approach is indicated based on baseline depressive severity. More research on group therapy and telehealth modalities of delivering CBT-I are required before making recommendations. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Evaluation of Two Mobile Health Apps in the Context of Smoking Cessation: Qualitative Study of Cognitive Behavioral Therapy (CBT) Versus Non-CBT-Based Digital Solutions.

    Science.gov (United States)

    Tudor-Sfetea, Carina; Rabee, Riham; Najim, Muhammad; Amin, Nima; Chadha, Mehak; Jain, Minal; Karia, Kishan; Kothari, Varun; Patel, Tejus; Suseeharan, Melanie; Ahmed, Maroof; Sherwani, Yusuf; Siddiqui, Sarim; Lin, Yuting; Eisingerich, Andreas B

    2018-04-18

    Mobile health (mHealth) apps can offer users numerous benefits, representing a feasible and acceptable means of administering health interventions such as cognitive behavioral therapy (CBT). CBT is commonly used in the treatment of mental health conditions, where it has a strong evidence base, suggesting that it represents an effective method to elicit health behavior change. More importantly, CBT has proved to be effective in smoking cessation, in the context of smoking-related costs to the National Health Service (NHS) having been estimated to be as high as £2.6bn in 2015. Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. The objective of this study was, first, to explore participants' perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Thematic analysis was carried out, and important themes were identified. Descriptive statistics regarding participants' perceptions and health behavior in relation to smoking cessation are also provided. The thematic analysis resulted in five higher themes and several subthemes. Participants were generally more positive about Quit Genius's features, as well as about its design and information engagement and quality. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using their allocated app after 1 week. Moreover

  1. Using cognitive behaviour therapy with South Asian Muslims: Findings from the culturally sensitive CBT project.

    Science.gov (United States)

    Naeem, Farooq; Phiri, Peter; Munshi, Tariq; Rathod, Shanaya; Ayub, Muhhhamad; Gobbi, Mary; Kingdon, David

    2015-01-01

    It has been suggested that cognitive behaviour therapy (CBT) needs adaptation for it to be effective for patients from collectivistic cultures, as currently CBT is underpinned by individualistic values. In prior studies we have demonstrated that CBT could be adapted for Pakistani patients in Southampton, UK, and for local populations in Pakistan. Findings from these studies suggest that CBT can be adapted for patients from collectivistic cultures using a series of steps. In this paper we focus on these steps, and the process of adapting CBT for specific groups. The adaptation process should focus on three major areas of therapy, rather than simple translation of therapy manuals. These include (1) awareness of relevant cultural issues and preparation for therapy, (2) assessment and engagement, and (3) adjustments in therapy. We also discuss the best practice guidelines that evolved from this work to help therapists working with this population. We reiterate that CBT can be adapted effectively for patients from traditional cultures. This is, however, an emerging area in psychotherapy, and further work is required to refine the methodology and to test adapted CBT.

  2. Examining adherence to components of cognitive-behavioral therapy for youth anxiety after training and consultation.

    Science.gov (United States)

    Edmunds, Julie M; Brodman, Douglas M; Ringle, Vanesa A; Read, Kendra L; Kendall, Philip C; Beidas, Rinad S

    2017-02-01

    The present study examined 115 service providers' adherence to components of cognitive-behavioral therapy (CBT) for youth anxiety prior to training, post workshop training, and after three months of weekly consultation. Adherence was measured using a role-play with a trained actor. We examined differences in individual adherence to CBT components across time and the relationship between number of consultation sessions attended and adherence ratings following consultation. Findings indicated that somatic arousal identification and relaxation were the most used treatment components prior to training. Adherence to all components of CBT increased following workshop training, except the usage of problem-solving. Adherence to problem-solving, positive reinforcement, the identification of anxious self-talk, and the creation of coping thoughts increased following consultation but usage of problem-solving remained low compared to other treatment components. Overall adherence remained less than optimal at the final measurement point. Number of consultation sessions attended predicted post-consultation adherence to identification of somatic arousal, identification of anxious self-talk, and positive reinforcement. Implications include tailoring future training based on baseline levels of adherence and spending more time during training and consultation on underutilized CBT components, such as problem-solving. Limitations of the present study, including how adherence was measured, are discussed. This study adds to the implementation science literature by providing more nuanced information on changes in adherence over the course of training and consultation of service providers.

  3. Self-practice and self-reflection in cognitive behaviour therapy training: what factors influence trainees' engagement and experience of benefit?

    Science.gov (United States)

    Bennett-Levy, James; Lee, Nicole K

    2014-01-01

    Previous studies of self-practice/self-reflection (SP/SR) CBT training have found that trainees report significant benefits from practising CBT techniques on themselves (self-practice) and reflecting on their experience (self-reflection) as a formal part of their CBT training. However, not all trainees experience the same level of benefit from SP/SR and not all types of training course produce benefits to the same extent. This paper examines the question: What factors influence trainees' reported benefit from SP/SR? The aim was to develop a model to maximize the value of SP/SR training. The authors used a grounded theory analysis of four SP/SR training courses, varying along several dimensions, to derive a model that could account for the data. A model was derived comprising of seven elements: Two outcomes - "Experience of Benefit" and "Engagement with the Process" - that mutually influence one another; and five other influencing factors - "Course Structure and Requirements", "Expectation of Benefit", "Feeling of Safety with the Process", "Group Process", and "Available Personal Resources" - that mediate the impact on Engagement with the Process and Experience of Benefit from SP/SR. A model that provides guidance about the best ways to set up and develop SP/SR programs has been developed. This model may now be subject to empirical testing by trainers and researchers. Implications and recommendations for the design and development of future SP/SR programs are discussed.

  4. Improving head and body pose estimation through semi-supervised manifold alignment

    KAUST Repository

    Heili, Alexandre

    2014-10-27

    In this paper, we explore the use of a semi-supervised manifold alignment method for domain adaptation in the context of human body and head pose estimation in videos. We build upon an existing state-of-the-art system that leverages on external labelled datasets for the body and head features, and on the unlabelled test data with weak velocity labels to do a coupled estimation of the body and head pose. While this previous approach showed promising results, the learning of the underlying manifold structure of the features in the train and target data and the need to align them were not explored despite the fact that the pose features between two datasets may vary according to the scene, e.g. due to different camera point of view or perspective. In this paper, we propose to use a semi-supervised manifold alignment method to bring the train and target samples closer within the resulting embedded space. To this end, we consider an adaptation set from the target data and rely on (weak) labels, given for example by the velocity direction whenever they are reliable. These labels, along with the training labels are used to bias the manifold distance within each manifold and to establish correspondences for alignment.

  5. Cognitive-Behavioral Therapy versus Usual Clinical Care for Youth Depression: An Initial Test of Transportability to Community Clinics and Clinicians

    Science.gov (United States)

    Weisz, John R.; Southam-Gerow, Michael A.; Gordis, Elana B.; Connor-Smith, Jennifer K.; Chu, Brian C.; Langer, David A.; McLeod, Bryce D.; Jensen-Doss, Amanda; Updegraff, Alanna; Weiss, Bahr

    2009-01-01

    Community clinic therapists were randomized to (a) brief training and supervision in cognitive-behavioral therapy (CBT) for youth depression or (b) usual care (UC). The therapists treated 57 youths (56% girls), ages 8-15, of whom 33% were Caucasian, 26% were African American, and 26% were Latino/Latina. Most youths were from low-income families…

  6. Late group-based rehabilitation has no advantages compared with supervised home-exercises after total knee arthroplasty

    DEFF Research Database (Denmark)

    Madsen, Majbritt; Larsen, Kristian; Madsen, Inger Kirkegård

    2013-01-01

    This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA).......This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA)....

  7. Computer-based training at Sellafield

    International Nuclear Information System (INIS)

    Cartmell, A.; Evans, M.C.

    1986-01-01

    British Nuclear Fuel Limited (BNFL) operate the United Kingdom's spent-fuel receipt, storage, and reprocessing complex at Sellafield. Spent fuel from graphite-moderated CO 2 -cooled Magnox reactors has been reprocessed at Sellafield for 22 yr. Spent fuel from light water and advanced gas reactors is stored pending reprocessing in the Thermal Oxide Reprocessing Plant currently being constructed. The range of knowledge and skills needed for plant operation, construction, and commissioning represents a formidable training requirement. In addition, employees need to be acquainted with company practices and procedures. Computer-based training (CBT) is expected to play a significant role in this process. In this paper, current applications of CBT to the filed of nuclear criticality safety are described and plans for the immediate future are outlined

  8. Yoga-Enhanced Cognitive Behavioral Therapy (Y-CBT) for Anxiety Management: A Pilot Study

    Science.gov (United States)

    Khalsa, Manjit K.; Greiner-Ferris, Julie M.; Hofmann, Stefan G.; Khalsa, Sat Bir S.

    2014-01-01

    Cognitive behavioral therapy is an effective treatment for generalized anxiety disorder (GAD), but there is still room for improvement. The aim of the present study was to examine the potential benefit of enriching cognitive behavioral therapy (CBT) with Kundalini Yoga (Y-CBT). Participants consisted of treatment resistant clients at a community mental health clinic. A total of 32 participants enrolled in the study and 22 completed the program. After the Y-CBT intervention, pre-post comparisons showed statistically significant improvements in state and trait anxiety, depression, panic, sleep, and quality of life. Results from this preliminary study suggest that Y-CBT may have potential as a promising treatment for those suffering from GAD. PMID:24804619

  9. Exploring the Effect of Case Formulation Driven CBT for Children with Anxiety Disorders

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Reinholdt-Dunne, Marie Louise; Nielsen, Sara K

    2015-01-01

    Background: Little is known about the effect of case-formulation based cognitive behaviour therapy (CBT) for anxious children. Aim: The present study explores the feasibility of case-formulation driven CBT for anxious children. Parents were involved in treatment as either co-facilitators (involved...... CBT was established by comparing the completion rate and the percentage of children free of anxiety after treatment, with manualized treatments reported in existing meta-analyses. Children aged 7-12 years and their parents participated (n = 54). Families were assessed at pre- and posttreatment...... approach to CBT may be a feasible option when selecting treatment for anxious children; however, further studies must be conducted before firm conclusions can be drawn....

  10. Computer-Assisted CBT for Child Anxiety: The Coping Cat CD-ROM

    Science.gov (United States)

    Khanna, Muniya S.; Kendall, Philip C.

    2008-01-01

    Empirical data support the efficacy of cognitive-behavioral therapy (CBT) for child anxiety, but there is need and merit in the development and evaluation of cost-effective and transportable CBT approaches. Relatedly, a widely endorsed goal is the dissemination of evidence-based treatments from research clinics to community settings.…

  11. Cognitive Behavioral Therapy (CBT) for Subacute Low Back Pain: a Systematic Review.

    Science.gov (United States)

    Mariano, Timothy Y; Urman, Richard D; Hutchison, Catherine A; Jamison, Robert N; Edwards, Robert R

    2018-02-23

    Chronic low back pain (CLBP) is a major source of physical and psychiatric morbidity and mortality, and the current overreliance on opioid analgesics has contributed to a burgeoning epidemic in the USA. Cognitive behavioral therapy (CBT) is an empirically supported treatment for CLBP, but little information exists regarding its potential efficacy for CLBP's precursor condition, subacute low back pain (sALBP), defined here as having a 7-12-week duration. Earlier intervention with CBT at the sALBP stage could produce larger clinical benefits. This systematic review was undertaken to characterize and highlight this knowledge gap. Of 240 unique articles identified by comprehensive database searches, only six prospective, sALBP-focused, randomized controlled trials (RCTs) published within the past 20 years met criteria for inclusion in this review. These studies varied widely in their sample sizes, precise definition of sALBP, nature of CBT intervention, and outcome measures. Five of the six showed significant improvements associated with CBT, but the heterogeneity of the studies prevented quantitative comparisons. CBT has not been adequately studied as a potential early intervention treatment for sALBP patients. None of the six identified papers studied US civilians or leveraged innovations such as teletherapy-able to reach patients in remote or underserved areas-underscoring critical gaps in current back pain treatment. Given the severity of the US opioid epidemic, non-pharmacologic options such as CBT should be rigorously explored in the sALBP population.

  12. Generative Adversarial Networks-Based Semi-Supervised Learning for Hyperspectral Image Classification

    Directory of Open Access Journals (Sweden)

    Zhi He

    2017-10-01

    Full Text Available Classification of hyperspectral image (HSI is an important research topic in the remote sensing community. Significant efforts (e.g., deep learning have been concentrated on this task. However, it is still an open issue to classify the high-dimensional HSI with a limited number of training samples. In this paper, we propose a semi-supervised HSI classification method inspired by the generative adversarial networks (GANs. Unlike the supervised methods, the proposed HSI classification method is semi-supervised, which can make full use of the limited labeled samples as well as the sufficient unlabeled samples. Core ideas of the proposed method are twofold. First, the three-dimensional bilateral filter (3DBF is adopted to extract the spectral-spatial features by naturally treating the HSI as a volumetric dataset. The spatial information is integrated into the extracted features by 3DBF, which is propitious to the subsequent classification step. Second, GANs are trained on the spectral-spatial features for semi-supervised learning. A GAN contains two neural networks (i.e., generator and discriminator trained in opposition to one another. The semi-supervised learning is achieved by adding samples from the generator to the features and increasing the dimension of the classifier output. Experimental results obtained on three benchmark HSI datasets have confirmed the effectiveness of the proposed method , especially with a limited number of labeled samples.

  13. A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training.

    Science.gov (United States)

    Thornley, Peter; Quinn, Alyson

    2017-11-10

    Clinical Audit (CA) has been recognized as a useful tool for tool for improving service delivery, clinical governance, and the education and performance of the dental team. This study develops the discussion by investigating its use as an educational tool within UK Dental Foundation Training (DFT). The aim was to investigate the views of Foundation Dentists (FDs) and Training Programme Directors (TPDs) on the CA module in their FD training schemes, to provide insight and recommendations for those supervising and undertaking CA. A literature review was conducted followed by a qualitative research methodology, using group interviews. The interviews were transcribed and thematically analyzed using NVIVO, a Computer-Assisted Qualitative Data Analysis tool. CA was found to be a useful tool for teaching management and professionalism and can bring some improvement to clinical practice, but TPDs have doubts about the long-term effects on service delivery. The role of the Educational Supervisor (ES) is discussed and recommendations are given for those supervising and conducting CA.

  14. A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training

    Directory of Open Access Journals (Sweden)

    Peter Thornley

    2017-11-01

    Full Text Available Clinical Audit (CA has been recognized as a useful tool for tool for improving service delivery, clinical governance, and the education and performance of the dental team. This study develops the discussion by investigating its use as an educational tool within UK Dental Foundation Training (DFT. The aim was to investigate the views of Foundation Dentists (FDs and Training Programme Directors (TPDs on the CA module in their FD training schemes, to provide insight and recommendations for those supervising and undertaking CA. A literature review was conducted followed by a qualitative research methodology, using group interviews. The interviews were transcribed and thematically analyzed using NVIVO, a Computer-Assisted Qualitative Data Analysis tool. CA was found to be a useful tool for teaching management and professionalism and can bring some improvement to clinical practice, but TPDs have doubts about the long-term effects on service delivery. The role of the Educational Supervisor (ES is discussed and recommendations are given for those supervising and conducting CA.

  15. Treatment engagement and response to CBT among Latinos with anxiety disorders in primary care.

    Science.gov (United States)

    Chavira, Denise A; Golinelli, Daniela; Sherbourne, Cathy; Stein, Murray B; Sullivan, Greer; Bystritsky, Alexander; Rose, Raphael D; Lang, Ariel J; Campbell-Sills, Laura; Welch, Stacy; Bumgardner, Kristin; Glenn, Daniel; Barrios, Velma; Roy-Byrne, Peter; Craske, Michelle

    2014-06-01

    In the current study, we compared measures of treatment outcome and engagement for Latino and non-Latino White patients receiving a cognitive behavioral therapy (CBT) program delivered in primary care. Participants were 18-65 years old and recruited from 17 clinics at 4 different sites to participate in a randomized controlled trial for anxiety disorders, which compared the Coordinated Anxiety Learning and Management (CALM) intervention (consisting of CBT, medication, or both) with usual care. Of those participants who were randomized to the intervention arm and selected CBT (either alone or in combination with medication), 85 were Latino and 251 were non-Latino White; the majority of the Latino participants received the CBT intervention in English (n = 77). Blinded assessments of clinical improvement and functioning were administered at baseline and at 6, 12, and 18 months after baseline. Measures of engagement, including attendance, homework adherence, understanding of CBT principles, and commitment to treatment, were assessed weekly during the CBT intervention. Findings from propensity-weighted linear and logistic regression models revealed no statistically significant differences between Latinos and non-Latino Whites on symptom measures of clinical improvement and functioning at almost all time points. There were significant differences on 2 of 7 engagement outcomes, namely, number of sessions attended and patients' understanding of CBT principles. These findings suggest that CBT can be an effective treatment approach for Latinos who are primarily English speaking and likely more acculturated, although continued attention should be directed toward engaging Latinos in such interventions. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  16. 46 CFR 199.100 - Manning of survival craft and supervision.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Manning of survival craft and supervision. 199.100....100 Manning of survival craft and supervision. (a) There must be a sufficient number of trained... craft and launching arrangements required for abandonment by the total number of persons on board. (c...

  17. Consultative Instructor Supervision and Evaluation

    Science.gov (United States)

    Lee, William W.

    2010-01-01

    Organizations vary greatly in how they monitor training instructors. The methods used in monitoring vary greatly. This article presents a systematic process for improving instructor skills that result in better teaching and better learning, which results in better-prepared employees for the workforce. The consultative supervision and evaluation…

  18. PERMIT PROCEDURE OF ESTHABLISMENT AND SUPERVISION OF NURSING CLINIC IN BANTUL REGENCY

    Directory of Open Access Journals (Sweden)

    Nasrullah Nasrullah

    2012-12-01

    Full Text Available As one of the health professions, nurse normally does no have independent authority to conduct medical practice. However, according to several regulations, nurse has a chance to establish and run his/her own nursing clinic. So far, there are six individual nursing clinics have been operated in Bantul Regency. By utilizing empirical research method with legislation approach, this research aims at finding out the importance and the permit procedure to establish nursing clinic as well as to know the supervision means used by the government upon the operated nursing clinic in Bantul Regency. This research proved that nursing clinics have given beneficial advantages on the society as whole. Meanwhile, to operate a nursing clinic a nurse has to be granted a Nursing Practice Permit Letter (Surat Izin Praktik Perawat/SIPP from the government. Finally, the nursing clinic is supervised by the Health Bureau by means of supervision and control program.Keywords: nursing practice, nursing clinic, Nursing Practice Permit Letter, supervision and control program

  19. Efficacy of Guided iCBT for Depression and Mediation of Change by Cognitive Skill Acquisition.

    Science.gov (United States)

    Forand, Nicholas R; Barnett, Jeffrey G; Strunk, Daniel R; Hindiyeh, Mohammed U; Feinberg, Jason E; Keefe, John R

    2018-03-01

    Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale-Self Report and the Behavioral Activation Scale for Depression-Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges' g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts. Copyright © 2017. Published by Elsevier Ltd.

  20. On being supervised: getting value from a clinical supervisor and making the relationship work when it is not.

    Science.gov (United States)

    Parker, Stephen; Suetani, Shuichi; Motamarri, Balaji

    2017-12-01

    The importance of clinical supervision is emphasised in psychiatric training programs. Despite this, the purpose and processes of supervision are often poorly defined. There is limited guidance available for trainees about their role in making supervision work. This paper considers the nature of supervision in psychiatric training and provides practical advice to help supervisees take active steps to make supervision work. In obtaining value from supervision, the active role of the supervisee in seeking feedback, finding value in criticism and building autonomy is emphasised. Additionally, the importance of exploring what value a supervisor can offer and maintaining realistic expectations is considered. Trainees can benefit from taking an active role in planning and managing their supervision to maximise their learning.

  1. Types of parental involvement in CBT with anxious youth: a preliminary meta-analysis.

    Science.gov (United States)

    Manassis, Katharina; Lee, Trevor Changgun; Bennett, Kathryn; Zhao, Xiu Yan; Mendlowitz, Sandra; Duda, Stephanie; Saini, Michael; Wilansky, Pamela; Baer, Susan; Barrett, Paula; Bodden, Denise; Cobham, Vanessa E; Dadds, Mark R; Flannery-Schroeder, Ellen; Ginsburg, Golda; Heyne, David; Hudson, Jennifer L; Kendall, Philip C; Liber, Juliette; Masia-Warner, Carrie; Nauta, Maaike H; Rapee, Ronald M; Silverman, Wendy; Siqueland, Lynne; Spence, Susan H; Utens, Elisabeth; Wood, Jeffrey J

    2014-12-01

    Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingency management (CM) and transfer of control (TC) as a potential outcome moderator using a meta-analysis with individual patient data. Investigators of randomized controlled trials (RCTs) of CBT for anxious children, identified systematically, were invited to submit their data. Conditions in each RCT were coded based on type of parental involvement in CBT (i.e., low involvement, active involvement without emphasis on CM or TC, active involvement with emphasis on CM or TC). Treatment outcomes were compared using a 1-stage meta-analysis. All cases involved in active treatment (894 of 1,618) were included for subgroup analyses. Across all CBT groups, means of clinical severity, anxiety, and internalizing symptoms significantly decreased posttreatment and were comparable across groups. The group without emphasis on CM or TC showed a higher proportion with posttreatment anxiety diagnoses than the low-involvement group. Between posttreatment and 1-year follow-up, the proportion with anxiety diagnoses significantly decreased in CBT with active parental involvement with emphasis on CM or TC, whereas treatment gains were merely maintained in the other 2 groups. CBT for anxious children is an effective treatment with or without active parental involvement. However, CBT with active parental involvement emphasizing CM or TC may support long-term maintenance of treatment gains. RESULTS should be replicated as additional RCTs are published.

  2. Computer Based Training Authors' and Designers' training

    Directory of Open Access Journals (Sweden)

    Frédéric GODET

    2016-03-01

    Full Text Available This communication, through couple of studies driven since 10 years, tries to show how important is the training of authors in Computer Based Training (CBT. We submit here an approach to prepare designers mastering Interactive Multimedia modules in this domain. Which institutions are really dedicating their efforts in training authors and designers in this area of CBTs? Television devices and broadcast organisations offered since year 60s' a first support for Distance Learning. New media, New Information and Communication Technologies (NICT allowed several public and private organisations to start Distance Learning projects. As usual some of them met their training objectives, other of them failed. Did their really failed? Currently, nobody has the right answer. Today, we do not have enough efficient tools allowing us to evaluate trainees' acquisition in a short term view. Training evaluation needs more than 10 to 20 years of elapsed time to bring reliable measures. Nevertheless, given the high investments already done in this area, we cannot wait until the final results of the pedagogical evaluation. A lot of analyses showed relevant issues which can be used as directions for CBTs authors and designers training. Warning - Our studies and the derived conclusions are mainly based on projects driven in the field. We additionally bring our several years experience in the training of movie film authors in the design of interactive multimedia products. Some of our examples are extracting from vocational training projects where we were involved in all development phases from the analysis of needs to the evaluation of the acquisition within the trainee's / employee job's. Obviously, we cannot bring and exhaustive approach in this domain where a lot of parameters are involved as frame for the CBT interactive multimedia modules authors' and designers' training.

  3. Preparing supervisors to provide safeguarding supervision for healthcare staff.

    Science.gov (United States)

    Smikle, Marcia

    2017-11-28

    This paper outlines why experienced supervisors at a London healthcare provider received skills training so they could offer safeguarding supervision to front-line colleagues with case management responsibilities for vulnerable children and young people. It examines how supervisors use the main functions of supervision and a cycle of reflection in clinical practice with supervisees. As well as the professional issues encountered by supervisors in relation to the benefits, the challenges of providing supervision and the action required to make safeguarding supervision a part of the organisational culture are also explored. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  4. [Analysis of interventions designed to improve clinical supervision of student nurses in Benin].

    Science.gov (United States)

    Otti, André; Pirson, Magali; Piette, Danielle; Coppieters T Wallant, Yves

    2017-12-05

    The absence of an explicit and coherent conception of the articulation between theory and practice in the reform of nursing training in Benin has resulted in poor quality clinical supervision of student nurses. The objective of this article is to analyze two interventions designed to improve the quality of supervision. A student welcome booklet developed by means of a consultative and provocative participatory approach was tested with twelve student nurses versus a control group. Content analysis of the data collected by individual semi-directed interviews and during two focus groups demonstrated the value of this tool. Student nurses were also taught to use to training diaries inspired by the ?experiential learning? Training diaries were analysed using a grid based on the descriptive elements of the five types of Scheepers training diaries (2008). According to the student nurses, the welcome booklet provided them with structured information to be used as a reference during their training and a better understanding of their teachers, and allowed them to situate the resources of the training course with a lower level of stress. Fifty-eight per cent of the training diaries were are mosaics, reflecting the reflective practice and self-regulated learning of student nurses. This activity also promoted metacognitive dialogue with their supervisors. The student welcome booklet appeared to facilitate integration of student nurses into the clinical setting and promoted professional and organizational socialization. The training diary improved the quality of clinical learning by repeated reflective observation of student nurses and helped to maintain permanent communication with the supervisors.

  5. Supervision to Enhance Educational and Vocational Guidance Practice: A Review

    Science.gov (United States)

    Reid, Hazel L.

    2010-01-01

    Supervision to support the work of career practitioners is evident in many countries, but is not universal. This author presents a literature review, intending to emphasise the prime importance of developing supervision for guidance work. The author also considers the issues facing those training to develop the role of supervisors in southeast…

  6. 46 CFR 109.323 - Manning of survival craft and supervision.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Manning of survival craft and supervision. 109.323... DRILLING UNITS OPERATIONS Operation and Stowage of Safety Equipment § 109.323 Manning of survival craft and supervision. (a) There must be a sufficient number of trained persons on board the survival craft for...

  7. Clinical supervision reflected in a Danish DPCCQ sample

    DEFF Research Database (Denmark)

    Nielsen, Jan; Jacobsen, Claus Haugaard

    Core Questionnaire (DPCCQ) has only few questions on supervision. To rectify this limitation, a recent Danish version of the DPCCQ included two new sections on supervision, one focusing on supervisees and another on supervisors and their supervisory training. This paper presents our initial findings...... on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...... on describing the amount and type of supervision received and given by the sample. Findings from these descriptive statistics will be compared within the sample across demographic parameters such as age and sex, and professional characteristics such as career level, theoretical preferences, type of clients...

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

    Science.gov (United States)

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

    2016-07-01

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

  9. Framing doctoral supervision as formative assessment

    DEFF Research Database (Denmark)

    Kobayashi, Sofie

    Doctoral supervision has been described through a number of models useful for understanding different aspects of supervision. None of these are all-encompassing, but each emphasizes a particular perspective, like the relationship, personal vs. structural support, process vs. product orientation. ...

  10. Guess Where? Actor-Supervision for Spatiotemporal Action Localization

    KAUST Repository

    Escorcia, Victor

    2018-04-05

    This paper addresses the problem of spatiotemporal localization of actions in videos. Compared to leading approaches, which all learn to localize based on carefully annotated boxes on training video frames, we adhere to a weakly-supervised solution that only requires a video class label. We introduce an actor-supervised architecture that exploits the inherent compositionality of actions in terms of actor transformations, to localize actions. We make two contributions. First, we propose actor proposals derived from a detector for human and non-human actors intended for images, which is linked over time by Siamese similarity matching to account for actor deformations. Second, we propose an actor-based attention mechanism that enables the localization of the actions from action class labels and actor proposals and is end-to-end trainable. Experiments on three human and non-human action datasets show actor supervision is state-of-the-art for weakly-supervised action localization and is even competitive to some fully-supervised alternatives.

  11. Guess Where? Actor-Supervision for Spatiotemporal Action Localization

    KAUST Repository

    Escorcia, Victor; Dao, Cuong D.; Jain, Mihir; Ghanem, Bernard; Snoek, Cees

    2018-01-01

    This paper addresses the problem of spatiotemporal localization of actions in videos. Compared to leading approaches, which all learn to localize based on carefully annotated boxes on training video frames, we adhere to a weakly-supervised solution that only requires a video class label. We introduce an actor-supervised architecture that exploits the inherent compositionality of actions in terms of actor transformations, to localize actions. We make two contributions. First, we propose actor proposals derived from a detector for human and non-human actors intended for images, which is linked over time by Siamese similarity matching to account for actor deformations. Second, we propose an actor-based attention mechanism that enables the localization of the actions from action class labels and actor proposals and is end-to-end trainable. Experiments on three human and non-human action datasets show actor supervision is state-of-the-art for weakly-supervised action localization and is even competitive to some fully-supervised alternatives.

  12. THE IMPORTANCE OF REGINONAL REGULATIONS SUPERVISION IN FINANCIAL SECTOR AFTER REGIONAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Iza Rumesten RS

    2015-01-01

    Full Text Available Autonomous regional administration may say 80% fail, even many violations in governance can be seen from the many local regulations canceled by the government. The problem of this study is how the regulatory supervision of the financial sector among local parent with a new autonomous regions. Methods used in this research is to examine the normative Law 23 of 2014 and Act No. 17 of 2003. From the results, that local governments still have to master to supervise all local regulations and regulatory policies that made the district / city, especially in the field of finance. An obligation on the parent region to assist funding over three years for new autonomous regions interfere with the delivery system of local governance parent, therefore before diotonomkan, candidates should be prepared to be autonomous administrative regions that after diotonomkan not interfere peyelenggaraan dependent and parent local government.

  13. The Practice of Supervision for Professional Learning: The Example of Future Forensic Specialists

    Science.gov (United States)

    Köpsén, Susanne; Nyström, Sofia

    2015-01-01

    Supervision intended to support learning is of great interest in professional knowledge development. No single definition governs the implementation and enactment of supervision because of different conditions, intentions, and pedagogical approaches. Uncertainty exists at a time when knowledge and methods are undergoing constant development. This…

  14. Challenges for Better thesis supervision.

    Science.gov (United States)

    Ghadirian, Laleh; Sayarifard, Azadeh; Majdzadeh, Reza; Rajabi, Fatemeh; Yunesian, Masoud

    2014-01-01

    Conduction of thesis by the students is one of their major academic activities. Thesis quality and acquired experiences are highly dependent on the supervision. Our study is aimed at identifing the challenges in thesis supervision from both students and faculty members point of view. This study was conducted using individual in-depth interviews and Focus Group Discussions (FGD). The participants were 43 students and faculty members selected by purposive sampling. It was carried out in Tehran University of Medical Sciences in 2012. Data analysis was done concurrently with data gathering using content analysis method. Our data analysis resulted in 162 codes, 17 subcategories and 4 major categories, "supervisory knowledge and skills", "atmosphere", "bylaws and regulations relating to supervision" and "monitoring and evaluation". This study showed that more attention and planning in needed for modifying related rules and regulations, qualitative and quantitative improvement in mentorship training, research atmosphere improvement and effective monitoring and evaluation in supervisory area.

  15. Improving access to psychological therapies in voice disorders: a cognitive behavioural therapy model.

    Science.gov (United States)

    Miller, Tracy; Deary, Vincent; Patterson, Jo

    2014-06-01

    The improving access to psychological therapies initiative has highlighted the importance of managing mental health problems effectively, and research has shown excellent outcomes from cognitive behavioural therapy (CBT) interventions. Patients presenting with functional dysphonia will often also describe psychological distress including anxiety, depression and reduced general well-being, and it is felt that effective voice therapy needs to include the management of psychological well-being. The evidence for the use of CBT enhanced voice therapy is limited to date. Recent research has only started to identify the benefits of this approach and questions regarding how to achieve and maintain competence are essential. Voice therapy outcomes are positive and patients receiving CBT with voice therapy have shown more improvement in their general well-being and distress. CBT is a very well evidenced therapy and recommended by The National Institute for Health and Care Excellence (NICE) as the treatment of choice for mental health difficulties and medically unexplained symptoms. Allied health professionals are increasingly being trained to use CBT skills in the management of a number of symptoms/illnesses, and this should be considered for the management of functional dysphonia. However, there is a need for more research and detailed consideration of how therapists should be trained and supervised and how cost-effective this approach may be.

  16. Cognitive behavioural therapy (CBT) for adults and adolescents with asthma.

    Science.gov (United States)

    Kew, Kayleigh M; Nashed, Marina; Dulay, Valdeep; Yorke, Janelle

    2016-09-21

    People with asthma have a higher prevalence of anxiety and depression than the general population. This is associated with poorer asthma control, medication adherence, and health outcomes. Cognitive behavioural therapy (CBT) may be a way to improve the quality of life of people with asthma by addressing associated psychological issues, which may lead to a lower risk of exacerbations and better asthma control. To assess the efficacy of CBT for asthma compared with usual care. We searched the Cochrane Airways Group Specialised Register, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also searched reference lists of all primary studies and review articles and contacted authors for unpublished data. The most recent searches were conducted in August 2016. We included parallel randomised controlled trials (RCTs) comparing any cognitive behavioural intervention to usual care or no intervention. We included studies of adults or adolescents with asthma, with or without comorbid anxiety or depression. We included studies reported as full text, those published as abstract only, and unpublished data. Two or more review authors independently screened the search results, extracted data, and assessed included studies for risk of bias. We analysed dichotomous data as odds ratios (ORs) and continuous data as mean differences (MDs) or standardised mean differences (SMD) where scales varied across studies, all using a random-effects model. The primary outcomes were asthma-related quality of life and exacerbations requiring at least a course of oral steroids. We rated all outcomes using GRADE and presented our confidence in the results in a 'Summary of findings' table. We included nine RCTs involving 407 adults with asthma in this review; no studies included adolescents under 18. Study size ranged from 10 to 94 (median 40), and mean age ranged from 39 to 53. Study populations generally had persistent asthma, but

  17. Flexible manifold embedding: a framework for semi-supervised and unsupervised dimension reduction.

    Science.gov (United States)

    Nie, Feiping; Xu, Dong; Tsang, Ivor Wai-Hung; Zhang, Changshui

    2010-07-01

    We propose a unified manifold learning framework for semi-supervised and unsupervised dimension reduction by employing a simple but effective linear regression function to map the new data points. For semi-supervised dimension reduction, we aim to find the optimal prediction labels F for all the training samples X, the linear regression function h(X) and the regression residue F(0) = F - h(X) simultaneously. Our new objective function integrates two terms related to label fitness and manifold smoothness as well as a flexible penalty term defined on the residue F(0). Our Semi-Supervised learning framework, referred to as flexible manifold embedding (FME), can effectively utilize label information from labeled data as well as a manifold structure from both labeled and unlabeled data. By modeling the mismatch between h(X) and F, we show that FME relaxes the hard linear constraint F = h(X) in manifold regularization (MR), making it better cope with the data sampled from a nonlinear manifold. In addition, we propose a simplified version (referred to as FME/U) for unsupervised dimension reduction. We also show that our proposed framework provides a unified view to explain and understand many semi-supervised, supervised and unsupervised dimension reduction techniques. Comprehensive experiments on several benchmark databases demonstrate the significant improvement over existing dimension reduction algorithms.

  18. Self-reflection in cognitive behavioural therapy and supervision.

    Science.gov (United States)

    Prasko, Jan; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos; Vyskocilova, Jana

    2012-12-01

    Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the

  19. Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; a randomized clinical trial.

    Science.gov (United States)

    Iftene, Felicia; Predescu, Elena; Stefan, Simona; David, Daniel

    2015-02-28

    Major depressive disorder is a highly prevalent and debilitating condition in youth, so developing efficient treatments is a priority for mental health professionals. Psychotherapy (i.e., cognitive behavioral therapy/CBT), pharmacotherapy (i.e., SSRI medication), and their combination have been shown to be effective in treating youth depression; however, the results are still mixed and there are few studies engaging multi-level analyses (i.e., subjective, cognitive, and biological). Therefore, the aims of this randomized control study (RCT) were both theoretical - integrating psychological and biological markers of depression in a multi-level outcome analysis - and practical - testing the generalizability of previous results on depressed Romanian youth population. Eighty-eight (N=88) depressed Romanian youths were randomly allocated to one of the three treatment arms: group Rational Emotive Behavior Therapy (REBT)/CBT (i.e., a form of CBT), pharmacotherapy (i.e., sertraline), and group REBT/CBT plus pharmacotherapy. The results showed that all outcomes (i.e., subjective, cognitive, and biological) significantly change from pre to post-treatment under all treatment conditions at a similar rate and there were no significant differences among conditions at post-test. In case of categorical analysis of the clinical response rate, we found a non-significant trend favoring group REBT/CBT therapy. Results of analyses concerning outcome interrelations are discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Optimizing area under the ROC curve using semi-supervised learning.

    Science.gov (United States)

    Wang, Shijun; Li, Diana; Petrick, Nicholas; Sahiner, Berkman; Linguraru, Marius George; Summers, Ronald M

    2015-01-01

    Receiver operating characteristic (ROC) analysis is a standard methodology to evaluate the performance of a binary classification system. The area under the ROC curve (AUC) is a performance metric that summarizes how well a classifier separates two classes. Traditional AUC optimization techniques are supervised learning methods that utilize only labeled data (i.e., the true class is known for all data) to train the classifiers. In this work, inspired by semi-supervised and transductive learning, we propose two new AUC optimization algorithms hereby referred to as semi-supervised learning receiver operating characteristic (SSLROC) algorithms, which utilize unlabeled test samples in classifier training to maximize AUC. Unlabeled samples are incorporated into the AUC optimization process, and their ranking relationships to labeled positive and negative training samples are considered as optimization constraints. The introduced test samples will cause the learned decision boundary in a multidimensional feature space to adapt not only to the distribution of labeled training data, but also to the distribution of unlabeled test data. We formulate the semi-supervised AUC optimization problem as a semi-definite programming problem based on the margin maximization theory. The proposed methods SSLROC1 (1-norm) and SSLROC2 (2-norm) were evaluated using 34 (determined by power analysis) randomly selected datasets from the University of California, Irvine machine learning repository. Wilcoxon signed rank tests showed that the proposed methods achieved significant improvement compared with state-of-the-art methods. The proposed methods were also applied to a CT colonography dataset for colonic polyp classification and showed promising results.

  1. Semi-Supervised Multiple Feature Analysis for Action Recognition

    Science.gov (United States)

    2013-11-26

    in saving la- beling costs while simultaneously achieving good performance. Most semi-supervised learning methods assume that nearby points are likely...3, 5, 10 and 15) per category in the training set, thus resulting in , , , and randomly la- beled videos, with the remaining training videos unlabeled...with the increase of la- beled training samples, the performance of all algorithms rises. Meanwhile, the performance differences between our method and

  2. The Size and Structure of Government

    OpenAIRE

    Michael, Bryane; Popov, Maja

    2015-01-01

    Does government size and structure adapt to changes in government’s organisational environment (particularly to uncertainty and complexity) as predicted by organisational theory? We find – using a range of statistical analyses – support for each of the major theories of organisation adaptation (the contingency-based view, resource-based view, and rational choice view). We find that both government size and structure change – holding other factors constant – for changes in the uncertaint...

  3. Distant Supervision for Relation Extraction with Ranking-Based Methods

    Directory of Open Access Journals (Sweden)

    Yang Xiang

    2016-05-01

    Full Text Available Relation extraction has benefited from distant supervision in recent years with the development of natural language processing techniques and data explosion. However, distant supervision is still greatly limited by the quality of training data, due to its natural motivation for greatly reducing the heavy cost of data annotation. In this paper, we construct an architecture called MIML-sort (Multi-instance Multi-label Learning with Sorting Strategies, which is built on the famous MIML framework. Based on MIML-sort, we propose three ranking-based methods for sample selection with which we identify relation extractors from a subset of the training data. Experiments are set up on the KBP (Knowledge Base Propagation corpus, one of the benchmark datasets for distant supervision, which is large and noisy. Compared with previous work, the proposed methods produce considerably better results. Furthermore, the three methods together achieve the best F1 on the official testing set, with an optimal enhancement of F1 from 27.3% to 29.98%.

  4. iCanADAPT Early protocol: randomised controlled trial (RCT) of clinician supervised transdiagnostic internet-delivered cognitive behaviour therapy (iCBT) for depression and/or anxiety in early stage cancer survivors -vs- treatment as usual

    OpenAIRE

    Murphy, M. J.; Newby, J. M.; Butow, P.; Kirsten, L.; Allison, K.; Loughnan, S.; Price, M. A.; Shaw, J.; Shepherd, H.; Smith, J.; Andrews, G.

    2017-01-01

    Background This RCT with two parallel arms will evaluate the efficacy of an internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for the treatment of clinical depression and/or anxiety in early stage cancer survivors. Methods/design Early stage cancer survivors will be recruited via the research arm of a not-for-profit clinical research unit and randomised to an intervention (iCBT) group or a ?treatment as usual? (TAU) control group. The minimum sample size for...

  5. Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors.

    Science.gov (United States)

    Mendoza, M E; Capafons, A; Gralow, J R; Syrjala, K L; Suárez-Rodríguez, J M; Fann, J R; Jensen, M P

    2017-11-01

    This study evaluated the efficacy of an intervention combining the Valencia model of waking hypnosis with cognitive-behavioral therapy (VMWH-CBT) in managing cancer-related pain, fatigue, and sleep problems in individuals with active cancer or who were post-treatment survivors. We hypothesized that four sessions of VMWH-CBT would result in greater improvement in participants' symptoms than four sessions of an education control intervention. Additionally, we examined the effects on several secondary outcome domains that are associated with increases in these symptoms (depression, pain interference, pain catastrophizing, and cancer treatment distress). The study design was a randomized controlled crossover clinical trial comparing the VMWH-CBT intervention with education control. Participants (N = 44) received four sessions of both treatments, in a counterbalanced order (n = 22 per order condition). Participants were 89% female (N = 39) with mean age of 61 years (SD = 12.2). They reported significantly greater improvement after receiving the active treatment relative to the control condition in all the outcome measures. Treatment gains were maintained at 3-month follow-up. This study supports the beneficial effects of the VMWH-CBT intervention relative to a control condition and that treatment gains remain stable. VMWH-CBT-trained clinicians should be accessible for managing symptoms both during and after cancer treatment, though the findings need to be replicated in larger samples of cancer survivors. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Cognitive-Behavioral Therapy versus Temporal Pulse Amplitude Biofeedback Training for Recurrent Headache

    Science.gov (United States)

    Martin, Paul R.; Forsyth, Michael R.; Reece, John

    2007-01-01

    Sixty-four headache sufferers were allocated randomly to cognitive-behavioral therapy (CBT), temporal pulse amplitude (TPA) biofeedback training, or waiting-list control. Fifty-one participants (14M/37F) completed the study, 30 with migraine and 21 with tension-type headache. Treatment consisted of 8, 1-hour sessions. CBT was highly effective,…

  7. Clinical Supervision of Mental Health Professionals Serving Youth: Format and Microskills.

    Science.gov (United States)

    Bailin, Abby; Bearman, Sarah Kate; Sale, Rafaella

    2018-03-21

    Clinical supervision is an element of quality assurance in routine mental health care settings serving children; however, there is limited scientific evaluation of its components. This study examines the format and microskills of routine supervision. Supervisors (n = 13) and supervisees (n = 20) reported on 100 supervision sessions, and trained coders completed observational coding on a subset of recorded sessions (n = 57). Results indicate that microskills shown to enhance supervisee competency in effectiveness trials and experiments were largely absent from routine supervision, highlighting potential missed opportunities to impart knowledge to therapists. Findings suggest areas for quality improvement within routine care settings.

  8. Culturally Adapted Transdiagnostic CBT for SSRI-Resistant Turkish Adolescents: A Pilot Study.

    Science.gov (United States)

    Acarturk, Z Ceren; Abuhamdeh, Sami; Jalal, Baland; Unaldı, Nurdan; Alyanak, Behiye; Cetinkaya, Mustafa; Gulen, Birgul; Hinton, Devon

    2018-01-18

    The most common mental health problems among adolescents are anxiety and mood disorders. While disorder-specific cognitive behavior therapy (CBT) is effective for each of these conditions, the comorbidity between anxiety and mood disorders indicates a need for the development of evidence-based transdiagnostic treatments. To examine the efficacy of culturally adapted transdiagnostic CBT (CA-CBT) in reducing symptoms of anxiety and depression in treatment-resistant Turkish adolescents, 13 adolescent participants with anxiety or mood disorders who were treatment resistant received 10 sessions of CA-CBT in group format. The main outcome measures were the Screen for Childhood Child Anxiety Related Disorders (SCARED), Beck Depression Inventory (BDI), and the Turkish Symptom and Syndrome Addendum (TSSA), which were assessed at baseline, posttreatment, and at 2-month follow-up. At posttreatment, there were large effect sizes for all measures: depression scores (BDI, d = .9), anxiety scores (SCARED, d = 1.1), and the Turkish Symptom and Syndrome Addendum (TSSA, d = 1.6). Moreover, at 2-month follow-up, depression and anxiety symptoms were either maintained or continued to improve such that from pretreatment to follow-up the effect sizes were as follows: depression scores (BDI, d = 1.4), anxiety scores (SCARED, d = 1.7), and the Turkish Symptom and Syndrome Addendum (TSSA, d = 2.4). In addition, there were no dropouts across treatment. This open trial suggests that CA-CBT is effective in reducing anxiety and depression symptoms and that the treatment is well accepted. A full randomized controlled trial to verify the effectiveness of transdiagnostic CA-CBT in similar populations is needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. CBT for anxiety disorders in children with and without autism spectrum disorders.

    Science.gov (United States)

    van Steensel, F J A; Bögels, S M

    2015-06-01

    The effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders in children with autism spectrum disorders (ASD) was examined, and compared with children without ASD. Children with ASD and comorbid anxiety disorders (n = 79, 58 boys; Mage = 11.76) and children with anxiety disorders (n = 95, 46 boys; Mage = 12.85), and their parents, participated. All families were referred to 1 of 7 mental health care centers and received the same CBT. Anxiety, quality of life, ASD-like behaviors, and emotional-behavioral problems were measured at waitlist (ASD-group only, n = 17), pretest, posttest, and 3 months, 1 year, and 2 years after CBT. CBT was more effective than waitlist for treating anxiety disorders (d = -1.45) and anxiety symptoms (d = -0.48) in children with ASD. At 2 years follow-up, 61% of the children with and 64% without ASD were free of their primary anxiety disorder (percentages not significantly different). The decrease in severity of anxiety disorders after CBT (d values ranging between -1.05 and -1.46) was not different for children with and without ASD. Improvements were less in children with ASD for (only) 2 out of 7 continuous outcomes measures: anxiety symptoms (d values ranging between -0.68 and -0.94 vs. d values ranging between -0.98 and -1.25) and quality of life (d values ranging between 0.39 and 0.56 vs. d values ranging between 0.77 and 0.98). CBT for anxiety disorders is effective for children with ASD, also in the long-term. Treatment gains may be somewhat less compared with children without ASD. (c) 2015 APA, all rights reserved).

  10. Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods.

    Science.gov (United States)

    Powell, David J.

    A case is made for professionalism in clinical training as substance abuse counseling becomes a unique field. Part 1, "Principles," includes: (1) "A Historical Review of Supervision"; (2) "A Working Definition of Supervision"; (3) "Leadership Principles for Supervisors" and; (4) "Traits of an Effective Clinical Supervisor." Part 2, "Models,"…

  11. Teacher training: challenges and possibilities of teaching of reproduction and sexuality in supervised curricular stage

    Directory of Open Access Journals (Sweden)

    Mayara Lustosa de Oliveira

    2012-02-01

    Full Text Available This work has its origins in a survey conducted during the supervised curricular stage of Biological Sciences course at Federal University of Goiás. The article describes critically and analytically every step of the curricular stage, especially the classes with the themes: reproduction and sexuality. The classes were taught to elementary students in State College St. Bernadete in Goiânia-GO. To facilitate the process of teaching and learning the trainees divided the themes into subtopics, and several teaching resources were developed for each subtopic. The research was descriptive and exploratory, using interviews with school students, teachers, supervisors and college students to collect data that allowed assessing the success of the teaching methodologies applied by the teachers in training. The field diaries of the trainees were also used to compose the analysis. Through the statements of the participants, it is considered that the methods achieved their goal in clarifying the issues. The resources used not only brought understanding, but encouraged the participation of the students. The article has been organized according to the steps of the curricular stage and it exposes all the impressions of the supervising teachers, school students and undergraduates during the internship, highlighting, comments, concerns, planning and execution process of the activities.

  12. The Impact of the School Counselor Supervision Model on the Self-Efficacy of School Counselor Site Supervisors

    Science.gov (United States)

    Brown, Carleton H.; Olivárez, Artura, Jr.; DeKruyf, Loraine

    2018-01-01

    Supervision is a critical element in the professional identity development of school counselors; however, available school counseling-specific supervision training is lacking. The authors describe a 4-hour supervision workshop based on the School Counselor Supervision Model (SCSM; Luke & Bernard, 2006) attended by 31 school counselors from…

  13. Adoption and Completeness of Documentation Using a Structured Delivery Record in Secondary Care, Subdistrict Government Hospitals of Karnataka State, India

    Directory of Open Access Journals (Sweden)

    Prem K. Mony

    2016-05-01

    Full Text Available Objective: Poor medical record documentation remains a pervasive problem in hospital delivery rooms, hampering efforts aimed at improving the quality of maternal and neonatal care in resource-limited settings. We evaluated the feasibility and completeness of labor room documentation within a quasi-experimental study aimed at improving emergency preparedness for obstetric and neonatal emergencies in 8 nonteaching, subdistrict, secondary care hospitals of Karnataka state, India. Methods: We redesigned the existing open-ended case sheet into a structured, delivery record cum job aide adhering to principles of local clinical relevance, parsimony, and computerizability. Skills and emergency drills training along with supportive supervision were introduced in 4 “intervention arm” hospitals while the new delivery records were used in eight intervention and control hospitals. Results: Introduction of the new delivery record was feasible over a “run-in” period of 4 months. About 92% (6103 of 6634 of women in intervention facilities and 80% (6205 of 7756 in control facilities had their delivery records filled in during the 1-year study period. Completeness of delivery record documentation fell into one of two subsets with one set of parameters being documented with minimal inputs (in both intervention and control sites and another set of parameters requiring more intensive training efforts (and seen more in intervention than in control sites; P < .05. Conclusion: Under the stewardship of the local government, it was possible to institute a robust, reliable, and valid medical record documentation system as part of efforts to improve intrapartum and postpartum maternal and newborn care in hospitals.

  14. The effectiveness of internet cognitive behavioural therapy (iCBT) for social anxiety disorder in routine practice

    NARCIS (Netherlands)

    Williams, A.D.; O'Moore, Kathleen; Mason, Elizabeth; Andrews, Gavin

    2014-01-01

    Social anxiety disorder (SAD) is a common, chronic and disabling mental disorder. Cognitive Behaviour Therapy (CBT) is a highly effective treatment of SAD and internet CBT (iCBT) offers a cost-effective and convenient alternative to face to face approaches, with high fidelity and demonstrated

  15. "Unscrambling what's in your head": A mixed method evaluation of clinical supervision for midwives.

    Science.gov (United States)

    Love, Bev; Sidebotham, Mary; Fenwick, Jennifer; Harvey, Susan; Fairbrother, Greg

    2017-08-01

    As a strategy to promote workforce sustainability a number of midwives working in one health district in New South Wales, Australia were trained to offer a reflective model of clinical supervision. The expectation was that these midwives would then be equipped to facilitate clinical supervision for their colleagues with the organisational aim of supporting professional development and promoting emotional well-being. To identify understanding, uptake, perceptions of impact, and the experiences of midwives accessing clinical supervision. Mixed Methods. In phase one 225 midwives were invited to complete a self-administered survey. Descriptive and inferential statistics were used to analyse the data. In phase two 12 midwives were interviewed. Thematic analysis was used to deepen understanding of midwives' experiences of receiving clinical supervision. Sixty percent of midwives responding in phase one had some experience of clinical supervision. Findings from both phases were complementary with midwives reporting a positive impact on their work, interpersonal skills, situational responses and career goals. Midwives described clinical supervision as a formal, structured and confidential space for 'safe reflection' that was valued as an opportunity for self-care. Barriers included misconceptions, perceived work related pressures and a sense that taking time out was unjustifiable. Education, awareness raising and further research into reflective clinical supervision, to support emotional well-being and professional midwifery practice is needed. In addition, health organisations need to design, implement and evaluate strategies that support the embedding of clinical supervision within midwives' clinical practice. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. The effectiveness of internet cognitive behavioural therapy (iCBT) for social anxiety disorder in routine practice

    OpenAIRE

    Williams, A.D.; O'Moore, Kathleen; Mason, Elizabeth; Andrews, Gavin

    2014-01-01

    Social anxiety disorder (SAD) is a common, chronic and disabling mental disorder. Cognitive Behaviour Therapy (CBT) is a highly effective treatment of SAD and internet CBT (iCBT) offers a cost-effective and convenient alternative to face to face approaches, with high fidelity and demonstrated efficacy. The aim of the current paper was to evaluate the effectiveness of an iCBT programme for SAD (The This Way Up Clinic Shyness Programme) when delivered in routine practice through two different p...

  17. Therapeutic validity and effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Vooijs, M.; Siemonsma, P.C.; Heus, I.; Sont, J.K.; Rövekamp, T.A.; Meeteren, N.L. van

    2016-01-01

    Objective: Our aim was to determine the effectiveness of supervised physical exercise training on exercise capacity in patients with chronic obstructive pulmonary disease taken into consideration indices such as therapeutic validity of interventions, methodological quality of studies, and exercise

  18. Analysis of the process of strategic management of costs and pricing in business games with computer based training support Análisis del proceso de gestión estratégica de costos y formación de precios, en el ámbito de los juegos de empresas, con apoyo del entrenamiento basado en la computadora (CBT Análise do processo de gestão estratégica de custos e formação de preços, no âmbito dos jogos de empresas, com apoio do treinamento baseado no computador (CBT

    Directory of Open Access Journals (Sweden)

    Federico Natalio Madkur

    2010-09-01

    Full Text Available This study explored the effects of integration of learning tools by analyzing the impact of computer based training (CBT in the experience of business games. This study, of quasi-experimental design, analyzed the effect of CBT on strategic management of cost and formation of pricing in the Enterprise Strategy Simulator business game by comparing of rates of economic performance and consistency of strategic alignment, with and without CBT. Comparative analysis was carried out for six years of undergraduate and postgraduate studies in Management at UEL. Use of CBT influenced return on assets and growth of equity in companies simulated by graduate students in two economic scenarios and by postgraduate students, however no variability was found in the results. Returns from students who used CBT indicated that it is effective in supporting professional training. However, it is not possible to affirm statistically that CBT integration with business games increases benefitsEn el presente trabajo, con la finalidad de investigar los efectos de la integración de herramientas de aprendizaje, se buscó analizar el impacto de la utilización del Entrenamiento Basado en la Computadora (CBT en el ámbito de la experiencia de los Juegos de Empresas. En el estudio caracterizado como casi-experimental, se analizó el efecto del uso del CBT de la gestión estratégica de costos y formación de precios en el juego de empresas SEE (Simulador de Estrategia Empresarial, por medio de la comparación entre índices de desempeño económico y la consistencia del alineamiento estratégico, con y sin la utilización del CBT. El análisis comparativo fue efectuado considerándose los últimos seis años de los cursos de graduación y post-graduación en Administración de la UEL. Los resultados obtenidos revelan que la utilización del CBT influenció en el retorno del activo y en el crecimiento del patrimonio líquido de las empresas simuladas por los alumnos de la

  19. Uptake of wheel-filtration among clients of a supervised injecting facility: Can structured education work?

    Science.gov (United States)

    Steele, Maureen; Silins, Edmund; Flaherty, Ian; Hiley, Sarah; van Breda, Nick; Jauncey, Marianne

    2018-01-01

    Wheel-filtration of pharmaceutical opioid tablets is a recognised harm reduction strategy, but uptake of the practice among people who inject drugs is low. The study aimed to: (i) examine perceptions of filtration practices; (ii) provide structured education on wheel-filtration; and (iii) assess uptake of the practice. Frequent opioid tablet injectors (n = 30) attending a supervised injecting facility in Sydney, Australia, received hands-on instruction on wheel-filtration based on recommended practice. Pre-education, post-education and follow-up questionnaires were administered. Wheel-filtration was generally regarded as better than cotton-filtration (the typical method) in terms of perceived effects on health, ease of use and overall drug effect. Sixty-eight percent of those who said they would try wheel-filtration after the education had actually done so. Of those who usually used cotton-filtration, over half (60%) had used wheel-filtration two weeks later. Uptake of safer preparation methods for pharmaceutical opioid tablets increases after structured education in wheel-filtration. Findings suggest that SIFs are an effective site for this kind of education. Supervised injecting facility workers are uniquely positioned to provide harm reduction education at the time of injection. [Steele M, Silins E, Flaherty I, Hiley S, van Breda N, Jauncey M. Uptake of wheel-filtration among clients of a supervised injecting facility: Can structured education work? Drug Alcohol Rev 2018;37:116-120]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  20. Sleep quality predicts treatment outcome in CBT for social anxiety disorder.

    Science.gov (United States)

    Zalta, Alyson K; Dowd, Sheila; Rosenfield, David; Smits, Jasper A J; Otto, Michael W; Simon, Naomi M; Meuret, Alicia E; Marques, Luana; Hofmann, Stefan G; Pollack, Mark H

    2013-11-01

    Sleep quality may be an important, yet relatively neglected, predictor of treatment outcome in cognitive-behavioral therapy (CBT) for anxiety disorders. Specifically, poor sleep quality may impair memory consolidation of in-session extinction learning. We therefore examined sleep quality as a predictor of treatment outcome in CBT for social anxiety disorder and the impact of d-cycloserine (DCS) on this relationship. One hundred sixty-nine participants with a primary diagnosis of DSM-IV generalized social anxiety disorder were recruited across three sites. Participants were enrolled in 12 weeks of group CBT. Participants randomly received 50 mg of DCS (n = 87) or pill placebo (n = 82) 1 hr prior to sessions 3-7. Participants completed a baseline measure of self-reported sleep quality and daily diaries recording subjective feelings of being rested upon wakening. Outcome measures including social anxiety symptoms and global severity scores were assessed at each session. Poorer baseline sleep quality was associated with slower improvement and higher posttreatment social anxiety symptom and severity scores. Moreover, patients who felt more "rested" after sleeping the night following a treatment session had lower levels of symptoms and global severity at the next session, controlling for their symptoms and severity scores the previous session. Neither of these effects were moderated by DCS condition. Our findings suggest that poor sleep quality diminishes the effects of CBT for social anxiety disorder and this relation is not attenuated by DCS administration. Therapeutic attention to sleep quality prior to initiation of CBT and during the acute treatment phase may be clinically indicated. © 2013 Wiley Periodicals, Inc.

  1. A Preliminary Evaluation of Instructional Effectiveness of Online Training Implemented at a Government Agency in Thailand

    Science.gov (United States)

    Supanakorn-Davila, Supawan; Bolliger, Doris U.

    2012-01-01

    Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…

  2. A Follow-Up Study from a Multisite, Randomized Controlled Trial for Traumatized Children Receiving TF-CBT.

    Science.gov (United States)

    Jensen, Tine K; Holt, Tonje; Ormhaug, Silje M

    2017-11-01

    Trauma-focused cognitive behavioral therapy (TF-CBT) is the treatment of choice for traumatized youth, however, follow-up studies are scarce, and treatment effects for co-occurring depression show mixed findings. The aims of this study were to examine whether treatment effects of TF-CBT are maintained at 18 month follow-up and whether degree of co-occurring depression influences treatment effects. As rapid improvement in psychological functioning is warranted for youth, we also investigated whether the symptom trajectory was different for TF-CBT compared to therapy as usual (TAU). The sample consisted of 156 youth (M age = 15.05, 79.50% girls) randomly assigned to TF-CBT or TAU. The youth were assessed for posttraumatic stress symptoms (PTSS), depression, anxiety and general mental health symptoms. Mixed effects analyses followed the symptom courses over 5 time points. Youth receiving TF-CBT maintained their symptom improvement at 18 months follow-up with scores below clinical cut-of on all symptom measures. The most depressed youth had also a significant decline in symptoms that were maintained at follow-up. Symptom trajectories differed as the TF-CBT group reported a more rapid symptom reduction compared to the TAU condition. In the TAU condition, participants received 1.5 times the number of treatment sessions compared to the TF-CBT participants. After 18 months the groups were significantly different on general mental health symptoms only. In conclusion, youth receiving TF-CBT experienced more efficient improvement in trauma related symptoms than youth receiving TAU and these improvements were maintained after 18 months. Also youth experiencing serious co-occurring depression benefitted from TF-CBT.

  3. The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

    2017-11-01

    Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

  4. A web-based training program using cognitive behavioral therapy to alleviate psychological distress among employees: randomized controlled pilot trial.

    Science.gov (United States)

    Mori, Makiko; Tajima, Miyuki; Kimura, Risa; Sasaki, Norio; Somemura, Hironori; Ito, Yukio; Okanoya, June; Yamamoto, Megumi; Nakamura, Saki; Tanaka, Katsutoshi

    2014-12-02

    A number of psychoeducational programs based on cognitive behavioral therapy (CBT) to alleviate psychological distress have been developed for implementation in clinical settings. However, while these programs are considered critical components of stress management education in a workplace setting, they are required to be brief and simple to implement, which can hinder development. The intent of the study was to examine the effects of a brief training program based on CBT in alleviating psychological distress among employees and facilitating self-evaluation of stress management skills, including improving the ability to recognize dysfunctional thinking patterns, transform dysfunctional thoughts to functional ones, cope with stress, and solve problems. Of the 187 employees at an information technology company in Tokyo, Japan, 168 consented to participate in our non-blinded randomized controlled study. The training group received CBT group education by a qualified CBT expert and 1 month of follow-up Web-based CBT homework. The effects of this educational program on the psychological distress and stress management skills of employees were examined immediately after completion of training and then again after 6 months. Although the training group did exhibit lower mean scores on the Kessler-6 (K6) scale for psychological distress after 6 months, the difference from the control group was not significant. However, the ability of training group participants to recognize dysfunctional thinking was significantly improved both immediately after training completion and after 6 months. While the ability of participants to cope with stress was not significantly improved immediately after training, improvement was noted after 6 months in the training group. No notable improvements were observed in the ability of participants to transform thoughts from dysfunctional to functional or in problem-solving skills. A sub-analysis of participants who initially exhibited clinically

  5. A new supervised learning algorithm for spiking neurons.

    Science.gov (United States)

    Xu, Yan; Zeng, Xiaoqin; Zhong, Shuiming

    2013-06-01

    The purpose of supervised learning with temporal encoding for spiking neurons is to make the neurons emit a specific spike train encoded by the precise firing times of spikes. If only running time is considered, the supervised learning for a spiking neuron is equivalent to distinguishing the times of desired output spikes and the other time during the running process of the neuron through adjusting synaptic weights, which can be regarded as a classification problem. Based on this idea, this letter proposes a new supervised learning method for spiking neurons with temporal encoding; it first transforms the supervised learning into a classification problem and then solves the problem by using the perceptron learning rule. The experiment results show that the proposed method has higher learning accuracy and efficiency over the existing learning methods, so it is more powerful for solving complex and real-time problems.

  6. Improved Anomaly Detection using Integrated Supervised and Unsupervised Processing

    Science.gov (United States)

    Hunt, B.; Sheppard, D. G.; Wetterer, C. J.

    There are two broad technologies of signal processing applicable to space object feature identification using nonresolved imagery: supervised processing analyzes a large set of data for common characteristics that can be then used to identify, transform, and extract information from new data taken of the same given class (e.g. support vector machine); unsupervised processing utilizes detailed physics-based models that generate comparison data that can then be used to estimate parameters presumed to be governed by the same models (e.g. estimation filters). Both processes have been used in non-resolved space object identification and yield similar results yet arrived at using vastly different processes. The goal of integrating the results of the two is to seek to achieve an even greater performance by building on the process diversity. Specifically, both supervised processing and unsupervised processing will jointly operate on the analysis of brightness (radiometric flux intensity) measurements reflected by space objects and observed by a ground station to determine whether a particular day conforms to a nominal operating mode (as determined from a training set) or exhibits anomalous behavior where a particular parameter (e.g. attitude, solar panel articulation angle) has changed in some way. It is demonstrated in a variety of different scenarios that the integrated process achieves a greater performance than each of the separate processes alone.

  7. Impact of data transformation and preprocessing in supervised ...

    African Journals Online (AJOL)

    Impact of data transformation and preprocessing in supervised learning ... Nowadays, the ideas of integrating machine learning techniques in power system has ... The proposed algorithm used Python-based split train and k-fold model ...

  8. Physical activity within a CBT intervention improves coping with pain in traumatized refugees: results of a randomized controlled design.

    Science.gov (United States)

    Liedl, Alexandra; Müller, Julia; Morina, Naser; Karl, Anke; Denke, Claudia; Knaevelsrud, Christine

    2011-02-01

    Many traumatized refugees experience both posttraumatic stress disorder and chronic pain. Based on Mutual Maintenance Theory and the Perpetual Avoidance Model, this study examined the additional effect of physical activity within a biofeedback-based cognitive behavioral therapy (CBT-BF) for traumatized refugees. In a controlled design, 36 patients were randomized into one of three conditions (CBT-BF, CBT-BF with physical activity [CBT-BF+active], and a waiting list control group [WL]). Thirty patients (n=10 in each group) completed the treatment and a follow-up assessment 3 months later. Participants' coping strategies, pain and mental health status, and physiological reactivity were assessed before and after the intervention and at 3-month follow-up. Treatment effects were analyzed using analyses of variance with baseline scores as covariates (ANCOVAs) and the Reliable Change Index. The CBT-BF and CBT-BF+active groups showed improvements in all outcome measures relative to the WL group. The effect sizes for the main outcome measures were higher in the CBT-BF+active group than in the CBT-BF group. Repeated measures analyses of covariance showed significant group effects for coping strategies--in particular, for the "cognitive restructuring" and "counter-activities" subscales as well as a marginally significant group effect for "perceived self-competence"--with the CBT-BF+active group showing more favorable outcomes than the CBT-BF group. Moreover, 60% of participants in the CBT-BF+active group showed clinically reliable intraindividual change in at least one subscale of the pain coping strategies questionnaire, compared with just 30% of participants in the CBT-BF group. Findings of improved coping strategies, larger effect sizes, and higher rates of clinical improvement in the CBT-BF+active group suggest that physical activity adds value to pain management interventions for traumatized refugees. Given the small sample size, however, these preliminary results need

  9. Introduction to the Special Section on Teaching, Training, and Supervision in Personality and Psychological Assessment.

    Science.gov (United States)

    Smith, Justin D

    2017-01-01

    This special section contains empirical and conceptual articles pertaining to the broad topic of teaching, training, and supervision of assessment. Despite some evidence of a decline in recent decades, assessment remains a defining practice of professional psychologists in many subfields, including clinical, counseling, school, and neuropsychology, that consumes a consequential proportion of their time. To restore assessment to its rightful place of prominence, a clear agenda needs to be developed for advancing teaching and training methods, increasing instruction to state-of-the-art methods, and defining aims that could be elucidated through empirical inquiry. The 7 articles in this special section provide a developmental perspective of these issues that collectively provide practical tools for instructors and begin to set the stage for a research agenda in this somewhat neglected area of study that is vital to the identity of professional psychology. Additionally, 2 comments are provided by distinguished figures in the field concerning the implications of the articles in the special section to health services psychology and the competencies-based movement in applied psychology.

  10. Continuing Vocational Training in Local Government in Portugal, 2000-05--What Has Changed?

    Science.gov (United States)

    Cabrito, Belmiro Gil; Simao, Ana Margarida Veiga; Alves, Mariana Gaio; Almeida, Antonio

    2009-01-01

    Local government in Portugal had a good opportunity to modernise through the Programa de Formacao para as Autarquias Locais (Foral) [Training programme for local authorities], implemented between 2000 and 2005. Substantial financial resources were made available through the programme to retrain local government human resources in order to improve…

  11. An Efficient Supervised Training Algorithm for Multilayer Spiking Neural Networks.

    Science.gov (United States)

    Xie, Xiurui; Qu, Hong; Liu, Guisong; Zhang, Malu; Kurths, Jürgen

    2016-01-01

    The spiking neural networks (SNNs) are the third generation of neural networks and perform remarkably well in cognitive tasks such as pattern recognition. The spike emitting and information processing mechanisms found in biological cognitive systems motivate the application of the hierarchical structure and temporal encoding mechanism in spiking neural networks, which have exhibited strong computational capability. However, the hierarchical structure and temporal encoding approach require neurons to process information serially in space and time respectively, which reduce the training efficiency significantly. For training the hierarchical SNNs, most existing methods are based on the traditional back-propagation algorithm, inheriting its drawbacks of the gradient diffusion and the sensitivity on parameters. To keep the powerful computation capability of the hierarchical structure and temporal encoding mechanism, but to overcome the low efficiency of the existing algorithms, a new training algorithm, the Normalized Spiking Error Back Propagation (NSEBP) is proposed in this paper. In the feedforward calculation, the output spike times are calculated by solving the quadratic function in the spike response model instead of detecting postsynaptic voltage states at all time points in traditional algorithms. Besides, in the feedback weight modification, the computational error is propagated to previous layers by the presynaptic spike jitter instead of the gradient decent rule, which realizes the layer-wised training. Furthermore, our algorithm investigates the mathematical relation between the weight variation and voltage error change, which makes the normalization in the weight modification applicable. Adopting these strategies, our algorithm outperforms the traditional SNN multi-layer algorithms in terms of learning efficiency and parameter sensitivity, that are also demonstrated by the comprehensive experimental results in this paper.

  12. Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy.

    Science.gov (United States)

    Sivec, Harry J; Montesano, Vicki L; Skubby, David; Knepp, Kristen A; Munetz, Mark R

    2017-02-01

    This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

  13. Supervised Transfer Sparse Coding

    KAUST Repository

    Al-Shedivat, Maruan

    2014-07-27

    A combination of the sparse coding and transfer learn- ing techniques was shown to be accurate and robust in classification tasks where training and testing objects have a shared feature space but are sampled from differ- ent underlying distributions, i.e., belong to different do- mains. The key assumption in such case is that in spite of the domain disparity, samples from different domains share some common hidden factors. Previous methods often assumed that all the objects in the target domain are unlabeled, and thus the training set solely comprised objects from the source domain. However, in real world applications, the target domain often has some labeled objects, or one can always manually label a small num- ber of them. In this paper, we explore such possibil- ity and show how a small number of labeled data in the target domain can significantly leverage classifica- tion accuracy of the state-of-the-art transfer sparse cod- ing methods. We further propose a unified framework named supervised transfer sparse coding (STSC) which simultaneously optimizes sparse representation, domain transfer and classification. Experimental results on three applications demonstrate that a little manual labeling and then learning the model in a supervised fashion can significantly improve classification accuracy.

  14. Improvement program of state supervision system for radioactive and nuclear installations

    International Nuclear Information System (INIS)

    Cardenas, J.

    1993-01-01

    The current program begins as part of a policy to take care of the development of the cuban nuclear program and with the objective of improving the state supervision system of nuclear and radioactive facilities on the basis of the national experience, good skills internationally accepted and taking into account IAEA recommendations. The program develops the following topics: reorientation and restructure of state supervision, review of the current nuclear legislature, update of regulations of facility safety and qualification and training of state supervision personnel

  15. Supervisor training

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2015-01-01

    on the experience of an integrated supervisor training programme offered in Aalborg, Denmark in 2009/2010. In this programme general issues of professional supervision and the application of artistic media as a core element in the supervisory process were Integrated. It is the hope of the author that this article...... will inspire other music therapists to develop supervisor training programmes for professional music therapists and also to undertake further research into professional supervision....

  16. Enhanced manifold regularization for semi-supervised classification.

    Science.gov (United States)

    Gan, Haitao; Luo, Zhizeng; Fan, Yingle; Sang, Nong

    2016-06-01

    Manifold regularization (MR) has become one of the most widely used approaches in the semi-supervised learning field. It has shown superiority by exploiting the local manifold structure of both labeled and unlabeled data. The manifold structure is modeled by constructing a Laplacian graph and then incorporated in learning through a smoothness regularization term. Hence the labels of labeled and unlabeled data vary smoothly along the geodesics on the manifold. However, MR has ignored the discriminative ability of the labeled and unlabeled data. To address the problem, we propose an enhanced MR framework for semi-supervised classification in which the local discriminative information of the labeled and unlabeled data is explicitly exploited. To make full use of labeled data, we firstly employ a semi-supervised clustering method to discover the underlying data space structure of the whole dataset. Then we construct a local discrimination graph to model the discriminative information of labeled and unlabeled data according to the discovered intrinsic structure. Therefore, the data points that may be from different clusters, though similar on the manifold, are enforced far away from each other. Finally, the discrimination graph is incorporated into the MR framework. In particular, we utilize semi-supervised fuzzy c-means and Laplacian regularized Kernel minimum squared error for semi-supervised clustering and classification, respectively. Experimental results on several benchmark datasets and face recognition demonstrate the effectiveness of our proposed method.

  17. Using CBT with Anxious Language Learners: The Potential Role of the Learning Advisor

    Directory of Open Access Journals (Sweden)

    Neil Curry

    2014-01-01

    Full Text Available Foreign Language Anxiety (FLA can be a crippling condition for many students, preventing them from taking an active part in the classroom, and also retarding their L2 use in wider communicative situations. Providing learners with the tools to overcome anxiety on an individual basis is an area which needs further investigation. Cognitive Behaviour Therapy (CBT is a widespread counselling practice used to treat anxieties. It shares similarities with some techniques employed in Advising in Language Learning (ALL for helping students with language goals, and it is worthwhile investigating and raising awareness of how it can be used for FLA. The article describes major characteristics of FLA and also CBT, and then describes four functions which CBT and ALL share: goal-setting, guided discovery, Socratic questioning and use of reflection. Preliminary research also demonstrates how some of the practices associated with CBT could be applied by Learning Advisors to help students to overcome FLA.

  18. Factors Affecting the Productivity of Government Workers

    Directory of Open Access Journals (Sweden)

    Jerry P. Haenisch

    2012-01-01

    Full Text Available While there have been a variety of studies concerning government worker motivation and productivity, few, if any, studies have focused specifically on state government workers’ perceptions about what factors affect their productivity. With more than 5 million workers employed by state governments in the United States, any improvement in state workplace productivity could have significant financial and service impact for society. In this study, state government workers identified those factors perceived as most affecting their workplace productivity. Data were collected through a survey offered to state government workers in the state of Wyoming. Factor analysis was used to derive key productivity factors from survey responses. The results indicate that state government workers appreciate having freedom and autonomy, like their jobs and the sense of achievement, and welcome teamwork, but feel limited by poor supervision and management, poor communications, and insufficient budgets and staffing. To improve productivity, the workers would eliminate bureaucracy, supervise better, and improve communication.

  19. Requirements for nurse supervisor training: A qualitative content analysis.

    Science.gov (United States)

    Dehghani, Khadijeh; Nasiriani, Khadijeh; Salimi, Tahere

    2016-01-01

    Supervisors should have certain characteristics and adequate preparation for their roles. Yet, there are no well-educated experts knowing about the supervisor's role and responsibilities and how to train them. So, this research was conducted with the purpose of finding the factors affecting nursing supervisor training. This research is an inductive content analysis. Participants were 25 in number, consisting of nurses and supervisors in Shahid Sadoughi University hospitals. The participants were chosen by a purposive sampling method. Data collection was done by semi-structured interviews and reviewing documents. Data were analyzed using conventional content analysis. Findings included two main themes: Firstly, establishment of a supervisory infrastructure that includes "making the appointments and retention of supervisors, clarifying the duties and authority of supervisor, developing supervisory culture, specializing supervision, and conducting practice-based training" and secondly, comprehensive supervisory competencies that include "acquiring scientific, managing, communicative, professional, ethical, pedagogical, and supporting adequacy." Clinical supervisor has a major role in ensuring the quality of nursing care. This leads to improvements in patient care and nurses' personal and professional development. So, it is necessary that for effective supervision in nursing, first an infrastructure is provided for supervision and then the comprehensive competency of a supervisor is enhanced to apply effective supervision.

  20. Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I): a narrative review.

    Science.gov (United States)

    Koffel, Erin; Bramoweth, Adam D; Ulmer, Christi S

    2018-04-04

    The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review. Implementation research testing specific interventions to increase routine and sustained use of CBT-I was lacking. Most research focused on pre-implementation work that revealed the complexity of delivering CBT-I in routine healthcare settings due to three distinct categories of barriers. First, system barriers result in limited access to CBT-I and behavioral sleep medicine (BSM) providers. Second, primary care providers are not adequately screening for sleep issues and referring appropriately due to a lack of knowledge, treatment beliefs, and a lack of motivation to assess and treat insomnia. Finally, patient barriers, including a lack of knowledge, treatment beliefs, and limited access, prevent patients from engaging in CBT-I. These findings are organized using a conceptual model to represent the many challenges inherent in providing guideline-concordant insomnia care. We conclude with an agenda for future implementation research to systematically address these challenges.

  1. Transaction cost determinants of credit governance structures of ...

    African Journals Online (AJOL)

    This paper explores transaction cost determinants of credit governance structures (CGS) of commercial banks in Tanzania. Descriptive statistics, linear regression model, binary and multinomial logistic regression models were employed for analysis. Findings revealed four modes of credit governance structures that are ...

  2. Corporate Sector Practice Informs Online Workforce Training for Australian Government Agencies: Towards Effective Educational-Learning Systems Design

    Science.gov (United States)

    McKay, Elspeth; Vilela, Cenie

    2011-01-01

    The purpose of this paper is to outline government online training practice. We searched individual research domains of the human-dimensions of Human Computer Interaction (HCI), information and communications technologies (ICT) and instructional design for evidence of either corporate sector or government training practices. We overlapped these…

  3. Supervision in social work NGOs in Bihor County

    Directory of Open Access Journals (Sweden)

    Cristiana Marcela MARC

    2012-01-01

    Full Text Available This paper presents a qualitative research which aims at analyzing supervision in the social services provided by NGOs in Bihor County. We used the method of sociological investigation by means of interview and data collection was accomplished through the technique of individual semi-structured interview. The obtained responses demonstrate that individual supervision was mostly used and in most cases the professional supervisor was from outside the organization. The respondents considered that supervision reduces professional stress. The main problems encountered in the implementation of supervision are the lack of financial resources and the association of supervision with bureaucratic control.

  4. Semi-supervised Learning for Phenotyping Tasks.

    Science.gov (United States)

    Dligach, Dmitriy; Miller, Timothy; Savova, Guergana K

    2015-01-01

    Supervised learning is the dominant approach to automatic electronic health records-based phenotyping, but it is expensive due to the cost of manual chart review. Semi-supervised learning takes advantage of both scarce labeled and plentiful unlabeled data. In this work, we study a family of semi-supervised learning algorithms based on Expectation Maximization (EM) in the context of several phenotyping tasks. We first experiment with the basic EM algorithm. When the modeling assumptions are violated, basic EM leads to inaccurate parameter estimation. Augmented EM attenuates this shortcoming by introducing a weighting factor that downweights the unlabeled data. Cross-validation does not always lead to the best setting of the weighting factor and other heuristic methods may be preferred. We show that accurate phenotyping models can be trained with only a few hundred labeled (and a large number of unlabeled) examples, potentially providing substantial savings in the amount of the required manual chart review.

  5. Magazine Picture Collage in Group Supervision

    Science.gov (United States)

    Shepard, Blythe C.; Guenette, Francis L.

    2010-01-01

    A magazine picture collage activity was used with three female counsellor education students as a vehicle to support them in processing their experience as counsellors in training. The use of magazine picture collage in group supervision is described, and the benefits and challenges are presented. The collages served as jumping-off points for…

  6. The efficacy and effectiveness of online CBT

    NARCIS (Netherlands)

    Ruwaard, J.-J.

    2013-01-01

    In 1997, researches at the University of Amsterdam developed one of the first psychotherapeutic applications of the World Wide Web. The implemented a standardized cognitive behavioural treatment (CBT) of post-traumatic stress symptoms in a website, and used this site to treat clients over the

  7. Sequential treatment with fluoxetine and relapse--prevention CBT to improve outcomes in pediatric depression.

    Science.gov (United States)

    Kennard, Betsy D; Emslie, Graham J; Mayes, Taryn L; Nakonezny, Paul A; Jones, Jessica M; Foxwell, Aleksandra A; King, Jessica

    2014-10-01

    The authors evaluated a sequential treatment strategy of fluoxetine and relapse-prevention cognitive-behavioral therapy (CBT) to determine effects on remission and relapse in youths with major depressive disorder. Youths 8-17 years of age with major depression were treated openly with fluoxetine for 6 weeks. Those with an adequate response (defined as a reduction of 50% or more on the Children's Depression Rating Scale-Revised [CDRS-R]) were randomly assigned to receive continued medication management alone or continued medication management plus CBT for an additional 6 months. The CBT was modified to address residual symptoms and was supplemented by well-being therapy. Primary outcome measures were time to remission (with remission defined as a CDRS-R score of 28 or less) and rate of relapse (with relapse defined as either a CDRS-R score of 40 or more with a history of 2 weeks of symptom worsening, or clinical deterioration). Of the 200 participants enrolled in acute-phase treatment, 144 were assigned to continuation treatment with medication management alone (N=69) or medication management plus CBT (N=75). During the 30-week continuation treatment period, time to remission did not differ significantly between treatment groups (hazard ratio=1.26, 95% CI=0.87, 1.82). However, the medication management plus CBT group had a significantly lower risk of relapse than the medication management only group (hazard ratio=0.31, 95% CI=0.13, 0.75). The estimated probability of relapse by week 30 was lower with medication management plus CBT than with medication management only (9% compared with 26.5%). Continuation-phase relapse-prevention CBT was effective in reducing the risk of relapse but not in accelerating time to remission in children and adolescents with major depressive disorder.

  8. Effects of Cognitive-Behavioral Therapy (CBT) on Brain Connectivity Supporting Catastrophizing in Fibromyalgia.

    Science.gov (United States)

    Lazaridou, Asimina; Kim, Jieun; Cahalan, Christine M; Loggia, Marco L; Franceschelli, Olivia; Berna, Chantal; Schur, Peter; Napadow, Vitaly; Edwards, Robert R

    2017-03-01

    Fibromyalgia (FM) is a chronic, common pain disorder characterized by hyperalgesia. A key mechanism by which cognitive-behavioral therapy (CBT) fosters improvement in pain outcomes is via reductions in hyperalgesia and pain-related catastrophizing, a dysfunctional set of cognitive-emotional processes. However, the neural underpinnings of these CBT effects are unclear. Our aim was to assess CBT's effects on the brain circuitry underlying hyperalgesia in FM patients, and to explore the role of treatment-associated reduction in catastrophizing as a contributor to normalization of pain-relevant brain circuitry and clinical improvement. In total, 16 high-catastrophizing FM patients were enrolled in the study and randomized to 4 weeks of individual treatment with either CBT or a Fibromyalgia Education (control) condition. Resting state functional magnetic resonance imaging scans evaluated functional connectivity between key pain-processing brain regions at baseline and posttreatment. Clinical outcomes were assessed at baseline, posttreatment, and 6-month follow-up. Catastrophizing correlated with increased resting state functional connectivity between S1 and anterior insula. The CBT group showed larger reductions (compared with the education group) in catastrophizing at posttreatment (PCBT produced significant reductions in both pain and catastrophizing at the 6-month follow-up (PCBT group also showed reduced resting state connectivity between S1 and anterior/medial insula at posttreatment; these reductions in resting state connectivity were associated with concurrent treatment-related reductions in catastrophizing. The results add to the growing support for the clinically important associations between S1-insula connectivity, clinical pain, and catastrophizing, and suggest that CBT may, in part via reductions in catastrophizing, help to normalize pain-related brain responses in FM.

  9. Supervised hub-detection for brain connectivity

    DEFF Research Database (Denmark)

    Kasenburg, Niklas; Liptrot, Matthew George; Reislev, Nina Linde

    2016-01-01

    , but can smooth discriminative signals in the population, degrading predictive performance. We present a novel hub-detection optimized for supervised learning that both clusters network nodes based on population level variation in connectivity and also takes the learning problem into account. The found......A structural brain network consists of physical connections between brain regions. Brain network analysis aims to find features associated with a parameter of interest through supervised prediction models such as regression. Unsupervised preprocessing steps like clustering are often applied...... hubs are a low-dimensional representation of the network and are chosen based on predictive performance as features for a linear regression. We apply our method to the problem of finding age-related changes in structural connectivity. We compare our supervised hub-detection (SHD) to an unsupervised hub...

  10. Transfer learning improves supervised image segmentation across imaging protocols

    DEFF Research Database (Denmark)

    van Opbroek, Annegreet; Ikram, M. Arfan; Vernooij, Meike W.

    2015-01-01

    with slightly different characteristics. The performance of the four transfer classifiers was compared to that of standard supervised classification on two MRI brain-segmentation tasks with multi-site data: white matter, gray matter, and CSF segmentation; and white-matter- /MS-lesion segmentation......The variation between images obtained with different scanners or different imaging protocols presents a major challenge in automatic segmentation of biomedical images. This variation especially hampers the application of otherwise successful supervised-learning techniques which, in order to perform...... well, often require a large amount of labeled training data that is exactly representative of the target data. We therefore propose to use transfer learning for image segmentation. Transfer-learning techniques can cope with differences in distributions between training and target data, and therefore...

  11. Interactive computer-based training program for radiological workers

    International Nuclear Information System (INIS)

    Trinoskey, P.A.; Camacho, P.I.; Wells, L.

    2000-01-01

    Lawrence Livermore National Laboratory is redesigning its existing Computer-Based Training (CBT) programs for radiological workers. The redesign represents a major effort that is aimed at producing a single highly interactive and flexible CBT program. The new CBT program is designed to address a variety of radiological workers, including researchers, x-ray operators, and individuals working in tritium, uranium, plutonium, and accelerator facilities. The program addresses the diversity of backgrounds found at a national laboratory. The CBT program includes photographs, line drawings and illustrations, sound, video, and simulations, and it allows for easy insertion and replacement of text, graphics, sound, and video. The new design supports timely updates and customization for use at other University of California sites. The CBT program is divided into ten basic modules. Introduction and Lessons Learned, History and Uses, Fundamentals, Background Radiation, Biological Effects of Radiation, Characteristics of Radionuclides, Radiological Controls, Monitoring, Emergency Response, Responsibilities. Some of the main modules features as many as seven or eight submodules. For example, the module on Characteristics of Radionuclides features submodules on common radionuclides, tritium uranium, plutonium, x-ray machines, E-beam devices, radiographic devices, and accelerators. Required submodules are tailored to an individual's type of work and facility, and they are determined by the answers to an onscreen questionnaire given at the outset of training. Individuals can challenge most individual modules, but certain submodules will be mandatory based on the initial survey. For example, individuals working in the uranium facility will be required to complete the submodule on 'History and Uses of Uranium'. However, all other submodules under the main module, 'History and Uses', will be available if selected for preview. For each module, an opportunity is provided for further

  12. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2016-10-01

    implement and evaluate a cost effective, web based self-paced training program to provide skills- oriented continuing education for mental health...Product Aim(s) The purpose of this study is to design, implement and evaluate a web based training program providing skills- oriented continuing education ...Rates and Data Quality i. The team collaborated with the VHA NCPTSD to monitor the collection rates and data quality on a weekly basis . b. Create Interim

  13. Cognitive-Behavioral Therapy for Suicide Prevention (CBT-SP): Treatment Model, Feasibility, and Acceptability

    Science.gov (United States)

    Stanley, Barbara; Brown, Gregory; Brent, David A.; Wells, Karen; Poling, Kim; Curry, John; Kennard, Betsy D.; Wagner, Ann; Cwik, Mary F.; Klomek, Anat Brunstein; Goldstein, Tina; Vitiello, Benedetto; Barnett, Shannon; Daniel, Stephanie; Hughes, Jennifer

    2009-01-01

    Objective: To describe the elements of a manual-based cognitive-behavioral therapy for suicide prevention (CBT-SP) and to report its feasibility in preventing the recurrence of suicidal behavior in adolescents who have recently attempted suicide. Method: The CBT-SP was developed using a risk reduction and relapse prevention approach and…

  14. Origins of Competency-Based Training

    Science.gov (United States)

    McCowan, Richard J.

    1998-01-01

    This paper describes the theories and social factors that contributed to the development of competency-based training (CBT). These include behaviorism (Edward L. Thorndike), scientific management (Frederick Taylor), progressive education (John Dewey), and derivative theories including operant conditioning (B.F. Skinner), objectives-based…

  15. Comparing the Efficacy of CBASP with Two Versions of CBT for Depression in a Routine Care Center: A Randomized Clinical Trial.

    Science.gov (United States)

    Rief, Winfried; Bleichhardt, Gabi; Dannehl, Katharina; Euteneuer, Frank; Wambach, Katrin

    2018-04-12

    The cognitive-behavioral analysis system of psychotherapy (CBASP) was developed for the treatment of chronic, early-onset depression. However, it is unclear whether this approach can be recommended for depression in general (episodic and chronic), and no direct comparisons between CBASP with different versions of cognitive-behavioral therapy (CBT) exist. A randomized controlled trial compared 3 treatment conditions (all lasting 16 sessions) with a waiting list group (WL): CBASP, CBT with a focus on physical exercise (CBT-E), and CBT with a focus on pleasurable, low-energy and mindful activities (CBT-M). We included 173 patients and involved 41 therapists. Assessments were at baseline, after session 8, and at the end of treatment. Our primary outcome Beck Depression Inventory-II indicated a general advantage of the CBT arms compared to CBASP [F(6, 154.5) = 4.2, p = 0.001], with significant contrasts in particular in favor of CBT-E. Effect sizes against WL were d = 0.91 (CBT-E), 0.87 (CBT-M), and 0.47 (CBASP). A triple interaction with an additional factor "chronic versus episodic depression" [F(6, 142.7) = 2.2, p = 0.048] indicated that the treatments resulted in different outcomes, with best results again for CBT-E in particular in episodic depression. Responder rates indicated significant improvements (56% in both CBT arms, 34% in the CBASP arm, 3.4% in WL; intention-to-treat samples). As compared to CBASP, response rates were significantly higher for CBT-E (OR = 2.48; 95% CI = 1.02-6.00) and CBT-M (OR = 2.46; 95% CI = 1.01-6.01). CBASP was more effective than WL, but less effective than the 2 CBT arms. This was mainly caused by an advantage of CBT interventions in episodic depression. © 2018 S. Karger AG, Basel.

  16. A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders.

    Science.gov (United States)

    Fairburn, Christopher G; Bailey-Straebler, Suzanne; Basden, Shawnee; Doll, Helen A; Jones, Rebecca; Murphy, Rebecca; O'Connor, Marianne E; Cooper, Zafra

    2015-07-01

    Eating disorders may be viewed from a transdiagnostic perspective and there is evidence supporting a transdiagnostic form of cognitive behaviour therapy (CBT-E). The aim of the present study was to compare CBT-E with interpersonal psychotherapy (IPT), a leading alternative treatment for adults with an eating disorder. One hundred and thirty patients with any form of eating disorder (body mass index >17.5 to CBT-E or IPT. Both treatments involved 20 sessions over 20 weeks followed by a 60-week closed follow-up period. Outcome was measured by independent blinded assessors. Twenty-nine participants (22.3%) did not complete treatment or were withdrawn. At post-treatment 65.5% of the CBT-E participants met criteria for remission compared with 33.3% of the IPT participants (p CBT-E remission rate remained higher (CBT-E 69.4%, IPT 49.0%; p = 0.028). The response to CBT-E was very similar to that observed in an earlier study. The findings indicate that CBT-E is potent treatment for the majority of outpatients with an eating disorder. IPT remains an alternative to CBT-E, but the response is less pronounced and slower to be expressed. ISRCTN 15562271. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. A Critical Review of Negative Affect and the Application of CBT for PTSD.

    Science.gov (United States)

    Brown, Wilson J; Dewey, Daniel; Bunnell, Brian E; Boyd, Stephen J; Wilkerson, Allison K; Mitchell, Melissa A; Bruce, Steven E

    2018-04-01

    Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.

  18. Parental acculturation level moderates outcome in peer-involved and parent-involved CBT for anxiety disorders in Latino youth.

    Science.gov (United States)

    Vaclavik, Daniella; Buitron, Victor; Rey, Yasmin; Marin, Carla E; Silverman, Wendy K; Pettit, Jeremy W

    2017-09-01

    Cognitive behavioral therapies (CBTs) are efficacious treatments for anxiety disorders in Latino youth. However, there is a gap in knowledge about moderators of CBT outcomes in Latino youth. This study addresses this gap by examining parental acculturation as a moderator of youth anxiety outcomes in a randomized controlled trial of parent-involved CBT (CBT/P) and peer-involved group CBT (GCBT) in 139 Latino youth (ages 6 to 16 years; mean age = 9.68 years). Comparable youth anxiety reduction effects were found for CBT/P and GCBT. Parental acculturation to majority US culture, but not identification with country of origin, significantly moderated youth anxiety outcomes: at low levels of parental acculturation to majority US culture, youth posttreatment anxiety scores were lower in GCBT than CBT/P; at high levels of parental acculturation to majority US culture, youth posttreatment anxiety scores were lower in CBT/P than GCBT. These findings provide further evidence for the efficacy of CBTs for anxiety disorders in Latino youth and also provide guidance for moving toward personalization of CBTs' selection depending on parental acculturation levels.

  19. Capital Structure Determinants and Governance Structure Variety in Franchising

    NARCIS (Netherlands)

    T. Jiang (Tao)

    2009-01-01

    textabstractThis thesis investigates two questions: the determinants of capital structure in franchising and its subsequent impact on the franchise financing decisions; and the efficient governance structure choice in franchising. We posit that firms franchise in order to benefit from the reduced

  20. Problems of Rural Food Safety and Strategies of Constructing Supervision System

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    This paper expounds the practical necessity of constructing diversified rural food safety supervision system as follows: it is the necessary requirements of guaranteeing people’s health and life safety; it is an important component of governmental function of social management and the logical extension of administrative responsibilities; it is the basis of maintaining order of rural society and constructing harmonious society. The main problems existing in the supervision of rural food safety are analyzed as follows: first, the legislative work of rural food safety lags behind to some extent; second, the supervision of governmental departments on rural food safety is insufficient; third, the industrial supervision mechanism of rural food security is not perfect; fourth, the role of rural social organizations in supervising food safety is limited; fifth, the farmers’ awareness of food safety supervision is not strong. Based on these problems, the targeted strategies of constructing diversified rural food safety supervision system are put forward as follows: accelerate the legislation of rural food safety, and ensure that there are laws to go by; give play to the dominant role of government, and strengthen administrative supervision on rural food safety; perfect industrial convention of rural food safety, and improve industrial supervision mechanism; actively support the fostering of social organizations, and give play to the role of supervision of organizations; cultivate correct concept of rights and obligations of farmers, and form awareness of food safety supervision.

  1. Implementation of CBT in School Settings: An Examination of the Barriers and Facilitators

    Science.gov (United States)

    Taylor, Jared C.

    2017-01-01

    Cognitive Behavioral Therapy (CBT) is a treatment method consisting of different interventions that have a long history of use with individuals with anxiety and depression. Despite CBT possessing a breadth of research support of which many interventions are considered evidenced based, the level of use in schools is not well known. Using the…

  2. Flipped clinical training: a structured training method for undergraduates in complete denture prosthesis.

    Science.gov (United States)

    K, Anbarasi; K, Kasim Mohamed; Vijayaraghavan, Phagalvarthy; Kandaswamy, Deivanayagam

    2016-12-01

    To design and implement flipped clinical training for undergraduate dental students in removable complete denture treatment and predict its effectiveness by comparing the assessment results of students trained by flipped and traditional methods. Flipped training was designed by shifting the learning from clinics to learning center (phase I) and by preserving the practice in clinics (phase II). In phase I, student-faculty interactive session was arranged to recap prior knowledge. This is followed by a display of audio synchronized video demonstration of the procedure in a repeatable way and subsequent display of possible errors that may occur in treatment with guidelines to overcome such errors. In phase II, live demonstration of the procedure was given. Students were asked to treat three patients under instructor's supervision. The summative assessment was conducted by applying the same checklist criterion and rubric scoring used for the traditional method. Assessment results of three batches of students trained by flipped method (study group) and three traditionally trained previous batches (control group) were taken for comparison by chi-square test. The sum of traditionally trained three batch students who prepared acceptable dentures (score: 2 and 3) and unacceptable dentures (score: 1) was compared with the same of flipped trained three batch students revealed that the number of students who demonstrated competency by preparing acceptable dentures was higher for flipped training (χ 2 =30.996 with p<0.001). The results reveal the supremacy of flipped training in enhancing students competency and hence recommended for training various clinical procedures.

  3. Proficiency in Motivational Interviewing among Nurses in Child Health Services Following Workshop and Supervision with Systematic Feedback.

    Directory of Open Access Journals (Sweden)

    Johanna Enö Persson

    Full Text Available Research on training in motivational interviewing (MI has shown eroding skills after workshops not followed by additional training input (supervision/coaching. There is a need for more research evaluating different types and lengths of post-workshop training with follow-up periods extending six months. This study is an extension of a previous evaluation of the level of proficiency in MI after workshop and four sessions of supervision among nurses in Swedish child health services.To explore the level of MI proficiency among nurses participating in an intervention to prevent childhood obesity (n = 33, after receiving five additional sessions of supervision including feedback on observed practice, as well as level of proficiency at follow-up.Level of proficiency was measured 4 and 12 months after completed supervision using recorded practice samples coded according to the Motivational Interviewing Treatment Integrity (MITI Code. Potential predictors of outcome were investigated.Proficiency remained on the same levels after nine sessions of supervision as after four sessions, and was generally low. The percentage of nurses reaching the proficiency level ranged from 18.2 to 54.5% across indicators. MI-spirit had increased significantly at follow-up, and the rest of the indicators remained on the same levels. No predictors of outcome were found.Comprehensive training programs with prolonged post-workshop supervision and feedback on observed practice may help to sustain but not improve participants' proficiency in MI. Potential explanations to the results and suggestions for future research are discussed.

  4. Constrained Deep Weak Supervision for Histopathology Image Segmentation.

    Science.gov (United States)

    Jia, Zhipeng; Huang, Xingyi; Chang, Eric I-Chao; Xu, Yan

    2017-11-01

    In this paper, we develop a new weakly supervised learning algorithm to learn to segment cancerous regions in histopathology images. This paper is under a multiple instance learning (MIL) framework with a new formulation, deep weak supervision (DWS); we also propose an effective way to introduce constraints to our neural networks to assist the learning process. The contributions of our algorithm are threefold: 1) we build an end-to-end learning system that segments cancerous regions with fully convolutional networks (FCNs) in which image-to-image weakly-supervised learning is performed; 2) we develop a DWS formulation to exploit multi-scale learning under weak supervision within FCNs; and 3) constraints about positive instances are introduced in our approach to effectively explore additional weakly supervised information that is easy to obtain and enjoy a significant boost to the learning process. The proposed algorithm, abbreviated as DWS-MIL, is easy to implement and can be trained efficiently. Our system demonstrates the state-of-the-art results on large-scale histopathology image data sets and can be applied to various applications in medical imaging beyond histopathology images, such as MRI, CT, and ultrasound images.

  5. Empirical study of supervised gene screening

    Directory of Open Access Journals (Sweden)

    Ma Shuangge

    2006-12-01

    Full Text Available Abstract Background Microarray studies provide a way of linking variations of phenotypes with their genetic causations. Constructing predictive models using high dimensional microarray measurements usually consists of three steps: (1 unsupervised gene screening; (2 supervised gene screening; and (3 statistical model building. Supervised gene screening based on marginal gene ranking is commonly used to reduce the number of genes in the model building. Various simple statistics, such as t-statistic or signal to noise ratio, have been used to rank genes in the supervised screening. Despite of its extensive usage, statistical study of supervised gene screening remains scarce. Our study is partly motivated by the differences in gene discovery results caused by using different supervised gene screening methods. Results We investigate concordance and reproducibility of supervised gene screening based on eight commonly used marginal statistics. Concordance is assessed by the relative fractions of overlaps between top ranked genes screened using different marginal statistics. We propose a Bootstrap Reproducibility Index, which measures reproducibility of individual genes under the supervised screening. Empirical studies are based on four public microarray data. We consider the cases where the top 20%, 40% and 60% genes are screened. Conclusion From a gene discovery point of view, the effect of supervised gene screening based on different marginal statistics cannot be ignored. Empirical studies show that (1 genes passed different supervised screenings may be considerably different; (2 concordance may vary, depending on the underlying data structure and percentage of selected genes; (3 evaluated with the Bootstrap Reproducibility Index, genes passed supervised screenings are only moderately reproducible; and (4 concordance cannot be improved by supervised screening based on reproducibility.

  6. Extracting microRNA-gene relations from biomedical literature using distant supervision.

    Directory of Open Access Journals (Sweden)

    Andre Lamurias

    Full Text Available Many biomedical relation extraction approaches are based on supervised machine learning, requiring an annotated corpus. Distant supervision aims at training a classifier by combining a knowledge base with a corpus, reducing the amount of manual effort necessary. This is particularly useful for biomedicine because many databases and ontologies have been made available for many biological processes, while the availability of annotated corpora is still limited. We studied the extraction of microRNA-gene relations from text. MicroRNA regulation is an important biological process due to its close association with human diseases. The proposed method, IBRel, is based on distantly supervised multi-instance learning. We evaluated IBRel on three datasets, and the results were compared with a co-occurrence approach as well as a supervised machine learning algorithm. While supervised learning outperformed on two of those datasets, IBRel obtained an F-score 28.3 percentage points higher on the dataset for which there was no training set developed specifically. To demonstrate the applicability of IBRel, we used it to extract 27 miRNA-gene relations from recently published papers about cystic fibrosis. Our results demonstrate that our method can be successfully used to extract relations from literature about a biological process without an annotated corpus. The source code and data used in this study are available at https://github.com/AndreLamurias/IBRel.

  7. Supervising away from home: clinical, cultural and professional challenges.

    Science.gov (United States)

    Abramovitch, Henry; Wiener, Jan

    2017-02-01

    This paper explores some challenges of supervising clinical work of trainees, known as 'routers', who live in countries with diverse cultural, social and political traditions, and the analysts who travel to supervise them. It is written as an evolving dialogue between the authors, who explore together the effects of their own culture of origin, and in particular the legacy and values of their own training institutes on the styles and models of analytic supervision. Their dialogue is framed around the meaning of home and experiences of homesickness for analysts working away from home in an interactive field of strangeness in countries where analytical psychology is a relatively new discipline. The authors outline the findings from their own qualitative survey, where other supervisors working abroad, and those they have supervised, describe their experiences and their encounters with difference. The dialogue ends with both authors discussing what they have learned about teaching and supervising abroad, the implications for more flexible use of Jungian concepts, and how such visits have changed their clinical practice in their home countries. © 2017, The Society of Analytical Psychology.

  8. Capital Structure, Strategic Competition, and Governance

    NARCIS (Netherlands)

    T.T. Nguyen (Thuy Thu)

    2008-01-01

    textabstractThis thesis consists of four studies on the interactions of capital structure and product market competition, and on several aspects of governance, firm financing and growth. The first study investigates how competitive behavior and market uncertainty affect the capital structure of a

  9. Smoking Cessation Treatment for Patients With Mental Disorders Using CBT and Combined Pharmacotherapy.

    Science.gov (United States)

    Loreto, Aline Rodrigues; Carvalho, Carlos Felipe Cavalcanti; Frallonardo, Fernanda Piotto; Ismael, Flavia; Andrade, Arthur Guerra de; Castaldelli-Maia, João Maurício

    2017-01-01

    The aim of this study was to investigate smoking treatment effectiveness and retention in a population with and without mental disorders (MD). Participants received cognitive behavioral therapy (CBT) plus nicotine patch alone or in combination with other medications (i.e., gum, bupropion, or nortriptyline) for smoking cessation treatment in a Brazilian Psychosocial Care Center unit (CAPS), taking into account sociodemographics and smoking profile covariates. The study involved comparison of treatment success (seven-day point prevalence abstinence at the end of the treatment) and retention (presence of the individual in all of the four medical consultations and six group sessions) in two subsamples of patients with MD (n = 267) and without MD (n = 397) who were included in a six-week treatment provided by a CAPS from 2007 to 2013. The treatment protocol comprised group CBT and pharmacotherapy (nicotine patches, nicotine gums, and bupropion and nortriptyline available, prescribed by psychiatrists). Within patients with MD, CBT plus nicotine patch plus bupropion (aOR = 2.00, 95% CI [1.14, 3.50], p = .015) and CBT plus nicotine patch plus gum (aOR = 2.10, 95% CI [1.04, 4.23], p = .036) were associated with treatment success. Within patients without MD, female gender (aOR = 0.60, 95% CI [0.37, 0.95], p = .031) and lower Heaviness of Smoking Index score (aOR = 0.80, 95% CI [0.65, 0.99], p = .048) were associated with treatment success. No variable was associated with dropout or retention within patients with or without MD. Our findings support the use of CBT plus nicotine patch plus bupropion as well as CBT plus nicotine patch plus gum in samples with high rates of medical, psychiatric, and addiction disorders. These findings support those of previous studies in the general population. Pharmacological treatment associated with group CBT based on cognitive-behavioral concepts and combined with ongoing MD treatment seems to be the best option for smoking cessation

  10. Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

    Science.gov (United States)

    Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif

    2015-08-13

    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

  11. The effectiveness of internet cognitive behaviour therapy (iCBT) for social anxiety disorder across two routine practice pathways

    OpenAIRE

    Williams, Alishia D.; O'Moore, Kathleen; Mason, Elizabeth; Andrews, Gavin

    2014-01-01

    Social anxiety disorder (SAD) is a common, chronic and disabling mental disorder. Cognitive Behaviour Therapy (CBT) is a highly effective treatment of SAD and internet CBT (iCBT) offers a cost-effective and convenient alternative to face to face approaches, with high fidelity and demonstrated efficacy. The aim of the current paper was to evaluate the effectiveness of an iCBT programme for SAD (The This Way Up Clinic Shyness Programme) when delivered in routine practice through two different p...

  12. Supervision of execution of dismantling; Supervision de ejecucion de desmantelamiento

    Energy Technology Data Exchange (ETDEWEB)

    Canizares, J.

    2015-07-01

    Enresa create and organizational structure that covers various areas involved in effective control of Decommissioning Project. One area is the Technical Supervision of Works Decommissioning Project, as Execution Department dependent Technical Management. In the structure, Execution Department acts as liaison between the project, disciplines involved in developing and specialized companies contracted work to achieve your intended target. Equally important is to ensure that such activities are carried out correctly, according to the project documentation. (Author)

  13. Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

    Science.gov (United States)

    Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

    2018-03-05

    Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

  14. Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.

    Science.gov (United States)

    Brown, H M; Lester, K J; Jassi, A; Heyman, I; Krebs, G

    2015-07-01

    Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.

  15. Sustainability of Governing Structures in Bulgarian Farming Industry

    Directory of Open Access Journals (Sweden)

    Hrabrin Bachev

    2017-08-01

    Full Text Available The issue of assessment of absolute and comparative sustainability of major governing structures in agrarian and farming industries is among the most topical issues for researchers, farmers, investors, administrators, politicians, interests groups, and the public worldwide. Despite this issue, practically there are no assessments on the sustainability level of the major types of Bulgarian farming enterprises in the conditions of European Union Common Agricultural Policy implementation. This study applies a holistic framework and assesses the absolute and comparative sustainability of major governing structures in Bulgarian farming industry—unregistered holdings, sole traders, cooperatives, and companies of various types. In this paper, the method of the study is outlined, the inclusion of a novel “governance aspect” of sustainability is justified, and the overall characteristics of the surveyed farming enterprises are presented. Then, the integral, governance, economic, social, and environmental sustainability of the farming structures of different juridical types is assessed. Next, the structure of farming enterprises with different sustainability levels is analyzed. Finally, the conclusion from this study and the directions for further research and amelioration of sustainability assessments are presented.

  16. The use of automated assessments in internet-based CBT: The computer will be with you shortly

    Directory of Open Access Journals (Sweden)

    Elizabeth C. Mason

    2014-10-01

    Full Text Available There is evidence from randomized control trials that internet-based cognitive behavioral therapy (iCBT is efficacious in the treatment of anxiety and depression, and recent research demonstrates the effectiveness of iCBT in routine clinical care. The aims of this study were to implement and evaluate a new pathway by which patients could access online treatment by completing an automated assessment, rather than seeing a specialist health professional. We compared iCBT treatment outcomes in patients who received an automated pre-treatment questionnaire assessment with patients who were assessed by a specialist psychiatrist prior to treatment. Participants were treated as part of routine clinical care and were therefore not randomized. The results showed that symptoms of anxiety and depression decreased significantly with iCBT, and that the mode of assessment did not affect outcome. That is, a pre-treatment assessment by a psychiatrist conferred no additional treatment benefits over an automated assessment. These findings suggest that iCBT is effective in routine care and may be implemented with an automated assessment. By providing wider access to evidence-based interventions and reducing waiting times, the use of iCBT within a stepped-care model is a cost-effective way to reduce the burden of disease caused by these common mental disorders.

  17. An assessment of the effectiveness of computer-based training for newly commissioned Surface Warfare Division officers. / by William R. Bowman, Crawford, Alice M., Stephen Mehay.

    OpenAIRE

    Bowman, William R.; Crawford, Alice M.; Mehay, Stephen

    2009-01-01

    Approved for public release; distribution unlimited. The goal of this study was to analyze the effectiveness of the new SWOS-at-Sea training for newly commissioned surface warfare officers that was introduced in 2003. The new regime combined self-paced computer-based training (CBT) with on-the-job training (OJT) on-board an officer's ship. The study relied on a variety of analytical techniques, including a literature review of CBT and OJT training, interviews and focus groups with junior a...

  18. The discrepancy between subjective and objective measures of sleep in older adults receiving CBT for comorbid insomnia.

    Science.gov (United States)

    Lund, Hannah G; Rybarczyk, Bruce D; Perrin, Paul B; Leszczyszyn, David; Stepanski, Edward

    2013-10-01

    To examine the effect of cognitive-behavioral therapy for insomnia (CBT-I) on the underreporting of sleep relative to objective measurement, a common occurrence among individuals with insomnia. Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia. The self-report data were published previously in a randomized controlled trial demonstrating the efficacy of CBT-I compared with a placebo treatment. Self-report measures significantly underestimated sleep at pre-treatment and CBT-I led to a correction in this discrepancy. There were no significant changes in PSG after CBT-I. Path analysis showed that an increase in an objective proxy measure of sleep quality (i.e., decreased stage N1 sleep) after CBT-I was significantly related to improvements in self-report of sleep, with full mediation by reductions in discrepancy. This is the first CBT-I outcome study to analyze discrepancy changes and demonstrate that these changes account for a significant portion of self-report outcome. In addition, improved sleep quality as measured by a decrease in percentage of stage N1 sleep following treatment may be one mechanism that explains why sleep estimation is more accurate following CBT-I. © 2012 Wiley Periodicals, Inc.

  19. District nurses' experience of supervising nursing students in primary health care: A pre- and post-implementation questionnaire study.

    Science.gov (United States)

    Bos, Elisabeth; Löfmark, Anna; Törnkvist, Lena

    2009-11-01

    Nursing students go through clinical supervision in primary health care settings but district nurses' (DNs) circumstances when supervising them are only briefly described in the literature. The aim of this study was to investigate DNs experience of supervising nursing students before and after the implementation of a new supervision model. Ninety-eight (74%) DNs answered a questionnaire before and 84 (65%) after implementation of the new supervision model. The study showed that DNs in most cases felt that conditions for supervision in the workplace were adequate. But about 70% lacked training for the supervisory role and 20% had no specialist district nurse training. They also experienced difficulty in keeping up-to-date with changes in nurse education programmes, in receiving support from the university and from their clinic managers, and in setting aside time for supervision. Improvements after the implementation of a new model chiefly concerned organisation; more DNs stated that one person had primary responsibility for students' clinical practice, that information packages for supervisors and students were available at the health care centres, and that conditions were in place for increasing the number of students they supervised. DNs also stated that supervisors and students benefited from supervision by more than one supervisor. To conclude, implementation of a new supervision model resulted in some improvements.

  20. Improving Semi-Supervised Learning with Auxiliary Deep Generative Models

    DEFF Research Database (Denmark)

    Maaløe, Lars; Sønderby, Casper Kaae; Sønderby, Søren Kaae

    Deep generative models based upon continuous variational distributions parameterized by deep networks give state-of-the-art performance. In this paper we propose a framework for extending the latent representation with extra auxiliary variables in order to make the variational distribution more...... expressive for semi-supervised learning. By utilizing the stochasticity of the auxiliary variable we demonstrate how to train discriminative classifiers resulting in state-of-the-art performance within semi-supervised learning exemplified by an 0.96% error on MNIST using 100 labeled data points. Furthermore...

  1. Processes that Inform Multicultural Supervision: A Qualitative Meta-Analysis.

    Science.gov (United States)

    Tohidian, Nilou B; Quek, Karen Mui-Teng

    2017-10-01

    As the fields of counseling and psychotherapy have become more cognizant that individuals, couples, and families bring with them a myriad of diversity factors into therapy, multicultural competency has also become a crucial component in the development of clinicians during clinical supervision and training. We employed a qualitative meta-analysis to provide a detailed and comprehensive description of similar themes identified in primary qualitative studies that have investigated supervisory practices with an emphasis on diversity. Findings revealed six meta-categories, namely: (a) Supervisor's Multicultural Stances; (b) Supervisee's Multicultural Encounters; (c) Competency-Based Content in Supervision; (d) Processes Surrounding Multicultural Supervision; (e) Culturally Attuned Interventions; and (f) Multicultural Supervisory Alliance. Implications for practice are discussed. © 2017 American Association for Marriage and Family Therapy.

  2. A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders

    Science.gov (United States)

    Fairburn, Christopher G.; Bailey-Straebler, Suzanne; Basden, Shawnee; Doll, Helen A.; Jones, Rebecca; Murphy, Rebecca; O'Connor, Marianne E.; Cooper, Zafra

    2015-01-01

    Eating disorders may be viewed from a transdiagnostic perspective and there is evidence supporting a transdiagnostic form of cognitive behaviour therapy (CBT-E). The aim of the present study was to compare CBT-E with interpersonal psychotherapy (IPT), a leading alternative treatment for adults with an eating disorder. One hundred and thirty patients with any form of eating disorder (body mass index >17.5 to <40.0) were randomized to either CBT-E or IPT. Both treatments involved 20 sessions over 20 weeks followed by a 60-week closed follow-up period. Outcome was measured by independent blinded assessors. Twenty-nine participants (22.3%) did not complete treatment or were withdrawn. At post-treatment 65.5% of the CBT-E participants met criteria for remission compared with 33.3% of the IPT participants (p < 0.001). Over follow-up the proportion of participants meeting criteria for remission increased, particularly in the IPT condition, but the CBT-E remission rate remained higher (CBT-E 69.4%, IPT 49.0%; p = 0.028). The response to CBT-E was very similar to that observed in an earlier study. The findings indicate that CBT-E is potent treatment for the majority of outpatients with an eating disorder. IPT remains an alternative to CBT-E, but the response is less pronounced and slower to be expressed. Current controlled trials ISRCTN 15562271. PMID:26000757

  3. The interplay of structural and relational governance in innovation alliances

    NARCIS (Netherlands)

    Garbade, P.J.P.; Omta, S.W.F.; Fortuin, F.T.J.M.

    2016-01-01

    The present paper aims to extend the discussion in the governance literature about whether structural and relational governance mechanisms complement or substitute each other in innovation alliances. Where structural governance mechanisms refer to the division of tasks within the alliance and to

  4. On psychoanalytic supervision as signature pedagogy.

    Science.gov (United States)

    Watkins, C Edward

    2014-04-01

    What is signature pedagogy in psychoanalytic education? This paper examines that question, considering why psychoanalytic supervision best deserves that designation. In focusing on supervision as signature pedagogy, I accentuate its role in building psychoanalytic habits of mind, habits of hand, and habits of heart, and transforming theory and self-knowledge into practical product. Other facets of supervision as signature pedagogy addressed in this paper include its features of engagement, uncertainty, formation, and pervasiveness, as well as levels of surface, deep, and implicit structure. Epistemological, ontological, and axiological in nature, psychoanalytic supervision engages trainees in learning to do, think, and value what psychoanalytic practitioners in the field do, think, and value: It is, most fundamentally, professional preparation for competent, "good work." In this paper, effort is made to shine a light on and celebrate the pivotal role of supervision in "making" or developing budding psychoanalysts and psychoanalytic psychotherapists. Now over a century old, psychoanalytic supervision remains unparalleled in (1) connecting and integrating conceptualization and practice, (2) transforming psychoanalytic theory and self-knowledge into an informed analyzing instrument, and (3) teaching, transmitting, and perpetuating the traditions, practice, and culture of psychoanalytic treatment.

  5. Supervising Scientist, Annual Report 2000-2001

    International Nuclear Information System (INIS)

    2001-01-01

    . Operations at the Ranger mine during 2000-01 were dominated by two principal issues: water management and the implementation of the recommendations in our report on the leak of tailings water at the mine during the previous year. The Advisory Committee for the National Centre for Tropical Wetland Research (nctwr) was established during the year and held its first two meetings. Members of this Committee include representatives of the governments of the Northern Territory, Queensland, Western Australia and the Commonwealth, and industry and community groups. The Committee provides advice to the Board on the setting of priorities for research and training. Successful nctwr projects completed during the year included risk assessments for land use in the Daly River basin for the Northern Territory Government and, on behalf of Parks Australia North, on the impact of cane toads on ecosystems of Kakadu National Park

  6. Supervision--growing and building a sustainable general practice supervisor system.

    Science.gov (United States)

    Thomson, Jennifer S; Anderson, Katrina J; Mara, Paul R; Stevenson, Alexander D

    2011-06-06

    This article explores various models and ideas for future sustainable general practice vocational training supervision in Australia. The general practitioner supervisor in the clinical practice setting is currently central to training the future general practice workforce. Finding ways to recruit, retain and motivate both new and experienced GP teachers is discussed, as is the creation of career paths for such teachers. Some of the newer methods of practice-based teaching are considered for further development, including vertically integrated teaching, e-learning, wave consulting and teaching on the run, teaching teams and remote teaching. Approaches to supporting and resourcing teaching and the required infrastructure are also considered. Further research into sustaining the practice-based general practice supervision model will be required.

  7. 75 FR 9516 - Paroling, Recommitting, and Supervising Federal Prisoners: Prisoners Serving Sentences Under the...

    Science.gov (United States)

    2010-03-03

    ... willfully disobeyed a Commission direction. The Commission's interim rules for the procedures governing early termination from supervision for DC parolees are almost identical to the rules governing early... of deficient behavior that requires correction. Third, PDS recommended that the rules be modified to...

  8. Generalization of Supervised Learning for Binary Mask Estimation

    DEFF Research Database (Denmark)

    May, Tobias; Gerkmann, Timo

    2014-01-01

    This paper addresses the problem of speech segregation by es- timating the ideal binary mask (IBM) from noisy speech. Two methods will be compared, one supervised learning approach that incorporates a priori knowledge about the feature distri- bution observed during training. The second method...

  9. An Incomplete Contracting Model of Governance Structure Variety in Franchising

    OpenAIRE

    Hendrikse, George; Jiang, Tao

    2007-01-01

    textabstractFor the purpose of explaining governance structure variety in franchising, we explore the impact of governance structure on the incentives to invest in specific assets for the franchisor as well as the distributors. Wholly-owned, wholly-franchised, and mixed (dual distribution) franchise systems are considered. Circumstances are identified when a dual distribution governance structure uniquely allocates efficient ownership over assets. Whether dual distribution benefits are realiz...

  10. Postgraduate supervision at an open distance e-learning institution ...

    African Journals Online (AJOL)

    Effective postgraduate supervision is a concern at universities worldwide, even under optimal conditions where post-graduate students are studying full-time. Universities are being pressured by their governments to increase the throughput of postgraduates where there is a need for supervisory guidance in order to produce ...

  11. ‘Runaway Train Never Going Back?’ The Implications of the New Economic Governance for Democracy in the EU

    Directory of Open Access Journals (Sweden)

    Matthias Dobbels

    2014-05-01

    Full Text Available When the debt crisis erupted in late 2009 in the European Union it was addressed with a fundamental reform of the EU’s system of economic governance. These reforms pushed an agenda of fiscal austerity and more integration by putting national budgets under strict European supervision. Situating itself in the wider academic debate on the EU’s democratic nature, this article determines the extent to which the reforms have affected the EU’s democratic legitimacy by analysing them in the light of four vectors of legitimation (indirect, parliamentary, technocratic and procedural legitimacy. It will show that having had a considerable impact on the substance of the legislation, the European Parliament has strengthened the technocratic aspects of the reforms, but has compromised both the EU’s procedural and indirect legitimacy. By consequence, national parliaments who are most affected by the reforms are left on their own to catch up with the ever running train of European integration. The new reforms may have brought about a more robust and efficient Stability and Growth Pact; this article shows it scores low in terms of procedural, indirect and parliamentary legitimacy.

  12. Effects of dynamic posturographic balance training versus conventional balance training on mobility and balance in elderly

    International Nuclear Information System (INIS)

    Saddiqi, F.A.; Masood, T.

    2017-01-01

    To determine the effects of dynamic posturographic balance training versus conventional balance training in improving mobility and balance in elderly. Methodology: Forty subjects between 50 to 80 years of age were selected via non-probability convenience sampling technique, for this randomized controlled trial. Both females and males with no major co-morbid conditions and cognitive impairments were recruited and randomized via coin toss method into two equal groups: Dynamic Posturographic balance training (DPG) group and Conventional balance training (CBT) group. The DPG training was provided via Biodex Balance System (Static and Dynamic). Both groups received interventions 3 times (35 to 45min each day) a week for 8 weeks, after which terminal assessment was done. Data were collected on demographic profile, balance via berg balance score and mobility by using Timed Up and Go Test. Independent samples t test was used to check difference between CBT group and DPG Group and repeated measures Analysis of Variance (ANOVA) was used for within-group analysis. Results: Baseline analysis of Berg balance scale and timed up and go test between two groups showed no significant difference with (p 0.805 and 0.251, respectively). After 8 weeks of intervention, there was significant difference between the groups in both variables (p 0.019 and 0.001, respectively). Conclusion: Dynamic posturographic balance training was more effective in improving dynamic balance and mobility in elderly population in comparison to conventional balance training. (author)

  13. Transdiagnostic culturally adapted CBT with Farsi-speaking refugees: a pilot study.

    Science.gov (United States)

    Kananian, Schahryar; Ayoughi, Sarah; Farugie, Arieja; Hinton, Devon; Stangier, Ulrich

    2017-01-01

    Background : Approximately half of all asylum seekers suffer from trauma-related disorders requiring treatment, among them Posttraumatic Stress Disorder (PTSD), depression, anxiety, and somatic symptoms. There is a lack of easily accessible, low-threshold treatments taking the cultural background into account. Culturally Adapted CBT (CA CBT) is a well evaluated, transdiagnostic group intervention for refugees, using psychoeducation, meditation, and Yoga-like exercises. Objective: An uncontrolled pilot study with male Farsi-speaking refugees from Afghanistan and Iran was conducted to investigate feasibility with this ethnic group; a group for which no previous CBT trials have been reported. Method : The participants were nine Farsi-speaking, male refugees with M.I.N.I./DSM-IV diagnoses comprising PTSD, major depressive disorder, and anxiety disorders. Treatment components were adapted to the specific cultural framework of perception of symptoms, causes, ideas of healing, and local therapeutic processes. Before and after 12 weeks of treatment, the primary outcome was assessed using the General Health Questionnaire (GHQ-28). Secondary outcome measures were the Posttraumatic Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Affective Style Questionnaire (ASQ), and Emotion Regulation Scale (ERS). Results : Seven participants completed treatment. In the completer analysis, improvements were found on almost all questionnaires. Large effect sizes were seen for the GHQ-28 ( d  = 2.0), WHOQOL-BREF scales ( d  = 1.0-2.3), ASQ tolerating subscale ( d  = 2.2), and ERS ( d  = 1.7). With respect to feasibility, cultural adaptation seemed to be a crucial means to promote effectiveness. Conclusion : CA CBT may reduce general psychopathological distress and improve quality of life. Improvement in emotion regulation strategies may mediate treatment effects. More support should be provided to

  14. Effectiveness of Home-Based Exercises Without Supervision by Physical Therapists for Patients With Early-Stage Amyotrophic Lateral Sclerosis: A Pilot Study.

    Science.gov (United States)

    Kitano, Kosuke; Asakawa, Takashi; Kamide, Naoto; Yorimoto, Keisuke; Yoneda, Masaki; Kikuchi, Yutaka; Sawada, Makoto; Komori, Tetsuo

    2018-03-31

    To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). A historical controlled study that is part of a multicenter collaborative study. Rehabilitation departments at general hospitals and outpatient clinics with a neurology department. Patients (N=21) with ALS were enrolled and designated as the home-based exercise (Home-EX) group, and they performed unsupervised home-based exercises. As a control group, 84 patients with ALS who underwent supervised exercise with a physical therapist for 6 months were extracted from a database of patients with ALS and matched with the Home-EX group in terms of their basic attributes and clinical features. The Home-EX group was instructed to perform structured home-based exercises without supervision by a physical therapist that consisted of muscle stretching, muscle training, and functional training for 6 months. The primary outcome was the score on the ALS Functional Rating Scale-Revised (ALSFRS-R), which is composed of 3 domains: bulbar function, limb function, and respiratory function. The score ranges from 0 to 48 points, with a higher score indicating better function. In the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out because of medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function subscore and total score on the ALSFRS-R than the control group at follow-up (P<.001 and P<.05, respectively). Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Effectiveness of a CBT Intervention for Persistent Insomnia and Hypnotic Dependency in an Outpatient Psychiatry Clinic.

    Science.gov (United States)

    Taylor, Hannah Lund; Rybarczyk, Bruce D; Nay, William; Leszczyszyn, David

    2015-07-01

    To test cognitive-behavioral therapy for insomnia (CBT-I) in patients who not only receive psychiatric treatment in a outpatient psychiatry clinic but also continue to experience chronic insomnia despite receiving pharmacological treatment for sleep. CBT-I included an optional module for discontinuing hypnotic medications. Patients were randomized to 5 sessions of individual CBT-I (n = 13) or treatment as usual (n = 10). Sleep parameters were assessed using sleep diaries at pre- and posttreatment. Questionnaires measuring depression, anxiety, and health-related quality of life were also administered. CBT-I was associated with significant improvement in sleep, with 46% obtaining normal global sleep ratings after treatment. However, no changes in secondary outcomes (depression, anxiety, quality of life) were obtained and no patients elected to discontinue their hypnotic medications. Patients with complex, chronic psychiatric conditions can obtain sleep improvements with CBT-I beyond those obtained with pharmacotherapy alone; however, sleep interventions alone may not have the same effect on mental health outcomes in samples with more severe and chronic psychiatric symptoms and dependency on hypnotic medications. © 2015 Wiley Periodicals, Inc.

  16. Interactive training model of TRIZ for mechanical engineers in China

    Science.gov (United States)

    Tan, Runhua; Zhang, Huangao

    2014-03-01

    Innovation is a process of taking an original idea and converting it into a business value, in which the engineers face some inventive problems which can be solved hardly by experience. TRIZ, as a new theory for companies in China, provides both conceptual and procedural knowledge for finding and solving inventive problems. Because the government plays a leading role in the diffusion of TRIZ, too many companies from different industries are waiting to be trained, but the quantity of the trainers mastering TRIZ is incompatible with that requirement. In this context, to improve the training effect, an interactive training model of TRIZ for the mechanical engineers in China is developed and the implementation in the form of training classes is carried out. The training process is divided into 6 phases as follows: selecting engineers, training stage-1, finding problems, training stage-2, finding solutions and summing up. The government, TRIZ institutions and companies to join the programs interact during the process. The government initiates and monitors a project in form of a training class of TRIZ and selects companies to join the programs. Each selected companies choose a few engineers to join the class and supervises the training result. The TRIZ institutions design the training courses and carry out training curriculum. With the beginning of the class, an effective communication channel is established by means of interview, discussion face to face, E-mail, QQ and so on. After two years training practices, the results show that innovative abilities of the engineers to join and pass the final examinations increased distinctly, and most of companies joined the training class have taken congnizance of the power of TRIZ for product innovation. This research proposes an interactive training model of TRIZ for mechanical engineers in China to expedite the knowledge diffusion of TRIZ.

  17. Evaluation of the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision: An embedded evaluation

    Directory of Open Access Journals (Sweden)

    Khorasani Parvaneh

    2016-08-01

    Full Text Available Background and Objective: Currently, patient education has been considered in medical centers. Clinical provision, which is one of the legal tools with training-support dimensions, can evaluate the consistency between the implemented procedures and the planned ones. This study aimed to evaluate the process of recording patient education, consistency of record-keeping with perception, and patient satisfaction after implementing clinical supervision. Materials and Methods: This longitudinal, embedded study was conducted during 2013-2015 in three stages of designing, implementation, and evaluation of the supervision program using randomized convenience sampling on 786 monitoring units (medical records of patients being discharged at Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. In the designing stage, the checklists for supervision of recording patient education and consistency of patient perception with the recorded trainings and the patient satisfaction questionnaire were designed and their valididty and reliability were established. In the implementation stage, structure of the monitoring program was designed with the cooperation of eight supervisors. During 12 months, 2333 checklists and questionnaires were completed at the time of hospital discharge in the evaluation stage. Data analysis was performed in SPSS, version 18, using One-way ANOVA. Results: After 12 months of embedded evaluation, the mean score of recording patient education was 88.5±21.75, and the mean scores of patient satisfaction with the training process and consistency between patients’ perception and the recorded trainings were 47.17±21.48 and 73±25.13, respectively. The mean scores of recording patient training and consistency between patients’ perception and the recorded trainings had an increasing trend (P<0.001, while the mean score of patient satisfaction reduced (P<0.001. Conclusion: The results of clinical supervision during

  18. The international forum of ophthalmic simulation: developing a virtual reality training curriculum for ophthalmology.

    Science.gov (United States)

    Saleh, George M; Lamparter, Julia; Sullivan, Paul M; O'Sullivan, Fiona; Hussain, Badrul; Athanasiadis, Ioannis; Litwin, Andre S; Gillan, Stewart N

    2013-06-01

    To investigate the effect of a structured, supervised, cataract simulation programme on ophthalmic surgeons in their first year of training, and to evaluate the level of skill transfer. Trainees with minimal intraocular and simulator experience in their first year of ophthalmology undertook a structured, sequential, customised, virtual reality (VR) cataract training programme developed through the International Forum of Ophthalmic Simulation. A set of one-handed, bimanual, static and dynamic tasks were evaluated before and after the course and scores obtained. Statistical significance was evaluated with the Wilcoxon sign-rank test. The median precourse score of 101.50/400 (IQR 58.75-145.75) was significantly improved after completing the training programme ((postcourse score: 302/400, range: 266.25-343), p<0.001). While improvement was evident and found to be statistically significant in all parameters, greatest improvements were found for capsulorhexis and antitremor training ((Capsulorhexis: precourse score=0/100, range 0-4.5; postcourse score=81/100, range 13-87.75; p=0.002), (antitremor training: precourse score=0/100, range 0-0; postcourse score=80/100, range 60.25-91.50; p=0.001)). Structured and supervised VR training can offer a significant level of skills transfer to novice ophthalmic surgeons. VR training at the earliest stage of ophthalmic surgical training may, therefore, be of benefit.

  19. Classification of perovskites with supervised self-organizing maps

    International Nuclear Information System (INIS)

    Kuzmanovski, Igor; Dimitrovska-Lazova, Sandra; Aleksovska, Slobotka

    2007-01-01

    In this work supervised self-organizing maps were used for structural classification of perovskites. For this purpose, structural data for total number of 286 perovskites, belonging to ABO 3 and/or A 2 BB'O 6 types, were collected from literature: 130 of these are cubic, 85 orthorhombic and 71 monoclinic. For classification purposes, the effective ionic radii of the cations, electronegativities of the cations in B-position, as well as, the oxidation states of these cations, were used as input variables. The parameters of the developed models, as well as, the most suitable variables for classification purposes were selected using genetic algorithms. Two-third of all the compounds were used in the training phase. During the optimization process the performances of the models were checked using cross-validation leave-1/10-out. The performances of obtained solutions were checked using the test set composed of the remaining one-third of the compounds. The obtained models for classification of these three classes of perovskite compounds show very good results. Namely, the classification of the compounds in the test set resulted in small number of discrepancies (4.2-6.4%) between the actual crystallographic class and the one predicted by the models. All these results are strong arguments for the validity of supervised self-organizing maps for performing such types of classification. Therefore, the proposed procedure could be successfully used for crystallographic classification of perovskites in one of these three classes

  20. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J

    2010-11-01

    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  1. Randomized controlled study of CBT in bronchial asthma

    Directory of Open Access Journals (Sweden)

    Grover Naveen

    2007-01-01

    Full Text Available The aim of the present study was to find out efficacy of cognitive behavior therapy, as an adjunct to standard pharmacotherapy, in bronchial asthma. In a random-ized two-group design with pre-and post assessments, forty asthma patients were randomly allotted to two groups: self management group and cognitive behavior therapy group. Both groups were exposed to 6-8 weeks of intervention, asthma self management program and cognitive behavior therapy. Assessment measures used were-Semi structured interview schedule, Asthma Symptom Checklist, Asthma di-ary, Asthma Bother Profile, Hospital Anxiety & Depression Scale, AQLQ and Peak Expiratory Flow Rate. Within group comparison showed significant improvement in both groups at the post assessment. Between group comparisons showed that CBT group reported significantly greater change than that of SM group. Cognitive behavior therapy helps in improving the managment of asthma.

  2. A cluster randomised controlled trial of a manualised cognitive behavioural anger management intervention delivered by supervised lay therapists to people with intellectual disabilities.

    Science.gov (United States)

    Willner, P; Rose, J; Jahoda, A; Stenfert Kroese, B; Felce, D; MacMahon, P; Stimpson, A; Rose, N; Gillespie, D; Shead, J; Lammie, C; Woodgate, C; Townson, J K; Nuttall, J; Cohen, D; Hood, K

    2013-05-01

    12 weekly 2-hour group sessions supplemented by 'homework'. Lay therapists received training and ongoing supervision from a clinical psychologist. Treatment fidelity, group attendance and resources used in intervention delivery were monitored. The primary outcome was the service user-rated Provocation Index (PI), a measure of response to hypothetical situations that may provoke anger. Secondary trial outcomes were the key worker-rated PI; the service user- and key worker-rated Profile of Anger Coping Skills (PACS); the service user-rated PACS imaginal provocation test (PACS-IPT), a measure of response to actual situations known to provoke anger; aggression; mental health; self-esteem; quality of life; and health and social care resource use. Assessments were administered before randomisation and at 16 weeks and 10 months after randomisation. Fourteen treatment groups were delivered, each with 12 sessions lasting an average of 114 minutes, with a mean of 4.9 service users and 2.0 lay therapists. The mean hourly cost per service user was £ 25.26. The mean hourly excess cost over treatment as usual was £ 12.34. There was no effect of intervention on the primary outcome - self-rated PI. There was a significant impact on the following secondary outcomes at the 10-month follow-up: key worker-rated PI, self-rated PACS-IPT and self- and key worker-rated PACS. Key workers and home carers reported significantly lower aggression at 16 weeks, but not at 10 months. There was no impact on mental health, self-esteem, quality of life or total cost of health and social care. Service users, key workers and service managers were uniformly positive. The intervention was effective at changing anger coping skills and staff-rated anger. Impact on self-rated anger was equivocal. With hindsight there are reasons, from an analysis of factors influencing outcomes, to think that self-rated PI was not a well-chosen primary outcome. Widespread implementation of manualised lay therapist-led but

  3. EMDR versus CBT for children with self-esteem and behavioral problems: a randomized controlled trial

    NARCIS (Netherlands)

    Wanders, F.; Serra, M.; de Jongh, A.

    2008-01-01

    This study compared eye movement desensitization and reprocessing (EMDR) with cognitive-behavioral therapy (CBT). Twenty-six children (average age 10.4 years) with behavioral problems were randomly assigned to receive either 4 sessions of EMDR or CBT prior to usual treatment provided in outpatient

  4. CANDiS: Coupled & Attention-Driven Neural Distant Supervision

    OpenAIRE

    Nagarajan, Tushar; Sharmistha; Talukdar, Partha

    2017-01-01

    Distant Supervision for Relation Extraction uses heuristically aligned text data with an existing knowledge base as training data. The unsupervised nature of this technique allows it to scale to web-scale relation extraction tasks, at the expense of noise in the training data. Previous work has explored relationships among instances of the same entity-pair to reduce this noise, but relationships among instances across entity-pairs have not been fully exploited. We explore the use of inter-ins...

  5. Effectiveness of Group Cognitive Behavioral Therapy for Insomnia (CBT-I) in a Primary Care Setting.

    Science.gov (United States)

    Davidson, Judith R; Dawson, Samantha; Krsmanovic, Adrijana

    2017-05-02

    Primary care is where many patients with insomnia first ask for professional help. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia. Although CBT-I's efficacy is well established, its effectiveness in real-life primary care has seldom been investigated. We examined the effectiveness of CBT-I as routinely delivered in a Canadian primary care setting. The patients were 70 women and 11 men (mean age = 57.0 years, SD = 12.3); 83% had medical comorbidity. For the first 81 patients who took the six-session group program we compared initial and postprogram sleep diaries, sleep medication use, Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS), and visits to the family physician. Sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, and ISI scores improved significantly (p 7). Wait-list data from 42 patients showed minimal sleep and mood improvements with the passage of time. Number of visits to the family physician six months postprogram decreased, although not significantly (p = .108). The CBT-I program was associated with improvement on all sleep and mood measures. Effect sizes were similar to, or larger than, those found in randomized controlled trials, demonstrating the real-world effectiveness of CBT-I in an interdisciplinary primary care setting.

  6. What influences palliative care nurses in their choice to engage in or decline clinical supervision?

    Science.gov (United States)

    Puffett, Nick; Perkins, Paul

    2017-11-02

    Clinical supervision (CS) has been around since the early 1990s in the UK and has been endorsed by government and professional bodies. Levels of engagement range from 18% to 85%. To investigate what influences palliative care nurses in their choice to engage in or decline clinical supervision. A qualitative study was undertaken in an inpatient hospice in England and employed two focus groups to compare the views of participants and non-participants in CS. Data were audio recorded and transcribed verbatim by the researchers and analysed using systematic text condensation. Palliative care nurses all used informal team support for 'in the moment' support. Some engaged in formal CS to reflect 'on action' and to challenge practice. Nurses reported a lack of clarity regarding CS but, once this was overcome and engagement with CS was established, it led to changes in practice, identification of training needs and team building. The option of choice between group and individual supervision was found to be important. Group supervision led to enhanced understanding of group members which also led to team building, individual sessions were useful for individual issues. Protected time was essential for staff to be able to engage in CS. Staff who worked in larger teams reported higher levels of engagement, whereas a small team reported less need due to more informal team support. These findings are positive as they illuminate the importance of choice for support. Nurses need to be aware of their options for support and ultimately how this support affects the care they provide. The Palliative Care Nurse's Model of Support was developed, which shows the effects of each choice and how this may lead to team-building.

  7. How to enhance route learning and visuo-spatial working memory in aging: a training for residential care home residents.

    Science.gov (United States)

    Mitolo, Micaela; Borella, Erika; Meneghetti, Chiara; Carbone, Elena; Pazzaglia, Francesca

    2017-05-01

    This study aimed to assess the efficacy of a route-learning training in a group of older adults living in a residential care home. We verified the presence of training-specific effects in tasks similar to those trained - route-learning tasks - as well as transfer effects on related cognitive processes - visuo-spatial short-term memory (VSSTM; Corsi Blocks Test (CBT), forward version), visuo-spatial working memory (VSWM; CBT, backward version; Pathway Span Tasks; Jigsaw Puzzle Test) - and in self-report measures. The maintenance of training benefits was examined after 3 months. Thirty 70-90-year-old residential care home residents were randomly assigned to the route-learning training group or to an active control group (involved in non-visuo-spatial activities). The trained group performed better than the control group in the route-learning tasks, retaining this benefit 3 months later. Immediate transfer effects were also seen in visuo-spatial span tasks (i.e., CBT forward and backward version and Pathway Span Task); these benefits had been substantially maintained at the 3-month follow-up. These findings suggest that a training on route learning is a promising approach to sustain older adults' environmental learning and some related abilities (e.g., VSSTM and VSWM), even in residential care home residents.

  8. Nuclear supervision - Administration by the federal states on behalf of the Federal Government or direct federal administration? Evaluation from a practical point of view; Atomaufsicht - Bundesauftragsverwaltung oder Bundeseigenverwaltung? Bewertung aus der Sicht der Praxis

    Energy Technology Data Exchange (ETDEWEB)

    Cloosters, W. [Ministerium fuer Soziales, Gesundheit und Verbraucherschutz des Landes Schleswig-Holstein, Kiel (Germany). Abt. Reaktorsicherheit

    2005-01-01

    The organization of supervisory authorities under the Atomic Energy Act is not a new issue. In fact, it was discussed vehemently in the Federal Republic of Germany as far back as in the early fifties. Federal legislation in late 1959 decided to have the Atomic Energy Act executed in part under direct federal responsibility and, as far as the important supervision of the nuclear power plants operated in the Federal Republic of Germany was concerned, by the federal states on behalf of the federal government. Federal Minister for the Environment Trittin reopened the debate about the organization of nuclear administration by announcing his intention to transfer the supervision of nuclear power plants to direct federal administration. This announcement not only raises the question of legal permissibility of transferring nuclear power plant oversight to federal administration, but also requires a critical review, as presented in this article, of practical regulatory supervision to ensure safe operation of nuclear facilities. In this connection, both the actual content of supervisory activities and the way in which they are carried out must be examined in an effort to find an answer based on solid premises to the question raised above. For reasons explained in the contribution, oversight of nuclear power plants cannot be carried out as a centralized function. Instead, the legislative decision of 1959 in favor of the federal states exercising supervision on behalf of the federal government continues to be correct at the present stage also in the light of the steps initiated to opt out of the peaceful uses of nuclear power. (orig.)

  9. GMDH-Based Semi-Supervised Feature Selection for Electricity Load Classification Forecasting

    Directory of Open Access Journals (Sweden)

    Lintao Yang

    2018-01-01

    Full Text Available With the development of smart power grids, communication network technology and sensor technology, there has been an exponential growth in complex electricity load data. Irregular electricity load fluctuations caused by the weather and holiday factors disrupt the daily operation of the power companies. To deal with these challenges, this paper investigates a day-ahead electricity peak load interval forecasting problem. It transforms the conventional continuous forecasting problem into a novel interval forecasting problem, and then further converts the interval forecasting problem into the classification forecasting problem. In addition, an indicator system influencing the electricity load is established from three dimensions, namely the load series, calendar data, and weather data. A semi-supervised feature selection algorithm is proposed to address an electricity load classification forecasting issue based on the group method of data handling (GMDH technology. The proposed algorithm consists of three main stages: (1 training the basic classifier; (2 selectively marking the most suitable samples from the unclassified label data, and adding them to an initial training set; and (3 training the classification models on the final training set and classifying the test samples. An empirical analysis of electricity load dataset from four Chinese cities is conducted. Results show that the proposed model can address the electricity load classification forecasting problem more efficiently and effectively than the FW-Semi FS (forward semi-supervised feature selection and GMDH-U (GMDH-based semi-supervised feature selection for customer classification models.

  10. Caring for the carer: a systematic review of pure technology-based cognitive behavioral therapy (TB-CBT) interventions for dementia carers.

    Science.gov (United States)

    Scott, Jennifer L; Dawkins, Sarah; Quinn, Michael G; Sanderson, Kristy; Elliott, Kate-Ellen J; Stirling, Christine; Schüz, Ben; Robinson, Andrew

    2016-08-01

    Face-to-face delivery of CBT is not always optimal or practical for informal dementia carers (DCs). Technology-based formats of CBT delivery (TB-CBT) have been developed with the aim to improve client engagement and accessibility, and lower delivery costs, and offers potential benefits for DCs. However, research of TB-CBT for DCs has maintained heavy reliance on therapist involvement. The efficacy of pure TB-CBT interventions for DCs is not currently established Methods: A systematic review of trials of pure TB-CBT intervention for DCs from 1995 was conducted. PsycINFO, Cochrane Reviews, Scopus and MedLine databases were searched using key terms related to CBT, carers and dementia. Four hundred and forty two articles were identified, and inclusion/exclusion criteria were applied; studies were only retained if quantitative data was available, and there was no active therapist contact. Four articles were retained; two randomized and two waitlist control trials. Methodological and reporting quality was assessed. Meta-analyses were conducted for the outcome measures of caregiver depression. Meta-analysis revealed small significant post-intervention effects of pure TB-CBT interventions for depression; equivalent to face-to-face interventions. However, there is no evidence regarding long-term efficacy of pure TB-CBT for DCs. The systematic review further identified critical methodological and reporting shortcomings pertaining to these trials Conclusions: Pure TB-CBT interventions may offer a convenient, economical method for delivering psychological interventions to DCs. Future research needs to investigate their long-term efficacy, and consider potential moderating and mediating factors underpinning the mechanisms of effect of these programs. This will help to provide more targeted interventions to this underserviced population.

  11. The efficacy of unsupervised home-based exercise regimens in comparison to supervised laboratory-based exercise training upon cardio-respiratory health facets.

    Science.gov (United States)

    Blackwell, James; Atherton, Philip J; Smith, Kenneth; Doleman, Brett; Williams, John P; Lund, Jonathan N; Phillips, Bethan E

    2017-09-01

    Supervised high-intensity interval training (HIIT) can rapidly improve cardiorespiratory fitness (CRF). However, the effectiveness of time-efficient unsupervised home-based interventions is unknown. Eighteen volunteers completed either: laboratory-HIIT (L-HIIT); home-HIIT (H-HIIT) or home-isometric hand-grip training (H-IHGT). CRF improved significantly in L-HIIT and H-HIIT groups, with blood pressure improvements in the H-IHGT group only. H-HIIT offers a practical, time-efficient exercise mode to improve CRF, away from the laboratory environment. H-IHGT potentially provides a viable alternative to modify blood pressure in those unable to participate in whole-body exercise. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  12. Government regulation and associated innovations in building energy-efficiency supervisory systems for large-scale public buildings in a market economy

    International Nuclear Information System (INIS)

    Dai Xuezhi; Wu Yong; Di Yanqiang; Li Qiaoyan

    2009-01-01

    The supervision of energy efficiency in government office buildings and large-scale public buildings is the main embodiment for government implementation of Public Administration in the fields of resource saving and environmental protection. Aimed at improving the current situation of lack of government administration in building energy efficiency, this paper proposes the concept of 'change and redesign of governmental supervision in building energy efficiency', repositioning the role of government supervision. Based on this theory and other related theories in regulation economic and modern management, this paper analyzes and researches the action and function of all level governments in execution of the supervisory system of building energy efficiency in government office buildings and large-scale public buildings. This paper also defines the importance of government supervision in energy-efficiency system. Finally, this paper analyzes and researches the interaction mechanism between government and owners of different type buildings, government and energy-efficiency service institution with gambling as main features. This paper also presents some measurements to achieve a common benefit community in implementation of building energy-efficiency supervisory system.

  13. Government regulation and associated innovations in building energy-efficiency supervisory systems for large-scale public buildings in a market economy

    Energy Technology Data Exchange (ETDEWEB)

    Dai Xuezhi [China Academy of Building Research, Beijing 100013 (China)], E-mail: daixz9999@126.com; Wu Yong [Ministry of Housing and Urban-Rural Development of the People' s Republic of China, Beijing 100835 (China); Di Yanqiang [China Academy of Building Research, Beijing 100013 (China); Li Qiaoyan [Department of Building, School of Design and Environment, National University of Singapore (Singapore)

    2009-06-15

    The supervision of energy efficiency in government office buildings and large-scale public buildings is the main embodiment for government implementation of Public Administration in the fields of resource saving and environmental protection. Aimed at improving the current situation of lack of government administration in building energy efficiency, this paper proposes the concept of 'change and redesign of governmental supervision in building energy efficiency', repositioning the role of government supervision. Based on this theory and other related theories in regulation economic and modern management, this paper analyzes and researches the action and function of all level governments in execution of the supervisory system of building energy efficiency in government office buildings and large-scale public buildings. This paper also defines the importance of government supervision in energy-efficiency system. Finally, this paper analyzes and researches the interaction mechanism between government and owners of different type buildings, government and energy-efficiency service institution with gambling as main features. This paper also presents some measurements to achieve a common benefit community in implementation of building energy-efficiency supervisory system.

  14. Government regulation and associated innovations in building energy-efficiency supervisory systems for large-scale public buildings in a market economy

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Xuezhi; Di, Yanqiang [China Academy of Building Research, Beijing 100013 (China); Wu, Yong [Ministry of Housing and Urban-Rural Development of the People' s Republic of China, Beijing 100835 (China); Li, Qiaoyan [Department of Building, School of Design and Environment, National University of Singapore (Singapore)

    2009-06-15

    The supervision of energy efficiency in government office buildings and large-scale public buildings is the main embodiment for government implementation of Public Administration in the fields of resource saving and environmental protection. Aimed at improving the current situation of lack of government administration in building energy efficiency, this paper proposes the concept of 'change and redesign of governmental supervision in building energy efficiency', repositioning the role of government supervision. Based on this theory and other related theories in regulation economic and modern management, this paper analyzes and researches the action and function of all level governments in execution of the supervisory system of building energy efficiency in government office buildings and large-scale public buildings. This paper also defines the importance of government supervision in energy-efficiency system. Finally, this paper analyzes and researches the interaction mechanism between government and owners of different type buildings, government and energy-efficiency service institution with gambling as main features. This paper also presents some measurements to achieve a common benefit community in implementation of building energy-efficiency supervisory system. (author)

  15. The supervisions in the field develop nuclear professionals; Las supervisiones en campo desarrollan profesionales nucleares

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez de la Casa, M.; Buedo, J. L.; Gonzalez, F.

    2015-07-01

    In 2011 Cofrentes Nuclear Power Plants began a training program for improving the supervision of managers in the field: the effort done not only has improved the quality of supervisions but also has defined a way to reinforce behavior expectations of Cofrentes Nuclear Power Plant. (Author)

  16. How to Evaluate a Faculty Governance Structure

    Science.gov (United States)

    Cordes, John W.; Dunbar, David; Gingerich, Jeff

    2013-01-01

    During the 2010-11 academic year, Cabrini College began an evaluation of a faculty governance structure that had been implemented in fall 2007. The processes involved might serve as a roadmap for faculty members and administrators at other institutions who seek to understand the strengths and weaknesses of their governance model and improve shared…

  17. Corporate Governance Structure and Audit Quality

    OpenAIRE

    ZENG, SHIWEN

    2012-01-01

    Audit quality has always been the focus of attention by government regulatory authorities, the legislature, public investment and other stakeholders. This paper is going to investigate the effects of corporate governance structure on audit quality for the UK evidence. The sample study consists of 226 companies among FTSE 350 listed on the London Stock Exchange (LSE) for the fiscal year of 2011. The regression results and analysis are used to investigate the relationship between the audit qual...

  18. Development and Initial Validation of a Client-Rated MET-CBT Adherence Measure

    Directory of Open Access Journals (Sweden)

    Wendy R. Ulaszek

    2012-01-01

    Full Text Available Traditional mechanisms for rating adherence or fidelity are labor-intensive. We developed and validated a tool to rate adherence to Motivational Enhancement Therapy–-Cognitive Behavioral Treatment (MET-CBT through anonymous client surveys. The instrument was used to survey clients in 3 methadone programs over 2 waves. Explanatory and Confirmatory Factor Analyses were used to establish construct validity for both MET and CBT. Internal consistency based on Cronbach's alpha was within adequate range (α > 0.70 for all but 2 of the subscales in one of the samples. Consensus between clients’ ratings (r wg(j scores were in the range of 0.6 and higher, indicating a moderate to strong degree of agreement among clients’ ratings of the same counselor. These results suggest that client surveys could be used to measure adherence to MET-CBT for quality monitoring that is more objective than counselor self-report and less resource-intensive than supervisor review of taped sessions. However, additional work is needed to develop this scale.

  19. Supervised Gaussian mixture model based remote sensing image ...

    African Journals Online (AJOL)

    Using the supervised classification technique, both simulated and empirical satellite remote sensing data are used to train and test the Gaussian mixture model algorithm. For the purpose of validating the experiment, the resulting classified satellite image is compared with the ground truth data. For the simulated modelling, ...

  20. Enhancing CBT for Chronic Insomnia: A Randomised Clinical Trial of Additive Components of Mindfulness or Cognitive Therapy.

    Science.gov (United States)

    Wong, Mei Yin; Ree, Melissa J; Lee, Christopher W

    2016-09-01

    Although cognitive behavioural therapy (CBT) for insomnia has resulted in significant reductions in symptoms, most patients are not classified as good sleepers after treatment. The present study investigated whether additional sessions of cognitive therapy (CT) or mindfulness-based therapy (MBT) could enhance CBT in 64 participants with primary insomnia. All participants were given four sessions of standard CBT as previous research had identified this number of sessions as an optimal balance between therapist guidance and patient independence. Participants were then allocated to further active treatment (four sessions of CT or MBT) or a no further treatment control. The additional treatments resulted in significant improvements beyond CBT on self-report and objective measures of sleep and were well tolerated as evidenced by no dropouts from either treatment. The effect sizes for each of these additional treatments were large and clinically significant. The mean scores on the primary outcome measure, the Insomnia Severity Index, were 5.74 for CT and 6.69 for MBT, which are within the good-sleeper range. Treatment effects were maintained at follow-up. There were no significant differences between CT and MBT on any outcome measure. These results provide encouraging data on how to enhance CBT for treatment of insomnia. Copyright © 2015 John Wiley & Sons, Ltd. CBT treatments for insomnia can be enhanced using recent developments in cognitive therapy. CBT treatments for insomnia can be enhanced using mindfulness-based treatments. Both cognitive therapy and mindfulness produce additional clinically significant change. Copyright © 2015 John Wiley & Sons, Ltd.

  1. The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan - study protocol for a randomized controlled trial.

    Science.gov (United States)

    Zafar, Shamsa; Sikander, Siham; Hamdani, Syed Usman; Atif, Najia; Akhtar, Parveen; Nazir, Huma; Maselko, Joanna; Rahman, Atif

    2016-04-06

    Rates of perinatal depression in low and middle income countries are reported to be very high. Perinatal depression not only has profound impact on women's health, disability and functioning, it is associated with poor child health outcomes such as pre-term birth, under-nutrition and stunting, which ultimately have an adverse trans-generational impact. There is strong evidence in the medical literature that perinatal depression can be effectively managed with psychological treatments delivered by non-specialists. Our previous research in Pakistan led to the development of a successful perinatal depression intervention, the Thinking Healthy Program (THP). The THP is a psychological treatment delivered by community health workers. The burden of perinatal depression can be reduced through scale-up of this proven intervention; however, training of health workers at scale is a major barrier. To enhance access to such interventions there is a need to look at technological solutions to training and supervision. This is a non-inferiority, single-blinded randomized controlled trial. Eighty community health workers called Lady Health Workers (LHWs) working in a post-conflict rural area in Pakistan (Swat) will be recruited through the LHW program. LHWs will be randomly allocated to Technology-assisted Cascade Training and Supervision (TACTS) or to specialist-delivered training (40 in each group). The TACTS group will receive training in THP through LHW supervisors using a tablet-based training package, whereas the comparison group will receive training directly from mental health specialists. Our hypothesis is that both groups will achieve equal competence. Primary outcome measure will be competence of health workers at delivering THP using a modified ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale immediately post training and after 3 months of supervision. Independent assessors will be blinded to the LHW allocation status. Women living in post

  2. What's in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects.

    Science.gov (United States)

    Rosenbluth, Glenn; Tabas, Jeffrey A; Baron, Robert B

    2016-01-01

    Residents are required to engage in quality improvement (QI) activities, which requires faculty engagement. Because of increasing program requirements and clinical demands, faculty may be resistant to taking on additional teaching and supervisory responsibilities without incentives. The authors sought to create an authentic benefit for University of California, San Francisco (UCSF) Pediatrics Residency Training Program faculty who supervise pediatrics residents' QI projects by offering maintenance of certification (MOC) Part 4 (Performance in Practice) credit. The authors identified MOC as an ideal framework to both more actively engage faculty who were supervising QI projects and provide incentives for doing so. To this end, in 2011, the authors designed an MOC portfolio program which included faculty development, active supervision of residents, and QI projects designed to improve patient care. The UCSF Pediatrics Residency Training Program's Portfolio Sponsor application was approved by the American Board of Pediatrics (ABP) in 2012, and faculty whose projects were included in the application were granted MOC Part 4 credit. As of December 2013, six faculty had received MOC Part 4 credit for their supervision of residents' QI projects. Based largely on the success of this program, UCSF has transitioned to the MOC portfolio program administered through the American Board of Medical Specialties, which allows the organization to offer MOC Part 4 credit from multiple specialty boards including the ABP. This may require refinements to screening, over sight, and reporting structures to ensure the MOC standards are met. Ongoing faculty development will be essential.

  3. Short and long-term effects of supervised versus unsupervised exercise training on health-related quality of life and functional outcomes following lung cancer surgery - a randomized controlled trial.

    Science.gov (United States)

    Brocki, Barbara Cristina; Andreasen, Jane; Nielsen, Lene Rodkjaer; Nekrasas, Vytautas; Gorst-Rasmussen, Anders; Westerdahl, Elisabeth

    2014-01-01

    Surgical resection enhances long-term survival after lung cancer, but survivors face functional deficits and report on poor quality of life long time after surgery. This study evaluated short and long-term effects of supervised group exercise training on health-related quality of life and physical performance in patients, who were radically operated for lung cancer. A randomized, assessor-blinded, controlled trial was performed on 78 patients undergoing lung cancer surgery. The intervention group (IG, n=41) participated in supervised out-patient exercise training sessions, one hour once a week for ten weeks. The sessions were based on aerobic exercises with target intensity of 60-80% of work capacity, resistance training and dyspnoea management. The control group (CG, n=37) received one individual instruction in exercise training. Measurements consisted of: health-related quality of life (SF36), six minute walk test (6MWT) and lung function (spirometry), assessed three weeks after surgery and after four and twelve months. Both groups were comparable at baseline on demographic characteristic and outcome values. We found a statistically significant effect after four months in the bodily pain domain of SF36, with an estimated mean difference (EMD) of 15.3 (95% CI:4 to 26.6, p=0.01) and a trend in favour of the intervention for role physical functioning (EMD 12.04, 95% CI: -1 to 25.1, p=0.07) and physical component summary (EMD 3.76, 95% CI:-0.1 to 7.6, p=0.06). At 12 months, the tendency was reversed, with the CG presenting overall slightly better measures. We found no effect of the intervention on 6MWT or lung volumes at any time-point. Supervised compared to unsupervised exercise training resulted in no improvement in health-related quality of life, except for the bodily pain domain, four months after lung cancer surgery. No effects of the intervention were found for any outcome after one year. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Characterization and reconstruction of 3D stochastic microstructures via supervised learning.

    Science.gov (United States)

    Bostanabad, R; Chen, W; Apley, D W

    2016-12-01

    The need for computational characterization and reconstruction of volumetric maps of stochastic microstructures for understanding the role of material structure in the processing-structure-property chain has been highlighted in the literature. Recently, a promising characterization and reconstruction approach has been developed where the essential idea is to convert the digitized microstructure image into an appropriate training dataset to learn the stochastic nature of the morphology by fitting a supervised learning model to the dataset. This compact model can subsequently be used to efficiently reconstruct as many statistically equivalent microstructure samples as desired. The goal of this paper is to build upon the developed approach in three major directions by: (1) extending the approach to characterize 3D stochastic microstructures and efficiently reconstruct 3D samples, (2) improving the performance of the approach by incorporating user-defined predictors into the supervised learning model, and (3) addressing potential computational issues by introducing a reduced model which can perform as effectively as the full model. We test the extended approach on three examples and show that the spatial dependencies, as evaluated via various measures, are well preserved in the reconstructed samples. © 2016 The Authors Journal of Microscopy © 2016 Royal Microscopical Society.

  5. Changes in Perceived Supervision Quality After Introduction of Competency-Based Orthopedic Residency Training: A National 6-Year Follow-Up Study.

    Science.gov (United States)

    van Vendeloo, Stefan N; Brand, Paul L P; Kollen, Boudewijn J; Verheyen, Cees C P M

    2018-04-27

    To evaluate the perceived quality of the learning environment, before and after introduction of competency-based postgraduate orthopedic education. From 2009 to 2014, we conducted annual surveys among Dutch orthopedic residents. The validated Dutch Residency Educational Climate Test (D-RECT, 50 items on 11 subscales) was used to assess the quality of the learning environment. Scores range from 1 (poor) to 5 (excellent). Dynamic cohort follow-up study. All Dutch orthopedic residents were surveyed during annual compulsory courses. Over the 6-year period, 641 responses were obtained (response rate 92%). Scores for "supervision" (95% CI for difference 0.06-0.28, p = 0.002) and "coaching and assessment" (95% CI 0.11-0.35, p < 0.001) improved significantly after introduction of competency-based training. There was no significant change in score on the other subscales of the D-RECT. After the introduction of some of the core components of competency-based postgraduate orthopedic education the perceived quality of "supervision" and "coaching and assessment" improved significantly. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Adopsi Model Competency Based Training dalam Kewirausahaan

    Directory of Open Access Journals (Sweden)

    I Ketut Santra

    2009-01-01

    Full Text Available The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulation the research continuing to implement the competency based training in the real class. The time consumed to implementing the CBT one semester, starting on September 2006 to early February 2007. The lesson learnt from the implementation period, the CBT could improve the student competence in Personal, Situational Strategic and Business. The three of the competencies are important for the success entrepreneur. It is a sign of application of “Kurikulum Berbasis Kompetensi”. There are many evidences to describe the achievement of the CBT in entrepreneurship subject. Firstly, physically achievement, that all of the student’s business plan could became the real business. The evidences are presented by picture of the student’s real business. Secondly theoretically achievement, that the Personal, Situational Strategic and Business competence statistically have significant relation with Business Plan even Real Business quality. The effect of the Personal, Situational Strategic and Business competence to Business Plan quality is 84.4%. and, to the Real Business quality 77.2%. The statistic’s evidence suggests that the redesign of the entrepreneurship subject is the right way. The content of the entrepreneur competence (Personal, Situational and Strategic and Business competence have impact to the student to conduct and running for own business.

  7. The Future of the Banking Supervision in Europe

    Directory of Open Access Journals (Sweden)

    Nicolae Dardac

    2009-08-01

    Full Text Available The current financial crisis marked the end of a period characterized by a profit rush and an ascending trend of taking risks. In order to diminish its effects, central banks and governments made a prompt and joint intervention which resulted in urgent measures to re-establish the trust in the international financial system.However, the deficiencies in the risk management (associated with other weaknesses in the functioning of the financial markets call for a profound reform of the financial regulatory and supervisory framework. The success of this process aiming the improvement of the regulatory structure and, especially, of the components which encountered major dysfunctions, cannot be conceived without revising the entire supervision architecture at both regional and international level, so that it can provide the revitalization, consolidation and effectiveness of the international financial system as a whole.

  8. Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis.

    Science.gov (United States)

    Karyotaki, Eirini; Kemmeren, Lise; Riper, Heleen; Twisk, Jos; Hoogendoorn, Adriaan; Kleiboer, Annet; Mira, Adriana; Mackinnon, Andrew; Meyer, Björn; Botella, Cristina; Littlewood, Elizabeth; Andersson, Gerhard; Christensen, Helen; Klein, Jan P; Schröder, Johanna; Bretón-López, Juana; Scheider, Justine; Griffiths, Kathy; Farrer, Louise; Huibers, Marcus J H; Phillips, Rachel; Gilbody, Simon; Moritz, Steffen; Berger, Thomas; Pop, Victor; Spek, Viola; Cuijpers, Pim

    2018-03-15

    Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration. Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates. Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice.

  9. Supportive supervision for volunteers to deliver reproductive health education: a cluster randomized trial.

    Science.gov (United States)

    Singh, Debra; Negin, Joel; Orach, Christopher Garimoi; Cumming, Robert

    2016-10-03

    Community Health Volunteers (CHVs) can be effective in improving pregnancy and newborn outcomes through community education. Inadequate supervision of CHVs, whether due to poor planning, irregular visits, or ineffective supervisory methods, is, however, recognized as a weakness in many programs. There has been little research on best practice supervisory or accompaniment models. From March 2014 to February 2015 a proof of concept study was conducted to compare training alone versus training and supportive supervision by paid CHWs (n = 4) on the effectiveness of CHVs (n = 82) to deliver education about pregnancy, newborn care, family planning and hygiene. The pair-matched cluster randomized trial was conducted in eight villages (four intervention and four control) in Budondo sub-county in Jinja, Uganda. Increases in desired behaviors were seen in both the intervention and control arms over the study period. Both arms showed high retention rates of CHVs (95 %). At 1 year follow-up there was a significantly higher prevalence of installed and functioning tippy taps for hand washing (p services. Supportive supervision involves creating a non-threatening, empowering environment in which both the CHV and the supervising CHW learn together and overcome obstacles that might otherwise demotivate the CHV. While the results seem promising for added value with supportive supervision for CHVs undertaking reproductive health activities, further research on a larger scale will be needed to substantiate the effect.

  10. Treating Anxiety Disorders in Inner City Schools: Results from a Pilot Randomized Controlled Trial Comparing CBT and Usual Care

    Science.gov (United States)

    Ginsburg, Golda S.; Becker, Kimberly D.; Drazdowski, Tess K.; Tein, Jenn-Yun

    2012-01-01

    Background: The effectiveness of cognitive-behavioral treatment (CBT) in inner city schools, when delivered by novice CBT clinicians, and compared to usual care (UC), is unknown. Objective: This pilot study addressed this issue by comparing a modular CBT for anxiety disorders to UC in a sample of 32 volunteer youth (mean age 10.28 years, 63%…

  11. Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Dèttore, Davide; Pozza, Andrea; Andersson, Gerhard

    2015-01-01

    Cognitive behavioural therapy (CBT) is a well-established treatment for obsessive-compulsive disorder (OCD). However, few patients receive CBT, due to factors such as geographic limitations, perceived stigmatization, and lack of CBT services. Technology-delivered cognitive behavioural therapy (T-CBT) could be an effective strategy to improve patients' access to CBT. To date, a meta-analysis on the effectiveness of T-CBT for OCD has not been conducted. This study used meta-analytic techniques to summarize evidence on the efficacy of T-CBT for OCD versus control conditions and therapist-administered CBT. A meta-analysis according to Prisma guidelines was conducted on randomized controlled trials (RCTs) of T-CBT for OCD. Treatment was classified as T-CBT if evidence-based CBT active ingredients for OCD were included (psychoeducation, ERP, and cognitive restructuring), delivered through health technologies (e.g. self-help books, leaflets, and other forms of bibliotherapy) or remote communication technologies (e.g. the Internet, web-cameras, telephones, telephone-interactive voice response systems, and CD-ROMS). Studies using validated outcomes for OCD or depression were included. Eight trials were included (N = 420). Two trials were classified as at high risk of bias. T-CBT seemed to be superior to control conditions on OCD symptom outcomes at post-treatment (d = 0.82, 99% CI = 0.55-1.08, p = 0.001), but not on comorbid depression (d = 0.33, 99% CI = - 0.01-0.67, p = 0.020). Difference in the efficacy on OCD symptoms between T-CBT and therapist-administered CBT was not significant, despite a trend favouring therapist-administered CBT emerged (d = 0.45, 95% CI = 0.03-0.87, p = 0.033). Directions for research are discussed. Further RCTs are warranted to examine the efficacy of T-CBT for OCD.

  12. Race in Supervision: Let's Talk About It.

    Science.gov (United States)

    Schen, Cathy R; Greenlee, Alecia

    2018-01-01

    Addressing race and racial trauma within psychotherapy supervision is increasingly important in psychiatry training. A therapist's ability to discuss race and racial trauma in psychotherapy supervision increases the likelihood that these topics will be explored as they arise in the therapeutic setting. The authors discuss the contextual and sociocultural dynamics that contributed to their own avoidance of race and racial trauma within the supervisory relationship. The authors examine the features that eventually led to a robust discussion of race and culture within the supervisory setting and identify salient themes that occurred during three phases of the conversation about race: pre-dialogue, the conversation, and after the conversation. These themes include building an alliance, supercompetence, avoidance, shared vulnerability, "if I speak on this, I own it," closeness versus distance, and speaking up. This article reviews the key literature in the field of psychiatry and psychology that has shaped how we understand race and racial trauma and concludes with guidelines for supervisors on how to facilitate talking about race in supervision.

  13. Testing a Web-Based, Trained-Peer Model to Build Capacity for Evidence-Based Practices in Community Mental Health Systems.

    Science.gov (United States)

    German, Ramaris E; Adler, Abby; Frankel, Sarah A; Stirman, Shannon Wiltsey; Pinedo, Paola; Evans, Arthur C; Beck, Aaron T; Creed, Torrey A

    2018-03-01

    Use of expert-led workshops plus consultation has been established as an effective strategy for training community mental health (CMH) clinicians in evidence-based practices (EBPs). Because of high rates of staff turnover, this strategy inadequately addresses the need to maintain capacity to deliver EBPs. This study examined knowledge, competency, and retention outcomes of a two-phase model developed to build capacity for an EBP in CMH programs. In the first phase, an initial training cohort in each CMH program participated in in-person workshops followed by expert-led consultation (in-person, expert-led [IPEL] phase) (N=214 clinicians). After this cohort completed training, new staff members participated in Web-based training (in place of in-person workshops), followed by peer-led consultation with the initial cohort (Web-based, trained-peer [WBTP] phase) (N=148). Tests of noninferiority assessed whether WBTP was not inferior to IPEL at increasing clinician cognitive-behavioral therapy (CBT) competency, as measured by the Cognitive Therapy Rating Scale. WBTP was not inferior to IPEL at developing clinician competency. Hierarchical linear models showed no significant differences in CBT knowledge acquisition between the two phases. Survival analyses indicated that WBTP trainees were less likely than IPEL trainees to complete training. In terms of time required from experts, WBTP required 8% of the resources of IPEL. After an initial investment to build in-house CBT expertise, CMH programs were able to use a WBTP model to broaden their own capacity for high-fidelity CBT. IPEL followed by WBTP offers an effective alternative to build EBP capacity in CMH programs, rather than reliance on external experts.

  14. Development and Implementation of Health and Wellness CBT for Individuals with Depression and HIV.

    Science.gov (United States)

    Kennard, B; Brown, L; Hawkins, L; Risi, A; Radcliffe, J; Emslie, G; Mayes, T; King, J; Foxwell, A; Buyukdura, J; Bethel, J; Naar-King, S; Xu, J; Lee, S; Garvie, P; London, C; Tanney, M; Thornton, S

    2014-05-01

    Rates of depression are reported to be between 22-33% in adults with HIV, which is double that of the general population. Depression negatively affects treatment adherence and health outcomes of those with medical illnesses. Further, it has been shown in adults that reducing depression may improve both adherence and health outcomes. To address the issues of depression and non-adherence, Health and Wellness (H&W) Cognitive Behavioral Therapy (CBT) and medication management (MM) treatment strategies have been developed specifically for youth living with both HIV and depression. H&W CBT is based on other studies with uninfected youth and upon research on adults with HIV. H&W CBT uses problem-solving, motivational interviewing, and cognitive-behavioral strategies to decrease adherence obstacles and increase wellness. The intervention is delivered in 14 planned sessions over a 6-month period, with three different stages of CBT. This paper summarizes the feasibility and acceptability data from an open depression trial with 8 participants, 16-24 years of age, diagnosed with HIV and with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of depression, conducted at two treatment sites in the Adolescent Trials Network (ATN). Both therapists and subjects completed a Session Evaluation Form (SEF) after each session, and results were strongly favorable. Results from The Quick Inventory of Depressive Symptomatology-Clinician (QIDS-C) also showed noteworthy improvement in depression severity. A clinical case vignette illustrates treatment response. Further research will examine the use of H&W CBT in a larger trial of youth diagnosed with both HIV and depression.

  15. Exploring paraprofessional and classroom factors affecting teacher supervision.

    Science.gov (United States)

    Irvin, Dwight W; Ingram, Paul; Huffman, Jonathan; Mason, Rose; Wills, Howard

    2018-02-01

    Paraprofessionals serve a primary role in supporting students with disabilities in the classroom, which necessitates teachers' supervision as a means to improve their practice. Yet, little is known regarding what factors affect teacher supervision. We sought to identify how paraprofessional competence and classroom type affected the levels of teacher direction. We administered an adapted version of the Paraprofessional Needs, Knowledge & Tasks Survey and the Survey for Teachers Supervising Paraprofessionals to teachers supervising paraprofessionals in elementary schools. Structural Equation Modeling was used to examine the link between paraprofessional competence and classroom factors affecting the level of teacher supervision. Our results indicated that when teachers perceived paraprofessionals as being more skilled, they provided more supervision, and when more supervision was provided the less they thought paraprofessionals should be doing their assigned tasks. Additionally, paraprofessionals working in classrooms with more students with mild disabilities received less supervision than paraprofessionals working in classrooms with more students with moderate-to-severe disabilities. Those paraprofessionals in classrooms serving mostly children with mild disabilities were also perceived as having lower levels of skill competence than those serving in classrooms with students with more moderate-to-severe disabilities. By understanding the factors that affect teacher supervision, policy and professional development opportunities can be refined/developed to better support both supervising teachers and paraprofessionals and, in turn, improve the outcomes of children with disabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Deep Web Search Interface Identification: A Semi-Supervised Ensemble Approach

    Directory of Open Access Journals (Sweden)

    Hong Wang

    2014-12-01

    Full Text Available To surface the Deep Web, one crucial task is to predict whether a given web page has a search interface (searchable HyperText Markup Language (HTML form or not. Previous studies have focused on supervised classification with labeled examples. However, labeled data are scarce, hard to get and requires tediousmanual work, while unlabeled HTML forms are abundant and easy to obtain. In this research, we consider the plausibility of using both labeled and unlabeled data to train better models to identify search interfaces more effectively. We present a semi-supervised co-training ensemble learning approach using both neural networks and decision trees to deal with the search interface identification problem. We show that the proposed model outperforms previous methods using only labeled data. We also show that adding unlabeled data improves the effectiveness of the proposed model.

  17. Cost-effectiveness of computer-assisted training in cognitive-behavioral therapy as an adjunct to standard care for addiction.

    Science.gov (United States)

    Olmstead, Todd A; Ostrow, Cary D; Carroll, Kathleen M

    2010-08-01

    To determine the cost-effectiveness, from clinic and patient perspectives, of a computer-based version of cognitive-behavioral therapy (CBT4CBT) as an addition to regular clinical practice for substance dependence. PARTICIPANTS, DESIGN AND MEASUREMENTS: This cost-effectiveness study is based on a randomized clinical trial in which 77 individuals seeking treatment for substance dependence at an outpatient community setting were randomly assigned to treatment as usual (TAU) or TAU plus biweekly access to computer-based training in CBT (TAU plus CBT4CBT). The primary patient outcome measure was the total number of drug-free specimens provided during treatment. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves (CEACs) were used to determine the cost-effectiveness of TAU plus CBT4CBT relative to TAU alone. Results are presented from both the clinic and patient perspectives and are shown to be robust to (i) sensitivity analyses and (ii) a secondary objective patient outcome measure. The per patient cost of adding CBT4CBT to standard care was $39 ($27) from the clinic (patient) perspective. From the clinic (patient) perspective, TAU plus CBT4CBT is likely to be cost-effective when the threshold value to decision makers of an additional drug-free specimen is greater than approximately $21 ($15), and TAU alone is likely to be cost-effective when the threshold value is less than approximately $21 ($15). The ICERs for TAU plus CBT4CBT also compare favorably to ICERs reported elsewhere for other empirically validated therapies, including contingency management. TAU plus CBT4CBT appears to be a good value from both the clinic and patient perspectives. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  18. Effectiveness of cognitive behavioural therapy (CBT) programmes for anxiety or depression in adults with intellectual disabilities: A review of the literature.

    Science.gov (United States)

    Unwin, Gemma; Tsimopoulou, Ioanna; Kroese, Biza Stenfert; Azmi, Sabiha

    2016-01-01

    Relatively little is known about the application of cognitive behavioural therapy (CBT) to people with intellectual disabilities (ID). This review sought to synthesise available evidence on the effectiveness of CBT for anxiety or depression to assess the current level of evidence and make recommendations for future research. A comprehensive systematic literature search was conducted to identify qualitative and quantitative studies. Robust criteria were applied to select papers that were relevant to the review. Included papers were subject to quality appraisal. Eleven out of the 223 studies considered met our inclusion criteria and were included in the review in which CBT was used with participants with ID and anxiety (n=3), depression (n=4) or a mixed clinical presentation (n=4). There remains a paucity of evidence of effectiveness, however, the studies indicate that CBT is feasible and well-tolerated and may be effective in reducing symptoms of depression among adults with mild ID. Qualitative data reflect a positive perception of CBT amongst clients and carers. Further research is required to investigate the components of CBT, suitability for CBT, and requisite skills for CBT, which uses valid, sensitive and more holistic outcome measures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Cognitive behaviour therapy for generalized anxiety disorder: Is CBT equally efficacious in adults of working age and older adults?

    Science.gov (United States)

    Kishita, Naoko; Laidlaw, Ken

    2017-03-01

    The current meta-analysis compared the efficacy of CBT for GAD between adults of working age and older people. In addition, we conducted a qualitative content analysis of treatment protocols used in studies with older clients to explore potential factors that may enhance treatment outcomes with this particular client group. Applying the inclusion criteria resulted in the identification of 15 studies with 22 comparisons between CBT and control groups (770 patients). When examining overall effect sizes for CBT for GAD between older people and adults of working age there were no statistically significant differences in outcome. However, overall effect size of CBT for GAD was moderate for older people (g=0.55, 95% CI 0.22-0.88) and large for adults of working age (g=0.94, 95% CI 0.52-1.36), suggesting that there is still room for improvement in CBT with older people. The main difference in outcome between CBT for GAD between the two age groups was related to methodological quality in that no older people studies used an intention-to-treat design. The content analysis demonstrated that studies with older clients were conducted according to robust CBT protocols but did not take account of gerontological evidence to make them more age-appropriate. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  20. Combining Cognitive Behavioral Therapy with Contingency Management for Smoking Cessation in Adolescent Smokers: A Preliminary Comparison of Two Different CBT Formats

    Science.gov (United States)

    Cavallo, Dana A.; Cooney, Judith L.; Duhig, Amy M.; Smith, Anne E.; Liss, Thomas B.; McFetridge, Amanda K.; Babuscio, Theresa; Nich, Charla; Carroll, Kathleen M.; Rounsaville, Bruce J.; Krishnan-Sarin, Suchitra

    2013-01-01

    This pilot study evaluated the optimal format of cognitive behavioral therapy (CBT) to combine with contingency management (CM) in a four-week, high school-based smoking cessation program. Thirty-four adolescent smokers received a standard weekly version of CBT or a frequent brief behavioral intervention. Results indicate a trend toward a higher seven-day point prevalence end-of-treatment abstinence rate and percent days abstinent during treatment in the CBT condition. In addition, significantly more participants in the CBT group completed treatment. These preliminary results suggest that when combined with CM, the standard weekly format of CBT is more acceptable to adolescent smokers. PMID:18058412

  1. Manage Anxiety Through CBT: Teach Yourself

    OpenAIRE

    Dryden, Windy

    2011-01-01

    Using the proven techniques of cognitive behavioural therapy, this book will show you how to manage your anxiety, in whatever form it appears, from phobias to panic attacks and general anxiety disorder. You will receive support for understanding with and coping with different types of anxiety, using CBT to manage your symptoms and alleviate much of your distress. You will also learn how to be more resilient and accepting of all your thoughts, fears and emotions, and discover new, healthier wa...

  2. Governance Structure, Product Diversification, and Performance

    NARCIS (Netherlands)

    A.A.C.J. van Oijen; G.W.J. Hendrikse (George)

    2002-01-01

    textabstractProduct diversification and its financial outcomes have been studied exhaustively. However, previous literature has focused on corporations, ignoring other important legal organizations or governance structures. In this paper, we study the diversification strategies of cooperatives and

  3. Semi-Supervised Generation with Cluster-aware Generative Models

    DEFF Research Database (Denmark)

    Maaløe, Lars; Fraccaro, Marco; Winther, Ole

    2017-01-01

    Deep generative models trained with large amounts of unlabelled data have proven to be powerful within the domain of unsupervised learning. Many real life data sets contain a small amount of labelled data points, that are typically disregarded when training generative models. We propose the Clust...... a log-likelihood of −79.38 nats on permutation invariant MNIST, while also achieving competitive semi-supervised classification accuracies. The model can also be trained fully unsupervised, and still improve the log-likelihood performance with respect to related methods.......Deep generative models trained with large amounts of unlabelled data have proven to be powerful within the domain of unsupervised learning. Many real life data sets contain a small amount of labelled data points, that are typically disregarded when training generative models. We propose the Cluster...

  4. Effective and Efficient Training Programs in Jeddah Government Hospitals: A Case Study of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Hasan Salih Suliman Al-Qudah

    2016-10-01

    Full Text Available Hospital care broadly covers and encompasses complete range of personal health service like promotion of health service, prevention of disease, early detection of disease, diagnosis and treatment, rehabilitation of the patient. This study will try to identify the" Effective and Efficient Training Programs in Jeddah government hospitals: Case Study of Saudi Arabia”. The study will examine the demographic aspects of employees (Gender and experience and the value of what can deferent training programmes can have deep impact on their performance. The total study sample was 291 of identify employees, but 275 were suitable for statistical analysis, descriptive and analytical approach was also used to achieve the study objectives. The study major finding that there was a medium degree of effective and efficient training programs held’s in Jeddah public hospitals, also the study found that there are no statistically significant differences at  α ≤ 0.05 related to training of human resources. The study has recommended the need to improve employee’s skills in Jeddah government hospitals through actual employees participation at any training courses on a regular basis, also there is a need for continue training program for employee’s to qualify them at any future development in the deferent department of  the  hospital.

  5. The Current Practices and Problems of School Based Supervision in ...

    African Journals Online (AJOL)

    The purpose of this study was to identify the current practice and problems of school based supervision in government primary schools of Jile Timuga Woreda of Oromia Zone. A descriptive survey design of research methodology was employed. Regarding sampling, there were 39 primary schools grouped in 10 cluster ...

  6. Predicting the outcome of a cognitive-behavioral group training for patients with unexplained physical symptoms: a one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Zonneveld Lyonne NL

    2012-10-01

    Full Text Available Abstract Background Although Cognitive-Behavioral Therapy (CBT is effective for Unexplained Physical Symptoms (UPS, some therapists in clinical practice seem to believe that CBT outcome will diminish if psychiatric comorbidity is present. The result is that patients with a psychiatric comorbidity are redirected from treatment for UPS into treatment for mental health problems. To explore whether this selection and allocation are appropriate, we explored whether CBT outcomes in UPS could be predicted by variables assessed at baseline and used in routine-practice assessments. Methods Patients (n=162 with UPS classified as undifferentiated somatoform disorder or chronic pain disorder were followed up until one year after they had attended a CBT group training. The time-points of the follow-up were at the end of CBT (immediate outcome, three months after CBT (short-term outcome, and one year after CBT (long-term outcome. CBT outcome was measured using the Physical Component Summary of the SF-36, which was the primary outcome measure in the randomized controlled trial that studied effectiveness of the CBT group training. Predictors were: 1. psychological symptoms (global severity score of SCL-90, 2. personality-disorder characteristics (sum of DSM-IV axis II criteria confirmed, 3. psychiatric history (past presence of DSM-IV axis I disorders, and 4. health-related quality of life in the mental domain (mental component summary of SF-36. The effect of this predictor set was explored using hierarchical multiple regression analyses into which these predictors had been entered simultaneously, after control for: a. pretreatment primary outcome scores, b. age, c. gender, d. marital status, and e. employment. Results The predictor set was significant only for short-term CBT outcome, where it explained 15% of the variance. A better outcome was predicted by more psychological symptoms, fewer personality-disorder characteristics, the presence of a psychiatric

  7. A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings

    Directory of Open Access Journals (Sweden)

    Ducat WH

    2015-08-01

    Full Text Available Wendy H Ducat,1,3 Saravana Kumar2 1Cunningham Centre, Darling Downs Hospital and Health Service, Australia; 2School of Health Sciences, International Centre for Allied Health Evidence, Sansom Institute, University of South Australia, Adelaide, SA, Australia; 3Rural Clinical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia Introduction: In regional, rural, and remote settings, allied health professional supervision is one organizational mechanism designed to support and retain the workforce, provide clinical governance, and enhance service delivery. A systematic approach to evaluating the evidence of the experience and effects of professional supervision for non-metropolitan allied health practitioners and their service delivery is needed. Methods: Studies investigating the experience and effects of professional supervision across 17 allied health disciplines in non-metropolitan health services were systematically searched for using standardized keywords across seven databases. The initial search identified 1,574 references. Of these studies, five met inclusion criteria and were subject to full methodological appraisal by both reviewers. Two studies were primarily qualitative with three studies primarily quantitative in their approach. Studies were appraised using McMaster critical appraisal tools and data were extracted and synthesized. Results: Studies reported the context specific benefits and challenges of supervision in non-metropolitan areas and the importance of supervision in enhancing satisfaction and support in these areas. Comparison of findings between metropolitan and non-metropolitan settings within one study suggested that allied health in non-metropolitan settings were more satisfied with supervision though less likely to access it and preferred supervision with other non-metropolitan practitioners over access to more experienced supervisors. One study in a regional health service identified the lack

  8. Public high school teachers opinions on school administrators supervision duty in Turkey

    Directory of Open Access Journals (Sweden)

    Nurhayat Celebi

    2010-09-01

    Full Text Available Supervision that has been conducted by public high school administrators plays a major role in the effectiveness of a school.Lack of having well defined criteria is thought to be causing some major problems in the educational environment. Subjectivity,administrative policy constraints, lack of teacher motivation and lack of job satisfaction are only a few examples of those kindsof problems. The study, which is based on the scanning model and a descriptive research, was performed on 303 teachersworking in randomly chosen high schools in the Bakırköy district of İstanbul. The data collection instrument was developed bythe researcher. The confirmatory factor analysis test was used to determine whether the scale confirm to the factor structureor not. It was noticed that the factor structure could be explained with 5 factor sub-dimensions, and accordingly, the measuringscale, which had been originally prepared in 45 items, was modified and reduced to 32 items. As a result of factor analysis, thefactors were confirmed as follows; “the leadership, supervision techniques, effective supervision, efficacy of administration andteaching quality”. All these factors are explain about 48 % for total test variance. Cronbach alpha internal consistency factorwhich has been calculated according to the reliability analysis and it’s value was ,90. Factor loadings of sub- dimensions arebetween ,41 and ,81. In accordance with the results, training programs must be applied regularly to the administrators in orderto enable them to acquire more supervision attitude and to increase the efficiency and quality levels of the schools

  9. Effect of back-pressure forcing on shock train structures in rectangular channels

    Science.gov (United States)

    Gnani, F.; Zare-Behtash, H.; White, C.; Kontis, K.

    2018-04-01

    The deceleration of a supersonic flow to the subsonic regime inside a high-speed engine occurs through a series of shock waves, known as a shock train. The generation of such a flow structure is due to the interaction between the shock waves and the boundary layer inside a long and narrow duct. The understanding of the physics governing the shock train is vital for the improvement of the design of high-speed engines and the development of flow control strategies. The present paper analyses the sensitivity of the shock train configuration to a back-pressure variation. The complex characteristics of the shock train at an inflow Mach number M = 2 in a channel of constant height are investigated with two-dimensional RANS equations closed by the Wilcox k-ω turbulence model. Under a sinusoidal back-pressure variation, the simulated results indicate that the shock train executes a motion around its mean position that deviates from a perfect sinusoidal profile with variation in oscillation amplitude, frequency, and whether the pressure is first increased or decreased.

  10. Cost-effectiveness of nurse-delivered cognitive behavioural therapy (CBT) compared to supportive listening (SL) for adjustment to multiple sclerosis.

    Science.gov (United States)

    Mosweu, I; Moss-Morris, R; Dennison, L; Chalder, T; McCrone, P

    2017-10-10

    Cognitive Behavioural Therapy (CBT) reduces distress in multiple sclerosis, and helps manage adjustment, but cost-effectiveness evidence is lacking. An economic evaluation was conducted within a multi-centre trial. 94 patients were randomised to either eight sessions of nurse-led CBT or supportive listening (SL). Costs were calculated from the health, social and indirect care perspectives, and combined with additional quality-adjusted life years (QALY) or improvement on the GHQ-12 score, to explore cost-effectiveness at 12 months. CBT had higher mean health costs (£1610, 95% CI, -£187 to 3771) and slightly better QALYs (0.0053, 95% CI, -0.059 to 0.103) compared to SL but these differences were not statistically significant. This yielded £301,509 per QALY improvement, indicating that CBT is not cost-effective according to established UK NHS thresholds. The extra cost per patient improvement on the GHQ-12 scale was £821 from the same perspective. Using a £20,000, threshold, CBT in this format has a 9% probability of being cost effective. Although subgroup analysis of patients with clinical levels of distress at baseline showed an improvement in the position of CBT compared to SL, CBT was still not cost-effective. Nurse delivered CBT is more effective in reducing distress among MS patients compared to SL, but is highly unlikely to be cost-effective using a preference-based measure of health (EQ-5D). Results from a disease-specific measure (GHQ-12) produced comparatively lower Incremental Cost-Effectiveness Ratios, but there is currently no acceptable willingness-to-pay threshold for this measure to guide decision-making.

  11. Nurses’ perceptions on nursing supervision in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Beatriz Francisco Farah

    2016-01-01

    Full Text Available Objective: to understand the perceptions of nurses on nursing supervision in the work process. Methods: this is a qualitative research, with a semi-structured interview, performed with 16 nurses. Data analysis was performed through content analysis. Results: two meanings topics emerged from the speeches of the participants: Nurses´ activities in Primary Health Care Units and Nurses´ perceptions about nursing supervision. In the first category, the actions listed were filling out forms and reports under the supervision of the nursing service. In the second category, supervision was perceived as a function of management and follow-up of the activities planned by the team, in opposition to the classical supervision concept, which is inspecting. Conclusion: nursing supervision has been configured for primary care nurses as an administrative function that involves planning, organization, coordination, evaluation, follow-up and support for the health team.

  12. Sustainable Development and African Local Government: Can Electronic Training Help Build Capacities?

    Science.gov (United States)

    Johnson, Hazel; Thomas, Alan

    2007-01-01

    A recent study carried out by European and African organizations into the potential for electronic distance training (EDT) on sustainability in African local governments concluded that EDT was both "useful and feasible". This article reflects on some of the theoretical and practical implications of that study. It focuses on the…

  13. A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

    Directory of Open Access Journals (Sweden)

    Kenicer David

    2012-09-01

    Full Text Available Abstract Background NICE recommends computerised cognitive behavioural therapy (cCBT for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.

  14. An Incomplete Contracting Model of Governance Structure Variety in Franchising

    NARCIS (Netherlands)

    G.W.J. Hendrikse (George); T. Jiang (Tao)

    2007-01-01

    textabstractFor the purpose of explaining governance structure variety in franchising, we explore the impact of governance structure on the incentives to invest in specific assets for the franchisor as well as the distributors. Wholly-owned, wholly-franchised, and mixed (dual distribution) franchise

  15. Trends in Psychotherapy Training: A National Survey of Psychiatry Residency Training

    Science.gov (United States)

    Sudak, Donna M.; Goldberg, David A.

    2012-01-01

    Objective: The authors sought to determine current trends in residency training of psychiatrists. Method: The authors surveyed U.S. general-psychiatry training directors about the amount of didactic training, supervised clinical experience, and numbers of patients treated in the RRC-mandated models of psychotherapy (psychodynamic,…

  16. Harmonization of Inspection Supervision in the Pharmaceutical Sector of the Republic of Macedonia in conformity with the Recommendations of the European Legislation and WHO

    Directory of Open Access Journals (Sweden)

    Vasilka Nicha

    2012-01-01

    Full Text Available The new Law on Inspection Supervision (Official Gazette 50/2010, implementation as of 1.04.2011 was passed in April 2010 with the aim of improving the quality of inspection in the pharmaceutical sector, as well. The new Law covers the spectrum of weaknesses recognized over time. The system of quality inspection encompasses a set of commonly required quality management process, objectives, conditions, policies, formal rules and procedures. The organizational scheme addresses all aspects of inspection activity. The inspection service has to assure that its personnel are not under any undue internal or external commercial, financial or other kind of pressure and influence that may adversely affect the quality of their work. Moreover, the inspection service needs a sufficient number of employees with the necessary education, training, technical knowledge and experience to perform inspection activities according to specified requirements and standards. An inspector’s engagements have to be within the scope of the responsibilities arising from his/her activities. Continued training in inspection activities should be established, including advanced training programs that offer various levels of inspectors’ qualification. In regard to their specific activity, new rule books governing inspection supervision in the pharmaceutical sector should be developed and adopted in the near future. This permanent upgrading process of the existing national policies in compliance with the EU legal policy has also become characteristic of the Macedonian pharmaceutical sector.

  17. A Protocol for the Use of Remotely-Supervised Transcranial Direct Current Stimulation (tDCS) in Multiple Sclerosis (MS).

    Science.gov (United States)

    Kasschau, Margaret; Sherman, Kathleen; Haider, Lamia; Frontario, Ariana; Shaw, Michael; Datta, Abhishek; Bikson, Marom; Charvet, Leigh

    2015-12-26

    Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that uses low amplitude direct currents to alter cortical excitability. With well-established safety and tolerability, tDCS has been found to have the potential to ameliorate symptoms such as depression and pain in a range of conditions as well as to enhance outcomes of cognitive and physical training. However, effects are cumulative, requiring treatments that can span weeks or months and frequent, repeated visits to the clinic. The cost in terms of time and travel is often prohibitive for many participants, and ultimately limits real-world access. Following guidelines for remote tDCS application, we propose a protocol that would allow remote (in-home) participation that uses specially-designed devices for supervised use with materials modified for patient use, and real-time monitoring through a telemedicine video conferencing platform. We have developed structured training procedures and clear, detailed instructional materials to allow for self- or proxy-administration while supervised remotely in real-time. The protocol is designed to have a series of checkpoints, addressing attendance and tolerability of the session, to be met in order to continue to the next step. The feasibility of this protocol was then piloted for clinical use in an open label study of remotely-supervised tDCS in multiple sclerosis (MS). This protocol can be widely used for clinical study of tDCS.

  18. Short cognitive behavioral therapy and cognitive training for adults with ADHD – a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Maarit Virta

    2010-07-01

    Full Text Available Maarit Virta1,2, Anita Salakari1, Mervi Antila1, Esa Chydenius1, Markku Partinen1, Markus Kaski1, Risto Vataja3, Hely Kalska2, Matti Iivanainen11Rinnekoti Research Centre, Espoo, Finland; 2Department of Psychology, University of Helsinki, Finland; 3Kellokoski Hospital, Kellokoski, FinlandAbstract: In clinical practice, a growing need exists for effective non-pharmacological ­treatments of adult attention-deficit/hyperactivity disorder (ADHD. Here, we present the results of a pilot study of 10 adults with ADHD participating in short-term individual ­cognitive-behavioral therapy (CBT, 9 adults participating in cognitive training (CT, and 10 controls. Self-report ­questionnaires, independent evaluations, and computerized neurocognitive testing were ­collected before and after the treatments to evaluate change. There were distinctive pre-hypotheses regarding the treatments, and therefore the statistical comparisons were conducted in pairs: CBT vs control, CT vs control, and CBT vs CT. In a combined ADHD symptom score based on self-reports, 6 participants in CBT, 2 in CT and 2 controls improved. Using independent evaluations, improvement was found in 7 of the CBT participants, 2 of CT ­participants and 3 controls. There was no treatment-related improvement in cognitive performance. Thus, in the CBT group, some encouraging improvement was seen, although not as clearly as in ­previous research with longer interventions. In the CT group, there was improvement in the trained tasks but no generalization of the improvement to the tasks of the neurocognitive testing, the ­self-report questionnaires, or the independent evaluations. These preliminary results warrant further studies with more participants and with more elaborate cognitive testing.Keywords: CBT, attention-deficit/hyperactivity disorder, cognitive testing, non-­pharmacological treatments

  19. The Effectiveness of Internet Cognitive Behavioural Therapy (iCBT) for Depression in Primary Care: A Quality Assurance Study

    OpenAIRE

    Williams, Alishia D; Andrews, Gavin

    2013-01-01

    BACKGROUND: Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT) could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs). METHOD: Quality assurance data from 359 patients prescribed the Sadness Pro...

  20. Cognitive-Behavioral Therapy for Depression Using Mind Over Mood: CBT Skill Use and Differential Symptom Alleviation.

    Science.gov (United States)

    Hawley, Lance L; Padesky, Christine A; Hollon, Steven D; Mancuso, Enza; Laposa, Judith M; Brozina, Karen; Segal, Zindel V

    2017-01-01

    Cognitive-behavioral therapy (CBT) for depression is highly effective. An essential element of this therapy involves acquiring and utilizing CBT skills; however, it is unclear whether the type of CBT skill used is associated with differential symptom alleviation. Outpatients (N = 356) diagnosed with a primary mood disorder received 14 two-hour group sessions of CBT for depression, using the Mind Over Mood protocol. In each session, patients completed the Beck Depression Inventory and throughout the week they reported on their use of CBT skills: behavioral activation (BA), cognitive restructuring (CR), and core belief (CB) strategies. Bivariate latent difference score (LDS) longitudinal analyses were used to examine patterns of differential skill use and subsequent symptom change, and multigroup LDS analyses were used to determine whether longitudinal associations differed as a function of initial depression severity. Higher levels of BA use were associated with a greater subsequent decrease in depressive symptoms for patients with mild to moderate initial depression symptoms relative to those with severe symptoms. Higher levels of CR use were associated with a greater subsequent decrease in depressive symptoms, whereas higher levels of CB use were followed by a subsequent increase in depressive symptoms, regardless of initial severity. Results indicated that the type of CBT skill used is associated with differential patterns of subsequent symptom change. BA use was associated with differential subsequent change as a function of initial severity (patients with less severe depression symptoms demonstrated greater symptom improvement), whereas CR use was associated with symptom alleviation and CB use with an increase in subsequent symptoms as related to initial severity. Copyright © 2016. Published by Elsevier Ltd.

  1. Does media governance restrict corporate overinvestment behavior? Evidence from Chinese listed firms

    Directory of Open Access Journals (Sweden)

    Huili Zhang

    2015-03-01

    Full Text Available Using China’s A-share listed firms from 2007 to 2011, this paper empirically tests how media governance affects firms’ levels of overinvestment and whether external supervision and informal institutional mechanisms reduce these levels. We find that media governance and overinvestment are significantly negatively related. When firms are located in a district with a stronger media governance environment their levels of overinvestment are lower, indicating that media governance significantly restricts overinvestment behavior. When internal corporate governance efficiency is low, the negative relationship between the media environment and overinvestment behavior is significantly enhanced, indicating that when internal governance or formal systems have reduced efficacy, an important complementary role is played by external supervision and the informal institutional environment. After considering endogeneity and different measures of overinvestment and other related variables, the conclusions remain unchanged.

  2. Capital Structure Determinants and Governance Structure Variety in Franchising

    OpenAIRE

    Jiang, Tao

    2009-01-01

    textabstractThis thesis investigates two questions: the determinants of capital structure in franchising and its subsequent impact on the franchise financing decisions; and the efficient governance structure choice in franchising. We posit that firms franchise in order to benefit from the reduced franchisees’ operational risks by limiting the debt level, such that the franchisor can bear more debt and gain tax-deduction benefits. Specific hypotheses are based on various theories like resource...

  3. Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone.

    Science.gov (United States)

    Waterman, Samantha; Hunter, Elaine Catherine Margaret; Cole, Charles L; Evans, Lauren Jayne; Greenberg, Neil; Rubin, G James; Beck, Alison

    2018-03-01

    Following the 2014 Ebola virus disease (EVD) outbreak in West Africa, the UK Department for International Development funded South London and Maudsley National Health Service (NHS) to develop a psychological intervention that ex-Ebola Treatment Centre (ETC) staff could be trained to deliver to their peers to improve mental health in Sierra Leone. The two key aims were to assess the feasibility of training a national team to deliver a cognitive behavioural therapy (CBT)-based group intervention, and to evaluate the effectiveness of the overall intervention within this population. UK clinicians travelled to Sierra Leone to train a small team of ex-ETC staff in a three-phased CBT-based intervention. Standardised clinical measures, as well as bespoke measures, were applied with participants through the intervention to assess changes in mental health symptomology, and the effectiveness of the intervention. The results found improvements across all factors of mental health in the bespoke measure from phase 1 to phase 3. Additionally, the majority of standardised clinical measures showed improvements between phase 2 and the start of phase 3, and pre- and post-phase 3. Overall, the findings suggest that it is possible to train staff from ETCs to deliver effective CBT interventions to peers. The implications of these results are discussed, including suggestions for future research and clinical intervention implementation within this population. The limitations of this research are also addressed.

  4. Effectiveness of Group Supervision versus Combined Group and Individual Supervision.

    Science.gov (United States)

    Ray, Dee; Altekruse, Michael

    2000-01-01

    Investigates the effectiveness of different types of supervision (large group, small group, combined group, individual supervision) with counseling students (N=64). Analyses revealed that all supervision formats resulted in similar progress in counselor effectiveness and counselor development. Participants voiced a preference for individual…

  5. Classification of gene expression data: A hubness-aware semi-supervised approach.

    Science.gov (United States)

    Buza, Krisztian

    2016-04-01

    Classification of gene expression data is the common denominator of various biomedical recognition tasks. However, obtaining class labels for large training samples may be difficult or even impossible in many cases. Therefore, semi-supervised classification techniques are required as semi-supervised classifiers take advantage of unlabeled data. Gene expression data is high-dimensional which gives rise to the phenomena known under the umbrella of the curse of dimensionality, one of its recently explored aspects being the presence of hubs or hubness for short. Therefore, hubness-aware classifiers have been developed recently, such as Naive Hubness-Bayesian k-Nearest Neighbor (NHBNN). In this paper, we propose a semi-supervised extension of NHBNN which follows the self-training schema. As one of the core components of self-training is the certainty score, we propose a new hubness-aware certainty score. We performed experiments on publicly available gene expression data. These experiments show that the proposed classifier outperforms its competitors. We investigated the impact of each of the components (classification algorithm, semi-supervised technique, hubness-aware certainty score) separately and showed that each of these components are relevant to the performance of the proposed approach. Our results imply that our approach may increase classification accuracy and reduce computational costs (i.e., runtime). Based on the promising results presented in the paper, we envision that hubness-aware techniques will be used in various other biomedical machine learning tasks. In order to accelerate this process, we made an implementation of hubness-aware machine learning techniques publicly available in the PyHubs software package (http://www.biointelligence.hu/pyhubs) implemented in Python, one of the most popular programming languages of data science. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Training in Robotic Surgery-an Overview.

    Science.gov (United States)

    Sridhar, Ashwin N; Briggs, Tim P; Kelly, John D; Nathan, Senthil

    2017-08-01

    There has been a rapid and widespread adoption of the robotic surgical system with a lag in the development of a comprehensive training and credentialing framework. A literature search on robotic surgical training techniques and benchmarks was conducted to provide an evidence-based road map for the development of a robotic surgical skills for the novice robotic surgeon. A structured training curriculum is suggested incorporating evidence-based training techniques and benchmarks for progress. This usually involves sequential progression from observation, case assisting, acquisition of basic robotic skills in the dry and wet lab setting along with achievement of individual and team-based non-technical skills, modular console training under supervision, and finally independent practice. Robotic surgical training must be based on demonstration of proficiency and safety in executing basic robotic skills and procedural tasks prior to independent practice.

  7. Self-care assessment as an indicator for clinical supervision in nursing

    Directory of Open Access Journals (Sweden)

    Sílvia Marlene Monteiro Teixeira

    2016-06-01

    Full Text Available Objective: to evaluate the needs of clinical supervision for nurses to assess the degree of dependence on self-care and planning of nursing interventions. Methods: analytical study, cross-cutting nature, collecting data from a sample of 110 patients. Results: it was shown the differences in the identification of the degree of dependence between registers and experts, as well as the selection of operations for each self-care and failures to the original assessment of the filling level (no evaluation self-care/no identification of the degree of dependence. Conclusion: there were gaps in the nursing process; they have proposed strategies such as clinical supervision sessions, training, case studies, protocols and guidance documents, to be included in a clinical supervision in nursing model.

  8. Supervised Sequence Labelling with Recurrent Neural Networks

    CERN Document Server

    Graves, Alex

    2012-01-01

    Supervised sequence labelling is a vital area of machine learning, encompassing tasks such as speech, handwriting and gesture recognition, protein secondary structure prediction and part-of-speech tagging. Recurrent neural networks are powerful sequence learning tools—robust to input noise and distortion, able to exploit long-range contextual information—that would seem ideally suited to such problems. However their role in large-scale sequence labelling systems has so far been auxiliary.    The goal of this book is a complete framework for classifying and transcribing sequential data with recurrent neural networks only. Three main innovations are introduced in order to realise this goal. Firstly, the connectionist temporal classification output layer allows the framework to be trained with unsegmented target sequences, such as phoneme-level speech transcriptions; this is in contrast to previous connectionist approaches, which were dependent on error-prone prior segmentation. Secondly, multidimensional...

  9. Predicting the Effectiveness of Work-Focused CBT for Common Mental Disorders: The Influence of Baseline Self-Efficacy, Depression and Anxiety.

    Science.gov (United States)

    Brenninkmeijer, Veerle; Lagerveld, Suzanne E; Blonk, Roland W B; Schaufeli, Wilmar B; Wijngaards-de Meij, Leoniek D N V

    2018-02-15

    Purpose This study examined who benefits most from a cognitive behavioural therapy (CBT)-based intervention that aims to enhance return to work (RTW) among employees who are absent due to common mental disorders (CMDs) (e.g., depression, anxiety, or adjustment disorder). We researched the influence of baseline work-related self-efficacy and mental health (depressive complaints and anxiety) on treatment outcomes of two psychotherapeutic interventions. Methods Using a quasi-experimental design, 12-month follow-up data of 168 employees were collected. Participants either received work-focused cognitive behavioural therapy (W-CBT) that integrated work aspects early into the treatment (n = 89) or regular cognitive behavioural therapy (R-CBT) without a focus on work (n = 79). Results Compared with R-CBT, W-CBT resulted in a faster partial RTW, irrespective of baseline self-efficacy. Among individuals with high self-efficacy, W-CBT also resulted in faster full RTW. The effectiveness of W-CBT on RTW did not depend on baseline depressive complaints or anxiety. The decline of mental health complaints did not differ between the two interventions, nor depended on baseline self-efficacy or mental health. Conclusions Considering the benefits of W-CBT for partial RTW, we recommend this intervention as a preferred method for employees with CMDs, irrespective of baseline self-efficacy, depression and anxiety. For individuals with high baseline self-efficacy, this intervention also results in higher full RTW. For those with low self-efficacy, extra exercises or components may be needed to promote full RTW.

  10. Kollegial supervision

    DEFF Research Database (Denmark)

    Andersen, Ole Dibbern; Petersson, Erling

    Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution......Publikationen belyser, hvordan kollegial supervision i en kan organiseres i en uddannelsesinstitution...

  11. Robust Semi-Supervised Manifold Learning Algorithm for Classification

    Directory of Open Access Journals (Sweden)

    Mingxia Chen

    2018-01-01

    Full Text Available In the recent years, manifold learning methods have been widely used in data classification to tackle the curse of dimensionality problem, since they can discover the potential intrinsic low-dimensional structures of the high-dimensional data. Given partially labeled data, the semi-supervised manifold learning algorithms are proposed to predict the labels of the unlabeled points, taking into account label information. However, these semi-supervised manifold learning algorithms are not robust against noisy points, especially when the labeled data contain noise. In this paper, we propose a framework for robust semi-supervised manifold learning (RSSML to address this problem. The noisy levels of the labeled points are firstly predicted, and then a regularization term is constructed to reduce the impact of labeled points containing noise. A new robust semi-supervised optimization model is proposed by adding the regularization term to the traditional semi-supervised optimization model. Numerical experiments are given to show the improvement and efficiency of RSSML on noisy data sets.

  12. REGULATION AND SUPERVISION OF BANKING ACTIVITY IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Anisoara Niculina APETRI

    2015-04-01

    Full Text Available The main challenges currently faced by most central banks are generated by the effects of the economic and financial crisis. Thus, at the national, European and international level there is a trend of changing the economic governance structures and improving the regulatory and supervisory policies, focusing on macro-prudential oversight. In the context of changes at the European Union level, the central banks of the Member States become also subject to changes in their carried out actions. The objectives of this research aim mainly at: highlighting the role of the National Bank of Romania in regulating and supervising the banking system in Romania and analyzing the measures implemented by the National Bank of Romania after the crisis so far; identifying the challenges of the National Bank of Romania on the basis of changes operated by European Union at the supervisory framework level.

  13. Trainees' use of supervision for therapy with sexual minority clients: A qualitative study.

    Science.gov (United States)

    Chui, Harold; McGann, Kevin J; Ziemer, Kathryn S; Hoffman, Mary Ann; Stahl, Jessica

    2018-01-01

    In the supervision literature, research on sexual orientation considerations often focuses on sexual minority supervisees and less often on their work with sexual minority clients. Yet both heterosexual and sexual minority supervisees serve sexual minority clients and may have different supervision needs. Twelve predoctoral interns from 12 APA-accredited counseling center internships were interviewed about how they made use of supervision for their work with a sexual minority client. The sample consisted of 6 heterosexual-identified supervisees and 6 supervisees who identified as lesbian, gay, or queer (LGQ). Data were analyzed using consensual qualitative research. All participants reported positive gains from supervision that carried over to their work with heterosexual and sexual minority clients, even when not all supervisors disclosed or discussed their own sexual orientation. Heterosexual supervisees used supervision to ensure that their heterosexuality does not interfere with an affirmative experience for their sexual minority client, whereas LGQ supervisees used supervision to explore differences in sexual identity development between themselves and their client to minimize the negative impact of overidentification. Thus, affirmative supervision may unfold with different foci depending on supervisees' sexual identity. Implications for training and supervision are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  14. Deconstructing Risk Management in Psychotherapy Supervision.

    Science.gov (United States)

    Kroll, Jerome; Radden, Jennifer

    2017-12-01

    In the ongoing controversy over how much regulation and standardization to impose on clinical practice and research, it is not surprising that the activity of psychotherapy supervision should be swept up in the drive for uniformity. The managers amongst us want to regulate and institutionalize all aspects of practice. In opposition, many clinicians resist the relentless march toward the safety of uniformity travel alongside managerial imposition of regulations. Psychotherapy supervision's method of a close apprenticeship relationship between supervisor and trainee and its focus on the process and ethics of professional interaction stand at the humanistic core of what is otherwise becoming an increasingly mechanistic model of providing care to persons with mental illness. Our commentary picks up on these themes as it reviews the work by Mehrtens et al about strengthening awareness of liability in psychiatry residency training programs. We argue that the practice of psychiatry is overburdened by documentation requirements. In imposing further record-keeping on psychotherapy supervision, we lose much more than we gain. We recommend that the supervisory process focus on the characterological virtues essential to functioning as an ethical therapist. We also argue that self-protective rules place restraints on possibilities for imaginative insights and innovations in psychotherapy. © 2017 American Academy of Psychiatry and the Law.

  15. Semi-Supervised Classification for Fault Diagnosis in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Ma, Jian Ping; Jiang, Jin

    2014-01-01

    Pattern classification methods have become important tools for fault diagnosis in industrial systems. However, it is normally difficult to obtain reliable labeled data to train a supervised pattern classification model for applications in a nuclear power plant (NPP). However, unlabeled data easily become available through increased deployment of supervisory, control, and data acquisition (SCADA) systems. In this paper, a fault diagnosis scheme based on semi-supervised classification (SSC) method is developed with specific applications for NPP. In this scheme, newly measured plant data are treated as unlabeled data. They are integrated with selected labeled data to train a SSC model which is then used to estimate labels of the new data. Compared to exclusive supervised approaches, the proposed scheme requires significantly less number of labeled data to train a classifier. Furthermore, it is shown that higher degree of uncertainties in the labeled data can be tolerated. The developed scheme has been validated using the data generated from a desktop NPP simulator and also from a physical NPP simulator using a graph-based SSC algorithm. Two case studies have been used in the validation process. In the first case study, three faults have been simulated on the desktop simulator. These faults have all been classified successfully with only four labeled data points per fault case. In the second case, six types of fault are simulated on the physical NPP simulator. All faults have been successfully diagnosed. The results have demonstrated that SSC is a promising tool for fault diagnosis

  16. Governance structures impact on eHealth

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2015-01-01

    Background National eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark...... serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures. Methods A case study approach was used to gather a combination of primary...... and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied...

  17. Supervised and non-supervised Nordic walking in the treatment of chronic low back pain: a single blind randomized clinical trial

    Science.gov (United States)

    2010-01-01

    Background Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. Methods A total of 151 patients with low back and/or leg pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and 136 patients were randomized to receive A) Nordic walking supervised by a specially trained instructor twice a week for eight weeks B) One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C) Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter. Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers. Data were analyzed on an intention-to-treat basis. Results No mean differences were found between the three groups in relation to any of the outcomes

  18. Improving the potential of pixel-based supervised classification in ...

    African Journals Online (AJOL)

    The goal of this paper was to describe the impact of various parameters when applying a supervised Maximum Likelihood Classifier (MLC) to SPOT 5 image analysis in a remote savanna biome. Pair separation indicators and probability thresholds were used to analyse the effect of training area size and heterogeneity as ...

  19. The complexities of power in feminist multicultural psychotherapy supervision.

    Science.gov (United States)

    Arczynski, Alexis V; Morrow, Susan L

    2017-03-01

    The goal of the present study was to understand how current feminist multicultural supervisors understand and implement their feminist multicultural principles into clinical supervision. We addressed this aim by answering the following research question: How do self-identified feminist multicultural psychotherapy supervisors conceptualize and practice feminist supervision that is explicitly multicultural? The perspectives of 14 participant supervisors were obtained by using semistructured initial interviews, follow-up interviews, and feedback interviews and were investigated via a feminist constructivist grounded theory design and analysis. Most participants identified as counseling psychologists (n = 12), women (n = 11) and temporarily able-bodied (n = 11); but they identified with diverse racial/ethnic, sexual, spiritual/religious, generational, and nationality statuses. A 7-category empirical framework emerged that explained how the participants anticipated and managed power in supervision. The core category, the complexities of power in supervision, explained how participants conceptualized power in supervisory relationships. The 6 remaining categories were bringing history into the supervision room, creating trust through openness and honesty, using a collaborative process, meeting shifting developmental (a)symmetries, cultivating critical reflexivity, and looking at and counterbalancing the impact of context. Limitations of the study, implications for research, and suggestions to use the theoretical framework to transform supervisory practice and training are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Treatment-as-usual (TAU) is anything but usual: a meta-analysis of CBT versus TAU for anxiety and depression.

    Science.gov (United States)

    Watts, Sarah E; Turnell, Adrienne; Kladnitski, Natalie; Newby, Jill M; Andrews, Gavin

    2015-04-01

    There were three aims of this study, the first was to examine the efficacy of CBT versus treatment-as-usual (TAU) in the treatment of anxiety and depressive disorders, the second was to examine how TAU is defined in TAU control groups for those disorders, and the third was to explore whether the type of TAU condition influences the estimate of effects of CBT. A systematic search of Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL was conducted. 48 studies of CBT for depressive or anxiety disorders (n=6926) that specified that their control group received TAU were identified. Most (n=45/48) provided an explanation of the TAU group however there was significant heterogeneity amongst TAU conditions. The meta-analysis showed medium effects favoring CBT over TAU for both anxiety (g=0.69, 95% CI 0.47-0.92, pCBT is superior to TAU and the size of the effect of CBT compared to TAU depends on the nature of the TAU condition. The term TAU is used in different ways and should be more precisely described. The four key details to be reported can be thought of as "who, what, how many, and any additional treatments?" Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Reviewing education and training for governance and active citizenship in Europe. A central and eastern European perspective. The implications of the research for Central and Eastern European policy design on active citizenship and governance

    NARCIS (Netherlands)

    Chioncel, N.E.; Jansen, T.J.M.

    2004-01-01

    The RE-ETGACE Project, "Reviewing Education and Training for Governance and Active Citizenship in Europe - A Central and Eastern European Perspective" is a complementary measure to the original ETGACE Project "Education and Training for Governance and Active Citizenship in Europe". The ETGAGE

  2. Reviewing education and training for governance and active citizenship in Europe : a Central and Eastern European perspective : the implications of the research for Central and Eastern European policy design on active citizenship and governance

    NARCIS (Netherlands)

    Chioncel, Nicoleta; Jansen, Theo

    2004-01-01

    The RE-ETGACE Project, 'Reviewing Education and Training for Governance and Active Citizenship in Europe - A Central and Eastern European Perspective' is a complementary measure to the original ETGACE Project 'Education and Training for Governance and Active Citizenship in Europe'. The ETGAGE

  3. Future of European Financial Supervision, Towards a European System of Financial Supervisors

    NARCIS (Netherlands)

    Arons, T.M.C.

    The 2008 financial crisis made clear the shortcomings in the European structure of financial supervision. In the cur­rent system of financial supervision the financial supervi­sor of the home Member State is in principle the only autho­rity entitled to supervise financial institutions even in case

  4. Mental health nursing and the problematic of supervision as a confessional act.

    Science.gov (United States)

    Banks, D; Clifton, A V; Purdy, M J; Crawshaw, P

    2013-09-01

    Mental health nurses frequently draw on self-disclosure practices within their working relationships. These 'confessional' acts can in turn be predicated on traditional assumptions of moral authority exercised by more senior colleagues. More broadly, attention has been drawn to the increasing significance of 'technologies of the self' inside neo-liberal regimes of governance. Through various forms of self-disclosure people are obliged 'to speak the truth about themselves'. By publically declaring themselves as 'fit for purpose' nurses are required to be reflexive, self-monitoring individuals, capable of constructing their own identities and biographies, and guided by expert knowledges. In this way, risk becomes a form of governance, as the individuals continually find themselves balancing risks and opportunities. Foucault's insights into the importance of 'care of the self' and 'surveillance of the self' to systems of social order and governance, such as mental health services, are significant in identifying nursing as a potential form of confessional practice. 'Reflective practice' and 'clinical supervision' are therefore 'technologies', functioning as 'modes of surveillance', and as 'confessional practices'. So 'clinical supervision' may be understood as part of a process of 'governance' that does not necessarily empower nurses, but can act to guide, correct and modify ways in which they conduct themselves. © 2012 John Wiley & Sons Ltd.

  5. Supervised Cross-Modal Factor Analysis for Multiple Modal Data Classification

    KAUST Repository

    Wang, Jingbin; Zhou, Yihua; Duan, Kanghong; Wang, Jim Jing-Yan; Bensmail, Halima

    2015-01-01

    . In this paper, we improve CFA by incorporating the supervision information to represent and classify both image and text modals of documents. We project both image and text data to a shared data space by factor analysis, and then train a class label predictor

  6. A supervised contextual classifier based on a region-growth algorithm

    DEFF Research Database (Denmark)

    Lira, Jorge; Maletti, Gabriela Mariel

    2002-01-01

    A supervised classification scheme to segment optical multi-spectral images has been developed. In this classifier, an automated region-growth algorithm delineates the training sets. This algorithm handles three parameters: an initial pixel seed, a window size and a threshold for each class. A su...

  7. Narrative Changes Predict a Decrease in Symptoms in CBT for Depression: An Exploratory Study.

    Science.gov (United States)

    Gonçalves, Miguel M; Silva, Joana Ribeiro; Mendes, Inês; Rosa, Catarina; Ribeiro, António P; Batista, João; Sousa, Inês; Fernandes, Carlos F

    2017-07-01

    Innovative moments (IMs) are new and more adjusted ways of thinking, acting, feeling and relating that emerge during psychotherapy. Previous research on IMs has provided sustainable evidence that IMs differentiate recovered from unchanged psychotherapy cases. However, studies with cognitive behavioural therapy (CBT) are so far absent. The present study tests whether IMs can be reliably identified in CBT and examines if IMs and symptoms' improvement are associated. The following variables were assessed in each session from a sample of six cases of CBT for depression (a total of 111 sessions): (a) symptomatology outcomes (Outcome Questionnaire-OQ-10) and (b) IMs. Two hierarchical linear models were used: one to test whether IMs predicted a symptom decrease in the next session and a second one to test whether symptoms in one session predicted the emergence of IMs in the next session. Innovative moments were better predictors of symptom decrease than the reverse. A higher proportion of a specific type of IMs-reflection 2-in one session predicted a decrease in symptoms in the next session. Thus, when clients further elaborated this type of IM (in which clients describe positive contrasts or elaborate on changes processes), a reduction in symptoms was observed in the next session. A higher expression and elaboration of reflection 2 IMs appear to have a facilitative function in the reduction of depressive symptoms in this sample of CBT. Copyright © 2016 John Wiley & Sons, Ltd. Elaborating innovative moments (IMs) that are new ways of thinking, feeling, behaving and relating, in the therapeutic dialogue, may facilitate change. IMs that are more predictive of amelioration of symptoms in CBT are the ones focused on contrasts between former problematic patterns and new adjusted ones; and the ones in which the clients elaborate on processes of change. Therapists may integrate these kinds of questions (centred on contrasts and centred on what allowed change from the client

  8. Fast and robust segmentation of white blood cell images by self-supervised learning.

    Science.gov (United States)

    Zheng, Xin; Wang, Yong; Wang, Guoyou; Liu, Jianguo

    2018-04-01

    A fast and accurate white blood cell (WBC) segmentation remains a challenging task, as different WBCs vary significantly in color and shape due to cell type differences, staining technique variations and the adhesion between the WBC and red blood cells. In this paper, a self-supervised learning approach, consisting of unsupervised initial segmentation and supervised segmentation refinement, is presented. The first module extracts the overall foreground region from the cell image by K-means clustering, and then generates a coarse WBC region by touching-cell splitting based on concavity analysis. The second module further uses the coarse segmentation result of the first module as automatic labels to actively train a support vector machine (SVM) classifier. Then, the trained SVM classifier is further used to classify each pixel of the image and achieve a more accurate segmentation result. To improve its segmentation accuracy, median color features representing the topological structure and a new weak edge enhancement operator (WEEO) handling fuzzy boundary are introduced. To further reduce its time cost, an efficient cluster sampling strategy is also proposed. We tested the proposed approach with two blood cell image datasets obtained under various imaging and staining conditions. The experiment results show that our approach has a superior performance of accuracy and time cost on both datasets. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Instructional Supervision and Its Relationship with Professional Development: Perception of Private and Government Secondary School Teachers in Addis Ababa

    Science.gov (United States)

    Tesfaw, T. A.; Hofman, R. H.

    2012-01-01

    (Purpose) The purpose of this study is to examine the existing perceptions and preferences of teachers toward instructional supervision, more specifically on the actual and ideal use of selected instructional supervisory approaches (such as clinical supervision, peer coaching, cognitive coaching, mentoring, reflective coaching, teaching…

  10. Feasibility, Acceptability and Preliminary Treatment Outcomes in a School-Based CBT Intervention Program for Adolescents with ASD and Anxiety in Singapore

    Science.gov (United States)

    Drmic, Irene E.; Aljunied, Mariam; Reaven, Judy

    2017-01-01

    Adolescents with autism spectrum disorder (ASD) are at high risk for anxiety difficulties and disorders. Clinic-based cognitive behavioral therapy (CBT) is effective; however, few published school-based CBT programs for youth with ASD exist. In this study, the Facing Your Fears CBT protocol was adapted for delivery and piloted within a school…

  11. An examination of a reciprocal relationship between network governance and network structure

    DEFF Research Database (Denmark)

    Bergenholtz, Carsten; Goduscheit, René Chester

    The present article examines the network structure and governance of inter-organisational innovation networks. Network governance refers to the issue of how to manage and coordinate the relational activities and processes in the network while research on network structure deals with the overall...... structural relations between the actors in the network. These streams of research do contain references to each other but mostly rely on a static conception of the relationship between network structure and the applied network governance. The paper is based on a primarily qualitative case study of a loosely...... coupled Danish inter-organisational innovation network. The proposition is that a reciprocal relation between network governance and network structure can be identified....

  12. Exploring the role of parent training in the treatment of childhood anxiety.

    Science.gov (United States)

    Khanna, Muniya S; Kendall, Philip C

    2009-10-01

    Data from a randomized clinical trial comparing the relative efficacy of individual cognitive-behavioral therapy (ICBT), family CBT (FCBT), and a family-based education/support/attention control (FESA) condition were used to examine associations between in-session therapeutic techniques related to parent training (PT) and treatment outcomes. This study explored the extent to which therapists' use of PT techniques, specifically (a) parental anxiety management, (b) transfer of control from therapist to parent to child over child's coping, (c) communication skills training, and (d) contingency management training, contributed to treatment outcome in family-based CBT. Children (N = 53; 31 males; 7.8-13.8 years of age; M = 10.1 years, SD = 2.3; 85% Caucasian, 9% African American, 4% Asian, 2% "other" background) with a principal anxiety disorder completed 16 sessions of CBT with their parents. The relative contributions of PT components on treatment outcome were evaluated. As hypothesized, both transfer-of-control and parental anxiety management techniques significantly contributed to improvement on clinician and parent ratings of child global functioning within FCBT. PT did not significantly contribute to improvement on measures of child anxiety. These preliminary findings suggest that when FCBT is conducted for child anxiety, PT (i.e., transfer-of-control and parental anxiety management techniques) may contribute to improvements in the child's global functioning. (c) 2009 APA, all rights reserved.

  13. Webly-Supervised Fine-Grained Visual Categorization via Deep Domain Adaptation.

    Science.gov (United States)

    Xu, Zhe; Huang, Shaoli; Zhang, Ya; Tao, Dacheng

    2018-05-01

    Learning visual representations from web data has recently attracted attention for object recognition. Previous studies have mainly focused on overcoming label noise and data bias and have shown promising results by learning directly from web data. However, we argue that it might be better to transfer knowledge from existing human labeling resources to improve performance at nearly no additional cost. In this paper, we propose a new semi-supervised method for learning via web data. Our method has the unique design of exploiting strong supervision, i.e., in addition to standard image-level labels, our method also utilizes detailed annotations including object bounding boxes and part landmarks. By transferring as much knowledge as possible from existing strongly supervised datasets to weakly supervised web images, our method can benefit from sophisticated object recognition algorithms and overcome several typical problems found in webly-supervised learning. We consider the problem of fine-grained visual categorization, in which existing training resources are scarce, as our main research objective. Comprehensive experimentation and extensive analysis demonstrate encouraging performance of the proposed approach, which, at the same time, delivers a new pipeline for fine-grained visual categorization that is likely to be highly effective for real-world applications.

  14. A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder.

    Science.gov (United States)

    Marsden, Zoe; Lovell, Karina; Blore, David; Ali, Shehzad; Delgadillo, Jaime

    2018-01-01

    This study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention. This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive-compulsive scale was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi-square tests. Effect size was examined using Cohen's d and multilevel modelling. Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale-Brown obsessive-compulsive scale severity post-treatment (d = -0.24, p = .38) or at 6 months follow-up (d = -0.03, p = .90). EMDR and CBT had comparable completion rates and clinical outcomes. Copyright © 2017 John Wiley & Sons, Ltd.

  15. A paediatric cardiopulmonary resuscitation training project in Honduras.

    Science.gov (United States)

    Urbano, Javier; Matamoros, Martha M; López-Herce, Jesús; Carrillo, Angel P; Ordóñez, Flora; Moral, Ramón; Mencía, Santiago

    2010-04-01

    It is possible that the exportation of North American and European models has hindered the creation of a structured cardiopulmonary resuscitation (CPR) training programme in developing countries. The objective of this paper is to describe the design and present the results of a European paediatric and neonatal CPR training programme adapted to Honduras. A paediatric CPR training project was set up in Honduras with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The programme was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. During the first phase, 24 Honduran doctors from paediatric intensive care, paediatric emergency and anaesthesiology departments attended the paediatric CPR course and 16 of them the course for preparation as instructors. The Honduran Paediatric and Neonatal CPR Group was formed. In the second phase, workshops were given by Honduran instructors and four of them attended a CPR course in Spain as trainee instructors. In the third phase, a CPR course was given in Honduras by the Honduran instructors, supervised by the Spanish team. In the final phase of independent teaching, eight courses were given, providing 177 students with training in CPR. The training of independent paediatric CPR groups with the collaboration and scientific assessment of an expert group could be a suitable model on which to base paediatric CPR training in Latin American developing countries. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  16. The effect of adding Coping Power Program-Sweden to Parent Management Training-effects and moderators in a randomized controlled trial.

    Science.gov (United States)

    Helander, Maria; Lochman, John; Högström, Jens; Ljótsson, Brjánn; Hellner, Clara; Enebrink, Pia

    2018-04-01

    For children with oppositional defiant disorder (ODD), Parent Management Training (PMT) is a recommended treatment in addition to child Cognitive Behavioral Therapy (child-CBT). There is however a lack of studies investigating the additive effect of group-based child-CBT to PMT for children between 8 and 12 years. The current study investigated the incremental effect of group-based child-CBT, based on the Coping Power Program, when added to the Swedish group-based PMT program KOMET. Outcomes were child behavior problems, child prosocial behavior, parenting skills and the moderating effect of child characteristics. One hundred and twenty children 8-12 years with ODD or Disruptive Behavioral Disorder NOS and their parents were randomized either to combined child-CBT and PMT (n = 63) or to PMT only (n = 57) in Swedish Child- and Adolescent Psychiatric settings. Participants were assessed pre- and post-treatment using semi-structured interviews and child- and parent ratings. After treatment, behavior problems were reduced in both groups. Prosocial behavior were significantly more improved in the combined treatment. Parenting skills were improved in both groups. In moderator analyses, behavior problems and prosocial behavior improved significantly more in the combined treatment compared to PMT only in the group of children with high levels of ODD symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Evaluation and impact of cardiotocography training programmes: a systematic review.

    Science.gov (United States)

    Pehrson, C; Sorensen, J L; Amer-Wåhlin, I

    2011-07-01

    The interpretation and management of cardiotocography (CTG) tracings are often criticised in obstetric malpractice cases. As a consequence, regular CTG training has been recommended, even though little is known about the effect of CTG training. To perform a systematic review of the existing literature on studies on CTG training in order to assess educational strategies, evaluation of training programmes, and impact of training programmes. The Medline database was searched to identify studies describing and/or evaluating CTG training programmes. The literature search resulted in 409 citations. Twenty studies describing and evaluating CTG training programmes were included. There was no restriction on study design. Data regarding study design, study quality, educational strategies used for training in CTG interpretation and decision making, target groups, number of participants, methods used for evaluation, quality of evaluation, level of evaluation and results of training was extracted from 20 articles, and analysed using Kirkpatrick's four-level model for the evaluation of education. Training was associated with improvements on all Kirkpatrick levels, resulting in increased CTG knowledge and interpretive skills, higher interobserver agreement, better management of intrapartum CTG, and improved quality of care. Computer-based training (CBT) might be less time-consuming than classroom teaching. Clinical skills seem to decrease faster than theoretical knowledge. Training can improve CTG competence and clinical practise. Further research on CBT, test-enhanced learning and long-term retention, evaluation of training and impact on clinical outcomes is recommended. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  18. How e-learning contributes to corporation competitiveness

    International Nuclear Information System (INIS)

    Ceclan, Mihai; Ionescu, Tudor Basarab; Ceclan, Rodica Elena

    2006-01-01

    This paper aims at presenting an original Computer Based Training (CBT) System (or e- Learning system) and the way to use CBT technology to increase corporate competitiveness. Our solution is called CBTCenter and it is a complete software platform which offers a variety of teaching and learning services to its users. CBT or e-Learning mean two things: a software platform and content authoring. Ideally, a software platform should be able to import any type of flat documentation and integrate it into a structured database which keeps track of pedagogically meaningful information (test and quiz results, etc.). CBT technology was successfully implemented at the Training Department of NPP Cernavoda. CBT technology has brought several advantages: - the technology improves overall communication between all individuals which are part of the educational process - students can access training materials from their own desk using the NPP intranet - the logistics problem decreased, while more and more classic disciplines (courses) will be converted to CBT objects. On the other hand the paper is focused on using CBT technology (e-Learning) as a tool for corporate competitiveness increasing. This comes a reality by ICT (Information and Communication Technology) integration in corporate learning environment

  19. China's Insurance Regulatory Reform, Corporate Governance Behavior and Insurers' Governance Effectiveness.

    Science.gov (United States)

    Li, Huicong; Zhang, Hongliang; Tsai, Sang-Bing; Qiu, Aichao

    2017-10-17

    External regulation is an important mechanism to improve corporate behavior in emerging markets. China's insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a sample of 85 firms during 2010-2011, which was obtained by providing a questionnaire to all of China's shareholding insurance companies. The empirical study results generally show that China's insurance governance effectiveness has significantly improved through strict regulation. Insurance corporate governance can improve business acumen and risk-control ability, but no significant evidence was found to prove its influence on profitability, as a result of focusing less attention on governance than on management. State ownership is associated with higher corporate governance effectiveness than non-state ownership. Listed companies tend to outperform non-listed firms, and life insurance corporate governance is more effective than that of property insurers. This study not only contributes to the comprehensive understanding of corporate governance effectiveness but also to the literature by highlighting the effect of corporate governance regulation in China's insurance industry and other emerging economies of the financial sector.

  20. Metacognitive therapy versus disorder-specific CBT for comorbid anxiety disorders: A randomized controlled trial.

    Science.gov (United States)

    Johnson, Sverre Urnes; Hoffart, Asle; Nordahl, Hans M; Wampold, Bruce E

    2017-08-01

    Few studies have compared the effects of Metacognitive therapy (MCT) and Cognitive behavioral therapy (CBT) for comorbid anxiety disorders. In the current study we compared CBT and MCT for heterogeneous anxiety disorders in a residential setting. Ninety patients with a primary diagnosis of Post Traumatic Stress Disorder, Social Phobia or Panic disorder, with and without Agoraphobia, were randomized to either CBT or MCT. Patients were assessed at pre-treatment, post-treatment and one-year follow-up. Primary outcome measures were Beck Anxiety Inventory and ADIS IV and secondary outcome measures were SCID II, Beck Depression Inventory, Penn State Worry Questionnaire, The Symptom Checklist-90 and the Inventory of Interpersonal Problems-64. Treatment fidelity was satisfactory and therapist credibility was equal in both treatments. There was a significant difference in the level of anxiety favouring MCT at post-treatment (d=0.7), but there were no differences at one-year follow-up, mainly due to a further improvement in the CBT group during the follow-up period. Both treatments were efficacious. No differences in effect on comorbid diagnoses and symptoms were found, but MCT produced larger change in personality problems. MCT seems to have a more rapid effect on anxiety symptoms, but there were no significant differences in the long term for patients with comorbid anxiety disorders. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.