WorldWideScience

Sample records for integration therapy program

  1. Integrating Therapy Dog Teams in a Physical Activity Program for Children with Autism Spectrum Disorders

    Science.gov (United States)

    Obrusnikova, Iva; Bibik, Janice M.; Cavalier, Albert R.; Manley, Kyle

    2012-01-01

    The use of therapy-dog teams in programs for children with disabilities is becoming increasingly popular in school and therapeutic settings and has been shown to provide physical, social, and emotional benefits for the children. This article describes the basic steps for implementing therapy dog-assisted activities in physical activity programs…

  2. [The IPT integrative program of psychological therapy for schizophrenia patients: new perspectives].

    Science.gov (United States)

    Pomini, Valentino

    2004-04-01

    The integrated psychological treatment for schizophrenic patients IPT is composed by six modules that can be implemented either separately or in an articulated way. In that case, the treatment begins with a cognitive remediation phase which is followed by a social skills training phase. In the first phase, exercises specifically focalize on selective attention, memory, logical reasoning, perception and communication skills. The second phase of the program offers three other modules that train other skills: 1) social skills, 2) emotional management, 3) interpersonal problem solving. The IPT program belong to the so called second generation of social skills training programmes. It has been validated by numerous controlled studies, either in its complete form or in partial forms containing only one ore more of its sub-programmes. The results of these studies are globally positive. They show that IPT is an interesting therapeutic contribution for the rehabilitation practice with schizophrenic patients. A third generation of social skills training has been elaborated on the basis of the current IPT program. These new adjunctions to the IPT tend to favour the utilization in the real life of the competencies trained in the sessions, either by adding specific homeworks, in-vivo or booster sessions, or by designating new programmes directed to specific rehabilitation objectives, such as the integration in a apartment, the management of leisure times or the return to a workplace. These new programmes have been studied. They are promising and seem to be a useful complement to the original IPT.

  3. Integrating spirituality into a group psychological therapy program for cancer patients.

    Science.gov (United States)

    Cunningham, Alastair J

    2005-06-01

    Although the importance of spiritual issues to people with cancer is by now widely acknowledged, there has been almost no research on the value of interventions specifically designed to enhance the spiritual experience of these patients. The present report describes an exploratory study on the effects of a brief psychoeducational course emphasizing spiritual aspects of coping and healing. Ninety-seven patients with various types and stages of cancer took part in the 8-session course as the third stage in a progressive, stepwise program of support and psychological education. Standard psychometric tests were administered at entry, 8 weeks, and 6 months. Written home assignments, returned by participants, provided an insight into their experience. Significant improvements in scores were found immediately following the intervention; by 6 months, however, these improvements above entry level had declined to about half the 8-week value. In their written homework, patients grappled with such issues as doubts about the existence of a god, judgment and forgiveness, guilt, projection, self-importance, and the meaning of love. As the course progressed, many claimed to be better able to accept their condition and to experience an enhanced sense of meaning in their lives, coupled with a heightened appreciation for the events of everyday life and less tendency to conflict with others. These preliminary findings indicate that further, more rigorous investigation would be worthwhile and support the growing view that addressing spiritual issues within the framework of group therapy can be of great benefit to people with cancer.

  4. Integrating Spanish language training across a Doctor of Physical Therapy curriculum: a case report of one program's evolving model.

    Science.gov (United States)

    Pechak, Celia; Diaz, Deborah; Dillon, Loretta

    2014-12-01

    As the Hispanic population continues to expand in the United States, health professionals increasingly may encounter people who speak Spanish and have limited English proficiency. Responding to these changes, various health profession educators have incorporated Spanish language training into their curricula. Of 12 doctor of physical therapy (DPT) programs identified as including elective or required Spanish courses, the program at The University of Texas at El Paso is the only one integrating required Spanish language training across the curriculum. The purpose of this case report is to describe the development, implementation, and preliminary outcomes of the evolving educational model at The University of Texas at El Paso. The University of Texas at El Paso is situated immediately across the border from Mexico. Responding to the large population with limited English proficiency in the community, faculty began to integrate required Spanish language training during a transition from a master-level to a DPT curriculum. The Spanish language curriculum pillar includes a Spanish medical terminology course, language learning opportunities threaded throughout the clinical courses, clinical education courses, and service-learning. Forty-five DPT students have completed the curriculum. Assessment methods were limited for early cohorts. Clinically relevant Spanish verbal proficiency was assessed with a practical examination in the Spanish course, a clinical instructor-rated instrument, and student feedback. Preliminary data suggested that the model is improving Spanish language proficiency. The model still is evolving. Spanish language learning opportunities in the curriculum are being expanded. Also, problems with the clinical outcome measure have been recognized. Better definition of intended outcomes and validation of a revised tool are needed. This report should promote opportunities for collaboration with others who are interested in linguistic competence. © 2014

  5. Complementary and Integrative Therapies

    Science.gov (United States)

    ... include: • Acupressure and acupuncture • Aromatherapy • Art therapy and music therapy • Chiropractic medicine and massage • Guided imagery • Meditation and ... should I avoid? • Is this complementary therapy (name therapy) safe? Is there research showing it is safe? • Are there side effects ...

  6. State Program Integrity Reviews

    Data.gov (United States)

    U.S. Department of Health & Human Services — State program integrity reviews play a critical role in how CMS provides effective support and assistance to states in their efforts to combat provider fraud and...

  7. Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Morris Meg E

    2012-07-01

    Full Text Available Abstract Background The high incidence of falls associated with Parkinson’s disease (PD increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated. Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education or a home-based life skills program (control intervention. Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined. Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD. Trial registration The trial is registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12608000390381.

  8. Integral Fast Reactor Program

    International Nuclear Information System (INIS)

    Chang, Y.I.; Walters, L.C.; Laidler, J.J.; Pedersen, D.R.; Wade, D.C.; Lineberry, M.J.

    1993-06-01

    This report summarizes highlights of the technical progress made in the Integral Fast Reactor (IFR) Program in FY 1992. Technical accomplishments are presented in the following areas of the IFR technology development activities: (1) metal fuel performance, (2) pyroprocess development, (3) safety experiments and analyses, (4) core design development, (5) fuel cycle demonstration, and (6) LMR technology R ampersand D

  9. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

    Science.gov (United States)

    Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

    2015-05-01

    The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  10. Integrating community pharmacy into community based anti-retroviral therapy program: A pilot implementation in Abuja, Nigeria.

    Directory of Open Access Journals (Sweden)

    Yohanna Kambai Avong

    Full Text Available The landscape of Human Immunodeficiency Virus (HIV epidemic control is shifting with the United Nations Programme on HIV/AIDS (UNAIDS 90-90-90 benchmarks for epidemic control. Community-based Antiretroviral Therapy (CART models have improved treatment uptake and demonstrated good clinical outcomes. We assessed the feasibility of integrating community pharmacy as a task shift structure for differentiated community ART in Abuja-Nigeria.Stable patients on first line ART regimens from public health facilities were referred to community pharmacies in different locations within the Federal Capital Territory, Abuja for prescription refills and treatment maintenance. Bio-demographic and clinical data were collected from February 25, 2016 to May 31st, 2017 and descriptive statistics analysis applied. The outcomes of measure were prescription refill and patient retention in care at the community pharmacy.Almost 10% of stable patients on treatment were successfully devolved from eight health facilities to ten community pharmacies. Median age of the participants was 35 years [interquartile range (IQR; 30, 41] with married women in the majority. Prescription refill was 100% and almost all the participants (99.3% were retained in care after they were devolved to the community pharmacies. Only one participant was lost-to-follow-up as a result of death.Excellent prescription refill and high retention in care with very low loss-to-follow-up were associated with the community pharmacy model. The use of community pharmacy for community ART is feasible in Nigeria. We recommend the scale up of the model in all the 36 states of Nigeria.

  11. Integrated data base program

    International Nuclear Information System (INIS)

    Notz, K.J.

    1981-01-01

    The IDB Program provides direct support to the DOE Nuclear Waste Management and Fuel Cycle Programs and their lead sites and support contractors by providing and maintaining a current, integrated data base of spent fuel and radioactive waste inventories and projections. All major waste types (HLW, TRU, and LLW) and sources (government, commerical fuel cycle, and I/I) are included. A major data compilation was issued in September, 1981: Spent Fuel and Radioactive Waste Inventories and Projections as of December 31, 1980, DOE/NE-0017. This report includes chapters on Spent Fuel, HLW, TRU Waste, LLW, Remedial Action Waste, Active Uranium Mill Tailings, and Airborne Waste, plus Appendices with more detailed data in selected areas such as isotopics, radioactivity, thermal power, projections, and land usage. The LLW sections include volumes, radioactivity, thermal power, current inventories, projected inventories and characteristics, source terms, land requirements, and a breakdown in terms of government/commercial and defense/fuel cycle/I and I

  12. Integrated therapy safety management system.

    Science.gov (United States)

    Podtschaske, Beatrice; Fuchs, Daniela; Friesdorf, Wolfgang

    2013-09-01

    The aim is to demonstrate the benefit of the medico-ergonomic approach for the redesign of clinical work systems. Based on the six layer model, a concept for an 'integrated therapy safety management' is drafted. This concept could serve as a basis to improve resilience. The concept is developed through a concept-based approach. The state of the art of safety and complexity research in human factors and ergonomics forms the basis. The findings are synthesized to a concept for 'integrated therapy safety management'. The concept is applied by way of example for the 'medication process' to demonstrate its practical implementation. The 'integrated therapy safety management' is drafted in accordance with the six layer model. This model supports a detailed description of specific work tasks, the corresponding responsibilities and related workflows at different layers by using the concept of 'bridge managers'. 'Bridge managers' anticipate potential errors and monitor the controlled system continuously. If disruptions or disturbances occur, they respond with corrective actions which ensure that no harm results and they initiate preventive measures for future procedures. The concept demonstrates that in a complex work system, the human factor is the key element and final authority to cope with the residual complexity. The expertise of the 'bridge managers' and the recursive hierarchical structure results in highly adaptive clinical work systems and increases their resilience. The medico-ergonomic approach is a highly promising way of coping with two complexities. It offers a systematic framework for comprehensive analyses of clinical work systems and promotes interdisciplinary collaboration. © 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.

  13. Integrated therapy safety management system

    Science.gov (United States)

    Podtschaske, Beatrice; Fuchs, Daniela; Friesdorf, Wolfgang

    2013-01-01

    Aims The aim is to demonstrate the benefit of the medico-ergonomic approach for the redesign of clinical work systems. Based on the six layer model, a concept for an ‘integrated therapy safety management’ is drafted. This concept could serve as a basis to improve resilience. Methods The concept is developed through a concept-based approach. The state of the art of safety and complexity research in human factors and ergonomics forms the basis. The findings are synthesized to a concept for ‘integrated therapy safety management’. The concept is applied by way of example for the ‘medication process’ to demonstrate its practical implementation. Results The ‘integrated therapy safety management’ is drafted in accordance with the six layer model. This model supports a detailed description of specific work tasks, the corresponding responsibilities and related workflows at different layers by using the concept of ‘bridge managers’. ‘Bridge managers’ anticipate potential errors and monitor the controlled system continuously. If disruptions or disturbances occur, they respond with corrective actions which ensure that no harm results and they initiate preventive measures for future procedures. The concept demonstrates that in a complex work system, the human factor is the key element and final authority to cope with the residual complexity. The expertise of the ‘bridge managers’ and the recursive hierarchical structure results in highly adaptive clinical work systems and increases their resilience. Conclusions The medico-ergonomic approach is a highly promising way of coping with two complexities. It offers a systematic framework for comprehensive analyses of clinical work systems and promotes interdisciplinary collaboration. PMID:24007448

  14. IMP - INTEGRATED MISSION PROGRAM

    Science.gov (United States)

    Dauro, V. A.

    1994-01-01

    IMP is a simulation language that is used to model missions around the Earth, Moon, Mars, or other planets. It has been used to model missions for the Saturn Program, Apollo Program, Space Transportation System, Space Exploration Initiative, and Space Station Freedom. IMP allows a user to control the mission being simulated through a large event/maneuver menu. Up to three spacecraft may be used: a main, a target and an observer. The simulation may begin at liftoff, suborbital, or orbital. IMP incorporates a Fehlberg seventh order, thirteen evaluation Runge-Kutta integrator with error and step-size control to numerically integrate the equations of motion. The user may choose oblate or spherical gravity for the central body (Earth, Mars, Moon or other) while a spherical model is used for the gravity of an additional perturbing body. Sun gravity and pressure and Moon gravity effects are user-selectable. Earth/Mars atmospheric effects can be included. The optimum thrust guidance parameters are calculated automatically. Events/maneuvers may involve many velocity changes, and these velocity changes may be impulsive or of finite duration. Aerobraking to orbit is also an option. Other simulation options include line-of-sight communication guidelines, a choice of propulsion systems, a soft landing on the Earth or Mars, and rendezvous with a target vehicle. The input/output is in metric units, with the exception of thrust and weight which are in English units. Input is read from the user's input file to minimize real-time keyboard input. Output includes vehicle state, orbital and guide parameters, event and total velocity changes, and propellant usage. The main output is to the user defined print file, but during execution, part of the input/output is also displayed on the screen. An included FORTRAN program, TEKPLOT, will display plots on the VDT as well as generating a graphic file suitable for output on most laser printers. The code is double precision. IMP is written in

  15. Sexual Health Education in Massage Therapy Programs: A Survey of Program Directors

    Science.gov (United States)

    Zamboni, Brian D.; Healey, Dale K.

    2016-01-01

    Massage therapy program directors completed an online survey to explore sexual education in massage therapy programs. The overall data suggest that program directors are supportive of sexual health education in the training of massage therapists and that such education is integrated into several aspects of their training programs. To enhance…

  16. Integrated maintenance program (IMP)

    International Nuclear Information System (INIS)

    Zemdegs, R.T.; Chout, Q.B.

    1998-01-01

    Approaches to the maintenance of nuclear power plants have undergone significant change in the past several decades. The traditional breakdown approach has been displaced by preventive (calendar-based) maintenance and more recently, by condition-based maintenance (CBM). This is largely driven by the fact that traditional maintenance programs, derived primarily from equipment vendor recommendations, are generally unsuccessful in controlling maintenance costs or equipment failures. Many advances in the maintenance field have taken place since the maintenance plans for Ontario Hydro's nuclear plants were initially established. Ontario Hydro nuclear plant operating costs can be substantially reduced and Incapability Factor improved with the application of modern maintenance processes and tools. Pickering is designated as the lead station for IMP. Of immediate concern is the fact that Pickering Nuclear Division has been experiencing a significant backlog of Operating Preventive Maintenance Callups. This backlog, over 2000, is unacceptable to both station management and the nuclear regulator, the Atomic Energy Control Board. In addition there are over 500 callups in various stages of revision (in hyperspace) without an adequate control nor reporting system to manage their completion. There is also considerable confusion about the classification of l icensing c allups, e.g. callups which are mandatory as a result of legal requirements. Furthermore the ineffectiveness of the Preventive Maintenance (PM) has been the subject of peer audits and Atomic Energy Control Board (AECB) findings over the past several years. The current preventive maintenance ratio PM2 /(PM+CM3) at Pickering ND is less than 20%, due to the current high load of equipment breakdown. This past summer, an Independent Integrated Performance Assessment (IIPA) review at Ontario Hydro confirmed these concerns. Over the past several years, Ontario Hydro nuclear staff have evaluated several programs to improve

  17. Integrated Financial Management Program

    Science.gov (United States)

    Pho, Susan

    2004-01-01

    Having worked in the Employees and Commercial Payments Branch of the Financial Management Division for the past 3 summers, I have seen the many changes that have occurred within the NASA organization. As I return each summer, I find that new programs and systems have been adapted to better serve the needs of the Center and of the Agency. The NASA Agency has transformed itself the past couple years with the implementation of the Integrated Financial Management Program (IFMP). IFMP is designed to allow the Agency to improve its management of its Financial, Physical, and Human Resources through the use of multiple enterprise module applications. With my mentor, Joseph Kan, being the branch chief of the Employees and Commercial Payments Branch, I have been exposed to several modules, such as Travel Manager, WebTads, and Core Financial/SAP, which were implemented in the last couple of years under the IFMP. The implementation of these agency-wide systems has sometimes proven to be troublesome. Prior to IFMP, each NASA Center utilizes their own systems for Payroll, Travel, Accounts Payable, etc. But with the implementation of the Integrated Financial Management Program, all the "legacy" systems had to be eliminated. As a result, a great deal of enhancement and preparation work is necessary to ease the transformation from the old systems to the new. All this work occurs simultaneously; for example, e-Payroll will "go live" in several months, but a system like Travel Manager will need to have information upgraded within the system to meet the requirements set by Headquarters. My assignments this summer have given me the opportunity to become involved with such work. So far, I have been given the opportunity to participate in projects resulting from a congressional request, several bankcard reconciliations, updating routing lists for Travel Manager, updating the majordomo list for Travel Manager approvers and point of contacts, and a NASA Headquarters project involving

  18. State Program Integrity Assessment (SPIA)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The State Program Integrity Assessment (SPIA) is the Centers for Medicare and Medicaid Services (CMS) first national data collection on state Medicaid program...

  19. SRS Tank Structural Integrity Program

    International Nuclear Information System (INIS)

    Maryak, Matthew

    2010-01-01

    The mission of the Structural Integrity Program is to ensure continued safe management and operation of the waste tanks for whatever period of time these tanks are required. Matthew Maryak provides an overview of the Structural Integrity Program to open Session 5 (Waste Storage and Tank Inspection) of the 2010 EM Waste Processing Technical Exchange.

  20. Integrating Research Competencies in Massage Therapy Education.

    Science.gov (United States)

    Hymel, Glenn M.

    The massage therapy profession is currently engaged in a competency-based education movement that includes an emphasis on promoting massage therapy research competencies (MTRCs). A systems-based model for integrating MTRCs into massage therapy education was therefore proposed. The model and an accompanying checklist describe an approach to…

  1. Integrative Music Therapy: A Healing Intervention.

    Science.gov (United States)

    Barnes, Thomas Bryan

    Music plays a significant role in the lives of individuals across the lifespan. Some healthcare providers may not appreciate music therapy and the positive benefits it can have on the environment, patients, caregivers, and healthcare staff. Integrative Music Therapy (IMT) has proven to be effective in multiple settings, offering therapy for behavioral, emotional, physiological, psychological, and psychosocial needs. IMT, performed by a trained, certified professional (MT-BC), does not seek to replace medication or other procedures, but works synergistically with provided healthcare.

  2. Steam generator tube integrity program

    International Nuclear Information System (INIS)

    Dierks, D.R.; Shack, W.J.; Muscara, J.

    1996-01-01

    A new research program on steam generator tubing degradation is being sponsored by the U.S. Nuclear Regulatory Commission (NRC) at Argonne National Laboratory. This program is intended to support a performance-based steam generator tube integrity rule. Critical areas addressed by the program include evaluation of the processes used for the in-service inspection of steam generator tubes and recommendations for improving the reliability and accuracy of inspections; validation and improvement of correlations for evaluating integrity and leakage of degraded steam generator tubes, and validation and improvement of correlations and models for predicting degradation in steam generator tubes as aging occurs. The studies will focus on mill-annealed Alloy 600 tubing, however, tests will also be performed on replacement materials such as thermally-treated Alloy 600 or 690. An overview of the technical work planned for the program is given

  3. An innovative art therapy program for cancer patients.

    Science.gov (United States)

    Deane, K; Fitch, M; Carman, M

    2000-01-01

    Art therapy is a healing art intended to integrate physical, emotional, and spiritual care by facilitating creative ways for patients to respond to their cancer experience. A new art therapy program was designed to provide cancer patients with opportunities to learn about the McMichael Canadian Art Collection and to explore personal feelings about their cancer experience through combined gallery and studio components. The role of the facilitator was to assist in the interpretation of a participant's drawing in order to reveal meaning in the art. This paper presents patients' perspectives about the new art therapy program. Content analysis of participant feedback provided information about the structure, process, and outcomes of the program. Evaluation of the art therapy/museum education program demonstrated many benefits for cancer patients including support, psychological strength, and new insights about their cancer experience.

  4. AN INTEGRATIVE GROUP PSYCHOTHERAPY PROGRAM FOR CHILDREN. THE WIZARDING SCHOOL

    Directory of Open Access Journals (Sweden)

    Oana Maria Popescu

    2012-02-01

    Full Text Available One of the most important tendencies in child psychotherapy is the integration of various psychotherapeutic approaches and technical interventions belonging to different orientations. Based on the Harry Potter stories, the „Wizarding School” structured group therapy program is a 12-step integratively oriented program applicable in personal development, individual and group therapy for children aged 6 to 13 (at present being adapted for adult psychotherapy. The program takes place within a fairy tale, being therefore a type of informal hypnotic trance. The interventions are drawn from the lessons described in Harry Potter’s story at Hogwarts, based on the fundamental principles of child psychotherapy and including elements of play therapy, art therapy, hypnotherapy, cognitive- behavioural therapy, transactional analysis, supportive therapy, family therapy and person centred therapy. From a theoretical point of view the program is based on elements from a number of psychotherapeutic approaches, the main concept being that we need to create a therapeutic myth that is acceptable to a child. The program is not suitable for children with structural deficits, who have difficulties in making the difference between fantasy and reality.

  5. Personal therapy for undergraduate music therapy students: a survey of AMTA program coordinators.

    Science.gov (United States)

    Gardstrom, Susan C; Jackson, Nancy A

    2011-01-01

    The primary purpose of this study was to gather information in order to understand if and how various modalities of personal therapy are employed with undergraduate music therapy students in the United States. AMTA degree program coordinators were asked about 3 therapy modalities, in particular: verbal therapy, music therapy, and expressive arts therapy (excluding music therapy). It was predicted that less than a quarter of the respondents would indicate that personal therapy of any modality was required in their undergraduate curricula, but that a larger percentage would indicate that it was encouraged. Both hypotheses were supported, with just over 14% of the respondents indicating that they require some form of personal therapy and 32% indicating that they encourage it, with 73% of this latter subgroup encouraging verbal therapy and 46% encouraging music therapy. It was further predicted that, when therapy was required or encouraged, it was most often provided by an individual who was associated with the college/university and that therapy was usually provided in a group format. Respondent comments related to these 2 questions revealed considerable confusion between experiential exercises and personal therapy, leading to dubious validity of some of the numerical data. Qualitative treatment of narrative responses illuminated 4 salient issues regarding personal therapy for undergraduate music therapy students, as follows: (a) the legal and ethical feasibility of making personal therapy a requirement; (b) the cost and availability of qualified professionals; (c) the benefits of personal therapy as an integral facet of undergraduate music therapy training and education; and (d) the appropriateness of personal therapy at the undergraduate level of training.

  6. Foreign energy conservation integrated programs

    International Nuclear Information System (INIS)

    Lisboa, Maria Luiza Viana; Bajay, Sergio Valdir

    1999-01-01

    The promotion of energy economy and efficiency is recognized as the single most cost-effective and least controversial component of any strategy of matching energy demand and supply with resource and environmental constraints. Historically such efficiency gains are not out of reach for the industrialized market economy countries, but are unlikely to be reached under present conditions by developing countries and economics in transition. The aim of the work was to analyze the main characteristics of United Kingdom, France, Japan, Canada, Australia and Denmark energy conservation integrated programs

  7. Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

    OpenAIRE

    Jennifer C. Reneker; Kyra Weems; Vincent Scaia

    2016-01-01

    This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at th...

  8. Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients with Eating Disorders

    Science.gov (United States)

    Federici, Anita; Wisniewski, Lucene; Ben-Porath, Denise

    2012-01-01

    The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well…

  9. Mixed wasted integrated program: Logic diagram

    International Nuclear Information System (INIS)

    Mayberry, J.; Stelle, S.; O'Brien, M.; Rudin, M.; Ferguson, J.; McFee, J.

    1994-01-01

    The Mixed Waste Integrated Program Logic Diagram was developed to provide technical alternative for mixed wastes projects for the Office of Technology Development's Mixed Waste Integrated Program (MWIP). Technical solutions in the areas of characterization, treatment, and disposal were matched to a select number of US Department of Energy (DOE) treatability groups represented by waste streams found in the Mixed Waste Inventory Report (MWIR)

  10. Hunter College Dance Therapy Masters Program.

    Science.gov (United States)

    Schmais, Claire; White, Elissa Q.

    Described is development of the Hunter College dance therapy 18-month 30-credit masters program involving 33 adult students, (in two classes beginning in 1971 and 1972), an educational model, internship in psychiatric institutions, and preparation of instructional materials. The dance therapist is said to incorporate the psychiatric patient's…

  11. Intensive integrated therapy of type 2 diabetes

    DEFF Research Database (Denmark)

    Gaede, Peter; Pedersen, Oluf

    2004-01-01

    The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial...... effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome...... of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy...

  12. Interpersonal, cognitive analytic and other integrative therapies versus other psychological therapies for depression

    OpenAIRE

    Hunot, Vivien; Moore, Theresa HM; Caldwell, Deborah; Davies, Philippa; Jones, Hannah; Lewis, Glyn; Churchill, Rachel

    2010-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all integrative therapies compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different integrative therapy models (IPT, CAT, psychodynamic-interpersonal therapy, CBASP, counselling) compared with all other psychological therapy approaches for acute depression.To examine the e...

  13. Boron neutron capture therapy: Brain Tumor Treatment Evaluation Program

    International Nuclear Information System (INIS)

    Griebenow, M.L.; Dorn, R.V. III; Gavin, P.R.; Spickard, J.H.

    1988-01-01

    The United States (US) Department of Energy (DOE) recently initiated a focused, multidisciplined program to evaluate Boron Neutron Capture Therapy (BNCT) for the treatment of brain tumors. The program, centered at the DOE/endash/Idaho National Engineering Laboratory (INEL), will develop the analytical, diagnostic and treatment tools, and the database required for BNCT technical assessment. The integrated technology will be evaluated in a spontaneously-occurring canine brain-tumor model. Successful animal studies are expected to lead to human clinical trials within four to five years. 2 refs., 3 figs

  14. State Program Integrity Review Reports List

    Data.gov (United States)

    U.S. Department of Health & Human Services — Comprehensive state program integrity (PI) review reports (and respective follow-up review reports) provide CMS assessment of the effectiveness of the states PI...

  15. Mixed wasted integrated program: Logic diagram

    Energy Technology Data Exchange (ETDEWEB)

    Mayberry, J.; Stelle, S. [Science Applications International Corp., Idaho Falls, ID (United States); O`Brien, M. [Univ. of Arizona, Tucson, AZ (United States); Rudin, M. [Univ. of Nevada, Las Vegas, NV (United States); Ferguson, J. [Lockheed Idaho Technologies Co., Idaho Falls, ID (United States); McFee, J. [I.T. Corp., Albuquerque, NM (United States)

    1994-11-30

    The Mixed Waste Integrated Program Logic Diagram was developed to provide technical alternative for mixed wastes projects for the Office of Technology Development`s Mixed Waste Integrated Program (MWIP). Technical solutions in the areas of characterization, treatment, and disposal were matched to a select number of US Department of Energy (DOE) treatability groups represented by waste streams found in the Mixed Waste Inventory Report (MWIR).

  16. Integral Ramjet Booster Demonstration Program

    Science.gov (United States)

    1975-02-01

    vibration loads before motor firing at -65, +70, and +1650F, (2) The chambers are fabricated from roll and welded ( TIG ) L-605 sheet that is cold...Typical Integral Booster Internal Configuration Keyhole Grain Pressure and Thrust Versus Time (+700F, Sea Level) Keyhole Grain Pressure and...Thrust Versus Time (+1650F, Sea Level) Keyhole Grain Pressure and Thrust Versus Time (-65^, Sea Level) Radial-Slot Grain Design Radial-Slot Grain

  17. Advances by the Integral Fast Reactor Program

    International Nuclear Information System (INIS)

    Lineberry, M.J.; Pedersen, D.R.; Walters, L.C.; Cahalan, J.E.

    1991-01-01

    The advances by the Integral Fast Reactor Program at Argonne National Laboratory are the subject of this paper. The Integral Fast Reactor (IFR) is an advanced liquid-metal-cooled reactor concept being developed at Argonne National Laboratory. The advances stressed in the paper include fuel irradiation performance, improved passive safety, and the development of a prototype fuel cycle facility. 14 refs

  18. Integrative Medicine and Complementary and Alternative Therapies

    Science.gov (United States)

    ... complementary therapies with your healthcare team: Are there complementary therapies that you would recommend? What research is available about this therapy’s safety and effectiveness? What are the benefits and risks of this ...

  19. Containment integrity research program plan

    International Nuclear Information System (INIS)

    1987-08-01

    This report presents a plan for research on the question of containment performance in postulated severe accident scenarios. It focuses on the research being performed by the Structural and Seismic Engineering Branch, Division of Engineering, Office of Nuclear Regulatory Research. Summaries of the plans for this work have previously been published in the ''Nuclear Power Plant Severe Accident Research Plan'' (NUREG-0900). This report provides an update to reflect current status. This plan provides a summary of results to date as well as an outline of planned activities and milestones to the contemplated completion of the program in FY 1989

  20. Characterization, Monitoring and Sensor Technology Integrated Program

    International Nuclear Information System (INIS)

    1993-01-01

    This booklet contains summary sheets that describe FY 1993 characterization, monitoring, and sensor technology (CMST) development projects. Currently, 32 projects are funded, 22 through the OTD Characterization, Monitoring, and Sensor Technology Integrated Program (CMST-IP), 8 through the OTD Program Research and Development Announcement (PRDA) activity managed by the Morgantown Energy Technology Center (METC), and 2 through Interagency Agreements (IAGs). This booklet is not inclusive of those CMST projects which are funded through Integrated Demonstrations (IDs) and other Integrated Programs (IPs). The projects are in six areas: Expedited Site Characterization; Contaminants in Soils and Groundwater; Geophysical and Hydrogeological Measurements; Mixed Wastes in Drums, Burial Grounds, and USTs; Remediation, D ampersand D, and Waste Process Monitoring; and Performance Specifications and Program Support. A task description, technology needs, accomplishments and technology transfer information is given for each project

  1. Integrative modeling of transcriptional regulation in response to antirheumatic therapy

    Directory of Open Access Journals (Sweden)

    Thiesen Hans-Juergen

    2009-08-01

    Full Text Available Abstract Background The investigation of gene regulatory networks is an important issue in molecular systems biology and significant progress has been made by combining different types of biological data. The purpose of this study was to characterize the transcriptional program induced by etanercept therapy in patients with rheumatoid arthritis (RA. Etanercept is known to reduce disease symptoms and progression in RA, but the underlying molecular mechanisms have not been fully elucidated. Results Using a DNA microarray dataset providing genome-wide expression profiles of 19 RA patients within the first week of therapy we identified significant transcriptional changes in 83 genes. Most of these genes are known to control the human body's immune response. A novel algorithm called TILAR was then applied to construct a linear network model of the genes' regulatory interactions. The inference method derives a model from the data based on the Least Angle Regression while incorporating DNA-binding site information. As a result we obtained a scale-free network that exhibits a self-regulating and highly parallel architecture, and reflects the pleiotropic immunological role of the therapeutic target TNF-alpha. Moreover, we could show that our integrative modeling strategy performs much better than algorithms using gene expression data alone. Conclusion We present TILAR, a method to deduce gene regulatory interactions from gene expression data by integrating information on transcription factor binding sites. The inferred network uncovers gene regulatory effects in response to etanercept and thus provides useful hypotheses about the drug's mechanisms of action.

  2. The Impact of a Therapy Dog Program on Children's Reading Skills and Attitudes toward Reading

    Science.gov (United States)

    Kirnan, Jean; Siminerio, Steven; Wong, Zachary

    2016-01-01

    An existing school program in which therapy dogs are integrated into the reading curriculum was analyzed to determine the effect on student reading. Previous literature suggests an improvement in both reading skills and attitudes towards reading when students read in the presence of a therapy dog. Using a mixed method model, the researchers…

  3. Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students' perceptions of geriatrics and geriatric education in the United States.

    Science.gov (United States)

    Reneker, Jennifer C; Weems, Kyra; Scaia, Vincent

    2016-01-01

    This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21-33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen's d values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15-0.30). Two perceptions of geriatric physical therapy demonstrated a significant positive increase (Pgeriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68) and enjoyment (d=1.96). Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

  4. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

    Science.gov (United States)

    Chen, Jia-Ching; Shaw, Fu-Zen

    2014-01-01

    Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into “a training package”, based on the patient’s functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients. PMID:25133141

  5. Strategies to teach alternative and complementary therapies in nursing: an integrative review

    Directory of Open Access Journals (Sweden)

    Natália Chantal Magalhães da Silva

    2013-12-01

    Full Text Available The lack of discussions that clarify the teaching of alternative and complementary therapies in undergraduate nursing programs shows the need for developing research on this topic. The objective of this study was to identify, in scientific literature, the strategies for teaching alternative and complementary therapies in nursing undergraduate programs. The guiding methodology used was integrative review. The search was performed on SCIENCE DIRECT, LILACS and MEDLINE databases. According to the articles included in this study, the proposals for including these therapies in the program are by: lectures, theoretical courses and discussion groups. However, studies should be conducted to confirm the efficacy of these strategies so these therapeutic methods can be included in the Pedagogical Political Project of the nursing undergraduate program, thus allowing for the consolidation of those practices. Descriptors: Education, Nursing; Education, Higher; Complementary Therapies.

  6. The Integrative Psychotherapy Alliance: Family, Couple and Individual Therapy Scales.

    Science.gov (United States)

    Pinsof, William M.; Catherall, Donald R.

    1986-01-01

    Presents an integrative definition of the therapeutic alliance that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this concept for therapy reserach are examined. Three new systematically oriented scales to measure the alliance are presented along with some preliminary data…

  7. 75 FR 34805 - Program Integrity Issues

    Science.gov (United States)

    2010-06-18

    ... Mathematics Access to Retain Talent Grant (National Smart Grant) Programs. DATES: We must receive your... Association of College and University Business Officers, representing business officers. Val Meyers, Michigan... identifying and handling test score abnormalities, ensuring the integrity of the testing environment, and...

  8. The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy.

    Science.gov (United States)

    Vatcher, C A; Bogo, M

    2001-01-01

    Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.

  9. Complementary and integrative therapies for lower urinary tract diseases.

    Science.gov (United States)

    Raditic, Donna M

    2015-07-01

    Consumer use of integrative health care is growing, but evidence-based research on its efficacy is limited. Research of veterinary lower urinary tract diseases could be translated to human medicine because veterinary patients are valuable translational models for human urinary tract infection and urolithiasis. An overview of complementary therapies for lower urinary tract disease includes cranberry supplements, mannose, oral probiotics, acupuncture, methionine, herbs, or herbal preparations. Therapies evaluated in dogs and cats, in vitro canine cells, and other relevant species, in vivo and in vitro, are presented for their potential use as integrative therapies for veterinary patients and/or translational research. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students’ perceptions of geriatrics and geriatric education in the United States

    Directory of Open Access Journals (Sweden)

    Jennifer C. Reneker

    2016-10-01

    Full Text Available This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT students, 21–33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen’s d-values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15–0.30. Two perceptions of geriatric physical therapy demonstrated a significant positive increase (P<0.05 with moderate effect sizes (d=0.47 and d=0.50. The students’ perceptions of geriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68 and enjoyment (d=1.96. Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

  11. Gestalt Therapy and Feminist Therapy: A Proposed Integration.

    Science.gov (United States)

    Enns, Carolyn Zerbe

    1987-01-01

    Offers a proposal for integrating the Gestalt goals of self-responsibility with a feminist perspective that places value on the web of relationships in women's lives and focuses attention on the environmental constraints and socialization that affect women's choices. Discusses Gestalt techniques for enhancing women's growth and examines…

  12. Integrated Data Base Program: a status report

    International Nuclear Information System (INIS)

    Notz, K.J.; Klein, J.A.

    1984-06-01

    The Integrated Data Base (IDB) Program provides official Department of Energy (DOE) data on spent fuel and radioactive waste inventories, projections, and characteristics. The accomplishments of FY 1983 are summarized for three broad areas: (1) upgrading and issuing of the annual report on spent fuel and radioactive waste inventories, projections, and characteristics, including ORIGEN2 applications and a quality assurance plan; (2) creation of a summary data file in user-friendly format for use on a personal computer and enhancing user access to program data; and (3) optimizing and documentation of the data handling methodology used by the IDB Program and providing direct support to other DOE programs and sites in data handling. Plans for future work in these three areas are outlined. 23 references, 11 figures

  13. Integral quality programs for radiodiagnostics Services

    International Nuclear Information System (INIS)

    Alastuey, F.; Barranco, C.; Marco, R.; Perez, C.; Sanchez, J.; Pardo, J.; Madrid, G.

    1993-01-01

    The aim of the work entitled ''Integral Quality Programs for Radiodiagnostics Services'' is to present the experience accumulated over the past 10 years by the Radiodiagnostics Service of C.M.E. Ramon y Cajal in Zaragoza. The term ''integral quality'' will be defined conceptually in order to differentiate it from the classical quality control which refers exclusively to the control of radiology equipment. The problem will be reviewed from the historical point of view and a basic, homologated model, contrasted on the basis of the work of these 10 years, is proposed mainly to serve as the backbone for the working system in a Radiodiagnostics Service. (Author) 46 ref

  14. Developing an integrated dam safety program

    International Nuclear Information System (INIS)

    Nielsen, N. M.; Lampa, J.

    1996-01-01

    An effort has been made to demonstrate that dam safety is an integral part of asset management which, when properly done, ensures that all objectives relating to safety and compliance, profitability, stakeholders' expectations and customer satisfaction, are achieved. The means to achieving this integration of the dam safety program and the level of effort required for each core function have been identified using the risk management approach to pinpoint vulnerabilities, and subsequently to focus priorities. The process is considered appropriate for any combination of numbers, sizes and uses of dams, and is designed to prevent exposure to unacceptable risks. 5 refs., 1 tab

  15. Impaired skin integrity related to radiation therapy

    International Nuclear Information System (INIS)

    Ratliff, C.

    1990-01-01

    Skin reactions associated with radiation therapy require frequent nursing assessment and intervention. Preventive interventions and early management can minimize the severity of the skin reaction. With the understanding of the pathogenesis of radiation skin reactions, the ET nurse can determine who is at risk and then implement preventive measures. Because radiation treatment is fractionated, skin reactions do not usually occur until midway through the course of therapy and will subside within a few weeks after completion of radiation. Many patients and their families still fear that radiation causes severe burns. Teaching and anticipatory guidance by the ET nurse is needed to assist patients and their families to overcome this fear, and to educate them on preventive skin care regimens

  16. Evidence-based music therapy practice: an integral understanding.

    Science.gov (United States)

    Abrams, Brian

    2010-01-01

    The American Music Therapy Association has recently put into action a plan called its Research Strategic Priority, with one of its central purposes to advance the music therapy field through research promoting Evidence-Based Practice of music therapy. The extant literature on music therapy practice, theory, and research conveys a range of very different perspectives on what may count as the "evidence" upon which practice is based. There is therefore a need to conceptualize evidence-based music therapy practice in a multifaceted, yet coherent and balanced way. The purpose of this paper is to illustrate a framework based upon four distinct epistemological perspectives on evidence-based music therapy practice that together represent an integral understanding.

  17. The integrated management for renal replacement therapy in Portugal.

    Science.gov (United States)

    Coelho, Anabela P; Sá, Helena O; Diniz, José A; Dussault, Gilles

    2014-01-01

    Portugal was the first European country to introduce an integrated management of end-stage renal disease (IM ESRD). This new program integrates various dialysis services and products, which are reimbursed at a fixed rate/patient/week called "comprehensive price payment." This initiative restructured the delivery of dialysis services, the monitoring of outcomes, and the funding of renal replacement therapy. This article described the implementation of a new model of comprehensive provision of hemodialysis (HD) services and aimed to assess its impact on dialysis care. Quality assessments and reports of patient satisfaction, produced by the Ministry of Health since 2008, as well as national registries and reports, provided the data for this review. Indicators of HD services in all continental facilities show positive results that have successively improved along the period of 2009-2011, in spite of an average annual growth of 3% of the population under HD treatment. Mortality rates for HD patients were 12.7%, 12%, and 11%, respectively in 2009, 2010, and 2011; annual hospitalization rates were 4.9%, 3.8%, and 4.4% for the same years; key performance indicators showed averages above the reference values such as hemoglobin, serum phosphorus, eKt/V, water quality, number of days of hospitalization per patient per year, and number of weekly dialysis sessions. The financing analysis of IM ESRD demonstrates a sustained control of global costs, without compromising quality. The IM ERSD program is an innovative and quality-driven approach that benefits both dialysis patients and providers, contributing toward the rationalization of service provision and the efficient use of resources. © 2013 International Society for Hemodialysis.

  18. Integrating Cybersecurity into the Program Management Organization

    Science.gov (United States)

    2015-05-13

    penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 13 MAY 2015 2...Threat to our National Economy DOD Cybersecurity Gaps Could Be Canary in Federal Acquisition Coal Mine Intangible Assets Create Vulnerabilities...operational approach integrates with current or planned CONOPS, BCP, information architecture, programs or initiatives Development  Approach to

  19. Gestalt Therapy with the Dying Patient: Integrative Work Using Clay, Poetry Therapy, and Creative Media.

    Science.gov (United States)

    Petzold, Hilarion G.

    1982-01-01

    Reports the use of death therapy with a cancer patient. Gestalt therapy and creative media were used to facilitate an integration of life and a sense of balance with life. Suggests that counseling the dying means walking along a stretch of the path together. (Author)

  20. Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs

    Science.gov (United States)

    Rait, Douglas Samuel

    2012-01-01

    Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…

  1. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Ruth Q. Wolever

    2015-01-01

    Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

  2. In Situ Remediation Integrated Program: FY 1994 program summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    The US Department of Energy (DOE) established the Office of Technology Development (EM-50) as an element of the Office of Environmental Management (EM) in November 1989. In an effort to focus resources and address priority needs, EM-50 introduced the concept of integrated programs (IPs) and integrated demonstrations (IDs). The In Situ Remediation Integrated Program (ISR IP) focuses research and development on the in-place treatment of contaminated environmental media, such as soil and groundwater, and the containment of contaminants to prevent the contaminants from spreading through the environment. Using in situ remediation technologies to clean up DOE sites minimizes adverse health effects on workers and the public by reducing contact exposure. The technologies also reduce cleanup costs by orders of magnitude. This report summarizes project work conducted in FY 1994 under the ISR IP in three major areas: treatment (bioremediation), treatment (physical/chemical), and containment technologies. Buried waste, contaminated soils and groundwater, and containerized waste are all candidates for in situ remediation. Contaminants include radioactive waste, volatile and nonvolatile organics, heavy metals, nitrates, and explosive materials.

  3. In Situ Remediation Integrated Program: FY 1994 program summary

    International Nuclear Information System (INIS)

    1995-04-01

    The US Department of Energy (DOE) established the Office of Technology Development (EM-50) as an element of the Office of Environmental Management (EM) in November 1989. In an effort to focus resources and address priority needs, EM-50 introduced the concept of integrated programs (IPs) and integrated demonstrations (IDs). The In Situ Remediation Integrated Program (ISR IP) focuses research and development on the in-place treatment of contaminated environmental media, such as soil and groundwater, and the containment of contaminants to prevent the contaminants from spreading through the environment. Using in situ remediation technologies to clean up DOE sites minimizes adverse health effects on workers and the public by reducing contact exposure. The technologies also reduce cleanup costs by orders of magnitude. This report summarizes project work conducted in FY 1994 under the ISR IP in three major areas: treatment (bioremediation), treatment (physical/chemical), and containment technologies. Buried waste, contaminated soils and groundwater, and containerized waste are all candidates for in situ remediation. Contaminants include radioactive waste, volatile and nonvolatile organics, heavy metals, nitrates, and explosive materials

  4. The Efficient Separations and Processing Integrated Program

    International Nuclear Information System (INIS)

    Kuhn, W.L.; Gephart, J.M.

    1994-08-01

    The Efficient Separations and Processing Integrated Program (ESPIP) was created in 1991 to identify, develop, and perfect separations technologies and processes to treat wastes and address environmental problems throughout the US Department of Energy (DOE) complex. The ESPIP funds several multiyear tasks that address high-priority waste remediation problems involving high-level, low-level, transuranic, hazardous, and mixed (radioactive and hazardous) wastes. The ESPIP supports applied R ampersand D leading to demonstration or use of these separations technologies by other organizations within DOE's Office of Environmental Restoration and Waste Management. Examples of current ESPIP-funded separations technologies are described here

  5. Concrete containment integrity program at EPRI

    International Nuclear Information System (INIS)

    Winkleblack, R.K.; Tang, Y.K.

    1984-01-01

    Many in the nuclear power plant business believe that the catastrophic failure mode for reactor containment structures is unrealistic. One of the goals of the EPRI containment integrity program is to demonstrate that this is true. The objective of the program is to provide the utility industry with an experimental data base and a test-validated analytical method for realistically evaluating the actual over-pressure capability of concrete containment buildings and to predict leakage behavior if higher pressures were to occur. The ultimate goal of this research effort is to characterize the containment leakage mode and rate as a function of internal pressure and time so that the risk can be realistically assessed for hypothetical degraded core accidents. Progress in the first and second phases of the three-phase analytical and testing efforts is discussed

  6. STEFINS: a steel freezing integral simulation program

    International Nuclear Information System (INIS)

    Frank, M.V.

    1980-09-01

    STEFINS (STEel Freezing INtegral Simulation) is a computer program for the calculation of the rate of solidification of molten steel on solid steel. Such computations arize when investigating core melt accidents in fast reactors. In principle this problem involves a coupled two-dimensional thermal and hydraulic approach. However, by physically reasonable assumptions a decoupled approach has been developed. The transient solidification of molten steel on a cold wall is solved in the direction normal to the molten steel flow and independent from the solution for the molten steel temperature and Nusselt number along the direction of flow. The solutions to the applicable energy equations have been programmed in cylindrical and slab geometries. Internal gamma heating of steel is included

  7. DOE In Situ Remediation Integrated Program

    International Nuclear Information System (INIS)

    Yow, J.L. Jr.

    1993-01-01

    The In Situ Remediation Integrated Program (ISRP) supports and manages a balanced portfolio of applied research and development activities in support of DOE environmental restoration and waste management needs. ISRP technologies are being developed in four areas: containment, chemical and physical treatment, in situ bioremediation, and in situ manipulation (including electrokinetics). the focus of containment is to provide mechanisms to stop contaminant migration through the subsurface. In situ bioremediation and chemical and physical treatment both aim to destroy or eliminate contaminants in groundwater and soils. In situ manipulation (ISM) provides mechanisms to access contaminants or introduce treatment agents into the soil, and includes other technologies necessary to support the implementation of ISR methods. Descriptions of each major program area are provided to set the technical context of the ISM subprogram. Typical ISM needs for major areas of in situ remediation research and development are identified

  8. Clinical application of sensory integration therapy for children with ...

    African Journals Online (AJOL)

    Nazurah Alwi

    skills in children with autism'' by Abdel Karim and. Mohammed [1]. Sensory integration therapy (SIT) is the most common interventions delivered to children with aut- ism spectrum disorder (ASD) who have atypical sensory behavior [2]. We applaud ... the author why they have not considered 6–9 year old chil- dren as they ...

  9. Adaptive Counseling and Therapy: An Integrative, Eclectic Model.

    Science.gov (United States)

    Howard, George S.; And Others

    1986-01-01

    Presents an integrative model, Adaptive Counseling and Therapy (ACT), for selecting a progression of therapist styles as clients move through developmental stages during the course of counseling and psychotherapy. ACT is intended to be useful to practitioners in case conceptualization and in the application of effective treatment planning.…

  10. SPORTS PHYSICAL THERAPY CURRICULA IN PHYSICAL THERAPIST PROFESSIONAL DEGREE PROGRAMS.

    Science.gov (United States)

    Mulligan, Edward P; DeVahl, Julie

    2017-10-01

    The specialty niche of sports physical therapy has grown at a significant rate over the past 40 years. Despite this growth there is little information or direction from the physical therapy education accreditation body or professional association to guide academic programs on the interest or necessity of this type of practice content in physical therapy professional degree programs. The purpose of this survey study is to report on the prevalence, attitudes, barriers, resources, and faculty expertise in providing required or elective sports physical therapy course work. Cross-sectional descriptive survey. A 57-item questionnaire with branching logic was distributed via a web-based electronic data capture tool to survey all Commission on Accreditation for Physical Therapy Education (CAPTE) accredited and candidate schools in the United States. Response data was analyzed to describe typical educational program profiles, faculty demographics, and correlational factors consistent with the presence or absence of specific sports physical therapy curricular content. Thirty one percent of the schools responded to the survey and the program demographics were consistent with all currently accredited schools in regards to their geography, Carnegie classification, and faculty and student size. Forty three percent of programs offered a required or elective course distinct to the practice of sports physical therapy. Descriptive information regarding the sequencing, curricular make-up, resources, and assessment of content competence is reported. The odds of providing this content nearly doubles for programs that have faculty with sports clinical specialist credentials, accredited sports residency curriculums, or state practice acts that allow sports venue coverage. This survey provides an initial overview of sports physical therapy educational efforts in professional physical therapy degree programs. The data can used to spur further discussion on the necessity, structure, and

  11. Integrating communication skills training in the curricula of 5 healthcare professions: nursing, occupational therapy, physical therapy, radiography and midwifery

    DEFF Research Database (Denmark)

    Nielsen, Annegrethe; Tørring, Birgitte; Hansen, Susanne Hjorth

    2014-01-01

    for professionals. In the effort of integrating communication skills training in the undergraduate curricula of nursing, radiography, occupational therapy, physiotherapy and midwifery, we established a communication skills laboratory and arranged a 5 day course for communication teachers from all 5 educational......Structured training of communication skills are needed in undergraduate healthcare education in order to prepare the future professionals to cooperate with patients. Often education in communication is not integrated in the curriculum – making it seem a side activity of less importance...... programs at University College North Denmark. After the course communication skills training was offered at least once during every 3½ year program and after 3 years this is retained and in some cases developed further. The combination of getting a room where to train and developing the skills to train...

  12. A Behaviorally-Oriented Activities Therapy Program for Adolescents.

    Science.gov (United States)

    Chasanoff, Enid; Schrader, Carl

    1979-01-01

    A behaviorally-oriented activities therapy program was designed and implemented with adolescents who manifested problems at school, at home, and with peers. Techniques employed included: contingency contracting, assertiveness training, relaxation training, and cognitive restructuring. (Author/KC)

  13. Integrative Therapies and Pediatric Inflammatory Bowel Disease: The Current Evidence.

    Science.gov (United States)

    Misra, Sanghamitra M

    2014-08-25

    Inflammatory bowel disease (IBD) primarily describes two distinct chronic conditions with unknown etiology, ulcerative colitis (UC) and Crohn's disease (CD). UC is limited to the colon, while CD may involve any portion of the gastrointestinal tract from mouth to anus. These diseases exhibit a pattern of relapse and remission, and the disease processes are often painful and debilitating. Due to the chronic nature of IBD and the negative side effects of many of the conventional therapies, many patients and their families turn to complementary and alternative medicine (CAM) for symptom relief. This article focuses on the current available evidence behind CAM/integrative therapies for IBD.

  14. Implementing antiretroviral therapy programs in resource-constrained settings: lessons from Monze, Zambia.

    Science.gov (United States)

    Adedimeji, Adebola; Malokota, Oliver; Manafa, Ogenna

    2011-05-01

    We describe the impact of an antiretroviral therapy program on human resource utilization and service delivery in a rural hospital in Monze, Zambia, using qualitative data. We assess project impact on staff capacity utilization, service delivery, and community perception of care. Increased workload resulted in fatigue, low staff morale, and exacerbated critical manpower shortages, but also an increase in users of antiretroviral therapy, improvement in hospital infrastructure and funding, and an overall community satisfaction with service delivery. Integrating HAART programs within existing hospital units and services may be a good alternative to increase overall efficiency.

  15. Integrating Occupational Therapy Specific Assessments in Practice: Exploring Practitioner Experiences

    Directory of Open Access Journals (Sweden)

    Eric Asaba

    2017-01-01

    Full Text Available Background. Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS among occupational therapists in Sweden and Japan. Methods. Interviews and qualitative thematic analyses were utilized. Findings. Four themes are reported: (1 use it or lose it, (2 simply no space until after hours, (3 biggest barriers can be colleagues, and (4 being more specific: communication. Conclusion. In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice.

  16. [Systemic therapies--a contribution to psychotherapy integration].

    Science.gov (United States)

    Schiepek, Günter

    2012-06-01

    Some converging lines from neuroscience, neurobiological psychotherapy research, process-outcome-research, internet-based change monitoring and the systems and complexity sciences actually allow for an open and generic definition of systemic therapies. The "family" of systemic therapies as designed here is not restricted to the field of psychotherapy. It is a scientifically founded and engaged, bio-psycho-social multi-level approach to a common or integrative psychotherapy, not restricted to a psychotherapeutic confession or exclusively to family or couples therapy. A core element of systemic therapy is the support of self-organizing processes and the use of data-driven feedback tools. The conclusion goes to a modified concept of evidence-based practice and, vice versa, practice-based evidence, to an integration of the medical model and the common factors model into a self-organization theory of human change processes, and to a list of criteria for scientifically based practice in psychotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  17. In Situ Remediation Integrated Program: Technology summary

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    The In Situ Remediation Integrated Program (ISR IP) was instituted out of recognition that in situ remediation could fulfill three important criteria: significant cost reduction of cleanup by eliminating or minimizing excavation, transportation, and disposal of wastes; reduced health impacts on workers and the public by minimizing exposure to wastes during excavation and processing; and remediation of inaccessible sites, including: deep subsurfaces, in, under, and around buildings. Buried waste, contaminated soils and groundwater, and containerized wastes are all candidates for in situ remediation. Contaminants include radioactive wastes, volatile and non-volatile organics, heavy metals, nitrates, and explosive materials. The ISR IP intends to facilitate development of in situ remediation technologies for hazardous, radioactive, and mixed wastes in soils, groundwater, and storage tanks. Near-term focus is on containment of the wastes, with treatment receiving greater effort in future years. ISR IP is an applied research and development program broadly addressing known DOE environmental restoration needs. Analysis of a sample of 334 representative sites by the Office of Environmental Restoration has shown how many sites are amenable to in situ remediation: containment--243 sites; manipulation--244 sites; bioremediation--154 sites; and physical/chemical methods--236 sites. This needs assessment is focused on near-term restoration problems (FY93--FY99). Many other remediations will be required in the next century. The major focus of the ISR EP is on the long term development of permanent solutions to these problems. Current needs for interim actions to protect human health and the environment are also being addressed.

  18. In Situ Remediation Integrated Program: Technology summary

    International Nuclear Information System (INIS)

    1994-02-01

    The In Situ Remediation Integrated Program (ISR IP) was instituted out of recognition that in situ remediation could fulfill three important criteria: significant cost reduction of cleanup by eliminating or minimizing excavation, transportation, and disposal of wastes; reduced health impacts on workers and the public by minimizing exposure to wastes during excavation and processing; and remediation of inaccessible sites, including: deep subsurfaces, in, under, and around buildings. Buried waste, contaminated soils and groundwater, and containerized wastes are all candidates for in situ remediation. Contaminants include radioactive wastes, volatile and non-volatile organics, heavy metals, nitrates, and explosive materials. The ISR IP intends to facilitate development of in situ remediation technologies for hazardous, radioactive, and mixed wastes in soils, groundwater, and storage tanks. Near-term focus is on containment of the wastes, with treatment receiving greater effort in future years. ISR IP is an applied research and development program broadly addressing known DOE environmental restoration needs. Analysis of a sample of 334 representative sites by the Office of Environmental Restoration has shown how many sites are amenable to in situ remediation: containment--243 sites; manipulation--244 sites; bioremediation--154 sites; and physical/chemical methods--236 sites. This needs assessment is focused on near-term restoration problems (FY93--FY99). Many other remediations will be required in the next century. The major focus of the ISR EP is on the long term development of permanent solutions to these problems. Current needs for interim actions to protect human health and the environment are also being addressed

  19. Auditory-Verbal Music Play Therapy: An Integrated Approach (AVMPT).

    Science.gov (United States)

    Mohammad Esmaeilzadeh, Sahar; Sharifi, Shahla; Tayarani Niknezhad, Hamid

    2013-09-01

    Hearing loss occurs when there is a problem with one or more parts of the ear or ears and causes children to have a delay in the language-learning process. Hearing loss affects children's lives and their development. Several approaches have been developed over recent decades to help hearing-impaired children develop language skills. Auditory-verbal therapy (AVT) is one such approach. Recently, researchers have found that music and play have a considerable effect on the communication skills of children, leading to the development of music therapy (MT) and play therapy (PT). There have been several studies which focus on the impact of music on hearing-impaired children. The aim of this article is to review studies conducted in AVT, MT, and PT and their efficacy in hearing-impaired children. Furthermore, the authors aim to introduce an integrated approach of AVT, MT, and PT which facilitates language and communication skills in hearing-impaired children. In this article we review studies of AVT, MT, and PT and their impact on hearing-impaired children. To achieve this goal, we searched databases and journals including Elsevier, Chor Teach, and Military Psychology, for example. We also used reliable websites such as American Choral Directors Association and Joint Committee on Infant Hearing websites. The websites were reviewed and key words in this article used to find appropriate references. Those articles which are related to ours in content were selected. VT, MT, and PT enhance children's communication and language skills from an early age. Each method has a meaningful impact on hearing loss, so by integrating them we have a comprehensive method in order to facilitate communication and language learning. To achieve this goal, the article offers methods and techniques to perform AVT and MT integrated with PT leading to an approach which offers all advantages of these three types of therapy.

  20. Integration of Massage Therapy in Outpatient Cancer Care.

    Science.gov (United States)

    Cowen, Virginia S; Tafuto, Barbara

    2018-03-01

    Massage therapy can be helpful in alleviating cancer-related symptoms and cancer treatment-related symptoms. While surveys have noted that cancer patients seek out massage as a nonpharmacologic approach during cancer treatment, little is known about the integration of massage in outpatient cancer care. The purpose of this study was to examine the extent to which massage is being integrated into outpatient cancer care at NCI-designated Cancer Centers. This study used descriptive methods to analyze the integration of massage in NCI-designated Cancer Centers providing clinical services to patients (n = 62). Data were collected from 91.1% of the centers (n = 59) using content analysis and a telephone survey. A dataset was developed and coded for analysis. The integration of massage was assessed by an algorithm that was developed from a set of five variables: 1) acceptance of treatment as therapeutic, 2) institution offers treatment to patients, 3) clinical practice guidelines in place, 4) use of evidence-based resources to inform treatment, and 5) shared knowledge about treatment among health care team. All centers were scored against all five variables using a six-point scale, with all variables rated equally. The integration of massage ranged from not at all (0) to very high (5) with all five levels of integration evident. Only 11 centers (17.7% of total) rated a very high level of integration; nearly one-third of the centers (n = 22) were found to have no integration of massage at all-not even provision of information about massage to patients through the center website. The findings of this analysis suggest that research on massage is not being leveraged to integrate massage into outpatient cancer care.

  1. Integration of Massage Therapy in Outpatient Cancer Care

    Science.gov (United States)

    Cowen, Virginia S.; Tafuto, Barbara

    2018-01-01

    Background Massage therapy can be helpful in alleviating cancer-related symptoms and cancer treatment-related symptoms. While surveys have noted that cancer patients seek out massage as a nonpharmacologic approach during cancer treatment, little is known about the integration of massage in outpatient cancer care. Purpose The purpose of this study was to examine the extent to which massage is being integrated into outpatient cancer care at NCI-designated Cancer Centers. Setting This study used descriptive methods to analyze the integration of massage in NCI-designated Cancer Centers providing clinical services to patients (n = 62). Design Data were collected from 91.1% of the centers (n = 59) using content analysis and a telephone survey. A dataset was developed and coded for analysis. Main Outcome Measure The integration of massage was assessed by an algorithm that was developed from a set of five variables: 1) acceptance of treatment as therapeutic, 2) institution offers treatment to patients, 3) clinical practice guidelines in place, 4) use of evidence-based resources to inform treatment, and 5) shared knowledge about treatment among health care team. All centers were scored against all five variables using a six-point scale, with all variables rated equally. Results The integration of massage ranged from not at all (0) to very high (5) with all five levels of integration evident. Only 11 centers (17.7% of total) rated a very high level of integration; nearly one-third of the centers (n = 22) were found to have no integration of massage at all—not even provision of information about massage to patients through the center website. Conclusions The findings of this analysis suggest that research on massage is not being leveraged to integrate massage into outpatient cancer care. PMID:29593842

  2. Integrated rural development programs: a skeptical perspective.

    Science.gov (United States)

    Ruttan, V W

    1975-11-01

    In examining integrated rural development programs the question that arises is why is it possible to identify several relatively successful small-scale or pilot rural development projects yet so difficult to find examples of successful rural development programs. 3 bodies of literature offer some insight into the morphology of rural development projects, programs, and processes: the urban-industrial impact hypothesis; the theory of induced technical change; and the new models of institutional change that deal with institution building and the economics of bureaucratic behavior. The urban-industrial impact hypothesis helps in the clarification of the relationships between the development of rural areas and the development of the total society of which rural areas are a part. It is useful in understanding the spatial dimensions of rural development where rural development efforts are likely to be most successful. Formulation of the hypothesis generated a series of empirical studies designed to test its validity. The effect of these studies has been the development of a rural development model in which the rural community is linked to the urban-industrial economy through a series of market relationships. Both the urban economy's rate of growth and the efficiency of the intersector product and factor markets place significant constraints on the possibilities of rural area development. It is not possible to isolate development processes in the contemporary rural community in a developing society from development processes in the larger society. The induced technical change theory provides a guide as to what must be done to gain access to efficient sources of economic growth, the new resources and incomes that are necessary to sustain rural development. Design of a successful rural development strategy involves a combination of technical and institutional change. The ability of rural areas to respond to the opportunities for economic growth generated by local urban

  3. Art therapy, psychodrama, and verbal therapy. An integrative model of group therapy in the treatment of adolescents with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Diamond-Raab, Lisa; Orrell-Valente, Joan K

    2002-04-01

    Anorexia nervosa and bulimia nervosa typically afflict individuals in adolescence. Given the intractability of these diseases in combination with the natural recalcitrance of adolescence, treatment with this population presents a daunting challenge. Traditional group therapy that focuses on verbal therapy is often not effective with this population, particularly in the acute stages of the diseases. A group therapy approach that integrates art therapy, psychodrama, and verbal therapy offers an innovative alternative to traditional group therapy.

  4. MIxed Waste Integrated Program (MWIP): Technology summary

    International Nuclear Information System (INIS)

    1994-02-01

    The mission of the Mixed Waste Integrated Program (MWIP) is to develop and demonstrate innovative and emerging technologies for the treatment and management of DOE's mixed low-level wastes (MLLW) for use by its customers, the Office of Waste Operations (EM-30) and the Office of Environmental Restoration (EM-40). The primary goal of MWIP is to develop and demonstrate the treatment and disposal of actual mixed waste (MMLW and MTRU). The vitrification process and the plasma hearth process are scheduled for demonstration on actual radioactive waste in FY95 and FY96, respectively. This will be accomplished by sequential studies of lab-scale non-radioactive testing followed by bench-scale radioactive testing, followed by field-scale radioactive testing. Both processes create a highly durable final waste form that passes leachability requirements while destroying organics. Material handling technology, and off-gas requirements and capabilities for the plasma hearth process and the vitrification process will be established in parallel

  5. Mixed Waste Integrated Program emerging technology development

    International Nuclear Information System (INIS)

    Berry, J.B.; Hart, P.W.

    1994-01-01

    The US Department of Energy (DOE) is responsible for the management and treatment of its mixed low-level wastes (MLLW). MLLW are regulated under both the Resource Conservation and Recovery Act and various DOE orders. Over the next 5 years, DOE will manage over 1.2 m 3 of MLLW and mixed transuranic (MTRU) wastes. In order to successfully manage and treat these mixed wastes, DOE must adapt and develop characterization, treatment, and disposal technologies which will meet performance criteria, regulatory approvals, and public acceptance. Although technology to treat MLLW is not currently available without modification, DOE is committed to developing such treatment technologies and demonstrating them at the field scale by FY 1997. The Office of Research and Development's Mixed Waste Integrated Program (MWIP) within the DOE Office of Environmental Management (EM), OfFice of Technology Development, is responsible for the development and demonstration of such technologies for MLLW and MTRU wastes. MWIP advocates and sponsors expedited technology development and demonstrations for the treatment of MLLW

  6. Mixed Waste Integrated Program emerging technology development

    Energy Technology Data Exchange (ETDEWEB)

    Berry, J.B. [Oak Ridge National Lab., TN (United States); Hart, P.W. [USDOE, Washington, DC (United States)

    1994-06-01

    The US Department of Energy (DOE) is responsible for the management and treatment of its mixed low-level wastes (MLLW). MLLW are regulated under both the Resource Conservation and Recovery Act and various DOE orders. Over the next 5 years, DOE will manage over 1.2 m{sup 3} of MLLW and mixed transuranic (MTRU) wastes. In order to successfully manage and treat these mixed wastes, DOE must adapt and develop characterization, treatment, and disposal technologies which will meet performance criteria, regulatory approvals, and public acceptance. Although technology to treat MLLW is not currently available without modification, DOE is committed to developing such treatment technologies and demonstrating them at the field scale by FY 1997. The Office of Research and Development`s Mixed Waste Integrated Program (MWIP) within the DOE Office of Environmental Management (EM), OfFice of Technology Development, is responsible for the development and demonstration of such technologies for MLLW and MTRU wastes. MWIP advocates and sponsors expedited technology development and demonstrations for the treatment of MLLW.

  7. [Psychological Effects of Forest Therapy Program on Workers].

    Science.gov (United States)

    Ikei, Harumi; Koizumi, Haruka; Song, Chorong; Kouzuki, Mitsunori; Teratani, Seiichiro; Sakuma, Takahiro; Miyazaki, Yoshifumi

    2015-01-01

    To examine the psychological effects of forest therapy program on workers. The subjective symptoms index, a shortened version of the profile of mood states (POMS), and a semantic differential (SD) method were used to measure the psychological effects. The evaluations were performed 3 days before, during, and 1, 3, and 5 days after the forest therapy. The following results were obtained: (1) the subjective symptoms improved before breakfast and continued for 5 days; (2) the mood evaluated using POMS improved before breakfast and continued for 3 days; and (3) “comfortable,” “relaxed,” and “natural” feelings evaluated using the SD method were enhanced before breakfast, lunch, and dinner during forest therapy. These results provided scientific evidence of the psychological effects of forest therapy program on workers.

  8. Formalizing an integrative, multidisciplinary cancer therapy discovery workflow

    Science.gov (United States)

    McGuire, Mary F.; Enderling, Heiko; Wallace, Dorothy I.; Batra, Jaspreet; Jordan, Marie; Kumar, Sushil; Panetta, John C.; Pasquier, Eddy

    2014-01-01

    Although many clinicians and researchers work to understand cancer, there has been limited success to effectively combine forces and collaborate over time, distance, data and budget constraints. Here we present a workflow template for multidisciplinary cancer therapy that was developed during the 2nd Annual Workshop on Cancer Systems Biology sponsored by Tufts University, Boston, MA in July 2012. The template was applied to the development of a metronomic therapy backbone for neuroblastoma. Three primary groups were identified: clinicians, biologists, and scientists (mathematicians, computer scientists, physicists and engineers). The workflow described their integrative interactions; parallel or sequential processes; data sources and computational tools at different stages as well as the iterative nature of therapeutic development from clinical observations to in vitro, in vivo, and clinical trials. We found that theoreticians in dialog with experimentalists could develop calibrated and parameterized predictive models that inform and formalize sets of testable hypotheses, thus speeding up discovery and validation while reducing laboratory resources and costs. The developed template outlines an interdisciplinary collaboration workflow designed to systematically investigate the mechanistic underpinnings of a new therapy and validate that therapy to advance development and clinical acceptance. PMID:23955390

  9. Distinguishing integrative from eclectic practice in cognitive behavioral therapies.

    Science.gov (United States)

    Petrik, Alexandra M; Kazantzis, Nikolaos; Hofmann, Stefan G

    2013-09-01

    In psychotherapy research, practice, and training, there remains marked controversy about the merits of theoretical purism (i.e., model specific), versus integration, as well as how such principles may be represented in practice. Adding to the confusion is that many attributes of the therapeutic relationship, processes in therapy, and techniques have been popularized in the context of one or two theoretical approaches, but are incorporated into the practice of many approaches. This article demonstrates the various ways in which three core interventions (i.e., activity scheduling, self-monitoring, and identification, evaluation, and modification of thoughts) can be applied within the context of different cognitive and behavioral therapeutic models. It also demonstrates the role of in-session therapist language in describing the theoretical basis and processes underpinning therapeutic interventions. Case examples are presented to illustrate therapy provided by two hypothetical clinicians, Therapist A and Therapist B. Whether or not a practitioner elects to practice integrative psychotherapy, we advocate for consistency in the theoretical approach through the course of a service for a particular patient. Implications are outlined and discussed within the context of the current state of cognitive and behaviorally focused psychotherapies and integrative psychotherapy. 2013 APA, all rights reserved

  10. A computer based learning program for radiation therapy

    International Nuclear Information System (INIS)

    Frenzel, T.; Kruell, A.; Schmidt, R.

    1999-01-01

    Many textbooks about radiation therapy for the education of medical, technical and scientific staff are available. But they are restricted to transfer of knowledge via text and figures. On the other hand movies and animated pictures can give you a more realistic impression of the procedures and technical equipment of a radiation therapy department. Therefore, an interactive multimedia teaching program was developed at the Universitaets-Krankenhaus Eppendorf for the department of radiation therapy. The electronic textbook runs under 'MS Windows 3.1 trademark ' (with multimedia extensions) and 'MS Windows 95 trademark ', contains eight chapters and can be used without any preliminary knowledge. The program has been tested by medical personnel, nurses, physicists and physicians and was generally welcome. The program was designed for people with different levels of education to reach as many users as possible. It was not created to replace textbooks but was designed for their supplement. (orig.) [de

  11. An integrative review of Reiki touch therapy research.

    Science.gov (United States)

    Vitale, Anne

    2007-01-01

    Reiki touch therapy is a complementary biofield energy therapy that involves the use of hands to help strengthen the body's ability to heal. There is growing interest among nurses to use Reiki in patient care and as a self-care treatment, however, with little supportive empirical research and evidence to substantiate these practices. The purpose of this integrative review is to begin the systematic process of evaluating the findings of published Reiki research. Selected investigations using Reiki for effects on stress, relaxation, depression, pain, and wound healing management, among others is reviewed and summarized. A summary of Reiki studies table illustrates the study descriptions and Reiki treatment protocols specified in the investigations. Synthesis of findings for clinical practice and implications for future research are explored.

  12. 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...

  13. The influence of integrative play therapy on children

    Directory of Open Access Journals (Sweden)

    Flora Lamçja (Zeqaj

    2015-11-01

    Full Text Available The integration of theory, technique and common factors in psychotherapy has gained prominence since the 1990s. Previously, it was called eclecticism, but integration has become the preferred term to describe the blending of theory, technique and common factors (Norcross 2005. In the past, eclecticism meant to choose from various theories and techniques a therapeutic strategy that appears best for a particular client (Schaefer 2003 p.308. However, Norcross (1987 explains eclecticism as a further integration through which various theories are applied on interactive and coordinated explanations of the therapy. Because of psychological disorders, especially for children and adolescents are multilayered, complex and multi determined a multifaceted treatment approach is needed (Schaefer 2003. Indeed, many clients do not come with a clearly defined diagnosis, but rather several overlapping problems due to the co morbidity of issues (such as in the cases of complex trauma resulting in overlapping attention problems, along with phobias and sexualized behaviors. The clinicians trained in one theoretical and treatment approach is finding the “one size” cannot fit in all the presenting problems that are being faced today. Due to this multidimensional aspect the play child/play therapy calls for the unique demand that the therapist should wear a lot of different hats and should be skillful in changing from one therapeutic stance to another, in order to meet the needs of the child and of the various members in the child’s life (Coonerty, 1993. In one moment, the play therapist is intensively involved in deeply evocative and conflicted play therapy the child client. At that moment, the therapist needs to deal with the child’s internal struggles, setting limits and being an educator or mediator with the child, while in the next moment the therapist should engaged with the role of a parent, or school psychologist, or classroom teacher to assess the

  14. Auditory-Verbal Music Play Therapy: An Integrated Approach (AVMPT

    Directory of Open Access Journals (Sweden)

    Sahar Mohammad Esmaeilzadeh

    2013-10-01

    Full Text Available Introduction: Hearing loss occurs when there is a problem with one or more parts of the ear or ears and causes children to have a delay in the language-learning process. Hearing loss affects children's lives and their development. Several approaches have been developed over recent decades to help hearing-impaired children develop language skills. Auditory-verbal therapy (AVT is one such approach. Recently, researchers have found that music and play have a considerable effect on the communication skills of children, leading to the development of music therapy (MT and play therapy (PT. There have been several studies which focus on the impact of music on hearing-impaired children. The aim of this article is to review studies conducted in AVT, MT, and PT and their efficacy in hearing-impaired children. Furthermore, the authors aim to introduce an integrated approach of AVT, MT, and PT which facilitates language and communication skills in hearing-impaired children.   Materials and Methods: In this article we review studies of AVT, MT, and PT and their impact on hearing-impaired children. To achieve this goal, we searched databases and journals including Elsevier, Chor Teach, and Military Psychology, for example. We also used reliable websites such as American Choral Directors Association and Joint Committee on Infant Hearing websites. The websites were reviewed and key words in this article used to find appropriate references. Those articles which are related to ours in content were selected.    Results: Recent technologies have brought about great advancement in the field of hearing disorders. Now these impairments can be detected at birth, and in the majority of cases, hearing impaired children can develop fluent spoken language through audition. According to researches on the relationship between hearing impaired children’s communication and language skills and different approaches of therapy, it is known that learning through listening and

  15. Physical therapy in preschool classrooms: successful integration of therapy into classroom routines.

    Science.gov (United States)

    Sekerak, Darlene Massey; Kirkpatrick, Dana B; Nelson, Kristal C; Propes, June H

    2003-01-01

    This exploratory investigation identifies factors that contribute to success of physical therapy services delivered in the context of the daily routines in preschool classroom settings. Ten pediatric physical therapists from rural and urban communities across North Carolina served as informants during telephone interviews. Qualitative analysis of the data led to the identification of six major themes: interactions among classroom personnel, impact of the classroom environment, individual characteristics of the child, logistical considerations, administrative policies and practices, and service delivery options. All 10 informants shared the perception that the cooperation and commitment of the teacher was essential for successful incorporation of therapy activities in classroom routines. Furthermore, the informants agreed that multiple models of service delivery were necessary to meet the individual needs of children. These results lead the authors to question the wisdom of promoting any one service delivery model as "best practice" and suggest guidelines for successful integration of physical therapy in the preschool classroom.

  16. Integrated approach to yoga therapy and autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Shantha Radhakrishna

    2010-01-01

    Full Text Available A specially designed Integrated Approach to Yoga Therapy module was applied to Autism Spectrum Disorders over a period of two academic years. Despite low numbers (six in each arm, consistency and magnitude of effects make the findings significant. Parental participation, allowing firm guidance to be given to each child, resulted in significant improvements in imitation and other skills, and in behavior at home and family relationships. We hypothesize that guided imitation of therapist body positions stimulated mirror neuron activation, resulting in improved sense of self.

  17. Program Collaboration and Service Integration At-a-Glance

    Centers for Disease Control (CDC) Podcasts

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses program collaboration and service integration, a strategy that promotes better collaboration between public health programs and supports appropriate service integration at the point-of-care.

  18. Integrated program of using of Probabilistic Safety Analysis in Spain

    International Nuclear Information System (INIS)

    1998-01-01

    Since 25 June 1986, when the CSN (Nuclear Safety Conseil) approve the Integrated Program of Probabilistic Safety Analysis, this program has articulated the main activities of CSN. This document summarize the activities developed during these years and reviews the Integrated programme

  19. Program collaboration and service integration activities among HIV programs in 59 U.S. health departments.

    Science.gov (United States)

    Fitz Harris, Lauren F; Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A; Nesheim, Steven R

    2014-01-01

    We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs.

  20. 20 CFR 220.64 - Program integrity.

    Science.gov (United States)

    2010-04-01

    ... for reasons bearing on professional competence, professional conduct, or financial integrity; who has surrendered such a license while formal disciplinary proceedings involving professional conduct were pending...

  1. Sensory integration dysfunction affects efficacy of speech therapy on children with functional articulation disorders

    Directory of Open Access Journals (Sweden)

    Tung LC

    2013-01-01

    Full Text Available Li-Chen Tung,1,# Chin-Kai Lin,2,# Ching-Lin Hsieh,3,4 Ching-Chi Chen,1 Chin-Tsan Huang,1 Chun-Hou Wang5,6 1Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, 2Program of Early Intervention, Department of Early Childhood Education, National Taichung University of Education, Taichung, 3School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, 4Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, 5School of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, 6Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan#These authors contributed equally Background: Articulation disorders in young children are due to defects occurring at a certain stage in sensory and motor development. Some children with functional articulation disorders may also have sensory integration dysfunction (SID. We hypothesized that speech therapy would be less efficacious in children with SID than in those without SID. Hence, the purpose of this study was to compare the efficacy of speech therapy in two groups of children with functional articulation disorders: those without and those with SID.Method: A total of 30 young children with functional articulation disorders were divided into two groups, the no-SID group (15 children and the SID group (15 children. The number of pronunciation mistakes was evaluated before and after speech therapy.Results: There were no statistically significant differences in age, sex, sibling order, education of parents, and pretest number of mistakes in pronunciation between the two groups (P > 0.05. The mean and standard deviation in the pre- and posttest number of mistakes in pronunciation were 10.5 ± 3.2 and 3.3 ± 3.3 in the no-SID group, and 10.1 ± 2.9 and 6.9 ± 3.5 in the SID group, respectively. Results showed great changes after speech therapy treatment (F

  2. Unifying the field: developing an integrative paradigm for behavior therapy.

    Science.gov (United States)

    Eifert, G H; Forsyth, J P; Schauss, S L

    1993-06-01

    The limitations of early conditioning models and treatments have led many behavior therapists to abandon conditioning principles and replace them with loosely defined cognitive theories and treatments. Systematic theory extensions to human behavior, using new concepts and processes derived from and built upon the basic principles, could have prevented the divisive debates over whether psychological dysfunctions are the results of conditioning or cognition and whether they should be treated with conditioning or cognitive techniques. Behavior therapy could also benefit from recent advances in experimental cognitive psychology that provide objective behavioral methods of studying dysfunctional processes. We suggest a unifying paradigm for explaining abnormal behavior that links and integrates different fields of study and processes that are frequently believed to be incompatible or antithetical such as biological vulnerability variables, learned behavioral repertoires, and that also links historical and current antecedents of the problem. An integrative paradigmatic behavioral approach may serve a unifying function in behavior therapy (a) by promoting an understanding of the dysfunctional processes involved in different disorders and (b) by helping clinicians conduct functional analyses that lead to theory-based, individualized, and effective treatments.

  3. 76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

    Science.gov (United States)

    2011-06-13

    ... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...

  4. A decade of building massage therapy services at an academic medical center as part of a healing enhancement program.

    Science.gov (United States)

    Rodgers, Nancy J; Cutshall, Susanne M; Dion, Liza J; Dreyer, Nikol E; Hauschulz, Jennifer L; Ristau, Crystal R; Thomley, Barb S; Bauer, Brent A

    2015-02-01

    The use of complementary and integrative medicine therapies is steadily becoming an integral part of health care. Massage therapy is increasingly offered to hospitalized patients for various conditions to assist with the management of common symptoms such as pain, anxiety, and tension. This article summarizes a decade of building the massage therapy service at a large tertiary care medical center, from the early pilot studies and research to the current program offerings, and the hopes and dreams for the future. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Exploring Art and Science Integration in an Afterschool Program

    Science.gov (United States)

    Bolotta, Alanna

    Science, technology, engineering, arts and math (STEAM) education integrates science with art, presenting a unique and interesting opportunity to increase accessibility in science for learners. This case study examines an afterschool program grounded in art and science integration. Specifically, I studied the goals of the program, it's implementation and the student experience (thinking, feeling and doing) as they participated in the program. My findings suggest that these programs can be powerful methods to nurture scientific literacy, creativity and emotional development in learners. To do so, this program made connections between disciplines and beyond, integrated holistic teaching and learning practices, and continually adapted programming while also responding to challenges. The program is therefore specially suited to engage the heads, hands and hearts of learners, and can make an important contribution to their learning and development. To conclude, I provide some recommendations for STEAM implementation in both formal and informal learning settings.

  6. Slide layout and integrated design (SLIDE) program

    International Nuclear Information System (INIS)

    Roberts, S.G.

    1975-01-01

    SLIDE is a FORTRAN IV program for producing 35 mm color slides on the Control Data CYBER-74. SLIDE interfaces with the graphics package, DISSPLA, on the CYBER-74. It was designed so that persons with no previous computer experience can easily and quickly generate their own textual 35 mm color slides for verbal presentations. SLIDE's features include seven different colors, five text sizes, ten tab positions, and two page sizes. As many slides as desired may be produced during any one run of the program. Each slide is designed to represent an 8 1 / 2 in. x 11 in. or an 11 in. x 8 1 / 2 in. page. The input data cards required to run the SLIDE program and the program output are described. Appendixes contain a sample program run showing input, output, and the resulting slides produced and a FORTRAN listing of the SLIDE program. (U.S.)

  7. Retrospective review of antiretroviral therapy program data in ...

    African Journals Online (AJOL)

    ÿþB e r n t L i n d t j ø r n

    2009-12-31

    Dec 31, 2009 ... Methods: Descriptive retrospective analyses of reported ART Program Data from accredited private hospitals, between May 2005 and ... retention and tracing in the accredited private hospitals in Addis Ababa City Administration. [Ethiop J Health Dev. ..... therapy in rural communities: The Lusikisiki model.

  8. The NSW radiation therapy PDY educational program. A review of the 2002 and 2003 programs

    International Nuclear Information System (INIS)

    Beldham-Collins, Rachael

    2005-01-01

    Each month, nine radiation oncology departments in the public health sector in New South Wales host a one-day educational program for graduate practitioners completing their professional development year (PDY). Various topics are presented which are considered relevant to graduates in the transition from the academic environment to full time work in busy clinical departments. This paper presents the findings of a review of the NSW State Radiation Therapy PDY educational program for 2002 and 2003 instigated by the NSW Chiefs Group. The program was evaluated to determine whether it enhanced the learning experiences of graduate practitioners during the PDY. The results indicate the educational program has been successful in enhancing the skills of the radiation therapy graduate practitioners. This finding suggests the program is having a positive impact on the experience of the graduate practitioners within radiation therapy in NSW. Copyright (2005) Australian Institute of Radiography

  9. Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial.

    Science.gov (United States)

    Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D'Angelo, Valerio; Urso, Viviana

    2015-01-01

    The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization.

  10. Integration of a mobile-integrated therapy with electronic health records: lessons learned.

    Science.gov (United States)

    Peeples, Malinda M; Iyer, Anand K; Cohen, Joshua L

    2013-05-01

    Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient-provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center. In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework. Findings from the diverse stakeholder group of a MIT-EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed. Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases. © 2013 Diabetes Technology Society.

  11. Program Integration for International Technology Exchange

    International Nuclear Information System (INIS)

    Rea, J.L.

    1993-01-01

    Sandia National Laboratories (SNL), Albuquerque, New Mexico, supports the International Technology Exchange Division (ITED) through the integration of all international activities conducted within the DOE's Office of Environmental Management (EM)

  12. 76 FR 20534 - Program Integrity Issues

    Science.gov (United States)

    2011-04-13

    ... Code of Federal Regulations is available via the Federal Digital System at: http://www.gpo.gov/fdsys... educational programs or those that provide marketing, advertising, recruiting, or admissions services. We have... the institution to provide services, such as food service, other than educational programs, marketing...

  13. 78 FR 17598 - Program Integrity Issues

    Science.gov (United States)

    2013-03-22

    ... College and Higher Education (TEACH) Grant Program, the Federal Pell Grant Program, and the Academic Competitiveness Grant (AGC) and National Science and Mathematics Access to Retain Talent Grant (National Smart... is most likely to be obtained. As the primary function of admissions representatives is to serve as...

  14. Integrating Play in Family Therapy: An Interview with Eliana Gil, Ph.D.

    Science.gov (United States)

    Christensen, Teresa M.; Thorngren, Jill M.

    2000-01-01

    Presents an interview with Eliana Gil, the current director of the Starbright Training Institute for child abuse and neglect, play therapy, and family play therapy in Springfield, Virginia. Gil's publications and experiences have spoken to coconstructing family therapy sessions that effectively integrate the paradigms of play and family therapy.…

  15. Integrating Robot Task Planning into Off-Line Programming Systems

    DEFF Research Database (Denmark)

    Sun, Hongyan; Kroszynski, Uri

    1988-01-01

    a system architecture for integrated robot task planning. It identifies and describes the components considered necessary for implementation. The focus is on functionality of these elements as well as on the information flow. A pilot implementation of such an integrated system architecture for a robot......The addition of robot task planning in off-line programming systems aims at improving the capability of current state-of-the-art commercially available off-line programming systems, by integrating modeling, task planning, programming and simulation together under one platform. This article proposes...... assembly task is discussed....

  16. Translation of the Speech Therapy Programs in the Logomon Assisted Therapy System

    Directory of Open Access Journals (Sweden)

    SCHIPOR, D. M.

    2010-05-01

    Full Text Available This interdisciplinary research was developed with a view to create and implement an intelligent informatics system for the treatment of dyslalic disorders, specific to the Romanian language (CBTS system - computer-based speech therapy, as a complementary speech therapy method, customised and client-oriented. The rules of the logotherapeutic guide have been expressed in pseudocode programs in order to allow a greater flexibility in expressing the logotherapeutic procedures in an informatics system. The pseudocode logopedic programs comprise the succession of stages of the therapeutic program from a speech therapy perspective, and based on what the expert system can achieve. The LOGOMON system is conceived in order to assist the physical therapist and the child during the entire therapeutic period, recording the main data related to the child, which proved to be useful in diagnosis and treatment. The experimental validation of the system proved that assisted therapy contributes to the improvement of classical therapy, to obtaining optimal results in correcting the dyslalic person's speech.

  17. Program Collaboration and Service Integration At-a-Glance

    Centers for Disease Control (CDC) Podcasts

    2010-09-15

    Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses program collaboration and service integration, a strategy that promotes better collaboration between public health programs and supports appropriate service integration at the point-of-care.  Created: 9/15/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 9/15/2010.

  18. A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic Stress Disorders.

    Science.gov (United States)

    McGovern, Mark P; Lambert-Harris, Chantal; Alterman, Arthur I; Xie, Haiyi; Meier, Andrea

    2011-01-01

    OBJECTIVE: Co-occurring posttraumatic stress (PTSD) and substance use disorders provide clinical challenges to addiction treatment providers. Interventions are needed that are effective, well-tolerated by patients, and capable of being delivered by typical clinicians in community settings. This is a randomized controlled trial of integrated cognitive behavioral therapy for co-occurring PTSD and substance use disorders. METHODS: Fifty-three participants sampled from seven community addiction treatment programs were randomized to integrated cognitive behavioral therapy plus standard care or individual addiction counseling plus standard care. Fourteen community therapists employed by these programs delivered both manual-guided therapies. Primary outcomes were PTSD symptoms, substance use symptoms and therapy retention. Participants were assessed at baseline, 3- and 6-month follow-up. RESULTS: Integrated cognitive behavioral therapy was more effective than individual addiction counseling in reducing PTSD re-experiencing symptoms and PTSD diagnosis. Individual addiction counseling was comparably effective to integrated cognitive behavioral therapy in substance use outcomes and on other measures of psychiatric symptom severity. Participants assigned to individual addiction counseling with severe PTSD were less likely to initiate and engage in the therapy than those assigned to integrated cognitive behavioral therapy. In general, participants with severe PTSD were more likely to benefit from integrated cognitive behavioral therapy. CONCLUSIONS: The findings support the promise of efficacy of integrated cognitive behavioral therapy in improving outcomes for persons in addiction treatment with PTSD. Community counselors delivered both interventions with satisfactory adherence and competence. Despite several limitations to this research, a larger randomized controlled trial of integrated cognitive behavioral therapy appears warranted.

  19. Integrating Ethics in Community Colleges' Accounting Programs.

    Science.gov (United States)

    Clarke, Clifton

    1990-01-01

    Argues that two-year college business programs need to provide moral guidance and leadership to students to help stem the proliferation of fraudulent and questionable financial reporting practices. Reviews amoral and moral unity theories of business ethics. Discusses barriers to ethical instruction in business curricula, and ways to overcome them.…

  20. A stochastic-programming approach to integrated asset and liability ...

    African Journals Online (AJOL)

    This increase in complexity has provided an impetus for the investigation into integrated asset- and liability-management frameworks that could realistically address dynamic portfolio allocation in a risk-controlled way. In this paper the authors propose a multi-stage dynamic stochastic-programming model for the integrated ...

  1. Opportunities for Integrated Fast Ignition program

    International Nuclear Information System (INIS)

    Mackinnon, A. J.; Key, M. H.; Hatchett, S. P.; Tabak, M.; Town, R.; Gregori, G.; Patel, P. K.; Snavely, R.; Freeman, R. R.; Stephens, R. B.; Beg, F.

    2005-01-01

    Experiments designed to investigate the physics of particle transport and heating of dense plasmas have been carried out in an number of facilities around the world since the publication of the fast ignition concept in 1997. To date a number of integrated experiments, examining the capsule implosion and subsequent heating have been carried out on the Gekko facility at the Institute of Laser Engineering (ILE) Osaka, Japan. The coupling of energy by the short pulse into the pre-compressed core in these experiments was very encouraging. More facilities capable of carrying out integrated experiments are currently under construction: Firex at ILEm the Omega EP facility at the University of Rochester, Z PW at Sandia National Lab, LIL in France and eventually high energy PW beams on the NIF. This presentation will review the current status of experiments in this area and discuss the capabilities of integrated fast ignition research that will be required to design the proof of principle and scaling experiments for fast ignition to be carried on the NIF. (Author)

  2. Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians.

    Science.gov (United States)

    Oshman, Lauren D; Combs, Gene N

    2016-05-01

    Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person's own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings. This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication. Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities. A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program. © The Author(s) 2016.

  3. Integrating cognitive rehabilitation: A preliminary program description and theoretical review of an interdisciplinary cognitive rehabilitation program.

    Science.gov (United States)

    Fleeman, Jennifer A; Stavisky, Christopher; Carson, Simon; Dukelow, Nancy; Maier, Sheryl; Coles, Heather; Wager, John; Rice, Jordyn; Essaff, David; Scherer, Marcia

    2015-01-01

    Interdisciplinary cognitive rehabilitation is emerging as the expected standard of care for individuals with mild to moderate degrees of cognitive impairment for a variety of etiologies. There is a growing body of evidence in cognitive rehabilitation literature supporting the involvement of multiple disciplines, with the use of cognitive support technologies (CSTs), in delivering cognitive therapy to individuals who require cognitive rehabilitative therapies. This article provides an overview of the guiding theories related to traditional approaches of cognitive rehabilitation and the positive impact of current theoretical models of an interdisciplinary approach in clinical service delivery of this rehabilitation. A theoretical model of the Integrative Cognitive Rehabilitation Program (ICRP) will be described in detail along with the practical substrates of delivering specific interventions to individuals and caregivers who are living with mild to moderate cognitive impairment. The ultimate goal of this article is to provide a clinically useful resource for direct service providers. It will serve to further clinical knowledge and understanding of the evolution from traditional silo based treatment paradigms to the current implementation of multiple perspectives and disciplines in the pursuit of patient centered care. The article will discuss the theories that contributed to the development of the interdisciplinary team and the ICRP model, implemented with individuals with mild to moderate cognitive deficits, regardless of etiology. The development and implementation of specific assessment and intervention strategies in this cognitive rehabilitation program will also be discussed. The assessment and intervention strategies utilized as part of ICRP are applicable to multiple clinical settings in which individuals with cognitive impairment are served. This article has specific implications for rehabilitation which include: (a) An Interdisciplinary Approach is an

  4. 75 FR 66665 - Program Integrity: Gainful Employment-New Programs

    Science.gov (United States)

    2010-10-29

    ..., requires the GAO to conduct a study and report on issues pertaining to the oral health of children... response to, an initiative by a governmental entity, such as the oral health program with the Federal... already understand the employment demands in their field. The commenters also believed that because...

  5. Using Research to Design Integrated Education and Training Programs

    Science.gov (United States)

    Pappalardo, Michele; Schaffer, William R.

    2016-01-01

    With the passage of the Workforce Innovation and Opportunity Act (WIOA) of 2014, Northampton Community College began the creation of Integrated Education and Training (IE&T) programs in October 2015. After a needs assessment was conducted with the partners, programs were created to address the needs in the hospitality and healthcare sectors.…

  6. Integrating computer programs for engineering analysis and design

    Science.gov (United States)

    Wilhite, A. W.; Crisp, V. K.; Johnson, S. C.

    1983-01-01

    The design of a third-generation system for integrating computer programs for engineering and design has been developed for the Aerospace Vehicle Interactive Design (AVID) system. This system consists of an engineering data management system, program interface software, a user interface, and a geometry system. A relational information system (ARIS) was developed specifically for the computer-aided engineering system. It is used for a repository of design data that are communicated between analysis programs, for a dictionary that describes these design data, for a directory that describes the analysis programs, and for other system functions. A method is described for interfacing independent analysis programs into a loosely-coupled design system. This method emphasizes an interactive extension of analysis techniques and manipulation of design data. Also, integrity mechanisms exist to maintain database correctness for multidisciplinary design tasks by an individual or a team of specialists. Finally, a prototype user interface program has been developed to aid in system utilization.

  7. Integrating pharmacogenomics into pharmacy practice via medication therapy management.

    Science.gov (United States)

    Reiss, Susan M

    2011-01-01

    To explore the application and integration of pharmacogenomics in pharmacy clinical practice via medication therapy management (MTM) to improve patient care. Department of Health & Human Services (HHS) Personalized Health Care Initiative, Food and Drug Administration (FDA) pharmacogenomics activity, and findings from the Utilizing E-Prescribing Technologies to Integrate Pharmacogenomics into Prescribing and Dispensing Practices Stakeholder Workshop, convened by the American Pharmacists Association (APhA) on March 5, 2009. Participants at the Stakeholder Workshop included diverse representatives from pharmacy, medicine, pathology, health information technology (HIT), standards, science, academia, government, and others with a key interest in the clinical application of pharmacogenomics. In 2006, HHS initiated the Personalized Health Care Initiative with the goal of building the foundation for the delivery of gene-based care, which may prove to be more effective for large patient subpopulations. In the years since the initiative was launched, drug manufacturers and FDA have begun to incorporate pharmacogenomic data and applications of this information into the drug development, labeling, and approval processes. New applications and processes for using this emerging pharmacogenomics data are needed to effectively integrate this information into clinical practice. Building from the findings of a stakeholder workshop convened by APhA and the advancement of the pharmacist's collaborative role in patient care through MTM, emerging roles for pharmacists using pharmacogenomic information to improve patient care are taking hold. Realizing the potential role of the pharmacist in pharmacogenomics through MTM will require connectivity of pharmacists into the electronic health record infrastructure to permit the exchange of pertinent health information among all members of a patient's health care team. Addressing current barriers, concerns, and system limitations and developing

  8. Occupational Therapy and Sensory Integration for Children with Autism: A Feasibility, Safety, Acceptability and Fidelity Study

    Science.gov (United States)

    Schaaf, Roseann C.; Benevides, Teal W.; Kelly, Donna; Mailloux-Maggio, Zoe

    2012-01-01

    Objective: To examine the feasibility, safety, and acceptability of a manualized protocol of occupational therapy using sensory integration principles for children with autism. Methods: Ten children diagnosed with autism spectrum disorder ages 4-8 years received intensive occupational therapy intervention using sensory integration principles…

  9. The Influence of Integrative Gestalt Therapy on Acquisition of Daily Life Skills and Habits.

    Science.gov (United States)

    Zic, Anamarija; And Others

    This study evaluated the effects of Integrative Gestalt Therapy on the intellectual aspects of social competence in 13 children, ages 7 to 11, living in Zagreb, Croatia. These children had intellectual disabilities (IQ 54 to 84) as well as psychological and/or behavior problems. Integrative Gestalt Therapy emphasizes the wholeness of a person's…

  10. When Veterinarians Support Canine Therapy: Bidirectional Benefits for Clinics and Therapy Programs

    Directory of Open Access Journals (Sweden)

    John-Tyler Binfet

    2018-01-01

    Full Text Available This paper proposes a mutually beneficial model of collaboration between veterinarians and canine therapy programs. Veterinarians and the clinics for whom they work routinely establish collaborations with multiple and varied stakeholders. This might include a laboratory for processing samples and the corresponding courier company needed to deliver samples to the lab or a partnership with a local dog rescue organization for whom discounted rates are offered. One community partnership that stands to benefit both the clinic and the community agency, is for veterinarians to work in tandem with a local canine-assisted therapy program. The benefits to such an alliance are multifold and address aspects of veterinary medicine including client recruitment, community education, and access to a network of devoted dog enthusiasts.

  11. Cognitive-Behavioral Therapy and Neuroscience: Towards Closer Integration

    Directory of Open Access Journals (Sweden)

    Nataša Jokić-Begić

    2010-12-01

    Full Text Available The aim of this review article is to provide an integrative perspective by combining basic assumptions of cognitive behavioral therapy (CBT with neuroscience research results. In recent years, interdisciplinary research in the field of neuroscience has expanded our knowledge about neurobiological correlates of mental processes and changes occurring in the brain due to therapeutic interventions. The studies are largely based on non-invasive brain imaging techniques, such as functional neuroimaging technologies of positron emission tomography (PET and functional magnetic resonance imaging (fMRI. The neuroscientific investigations of basic CBT hypotheses have shown that (i functional and non-functional behavior and experiences may be learned through lifelong learning, due to brain neuroplasticity that continues across the entire lifespan; (ii cognitive activity contributes to dysfunctional behavior and emotional experience through focusing, selective perception, memory and recall, and characteristic cognitive distortion; on a neurobiological level, there is a relationship between top-down and bottom-up regulation of unpleasant emotional states; and (iii cognitive activity may be changed, as shown by therapeutic success achieved by metacognitive and mindfulness techniques, which also have their neurobiological correlates in the changes occurring in the cortical and subcortical structures and endocrine and immune systems. The empirical research also shows that neurobiological changes occur after CBT in patients with arachnophobia, obsessive-compulsive disorder, panic disorder, social phobia, major depressive disorder and chronic fatigue syndrome.disorder and chronic fatigue syndrome.

  12. Light Water Reactor Sustainability Program: Integrated Program Plan

    International Nuclear Information System (INIS)

    2016-02-01

    and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program's plans. For the LWRS Program, sustainability is defined as the ability to maintain safe and economic operation of the existing fleet of nuclear power plants for a longer-than-initially-licensed lifetime. It has two facets with respect to long-term operations: (1) manage the aging of plant systems, structures, and components so that nuclear power plant lifetimes can be extended and the plants can continue to operate safely, efficiently, and economically; and (2) provide science-based solutions to the industry to implement technology to exceed the performance of the current labor-intensive business model.

  13. Light Water Reactor Sustainability Program: Integrated Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-02-15

    proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program's plans. For the LWRS Program, sustainability is defined as the ability to maintain safe and economic operation of the existing fleet of nuclear power plants for a longer-than-initially-licensed lifetime. It has two facets with respect to long-term operations: (1) manage the aging of plant systems, structures, and components so that nuclear power plant lifetimes can be extended and the plants can continue to operate safely, efficiently, and economically; and (2) provide science-based solutions to the industry to implement technology to exceed the performance of the current labor-intensive business model.

  14. Integrative Care Therapies and Physiological and Pain-related Outcomes in Hospitalized Infants

    OpenAIRE

    Hathaway, Elizabeth E.; Luberto, Christina M.; Bogenschutz, Lois H.; Geiss, Sue; Wasson, Rachel S.; Cotton, Sian

    2015-01-01

    Background: Pain management is a frequent problem in the neonatal intensive care unit (NICU). Few studies examining effects of integrative care therapies on pain-related outcomes in neonates have included physiological outcomes or investigated the use of such therapies in a practice-based setting. Objective: The purpose of this practice-based retrospective study was to examine the associations between integrative care therapies, particularly massage and healing touch, and pain-related outcome...

  15. Light Water Reactor Sustainability Program Integrated Program Plan

    International Nuclear Information System (INIS)

    Griffith, George; Youngblood, Robert; Busby, Jeremy; Hallbert, Bruce; Barnard, Cathy; McCarthy, Kathryn

    2012-01-01

    Nuclear power has safely, reliably, and economically contributed almost 20% of electrical generation in the United States over the past two decades. It remains the single largest contributor (more than 70%) of non-greenhouse-gas-emitting electric power generation in the United States. Domestic demand for electrical energy is expected to experience a 31% growth from 2009 to 2035. At the same time, most of the currently operating nuclear power plants will begin reaching the end of their initial 20-year extension to their original 40-year operating license for a total of 60 years of operation. Figure E-1 shows projected nuclear energy contribution to the domestic generating capacity. If current operating nuclear power plants do not operate beyond 60 years, the total fraction of generated electrical energy from nuclear power will begin to decline - even with the expected addition of new nuclear generating capacity. The oldest commercial plants in the United States reached their 40th anniversary in 2009. The U.S. Department of Energy Office of Nuclear Energy's Research and Development Roadmap (Nuclear Energy Roadmap) organizes its activities around four objectives that ensure nuclear energy remains a compelling and viable energy option for the United States. The four objectives are as follows: (1) develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of the current reactors; (2) develop improvements in the affordability of new reactors to enable nuclear energy to help meet the Administration's energy security and climate change goals; (3) develop sustainable nuclear fuel cycles; and (4) understand and minimize the risks of nuclear proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program's plans.

  16. Light Water Reactor Sustainability Program Integrated Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    George Griffith; Robert Youngblood; Jeremy Busby; Bruce Hallbert; Cathy Barnard; Kathryn McCarthy

    2012-01-01

    Nuclear power has safely, reliably, and economically contributed almost 20% of electrical generation in the United States over the past two decades. It remains the single largest contributor (more than 70%) of non-greenhouse-gas-emitting electric power generation in the United States. Domestic demand for electrical energy is expected to experience a 31% growth from 2009 to 2035. At the same time, most of the currently operating nuclear power plants will begin reaching the end of their initial 20-year extension to their original 40-year operating license for a total of 60 years of operation. Figure E-1 shows projected nuclear energy contribution to the domestic generating capacity. If current operating nuclear power plants do not operate beyond 60 years, the total fraction of generated electrical energy from nuclear power will begin to decline - even with the expected addition of new nuclear generating capacity. The oldest commercial plants in the United States reached their 40th anniversary in 2009. The U.S. Department of Energy Office of Nuclear Energy's Research and Development Roadmap (Nuclear Energy Roadmap) organizes its activities around four objectives that ensure nuclear energy remains a compelling and viable energy option for the United States. The four objectives are as follows: (1) develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of the current reactors; (2) develop improvements in the affordability of new reactors to enable nuclear energy to help meet the Administration's energy security and climate change goals; (3) develop sustainable nuclear fuel cycles; and (4) understand and minimize the risks of nuclear proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program's plans.

  17. Light Water Reactor Sustainability Program: Integrated Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2017-05-01

    proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program’s plans. For the LWRS Program, sustainability is defined as the ability to maintain safe and economic operation of the existing fleet of nuclear power plants for a longer-than-initially-licensed lifetime. It has two facets with respect to long-term operations: (1) manage the aging of plant systems, structures, and components so that nuclear power plant lifetimes can be extended and the plants can continue to operate safely, efficiently, and economically; and (2) provide science-based solutions to the industry to implement technology to exceed the performance of the current labor-intensive business model.

  18. Mixed Waste Integrated Program Quality Assurance requirements plan

    International Nuclear Information System (INIS)

    1994-01-01

    Mixed Waste Integrated Program (MWIP) is sponsored by the US Department of Energy (DOE), Office of Technology Development, Waste Management Division. The strategic objectives of MWIP are defined in the Mixed Waste Integrated Program Strategic Plan, and expanded upon in the MWIP Program Management Plan. This MWIP Quality Assurance Requirement Plan (QARP) applies to mixed waste treatment technologies involving both hazardous and radioactive constituents. As a DOE organization, MWIP is required to develop, implement, and maintain a written Quality Assurance Program in accordance with DOE Order 4700.1 Project Management System, DOE Order 5700.6C, Quality Assurance, DOE Order 5820.2A Radioactive Waste Management, ASME NQA-1 Quality Assurance Program Requirements for Nuclear Facilities and ANSI/ASQC E4-19xx Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs. The purpose of the MWIP QA program is to establish controls which address the requirements in 5700.6C, with the intent to minimize risks and potential environmental impacts; and to maximize environmental protection, health, safety, reliability, and performance in all program activities. QA program controls are established to assure that each participating organization conducts its activities in a manner consistent with risks posed by those activities

  19. Mixed Waste Integrated Program Quality Assurance requirements plan

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-15

    Mixed Waste Integrated Program (MWIP) is sponsored by the US Department of Energy (DOE), Office of Technology Development, Waste Management Division. The strategic objectives of MWIP are defined in the Mixed Waste Integrated Program Strategic Plan, and expanded upon in the MWIP Program Management Plan. This MWIP Quality Assurance Requirement Plan (QARP) applies to mixed waste treatment technologies involving both hazardous and radioactive constituents. As a DOE organization, MWIP is required to develop, implement, and maintain a written Quality Assurance Program in accordance with DOE Order 4700.1 Project Management System, DOE Order 5700.6C, Quality Assurance, DOE Order 5820.2A Radioactive Waste Management, ASME NQA-1 Quality Assurance Program Requirements for Nuclear Facilities and ANSI/ASQC E4-19xx Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs. The purpose of the MWIP QA program is to establish controls which address the requirements in 5700.6C, with the intent to minimize risks and potential environmental impacts; and to maximize environmental protection, health, safety, reliability, and performance in all program activities. QA program controls are established to assure that each participating organization conducts its activities in a manner consistent with risks posed by those activities.

  20. A program for performing angular integrations for transition operators

    International Nuclear Information System (INIS)

    Froese Fischer, C.; Godefroid, M.R.; Hibbert, A.

    1991-01-01

    The MCHF-MLTPOL program performs the angular integrations necessary for expressing the matrix elements of transition operators, E1, E2, ..., or M1, M2, ..., as linear combinations of radial integrals. All matrix elements for transitions between two lists of configuration states will be evaluated. A limited amount of non-orthogonality is allowed between orbitals of the initial and final state. (orig.)

  1. Light Water Reactor Sustainability Program Integrated Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    McCarthy, Kathryn A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Busby, Jeremy [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hallbert, Bruce [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bragg-Sitton, Shannon [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smith, Curtis [Idaho National Lab. (INL), Idaho Falls, ID (United States); Barnard, Cathy [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-04-01

    Nuclear power has safely, reliably, and economically contributed almost 20% of electrical generation in the United States over the past two decades. It remains the single largest contributor (more than 70%) of non-greenhouse-gas-emitting electric power generation in the United States. Domestic demand for electrical energy is expected to experience a 31% growth from 2009 to 2035. At the same time, most of the currently operating nuclear power plants will begin reaching the end of their initial 20-year extension to their original 40-year operating license for a total of 60 years of operation. Figure E-1 shows projected nuclear energy contribution to the domestic generating capacity. If current operating nuclear power plants do not operate beyond 60 years, the total fraction of generated electrical energy from nuclear power will begin to decline—even with the expected addition of new nuclear generating capacity. The oldest commercial plants in the United States reached their 40th anniversary in 2009. The U.S. Department of Energy Office of Nuclear Energy’s Research and Development Roadmap (Nuclear Energy Roadmap) organizes its activities around four objectives that ensure nuclear energy remains a compelling and viable energy option for the United States. The four objectives are as follows: (1) develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of the current reactors; (2) develop improvements in the affordability of new reactors to enable nuclear energy to help meet the Administration’s energy security and climate change goals; (3) develop sustainable nuclear fuel cycles; and (4) understand and minimize the risks of nuclear proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program’s plans.

  2. Light Water Reactor Sustainability Program Integrated Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Kathryn McCarthy; Jeremy Busby; Bruce Hallbert; Shannon Bragg-Sitton; Curtis Smith; Cathy Barnard

    2013-04-01

    Nuclear power has safely, reliably, and economically contributed almost 20% of electrical generation in the United States over the past two decades. It remains the single largest contributor (more than 70%) of non-greenhouse-gas-emitting electric power generation in the United States. Domestic demand for electrical energy is expected to experience a 31% growth from 2009 to 2035. At the same time, most of the currently operating nuclear power plants will begin reaching the end of their initial 20-year extension to their original 40-year operating license for a total of 60 years of operation. Figure E-1 shows projected nuclear energy contribution to the domestic generating capacity. If current operating nuclear power plants do not operate beyond 60 years, the total fraction of generated electrical energy from nuclear power will begin to decline—even with the expected addition of new nuclear generating capacity. The oldest commercial plants in the United States reached their 40th anniversary in 2009. The U.S. Department of Energy Office of Nuclear Energy’s Research and Development Roadmap (Nuclear Energy Roadmap) organizes its activities around four objectives that ensure nuclear energy remains a compelling and viable energy option for the United States. The four objectives are as follows: (1) develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of the current reactors; (2) develop improvements in the affordability of new reactors to enable nuclear energy to help meet the Administration’s energy security and climate change goals; (3) develop sustainable nuclear fuel cycles; and (4) understand and minimize the risks of nuclear proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document summarizes the LWRS Program’s plans.

  3. Integration of safety engineering into a cost optimized development program.

    Science.gov (United States)

    Ball, L. W.

    1972-01-01

    A six-segment management model is presented, each segment of which represents a major area in a new product development program. The first segment of the model covers integration of specialist engineers into 'systems requirement definition' or the system engineering documentation process. The second covers preparation of five basic types of 'development program plans.' The third segment covers integration of system requirements, scheduling, and funding of specialist engineering activities into 'work breakdown structures,' 'cost accounts,' and 'work packages.' The fourth covers 'requirement communication' by line organizations. The fifth covers 'performance measurement' based on work package data. The sixth covers 'baseline requirements achievement tracking.'

  4. Hazardous Waste Remedial Actions Program: integrating waste management

    International Nuclear Information System (INIS)

    Petty, J.L.; Sharples, F.E.

    1986-01-01

    The Hazardous Waste Remedial Actions Program was established to integrate Defense Programs' activities in hazardous and mixed waste management. The Program currently provides centralized planning and technical support to the Office of the Assistant Secretary for Defense Programs. More direct project management responsibilities may be assumed in the future. The Program, under the direction of the ASDP's Office of Defense Waste and Transportation Management, interacts with numerous organizational entities of the Department. The Oak Ridge Operations Office has been designated as the Lead Field Office. The Program's four current components cover remedial action project identification and prioritization; technology adaptation; an informative system; and a strategy study for long-term, ''corporate'' project and facility planning

  5. Boosting program integrity and effectiveness of the cognitive behavioral program EQUIP for incarcerated youth in The Netherlands

    NARCIS (Netherlands)

    Helmond, P.; Overbeek, G.; Brugman, D.

    2014-01-01

    This study examined whether a "program integrity booster" could improve the low to moderate program integrity and effectiveness of the EQUIP program for incarcerated youth as practiced in The Netherlands. Program integrity was assessed in EQUIP groups before and after the booster. Youth residing in

  6. Attitudes Toward Integration as Perceived by Preservice Teachers Enrolled in an Integrated Mathematics, Science, and Technology Teacher Education Program.

    Science.gov (United States)

    Berlin, Donna F.; White, Arthur L.

    2002-01-01

    Describes the purpose of the Master of Education (M. Ed.) Program in Integrated Mathematics, Science, and Technology Education (MSAT Program) at The Ohio State University and discusses preservice teachers' attitudes and perceptions toward integrated curriculum. (Contains 35 references.) (YDS)

  7. Integrated inspection programs at Bruce Heavy Water Plant

    International Nuclear Information System (INIS)

    Brown, K.C.

    1992-01-01

    Quality pressure boundary maintenance and an excellent loss prevention record at Bruce Heavy Water Plant are the results of the Material and Inspection Unit's five inspection programs. Experienced inspectors are responsible for the integrity of the pressure boundary in their own operating area. Inspectors are part of the Technical Section, and along with unit engineering staff, they provide technical input before, during, and after the job. How these programs are completed, and the results achieved, are discussed. 5 figs., 1 appendix

  8. IAEA integrated safeguards instrumentation program (I2SIP)

    International Nuclear Information System (INIS)

    Arlt, R.; Fortakov, V.; Gaertner, K.J.

    1995-01-01

    This article is a review of the IAEA integrated safeguards instrumentation program. The historical development of the program is outlined, and current activities are also noted. Brief technical descriptions of certain features are given. It is concluded that the results of this year's efforts in this area will provide significant input and be used to assess the viability of the proposed concepts and to decide on the directions to pursue in the future

  9. Integrated inspection programs at Bruce Heavy Water Plant

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K C [Ontario Hydro, Tiverton, ON (Canada)

    1993-12-31

    Quality pressure boundary maintenance and an excellent loss prevention record at Bruce Heavy Water Plant are the results of the Material and Inspection Unit`s five inspection programs. Experienced inspectors are responsible for the integrity of the pressure boundary in their own operating area. Inspectors are part of the Technical Section, and along with unit engineering staff, they provide technical input before, during, and after the job. How these programs are completed, and the results achieved, are discussed. 5 figs., 1 appendix.

  10. Integrative Therapies for Women with a High Risk Pregnancy During Antepartum Hospitalization.

    Science.gov (United States)

    Schlegel, Merry L; Whalen, Jeanne L; Williamsen, Pilar M

    High-risk pregnancies that require lengthy hospitalization can cause anxiety and stress for pregnant women. Integrative medicine therapies may be beneficial for this population, but have not been widely studied. The purpose of this study was to evaluate potential effects of acupuncture, guided imagery, Healing Touch, massage therapy, and reflexology on pain and anxiety of hospitalized pregnant women. A retrospective analysis of the effects of integrative medicine therapies was conducted; N = 554 individual therapies were provided to hospitalized women with high-risk pregnancies. They included acupuncture (n = 83), guided imagery (n = 71), Healing Touch (n = 119), massage therapy (n = 196), and reflexology (n = 85) over an 18-month period. Pain and anxiety were measured pre- and posttherapy using a scale of 0 to 10, where 0 means no pain or no anxiety and 10 means high pain or high anxiety. Analysis of mean scores of pre- and posttherapies for pain and anxiety found a decrease of pain and anxiety after all of the therapies, ranging from an 84.5% to 61.4% decrease for pain (p < .0001) and a 91% to 70. 9% decrease for anxiety (p < .0001). Overall, patients rated their anxiety higher than pain prior to each therapy. Hospitalized pregnant women responded favorably to the therapies. There were no adverse reactions reported. Results suggest potential benefits of integrative medicine therapies for this group of inpatients. Anxiety was more prevalent than pain among hospitalized pregnant women who received integrative medicine therapy.

  11. Integrative therapies for low back pain that include complementary and alternative medicine care: a systematic review.

    Science.gov (United States)

    Kizhakkeveettil, Anupama; Rose, Kevin; Kadar, Gena E

    2014-09-01

    Systematic review of the literature. To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians.

  12. Danish integrated antimicrobial in resistance monitoring and research program

    DEFF Research Database (Denmark)

    Hammerum, Anette Marie; Heuer, Ole Eske; Emborg, Hanne-Dorthe

    2007-01-01

    a systematic and continuous monitoring program of antimicrobial drug consumption and antimicrobial agent resistance in animals, food, and humans, the Danish Integrated Antimicrobial Resistance Monitoring and Research Program (DANMAP). Monitoring of antimicrobial drug resistance and a range of research......Resistance to antimicrobial agents is an emerging problem worldwide. Awareness of the undesirable consequences of its widespread occurrence has led to the initiation of antimicrobial agent resistance monitoring programs in several countries. In 1995, Denmark was the first country to establish...... activities related to DANMAP have contributed to restrictions or bans of use of several antimicrobial agents in food animals in Denmark and other European Union countries....

  13. Trends and Features of Student Research Integration in Educational Program

    Science.gov (United States)

    Grinenko, Svetlana; Makarova, Elena; Andreassen, John-Erik

    2016-01-01

    This study examines trends and features of student research integration in educational program during international cooperation between Østfold University College in Norway and Southern Federal University in Russia. According to research and education approach the international project is aimed to use four education models, which linked student…

  14. Planning integration FY 1996 program plan. Revision 1

    International Nuclear Information System (INIS)

    1995-09-01

    This Multi-Year Program Plan (MAP) Planning Integration Program, Work Breakdown Structure (WBS) Element 1.8.2, is the primary management tool to document the technical, schedule, and cost baseline for work directed by the US Department of Energy (DOE), Richland Operations Office (RL). As an approved document, it establishes an agreement between RL and the performing contractors for the work to be performed. It was prepared by Westinghouse Hanford Company (WHC) and Pacific Northwest Laboratory (PNL). The MYPPs for the Hanford Site programs are to provide a picture from fiscal year (FY) 1996 through FY 2002. At RL Planning and Integration Division (PID) direction, only the FY 1996 Planning Integration Program work scope has been planned and presented in this MAP. Only those known significant activities which occur after FY 1996 are portrayed in this MAP. This is due to the uncertainty of who will be accomplishing what work scope when, following the award of the Management and Integration (M ampersand I) contract

  15. Integral Fast Reactor Program annual progress report, FY 1991

    International Nuclear Information System (INIS)

    1992-06-01

    This report summarizes highlights of the technical progress made in the Integral Fast Reactor (IFR) Program in FY 1991. Technical accomplishments are presented in the following areas of the IFR technology development activities: (1) metal fuel performance, (2) pyroprocess development, (3) safety experiments and analyses, (4) core design development, (5) fuel cycle demonstration, and (6) LMR technology R ampersand D

  16. A mixed integer linear program for an integrated fishery | Hasan ...

    African Journals Online (AJOL)

    ... and labour allocation of quota based integrated fisheries. We demonstrate the workability of our model with a numerical example and sensitivity analysis based on data obtained from one of the major fisheries in New Zealand. Keywords: mixed integer linear program, fishing, trawler scheduling, processing, quotas ORiON: ...

  17. Integral Fast Reactor Program. Annual progress report, FY 1992

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Y.I.; Walters, L.C.; Laidler, J.J.; Pedersen, D.R.; Wade, D.C.; Lineberry, M.J.

    1993-06-01

    This report summarizes highlights of the technical progress made in the Integral Fast Reactor (IFR) Program in FY 1992. Technical accomplishments are presented in the following areas of the IFR technology development activities: (1) metal fuel performance, (2) pyroprocess development, (3) safety experiments and analyses, (4) core design development, (5) fuel cycle demonstration, and (6) LMR technology R&D.

  18. Integral Fast Reactor Program annual progress report, FY 1994

    International Nuclear Information System (INIS)

    Chang, Y.I.; Walters, L.C.; Laidler, J.J.; Pedersen, D.R.; Wade, D.C.; Lineberry, J.J.

    1994-12-01

    This report summarizes highlights of the technical progress made in the Integral Fast Reactor (IFR) Program in FY 1994. Technical accomplishments are presented in the following areas of the IFR technology development activities: metal fuel performance; pyroprocess development; safety experiments and analyses; core design development; fuel cycle demonstration; and LMR technology R ampersand D

  19. Hawaii Integrated Biofuels Research Program: Final Subcontract Report, Phase III

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-01

    This report is a compilation of studies done to develop an integrated set of strategies for the production of energy from renewable resources in Hawaii. Because of the close coordination between this program and other ongoing DOE research, the work will have broad-based applicability to the entire United States.

  20. Integral Fast Reactor Program. Annual progress report, FY 1993

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Y.I.; Walters, L.C.; Laidler, J.J.; Pedersen, D.R.; Wade, D.C.; Lineberry, M.J.

    1994-10-01

    This report summarizes highlights of the technical progress made in the Integral Fast Reactor (IFR) Program in FY 1993. Technical accomplishments are presented in the following areas of the IFR technology development activities: (1) metal fuel performance, (2) pyroprocess development, (3) safety experiments and analyses, (4) core design development, (5) fuel cycle demonstration, and (6) LMR technology R and D.

  1. Integral Fast Reactor Program. Annual progress report, FY 1993

    International Nuclear Information System (INIS)

    Chang, Y.I.; Walters, L.C.; Laidler, J.J.; Pedersen, D.R.; Wade, D.C.; Lineberry, M.J.

    1994-10-01

    This report summarizes highlights of the technical progress made in the Integral Fast Reactor (IFR) Program in FY 1993. Technical accomplishments are presented in the following areas of the IFR technology development activities: (1) metal fuel performance, (2) pyroprocess development, (3) safety experiments and analyses, (4) core design development, (5) fuel cycle demonstration, and (6) LMR technology R and D

  2. Biomass Program 2007 Peer Review - Integrated Biorefinery Platform Summary

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2009-10-27

    This document discloses the comments provided by a review panel at the U.S. Department of Energy Office of the Biomass Program Peer Review held on November 15-16, 2007 in Baltimore, MD and the Integrated Biorefinery Platform Review held on August 13-15, 2007 in Golden, Colorado.

  3. What is Program Collaboration and Service Integration (PCSI)?

    Centers for Disease Control (CDC) Podcasts

    2009-12-07

    This podcast provides a description of Program Collaboration and Service Integration (PCSI).  Created: 12/7/2009 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 12/7/2009.

  4. Classroom drama therapy program for immigrant and refugee adolescents: a pilot study.

    Science.gov (United States)

    Rousseau, Cécile; Benoit, Maryse; Gauthier, Marie-France; Lacroix, Louise; Alain, Néomée; Rojas, Musuk Viger; Moran, Alejandro; Bourassa, Dominique

    2007-07-01

    This evaluative study assesses the effects of a school drama therapy program for immigrant and refugee adolescents designed to prevent emotional and behavioral problems and to enhance school performance. The 9-week program involved 136 newcomers, aged 12 to 18, attending integration classes in a multiethnic school. Pretest and posttest data were collected from the students and their teachers. The self-report and teacher's forms of the Strengths and Difficulties Questionnaire were used to assess emotional and behavioral symptoms. At the end of the program, although there were no reported improvement in self-esteem or emotional and behavioral symptoms, the adolescents in the experimental group reported lower mean levels of impairment by symptoms than those in the control group, when baseline data were controlled for. Their performance in mathematics also increased significantly compared to that of their control peers. The findings suggest that the workshops may have an impact on social adjustment of recently arrived immigrants and refugees. This drama therapy program appears to be a promising way of working preventively and in a nonstigmatizing manner with adolescents who have been exposed to diverse forms of adversity, among which are war and violence.

  5. 25 CFR 39.132 - Can a school integrate Language Development programs into its regular instructional program?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can a school integrate Language Development programs into... Language Development Programs § 39.132 Can a school integrate Language Development programs into its regular instructional program? A school may offer Language Development programs to students as part of its...

  6. Integrated initial training program for a CEGB operations engineer

    International Nuclear Information System (INIS)

    Tompsett, P.A.

    1987-01-01

    This paper considers the overall training programs undertaken by a newly appointed Operations Engineer at one of the Central Electricity Generating Board's (CEGB) Advanced Gas Cooled Reactor (AGR) nuclear power stations. The training program is designed to equip him with the skills and knowledge necessary for him to discharge his duties safely and effectively. In order to assist the learning process and achieve and integrated program, aspects of reactor technology and operation, initially the subject of theoretical presentations at the CEGB's Nuclear Power Training Center (NPTC) are reinforced by either simulation and/or practical experience on site. In the later stages plant-specific simulators, operated by trained tutors, are incorporated into the training program to provide the trainee with practical experience of plant operation. The trainee's performance is assessed throughout the program to provide feedback to the trainee, the trainers and station management

  7. Achieving High Reliability Operations Through Multi-Program Integration

    Energy Technology Data Exchange (ETDEWEB)

    Holly M. Ashley; Ronald K. Farris; Robert E. Richards

    2009-04-01

    Over the last 20 years the Idaho National Laboratory (INL) has adopted a number of operations and safety-related programs which has each periodically taken its turn in the limelight. As new programs have come along there has been natural competition for resources, focus and commitment. In the last few years, the INL has made real progress in integrating all these programs and are starting to realize important synergies. Contributing to this integration are both collaborative individuals and an emerging shared vision and goal of the INL fully maturing in its high reliability operations. This goal is so powerful because the concept of high reliability operations (and the resulting organizations) is a masterful amalgam and orchestrator of the best of all the participating programs (i.e. conduct of operations, behavior based safety, human performance, voluntary protection, quality assurance, and integrated safety management). This paper is a brief recounting of the lessons learned, thus far, at the INL in bringing previously competing programs into harmony under the goal (umbrella) of seeking to perform regularly as a high reliability organization. In addition to a brief diagram-illustrated historical review, the authors will share the INL’s primary successes (things already effectively stopped or started) and the gaps yet to be bridged.

  8. Steam-Generator Integrity Program/Steam-Generator Group Project

    International Nuclear Information System (INIS)

    1982-10-01

    The Steam Generator Integrity Program (SGIP) is a comprehensive effort addressing issues of nondestructive test (NDT) reliability, inservice inspection (ISI) requirements, and tube plugging criteria for PWR steam generators. In addition, the program has interactive research tasks relating primary side decontamination, secondary side cleaning, and proposed repair techniques to nondestructive inspectability and primary system integrity. The program has acquired a service degraded PWR steam generator for research purposes. This past year a research facility, the Steam Generator Examination Facility (SGEF), specifically designed for nondestructive and destructive examination tasks of the SGIP was completed. The Surry generator previously transported to the Hanford Reservation was then inserted into the SGEF. Nondestructive characterization of the generator from both primary and secondary sides has been initiated. Decontamination of the channelhead cold leg side was conducted. Radioactive field maps were established in the steam generator, at the generator surface and in the SGEF

  9. Decoding the integrated approach to yoga therapy: Qualitative evidence based conceptual framework.

    Science.gov (United States)

    Villacres, Maria Del Carmen; Jagannathan, Aarti; Nagarathna, R; Ramakrsihna, Jayashree

    2014-01-01

    The aim of this study was to define, decode, and append to the conceptual frame-work of the integrated approach to yoga therapy (IAYT). Four stakeholders who followed two in-patients with depression over a period of 2 weeks in the residential center Arogyadhama (of Swami Vivekananda Yoga Anusandana Samsthana, Bangalore, India) were interviewed before the start of the IAYT treatment and prior to discharge of the patient. The patients were also interviewed pre and post and were observed once during their session. The data from the audio recordings from eight in-depth interviews were transcribed manually and qualitative analysis was conducted. The conceptual frame-work of IAYT depicts that patient related factors ("co-operation of patient", "patients awareness of his/her condition"), therapist related factors ("ability to guide", "the assistance to the patients", "explanation of the exercises") and treatment related factors ("combination of psychiatric or Ayurvedic medication with yoga", "counseling during the IAYT treatment", duration of treatment), play an integrated role in reaching the "aim of IAYT" and experiencing "improvements and changes". The IAYT is a holistic program and the ability of the patient to cooperate with and integrate the available factors (therapist related and treatment related) could enable best results.

  10. The use of art and music therapy in substance abuse treatment programs.

    Science.gov (United States)

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

    2014-01-01

    Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

  11. Power and Responsibility in Therapy: Integrating Feminism and Multiculturalism

    Science.gov (United States)

    Williams, Elizabeth Nutt; Barber, Jill S.

    2004-01-01

    The integration of feminist and multicultural approaches to psychotherapy, called for many times, has not yet materialized. This article reviews possible reasons this integration has not taken place and offers an approach to integration based on the guiding principles of power and responsibility, which builds on previous theories and approaches.

  12. Integrating Music Therapy Services and Speech-Language Therapy Services for Children with Severe Communication Impairments: A Co-Treatment Model

    Science.gov (United States)

    Geist, Kamile; McCarthy, John; Rodgers-Smith, Amy; Porter, Jessica

    2008-01-01

    Documenting how music therapy can be integrated with speech-language therapy services for children with communication delay is not evident in the literature. In this article, a collaborative model with procedures, experiences, and communication outcomes of integrating music therapy with the existing speech-language services is given. Using…

  13. The integration of occupational therapy into primary care: a multiple case study design

    Science.gov (United States)

    2013-01-01

    Background For over two decades occupational therapists have been encouraged to enhance their roles within primary care and focus on health promotion and prevention activities. While there is a clear fit between occupational therapy and primary care, there have been few practice examples, despite a growing body of evidence to support the role. In 2010, the province of Ontario, Canada provided funding to include occupational therapists as members of Family Health Teams, an interprofessional model of primary care. The integration of occupational therapists into this model of primary care is one of the first large scale initiatives of its kind in North America. The objective of the study was to examine how occupational therapy services are being integrated into primary care teams and understand the structures supporting the integration. Methods A multiple case study design was used to provide an in-depth description of the integration of occupational therapy. Four Family Health Teams with occupational therapists as part of the team were identified. Data collection included in-depth interviews, document analyses, and questionnaires. Results Each Family Health Team had a unique organizational structure that contributed to the integration of occupational therapy. Communication, trust and understanding of occupational therapy were key elements in the integration of occupational therapy into Family Health Teams, and were supported by a number of strategies including co-location, electronic medical records and team meetings. An understanding of occupational therapy was critical for integration into the team and physicians were less likely to understand the occupational therapy role than other health providers. Conclusion With an increased emphasis on interprofessional primary care, new professions will be integrated into primary healthcare teams. The study found that explicit strategies and structures are required to facilitate the integration of a new professional group

  14. The Impact of a Therapy Dog Program on Children's Reading: Follow-Up and Extension to ELL Students

    Science.gov (United States)

    Kirnan, Jean; Ventresco, Nina E.; Gardner, Thomas

    2018-01-01

    An initiative in which therapy dogs were integrated into a school-wide reading curriculum was analyzed to determine the effect on student reading in the program's second year. Prior research on the first year of this specific program (Kirnan et al. in "Early Child Educ J" 44(6):637-651) demonstrated improvement in reading scores only for…

  15. Documentation of COMRAD program (= Comprehensive System for Interactive Planning in Radiation Therapy)

    International Nuclear Information System (INIS)

    Pfister, G.; Friedlein, H.P.

    1984-05-01

    COMRAD is a radiotherapy planning program for calculating dose distribution in two- and three-dimensional patient geometries with coplanar or non-coplanar fields. The program was developed at the IBM Scientific Center Heidelberg and extended for applications in neutron therapy at the IKE by integration of the neutron dose formula and further specification options. These modifications were necessary for an accurate determination of inhomogeneities in neutron therapy and for neutron kerma calculations. Administrative data, e.g. patient name and number, date, doctor and physicist appear on all printed dose distributions. The treatment data comprise the therapy unit in use, specifications of the radiation field (radiation axis, source/skin distance, portal size, rotation parameters), dose specifications, and field specifications. The location and orientation of the planar cuts through the patient (windows) into which dose distributions shall be calculated can be set at will. The same applies to the density of the raster points at which dose values shall be computed. (orig./HP) [de

  16. International Piping Integrity Research Group (IPIRG) Program. Final report

    International Nuclear Information System (INIS)

    Wilkowski, G.; Schmidt, R.; Scott, P.

    1997-06-01

    This is the final report of the International Piping Integrity Research Group (IPIRG) Program. The IPIRG Program was an international group program managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United States. The program objective was to develop data needed to verify engineering methods for assessing the integrity of circumferentially-cracked nuclear power plant piping. The primary focus was an experimental task that investigated the behavior of circumferentially flawed piping systems subjected to high-rate loadings typical of seismic events. To accomplish these objectives a pipe system fabricated as an expansion loop with over 30 meters of 16-inch diameter pipe and five long radius elbows was constructed. Five dynamic, cyclic, flawed piping experiments were conducted using this facility. This report: (1) provides background information on leak-before-break and flaw evaluation procedures for piping, (2) summarizes technical results of the program, (3) gives a relatively detailed assessment of the results from the pipe fracture experiments and complementary analyses, and (4) summarizes advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG program

  17. International Piping Integrity Research Group (IPIRG) Program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Wilkowski, G.; Schmidt, R.; Scott, P. [and others

    1997-06-01

    This is the final report of the International Piping Integrity Research Group (IPIRG) Program. The IPIRG Program was an international group program managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United States. The program objective was to develop data needed to verify engineering methods for assessing the integrity of circumferentially-cracked nuclear power plant piping. The primary focus was an experimental task that investigated the behavior of circumferentially flawed piping systems subjected to high-rate loadings typical of seismic events. To accomplish these objectives a pipe system fabricated as an expansion loop with over 30 meters of 16-inch diameter pipe and five long radius elbows was constructed. Five dynamic, cyclic, flawed piping experiments were conducted using this facility. This report: (1) provides background information on leak-before-break and flaw evaluation procedures for piping, (2) summarizes technical results of the program, (3) gives a relatively detailed assessment of the results from the pipe fracture experiments and complementary analyses, and (4) summarizes advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG program.

  18. Human Research Program Integrated Research Plan. Revision A January 2009

    Science.gov (United States)

    2009-01-01

    The Integrated Research Plan (IRP) describes the portfolio of Human Research Program (HRP) research and technology tasks. The IRP is the HRP strategic and tactical plan for research necessary to meet HRP requirements. The need to produce an IRP is established in HRP-47052, Human Research Program - Program Plan, and is under configuration management control of the Human Research Program Control Board (HRPCB). Crew health and performance is critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) is essential to enabling extended periods of space exploration because it provides knowledge and tools to mitigate risks to human health and performance. Risks include physiological and behavioral effects from radiation and hypogravity environments, as well as unique challenges in medical support, human factors, and behavioral or psychological factors. The Human Research Program (HRP) delivers human health and performance countermeasures, knowledge, technologies and tools to enable safe, reliable, and productive human space exploration. Without HRP results, NASA will face unknown and unacceptable risks for mission success and post-mission crew health. This Integrated Research Plan (IRP) describes HRP s approach and research activities that are intended to address the needs of human space exploration and serve HRP customers and how they are integrated to provide a risk mitigation tool. The scope of the IRP is limited to the activities that can be conducted with the resources available to the HRP; it does not contain activities that would be performed if additional resources were available. The timescale of human space exploration is envisioned to take many decades. The IRP illustrates the program s research plan through the timescale of early lunar missions of extended duration.

  19. Integrated cognitive behavioral therapy for patients with substance use disorder and comorbid ADHD: two case presentations

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wim; Schoevers, Robert A.

    2015-01-01

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option

  20. Integrated cognitive behavioral therapy for patients with Substance Use Disorder and Comorbid ADHD : Two case presentations

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wir; Schoevers, Robert A.

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option. (C) 2015 Elsevier Ltd. All rights reserved.

  1. Integrating the GalileoScope into Successful Outreach Programming

    Science.gov (United States)

    Michaud, Peter D.; Slater, S.; Goldstein, J.; Harvey, J.; Garcia, A.

    2010-01-01

    Since 2004, the Gemini Observatory’s week-long Journey Through the Universe (JTtU) program has successfully shared the excitement of scientific research with teachers, students and the public on Hawaii’s Big Island. Based on the national JTtU program started in 1999, the Hawai‘i version reaches an average of 7,000 students annually and each year features a different theme shared with a diverse set of learners. In 2010, the theme includes the integration of the GalileoScope-produced as a keystone project for the International Year of Astronomy. In preparation, a pilot teacher workshop (held in October 2009) introduced local island teachers to the GalileoScope and a 128-page educator’s activity resource book coordinated by the University of Wyoming. Response from this initial teacher’s workshop has been strong and evaluations plus follow-up actions by participating teachers illustrate that the integration of the GalileoScope has been successful based upon this diverse sample. Integrating GalileoScopes into Chilean schools in 2010 is also underway at Gemini South. This program will solicit informal proposals from educators who wish to use the telescopes in classrooms and a Spanish version of the teacher resource book is planned. The authors conclude that integration of the GalileoScope into an existing outreach program is an effective way to keep content fresh, relevant and engaging for both educators and students. This initiative is funded by Gemini Observatory outreach program. The Gemini Observatory is operated by the Association of Universities for Research in Astronomy, Inc., under a cooperative agreement with the NSF on behalf of the Gemini partnership: the National Science Foundation (US), the Science and Technology Facilities Council (UK), the National Research Council (Canada), CONICYT (Chile), the Australian Research Council (Australia), Ministério da Ciência e Tecnologia (Brazil), and Ministerio de Ciencia, Tecnología e Innovación Productiva

  2. The Use of Art and Music Therapy in Substance Abuse Treatment Programs

    Science.gov (United States)

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

    2014-01-01

    While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

  3. Stochastic programming problems with generalized integrated chance constraints

    Czech Academy of Sciences Publication Activity Database

    Branda, Martin

    2012-01-01

    Roč. 61, č. 8 (2012), s. 949-968 ISSN 0233-1934 R&D Projects: GA ČR GAP402/10/1610 Grant - others:SVV(CZ) 261315/2010 Institutional support: RVO:67985556 Keywords : chance constraints * integrated chance constraints * penalty functions * sample approximations * blending problem Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.707, year: 2012 http://library.utia.cas.cz/separaty/2012/E/branda-stochastic programming problems with generalized integrated.pdf

  4. Developing an Integrative Play Therapy Group Model for Middle School Male Students to Address Bullying Behaviors

    Science.gov (United States)

    Jordan, Jakarla

    2016-01-01

    This research examines the systematic process of developing an integrative play therapy group model for middle school male students, ages 11-15 who participate in bullying behaviors. Play therapy approaches and evidence-based practices are documented as effective measures for addressing bullying behaviors with children and adolescents. This group…

  5. Integrating play therapy in the treatment of children with obsessive-compulsive disorder.

    Science.gov (United States)

    Gold-Steinberg, S; Logan, D

    1999-10-01

    While behavioral and psychopharmacological approaches are the most effective interventions for treating obsessive-compulsive disorder (OCD), psychodynamically oriented play therapy can enhance the treatment of children with this disorder. Play therapy techniques are useful in addressing treatment resistance, feelings of shame around OCD symptoms, negative self-concept, and issues of psychosocial adjustment. A case study illustrates this integrated approach to treatment.

  6. Integrative Problem-Centered Therapy: Toward the Synthesis of Family and Individual Psychotherapies.

    Science.gov (United States)

    Pinsof, William M.

    1983-01-01

    Presents an overview of the Integrative Problem-Centered Therapy (IPCT) Model, and describes its core principles and premises, and basic methodological steps. The IPCT provides a technique for applying individual and family therapy and behavioral, communicational, and psychodynamic orientations to client problems. Its goal is to create efficient…

  7. Report of the Integrated Program Planning Activity for the DOE Fusion Energy Sciences Program

    International Nuclear Information System (INIS)

    None

    2000-01-01

    This report of the Integrated Program Planning Activity (IPPA) has been prepared in response to a recommendation by the Secretary of Energy Advisory Board that, ''Given the complex nature of the fusion effort, an integrated program planning process is an absolute necessity.'' We, therefore, undertook this activity in order to integrate the various elements of the program, to improve communication and performance accountability across the program, and to show the inter-connectedness and inter-dependency of the diverse parts of the national fusion energy sciences program. This report is based on the September 1999 Fusion Energy Sciences Advisory Committee's (FESAC) report ''Priorities and Balance within the Fusion Energy Sciences Program''. In its December 5,2000, letter to the Director of the Office of Science, the FESAC has reaffirmed the validity of the September 1999 report and stated that the IPPA presents a framework and process to guide the achievement of the 5-year goals listed in the 1999 report. The National Research Council's (NRC) Fusion Assessment Committee draft final report ''An Assessment of the Department of Energy's Office of Fusion Energy Sciences Program'', reviewing the quality of the science in the program, was made available after the IPPA report had been completed. The IPPA report is, nevertheless, consistent with the recommendations in the NRC report. In addition to program goals and the related 5-year, 10-year, and 15-year objectives, this report elaborates on the scientific issues associated with each of these objectives. The report also makes clear the relationships among the various program elements, and cites these relationships as the reason why integrated program planning is essential. In particular, while focusing on the science conducted by the program, the report addresses the important balances between the science and energy goals of the program, between the MFE and IFE approaches, and between the domestic and international aspects

  8. Integrating student-focused career planning into undergraduate gerontology programs.

    Science.gov (United States)

    Manoogian, Margaret M; Cannon, Melissa L

    2018-04-02

    As our global older adult populations are increasing, university programs are well-positioned to produce an effective, gerontology-trained workforce (Morgan, 2012; Silverstein & Fitzgerald, 2017). A gerontology curriculum comprehensively can offer students an aligned career development track that encourages them to: (a) learn more about themselves as a foundation for negotiating career paths; (b) develop and refine career skills; (c) participate in experiential learning experiences; and (d) complete competency-focused opportunities. In this article, we discuss a programmatic effort to help undergraduate gerontology students integrate development-based career planning and decision-making into their academic programs and achieve postgraduation goals.

  9. Implementation and integration of program packages NAMMU and HYPAC

    International Nuclear Information System (INIS)

    Nedbal, T.

    1986-05-01

    This work is prepared for the Swedish Power Inspectorate (SKI). The SKI has from the Atomic Energy Research Establishment (AERE) at Harwell, U.K., acquired the computer model NAMMU for groundwater hydrology calculations. The code was first implemented on an AMDAHL 470, a IBM compatible computer, and then modified in order to integrate it with HYPAC, which is a program package for pre- and post-processing finite element data, developed by KEMAKTA AB. This report describes the modifications done to both NAMMU and HYPAC, and the verification of the coupled program system NAMMU-HYPAC. (author)

  10. An integrated approach to fire penetration seal program management

    International Nuclear Information System (INIS)

    Rispoli, R.D.

    1996-01-01

    This paper discusses the utilization of a P.C. based program to facilitate the management of Entergy Operations Arkansas Nuclear One (ANO) fire barrier penetration seal program. The computer program was developed as part of a streamlining process to consolidate all aspects of the ANO Penetration Seal Program under one system. The program tracks historical information related to each seal such as maintenance activities, design modifications and evaluations. The program is integrated with approved penetration seal design details which have been substantiated by full scale fire tests. This control feature is intended to prevent the inadvertent utilization of an unacceptable penetration detail in a field application which may exceed the parameters tested. The system is also capable of controlling the scope of the periodic surveillance of penetration seals by randomly selecting the inspection population and generating associated inspection forms. Inputs to the data base are required throughout the modification and maintenance process to ensure configuration control and maintain accurate data base information. These inputs are verified and procedurally controlled by Fire Protection Engineering (FPE) personnel. The implementation of this system has resulted in significant cost savings and has minimized the allocation of resources necessary to ensure long term program viability

  11. Adherence to immunosuppressive therapy following liver transplantation: an integrative review.

    Science.gov (United States)

    Oliveira, Ramon Antônio; Turrini, Ruth Natália Teresa; Poveda, Vanessa de Brito

    2016-08-29

    to investigate the evidence available in the literature on non-adherence to immunosuppressive therapy among patients undergoing liver transplantation. integrative literature review, including research whose sample consisted of patients aged over 18 years undergoing liver transplantation. It excluded those containing patients undergoing multiple organ transplants. For the selection of articles, Medline / Pubmed, CINAHL, LILACS, Scopus and Embase were searched. The search period corresponded to the initial date of indexation of different bases, up to the deadline of February 10, 2015, using controlled and uncontrolled descriptors: liver transplantation, hepatic transplantation, liver orthotopic transplantation, medication adherence, medication non-adherence, medication compliance and patient compliance. were located 191 investigations, 10 of which met the objectives of the study and were grouped into four categories, namely: educational process and non-adherence; non-adherence related to the number of daily doses of immunosuppressive medications; detection methods for non-adherence and side effects of therapy. there were risk factors related to the health service, such as control and reduction of the number of doses; related to the individual, such as being male, divorced, alcohol or other substances user, exposed to low social support and being mentally ill. investigar as evidências disponíveis na literatura sobre a não adesão à terapêutica imunossupressora entre pacientes submetidos ao transplante de fígado. revisão integrativa da literatura, que incluiu investigações cuja amostra era composta por pacientes com idade igual ou superior a 18 anos, submetidos a transplante de fígado. Excluíram-se as que continham pacientes submetidos a transplantes de múltiplos órgãos. Para a seleção dos artigos foram consultadas as bases Medline/Pubmed, CINAHL, LILACS, Scopus e Embase. O período de busca determinado correspondeu à data inicial de indexação das

  12. Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

    Science.gov (United States)

    Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

    2017-07-01

    New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

  13. [Schema therapy: an integrative approach for personality disorders].

    Science.gov (United States)

    Roediger, Eckhard; Dieckmann, Eva

    2012-01-01

    Schema Therapy (ST) is a comprehensive approach deriving from cognitive behavioral therapy (CBT) for the treatment of chronic personality problems. ST extends CBT in 3 major issues: 1. The Schema-Mode-Model. 2. The therapeutic relationship. 3. The intensive use of experiential techniques. Schemas are persistent, rigid, and dysfunctional patterns preventing the patient from further personal emotive-interpersonal development. The central focus of the therapeutic process is the relationship between the therapist and the patient. Supported by the therapeutic relationship the patient gets in touch with painful childhood experiences. In ST, the core schemas are identified, put into a biographical context, and weakened by using several specific therapeutic techniques including experiential methods and strategies taken from Gestalt therapy that enrich traditional CBT techniques. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Integrating Hypnosis with Other Therapies for Treating Specific Phobias: A Case Series.

    Science.gov (United States)

    Hirsch, Joseph A

    2018-04-01

    There is a high prevalence of anxiety disorders including specific phobias and panic disorder in the United States and Europe. A variety of therapeutic modalities including pharmacotherapy, cognitive behavioral therapy, systematic desensitization, hypnosis, in vivo exposure, and virtual reality exposure therapy have been applied. No one modality has been entirely successful. There has been only a limited attempt to combine psychological therapies in the treatment of specific phobias and panic disorder and what has been done has been primarily with systematic desensitization or cognitive behavioral therapy along with hypnotherapy. I present two cases of multiple specific phobias that were successfully treated with hypnotherapy combined with virtual reality exposure therapy or in vivo exposure therapy. The rationale for this integrative therapy and the neurobiological constructs are considered.

  15. Integration of the TNXYZ computer program inside the platform Salome

    International Nuclear Information System (INIS)

    Chaparro V, F. J.

    2014-01-01

    The present work shows the procedure carried out to integrate the code TNXYZ as a calculation tool at the graphical simulation platform Salome. The TNXYZ code propose a numerical solution of the neutron transport equation, in several groups of energy, steady-state and three-dimensional geometry. In order to discretized the variables of the transport equation, the code uses the method of discrete ordinates for the angular variable, and a nodal method for the spatial dependence. The Salome platform is a graphical environment designed for building, editing and simulating mechanical models mainly focused on the industry and unlike other software, in order to form a complete scheme of pre and post processing of information, to integrate and control an external source code. Before the integration the in the Salome platform TNXYZ code was upgraded. TNXYZ was programmed in the 90s using Fortran 77 compiler; for this reason the code was adapted to the characteristics of the current Fortran compilers; in addition, with the intention of extracting partial results over the process sequence, the original structure of the program underwent a modularization process, i.e. the main program was divided into sections where the code performs major operations. This procedure is controlled by the information module (YACS) on Salome platform, and it could be useful for a subsequent coupling with thermal-hydraulics codes. Finally, with the help of the Monte Carlo code Serpent several study cases were defined in order to check the process of integration; the verification process consisted in performing a comparison of the results obtained with the code executed as stand-alone and after modernized, integrated and controlled by the Salome platform. (Author)

  16. The integrated approach to teaching programming in secondary school

    Directory of Open Access Journals (Sweden)

    Martynyuk A.A.

    2018-02-01

    Full Text Available the article considers an integrated approach to teaching programming with the use of technologies of computer modeling and 3D-graphics, allowing to improve the quality of education. It is shown that this method will allow you to systematize knowledge, improve the level of motivation through the inclusion of relevant technologies, to develop skills of project activities, to strengthen interdisciplinary connections, and promotes professional and personal self-determination of students of secondary school.

  17. Program integration of predictive maintenance with reliability centered maintenance

    International Nuclear Information System (INIS)

    Strong, D.K. Jr; Wray, D.M.

    1990-01-01

    This paper addresses improving the safety and reliability of power plants in a cost-effective manner by integrating the recently developed reliability centered maintenance techniques with the traditional predictive maintenance techniques of nuclear power plants. The topics of the paper include a description of reliability centered maintenance (RCM), enhancing RCM with predictive maintenance, predictive maintenance programs, condition monitoring techniques, performance test techniques, the mid-Atlantic Reliability Centered Maintenance Users Group, test guides and the benefits of shared guide development

  18. Program NICOLET to integrate energy loss in superconducting coils

    International Nuclear Information System (INIS)

    Vogel, H.F.

    1978-08-01

    A voltage pickup coil, inductively coupled to the magnetic field of the superconducting coil under test, is connected so its output may be compared with the terminal voltage of the coil under test. The integrated voltage difference is indicative of the resistive volt-seconds. When multiplied with the main coil current, the volt-seconds yield the loss. In other words, a hysteresis loop is obtained if the integrated voltage difference phi = ∫ΔVdt is plotted as a function of the coil current, i. First, time functions of the two signals phi(t) and i(t) are recorded on a dual-trace digital oscilloscope, and these signals are then recorded on magnetic tape. On a CDC-6600, the recorded information is decoded and plotted, and the hysteresis loops are integrated by the set of FORTRAN programs NICOLET described in this report. 4 figures

  19. Application of an artificial intelligence program to therapy of high-risk surgical patients.

    Science.gov (United States)

    Patil, R S; Adibi, J; Shoemaker, W C

    1996-11-01

    We developed an artificial intelligence program from a large computerized database of hemodynamic and oxygen transport measurements together with prior studies defining survivors' values, outcome predictors, and a branched-chain decision tree. The artificial intelligence program was then tested on the data of 100 survivors and 100 nonsurvivors not used for the development of the program or other analyses. Using the predictor as a surrogate outcome measure, the therapy recommended by the program improved the predicted outcome 3.16% per therapeutic intervention while the actual therapy given increased outcome 1.86% in surviving patients; the artificial intelligence-recommended therapy improved outcome 7.9% in nonsurvivors, while the actual therapy given increased predicted outcome -0.29% in nonsurvivors (p < .05). There were fewer patients whose predicted outcome decreased after recommended treatment (14%) than after the actual therapy given (37%). Review of therapy recommended by the program did not reveal instances of inappropriate or potentially harmful recommendations.

  20. Feasibility of group Cognitive Remediation Therapy in an adult eating disorder day program in New Zealand.

    Science.gov (United States)

    Roberts, Marion E

    2018-05-02

    To explore the feasibility of integrating group Cognitive Remediation Therapy (gCRT) into an eating disorder day program in Auckland, New Zealand. A consecutive series of 28 patients took part over an 8-month period in the context of a service audit. Main outcome measures were the Detail and Flexibility Questionnaire (DFlex) and qualitative feedback from patients. Significant shifts in self-report inefficient cognitive style were observed pre/post gCRT with large effect sizes (Cohen's d av ) for both cognitive rigidity and attention to detail outcomes. Patient feedback was positive, with themes of enjoyment, increased insight, and positive social interaction/esteem boosting in the context of the group emerging. Support for the acceptability, adaptation, expansion, practicality, and limited-efficacy testing of gCRT in an Australasian day program setting has been found, suggesting integration of this module into existing day treatment programs is merited. Larger scale trials may help delineate the clinical characteristics of good responders. Copyright © 2018. Published by Elsevier Ltd.

  1. 76 FR 13404 - Cancer Therapy Evaluation Program Intellectual Property Option to Collaborator

    Science.gov (United States)

    2011-03-11

    ... Option to Collaborator AGENCY: National Institutes of Health, HHS. ACTION: Notice. SUMMARY: The National... Cancer Therapy Evaluation Program's Intellectual Property Option to Collaborator. [[Page 13405... Evaluation Program (CTEP)'s Intellectual Property Option to Collaborator. The proposed revision represents a...

  2. Integrating human resources and program-planning strategies.

    Science.gov (United States)

    Smith, J E

    1989-06-01

    The integration of human resources management (HRM) strategies with long-term program-planning strategies in hospital pharmacy departments is described. HRM is a behaviorally based, comprehensive strategy for the effective management and use of people that seeks to achieve coordination and integration with overall planning strategies and other managerial functions. It encompasses forecasting of staffing requirements; determining work-related factors that are strong "motivators" and thus contribute to employee productivity and job satisfaction; conducting a departmental personnel and skills inventory; employee career planning and development, including training and education programs; strategies for promotion and succession, including routes of advancement that provide alternatives to the managerial route; and recruitment and selection of new personnel to meet changing departmental needs. Increased competitiveness among hospitals and a shortage of pharmacists make it imperative that hospital pharmacy managers create strategies to attract, develop, and retain the right individuals to enable the department--and the hospital as a whole--to grow and change in response to the changing health-care environment in the United States. Pharmacy managers would be greatly aided in this mission by the establishment of a well-defined, national strategic plan for pharmacy programs and services that includes an analysis of what education and training are necessary for their successful accomplishment. Creation of links between overall program objectives and people-planning strategies will aid hospital pharmacy departments in maximizing the long-term effectiveness of their practice.

  3. The Glory Program: Global Science from a Unique Spacecraft Integration

    Science.gov (United States)

    Bajpayee Jaya; Durham, Darcie; Ichkawich, Thomas

    2006-01-01

    The Glory program is an Earth and Solar science mission designed to broaden science community knowledge of the environment. The causes and effects of global warming have become a concern in recent years and Glory aims to contribute to the knowledge base of the science community. Glory is designed for two functions: one is solar viewing to monitor the total solar irradiance and the other is observing the Earth s atmosphere for aerosol composition. The former is done with an active cavity radiometer, while the latter is accomplished with an aerosol polarimeter sensor to discern atmospheric particles. The Glory program is managed by NASA Goddard Space Flight Center (GSFC) with Orbital Sciences in Dulles, VA as the prime contractor for the spacecraft bus, mission operations, and ground system. This paper will describe some of the more unique features of the Glory program including the integration and testing of the satellite and instruments as well as the science data processing. The spacecraft integration and test approach requires extensive analysis and additional planning to ensure existing components are successfully functioning with the new Glory components. The science mission data analysis requires development of mission unique processing systems and algorithms. Science data analysis and distribution will utilize our national assets at the Goddard Institute for Space Studies (GISS) and the University of Colorado's Laboratory for Atmospheric and Space Physics (LASP). The Satellite was originally designed and built for the Vegetation Canopy Lidar (VCL) mission, which was terminated in the middle of integration and testing due to payload development issues. The bus was then placed in secure storage in 2001 and removed from an environmentally controlled container in late 2003 to be refurbished to meet the Glory program requirements. Functional testing of all the components was done as a system at the start of the program, very different from a traditional program

  4. Program integration on the Civilian Radioactive Waste Management System

    International Nuclear Information System (INIS)

    Trebules, V.B.

    1995-01-01

    The recent development and implementation of a revised Program Approach for the Civilian Radioactive Waste Management System (CRWMS) was accomplished in response to significant changes in the environment in which the program was being executed. The lack of an interim storage site, growing costs and schedule delays to accomplish the full Yucca Mountain site characterization plan, and the development and incorporation of a multi-purpose (storage, transport, and disposal) canister (MPC) into the CRWMS required a reexamination of Program plans and priorities. Dr. Daniel A. Dreyfus, the Director of the Office of Civilian Radioactive Waste Management (OCRWM), established top-level schedule, targets and cost goals and commissioned a Program-wide task force of DOE and contractor personnel to identify and evaluate alternatives to meet them. The evaluation of the suitability of Yucca Mountain site by 1998 and the repository license application data of 2001 were maintained and a target date of January 1998 for MPC availability was established. An increased multi-year funding profile was baselined and agreed to by Congress. A $1.3 billion reduction in Yucca Mountain site characterization costs was mandated to hold the cost to $5 billion. The replanning process superseded all previous budget allocations and focused on program requirements and their relative priorities within the cost profiles. This paper discusses the process for defining alternative scenarios to achieve the top-level program goals in an integrated fashion

  5. Faculty perceptions of the integration of SAP in academic programs

    Directory of Open Access Journals (Sweden)

    Sam Khoury

    2012-08-01

    Full Text Available In order to prepare students for the workforce, academic programs incorporate a variety of tools that students are likely to use in their future careers. One of these tools employed by business and technology programs is the integration of live software applications such as SAP through the SAP University Alliance (SAP UA program. Since the SAP UA program has been around for only about 10 years and the available literature on the topic is limited, research is needed to determine the strengths and weaknesses of the SAP UA program. A collaborative study of SAP UA faculty perceptions of their SAP UAs was conducted in the fall of 2011. Of the faculty invited to participate in the study, 31% completed the online survey. The results indicate that most faculty experienced difficulty implementing SAP into their programs and report that a need exists for more standardized curriculum and training, while a large percentage indicated that they are receiving the support they need from their schools and SAP.

  6. Narrative Financial Therapy: Integrating a Financial Planning Approach with Therapeutic Theory

    Directory of Open Access Journals (Sweden)

    Megan A. McCoy

    2014-03-01

    Full Text Available The article serves as one of the first attempts to develop an integrated theoretical approach to financial therapy that can be used by practitioners from multiple disciplines. The presented approach integrates the components of the six-step financial planning process with components of empirically-supported therapeutic methods. This integration provides the foundation for a manualized approach to financial therapy, shaped by the writings of narrative theorists and select cognitive-behavioral interventions that can be used both by mental health and financial professionals.

  7. Steam generator tube integrity program: Phase II, Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, R.J.; Bickford, R.L.; Clark, R.A.; Morris, C.J.; Simonen, F.A.; Wheeler, K.R.

    1988-08-01

    The Steam Generator Tube Integrity Program (SGTIP) was a three phase program conducted for the US Nuclear Regulatory Commission (NRC) by Pacific Northwest Laboratory (PNL). The first phase involved burst and collapse testing of typical steam generator tubing with machined defects. The second phase of the SGTIP continued the integrity testing work of Phase I, but tube specimens were degraded by chemical means rather than machining methods. The third phase of the program used a removed-from-service steam generator as a test bed for investigating the reliability and effectiveness of in-service nondestructive eddy-current inspection methods and as a source of service degraded tubes for validating the Phase I and Phase II data on tube integrity. This report describes the results of Phase II of the SGTIP. The object of this effort included burst and collapse testing of chemically defected pressurized water reactor (PWR) steam generator tubing to validate empirical equations of remaining tube integrity developed during Phase I. Three types of defect geometries were investigated: stress corrosion cracking (SCC), uniform thinning and elliptical wastage. In addition, a review of the publicly available leak rate data for steam generator tubes with axial and circumferential SCC and a comparison with an analytical leak rate model is presented. Lastly, nondestructive eddy-current (EC) measurements to determine accuracy of defect depth sizing using conventional and alternate standards is described. To supplement the laboratory EC data and obtain an estimate of EC capability to detect and size SCC, a mini-round robin test utilizing several firms that routinely perform in-service inspections was conducted.

  8. Steam generator tube integrity program: Phase II, Final report

    International Nuclear Information System (INIS)

    Kurtz, R.J.; Bickford, R.L.; Clark, R.A.; Morris, C.J.; Simonen, F.A.; Wheeler, K.R.

    1988-08-01

    The Steam Generator Tube Integrity Program (SGTIP) was a three phase program conducted for the US Nuclear Regulatory Commission (NRC) by Pacific Northwest Laboratory (PNL). The first phase involved burst and collapse testing of typical steam generator tubing with machined defects. The second phase of the SGTIP continued the integrity testing work of Phase I, but tube specimens were degraded by chemical means rather than machining methods. The third phase of the program used a removed-from-service steam generator as a test bed for investigating the reliability and effectiveness of in-service nondestructive eddy-current inspection methods and as a source of service degraded tubes for validating the Phase I and Phase II data on tube integrity. This report describes the results of Phase II of the SGTIP. The object of this effort included burst and collapse testing of chemically defected pressurized water reactor (PWR) steam generator tubing to validate empirical equations of remaining tube integrity developed during Phase I. Three types of defect geometries were investigated: stress corrosion cracking (SCC), uniform thinning and elliptical wastage. In addition, a review of the publicly available leak rate data for steam generator tubes with axial and circumferential SCC and a comparison with an analytical leak rate model is presented. Lastly, nondestructive eddy-current (EC) measurements to determine accuracy of defect depth sizing using conventional and alternate standards is described. To supplement the laboratory EC data and obtain an estimate of EC capability to detect and size SCC, a mini-round robin test utilizing several firms that routinely perform in-service inspections was conducted

  9. Factors Influencing Learning Environments in an Integrated Experiential Program

    Science.gov (United States)

    Koci, Peter

    The research conducted for this dissertation examined the learning environment of a specific high school program that delivered the explicit curriculum through an integrated experiential manner, which utilized field and outdoor experiences. The program ran over one semester (five months) and it integrated the grade 10 British Columbian curriculum in five subjects. A mixed methods approach was employed to identify the students' perceptions and provide richer descriptions of their experiences related to their unique learning environment. Quantitative instruments were used to assess changes in students' perspectives of their learning environment, as well as other supporting factors including students' mindfulness, and behaviours towards the environment. Qualitative data collection included observations, open-ended questions, and impromptu interviews with the teacher. The qualitative data describe the factors and processes that influenced the learning environment and give a richer, deeper interpretation which complements the quantitative findings. The research results showed positive scores on all the quantitative measures conducted, and the qualitative data provided further insight into descriptions of learning environment constructs that the students perceived as most important. A major finding was that the group cohesion measure was perceived by students as the most important attribute of their preferred learning environment. A flow chart was developed to help the researcher conceptualize how the learning environment, learning process, and outcomes relate to one another in the studied program. This research attempts to explain through the consideration of this case study: how learning environments can influence behavioural change and how an interconnectedness among several factors in the learning process is influenced by the type of learning environment facilitated. Considerably more research is needed in this area to understand fully the complexity learning

  10. Where and how does physical therapy fit? Integrating physical therapy into interprofessional HIV care.

    Science.gov (United States)

    deBoer, Heather; Andrews, Matthew; Cudd, Stephanie; Leung, Ellie; Petrie, Alana; Chan Carusone, Soo; O'Brien, Kelly K

    2018-03-13

    To investigate the role of physical therapy in HIV care from the perspective of people living with HIV and health care professionals with expertise in HIV care. We conducted a qualitative descriptive study using semistructured interviews (with health care professionals) and focus groups (with people living with HIV). We purposively sampled health care professionals and recruited people living with HIV in collaboration with an HIV-specialty hospital. We asked participants about their knowledge of and experiences with physical therapy, and perceptions of the physical therapy role in interprofessional HIV care. We analyzed data using content analytical techniques. Thirteen people living with HIV and 12 health care professionals conceptualized physical therapy as positively influencing independence and social participation, and as a valuable ally in interprofessional collaboration. The Framework of Physical Therapy Role in HIV Care consists of two components: (1) multidimensional and client-centered roles of physical therapy addressing physical, psychological and social health domains; and (2) contextual factors important to consider for the role of physical therapy: aging, episodic nature of HIV, multimorbidity, competing priorities, continuity of care, stigma, resource security and social isolation. The interaction between contextual factors and health domains can influence the role of physical therapy. The role of physical therapy in HIV is multidimensional and client-centered. This Framework can be used by rehabilitation professionals working with people living with HIV. Implications for Rehabilitation Participants living with HIV in this study experienced physical therapy as a means of addressing rehabilitation goals that positively influenced physical health and social participation. The role of physical therapy in HIV care is multidimensional and client-centered and can address health challenges in physical, social and psychological health domains. The presence

  11. Process and Outcome Evaluation of an Art Therapy Program for People Living with HIV/AIDS

    Science.gov (United States)

    Feldman, Matthew B.; Betts, Donna J.; Blausey, Daniel

    2014-01-01

    Program evaluation offers an opportunity for improving the implementation and impact of art therapy. This article describes a process and outcomes evaluation of an art therapy program within the mental health services unit of a community-based organization for people living with HIV/AIDS. The aims were to assess utilization patterns and program…

  12. Patient-centered care in cancer treatment programs: the future of integrative oncology through psychoeducation.

    Science.gov (United States)

    Garchinski, Christina M; DiBiase, Ann-Marie; Wong, Raimond K; Sagar, Stephen M

    2014-12-01

    The reciprocal relationship between the mind and body has been a neglected process for improving the psychosocial care of cancer patients. Emotions form an important link between the mind and body. They play a fundamental role in the cognitive functions of decision-making and symptom control. Recognizing this relationship is important for integrative oncology. We define psychoeducation as the teaching of self-evaluation and self-regulation of the mind-body process. A gap exists between research evidence and implementation into clinical practice. The patients' search for self-empowerment through the pursuit of complementary therapies may be a surrogate for inadequate psychoeducation. Integrative oncology programs should implement psychoeducation that helps patients to improve both emotional and cognitive intelligence, enabling them to better negotiate cancer treatment systems.

  13. Integrating Retired Registered Nurses Into a New Graduate Orientation Program.

    Science.gov (United States)

    Baldwin, Kathleen M; Black, Denice L; Normand, Lorrie K; Bonds, Patricia; Townley, Melissa

    2016-01-01

    The project goal of was to decrease new graduate nurse (NGN) attrition during the first year of employment by improving communication skills and providing additional mentoring for NGNs employed in a community hospital located in a rural area. All NGNs participate in the Versant Residency Program. Even with this standardized residency program, exit interviews of NGNs who resigned during their first year of employment revealed 2 major issues: communication problems with patients and staff and perceived lack of support/mentoring from unit staff. A clinical nurse specialist-led nursing team developed an innovative program integrating retired nurses, Volunteer Nurse Ambassadors (VNAs), into the Versant Residency Program to address both of those issues. All NGNs mentored by a retired nurse remain employed in the hospital (100% retention). Before the VNA program, the retention rate was 37.5%. Both the NGNs and VNAs saw value in their mentor-mentee relationship. There have been no critical incidences or failure to rescue events involving NGNs mentored by a VNA. Use of VNAs to support NGNs as they adjust to the staff nurse role can prevent attrition during their first year of nursing practice by providing additional support to the NGN.

  14. INTEGRATION OPPORTUNITIES OF MIGRANTS, WITH ESPECIAL REGARDS TO SENSITIZATION PROGRAMS

    Directory of Open Access Journals (Sweden)

    Krisztina DAJNOKI

    2017-06-01

    Full Text Available As a result of the migration wave appearing in summer 2015, the issue of immigrant integration has more often become conspicuous. Although a significant decline has been recorded in the number of immigrants, social-economic-labor market integration is still a challenge for experts and a task to be resolved. In our opinion, the key to the success of migration strategies and integration-aimed programs depends on the attitude and awareness of society (public opinion and – on the organizational level – the manager and future colleagues as well as on the organizational culture and the approach of a proper human resource expert. Besides adequate information, the recognition of international ‘best practices’ and the adaptation of operational diversity-management, one of the possible methods of facilitating integration is the utilization of sensitization trainings. The article introduces partial results of a questionnaire survey involving 220 employees with respect to attributes associated with migrants and emphasizing the peculiarity and significance of sensitization trainings.

  15. Analysis of integrated plant upgrading/life extension programs

    International Nuclear Information System (INIS)

    McCutchan, D.A.; Massie, H.W. Jr.; McFetridge, R.H.

    1988-01-01

    A present-worth generating cost model has been developed and used to evaluate the economic value of integrated plant upgrading life extension project in nuclear power plants. This paper shows that integrated plant upgrading programs can be developed in which a mix of near-term availability, power rating, and heat rate improvements can be obtained in combination with life extension. All significant benefits and costs are evaluated from the viewpoint of the utility, as measured in discounted revenue requirement differentials between alternative plans which are equivalent in system generating capacity. The near-term upgrading benefits are shown to enhance the benefit picture substantially. In some cases the net benefit is positive, even if the actual life extension proves to be less than expected

  16. Benefits of Play Therapy in Hospitalized Children: An Integrative Review of the Literature

    Directory of Open Access Journals (Sweden)

    Olívia Engenheiro

    2016-04-01

    Full Text Available Objective: To identify the trend of articles published by nurses in databases on the benefits of play therapy to hospitalized children. Methodology: The PI[C]O method was used to elaborate the guiding question and the definition of inclusion and exclusion criteria for the selection of articles. Keywords were organized with the addition of the Boolean AND: Hospitalized Child; AND Play Therapy; AND Benefits and their combinations in Spanish and Portuguese languages. The study consists of an integrative bibliographical research with qualitative approach, and it was performed in the platforms of electronic databases EBSCO and B-ON, within the 2009-2013 chronological interval. Fifty articles that fitted into the objective of this study were selected. We elaborated a data collection instrument with the variables considered more relevant. Data were analyzed according to Braden and Minayo. Results: After the analysis, we proceeded to the categorization of studies: 1 Meaning of the therapy toy; 2 Ways of play therapy and types of therapy toy; 3 Importance/ benefits of using the therapy toy. Conclusion: According to the results, the benefits of play therapy are evidenced in all articles analyzed. Thus, it becomes essential to insert the play therapy in the pediatric nursing care plan for an integral and quality care.

  17. Critical Care Organizations: Building and Integrating Academic Programs.

    Science.gov (United States)

    Moore, Jason E; Oropello, John M; Stoltzfus, Daniel; Masur, Henry; Coopersmith, Craig M; Nates, Joseph; Doig, Christopher; Christman, John; Hite, R Duncan; Angus, Derek C; Pastores, Stephen M; Kvetan, Vladimir

    2018-04-01

    Academic medical centers in North America are expanding their missions from the traditional triad of patient care, research, and education to include the broader issue of healthcare delivery improvement. In recent years, integrated Critical Care Organizations have developed within academic centers to better meet the challenges of this broadening mission. The goal of this article was to provide interested administrators and intensivists with the proper resources, lines of communication, and organizational approach to accomplish integration and Critical Care Organization formation effectively. The Academic Critical Care Organization Building section workgroup of the taskforce established regular monthly conference calls to reach consensus on the development of a toolkit utilizing methods proven to advance the development of their own academic Critical Care Organizations. Relevant medical literature was reviewed by literature search. Materials from federal agencies and other national organizations were accessed through the Internet. The Society of Critical Care Medicine convened a taskforce entitled "Academic Leaders in Critical Care Medicine" on February 22, 2016 at the 45th Critical Care Congress using the expertise of successful leaders of advanced governance Critical Care Organizations in North America to develop a toolkit for advancing Critical Care Organizations. Key elements of an academic Critical Care Organization are outlined. The vital missions of multidisciplinary patient care, safety, and quality are linked to the research, education, and professional development missions that enhance the value of such organizations. Core features, benefits, barriers, and recommendations for integration of academic programs within Critical Care Organizations are described. Selected readings and resources to successfully implement the recommendations are provided. Communication with medical school and hospital leadership is discussed. We present the rationale for critical

  18. In situ remediation integrated program: Success through teamwork

    International Nuclear Information System (INIS)

    Peterson, M.E.

    1994-08-01

    The In Situ Remediation Integrated Program (ISR IP), managed under the US Department of Energy's (DOE) Office of Technology Development, focuses research and development efforts on the in-place treatment of contaminated environmental media, such as soil and groundwater, and the containment of contaminants to prevent the contaminants from spreading through the environment. As described here, specific ISR IP projects are advancing the application of in situ technologies to the demonstration point, providing developed technologies to customers within DOE. The ISR IP has also taken a lead role in assessing and supporting innovative technologies that may have application to DOE

  19. The safety basis of the integral fast reactor program

    International Nuclear Information System (INIS)

    Pedersen, D.R.; Seidel, B.R.

    1990-01-01

    The Integral Fast Reactor (IFR) and metallic fuel have emerged as the US Department of Energy reference reactor concept and fuel system for the development of an advanced liquid-metal reactor. This article addresses the basic elements of the IFR reactor concept and focuses on the safety advances achieved by the IFR Program in the areas of (1) fuel performance, (2) superior local faults tolerance, (3) transient fuel performance, (4) fuel-failure mechanisms, (5) performance in anticipated transients without scram, (6) core-melt mitigation, and (7) actinide recycle

  20. Nuclear methods - an integral part of the NBS certification program

    International Nuclear Information System (INIS)

    Gills, T.E.

    1984-01-01

    Within the past twenty years, new techniques and methods have emerged in response to new technologies that are based upon the performance of high-purity and well-characterized materials. The National Bureau of Standards, through its Standard Reference Materials (SRM's) Program, provides standards in the form of many of these materials to ensure accuracy and the compatibility of measurements throughout the US and the world. These standards, defined by the National Bureau of Standards as Standard Reference Materials (SRMs), are developed by using state-of-the-art methods and procedures for both preparation and analysis. Nuclear methods-activation analysis constitute an integral part of that analysis process

  1. Integrating Professional Development into STEM Graduate Programs: Student-Centered Programs for Career Preparation

    Science.gov (United States)

    Lautz, L.; McCay, D.; Driscoll, C. T.; Glas, R. L.; Gutchess, K. M.; Johnson, A.; Millard, G.

    2017-12-01

    Recognizing that over half of STEM Ph.D. graduates are finding work outside of academia, a new, NSF-funded program at Syracuse University, EMPOWER (or Education Model Program on Water-Energy Research) is encouraging its graduate students to take ownership of their graduate program and design it to meet their anticipated needs. Launched in 2016, EMPOWER's goal is to prepare graduate students for careers in the water-energy field by offering targeted workshops, professional training coursework, a career capstone experience, a professional development mini-grant program, and an interdisciplinary "foundations" seminar. Through regular student feedback and program evaluation, EMPOWER has learned some important lessons this first year: career options and graduate students' interests are diverse, requiring individualized programs designed to meet the needs of prospective employers and employees; students need exposure to the range of careers in their field to provide a roadmap for designing their own graduate school experience; effective programs nurture a culture that values professional development thereby giving students permission to pursue career paths and professional development opportunities that meet their own needs and interests; and existing university resources support the effective and efficient integration of professional development activities into graduate programs. Many of the positive outcomes experienced by EMPOWER students may be achieved in departmental graduate programs with small changes to their graduate curricula.

  2. BWR Full Integral Simulation Test (FIST) program: facility description report

    International Nuclear Information System (INIS)

    Stephens, A.G.

    1984-09-01

    A new boiling water reactor safety test facility (FIST, Full Integral Simulation Test) is described. It will be used to investigate small breaks and operational transients and to tie results from such tests to earlier large-break test results determined in the TLTA. The new facility's full height and prototypical components constitute a major scaling improvement over earlier test facilities. A heated feedwater system, permitting steady-state operation, and a large increase in the number of measurements are other significant improvements. The program background is outlined and program objectives defined. The design basis is presented together with a detailed, complete description of the facility and measurements to be made. An extensive component scaling analysis and prediction of performance are presented

  3. 22B. Integrative Therapy for Patients With Severe Tinnitus

    OpenAIRE

    Kosey, Julie; Wolever, Ruth

    2013-01-01

    Focus Area: Integrative Approaches to Care Tinnitus is a common problem for which there is no universally effective treatment. The best available estimates indicate that 10% to 15% of adults report having tinnitus symptoms, but only 20% of those who report tinnitus suffer from it and subsequently seek treatment. Individuals with persistent severe tinnitus are unable to habituate to the tinnitus sound that most likely originates in the central auditory system (CAS) in response to peripheral in...

  4. Nuclear Application Programs Development and Integration for a Simulator

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun-Joon; Lee, Tae-Woo [KEPCO Engineering and Construction Co., Deajeon (Korea, Republic of)

    2016-10-15

    KEPCO E and C participated in the NAPS (Nuclear Application Programs) development project for BNPP (Barakah Nuclear Power Plant) simulator. The 3KEY MASTER™ was adopted for this project, which is comprehensive simulation platform software developed by WSC (Western Services Corporation) for the development, and control of simulation software. The NAPS based on actual BNPP project was modified in order to meet specific requirements for nuclear power plant simulators. Considerations regarding software design for BNPP simulator and interfaces between the 3KM platform and application programs are discussed. The repeatability is one of functional requirements for nuclear power plant simulators. In order to migrate software from actual plants to simulators, software functions for storing and retrieving plant conditions and program variables should be implemented. In addition, software structures need to be redesigned to meet the repeatability, and source codes developed for actual plants would have to be optimized to reflect simulator’s characteristics as well. The synchronization is an important consideration to integrate external application programs into the 3KM simulator.

  5. Integrated research training program of excellence in radiochemistry

    Energy Technology Data Exchange (ETDEWEB)

    Lapi, Suzanne [Washington Univ., St. Louis, MO (United States)

    2015-09-18

    The overall goal of this “Integrated Research Training Program of Excellence in Radiochemistry” is to provide a rich and deep research experience in state-of-the-art radiochemistry and in the fundamentals of radioisotopic labeling and tracer methodology to develop researchers who are capable of meeting the challenges of designing and preparing radiotracers of broad applicability for monitoring and imaging diverse biological systems and environmental processes. This program was based in the Departments of Radiology and Radiation Oncology at Washington University Medical School and the Department of Chemistry at the University of Illinois at Urbana Champaign, and it was initially directed by Professor Michael J. Welch as Principal Investigator. After his passing in 2012, the program was led by Professor Suzanne E. Lapi. Programmatic content and participant progress was overseen by an Internal Advisory Committee of senior investigators consisting of the PIs, Professor Mach from the Department of Radiology at Washington University and Professor John A. Katzenellenbogen of the Department of Chemistry at the University of Illinois. A small External Advisory Committee to give overall program guidance was also constituted of experts in radiolabeled compounds and in their applications in environmental and plant science.

  6. Integrated Risk Management Within NASA Programs/Projects

    Science.gov (United States)

    Connley, Warren; Rad, Adrian; Botzum, Stephen

    2004-01-01

    As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the

  7. 'The singing hospital'--integrated group therapy in the Black mentally ill.

    Science.gov (United States)

    Benjamin, B

    1983-06-04

    Integrated group therapy was originally introduced at Sterkfontein Hospital in 1957, and reintroduced 6 years ago in an effort to overcome difficulties in communication with approximately 100 Black male and female mental hospital patients. This therapy consisted mainly of song and dance activation, sociodrama, psychodrama and behavioural modification methods. These techniques are flexible, and can be carried out by proxy therapists working with doctors and psychologists.

  8. Integration of genomics, proteomics, and imaging for cardiac stem cell therapy

    International Nuclear Information System (INIS)

    Chun, Hyung J.; Wilson, Kitch O.; Huang, Mei; Wu, Joseph C.

    2007-01-01

    Cardiac stem cell therapy is beginning to mature as a valid treatment for heart disease. As more clinical trials utilizing stem cells emerge, it is imperative to establish the mechanisms by which stem cells confer benefit in cardiac diseases. In this paper, we review three methods - molecular cellular imaging, gene expression profiling, and proteomic analysis - that can be integrated to provide further insights into the role of this emerging therapy. (orig.)

  9. A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents.

    Science.gov (United States)

    Brody, Janet L; Scherer, David G; Turner, Charles W; Annett, Robert D; Dalen, Jeanne

    2017-06-07

    Individual and group-based psychotherapeutic interventions increasingly incorporate mindfulness-based principles and practices. These practices include a versatile set of skills such as labeling and attending to present-moment experiences, acting with awareness, and avoiding automatic reactivity. A primary motivation for integrating mindfulness into these therapies is compelling evidence that it enhances emotion regulation. Research also demonstrates that family relationships have a profound influence on emotion regulation capacities, which are central to family functioning and prosocial behavior more broadly. Despite this evidence, no framework exists to describe how mindfulness might integrate into family therapy. This paper describes the benefits of mindfulness-based interventions, highlighting how and why informal mindfulness practices might enhance emotion regulation when integrated with family therapy. We provide a clinical framework for integrating mindfulness into family therapy, particularly as it applies to families with adolescents. A brief case example details sample methods showing how incorporating mindfulness practices into family therapy may enhance treatment outcomes. A range of assessment modalities from biological to behavioral demonstrates the breadth with which the benefits of a family-based mindfulness intervention might be evaluated. © 2017 The Authors. Family Process published by Wiley Periodicals, Inc. on behalf of Family Process Institute.

  10. Benefits and costs of integrating technology into undergraduate nursing programs.

    Science.gov (United States)

    Glasgow, Mary Ellen Smith; Cornelius, Frances H

    2005-01-01

    Advances in technology over the last decade have resulted in increased opportunities for educators to become more innovative in classroom and clinical teaching. These innovations have allowed students and faculty to access essential clinical information at the point of care/need. By capitalizing on technologies such as personal digital assistants and course delivery shells, faculty and students have both portable and remote access to information that can guide practice and learning activities in clinical, classroom, and distance settings. For instance, a student can use a personal digital assistant to research a patient's new medication at the bedside, study course information, access references during class in response to a question, or download clinical materials from home. Although the benefits of having ready access to information seem obvious, there are costs and strategic planning activities associated with implementing these projects. Clearly, the objective of any academic nursing program is to develop skills among students so they can efficiently access information and use that information to guide their nursing practice. To do so, academic nursing administrators must have the forethought to envision how new technologies can support achieving this goal as well as the ability to put in place the infrastructure supports needed for success. This article presents a case study of how one institution developed the necessary infrastructure and garnished the appropriate resources to implement an ambitious technology initiative integrated throughout a large undergraduate nursing program. In addition, how the integration of technology, online and mobile, can enhance clinical learning will be discussed.

  11. Optimising an integrated crop-livestock farm using risk programming

    Directory of Open Access Journals (Sweden)

    SE Visagie

    2004-06-01

    Full Text Available Numerous studies have analysed farm planning decisions focusing on producer risk preferences. Few studies have focussed on the farm planning decisions in an integrated croplivestock farm context. Income variability and means of managing risk continues to receive much attention in farm planning research. Different risk programming models have attempted to focus on minimising the income variability of farm activities. This study attempts to identify the optimal mix of crops and the number of animals the farm needs to keep in the presence of crop production risk for a range of risk levels. A mixed integer linear programming model was developed to model the decision environment faced by an integrated crop-livestock farmer. The deviation of income from the expected value was used as a measure of risk. A case study is presented with representative data from a farm in the Swartland area. An investigation of the results of the model under different constraints shows that, in general, strategies that depend on crop rotation principles are preferred to strategies that follow mono-crop production practices.

  12. Changes in dyadic communication during and after integrative and traditional behavioral couple therapy.

    Science.gov (United States)

    Baucom, Katherine J W; Baucom, Brian R; Christensen, Andrew

    2015-02-01

    To examine changes in dyadic communication, as well as links between communication and long-term relationship outcomes, 134 distressed couples randomly assigned to either Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) or Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) were observed in video-recorded interactions. Observers rated discussions of relationship problems at 3 time points (pre-therapy, post-therapy, 2-year follow-up) and relationship outcomes (i.e., treatment response and relationship stability) were measured at a 5-year follow-up. Consistent with previous examinations of individual partner communication (K.J.W. Baucom et al., 2011; Sevier et al., 2008), TBCT produced greater improvements from pre-therapy to post-therapy (d = 0.27-0.43) and superior communication at post-therapy (d = 0.30-0.37). However, IBCT produced greater improvements from post-therapy to 2-year follow-up (d = 0.32-0.39). Both levels of, and changes in, dyadic communication were associated with relationship outcomes, even when controlling for individual communication. Our findings lend additional support for theoretical and practical differences between these two therapies and the utility of assessment at the level of the couple. Furthermore, they contribute to a broader pattern of findings in which relationship outcomes are more consistently linked with constructive communication than with destructive communication. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Eva between anxiety and hope: integrating anthroposophic music therapy in supportive oncology care

    Directory of Open Access Journals (Sweden)

    Eran Ben-Arye

    2015-11-01

    Full Text Available Music therapy is a significant modality in the treatment of patients with cancer, who suffer emotional and spiritual distress as well as chemotherapy side effects that impair their quality of life. In this article, we present a case study of a patient challenged with recurrent ovarian cancer who received, concomitant with chemotherapy, a special form of music therapy based on anthroposophic medicine (AM aimed at alleviating anxiety and improving her general well-being. AM-centered music therapy goals are discussed in regard to two modes of treatment: receptive listening and clinical composition. Next, these two treatment modes are discussed in a broader context by reviewing conventional music therapy interventions during chemotherapy on two axes: a. standardized vs. individualized treatment; b. patient’s involvement on a passive to active continuum. In conclusion, psycho-oncology care can be enriched by adding anthroposophic medicine-oriented music therapy integrated within patients’ supportive care.

  14. Two Inseparable Facets of Technology Integration Programs: Technology and Theoretical Framework

    Science.gov (United States)

    Demir, Servet

    2011-01-01

    This paper considers the process of program development aiming at technology integration for teachers. For this consideration, the paper focused on an integration program which was recently developed as part of a larger project. The participants of this program were 45 in-service teachers. The program continued four weeks and the conduct of the…

  15. Process improvement program evolves into compliance program at an integrated delivery system.

    Science.gov (United States)

    Tyk, R C; Hylton, P G

    1998-09-01

    An integrated delivery system discovered questionable practices when it undertook a process-improvement initiative for its revenue-to-cash cycle. These discoveries served as a wake-up call to the organization that it needed to develop a comprehensive corporate compliance program. The organization engaged legal counsel to help it establish such a program. A corporate compliance officer was hired, and a compliance committee was set up. They worked with counsel to develop the structure and substance of the program and establish a corporate code of conduct that became a part of the organization's policies and procedures. Teams were formed in various areas of the organization to review compliance-related activities and suggest improvements. Clinical and nonclinical staff attended mandatory educational sessions about the program. By approaching compliance systematically, the organization has put itself in an excellent position to avoid fraudulent and abusive activities- and the government scrutiny they invite.

  16. Integration of the program TNXYZ in the platform SALOME

    International Nuclear Information System (INIS)

    Chaparro V, F. J.; Silva A, L.; Del Valle G, E.; Gomez T, A. M.; Vargas E, S.

    2013-10-01

    This work presents the procedure realized to integrate the code TNXYZ like a processing tool to the graphic simulation platform SALOME. The code TNXYZ solves the neutron transport equation in stationary state, for several energy groups, quantizing the angular variable by the discrete ordinates method and the space variable by nodal methods. The platform SALOME is a graphic surrounding designed for the construction, edition and simulation of mechanical models focused to the industry and contrary to other software, it allows to integrate external source codes to the surrounding, to form a complete scheme of execution, supervision, pre and post information processing. The code TNXYZ was programmed in the 90s in a Fortran compiler, but to be used at the present time the code should be actualized to the current compiler characteristics; also, in the original scheme was carried out a modularization process, that is to say, the main program was divided in sections where the code carries out important operations, with the intention of flexibility the data extraction process along its processing sequence and that can be useful in a later development of coupling. Finally, to verify the integration a fuel assembly BWR was modeled, as well as a control cell. The cross sections were obtained with the Monte Carlo Serpent code. Some results obtained with Serpent were used to verify and to begin with the validation of the code, being obtained an acceptable comparison in the infinite multiplication factor. The validation process should extend and one has planned to present in a future work. This work is part of the development of the research group formed between the Escuela Superior de Fisica y Matematicas del Instituto Politecnico Nacional (IPN) and the Instituto Nacional de Investigaciones Nucleares (ININ) in which a simulation Mexican platform of nuclear reactors is developed. (Author)

  17. Strategic planning of an integrated program for state oversight agreements

    International Nuclear Information System (INIS)

    Walzer, A.E.; Cothron, T.K.

    1991-01-01

    Among the barrage of agreements faced by federal facilities are the State Oversight Agreements (known as Agreements in Principle in many states). These agreements between the Department of Energy (DOE) and the states fund the states to conduct independent environmental monitoring and oversight which requires plans, studies, inventories, models, and reports from DOE and its management and operating contractors. Many states have signed such agreements, including Tennessee, Kentucky, Washington, Idaho, Colorado, California, and Florida. This type of oversight agreement originated in Colorado as a result of environmental concerns at the Rocky Flats Plant. The 5-year State Oversight Agreements for Tennessee and Kentucky became effective on May 13, 1991, and fund these states nearly $21 million and $7 million, respectively. Implementation of these open-quotes comprehensive and integratedclose quotes agreements is particularly complex in Tennessee where the DOE Oak Ridge Reservation houses three installations with distinctly different missions. The program development and strategic planning required for coordinating and integrating a program of this magnitude is discussed. Included are the organizational structure and interfaces required to define and coordinate program elements across plants and to also effectively negotiate scope and schedules with the state. The planned Program Management Plan, which will contain implementation and procedural guidelines, and the management control system for detailed tracking of activities and costs are outlined. Additionally, issues inherent in the nature of the agreements and implementation of a program of this magnitude are discussed. Finally, a comparison of the agreements for Tennessee, Kentucky, Colorado, and Idaho is made to gain a better understanding of the similarities and differences in State Oversight Agreements to aid in implementation of these agreements

  18. EM-54 Technology Development In Situ Remediation Integrated Program

    International Nuclear Information System (INIS)

    1993-08-01

    The Department of Energy (DOE) established the Office of Technology Development (EM-50) as an element of Environmental Restoration and Waste Management (EM) in November 1989. EM manages remediation of all DOE sites as well as wastes from current operations. The goal of the EM program is to minimize risks to human health, safety and the environment, and to bring all DOE sites into compliance with Federal, state, and local regulations by 2019. EM-50 is charged with developing new technologies that are safer, more effective and less expensive than current methods. The In Situ Remediation Integrated Program (the subject of this report) is part of EM-541, the Environmental Restoration Research and Development Division of EM-54. The In Situ Remediation Integrated Program (ISR IP) was instituted out of recognition that in situ remediation could fulfill three important criteria: Significant cost reduction of cleanup by eliminating or minimizing excavation, transportation, and disposal of wastes; reduced health impacts on workers and the public by minimizing exposure to wastes during excavation and processing; and remediation of inaccessible sites, including: deep subsurfaces; in, under, and around buildings. Buried waste, contaminated soils and groundwater, and containerized wastes are all candidates for in situ remediation. Contaminants include radioactive wastes, volatile and non-volatile organics, heavy metals, nitrates, and explosive materials. The ISR IP tends to facilitate development of in situ remediation technologies for hazardous, radioactive, and mixed wastes in soils, groundwater, and storage tanks. Near-term focus is on containment of the wastes, with treatment receiving greater effort in future years

  19. Integrative Reiki for cancer patients: a program evaluation.

    Science.gov (United States)

    Fleisher, Kimberly A; Mackenzie, Elizabeth R; Frankel, Eitan S; Seluzicki, Christina; Casarett, David; Mao, Jun J

    2014-01-01

    This mixed methods study sought to evaluate the outcomes of an integrative Reiki volunteer program in an academic medical oncology center setting. We used de-identified program evaluation data to perform both quantitative and qualitative analyses of participants' experiences of Reiki sessions. The quantitative data were collected pre- and postsession using a modified version of the distress thermometer. The pre- and postsession data from the distress assessment were analyzed using a paired Student's : test. The qualitative data were derived from written responses to open-ended questions asked after each Reiki session and were analyzed for key words and recurring themes. Of the 213 pre-post surveys of first-time sessions in the evaluation period, we observed a more than 50% decrease in self-reported distress (from 3.80 to 1.55), anxiety (from 4.05 to 1.44), depression (from 2.54 to 1.10), pain (from 2.58 to 1.21), and fatigue (from 4.80 to 2.30) with P Reiki, we found 176 (82.6%) of participants liked the Reiki session, 176 (82.6%) found the Reiki session helpful, 157 (73.7%) plan to continue using Reiki, and 175 (82.2%) would recommend Reiki to others. Qualitative analyses found that individuals reported that Reiki induced relaxation and enhanced spiritual well-being. An integrative Reiki volunteer program shows promise as a component of supportive care for cancer patients. More research is needed to evaluate and understand the impact that Reiki may have for patients, caregivers, and staff whose lives have been affected by cancer.

  20. Brazilian Air Force aircraft structural integrity program: An overview

    Directory of Open Access Journals (Sweden)

    Alberto W. S. Mello Junior

    2009-01-01

    Full Text Available This paper presents an overview of the activities developed by the Structural Integrity Group at the Institute of Aeronautics and Space - IAE, Brazil, as well as the status of ongoing work related to the life extension program for aircraft operated by the Brazilian Air Force BAF. The first BAF-operated airplane to undergo a DTA-based life extension was the F-5 fighter, in the mid 1990s. From 1998 to 2001, BAF worked on a life extension project for the BAF AT- 26 Xavante trainer. All analysis and tests were performed at IAE. The fatigue critical locations (FCLs were presumed based upon structural design and maintenance data and also from exchange of technical information with other users of the airplane around the world. Following that work, BAF started in 2002 the extension of the operational life of the BAF T-25 “Universal”. The T-25 is the basic training airplane used by AFA - The Brazilian Air Force Academy. This airplane was also designed under the “safe-life” concept. As the T-25 fleet approached its service life limit, the Brazilian Air Force was questioning whether it could be kept in flight safely. The answer came through an extensive Damage Tolerance Analysis (DTA program, briefly described in this paper. The current work on aircraft structural integrity is being performed for the BAF F-5 E/F that underwent an avionics and weapons system upgrade. Along with the increase in weight, new configurations and mission profiles were established. Again, a DTA program was proposed to be carried out in order to establish the reliability of the upgraded F-5 fleet. As a result of all the work described, the BAF has not reported any accident due to structural failure on aircraft submitted to Damage Tolerance Analysis.

  1. Integrating New Technologies and Existing Tools to Promote Programming Learning

    Directory of Open Access Journals (Sweden)

    Álvaro Santos

    2010-04-01

    Full Text Available In recent years, many tools have been proposed to reduce programming learning difficulties felt by many students. Our group has contributed to this effort through the development of several tools, such as VIP, SICAS, OOP-Anim, SICAS-COL and H-SICAS. Even though we had some positive results, the utilization of these tools doesn’t seem to significantly reduce weaker student’s difficulties. These students need stronger support to motivate them to get engaged in learning activities, inside and outside classroom. Nowadays, many technologies are available to create contexts that may help to accomplish this goal. We consider that a promising path goes through the integration of solutions. In this paper we analyze the features, strengths and weaknesses of the tools developed by our group. Based on these considerations we present a new environment, integrating different types of pedagogical approaches, resources, tools and technologies for programming learning support. With this environment, currently under development, it will be possible to review contents and lessons, based on video and screen captures. The support for collaborative tasks is another key point to improve and stimulate different models of teamwork. The platform will also allow the creation of various alternative models (learning objects for the same subject, enabling personalized learning paths adapted to each student knowledge level, needs and preferential learning styles. The learning sequences will work as a study organizer, following a suitable taxonomy, according to student’s cognitive skills. Although the main goal of this environment is to support students with more difficulties, it will provide a set of resources supporting the learning of more advanced topics. Software engineering techniques and representations, object orientation and event programming are features that will be available in order to promote the learning progress of students.

  2. Data integrity systems for organ contours in radiation therapy planning.

    Science.gov (United States)

    Shah, Veeraj P; Lakshminarayanan, Pranav; Moore, Joseph; Tran, Phuoc T; Quon, Harry; Deville, Curtiland; McNutt, Todd R

    2018-06-12

    The purpose of this research is to develop effective data integrity models for contoured anatomy in a radiotherapy workflow for both real-time and retrospective analysis. Within this study, two classes of contour integrity models were developed: data driven models and contiguousness models. The data driven models aim to highlight contours which deviate from a gross set of contours from similar disease sites and encompass the following regions of interest (ROI): bladder, femoral heads, spinal cord, and rectum. The contiguousness models, which individually analyze the geometry of contours to detect possible errors, are applied across many different ROI's and are divided into two metrics: Extent and Region Growing over volume. After analysis, we found that 70% of detected bladder contours were verified as suspicious. The spinal cord and rectum models verified that 73% and 80% of contours were suspicious respectively. The contiguousness models were the most accurate models and the Region Growing model was the most accurate submodel. 100% of the detected noncontiguous contours were verified as suspicious, but in the cases of spinal cord, femoral heads, bladder, and rectum, the Region Growing model detected additional two to five suspicious contours that the Extent model failed to detect. When conducting a blind review to detect false negatives, it was found that all the data driven models failed to detect all suspicious contours. The Region Growing contiguousness model produced zero false negatives in all regions of interest other than prostate. With regards to runtime, the contiguousness via extent model took an average of 0.2 s per contour. On the other hand, the region growing method had a longer runtime which was dependent on the number of voxels in the contour. Both contiguousness models have potential for real-time use in clinical radiotherapy while the data driven models are better suited for retrospective use. © 2018 The Authors. Journal of Applied Clinical

  3. [Educative programs based on self-management: an integrative review].

    Science.gov (United States)

    Nascimento, Luciana da Silva; de Gutierrez, Maria Gaby Rivero; De Domenico, Edvane Birelo Lopes

    2010-06-01

    The objective was to identify definitions and/or explanations of the term self-management in educative programs that aim its development. The authors also aimed to describe the educative plans and results of the educative programs analyzed. As a methodology we used integrative review, with 15 published articles (2002 the 2007). The inclusion criteria was: the occurrence of the term self-management; the existence of an educative program for the development of self-management; to be related to the area of the health of the adult. Self-management means the improvement or acquisition of abilities to solve problems in biological, social and affective scopes. The review pointed to different educational methodologies. However, it also showed the predominance of traditional methods, with conceptual contents and of physiopathological nature. The learning was evaluated as favorable, with warns in relation to the application in different populations and contexts and to the increase of costs of the educative intervention. It was concluded that research has evidenced the importance of the education for self-management, but lacked in strength for not relating the biopsychosocial demands of the chronic patient and for not describing in detail the teaching and evaluation methodologies employed.

  4. Integrating Motivational Interviewing and Brief Behavioral Activation Therapy: Theoretical and Practical Considerations

    OpenAIRE

    Balán, Iván C.; Lejuez, C. W.; Hoffer, Marcela; Blanco, Carlos

    2016-01-01

    Behavioral Activation and specifically the Brief Behavioral Activation Therapy for Depression (BATD) has a strong record of empirical support but its focus on practical out of session activation-based assignments can lead to poor levels of adherence if efforts to enhance motivation are not prioritized. Towards this end, this manuscript describes the assimilative integration of Motivational Interviewing (MI) and BATD to improve clinical outcomes by integrating MI's focus on building and mainta...

  5. Home programs for upper extremity recovery post-stroke: a survey of occupational therapy practitioners.

    Science.gov (United States)

    Donoso Brown, Elena V; Fichter, Renae

    2017-12-01

    Upper extremity hemiparesis is an impairment post-stroke that impacts quality of life. Home programs are an intervention strategy used by many occupational therapists to support continued motor recovery post-stroke, yet little is known about how these programs are designed and implemented. The purpose of this study was to describe how occupational therapy practitioners approach this task and specifically what strategies they use to support adherence and what types of technology are most commonly used. An on-line survey methodology was used. Participants were recruited through multiple sources including state associations and occupational therapy educational program directors. A total of 73 occupational therapy practitioners submitted complete surveys. It was found that majority of occupational therapy practitioners in the sample (n = 53) reported creating home programs focused on upper extremity motor recovery more than 80% of the time. Range of motion and strengthening were reported as being in the top three most commonly used interventions by more than half the sample, however incorporating clients' goals and interests were reported most often as strategies to create meaning in the home program. Respondents also reported limited incorporation of technology and strategies to support adherence. Personal motivation was reported by occupational therapy practitioners to be a key moderator of adherence to a home program. Occupational therapy practitioners often provide home programs for individuals post-stroke focusing on upper extremity function. Future research that aims to understand stakeholders' perspectives on home programs and determine effective strategies for ensuring adherence is needed.

  6. Integrating prevention of mother-to-child HIV transmission programs to improve uptake: a systematic review.

    Directory of Open Access Journals (Sweden)

    Lorainne Tudor Car

    Full Text Available BACKGROUND: We performed a systematic review to assess the effect of integrated perinatal prevention of mother-to-child transmission of HIV interventions compared to non- or partially integrated services on the uptake in low- and middle-income countries. METHODS: We searched for experimental, quasi-experimental and controlled observational studies in any language from 21 databases and grey literature sources. RESULTS: Out of 28 654 citations retrieved, five studies met our inclusion criteria. A cluster randomized controlled trial reported higher probability of nevirapine uptake at the labor wards implementing HIV testing and structured nevirapine adherence assessment (RRR 1.37, bootstrapped 95% CI, 1.04-1.77. A stepped wedge design study showed marked improvement in antiretroviral therapy (ART enrolment (44.4% versus 25.3%, p<0.001 and initiation (32.9% versus 14.4%, p<0.001 in integrated care, but the median gestational age of ART initiation (27.1 versus 27.7 weeks, p = 0.4, ART duration (10.8 versus 10.0 weeks, p = 0.3 or 90 days ART retention (87.8% versus 91.3%, p = 0.3 did not differ significantly. A cohort study reported no significant difference either in the ART coverage (55% versus 48% versus 47%, p = 0.29 or eight weeks of ART duration before the delivery (50% versus 42% versus 52%; p = 0.96 between integrated, proximal and distal partially integrated care. Two before and after studies assessed the impact of integration on HIV testing uptake in antenatal care. The first study reported that significantly more women received information on PMTCT (92% versus 77%, p<0.001, were tested (76% versus 62%, p<0.001 and learned their HIV status (66% versus 55%, p<0.001 after integration. The second study also reported significant increase in HIV testing uptake after integration (98.8% versus 52.6%, p<0.001. CONCLUSION: Limited, non-generalizable evidence supports the effectiveness of integrated PMTCT programs. More research measuring coverage and

  7. Play Therapy Training among School Psychology, Social Work, and School Counseling Graduate Training Programs

    Science.gov (United States)

    Pascarella, Christina Bechle

    2012-01-01

    This study examined play therapy training across the nation among school psychology, social work, and school counseling graduate training programs. It also compared current training to previous training among school psychology and school counseling programs. A random sample of trainers was selected from lists of graduate programs provided by…

  8. Assessment of the psychopathological effects of a horticultural therapy program in patients with schizophrenia.

    Science.gov (United States)

    Oh, Yun-Ah; Park, Sin-Ae; Ahn, Byung-Eun

    2018-02-01

    This study assessed the psychopathological effects of participation in a 10-session horticultural therapy program in patients with schizophrenia. The study design was pre and post test design of experimental and control groups. Twenty-eight Korean patients with schizophrenia, recruited from a mental health clinic and two mental health rehabilitation centers in Suwon, South Korea, were voluntarily assigned to either a control group (average age: 33.4±9.4years) or a horticultural therapy group (average age: 42.1±13.0years). The participants in the horticultural therapy group participated in a 10-session horticultural therapy program designed around various plant cultivating activities. The horticultural therapy program involved sessions once a week from April 2017 to June 2017. A psychiatrist evaluated the psychopathological symptoms of schizophrenic patients in both groups. To assess the clinical psychopathological effects, the Korean version of the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) were used. The horticultural therapy group significantly improved in terms of positive, negative, and general symptoms on the PANSS after the 10-session horticultural therapy program. Moreover, the horticultural therapy group significantly improved in terms of clinical symptoms of schizophrenia in BPRS after the 10-session horticultural therapy program. However, there was no change in the PANSS and BPRS scores in the control group. This study showed the potential of horticultural therapy in improving psychopathological symptoms in psychiatric patients. Future studies should investigate the effects of long-term horticultural therapy program on the chronic symptoms of patients with schizophrenia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Palliative care and palliative radiation therapy education in radiation oncology: A survey of US radiation oncology program directors.

    Science.gov (United States)

    Wei, Randy L; Colbert, Lauren E; Jones, Joshua; Racsa, Margarita; Kane, Gabrielle; Lutz, Steve; Vapiwala, Neha; Dharmarajan, Kavita V

    The purpose of this study was to assess the state of palliative and supportive care (PSC) and palliative radiation therapy (RT) educational curricula in radiation oncology residency programs in the United States. We surveyed 87 program directors of radiation oncology residency programs in the United States between September 2015 and November 2015. An electronic survey on PSC and palliative RT education during residency was sent to all program directors. The survey consisted of questions on (1) perceived relevance of PSC and palliative RT to radiation oncology training, (2) formal didactic sessions on domains of PSC and palliative RT, (3) effective teaching formats for PSC and palliative RT education, and (4) perceived barriers for integrating PSC and palliative RT into the residency curriculum. A total of 57 responses (63%) was received. Most program directors agreed or strongly agreed that PSC (93%) and palliative radiation therapy (99%) are important competencies for radiation oncology residents and fellows; however, only 67% of residency programs had formal educational activities in principles and practice of PSC. Most programs had 1 or more hours of formal didactics on management of pain (67%), management of neuropathic pain (65%), and management of nausea and vomiting (63%); however, only 35%, 33%, and 30% had dedicated lectures on initial management of fatigue, assessing role of spirituality, and discussing advance care directives, respectively. Last, 85% of programs reported having a formal curriculum on palliative RT. Programs were most likely to have education on palliative radiation to brain, bone, and spine, but less likely on visceral, or skin, metastasis. Residency program directors believe that PSC and palliative RT are important competencies for their trainees and support increasing education in these 2 educational domains. Many residency programs have structured curricula on PSC and palliative radiation education, but room for improvement exists in

  10. Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

    Science.gov (United States)

    Day, Kristen W.

    2009-01-01

    In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

  11. Integrating EMDR into an evolutionary-based therapy for depression: a case study

    OpenAIRE

    Krupnik, Valery

    2015-01-01

    Key Clinical Message We present an intervention in a case of major depression, where eye movement desensitization and reprocessing (EMDR) therapy was integrated into an evolutionary-based psychotherapy for depression. At the end of the treatment and at follow up assessment we observed a more accepting disposition and decreased depressive but not anxiety symptoms.

  12. Integrating EMDR into an evolutionary-based therapy for depression: a case study

    Science.gov (United States)

    Krupnik, Valery

    2015-01-01

    Key Clinical Message We present an intervention in a case of major depression, where eye movement desensitization and reprocessing (EMDR) therapy was integrated into an evolutionary-based psychotherapy for depression. At the end of the treatment and at follow up assessment we observed a more accepting disposition and decreased depressive but not anxiety symptoms. PMID:25984310

  13. A Comparison of Sensory Integrative and Behavioral Therapies as Treatment for Pediatric Feeding Disorders

    Science.gov (United States)

    Addison, Laura R.; Piazza, Cathleen C.; Patel, Meeta R.; Bachmeyer, Melanie H.; Rivas, Kristi M.; Milnes, Suzanne M.; Oddo, Jackie

    2012-01-01

    We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory…

  14. Integrative Solution-Focused Brief Therapy with a Chinese Female College Student Dealing with Relationship Loss

    Science.gov (United States)

    Ng, Kok-Mun; Parikh, Sejal; Guo, Lan

    2012-01-01

    Through case presentation, this article illustrates the integration of person-centered skills and guided imagery into Solution-Focused Brief Therapy (SFBT) with a Chinese female college student who was experiencing emotional distress due to relationship loss. Transcripts from select portions of actual counseling sessions further demonstrate the…

  15. A Study On the Effectiveness of Emotionally Focused Couple Therapy and Integrated Systemic Couple Therapy on reducing Intimacy Anxiety

    Directory of Open Access Journals (Sweden)

    هاجر فلاح زاده

    2015-04-01

    Full Text Available This study examined the effectiveness of emotionally focused couple therapy (EFT and integrated systemic couple therapy (IST on resolving intimacy anxiety. For this purpose, 30 couples were randomly selected and based on their pretests were assigned into two experimental and one control groups. Research instruments were Fear of Intimacy Scale (FIS (Descutner & Thelen, and the Dyadic Adjustment Scale (DAS (Spanier, 1976. A Nine-session of EFT was conducted for one experiment group and eight sessions of IST for the other. The control group did not receive any treatment. These three groups completed post test at the end of the experiment, and follow-up test 3 months later. Results indicated that EFT and IST significantly decreased intimacy anxiety in couples, and the treatment effect was consistent after 3 months follow-up.

  16. Integrated Data Analysis (IDCA) Program - PETN Class 4 Standard

    Energy Technology Data Exchange (ETDEWEB)

    Sandstrom, Mary M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brown, Geoffrey W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Preston, Daniel N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pollard, Colin J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Warner, Kirstin F. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Sorensen, Daniel N. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Remmers, Daniel L. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Shelley, Timothy J. [Air Force Research Lab. (AFRL), Tyndall AFB, FL (United States); Reyes, Jose A. [Applied Research Associates, Tyndall AFB, FL (United States); Phillips, Jason J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hsu, Peter C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Reynolds, John G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2012-08-01

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the results for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis of PETN Class 4. The PETN was found to have: 1) an impact sensitivity (DH50) range of 6 to 12 cm, 2) a BAM friction sensitivity (F50) range 7 to 11 kg, TIL (0/10) of 3.7 to 7.2 kg, 3) a ABL friction sensitivity threshold of 5 or less psig at 8 fps, 4) an ABL ESD sensitivity threshold of 0.031 to 0.326 j/g, and 5) a thermal sensitivity of an endothermic feature with Tmin = ~ 141 °C, and a exothermic feature with a Tmax = ~205°C.

  17. Integrated Data Collection Analysis (IDCA) Program — Ammonium Nitrate

    Energy Technology Data Exchange (ETDEWEB)

    Sandstrom, Mary M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brown, Geoffrey W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Preston, Daniel N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pollard, Colin J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Warner, Kirstin F. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Sorensen, Daniel N. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Remmers, Daniel L. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Phillips, Jason J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Shelley, Timothy J. [Bureau of Alcohol, Tobacco and Firearms, Redstone Arsenal, AL (United States); Reyes, Jose A. [Applied Research Associates, Tyndall AFB, FL (United States); Hsu, Peter C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Reynolds, John G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2013-05-17

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the results for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis of ammonium nitrate (AN). AN was tested, in most cases, as both received from manufacturer and dried/sieved. The participants found the AN to be: 1) insensitive in Type 12A impact testing (although with a wide range of values), 2) completely insensitive in BAM friction testing, 3) less sensitive than the RDX standard in ABL friction testing, 4) less sensitive than RDX in ABL ESD testing, and 5) less sensitive than RDX and PETN in DSC thermal analyses.

  18. Characterization, Monitoring, and Sensor Technology Integrated Program (CMST-IP)

    International Nuclear Information System (INIS)

    1994-04-01

    The Characterization, Monitoring, and Sensor Technology Integrated Program seeks to deliver needed technologies, timely and cost-effectively, to the Office of Waste Management (EM-30), the Office of Environmental Restoration (EM-40), and the Office of Facility Transition and Management (EM-60). The scope of characterizations monitoring, and sensor technology needs that are required by those organizations encompass: (1) initial location and characterization of wastes and waste environments - prior to treatment; (2) monitoring of waste retrieval, remediation and treatment processes; (3) characterization of the co-position of final waste treatment forms to evaluate the performance of waste treatments processes; and (4) site closure and compliance monitoring. Wherever possible, the CMST-IP fosters technology transfer and commercialization of technologies that it sponsors

  19. Steam generator tube integrity program. Phase I report

    International Nuclear Information System (INIS)

    Alzheimer, J.M.; Clark, R.A.; Morris, C.J.; Vagins, M.

    1979-09-01

    The results are presented of the pressure tests performed as part of Phase I of the Steam Generator Tube Integrity (SGTI) program at Battelle Pacific Northwest Laboratory. These tests were performed to establish margin-to-failure predictions for mechanically defected Pressurized Water Reactor (PWR) steam generator tubing under operating and accident conditions. Defect geometries tested were selected because they simulate known or expected defects in PWR steam generators. These defect geometries are Electric Discharge Machining (EDM) slots, elliptical wastage, elliptical wastage plus through-wall slot, uniform thinning, denting, denting plus uniform thinning, and denting plus elliptical wastage. All defects were placed in tubing representative of that currently used in PWR steam generators

  20. The driving elements of an integrated configuration management program

    International Nuclear Information System (INIS)

    Zaalouk, M.G.

    1990-01-01

    The need for an effective long term Plant Configuration Management Program (CMP) has been demonstrated in response to Plant Design Modification and Plant Life Extension activities. Having particular need are those Utilities operating early vintage nuclear plants, where numerous modifications have been made without the benefit of an accurate, complete, properly maintained and controlled Design Basis. This paper presents a model for a long term, cost effective CMP which is based on and driven by the development, maintenance and control of accurate plant Design Basis Information. The model also provides a systematic approach for devising and implementing an integrated Plant CMP based on the essential attributes of the Plant Configuration Management, including Design Basis

  1. Integrity of the marriage and family therapy research literature: perceptions and recommendations.

    Science.gov (United States)

    Brock, Gregory W; Whiting, Jason B; Matern, Brianne; Fife, Stephen T

    2009-04-01

    Reports of falsification, fabrication, plagiarism, and other violations of research integrity across the sciences are on the increase. Joining with other disciplines to actively protect the integrity of the marriage and family therapy (MFT) research literature is of utmost importance to both the discipline and the future of the profession. To inform the issues raised, results are presented of an informal survey among MFT clinical members on their perceptions about the literature together with their preferences for how best to protect its integrity. This article initiates an important discussion about the honesty of MFT research.

  2. International piping integrity research group (IPIRG) program final report

    International Nuclear Information System (INIS)

    Schmidt, R.; Wilkowski, G.; Scott, P.; Olsen, R.; Marschall, C.; Vieth, P.; Paul, D.

    1992-04-01

    This is the final report of the International Piping Integrity Research Group (IPIRG) Programme. The IPIRG Programme was an international group programme managed by the U.S. Nuclear Regulatory Commission and funded by a consortium of organizations from nine nations: Canada, France, Italy, Japan, Sweden, Switzerland, Taiwan, the United Kingdom, and the United states. The objective of the programme was to develop data needed to verify engineering methods for assessing the integrity of nuclear power plant piping that contains circumferential defects. The primary focus was an experimental task that investigated the behaviour of circumferentially flawed piping and piping systems to high-rate loading typical of seismic events. To accomplish these objectives a unique pipe loop test facility was designed and constructed. The pipe system was an expansion loop with over 30 m of 406-mm diameter pipe and five long radius elbows. Five experiments on flawed piping were conducted to failure in this facility with dynamic excitation. The report: provides background information on leak-before-break and flaw evaluation procedures in piping; summarizes the technical results of the programme; gives a relatively detailed assessment of the results from the various pipe fracture experiments and complementary analyses; and, summarizes the advances in the state-of-the-art of pipe fracture technology resulting from the IPIRG Program

  3. High-level waste program integration within the DOE complex

    International Nuclear Information System (INIS)

    Valentine, J.H.; Malone, K.; Schaus, P.S.

    1998-03-01

    Eleven major Department of Energy (DOE) site contractors were chartered by the Assistant Secretary to use a systems engineering approach to develop and evaluate technically defensible cost savings opportunities across the complex. Known as the complex-wide Environmental Management Integration (EMI), this process evaluated all the major DOE waste streams including high level waste (HLW). Across the DOE complex, this waste stream has the highest life cycle cost and is scheduled to take until at least 2035 before all HLW is processed for disposal. Technical contract experts from the four DOE sites that manage high level waste participated in the integration analysis: Hanford, Savannah River Site (SRS), Idaho National Engineering and Environmental Laboratory (INEEL), and West Valley Demonstration Project (WVDP). In addition, subject matter experts from the Yucca Mountain Project and the Tanks Focus Area participated in the analysis. Also, departmental representatives from the US Department of Energy Headquarters (DOE-HQ) monitored the analysis and results. Workouts were held throughout the year to develop recommendations to achieve a complex-wide integrated program. From this effort, the HLW Environmental Management (EM) Team identified a set of programmatic and technical opportunities that could result in potential cost savings and avoidance in excess of $18 billion and an accelerated completion of the HLW mission by seven years. The cost savings, schedule improvements, and volume reduction are attributed to a multifaceted HLW treatment disposal strategy which involves waste pretreatment, standardized waste matrices, risk-based retrieval, early development and deployment of a shipping system for glass canisters, and reasonable, low cost tank closure

  4. Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

    Science.gov (United States)

    Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

    2007-11-23

    Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common

  5. Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

    Directory of Open Access Journals (Sweden)

    Burgers Jako S

    2007-11-01

    Full Text Available Abstract Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes

  6. Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

    Science.gov (United States)

    Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

    2017-12-01

    The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

  7. Medical Music Therapy: A Model Program for Clinical Practice, Education, Training and Research

    Science.gov (United States)

    Standley, Jayne

    2005-01-01

    This monograph evolved from the unique, innovative partnership between the Florida State University Music Therapy Program and Tallahassee Memorial HealthCare. Its purpose is to serve as a model for music therapy educators, students, clinicians, and the hospital administrators who might employ them. This book should prove a valuable resource for…

  8. Take a Paws: Fostering Student Wellness with a Therapy Dog Program at Your University Library

    Science.gov (United States)

    Lannon, Amber; Harrison, Pamela

    2015-01-01

    Therapy dogs are trained and socialized to provide comfort to individuals who are ill or experiencing stress. The following article explores therapy dog outreach programs in academic libraries by describing a successful venture at McGill University Library. Background, planning advice, assessment results, and recommendations are presented with an…

  9. Integrated Data Collection Analysis (IDCA) Program - SSST Testing Methods

    Energy Technology Data Exchange (ETDEWEB)

    Sandstrom, Mary M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brown, Geoffrey W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Preston, Daniel N. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pollard, Colin J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Warner, Kirstin F. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Remmers, Daniel L. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Sorensen, Daniel N. [Naval Surface Warfare Center (NSWC), Indian Head, MD (United States). Indian Head Division; Whinnery, LeRoy L. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Phillips, Jason J. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Shelley, Timothy J. [Bureau of Alcohol, Tobacco and Firearms (ATF), Huntsville, AL (United States); Reyes, Jose A. [Applied Research Associates, Tyndall AFB, FL (United States); Hsu, Peter C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Reynolds, John G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2013-03-25

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the methods used for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis during the IDCA program. These methods changed throughout the Proficiency Test and the reasons for these changes are documented in this report. The most significant modifications in standard testing methods are: 1) including one specified sandpaper in impact testing among all the participants, 2) diversifying liquid test methods for selected participants, and 3) including sealed sample holders for thermal testing by at least one participant. This effort, funded by the Department of Homeland Security (DHS), is putting the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study will suggest new guidelines and methods and possibly establish the SSST testing accuracies needed to develop safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods wherever possible. The testing performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent.

  10. Integrated energy and climate program without nuclear power

    International Nuclear Information System (INIS)

    Haller, W.

    2007-01-01

    Under the German EU Council presidency, the European Union adopted an ambitious climate protection program in spring this year which has consequences for the entire energy sector. A fair system of burden sharing is currently being sought on the level of the European Union. However, the German federal government does not wait for that agreement to be reached, but has added to the clearcut EU plans in order to achieve more climate protection. At the closed meeting of the federal cabinet in Meseberg on August 23-24, 2007, the key points of an integrated energy and climate program were adopted. The unprecedented set of measures comprises 30 points. In many cases, legal measures are required for implementation, which implies a heavy workload facing the federal government and parliament. A major step forward is seen in the federal government's intention to preserve the international competitiveness of the producing sector and energy-intensive industries also under changed framework conditions. The imperative guiding principle must be that care should take precedence over speed. European or worldwide solutions must be found for all measures, be it energy efficiency or climate protection, and all countries must be involved because, otherwise, specific measures taken by individual states will be ineffective. (orig.)

  11. GENP-2, Program System for Integral Reactor Perturbation

    International Nuclear Information System (INIS)

    Boioli, A.; Cecchini, G.P.

    1975-01-01

    1 - Description of problem or function: GENP-2 is a system of programs that use 'generalized perturbation theory' to calculate the perturbations of reactor integral characteristics which can be expressed by means of ratios between linear or bilinear functionals of the real and/or adjoint fluxes (e.g. reaction rate ratios), due to cross section perturbations. 2 - Method of solution: GENP-2 consists of the following codes: DDV, SORCI, CIAP-PMN and GLOBP-2D. DDV calculates the real or adjoint fluxes and power distribution using multigroup diffusion theory in 2-dimensions. SORCI uses the fluxes from DDV to calculate the real and/or adjoint general perturbation sources. CIAP-PMN reads the sources from SORCI and uses them in the real or adjoint generalised importance calculations (2 dimensions, multi- group diffusion). GLOBP-2D uses the importance calculated by CIAP-PMN, and the fluxes calculated by DDV, in generalised perturbation expressions to calculate the perturbation in the quantity of interest. 3 - Restrictions on the complexity of the problem: DDV although variably dimensioned has the following restrictions: - max. number of mesh points 6400; - max. number of mesh points in 1-dimension 81; - max. number of regions 6400; - max. number of energy groups 100; - if power distribution calculated, product of number of groups and number of regions 2500. The other programs have the same restrictions if applicable

  12. Towards the integration of mental practice in rehabilitation programs. A critical review

    Directory of Open Access Journals (Sweden)

    Francine eMalouin

    2013-09-01

    Full Text Available Many clinical studies have investigated the use of mental practice (MP through motor imagery (MI to enhance functional recovery of patients with diverse physical disabilities. Although beneficial effects have been generally reported for training motor functions in persons with chronic stroke (e.g. reaching, writing, walking, attempts to integrate MP within rehabilitation programs have been met with mitigated results. These findings have stirred further questioning about the value of MP in neurological rehabilitation. In fact, despite abundant systematic reviews, which customarily focused on the methodological merits of selected studies, several questions about factors underlying observed effects remain to be addressed. This review discusses these issues in an attempt to identify factors likely to hamper the integration of MP within rehabilitation programs. First, the rationale underlying the use of MP for training motor function is briefly reviewed. Second, three modes of MI delivery are proposed based on the analysis of the research protocols from 27 studies in persons with stroke and Parkinson’s disease. Third, for each mode of MI delivery, a general description of MI training is provided. Fourth, the review discusses factors influencing MI training outcomes such as: the adherence to MI training, the amount of training and the interaction between physical and mental rehearsal; the use of relaxation, the selection of reliable, valid and sensitive outcome measures, the heterogeneity of the patient groups, the selection of patients and the mental rehearsal procedures. To conclude, the review proposes a framework for integrating MP in rehabilitation programs and suggests research targets for steering the implementation of MP in the early stages of the rehabilitation process. The challenge has now shifted towards the demonstration that MI training can enhance the effects of regular therapy in persons with subacute stroke during the period of

  13. Critical Issues Forum: A multidisciplinary educational program integrating computer technology

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, R.J.; Robertson, B.; Jacobs, D. [Los Alamos National Lab., NM (United States)

    1998-09-01

    The Critical Issues Forum (CIF) funded by the US Department of Energy is a collaborative effort between the Science Education Team of Los Alamos National Laboratory (LANL) and New Mexico high schools to improve science education throughout the state of New Mexico as well as nationally. By creating an education relationship between the LANL with its unique scientific resources and New Mexico high schools, students and teachers participate in programs that increase not only their science content knowledge but also their critical thinking and problem-solving skills. The CIF program focuses on current, globally oriented topics crucial to the security of not only the US but to that of all nations. The CIF is an academic-year program that involves both teachers and students in the process of seeking solutions for real world concerns. Built around issues tied to LANL`s mission, participating students and teachers are asked to critically investigate and examine the interactions among the political, social, economic, and scientific domains while considering diversity issues that include geopolitical entities and cultural and ethnic groupings. Participants are expected to collaborate through telecommunications during the research phase and participate in a culminating multimedia activity, where they produce and deliver recommendations for the current issues being studied. The CIF was evaluated and found to be an effective approach for teacher professional training, especially in the development of skills for critical thinking and questioning. The CIF contributed to students` ability to integrate diverse disciplinary content about science-related topics and supported teachers in facilitating the understanding of their students using the CIF approach. Networking technology in CIF has been used as an information repository, resource delivery mechanism, and communication medium.

  14. Evaluation of integrated child development services program in rajasthan, India

    Directory of Open Access Journals (Sweden)

    Madan Singh Rathore

    2015-01-01

    Full Text Available Background: The Integrated Child Development Services (ICDS scheme is the largest program for promotion of maternal and child health and nutrition. Aims: The present study is aimed to evaluate ICDS program in terms of infrastructure of anganwadi centers (AWCs, characteristics of anganwadi workers (AWWs, coverage of supplementary nutrition (SN, and preschool education (PSE to the beneficiaries. Methods: A total of 39 AWCs from a rural area and 15 from the urban area were surveyed. AWWs were interviewed, and records were reviewed. Information was collected using a predesigned and pretested questionnaire. Results: In the selected AWCs, 88.9% were running in Pucca buildings, 38.9% had electricity, 35.1% had a separate kitchen, 1.8% had cooking gas, and toilets were available in 59.3% AWCs. All the AWW have received job training, 83.3% AWW have received refresher training. 38.8% AWW have received orientation training, 37% have received skill training in World Health Organization growth standards and 18.5% AWW have received skill training in mother and child health. 86.9% registered pregnant women, 90.7% registered lactating women, 72.6% registered adolescent girls were availing SN. 95.4% registered children 6 months to 3 years and 92.4% registered children 3-6 years of age were availing SN. Interruption in SN in last 6 months was seen in 22.2% AWCs. Appropriate and adequate PSE material was available in 59.2% AWCs. Conclusion: There are program gaps in the infrastructure of AWCs, training of AWW, coverage of SN, interruption in the supply of SN.

  15. A Longitudinal Assessment of Early Childhood Education with Integrated Speech Therapy for Children with Significant Language Impairment in Germany

    Science.gov (United States)

    Ullrich, Dieter; Ullrich, Katja; Marten, Magret

    2014-01-01

    Background: In Lower Saxony, Germany, pre-school children with language- and speech-deficits have the opportunity to access kindergartens with integrated language-/speech therapy prior to attending primary school, both regular or with integrated speech therapy. It is unknown whether these early childhood education treatments are helpful and…

  16. Configuration Management Program - a part of Integrated Management System

    International Nuclear Information System (INIS)

    Mancev, Bogomil; Yordanova, Vanja; Nenkova, Boyka

    2014-01-01

    the Integrated Management System. CM ensures that during the entire operational life of the plant the following requirements are met: · The basic design requirements of the plant are established, documented and maintained; · The physical structures, systems and components (SSCs) of the plant are in conformity with the design requirements; · The physical and functional characteristics of the plant are correctly incorporated in the operational and maintenance documentation, as well as in the documents for testing and training; · The changes in the design documentation are incorporated in the physical configuration and · the operative documentation; · The changes in the design are minimized by management process for review according to approved criteria. The purpose of this report is to try to clarify the place of configuration management program within the Integrated Management System of Kozloduy NPP and to present the computerized information system for organization of the operational activities (IS OOA) as a tool for effective management of the facility. (authors)

  17. Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs.

    Directory of Open Access Journals (Sweden)

    Arianna Rubin Means

    2016-10-01

    Full Text Available While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration.We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list.In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group.Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and efficient integrated NTD

  18. A 12-week supervised exercise therapy program for young adults with a meniscal tear: Program development and feasibility study

    DEFF Research Database (Denmark)

    Skou, Søren T.; Thorlund, Jonas B.

    2018-01-01

    on clinical expertise and available evidence. Six patients (age range 22–39 years) considered eligible for meniscal surgery by an orthopedic surgeon underwent the program. Patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and evaluated the program during a semi-structured qualitative...... interview. Feedback from patients was included to finalize the exercise therapy program. Median improvements (Range) in KOOS subscales were 15 (0–33) for Pain, 11 (−11 to 50) for Symptoms, 16 (3–37) for Function in daily living, 23 (10–45) for Function in sport and recreation, and 9 (−6 to 31) for Quality...... of life. The patients found the program relevant and effective with only a few short-lasting adverse events and important clinical improvements after four to ten weeks. Physical therapist supervision was considered important. No patients wanted surgery up to 6 month after the exercise therapy program...

  19. Integrated Pest Management: A Curriculum for Early Care and Education Programs

    Science.gov (United States)

    California Childcare Health Program, 2011

    2011-01-01

    This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early…

  20. 42 CFR 455.232 - Medicaid integrity audit program contractor functions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

  1. Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocess­ing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial

    Directory of Open Access Journals (Sweden)

    Triscari MT

    2015-10-01

    Full Text Available Maria Teresa Triscari,1 Palmira Faraci,2 Dario Catalisano,3 Valerio D’Angelo,1 Viviana Urso1 1Laboratory for Psychosomatic Disorders, Local Health Trust, Palermo, Italy; 2Faculty of Human and Social Sciences, University of Enna “Kore”, Enna, Italy; 3Italian Flight Safety Committee, Aeroporto di Fiumicino, Fiumicino (RM, Italy Abstract: The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization. Keywords: flight anxiety, fear of flying, aerophobia, cognitive behavioral therapy, EMDR, VRET 

  2. The impact of a service learning experience to enhance curricular integration in a physical therapist education program.

    Science.gov (United States)

    Gazsi, Claudia C; Oriel, Kathryn N

    2010-01-01

    A goal when designing the Physical Therapy Program at Lebanon Valley College (LVC) was to maximize vertical and horizontal integration of course content related to (a) medical Spanish, (b) geriatrics, and (c) health promotion through a service learning engagement. Seventeen Doctor of Physical Therapy students from LVC participated in a fall risk screening at a local senior center in a Spanish-speaking neighborhood. The screen included the single leg stance, timed-up-and-go (TUG), and functional reach tests. The students screened 30 participants over a 3-hour time period. Following the screening event, students were asked to reflect on their experience. Reflections revealed that the activity supported integration of concurrent didactic course material and Core Values, reinforced cultural issues presented the previous year, and convinced students that physical therapists have a distinct and important role in primary and secondary prevention in meeting the needs of the Spanish-speaking elderly community.

  3. The Integration of Cognitive Remediation Therapy into the Whole Psychosocial Rehabilitation Process: An Evidence-Based and Person-Centered Approach

    Directory of Open Access Journals (Sweden)

    Rafael Penadés

    2012-01-01

    Full Text Available Cognitive remediation therapies seem to ameliorate cognitive impairments in patients with schizophrenia. Interestingly, some improvement in daily functioning can also be expected as a result. However, to achieve these results it is necessary that cognitive remediation is carried out in the context of broader psychosocial rehabilitation involving the learning of other communication, social, and self-control skills. Unfortunately, little is known about how to integrate these different rehabilitation tools in broader rehabilitation programs. Based on both the neurocognitive behavioral approach and the action theory framework, a hierarchical flowchart is represented in this paper to integrate CRT with other evidence-based psychological therapies in outpatient settings. Finally, some evidence is provided in which cognitive abilities need to be targeted in remediation programs to improve functioning. In summary, to improve daily functioning, according to these studies, cognitive remediation needs to include the teaching of some cognitive strategies that target executive skills.

  4. A new graduate education program in radiation therapy

    International Nuclear Information System (INIS)

    Beldham-Collins, Rachael; Milinkovic, Danielle

    2009-01-01

    Purpose: The evaluation of the Radiation Oncology Network's (RON) in house professional development year (PDY) support program was implemented to determine the appropriate teaching, learning and transfer of learning strategies that assist the newly practicing radiation therapists' transition into the busy working environment. As the AIR program saw little clinical support offered to participating new graduates and thus a need for further educational support was felt. The RON support program was initially introduced as the clinical education support component of the NSW PDY program that was introduced in 1995 by the Australian Institute of Radiography. Method: Following the facilitation of the RON PDY program over a twelve month period, qualitative feedback was obtained using a focus group consisting of new graduates from the program. Two moderators facilitated the focus group: one moderator facilitated the discussion while the second moderator transcribed it. The graduate practitioners were asked a number of questions related to the teaching and learning strategies employed by the program as well as the structure of the program. Results/discussion: The responses were analysed into the following themes: teaching and learning strategies, transfer of learning, facilitation and future learning needs. Overall the graduate practitioners found the program nurtured their skill, knowledge and attitudes appropriately at such a critical stage in their career

  5. A new graduate education program in radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Beldham-Collins, Rachael [Radiation Oncology Network, Department of Radiation Oncology, Westmead Hospital, PO Box 533, Wentworthville NSW 2145 (Australia); School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia); Milinkovic, Danielle [School of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825 (Australia)], E-mail: d.milinkovic@fhs.usyd.edu.au

    2009-02-15

    Purpose: The evaluation of the Radiation Oncology Network's (RON) in house professional development year (PDY) support program was implemented to determine the appropriate teaching, learning and transfer of learning strategies that assist the newly practicing radiation therapists' transition into the busy working environment. As the AIR program saw little clinical support offered to participating new graduates and thus a need for further educational support was felt. The RON support program was initially introduced as the clinical education support component of the NSW PDY program that was introduced in 1995 by the Australian Institute of Radiography. Method: Following the facilitation of the RON PDY program over a twelve month period, qualitative feedback was obtained using a focus group consisting of new graduates from the program. Two moderators facilitated the focus group: one moderator facilitated the discussion while the second moderator transcribed it. The graduate practitioners were asked a number of questions related to the teaching and learning strategies employed by the program as well as the structure of the program. Results/discussion: The responses were analysed into the following themes: teaching and learning strategies, transfer of learning, facilitation and future learning needs. Overall the graduate practitioners found the program nurtured their skill, knowledge and attitudes appropriately at such a critical stage in their career.

  6. Integrating scientific knowledge into large-scale restoration programs: the CALFED Bay-Delta Program experience

    Science.gov (United States)

    Taylor, K.A.; Short, A.

    2009-01-01

    Integrating science into resource management activities is a goal of the CALFED Bay-Delta Program, a multi-agency effort to address water supply reliability, ecological condition, drinking water quality, and levees in the Sacramento-San Joaquin Delta of northern California. Under CALFED, many different strategies were used to integrate science, including interaction between the research and management communities, public dialogues about scientific work, and peer review. This paper explores ways science was (and was not) integrated into CALFED's management actions and decision systems through three narratives describing different patterns of scientific integration and application in CALFED. Though a collaborative process and certain organizational conditions may be necessary for developing new understandings of the system of interest, we find that those factors are not sufficient for translating that knowledge into management actions and decision systems. We suggest that the application of knowledge may be facilitated or hindered by (1) differences in the objectives, approaches, and cultures of scientists operating in the research community and those operating in the management community and (2) other factors external to the collaborative process and organization.

  7. Patient's and health care provider's perspectives on music therapy in palliative care - an integrative review.

    Science.gov (United States)

    Schmid, W; Rosland, J H; von Hofacker, S; Hunskår, I; Bruvik, F

    2018-02-20

    The use of music as therapy in multidisciplinary end-of-life care dates back to the 1970s and nowadays music therapy (MT) is one of the most frequently used complementary therapy in in-patient palliative care in the US. However existing research investigated music therapy's potential impact mainly from one perspective, referring to either a quantitative or qualitative paradigm. The aim of this review is to provide an overview of the users' and providers' perspectives on music therapy in palliative care within one research article. A systematic literature search was conducted using several databases supplemented with a hand-search of journals between November 1978 and December 2016. Inclusion criteria were: Music therapy with adults in palliative care conducted by a certified music therapist. Both quantitative and qualitative studies in English, German or a Scandinavian language published in peer reviewed journals were included. We aimed to identify and discuss the perspectives of both patients and health care providers on music therapy's impact in palliative care to forward a comprehensive understanding of it's effectiveness, benefits and limitations. We investigated themes mentioned by patients within qualitative studies, as well as commonly chosen outcome measures in quantitative research. A qualitative approach utilizing inductive content analysis was carried out to analyze and categorize the data. Twelve articles, reporting on nine quantitative and three qualitative research studies were included. Seven out of the nine quantitative studies investigated pain as an outcome. All of the included quantitative studies reported positive effects of the music therapy. Patients themselves associated MT with the expression of positive as well as challenging emotions and increased well-being. An overarching theme in both types of research is a psycho-physiological change through music therapy. Both quantitative as well as qualitative research showed positive changes in

  8. Anatomy in Occupational Therapy Program Curriculum: Practitioners' Perspectives

    Science.gov (United States)

    Schofield, Katherine Anne

    2014-01-01

    Anatomy education is undergoing significant transformation. It is unknown whether changes are in accordance with occupational therapy (OT) practice needs. The purpose of this pilot study was to survey OT clinicians to determine their perspectives on the value of anatomy in OT curricula, and anatomical knowledge required for practice. In addition…

  9. Emotional Safety in Adventure Therapy Programs: Can It Be Defined?

    Science.gov (United States)

    Vincent, Suzanne M.

    1995-01-01

    Ninety-eight adventure therapy professionals analyzed a proposed definition of emotional safety and rated 26 factors hypothesized to affect an individual's level of emotional safety during adventure activities. Factors were related to specific techniques used by instructors, instructor skills and abilities, the physical environment, and group…

  10. Available clinical markers of treatment outcome integrated in mathematical models to guide therapy in HIV infection.

    Science.gov (United States)

    Vergu, Elisabeta; Mallet, Alain; Golmard, Jean-Louis

    2004-02-01

    Because treatment failure in many HIV-infected persons may be due to multiple causes, including resistance to antiretroviral agents, it is important to better tailor drug therapy to individual patients. This improvement requires the prediction of treatment outcome from baseline immunological or virological factors, and from results of resistance tests. Here, we review briefly the available clinical factors that have an impact on therapy outcome, and discuss the role of a predictive modelling approach integrating these factors proposed in a previous work. Mathematical and statistical models could become essential tools to address questions that are difficult to study clinically and experimentally, thereby guiding decisions in the choice of individualized drug regimens.

  11. Integrating Quality and Safety Competencies to Improve Outcomes: Application in Infusion Therapy Practice.

    Science.gov (United States)

    Sherwood, Gwen; Nickel, Barbara

    Despite intense scrutiny and process improvement initiatives, patient harm continues to occur in health care with alarming frequency. The Quality and Safety Education for Nursing (QSEN) project provides a roadmap to transform nursing by integrating 6 competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As front-line caregivers, nurses encounter inherent risks in their daily work. Infusion therapy is high risk with multiple potential risks for patient harm. This study examines individual and system application of the QSEN competencies and the Infusion Nurses Society's 2016 Infusion Therapy Standards of Practice in the improvement of patient outcomes.

  12. PRACTICING SPEECH THERAPY INTERVENTION FOR SOCIAL INTEGRATION OF CHILDREN WITH SPEECH DISORDERS

    Directory of Open Access Journals (Sweden)

    Martin Ofelia POPESCU

    2016-11-01

    Full Text Available The article presents a concise speech correction intervention program in of dyslalia in conjunction with capacity development of intra, interpersonal and social integration of children with speech disorders. The program main objectives represent: the potential increasing of individual social integration by correcting speech disorders in conjunction with intra- and interpersonal capacity, the potential growth of children and community groups for social integration by optimizing the socio-relational context of children with speech disorder. In the program were included 60 children / students with dyslalia speech disorders (monomorphic and polymorphic dyslalia, from 11 educational institutions - 6 kindergartens and 5 schools / secondary schools, joined with inter-school logopedic centre (CLI from Targu Jiu city and areas of Gorj district. The program was implemented under the assumption that therapeutic-formative intervention to correct speech disorders and facilitate the social integration will lead, in combination with correct pronunciation disorders, to social integration optimization of children with speech disorders. The results conirm the hypothesis and gives facts about the intervention program eficiency.

  13. NASA Space Radiation Program Integrative Risk Model Toolkit

    Science.gov (United States)

    Kim, Myung-Hee Y.; Hu, Shaowen; Plante, Ianik; Ponomarev, Artem L.; Sandridge, Chris

    2015-01-01

    NASA Space Radiation Program Element scientists have been actively involved in development of an integrative risk models toolkit that includes models for acute radiation risk and organ dose projection (ARRBOD), NASA space radiation cancer risk projection (NSCR), hemocyte dose estimation (HemoDose), GCR event-based risk model code (GERMcode), and relativistic ion tracks (RITRACKS), NASA radiation track image (NASARTI), and the On-Line Tool for the Assessment of Radiation in Space (OLTARIS). This session will introduce the components of the risk toolkit with opportunity for hands on demonstrations. The brief descriptions of each tools are: ARRBOD for Organ dose projection and acute radiation risk calculation from exposure to solar particle event; NSCR for Projection of cancer risk from exposure to space radiation; HemoDose for retrospective dose estimation by using multi-type blood cell counts; GERMcode for basic physical and biophysical properties for an ion beam, and biophysical and radiobiological properties for a beam transport to the target in the NASA Space Radiation Laboratory beam line; RITRACKS for simulation of heavy ion and delta-ray track structure, radiation chemistry, DNA structure and DNA damage at the molecular scale; NASARTI for modeling of the effects of space radiation on human cells and tissue by incorporating a physical model of tracks, cell nucleus, and DNA damage foci with image segmentation for the automated count; and OLTARIS, an integrated tool set utilizing HZETRN (High Charge and Energy Transport) intended to help scientists and engineers study the effects of space radiation on shielding materials, electronics, and biological systems.

  14. Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

    Science.gov (United States)

    Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

    2014-07-01

    The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. Copyright © 2014. Published by Elsevier Ltd.

  15. Integrated motivational interviewing and cognitive-behavioural therapy for bipolar disorder with comorbid substance use.

    Science.gov (United States)

    Jones, Steven H; Barrowclough, Christine; Allott, Rory; Day, Christine; Earnshaw, Paul; Wilson, Ian

    2011-01-01

    Although comorbid substance use is a common problem in bipolar disorder, there has been little research into options for psychological therapy. Studies to date have concentrated on purely cognitive-behavioural approaches, which are not equipped to deal with the ambivalence to change exhibited by many towards therapy designed to change substance use. This paper provides the first report of an integrated psychological treatment approach for bipolar disorder with comorbid substance use. The intervention reported combines motivational interviewing and cognitive-behavioural therapy to address ambivalence and equips individuals with strategies to address substance use. Across five individual case studies, preliminary evidence is reported to support the acceptability and the feasibility of this approach. Despite most participants not highlighting their substance use as a primary therapy target, all but one exhibited reduced use of drugs or alcohol at the end of therapy, sustained at 6 months' follow-up. There was some evidence for improvements in mood symptoms and impulsiveness, but this was less clear-cut. The impact of social and relationship issues on therapy process and outcome is discussed. The implications of the current findings for future intervention research in this area are considered. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Gender and Diversity Topics Taught in Commission on Accreditation for Marriage and Family Therapy Education Programs

    Science.gov (United States)

    Winston, Ebony Joy; Piercy, Fred P.

    2010-01-01

    This article explores how the topics of gender and diversity are being taught and defined in accredited marriage and family therapy programs through syllabi content analysis and interviews with selected faculty. We examined findings by program (master's and doctoral) and type of training (those that taught specific gender and culture courses and…

  17. The effects of animal-assisted therapy on wounded warriors in an Occupational Therapy Life Skills program.

    Science.gov (United States)

    Beck, Christine E; Gonzales, Florie; Sells, Carol Haertlein; Jones, Cynthia; Reer, Theresa; Zhu, Yao Yao

    2012-01-01

    Animal-assisted therapy (AAT) has gained much attention in civilian and military health care. Evidence supports its benefits with varied populations with diseases and disabilities, but no research has been done with injured or ill service members. This pretest, posttest nonrandomized control group study evaluated the effects of AAT on Warriors in transition (N=24) attending an Occupational Therapy Life Skills program with the long-term goal of improving their successful reintegration. Although significant differences were not found between the groups on most measures, anecdotal reports by participants and observers indicate that participants eagerly anticipated being with the therapy dogs, expressed pleasure and satisfaction with the experience, and regretted seeing it end. There were significant correlations between mood, stress, resilience, fatigue, and function at various measurement points. This is the first study to formally assess the benefits of AAT with wounded service members in garrison. Suggestions for future research are provided.

  18. Mixed Waste Integrated Program -- Problem-oriented technology development

    International Nuclear Information System (INIS)

    Hart, P.W.; Wolf, S.W.; Berry, J.B.

    1994-01-01

    The Mixed Waste Integrated Program (MWIP) is responding to the need for DOE mixed waste treatment technologies that meet these dual regulatory requirements. MWIP is developing emerging and innovative treatment technologies to determine process feasibility. Technology demonstrations will be used to determine whether processes are superior to existing technologies in reducing risk, minimizing life-cycle cost, and improving process performance. Technology development is ongoing in technical areas required to process mixed waste: materials handling, chemical/physical treatment, waste destruction, off-gas treatment, final forms, and process monitoring/control. MWIP is currently developing a suite of technologies to process heterogeneous waste. One robust process is the fixed-hearth plasma-arc process that is being developed to treat a wide variety of contaminated materials with minimal characterization. Additional processes encompass steam reforming, including treatment of waste under the debris rule. Advanced off-gas systems are also being developed. Vitrification technologies are being demonstrated for the treatment of homogeneous wastes such as incinerator ash and sludge. An alternative to conventional evaporation for liquid removal--freeze crystallization--is being investigated. Since mercury is present in numerous waste streams, mercury removal technologies are being developed

  19. Knowledge-based immunosuppressive therapy for kidney transplant patients--from theoretical model to clinical integration.

    Science.gov (United States)

    Seeling, Walter; Plischke, Max; de Bruin, Jeroen S; Schuh, Christian

    2015-01-01

    Immunosuppressive therapy is a risky necessity after a patient received a kidney transplant. To reduce risks, a knowledge-based system was developed that determines the right dosage of the immunosuppresive agent Tacrolimus. A theoretical model, to classify medication blood levels as well as medication adaptions, was created using data from almost 500 patients, and over 13.000 examinations. This model was then translated into an Arden Syntax knowledge base, and integrated directly into the hospital information system of the Vienna General Hospital. In this paper we give an overview of the construction and integration of such a system.

  20. Use of Gestalt Therapy Within a Drug Treatment Program.

    Science.gov (United States)

    Sideroff, Stephen I.

    1979-01-01

    Presents a Gestalt therapeutic approach that has shown promise within a drug treatment program. The major issues discussed include the acquisition of self-support, taking responsibility, dealing with anxiety, contact, and the expression of pent-up feelings. (Author)

  1. Gender and diversity topics taught in Commission on Accreditation for Marriage and Family Therapy Education programs.

    Science.gov (United States)

    Winston, Ebony Joy; Piercy, Fred P

    2010-10-01

    This article explores how the topics of gender and diversity are being taught and defined in accredited marriage and family therapy programs through syllabi content analysis and interviews with selected faculty. We examined findings by program (master's and doctoral) and type of training (those that taught specific gender and culture courses and those that attempted to infuse gender and culture throughout the curriculum). We examined 39 syllabi from 21 master's and 18 doctoral training programs. In addition, we conducted 20 interviews with faculty members. (Eighteen were White/Caucasian, one was African American and one was Asian Indian.) Some variation in topic areas was found between master's and doctoral programs and between those programs that offered specific course content and those that offered infused course content. However, qualitative interview data reflected many similarities. Particularly apparent was the level of commitment, transparency, and experiential learning methods professors used, regardless of program level or type. © 2010 American Association for Marriage and Family Therapy.

  2. Need of integrated dietary therapy for persons with diabetes mellitus and "unhealthy" body constitution presentations.

    Science.gov (United States)

    Wong, Yee Chi Peggy

    2016-07-01

    From a perspective of Chinese medicine (CM), persons with unregulated "unhealthy" body constitution (BC) will further develop chronic diseases, such as diabetes mellitus (DM). Conventional dietary therapy with nutrition component has its limitations in the regulation of "unhealthy" BC. However, empirical evidence supports that "unhealthy" BC can be regulated with food natures and flavors from a perspective of CM. Presentations of "unhealthy" BC types, such as Yin-deficiency, Yang-deficiency and Yin-Yang-deficiency were found in persons with DM. It would be necessary to regulate the "unhealthy" BC presentations with integration of conventional dietary therapy and Chinese food therapy. The ultimate goal is to either stabilize glycaemic control or prevent the development of other chronic diseases leading to reduction of disease burden, such as disease-related poor quality of life, stress of healthcare professionals and the rising of healthcare cost.

  3. Parents' explanatory models and hopes for outcomes of occupational therapy using a sensory integration approach.

    Science.gov (United States)

    Cohn, Ellen S; Kramer, Jessica; Schub, Jamie A; May-Benson, Teresa

    2014-01-01

    PURPOSE. To describe parents' concerns and hopes for their children who would be receiving occupational therapy using a sensory integration approach. METHOD. Content analysis of 275 parental responses to three open-ended questions on developmental-sensory history intake forms. FINDINGS. Parents' descriptions of why they sought for their children were categorized into four overarching concerns about their children's challenges: self-regulation, interacting with peers, participating in skilled motor activities, and self-confidence. Parents often linked these concerns together, revealing explanatory models of how they make sense of potential relationships among their children's challenges and how these challenges affect occupational performance. Parents hoped occupational therapy would help their children develop self-understanding and frustration tolerance to self-regulate their behavior in socially acceptable ways. IMPLICATIONS. Assessment and intervention should explicitly focus on links among self-regulation, social participation, skills, and perceived competence to address parents' expectations. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  4. Integrated analysis of the molecular action of Vorinostat identifies epi-sensitised targets for combination therapy.

    Science.gov (United States)

    Hay, Jodie F; Lappin, Katrina; Liberante, Fabio; Kettyle, Laura M; Matchett, Kyle B; Thompson, Alexander; Mills, Ken I

    2017-09-15

    Several histone deacetylase inhibitors including Vorinostat have received FDA approval for the treatment of haematological malignancies. However, data from these trials indicate that Vorinostat has limited efficacy as a monotherapy, prompting the need for rational design of combination therapies. A number of epi-sensitised pathways, including sonic hedgehog (SHH), were identified in AML cells by integration of global patterns of histone H3 lysine 9 (H3K9) acetylation with transcriptomic analysis following Vorinostat-treatment. Direct targeting of the SHH pathway with SANT-1, following Vorinostat induced epi-sensitisation, resulted in synergistic cell death of AML cells. In addition, xenograft studies demonstrated that combination therapy induced a marked reduction in leukemic burden compared to control or single agents. Together, the data supports epi-sensitisation as a potential component of the strategy for the rational development of combination therapies in AML.

  5. Computer-based Programs in Speech Therapy of Dyslalia and Dyslexia- Dysgraphia

    Directory of Open Access Journals (Sweden)

    Mirela Danubianu

    2010-04-01

    Full Text Available During the last years, the researchers and therapists in speech therapy have been more and more concerned with the elaboration and use of computer programs in speech disorders therapy. The main objective of this study was to evaluate the therapeutic effectiveness of computer-based programs for the Romanian language in speech therapy. Along the study, we will present the experimental research through assessing the effectiveness of computer programs in the speech therapy for speech disorders: dyslalia, dyslexia and dysgraphia. Methodologically, the use of the computer in the therapeutic phases was carried out with the help of some computer-based programs (Logomon, Dislex-Test etc. that we elaborated and we experimented with during several years of therapeutic activity. The sample used in our experiments was composed of 120 subjects; two groups of 60 children with speech disorders were selected for both speech disorders: 30 for the experimental ('computer-based' group and 30 for the control ('classical method' group. The study hypotheses verified whether the results, obtained by the subjects within the experimental group, improved significantly after using the computer-based program, compared to the subjects within the control group, who did not use this program but got a classical therapy. The hypotheses were confirmed for the speech disorders included in this research; the conclusions of the study confirm the advantages of using computer-based programs within speech therapy by correcting these disorders, as well as due to the positive influence these programs have on the development of children’s personality.

  6. Integrated orofacial therapy in chronic rhinosinusitis management for children with sleep bruxism

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2010-06-01

    Full Text Available Background: The prevalence of rhinosinusitis was 20% in ambulatory patients and was mostly affected by viral infections and allergy. If conservative treatments of rhinosinusitis failed, surgical procedure is an alternative choice. Previous case report revealed that the rhinosinusitis symptoms were successfully relieved by the "assisted drainage" therapy only. Nevertheless, this therapy was less successful in children with sleep bruxism (SB. Purpose: To report an integrated orofacial therapy for management of rhinosinusitis children with sleep bruxism (SB which consisted of the assisted drainage, night-guard and masseter muscle massage therapies. Case: Two boys who suffered from rhinosinusitis with bruxism were unsuccessfully treated with conventional treatment. Case management: Patients was subjected to the assisted drainage therapy that was scaling and root planning combined with gingival massage, and masseter muscle massage; night guard was worn in night sleep. They successfully relieved the rhinosinusitis symptoms. Conclusion: Based on the successful result, this integrated therapy could be suggested as an adjuvant in rhinosinusitis management.Latar belakang: Prevalensi rinosinusitis adalah 20% pasien rawat jalan dan umumnya disebabkan oleh infeksi virus dan alergi. Apabila terapi konservatif rinosinusitis mengalami kegagalan maka pilihan terakhir adalah operasi. Pada laporan kasus yang ada telah terjadi perbaikan gejala rinosinusitis setelah dilakukan terapi “assisted drainage” saja. Akan tetapi, terapi ini kurang berhasil pada anak dengan sleep bruxism (SB. Tujuan: Melaporkan suatu terapi orofasial terintegrasi untuk tatalaksana rinosinusitis pada anak dengan sleep bruxism (SB yang terdiri dari terapi assisted drainage, night guard dan masase otot masseter. Kasus: Dua anak laki-laki yang menderita rinosinusitis dengan bruxism telah mengalami kegagalan pada perawatan konsvensional. Tatalaksana kasus: Pasien dilakukan terapi assisted

  7. Blending work-integrated learning with distance education in an Australian radiation therapy advanced practice curriculum

    International Nuclear Information System (INIS)

    Matthews, Kristie; Wright, Caroline; Osborne, Catherine

    2014-01-01

    Advanced practice for radiation therapists has been a part of the international landscape for several years; however formal implementation into the Australian health care system is yet to happen. Despite this, three short course radiation therapy advanced practitioner programs have been established by an Australian tertiary institution in response to clinical service needs at several organisations. This paper describes the rationale for curriculum design and development of the program materials, the small-scale implementation of the programs at pilot sites, and the evolution of the curriculum to be available to registered radiation therapists nationally. Each program has been designed around a specific clinical role, where flexibility of delivery to busy practitioners was central to the decision to offer them via distance education. The curriculum comprises theoretical units of study which run in parallel to and underpin clinical practice units, where advanced competence in the specific area of practice is overseen by an experienced radiation oncologist mentor. Given the nature of the disparate clinical services requiring an advanced radiation therapy practitioner, the workplace learning component of the course is individually negotiated at a local level. Outcomes suggest that the flexible clinically based training underpinned by a distance education academic curriculum is able to support the development of advanced radiation therapy practitioners responsive to local service need, and ultimately may improve the patient experience

  8. Adapting Animal-Assisted Therapy Trials to Prison-Based Animal Programs.

    Science.gov (United States)

    Allison, Molly; Ramaswamy, Megha

    2016-09-01

    Prison-based animal programs have shown promise when it comes to increased sociability, responsibility, and levels of patience for inmates who participate in these programs. Yet there remains a dearth of scientific research that demonstrates the impact of prison-based animal programs on inmates' physical and mental health. Trials of animal-assisted therapy interventions, a form of human-animal interaction therapy most often used with populations affected by depression/anxiety, mental illness, and trauma, may provide models of how prison-based animal program research can have widespread implementation in jail and prison settings, whose populations have high rates of mental health problems. This paper reviews the components of prison-based animal programs most commonly practiced in prisons today, presents five animal-assisted therapy case studies, evaluates them based on their adaptability to prison-based animal programs, and discusses the institutional constraints that act as barriers for rigorous prison-based animal program research implementation. This paper can serve to inform the development of a research approach to animal-assisted therapy that nurses and other public health researchers can use in working with correctional populations. © 2016 Wiley Periodicals, Inc.

  9. Part 2 -- current program integrating strategies and lubrication technology

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, B.

    1996-12-01

    This paper is the second of two that describe the Predictive Maintenance Program for rotating machinery at the Palo Verde Nuclear Generating Station. The Predictive Maintenance program has been enhanced through organizational changes and improved interdisciplinary usage of technology. This paper will discuss current program strategies that have improved the interaction between the Vibration and Lube Oil programs. The {open_quotes}Lube Oil{close_quotes} view of the combined program along with case studies will then be presented.

  10. Part 2 -- current program integrating strategies and lubrication technology

    International Nuclear Information System (INIS)

    Johnson, B.

    1996-01-01

    This paper is the second of two that describe the Predictive Maintenance Program for rotating machinery at the Palo Verde Nuclear Generating Station. The Predictive Maintenance program has been enhanced through organizational changes and improved interdisciplinary usage of technology. This paper will discuss current program strategies that have improved the interaction between the Vibration and Lube Oil programs. The open-quotes Lube Oilclose quotes view of the combined program along with case studies will then be presented

  11. School Integration Program in Chile: gaps and challenges for the implementation of an inclusive education program

    Directory of Open Access Journals (Sweden)

    Mauro Tamayo Rozas

    2018-06-01

    Full Text Available Constructing inclusive societies, leaving no one behind, it is an ethical obligation. Developing inclusive educational programs allows ensuring equal opportunities in one of the most critical stages of development. The aim of this study is to describe the implementation of the School Integration Program (SIP in its different dimensions and in different zones of Chile. A descriptive and cross-sectional study of the perception of SIP Coordinators was performed in public and subsidized schools at the country through a web-based survey. A simple random convenience sampling of schools was performed, obtaining 1742 answers from educational establishments with SIP. Higher level of implementation of the program was identified in areas related to interdisciplinary work and comprehensive training, curricular and institutional aspects. On the other hand, deficiencies were identified in the implementation of accessibility, development of reasonable adjustments and participation of the educational community. Likewise, there are differences between the zones of Chile, with the North zone having the least progress. Although there are results in the work team and institutional development, the development of objective conditions and participation is still a pending task in the implementation of the SIP.

  12. Integrated Task And Data Parallel Programming: Language Design

    Science.gov (United States)

    Grimshaw, Andrew S.; West, Emily A.

    1998-01-01

    his research investigates the combination of task and data parallel language constructs within a single programming language. There are an number of applications that exhibit properties which would be well served by such an integrated language. Examples include global climate models, aircraft design problems, and multidisciplinary design optimization problems. Our approach incorporates data parallel language constructs into an existing, object oriented, task parallel language. The language will support creation and manipulation of parallel classes and objects of both types (task parallel and data parallel). Ultimately, the language will allow data parallel and task parallel classes to be used either as building blocks or managers of parallel objects of either type, thus allowing the development of single and multi-paradigm parallel applications. 1995 Research Accomplishments In February I presented a paper at Frontiers '95 describing the design of the data parallel language subset. During the spring I wrote and defended my dissertation proposal. Since that time I have developed a runtime model for the language subset. I have begun implementing the model and hand-coding simple examples which demonstrate the language subset. I have identified an astrophysical fluid flow application which will validate the data parallel language subset. 1996 Research Agenda Milestones for the coming year include implementing a significant portion of the data parallel language subset over the Legion system. Using simple hand-coded methods, I plan to demonstrate (1) concurrent task and data parallel objects and (2) task parallel objects managing both task and data parallel objects. My next steps will focus on constructing a compiler and implementing the fluid flow application with the language. Concurrently, I will conduct a search for a real-world application exhibiting both task and data parallelism within the same program m. Additional 1995 Activities During the fall I collaborated

  13. Integrated Cognitive Behavioral Therapy Versus Cognitive Processing Therapy for Adults With Depression, Substance Use Disorder, and Trauma.

    Science.gov (United States)

    Haller, Moira; Norman, Sonya B; Cummins, Kevin; Trim, Ryan S; Xu, Xiaomin; Cui, Ruifeng; Allard, Carolyn B; Brown, Sandra A; Tate, Susan R

    2016-03-01

    The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history. Copyright © 2015. Published by Elsevier Inc.

  14. Combinatorial therapy discovery using mixed integer linear programming.

    Science.gov (United States)

    Pang, Kaifang; Wan, Ying-Wooi; Choi, William T; Donehower, Lawrence A; Sun, Jingchun; Pant, Dhruv; Liu, Zhandong

    2014-05-15

    Combinatorial therapies play increasingly important roles in combating complex diseases. Owing to the huge cost associated with experimental methods in identifying optimal drug combinations, computational approaches can provide a guide to limit the search space and reduce cost. However, few computational approaches have been developed for this purpose, and thus there is a great need of new algorithms for drug combination prediction. Here we proposed to formulate the optimal combinatorial therapy problem into two complementary mathematical algorithms, Balanced Target Set Cover (BTSC) and Minimum Off-Target Set Cover (MOTSC). Given a disease gene set, BTSC seeks a balanced solution that maximizes the coverage on the disease genes and minimizes the off-target hits at the same time. MOTSC seeks a full coverage on the disease gene set while minimizing the off-target set. Through simulation, both BTSC and MOTSC demonstrated a much faster running time over exhaustive search with the same accuracy. When applied to real disease gene sets, our algorithms not only identified known drug combinations, but also predicted novel drug combinations that are worth further testing. In addition, we developed a web-based tool to allow users to iteratively search for optimal drug combinations given a user-defined gene set. Our tool is freely available for noncommercial use at http://www.drug.liuzlab.org/. zhandong.liu@bcm.edu Supplementary data are available at Bioinformatics online.

  15. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

    OpenAIRE

    Chen, Jia-Ching; Shaw, Fu-Zen

    2014-01-01

    Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulati...

  16. Program Description: Physical Therapy in a Heart Failure Clinic

    OpenAIRE

    Knocke, Ann

    2012-01-01

    Aerobic exercise and resistance training have been proven to be beneficial for patients with heart failure. Current reimbursement guidelines exclude these patients from our traditional cardiac rehabilitation program, so at Newton Wellesley Hospital a clinic model was developed for the disease management and exercise of heart failure patients.

  17. Integration Site and Clonal Expansion in Human Chronic Retroviral Infection and Gene Therapy

    Science.gov (United States)

    Niederer, Heather A.; Bangham, Charles R. M.

    2014-01-01

    Retroviral vectors have been successfully used therapeutically to restore expression of genes in a range of single-gene diseases, including several primary immunodeficiency disorders. Although clinical trials have shown remarkable results, there have also been a number of severe adverse events involving malignant outgrowth of a transformed clonal population. This clonal expansion is influenced by the integration site profile of the viral integrase, the transgene expressed, and the effect of the viral promoters on the neighbouring host genome. Infection with the pathogenic human retrovirus HTLV-1 also causes clonal expansion of cells containing an integrated HTLV-1 provirus. Although the majority of HTLV-1-infected people remain asymptomatic, up to 5% develop an aggressive T cell malignancy. In this review we discuss recent findings on the role of the genomic integration site in determining the clonality and the potential for malignant transformation of cells carrying integrated HTLV-1 or gene therapy vectors, and how these results have contributed to the understanding of HTLV-1 pathogenesis and to improvements in gene therapy vector safety. PMID:25365582

  18. Development of a Mathematics, Science, and Technology Education Integrated Program for a Maglev

    Science.gov (United States)

    Park, Hyoung Seo

    2006-01-01

    The purpose of the study was to develop an MST Integrated Program for making a Maglev hands-on activity for higher elementary school students in Korea. In this MST Integrated Program, students will apply Mathematics, Science, and Technology principles and concepts to the design, construction, and evaluation of a magnetically levitated vehicle. The…

  19. McGill's Integrated Civil and Common Law Program.

    Science.gov (United States)

    Morissette, Yves-Marie

    2002-01-01

    Describes the bijural program of McGill University Faculty of Law. The program educates all first-degree law students in both the common law and civil law traditions, preparing them for the increasing globalization of legal practice. (EV)

  20. INTEGRATION BETWEEN MRI AND PHYSICAL THERAPY TO IMPROVE TREATMENT OF PATIENTS WITH SHOULDER PAIN

    Directory of Open Access Journals (Sweden)

    Awad Mohamed Elkhadir

    2016-08-01

    Full Text Available Background: Shoulder pain is the second most common musculoskeletal disorder treated by physical therapists. The cause for the shoulder pain is multifactorial. However, a specific diagnosis is crucial in the right management of shoulder dysfunction. Therefore, the aim of this study was to find out the efficacy of integrating the MRI for the accurate diagnosis and impact of this on rendering the effective physical therapy interventions in shoulder dysfunction patients. Methods: A retrospective study conducted on 14 patients who undergone an MRI with a 1.5 T unit MAGNETOM Symphony (Siemens, for their shoulder pain, where the diagnosis might be Muscle tears like, subscapularis, infraspinatus,supraspinatus and teres minor muscles; subacromial or subdeltoid bursitis and labral tears were included. All the subjects were then continued with usual physical therapy treatments for four weeks depending on their diagnosis which includes; advice, stretching, mobilization and strengthening exercises, manual therapy, massage, strapping, and electrotherapy . The outcome measures documented from the case sheet were; Visual Analogue Scale grade and passive range of motion of shoulder external / internal rotation and abduction. Results: Paired t test was used to compare the PROM between pre rehabilitation and post rehabilitation testing and the non parametric test, Mann Whitney U test was used for the comparison of VAS. All patients showed a significant improvement in VAS and PROM of abduction, internal and external rotation following physical therapy (P≤ 0.05. Conclusion: MRI is found to be a reliable method of diagnostic procedure for the shoulder pain and the integration of MRI and physical therapy to treat shoulder dysfunction leads to a better outcome.

  1. Software-Programmed Optical Networking with Integrated NFV Service Provisioning

    DEFF Research Database (Denmark)

    Mehmeri, Victor; Wang, Xi; Basu, Shrutarshi

    2017-01-01

    We showcase demonstrations of “program & compile” styled optical networking as well as open platforms & standards based NFV service provisioning using a proof-of-concept implementation of the Software-Programmed Networking Operating System (SPN OS).......We showcase demonstrations of “program & compile” styled optical networking as well as open platforms & standards based NFV service provisioning using a proof-of-concept implementation of the Software-Programmed Networking Operating System (SPN OS)....

  2. Specialization-Specific Course Assessments Integrated for Program Assessment

    OpenAIRE

    Qurban A. Memon; Adnan Harb; Shakeel Khoja

    2012-01-01

    The program assessment process combines assessments from individual courses to generate final program assessment to match accreditation benchmarks. In developing countries, industrial environment is not diversified to allow graduating engineers to seek jobs in all disciplines or specializations of an engineering program. Hence, it seems necessary to seek evolution of an engineering program assessment for specialized requirements of the industry. This paper describes how specialization-specifi...

  3. Investigating the experiences in a school-based occupational therapy program to inform community-based paediatric occupational therapy practice.

    Science.gov (United States)

    Rens, Lezahn; Joosten, Annette

    2014-06-01

    A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.

  4. 76 FR 34385 - Program Integrity: Gainful Employment-Debt Measures

    Science.gov (United States)

    2011-06-13

    ... bachelor's and master's degree programs, and 20 years for programs that lead to a doctoral or first...-risk and underserved populations of students; and limit the growth of, and innovation in, new programs... and to society in general, nor that they would represent a poor financial risk. Sen. Rep. No. 758...

  5. OSMOSE: An experimental program for the qualification of integral cross sections of actinides

    International Nuclear Information System (INIS)

    Hudelot, J. P.; Klann, R.; Fougeras, P.; Jorion, F.; Drin, N.; Donnet, L.

    2004-01-01

    The accurate integral cross sectional reaction rates in representative spectra for the actinides are discussed at OSMOSE program. The first step in obtaining better nuclear data consists of measuring accurate integral data and comparing it to integrated energy dependent data: this comparison provides a direct assessment of the effect of deficiencies in the differential data. The OSMOSE program includes a complete analytical program associated with experimental measurement program and aims at understanding and resolving discrepancies between calculated and measured values. The measurement covers a wide range of neutron spectra, from over-moderate thermal spectra to fast spectra. (authors)

  6. Art Therapy Programs with At-Risk Students in Public Schools

    Science.gov (United States)

    Varallo, Patrick A.

    2012-01-01

    Educating and meeting the multiple needs of students at risk of low academic achievement has been a growing concern for public schools in the United States. Many at-risk students require alternative school-based interventions. This study examined the operation, premise, and objectives of art therapy integrated in 14 school districts across the…

  7. The effectiveness of a cardiometabolic prevention program in general practices offering integrated care programs including a patient tailored lifestyle treatment.

    NARCIS (Netherlands)

    Hollander, M.; Eppink, L.; Nielen, M.; Badenbroek, I.; Stol, D.; Schellevis, F.; Wit, N. de

    2016-01-01

    Background & Aim: Selective cardio-metabolic prevention programs (CMP) may be especially effective in well-organized practices. We studied the effect of a CMP program in the academic primary care practices of the Julius Health Centers (JHC) that offer integrated cardiovascular disease management

  8. What Patients and Providers Want to Know About Complementary and Integrative Health Therapies.

    Science.gov (United States)

    Taylor, Stephanie L; Giannitrapani, Karleen F; Yuan, Anita; Marshall, Nell

    2018-01-01

    We conducted a quality improvement project to determine (1) what information providers and patients most wanted to learn about complementary and integrative health (CIH) therapies and (2) in what format they wanted to receive this information. The overall aim was to develop educational materials to facilitate the CIH therapy decision-making processes. We used mixed methods to iteratively pilot test and revise provider and patient educational materials on yoga and meditation. We conducted semistructured interviews with 11 medical providers and held seven focus groups and used feedback forms with 52 outpatients. We iteratively developed and tested three versions of both provider and patient materials. Activities were conducted at four Veterans Administration medical facilities (two large medical centers and two outpatient clinics). Patients want educational materials with clearly stated basic information about: (1) what mindfulness and yoga are, (2) what a yoga/meditation class entails and how classes can be modified to suit different abilities, (3) key benefits to health and wellness, and (4) how to find classes at the hospital/clinic. Diverse media (videos, handouts, pocket guides) appealed to different Veterans. Videos should depict patients speaking to patients and demonstrating the CIH therapy. Written materials should be one to three pages with colors, and images and messages targeting a variety of patients. Providers wanted a concise (one-page) sheet in black and white font with no images listing the scientific evidence for CIH therapies from high-impact journals, organized by either type of CIH or health condition to use during patient encounters, and including practical information about how to refer patients. Providers and patients want to learn more about CIH therapies, but want the information in succinct, targeted formats. The information learned and materials developed in this study can be used by others to educate patients and providers on CIH

  9. Integration with Writing Programs: A Strategy for Quantitative Reasoning Program Development

    Directory of Open Access Journals (Sweden)

    Nathan D. Grawe

    2009-07-01

    Full Text Available As an inherently interdisciplinary endeavor, quantitative reasoning (QR risks falling through the cracks between the traditional “silos” of higher education. This article describes one strategy for developing a truly cross-campus QR initiative: leverage the existing structures of campus writing programs by placing QR in the context of argument. We first describe the integration of Carleton College’s Quantitative Inquiry, Reasoning, and Knowledge initiative with the Writing Program. Based on our experience, we argue that such an approach leads to four benefits: it reflects important aspects of QR often overlooked by other approaches; it defuses the commonly raised objection that QR is merely remedial math; it sidesteps challenges of institutional culture (idiosyncratic campus history, ownership, and inertia; and it improves writing instruction. We then explore the implications of our approach for QR graduation standards. Our experience suggests that once we engaged faculty from across the curriculum in our work, it would have been difficult to adopt a narrowly defined requirement of skills-based courses. The article concludes by providing resources for those who would like to implement this approach at the course and institutional level.

  10. Montana Integrated Carbon to Liquids (ICTL) Demonstration Program

    Energy Technology Data Exchange (ETDEWEB)

    Fiato, Rocco A. [Accelergy Corporation, Houston, TX (United States); Sharma, Ramesh [Univ. of North Dakota, Grand Forks, ND (United States). Energy & Environmental Research Center (EERC); Allen, Mark [Accelergy Corporation, Houston, TX (United States). Integrated Carbon Solutions; Peyton, Brent [Montana State Univ., Bozeman, MT (United States); Macur, Richard [Montana State Univ., Bozeman, MT (United States). Dept. of Land Resources and Environmental Sciences; Cameron, Jemima [Australian Energy Company Ltd., Hovea (Australia). Australian American Energy Corporation (AAEC)

    2013-12-01

    Integrated carbon-to-liquids technology (ICTL) incorporates three basic processes for the conversion of a wide range of feedstocks to distillate liquid fuels: (1) Direct Microcatalytic Coal Liquefaction (MCL) is coupled with biomass liquefaction via (2) Catalytic Hydrodeoxygenation and Isomerization (CHI) of fatty acid methyl esters (FAME) or trigylceride fatty acids (TGFA) to produce liquid fuels, with process derived (3) CO2 Capture and Utilization (CCU) via algae production and use in BioFertilizer for added terrestrial sequestration of CO2, or as a feedstock for MCL and/or CHI. This novel approach enables synthetic fuels production while simultaneously meeting EISA 2007 Section 526 targets, minimizing land use and water consumption, and providing cost competitive fuels at current day petroleum prices. ICTL was demonstrated with Montana Crow sub-bituminous coal in MCL pilot scale operations at the Energy and Environmental Research Center at the University of North Dakota (EERC), with related pilot scale CHI studies conducted at the University of Pittsburgh Applied Research Center (PARC). Coal-Biomass to Liquid (CBTL) Fuel samples were evaluated at the US Air Force Research Labs (AFRL) in Dayton and greenhouse tests of algae based BioFertilizer conducted at Montana State University (MSU). Econometric modeling studies were also conducted on the use of algae based BioFertilizer in a wheat-camelina crop rotation cycle. We find that the combined operation is not only able to help boost crop yields, but also to provide added crop yields and associated profits from TGFA (from crop production) for use an ICTL plant feedstock. This program demonstrated the overall viability of ICTL in pilot scale operations. Related work on the Life Cycle Assessment (LCA) of a Montana project indicated that CCU could be employed very effectively to reduce the overall carbon footprint of the MCL/CHI process. Plans are currently being made to conduct larger

  11. Role of innovative institutional structures in integrated governance. A case study of integrating health and nutrition programs in Chhattisgarh, India.

    Science.gov (United States)

    Kalita, Anuska; Mondal, Shinjini

    2012-01-01

    The aim of this paper is to highlight the significance of integrated governance in bringing about community participation, improved service delivery, accountability of public systems and human resource rationalisation. It discusses the strategies of innovative institutional structures in translating such integration in the areas of public health and nutrition for poor communities. The paper draws on experience of initiating integrated governance through innovations in health and nutrition programming in the resource-poor state of Chhattisgarh, India, at different levels of governance structures--hamlets, villages, clusters, blocks, districts and at the state. The study uses mixed methods--i.e. document analysis, interviews, discussions and quantitative data from facilities surveys--to present a case study analyzing the process and outcome of integration. The data indicate that integrated governance initiatives improved convergence between health and nutrition departments of the state at all levels. Also, innovative structures are important to implement the idea of integration, especially in contexts that do not have historical experience of such partnerships. Integration also contributed towards improved participation of communities in self-governance, community monitoring of government programs, and therefore, better services. As governments across the world, especially in developing countries, struggle towards achieving better governance, integration can serve as a desirable process to address this. Integration can affect the decentralisation of power, inclusion, efficiency, accountability and improved service quality in government programs. The institutional structures detailed in this paper can provide models for replication in other similar contexts for translating and sustaining the idea of integrated governance. This paper is one of the few to investigate innovative public institutions of a and community mobilisation to explore this important, and under

  12. Clinical practice guidelines on the evidence-based use of integrative therapies during and following breast cancer treatment

    Science.gov (United States)

    Greenlee, Heather; DuPont-Reyes, Melissa J.; Balneaves, Lynda G.; Carlson, Linda E.; Cohen, Misha R.; Deng, Gary; Johnson, Jillian A.; Mumber, Matthew; Seely, Dugald; Zick, Suzanna; Boyce, Lindsay; Tripathy, Debu

    2018-01-01

    Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. PMID:28436999

  13. Physiological and Psychological Effects of a Forest Therapy Program on Middle-Aged Females.

    Science.gov (United States)

    Ochiai, Hiroko; Ikei, Harumi; Song, Chorong; Kobayashi, Maiko; Miura, Takashi; Kagawa, Takahide; Li, Qing; Kumeda, Shigeyoshi; Imai, Michiko; Miyazaki, Yoshifumi

    2015-12-01

    The natural environment is increasingly recognized as an effective counter to urban stress, and "Forest Therapy" has recently attracted attention as a relaxation and stress management activity with demonstrated clinical efficacy. The present study assessed the physiological and psychological effects of a forest therapy program on middle-aged females. Seventeen Japanese females (62.2 ± 9.4 years; mean ± standard deviation) participated in this experiment. Pulse rate, salivary cortisol level, and psychological indices were measured on the day before forest therapy and on the forest therapy day. Pulse rate and salivary cortisol were significantly lower than baseline following forest therapy, indicating that subjects were in a physiologically relaxed state. Subjects reported feeling significantly more "comfortable," "relaxed," and "natural" according to the semantic differential (SD) method. The Profile of Mood State (POMS) negative mood subscale score for "tension-anxiety" was significantly lower, while that for "vigor" was significantly higher following forest therapy. Our study revealed that forest therapy elicited a significant (1) decrease in pulse rate, (2) decrease in salivary cortisol levels, (3) increase in positive feelings, and (4) decrease in negative feelings. In conclusion, there are substantial physiological and psychological benefits of forest therapy on middle-aged females.

  14. Integrating Dialectical Behavior Therapy and Prolonged Exposure to Treat Co-Occurring Borderline Personality Disorder and PTSD: Two Case Studies

    Science.gov (United States)

    Harned, Melanie S.; Linehan, Marsha M.

    2008-01-01

    Despite the high rate of trauma and PTSD among individuals with borderline personality disorder (BPD), no studies have specifically evaluated the treatment of PTSD in a BPD population. These case studies illustrate the use of a protocol based on prolonged exposure therapy that can be integrated into standard dialectical behavior therapy to treat…

  15. Relaxation Therapy with Guided Imagery for Postoperative Pain Management: An Integrative Review.

    Science.gov (United States)

    Felix, Márcia Marques Dos Santos; Ferreira, Maria Beatriz Guimarães; da Cruz, Luciana Falcão; Barbosa, Maria Helena

    2017-12-14

    To identify the evidence in the literature about relaxation therapy with guided imagery for postoperative pain management. Integrative review. PubMed, Lilacs, Cochrane, Embase, Web of Science, Scopus and Cinahl, between August 2006 and December 2016. Descriptors: Postoperative Pain, Imagery (Psychotherapy) and Guided Imagery. original studies published in English, Spanish and Portuguese. 291 studies were identified and eight were selected. Descriptive data analysis, presented in detail, with a summary of the knowledge produced in each study. In the primary studies included, the use of guided imagery associated with other complementary therapies was highlighted: hand and foot "M" technique, education on postoperative pain management with analgesic drugs, relaxation exercises, respiration exercises, meditation, soothing biorhythmic music combined with positive and encouraging assertions and music with nature sounds. The knowledge synthesis resulting from this study indicates that evidence could be identified on the use of guided imagery associated with relaxation therapy as a complementary approach to drug analgesia in postoperative pain control strengthens its indication for nursing practice. This evidence, however, demonstrates that the quality of the use of this therapy is limited, and it is necessary to carry out new randomized clinical studies to fill the existing gaps in this topic. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  16. The Use of Integrative Therapies in Patients with Amyotrophic Lateral Sclerosis in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Weidong Pan

    2013-01-01

    Full Text Available Objective. To investigate the current use of integrative therapies (IT in the treatment of patients with amyotrophic lateral sclerosis (ALS. Methods. A cross-sectional, multicenter clinical epidemiological survey was conducted in 12 hospitals in Shanghai. We investigated the type and frequency of IT use and determined whether the use of IT correlated with demographic, social, or disease-specific characteristics in our patient population. Results. A total of 231 (89.5% of 258 patients with ALS were eligible for the study and 229 (99% of all of 231 reported the use of at least one IT for the treatment of ALS. Vitamins and Chinese herb decoctions, Chinese herb compounds, massage therapy, and acupuncture were the 5 most commonly used therapies. There was a strong association between education level, income, and use of IT. A household income of more than 75,000 RMB ($49,995 correlated with multiple IT use, and married patients used IT more often than single individuals. The main reasons for using IT were to treat weakness and fatigue, muscle atrophy, the development of ALS, depression, insomnia, limb pain or numbness, and side effects associated with Riluzole. Conclusion. The use of IT is common in patients with ALS in Shanghai. Vitamins and TCM are the most used additional therapies and the widespread and largely unexamined use of IT for ALS requires more attention.

  17. 47 CFR 76.504 - Limits on carriage of vertically integrated programming.

    Science.gov (United States)

    2010-10-01

    ... programming. 76.504 Section 76.504 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... Limits on carriage of vertically integrated programming. (a) Except as otherwise provided in this section... national video programming services owned by the cable operator or in which the cable operator has an...

  18. An Integrative Suicide Prevention Program for Visitor Charcoal Burning Suicide and Suicide Pact

    Science.gov (United States)

    Wong, Paul W. C.; Liu, Patricia M. Y.; Chan, Wincy S. C.; Law, Y. W.; Law, Steven C. K.; Fu, King-Wa; Li, Hana S. H.; Tso, M. K.; Beautrais, Annette L.; Yip, Paul S. F.

    2009-01-01

    An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42…

  19. 77 FR 72435 - Pipeline Safety: Using Meaningful Metrics in Conducting Integrity Management Program Evaluations

    Science.gov (United States)

    2012-12-05

    ... effectiveness of their integrity management programs. Program evaluation is one of the key required program... activities that are in place to control risk. These measures indicate how well an operator is implementing... outcome is being achieved or not, despite the risk control activities in place. Failure Measures that...

  20. Active Participation of Integrated Development Environments in the Teaching of Object-Oriented Programming

    Science.gov (United States)

    Depradine, Colin; Gay, Glenda

    2004-01-01

    With the strong link between programming and the underlying technology, the incorporation of computer technology into the teaching of a programming language course should be a natural progression. However, the abstract nature of programming can make such integration a difficult prospect to achieve. As a result, the main development tool, the…

  1. Metacognitive Reflection and Insight Therapy for Early Psychosis: A preliminary study of a novel integrative psychotherapy.

    Science.gov (United States)

    Vohs, Jenifer L; Leonhardt, Bethany L; James, Alison V; Francis, Michael M; Breier, Alan; Mehdiyoun, Nikki; Visco, Andrew C; Lysaker, Paul H

    2018-05-01

    Poor insight impedes treatment in early phase psychosis (EPP). This manuscript outlines preliminary findings of an investigation of the novel metacognitively oriented integrative psychotherapy, Metacognitive Reflection and Insight Therapy, for individuals with early phase psychosis (MERIT-EP). Twenty adults with EPP and poor insight were randomized to either six months of MERIT-EP or treatment as usual (TAU). Therapists were trained and therapy was successfully delivered under routine, outpatient conditions. Insight, assessed before and after treatment, revealed significant improvement for the MERIT-EP, but not TAU, group. These results suggest MERIT-EP is feasible to deliver, accepted by patients, and leads to clinically significant improvements in insight. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. A Randomized Controlled Comparison of Integrative Cognitive-Affective Therapy and Cognitive-Behavioral Therapy-Enhanced for Bulimia Nervosa

    Science.gov (United States)

    Wonderlich, Stephen A.; Peterson, Carol B.; Crosby, Ross D.; Smith, Tracey L.; Klein, Marjorie H.; Mitchell, James E.; Crow, Scott J.

    2016-01-01

    Background The purpose of this investigation was to compare a new psychotherapy for bulimia nervosa, Integrative Cognitive-Affective Therapy (ICAT), with an established treatment, Cognitive-Behavioral Therapy-Enhanced (CBT-E). Method Eighty adults with symptoms of bulimia nervosa were randomized to ICAT or CBT-E for 21 sessions over 19 weeks. Bulimic symptoms, measured by the Eating Disorder Examination, were assessed at baseline, end of treatment, and 4-month follow-up. Treatment outcome, as measured by binge eating frequency, purging frequency, global eating disorder severity, emotion regulation, self-oriented cognition, depression, anxiety, and self-esteem, was determined using generalized estimating equations, logistic regression, and a general linear model (intent-to-treat). Results Both treatments were associated with significant improvement in bulimic symptoms as well as all measures of outcome, and no statistically significant differences were observed between the two conditions at end of treatment or follow-up. Intent-to-treat abstinence rates for ICAT (37.5% at end of treatment, 32.5% at follow-up) and CBT-E (22.5% at both end of treatment and follow-up) were not significantly different. Conclusions ICAT was associated with significant improvements in bulimic and associated symptoms that did not differ from those obtained with CBT-E. This initial randomized controlled trial of a new individual psychotherapy for bulimia nervosa suggests that targeting emotion and self-oriented cognition in the context of nutritional rehabilitation may be efficacious and worthy of further study. PMID:23701891

  3. Assessing an Intergenerational Horticulture Therapy Program for Elderly Adults and Preschool Children

    OpenAIRE

    Predny, Mary Lorraine

    1999-01-01

    ASSESSING AN INTERGENERATIONAL HORTICULTURE THERAPY PROGRAM FOR ELDERLY ADULTS AND PRESCHOOL CHILDREN by Mary Lorraine Predny Dr. Diane Relf, Chair Horticulture Department ABSTRACT The goal of this research project was to determine if introducing intergenerational interactions would supplement or detract from the use of horticulture as a therapeutic tool when working with elderly adults and preschool children. The program was set up to compare ind...

  4. Unintentional injury prevention and the role of occupational therapy in the Solomon Islands: an integrative review.

    Science.gov (United States)

    Daufanamae, Barbara U; Franklin, Richard C; Eagers, Jackie

    2016-01-01

    Unintentional injuries (injuries for which there is no evidence of a predetermined intent) are one of the leading causes of death worldwide, particularly in low- and middle-income countries (LMICs). Although evidence demonstrates unintentional injuries are preventable it is a public health challenge for many LMICs such as the Solomon Islands. Occupational therapists are well placed to contribute to injury prevention, as they have specialised skills to analyse the accessibility and safety of the environments within which people conduct their daily occupations. While the role of occupational therapy in unintentional injury prevention is well known in high-income countries, it is unfamiliar in LMICs, especially in the Solomon Islands. This integrative review aimed to explore the incidence of common unintentional injuries, and the burden in the Solomon Islands; and explore the potential role of occupational therapy in unintentional injury prevention in the Solomon Islands, based on current activities in LMICs. Articles were reviewed from six databases (Medline, CINAHL, OTDBase, OT Seeker, Scopus and PsychInfo). Five articles met the inclusion criteria for the first objective and 15 articles met the inclusion criteria for the second objective. These articles were thematically analysed where themes and codes associated with the research objectives were extracted and analysed. Unintentional injuries in the Solomon Islands reported in the literature included ocular trauma, falls from fruit trees and coconut palms, and road traffic crashes. Burden of injury reported was mostly associated with loss of productivity. Occupational therapists undertook rehabilitative, biomechanical, neurodevelopmental and educational roles in LMIC, focusing on tertiary and secondary injury prevention. This integrative review suggests that there is limited information regarding injury in the Solomon Islands. However, evidence is available in LMICs to suggest that occupational therapy services can

  5. Reluctant gerontologists: integrating gerontological nursing content into a prelicensure program.

    Science.gov (United States)

    Miller, Joanne M; Coke, Lola; Moss, Angela; McCann, Judith J

    2009-01-01

    Integration of readily available resources on care of older adults increased student and faculty interest and knowledge of gerontological nursing. The authors describe their use of these practical and easy-to-implement resources.

  6. Management of pain induced by exercise and mobilization during physical therapy programs: views of patients and care providers

    Directory of Open Access Journals (Sweden)

    Rannou François

    2011-07-01

    Full Text Available Abstract Background The expectations of patients for managing pain induced by exercise and mobilization (PIEM have seldom been investigated. We identified the views of patients and care providers regarding pain management induced by exercise and mobilization during physical therapy programs. Methods We performed a qualitative study based on semi-structured interviews with a stratified sample of 12 patients (7 women and 14 care providers (6 women: 4 general practitioners [GPs], 1 rheumatologist, 1 physical medicine physician, 1 geriatrician, 2 orthopedic surgeons, and 5 physical therapists. Results Patients and care providers have differing views on PIEM in the overall management of the state of disease. Patients' descriptions of PIEM were polymorphic, and they experienced it as decreased health-related quality of life. The impact of PIEM was complex, and patient views were sometimes ambivalent, ranging from denial of symptoms to discontinuation of therapy. Care providers agreed that PIEM is generally not integrated in management strategies. Care providers more often emphasized the positive and less often the negative dimensions of PIEM than did patients. However, the consequences of PIEM cited included worsened patient clinical condition, fears about physical therapy, rejection of the physical therapist and refusal of care. PIEM follow-up is not optimal and is characterized by poor transmission of information. Patients expected education on how better to prevent stress and anxiety generated by pain, education on mobilization, and adaptations of physical therapy programs according to pain intensity. Conclusion PIEM management could be optimized by alerting care providers to the situation, improving communication among care providers, and providing education to patients and care providers.

  7. Using management action plans to integrate program improvement efforts

    Energy Technology Data Exchange (ETDEWEB)

    Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N. [Project Performance Corporation, Sterling, VA (United States)

    1994-12-31

    The Department of Energy`s (DOE`s) Environmental Management Program is the country`s largest and most sophisticated environmental program to date. The rapid expansion of the DOE`s environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program`s management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities.

  8. Paradox applications integration ATP's for MAC and mass balance programs

    International Nuclear Information System (INIS)

    Russell, V.K.; Mullaney, J.E.

    1994-01-01

    The K Basins Materials Accounting (MAC) and Material Balance (MBA) database system were set up to run under one common applications program. This Acceptance Test Plan (ATP) describes how the code was to be tested to verify its correctness. The scope of the tests is minimal, since both MAC and MBA have already been tested in detail as stand-alone programs

  9. The Performance Enhancement Group Program: Integrating Sport Psychology and Rehabilitation

    Science.gov (United States)

    Granito, Vincent J.; Hogan, Jeffery B.; Varnum, Lisa K.

    1995-01-01

    In an effort to improve the psychological health of the athlete who has sustained an injury, the Performance Enhancement Group program for injured athletes was created. This paper will offer a model for the Performance Enhancement Group program as a way to: 1) support the athlete, both mentally and physically; 2) deal with the demands of rehabilitation; and 3) facilitate the adjustments the athlete has to make while being out of the competitive arena. The program consists of responsibilities for professionals in sport psychology (ie, assessment/orientation, support, education, individual counseling, and evaluation) and athletic training (ie, organization/administration, recruitment and screening, support, application of techniques, and program compliance). The paper will emphasize that the success of the program is dependent on collaboration between professionals at all levels. PMID:16558357

  10. Integrated environmental monitoring program at the Hanford Site

    International Nuclear Information System (INIS)

    Jaquish, R.E.

    1990-08-01

    The US Department of Energy's Hanford Site, north of Richland, Washington, has a mission of defense production, waste management, environmental restoration, advanced reactor design, and research development. Environmental programs at Hanford are conducted by Pacific Northwest Laboratory (PNL) and the Westinghouse Hanford Company (WHC). The WHC environmental programs include the compliance and surveillance activities associated with site operations and waste management. The PNL environmental programs address the site-wide and the of-site areas. They include the environmental surveillance and the associated support activities, such as dose calculations, and also the monitoring of environmental conditions to comply with federal and state environmental regulations on wildlife and cultural resources. These are called ''independent environmental programs'' in that they are conducted completely separate from site operations. The Environmental Surveillance and Oversight Program consists of the following projects: surface environmental surveillance; ground-water surveillance; wildlife resources monitoring; cultural resources; dose overview; radiation standards and calibrations; meteorological and climatological services; emergency preparedness

  11. A Pharmaceutical Care Program to Improve Adherence to Statin Therapy : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Eussen, Simone R. B. M.; van der Elst, Menno E.; Klungel, Olaf H.; Rompelberg, Cathy J. M.; Garssen, Johan; Oosterveld, Marco H.; de Boer, Anthonius; de Gier, Johan J.; Bouvy, Marcel L.

    2010-01-01

    BACKGROUND: Despite the well-known beneficial effects of statins, many patients do not adhere to chronic medication regimens. OBJECTIVE: To implement and assess the effectiveness of a community pharmacy based pharmaceutical care program developed to improve patients' adherence to statin therapy.

  12. Reintegrating Family Therapy Training in Psychiatric Residency Programs: Making the Case

    Science.gov (United States)

    Rait, Douglas; Glick, Ira

    2008-01-01

    Objective: Given the marginalization of couples and family therapy in psychiatric residency programs over the past two decades, the authors propose a rationale for the reintegration of these important psychosocial treatments into the mainstream of general psychiatric residency education. Methods: After reviewing recent trends in the field that…

  13. Multicultural training in the United States: a survey of occupational therapy programs.

    Science.gov (United States)

    Brown, Elena Verdine Donoso; Muñoz, Jaime Phillip; Powell, Janet M

    2011-01-01

    ABSTRACT This study was designed to describe multicultural training practices in occupational therapy programs. A survey was sent to occupational therapy programs in the United States to gather information on multicultural content, skills, and teaching methods as well as diversity context and challenges. The response rate was 54%. The most frequently covered multicultural content was related to cultural background and sociopolitical factors. Multicultural skills covered most often were practice oriented and interpersonal skills. Teaching methods reported as used most often differed from the methods thought by the respondents to be most effective. Programs reported multiple challenges to multicultural training including lack of time and lack of diversity in the student body, faculty, and environment. Results suggest that educators may need to expand multicultural content and skills to prepare occupational therapy students for providing care in increasingly diverse practice settings. In addition, increased use of teaching methods that focus on exposure to diverse populations and reflection may be needed to improve the effectiveness of multicultural training in occupational therapy programs.

  14. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  15. Cost-effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints.

    NARCIS (Netherlands)

    Geraets, J.J.; Goossens, M.E.J.B.; Bruijn, C.P. de; Groot, I.J.M. de; Koke, A.J.; Pelt, R.A.; Heijden, G. van der; Dinant, G.J.; Heuvel, W.J.A. van den

    2006-01-01

    OBJECTIVES: The present study evaluated the cost-effectiveness of a behavioral graded exercise therapy (GET) program compared with usual care (UC) in terms of the performance of daily activities by patients with chronic shoulder complaints in primary care. METHODS: A total of 176 patients were

  16. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

  17. Feasibility of a Prototype Web-Based Acceptance and Commitment Therapy Prevention Program for College Students

    Science.gov (United States)

    Levin, Michael E.; Pistorello, Jacqueline; Seeley, John R.; Hayes, Steven C.

    2014-01-01

    Objective: This study examined the feasibility of a prototype Web-based acceptance and commitment therapy (ACT) program for preventing mental health problems among college students. Participants: Undergraduate first-year students ("N" = 76) participated between May and November 2011. Methods: Participants were randomized to ACT or a…

  18. The "RAPID" Cognitive-Behavioral Therapy Program for Inattentive Children: Preliminary Findings

    Science.gov (United States)

    Young, Susan

    2013-01-01

    Objective: The objectives of the current study were to ascertain feasibility and acceptability of directly delivering a cognitive-behavioral therapy (CBT) group intervention for inattentive children in a school setting, to examine the reliability of the RATE-C Questionnaires that accompany the program, and to determine whether they can be used to…

  19. Prevalence of Physical Disability and Accommodation Needs among Students in Physical Therapy Education Programs

    Science.gov (United States)

    Hinman, Martha R.; Peterson, Cathryn A.; Gibbs, Karen A.

    2015-01-01

    Most research on graduate students with disabilities (SWDs) has focused on medical education. The purposes of this study were to: (1) estimate the prevalence of students with physical disabilities (SWPDs) in physical therapy programs, (2) identify common types of physical disabilities, (3) document the types of accommodations requested by SWPDs,…

  20. Accreditation of emerging oral health professions: options for dental therapy education programs.

    Science.gov (United States)

    Gelmon, Sherril B; Tresidder, Anna Foucek

    2011-01-01

    The study explored the options for accreditation of educational programs to prepare a new oral health provider, the dental therapist. A literature review and interviews of 10 content experts were conducted. The content experts represented a wide array of interests, including individuals associated with the various dental stakeholder organizations in education, accreditation, practice, and licensure, as well as representatives of non-dental accrediting organizations whose experience could inform the study. Development of an educational accreditation program for an emerging profession requires collaboration among key stakeholders representing education, practice, licensure, and other interests. Options for accreditation of dental therapy education programs include establishment of a new independent accrediting agency; seeking recognition as a committee within the Commission on Accreditation of Allied Health Education Programs; or working with the Commission on Dental Accreditation (CODA) to create a new accreditation program within CODA. These options are not mutually exclusive, and more than one accreditation program could potentially exist. An educational accreditation program is built upon a well-defined field, where there is a demonstrated need for the occupation and for accreditation of educational programs that prepare individuals to enter that occupation. The fundamental value of accreditation is as one player in the overall scheme of improving the quality of higher education delivered to students and, ultimately, the delivery of health services. Leaders concerned with the oral health workforce will need to consider future directions and the potential roles of new oral health providers as they determine appropriate directions for educational accreditation for dental therapy.

  1. INDDGO: Integrated Network Decomposition & Dynamic programming for Graph Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Groer, Christopher S [ORNL; Sullivan, Blair D [ORNL; Weerapurage, Dinesh P [ORNL

    2012-10-01

    It is well-known that dynamic programming algorithms can utilize tree decompositions to provide a way to solve some \\emph{NP}-hard problems on graphs where the complexity is polynomial in the number of nodes and edges in the graph, but exponential in the width of the underlying tree decomposition. However, there has been relatively little computational work done to determine the practical utility of such dynamic programming algorithms. We have developed software to construct tree decompositions using various heuristics and have created a fast, memory-efficient dynamic programming implementation for solving maximum weighted independent set. We describe our software and the algorithms we have implemented, focusing on memory saving techniques for the dynamic programming. We compare the running time and memory usage of our implementation with other techniques for solving maximum weighted independent set, including a commercial integer programming solver and a semi-definite programming solver. Our results indicate that it is possible to solve some instances where the underlying decomposition has width much larger than suggested by the literature. For certain types of problems, our dynamic programming code runs several times faster than these other methods.

  2. Using management action plans to integrate program improvement efforts

    International Nuclear Information System (INIS)

    Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N.

    1994-01-01

    The Department of Energy's (DOE's) Environmental Management Program is the country's largest and most sophisticated environmental program to date. The rapid expansion of the DOE's environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program's management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities

  3. Integrated Transdisciplinary Teams.

    Science.gov (United States)

    Gallivan-Fenlon, Amanda

    1994-01-01

    This article reviews the use of transdisciplinary teaming and integrated therapy for young children with multiple disabilities. It presents examples and suggestions for implementation, in the areas of flexibility, Individualized Education Program development, and parent participation. (JDD)

  4. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. M. Batyushin

    2015-12-01

    Full Text Available Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT.Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP. This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE inhibitor, thiazid diuretic (indapamide and dihydropyridine calcium antagonist (nifedipine XL.Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1% is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL provides effective control of BP in refractory and pseudorefractory HT.

  5. Physiological and Psychological Effects of a Forest Therapy Program on Middle-Aged Females

    Directory of Open Access Journals (Sweden)

    Hiroko Ochiai

    2015-12-01

    Full Text Available The natural environment is increasingly recognized as an effective counter to urban stress, and “Forest Therapy” has recently attracted attention as a relaxation and stress management activity with demonstrated clinical efficacy. The present study assessed the physiological and psychological effects of a forest therapy program on middle-aged females. Seventeen Japanese females (62.2 ± 9.4 years; mean ± standard deviation participated in this experiment. Pulse rate, salivary cortisol level, and psychological indices were measured on the day before forest therapy and on the forest therapy day. Pulse rate and salivary cortisol were significantly lower than baseline following forest therapy, indicating that subjects were in a physiologically relaxed state. Subjects reported feeling significantly more “comfortable,” “relaxed,” and “natural” according to the semantic differential (SD method. The Profile of Mood State (POMS negative mood subscale score for “tension–anxiety” was significantly lower, while that for “vigor” was significantly higher following forest therapy. Our study revealed that forest therapy elicited a significant (1 decrease in pulse rate, (2 decrease in salivary cortisol levels, (3 increase in positive feelings, and (4 decrease in negative feelings. In conclusion, there are substantial physiological and psychological benefits of forest therapy on middle-aged females.

  6. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. M. Batyushin

    2007-01-01

    Full Text Available Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT.Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP. This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE inhibitor, thiazid diuretic (indapamide and dihydropyridine calcium antagonist (nifedipine XL.Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1% is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL provides effective control of BP in refractory and pseudorefractory HT.

  7. Integrating Medication Therapy Management (MTM Services Provided by Community Pharmacists into a Community-Based Accountable Care Organization (ACO

    Directory of Open Access Journals (Sweden)

    Brian Isetts

    2017-10-01

    Full Text Available (1 Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM services provided by community pharmacists into the clinical care teams and the health information technology (HIT infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO. (2 Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3 Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4 Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.

  8. Universal file processing program for field programmable integrated circuits

    International Nuclear Information System (INIS)

    Freytag, D.R.; Nelson, D.J.

    1985-01-01

    A computer program is presented that translates logic equations into promburner files (or the reverse) for programmable logic devices of various kinds, namely PROMs FPLAs, FPLSs and PALs. The program achieves flexibility through the use of a database containing detailed information about the devices to be programmed. New devices can thus be accommodated through simple extensions of the database. When writing logic equations, the user can define logic combinations of signals as new logic variables for use in subsequent equations. This procedure yields compact and transparent expressions for logic operations, thus reducing the chances for error. A logic simulation program is also provided so that an independent check of the design can be performed at the software level

  9. Generic multiset programming for language-integrated querying

    DEFF Research Database (Denmark)

    Henglein, Fritz; Larsen, Ken Friis

    2010-01-01

    This paper demonstrates how relational algebraic programming based on efficient symbolic representations of multisets and operations on them can be applied to the query sublanguage of SQL in a type-safe fashion. In essence, it provides a library for naïve programming with multisets in a generalized...... SQL-style fashion, but avoids many cases of asymptotically inefficient nested iteration through cross-products....

  10. The integration of blended learning into an occupational therapy curriculum: a qualitative reflection.

    Science.gov (United States)

    Barnard-Ashton, Paula; Rothberg, Alan; McInerney, Patricia

    2017-08-17

    This paper presents a critical reflection of the integration of Blended Learning (BL) into an undergraduate occupational therapy curriculum which was delivered through Problem Based Learning (PBL). This is a qualitative reflection of a Participatory Action Research (PAR) study using Brookfield's model for critical reflection of an educator's practice. The model uses four 'lenses' through which to focus enquiry: Lens 1) our autobiography as a learner of practice; Lens 2) our learners' eyes; Lens 3) our colleagues' experiences; and Lens 4) the theoretical literature. Grounded theory analysis was applied to the data. The factors that contributed to successful integration of technology and e-Learning into an existing curriculum, the hurdles that were navigated along the way, and how these influenced decisions and innovation are explored. The core categories identified in the data were "drivers of change" and "outcomes of BL integration". Key situations and pivotal events are highlighted for their role in the process that led to the project maturing. Each lens reflects the successes and hurdles experienced during the study. Brookfield's model provides an objective method of reflection which showed that despite the hurdles, e-Learning was successfully integrated into the curriculum.

  11. National Acid Precipitation Assessment Program: 1990 Integrated Assessment report

    International Nuclear Information System (INIS)

    1991-11-01

    The document, the 'Integrated Assessment,' is a summary of the causes and effects of acidic deposition and a comparison of the costs and effectiveness of alternative emission control scenarios. In developing the 'Integrated Assessment,' it was NAPAP's goal to produce a structured compilation of policy-relevant technical information. The Integrated Assessment is based on findings and data from a series of twenty-seven State-of-Science/Technology Reports (SOS/T) on acidic deposition published by NAPAP in 1990. The scope of the documents includes: (1) emissions, atmospheric processes and deposition; (2) effects on surface waters, forests, agricultural crops, exposed materials, human health, and visibility; and (3) control technologies, future emissions, and effects valuation

  12. Employee health services integration: meeting the challenge. Successful program.

    Science.gov (United States)

    Lang, Y C

    1998-02-01

    1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.

  13. Sensory integration dysfunction affects efficacy of speech therapy on children with functional articulation disorders

    OpenAIRE

    Tung, Li-Chen; Lin, Chin-Kai; Hsieh, Ching-Lin; Chen, Ching-Chi; Huang, Chin-Tsan; Wang, Chun-Hou

    2013-01-01

    Li-Chen Tung,1,# Chin-Kai Lin,2,# Ching-Lin Hsieh,3,4 Ching-Chi Chen,1 Chin-Tsan Huang,1 Chun-Hou Wang5,6 1Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, 2Program of Early Intervention, Department of Early Childhood Education, National Taichung University of Education, Taichung, 3School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, 4Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, ...

  14. [Effects of an intensive thalassotherapy and aquatic therapy program in stroke patients. A pilot study].

    Science.gov (United States)

    Morer, C; Boestad, C; Zuluaga, P; Alvarez-Badillo, A; Maraver, F

    2017-09-16

    Stroke remains the leading cause of acquired disability. Health and social planning and management may vary and although prevention is crucial, having better treatments and strategies to reduce disability is needed. To determine the effect of an intensive program of thalassotherapy and aquatic therapy in stroke patients, valuing clinical parameters and functional validated scales. A quasi-experimental prospective study consisting of a specific program assessed pre- and post- 3 weeks treatment to 26 stroke patients with a mild-moderate disability. The outcomes measured were: Berg Balance scale, Timed Up and Go test, 10-meter walking test, 6-minute walking test and pain Visual Analogue Scale. After intervention, participants had a significant improvement in all outcomes measured. Our results suggest that an intensive program of thalassotherapy and aquatic therapy could be useful during stroke rehabilitation to improve balance, gait and pain.

  15. The Environment for Application Software Integration and Execution (EASIE), version 1.0. Volume 2: Program integration guide

    Science.gov (United States)

    Jones, Kennie H.; Randall, Donald P.; Stallcup, Scott S.; Rowell, Lawrence F.

    1988-01-01

    The Environment for Application Software Integration and Execution, EASIE, provides a methodology and a set of software utility programs to ease the task of coordinating engineering design and analysis codes. EASIE was designed to meet the needs of conceptual design engineers that face the task of integrating many stand-alone engineering analysis programs. Using EASIE, programs are integrated through a relational data base management system. In volume 2, the use of a SYSTEM LIBRARY PROCESSOR is used to construct a DATA DICTIONARY describing all relations defined in the data base, and a TEMPLATE LIBRARY. A TEMPLATE is a description of all subsets of relations (including conditional selection criteria and sorting specifications) to be accessed as input or output for a given application. Together, these form the SYSTEM LIBRARY which is used to automatically produce the data base schema, FORTRAN subroutines to retrieve/store data from/to the data base, and instructions to a generic REVIEWER program providing review/modification of data for a given template. Automation of these functions eliminates much of the tedious, error prone work required by the usual approach to data base integration.

  16. Integration Of Innovative Technologies And Affective Teaching amp Learning In Programming Courses

    Directory of Open Access Journals (Sweden)

    Alvin Prasad

    2015-08-01

    Full Text Available Abstract Technology has been integral component in the teaching and learning process in this millennium. In this review paper we evaluate the different technologies which are used to currently facilitate the teaching and learning of computer programming courses. The aim is to identify problems or gaps in technology usage in the learning environment and suggest affective solutions for technology integration into programming courses at the University levels in the future. We believe that with the inclusion of suggested innovative technologies and affective solutions in programming courses teaching and learning will be attractive and best for the programming industry.

  17. High-throughput monitoring of integration site clonality in preclinical and clinical gene therapy studies

    Directory of Open Access Journals (Sweden)

    Frank A Giordano

    Full Text Available Gene transfer to hematopoietic stem cells with integrating vectors not only allows sustained correction of monogenic diseases but also tracking of individual clones in vivo. Quantitative real-time PCR (qPCR has been shown to be an accurate method to quantify individual stem cell clones, yet due to frequently limited amounts of target material (especially in clinical studies, it is not useful for large-scale analyses. To explore whether vector integration site (IS recovery techniques may be suitable to describe clonal contributions if combined with next-generation sequencing techniques, we designed artificial ISs of different sizes which were mixed to simulate defined clonal situations in clinical settings. We subjected all mixes to either linear amplification–mediated PCR (LAM-PCR or nonrestrictive LAM-PCR (nrLAM-PCR, both combined with 454 sequencing. We showed that nrLAM-PCR/454-detected clonality allows estimating qPCR-detected clonality in vitro. We then followed the kinetics of two clones detected in a patient enrolled in a clinical gene therapy trial using both, nrLAM-PCR/454 and qPCR and also saw nrLAM-PCR/454 to correlate to qPCR-measured clonal contributions. The method presented here displays a feasible high-throughput strategy to monitor clonality in clinical gene therapy trials is at hand.

  18. The Effects of Integrative Reminiscence Therapy on Signs and Symptoms of Depression in the Elderly

    Directory of Open Access Journals (Sweden)

    Asghar Mohammadzadeh

    2011-04-01

    Full Text Available Objectives: The Main aim of this study was to determine the effects of integrative reminiscence therapy on signs and symptoms of depression in the institutionalized elderly. Methods & Materials: This study was an experimental study with pre-test and post-test along with control group. The statistical society in this study consisted of all elderly adults residing in centers of Isfahan. Sample selection style was simple random sampling. The Geriatric Depression Scale (GDS and Mini Mental Status Examination (MMSE were primarily administered and the scores of higher than ten in GDS (severe and moderate depression and higher than twenty one in MMSE were identified and a number of 36 subjects were randomly selected and were randomly divided into two groups, 18 participants to experiment group and 18 participants to the control group. Results: The analysis of the results was performed using independent t-test and chisquare. Mean of the difference of pretest and posttest results was acquired in experimental group (M=2.5385, SD=0.87706and control group (M=1, SD=0.93541. Conclusion: The results of this study suggest that integrative reminiscence therapy can significantly result in reducing depression signs and symptoms in older adults. This intervention can serve as a supplementary treatment along with pharmaceutical treatment.

  19. Integrative dynamic therapy for bulimia nervosa: An evidence-based case study.

    Science.gov (United States)

    Richards, Lauren K; Shingleton, Rebecca M; Goldman, Rachel; Siegel, Deborah; Thompson-Brenner, Heather

    2016-06-01

    Both cognitive-behavioral therapy (CBT) and psychodynamic psychotherapy are commonly used to treat eating disorders. To further investigate the effectiveness of integrative dynamic therapy (IDT) for bulimia nervosa (BN), our research group undertook a randomized, controlled pilot study comparing IDT with CBT for BN. The case described here was selected from a sample of N = 38 female patients with the symptoms of BN who enrolled in the study. IDT incorporated aspects of the first 4-week stage of CBT, including psychoeducation, self-monitoring, and regular eating. Subsequently, the treatment focused on emotional expression, emotion regulation (defenses), intrapsychic conflict, and interpersonal relationships. The objectives of the report are to demonstrate the effectiveness of an integrative approach to the treatment of eating disorders to address the symptoms of BN and personality issues using pre-, mid-, and posttreatment data, and to illustrate the patient and clinician reactions to each approach to treatment using excerpts from session transcripts and alliance data. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Life-crossroads on stage: integrating life review and drama therapy for older adults.

    Science.gov (United States)

    Keisari, Shoshi; Palgi, Yuval

    2017-10-01

    This paper examines the contribution of a new group of therapeutic interventions for older adults, based on a rudimentary life-review intervention. The intervention includes narrative elements together with drama therapy. The current study examines the influence of this therapeutic intervention on key indicators of mental health and psychological well-being among older adults. Fifty-five people (n = 55), ranging in age from 62 to 93, participated in a before-after study design. The following indices - meaning in life, self-acceptance, relationships with others, depressive symptoms, and experience of successful aging - were compared between an intervention group (n = 27) and a care-as-usual control group (n = 28). Repeated measures analyses of variance showed a significant improvement over time in the experimental group. In addition, results also showed time-group interaction regarding the treatment's effectiveness for self-acceptance, relationships with others, sense of meaning in life, sense of successful aging, and depressive symptoms. Our findings confirm that the new therapeutic intervention, which integrates life-review with drama therapy, increases self-acceptance, relationships with others, sense of meaning in life, and sense of successful aging; in turn, it also decreases depressive symptoms among older adults. The contribution of this research is based on the development of a therapeutic intervention that combines narrative together with drama therapy tools, which can be used in focused and short-term group treatments with the elderly.

  1. Developing a dashboard for benchmarking the productivity of a medication therapy management program.

    Science.gov (United States)

    Umbreit, Audrey; Holm, Emily; Gander, Kelsey; Davis, Kelsie; Dittrich, Kristina; Jandl, Vanda; Odell, Laura; Sweeten, Perry

    To describe a method for internal benchmarking of medication therapy management (MTM) pharmacist activities. Multisite MTM pharmacist practices within an integrated health care system. MTM pharmacists are located within primary care clinics and provide medication management through collaborative practice. MTM pharmacist activity is grouped into 3 categories: direct patient care, nonvisit patient care, and professional activities. MTM pharmacist activities were tracked with the use of the computer-based application Pharmacist Ambulatory Resource Management System (PhARMS) over a 12-month period to measure growth during a time of expansion. A total of 81% of MTM pharmacist time was recorded. A total of 1655.1 hours (41%) was nonvisit patient care, 1185.2 hours (29%) was direct patient care, and 1190.4 hours (30%) was professional activities. The number of patient visits per month increased during the study period. There were 1496 direct patient care encounters documented. Of those, 1051 (70.2%) were face-to-face visits, 257 (17.2%) were by telephone, and 188 (12.6%) were chart reviews. Nonvisit patient care and professional activities also increased during the period. PhARMS reported MTM pharmacist activities and captured nonvisit patient care work not tracked elsewhere. Internal benchmarking data proved to be useful for justifying increases in MTM pharmacist personnel resources. Reviewing data helped to identify best practices from high-performing sites. Limitations include potential for self-reporting bias and lack of patient outcomes data. Implementing PhARMS facilitated internal benchmarking of patient care and nonpatient care activities in a regional MTM program. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

    Science.gov (United States)

    Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

    2006-01-01

    Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

  3. Dynamic programming for Integrated Emission Management in diesel engines

    NARCIS (Netherlands)

    Schijndel, J. van; Donkers, M.C.F.; Willems, F.P.T.; Heemels, W.P.M.H.

    2014-01-01

    Integrated Emission Management (IEM) is a supervisory control strategy that aims at minimizing the operational costs of diesel engines with an aftertreatment system, while satisfying emission constraints imposed by legislation. In previous work on IEM, a suboptimal real-time implementable solution

  4. 20 CFR 404.1503a - Program integrity.

    Science.gov (United States)

    2010-04-01

    ... is currently revoked or suspended by any State licensing authority pursuant to adequate due process procedures for reasons bearing on professional competence, professional conduct, or financial integrity; or who, until a final determination is made, has surrendered such a license while formal disciplinary...

  5. Beliefs About a Complementary and Alternative Therapy-Based Chronic Pain Management Program for a Medicaid Population.

    Science.gov (United States)

    Donovan, Elizabeth; Ranney, Megan L; Patry, Emily J; McKenzie, Michelle; Baird, Janette; Green, Traci C

    2017-09-01

    Rhode Island Medicaid offers high emergency department utilizers the opportunity to take part in the Chronic Pain Program, an integrated treatment approach that includes free complementary therapies (massage, chiropractic, and acupuncture). The aim of the current analysis was to understand beliefs about the Rhode Island Chronic Pain Program from the perspective of the patient receiving services, the provider delivering services, and the administrator implementing the program. A qualitative interview-based study. Patients (N = 24), providers (N = 13), and administrators (N = 11) who were already involved, or were eligible to be involved, in the Chronic Pain Program. Semistructured interviews were conducted to elicit information about experiences with the program. Transcriptions of audio recordings were analyzed according to principles of deductive thematic analysis. Patient interviews revealed five themes: 1) relationship between stress and pain, 2) trusting patient-provider relationships, 3) increased quality of life, 4) temporary pain relief, and 5) anxiety and discomfort associated with acupuncture. Provider interviews revealed three themes: 1) a way to reach the disenfranchised, 2) not enough visits with patients, and 3) opportunity to build relationships with patients. Administrator interviews revealed two themes: 1) a means to offer a range of support services to complicated patients and 2) unanswered questions over whether the program adequately serves patients with the greatest needs. Key stakeholders in this new initiative agree that the Rhode Island Chronic Pain Program shows promise and that the holistic approach may be a good match for this hard-to-reach population. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. Patients' mental models and adherence to outpatient physical therapy home exercise programs.

    Science.gov (United States)

    Rizzo, Jon

    2015-05-01

    Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.

  7. Multimodal, integrative therapies for the self-management of chronic pain symptoms.

    Science.gov (United States)

    Lee, Courtney; Crawford, Cindy; Swann, Steven

    2014-04-01

    Chronic pain management typically consists of prescription medications or provider-based, behavioral, or interventional procedures which are often ineffective, may be costly, and can be associated with undesirable side effects. Because chronic pain affects the whole person (body, mind, and spirit), patient-centered complementary and integrative medicine (CIM) therapies that acknowledge the patients' roles in their own healing processes have the potential to provide more efficient and comprehensive chronic pain management. Active self-care CIM therapies (ACT-CIM) allow for a more diverse, patient-centered treatment of complex symptoms, promote self-management, and are relatively safe and cost-effective. To date, there are no systematic reviews examining the full range of ACT-CIM used for chronic pain symptom management. A systematic review was conducted, using Samueli Institute's rapid evidence assessment of the literature methodology, to rigorously assess both the quality of the research on ACT-CIM modalities and the evidence for their efficacy and effectiveness in treating chronic pain symptoms. A working group of subject matter experts was also convened to evaluate the overall literature pool and develop recommendations for the use and implementation of these modalities. Following key database searches, 146 randomized controlled trials were included in the review, 26 of which investigated multimodal, integrative therapies, as defined by the authors. This article summarizes the current evidence, quality, and effectiveness of these modalities. Recommendations and next steps to move this field of research forward are also discussed. The entire scope of the review is detailed throughout the current Pain Medicine supplement. Wiley Periodicals, Inc.

  8. 75 FR 5244 - Pipeline Safety: Integrity Management Program for Gas Distribution Pipelines; Correction

    Science.gov (United States)

    2010-02-02

    ... Management Program for Gas Distribution Pipelines; Correction AGENCY: Pipeline and Hazardous Materials Safety... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Part... Regulations to require operators of gas distribution pipelines to develop and implement integrity management...

  9. 10 CFR 70.62 - Safety program and integrated safety analysis.

    Science.gov (United States)

    2010-01-01

    ...; (iv) Potential accident sequences caused by process deviations or other events internal to the... have experience in nuclear criticality safety, radiation safety, fire safety, and chemical process... this safety program; namely, process safety information, integrated safety analysis, and management...

  10. The Transuranic Waste Program's integration and planning activities and the contributions of the TRU partnership

    International Nuclear Information System (INIS)

    Harms, T.C.; O'Neal, W.; Petersen, C.A.; McDonald, C.E.

    1994-02-01

    The Technical Support Division, EM-351 manages the integration and planning activities of the Transuranic Waste Program. The Transuranic Waste Program manager provides transuranic waste policy, guidance, and issue resolution to Headquarters and the Operations Offices. In addition, the program manager is responsible for developing and implementing an integrated, long-range waste management plan for the transuranic waste system. A steering committee, a core group of support contractors, and numerous interface working groups support the efforts of the program manager. This paper provides an overview of the US Department of Energy's transuranic waste integration activities and a long-range planning process that includes internal and external stakeholder participation. It discusses the contributions and benefits provided by the Transuranic Partnership, most significantly, the integration activities and the body of data collected and assembled by the Partnership

  11. Glutaminolysis and Fumarate Accumulation Integrate Immunometabolic and Epigenetic Programs in Trained Immunity

    NARCIS (Netherlands)

    Arts, R.J; Novakovic, B.; Horst, R; Carvalho, A.; Bekkering, S.; Lachmandas, E.; Rodrigues, F.; Silvestre, R.; Cheng, S.C.; Wang, S.; Habibi, E.; Goncalves, L.G.; Mesquita, I.; Cunha, C.; Laarhoven, A. van; Veerdonk, F.L van de; Williams, D.L.; Meer, J.W van der; Logie, C.; O'Neill, L.A.; Dinarello, C.A.; Riksen, N.P; Crevel, R. van; Clish, C.; Notebaart, R.A; Joosten, L.A.; Stunnenberg, H.G.; Xavier, R.J.; Netea, M.G

    2016-01-01

    Induction of trained immunity (innate immune memory) is mediated by activation of immune and metabolic pathways that result in epigenetic rewiring of cellular functional programs. Through network-level integration of transcriptomics and metabolomics data, we identify glycolysis, glutaminolysis, and

  12. Mismatch or cumulative stress : Toward an integrated hypothesis of programming effects

    NARCIS (Netherlands)

    Nederhof, Esther; Schmidt, Mathias V.

    2012-01-01

    This paper integrates the cumulative stress hypothesis with the mismatch hypothesis, taking into account individual differences in sensitivity to programming. According to the cumulative stress hypothesis, individuals are more likely to suffer from disease as adversity accumulates. According to the

  13. Curricular intersections of university extension and teaching in Physical Therapy programs

    Directory of Open Access Journals (Sweden)

    Shamyr Sulyvan de Castro

    Full Text Available Introduction University extension can be a vehicle for social change and aid in the education of university students; however, it is important to study how it is inserted in university programs so that educational actions and policies can be planned more adequately. Objectives To study the insertion of extension activities in undergraduate physical therapy curricula in Brazilian federal universities. Method Documentary research conducted by accessing files available on the Internet. Data were analyzed quantitatively in the form of numbers and percentages. We examined documents from 22 of the 29 federal universities that offered physical therapy programs. Results University extension takes the form of complementary academic activities together with other options such as participating in conferences, specific training courses and working as a teaching assistant. Undergraduate physical therapy courses have a 4,000h to 4,925h course load, of which 0.72% to 8.9% are dedicated to extension activities. Conclusion The data indicate that the insertion of extension activities in undergraduate physical therapy programs offered by Brazilian federal universities needs to be reassessed according to recommended policies and guidelines.

  14. Integrating declarative knowledge programming styles and tools for building expert systems

    Energy Technology Data Exchange (ETDEWEB)

    Barbuceanu, M; Trausan-Matu, S; Molnar, B

    1987-01-01

    The XRL system reported in this paper is an integrated knowledge programming environment whose major research theme is the investigation of declarative knowledge programming styles and features and of the way they can be effectively integrated and used to support AI programming. This investigation is carried out in the context of the structured-object representation paradigm which provides the glue keeping XRL components together. The paper describes several declarative programming styles and associated support tools available in XRL. These include an instantiation system supporting a generalized view of the ubiquous frame installation process, a description based programming system providing a novel declarative programming style which embeds a mathematical oriented description language in the structured object environment and a transformational interpreter for using it, a semantics oriented programming framework which offers a specific semantic construct based approach supporting maintenance and evolution and a self description and self generation tool which applies the latter approach to XRL itself. 29 refs., 16 figs.

  15. The Role of Occupational Therapy in Community-Based Programming: Addressing Childhood Health Promotion

    Directory of Open Access Journals (Sweden)

    Julie Kugel

    2017-01-01

    Full Text Available Background: Obesity and poor health habits impact youth’s health and occupational participation. Occupational therapy’s role in preventing and treating obesity continues to emerge in the research literature. This article explores the impact of a community-based program emphasizing health and wellness for female youth. Methods: Five girls 11 to 13 years of age participated in the healthy occupations program. Before and after the program, the participants engaged in an individual semi-structured interview and completed the Canadian Occupational Performance Measure and the CATCH Kids Club Questionnaire. The youth participated in a focus group midprogram. Results: The participants were receptive to information regarding healthy behaviors and initiated positive health behavior changes after implementation of a 7-week healthy lifestyle community- based program. Conclusion: Occupational therapy can collaborate with community partners to provide programming focused on health promotion and prevention as part of the interprofessional approach to preventing and treating childhood obesity and building healthier communities.

  16. Glass sampling program during DWPF Integrated Cold Runs

    International Nuclear Information System (INIS)

    Plodinec, M.J.

    1990-01-01

    The described glass sampling program is designed to achieve two objectives: To demonstrate Defense Waste Processing Facility (DWPF) ability to control and verify the radionuclide release properties of the glass product; To confirm DWPF's readiness to obtain glass samples during production, and SRL's readiness to analyze and test those samples remotely. The DWPF strategy for control of the radionuclide release properties of the glass product, and verification of its acceptability are described in this report. The basic approach of the test program is then defined

  17. Integrated predictive maintenance program vibration and lube oil analysis: Part I - history and the vibration program

    Energy Technology Data Exchange (ETDEWEB)

    Maxwell, H.

    1996-12-01

    This paper is the first of two papers which describe the Predictive Maintenance Program for rotating machines at the Palo Verde Nuclear Generating Station. The organization has recently been restructured and significant benefits have been realized by the interaction, or {open_quotes}synergy{close_quotes} between the Vibration Program and the Lube Oil Analysis Program. This paper starts with the oldest part of the program - the Vibration Program and discusses the evolution of the program to its current state. The {open_quotes}Vibration{close_quotes} view of the combined program is then presented.

  18. Integrated predictive maintenance program vibration and lube oil analysis: Part I - history and the vibration program

    International Nuclear Information System (INIS)

    Maxwell, H.

    1996-01-01

    This paper is the first of two papers which describe the Predictive Maintenance Program for rotating machines at the Palo Verde Nuclear Generating Station. The organization has recently been restructured and significant benefits have been realized by the interaction, or open-quotes synergyclose quotes between the Vibration Program and the Lube Oil Analysis Program. This paper starts with the oldest part of the program - the Vibration Program and discusses the evolution of the program to its current state. The open-quotes Vibrationclose quotes view of the combined program is then presented

  19. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    Science.gov (United States)

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  20. Clinical capabilities of graduates of an outcomes-based integrated medical program

    Directory of Open Access Journals (Sweden)

    Scicluna Helen A

    2012-06-01

    Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

  1. FY-94 buried waste integrated demonstration program report

    International Nuclear Information System (INIS)

    1994-01-01

    The Buried Waste Integrated Demonstration (BWID) supports the applied research, development, demonstration, and evaluation of a multitude of advanced technologies. These technologies are being integrated to form a comprehensive remediation system for the effective and efficient remediation of buried waste. These efforts are identified and coordinated in support of the U.S. Department of Energy (DOE), Environmental Restoration and Waste Management (ER/WM) needs and objectives. This document summarizes previous demonstrations and describes the FY-94 BWID technology development and demonstration activities. Sponsored by the DOE Office of Technology Development (OTD), BWID works with universities and private industry to develop these technologies, which are being transferred to the private sector for use nationally and internationally. A public participation policy has been established to provide stakeholders with timely and accurate information and meaningful opportunities for involvement in the technology development and demonstration process

  2. [The development of an integrated suicide-violence prevention program for adolescents].

    Science.gov (United States)

    Park, Hyun Sook

    2008-08-01

    The purpose of this study was to develop an integrated suicide-violence prevention program for adolescents. Another purpose was to evaluate the effects of the integrated suicide-violence prevention program on self-esteem, parent-child communication, aggression, and suicidal ideation in adolescents. The study employed a quasi-experimental design. Participants for the study were high school students, 24 in the experimental group and 25 in the control group. Data was analyzed by using the SPSS/WIN. 11.5 program with chi2 test, t-test, and 2-way ANOVA. Participants in the integrated suicide-violence prevention program reported increased self-esteem scores, which was significantly different from those in the control group. Participants in the integrated suicide-violence prevention program reported decreased aggression and suicidal ideation scores, which was significantly different from those in the control group. The integrated suicide-violence prevention program was effective in improving self-esteem and decreasing aggression and suicidal ideation for adolescents. Therefore, this approach is recommended as the integrated suicide-violence prevention strategy for adolescents.

  3. A Developmental Mapping Program Integrating Geography and Mathematics.

    Science.gov (United States)

    Muir, Sharon Pray; Cheek, Helen Neely

    Presented and discussed is a model which can be used by educators who want to develop an interdisciplinary map skills program in geography and mathematics. The model assumes that most children in elementary schools perform cognitively at Piaget's concrete operational stage, that readiness for map skills can be assessed with Piagetian or…

  4. How to Integrate International Financial Reporting Standards into Accounting Programs

    Science.gov (United States)

    Singer, Robert A.

    2012-01-01

    It is expected the SEC will require U.S. domestic companies to prepare and file their annual 10Ks in accordance with international financial reporting standards (IFRS) by 2016. Given the probability that the FASB-IASB convergence project (i.e., Norwalk Agreement) will continue subsequent to mandatory adoption, US accounting programs will be…

  5. The Next Step in Educational Program Budgets and Information Resource Management: Integrated Data Structures.

    Science.gov (United States)

    Jackowski, Edward M.

    1988-01-01

    Discusses the role that information resource management (IRM) plays in educational program-oriented budgeting (POB), and presents a theoretical IRM model. Highlights include design considerations for integrated data systems; database management systems (DBMS); and how POB data can be integrated to enhance its value and use within an educational…

  6. Merging Regular and Special Education Teacher Preparation Programs: The Integrated Special Education-English Project (ISEP).

    Science.gov (United States)

    Miller, Darcy E.

    1991-01-01

    Describes the Integrated Special Education-English Project (ISEP) which facilitated the gradual integration of special education and English teacher preparation programs. A description of the ISEP model and a case study are included. The case study indicated student teachers who participated in the ISEP improved special education and English…

  7. 49 CFR 192.911 - What are the elements of an integrity management program?

    Science.gov (United States)

    2010-10-01

    ...) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas Transmission Pipeline Integrity Management § 192.911 What are the elements of an integrity management program...

  8. A Critical Agency Network Model for Building an Integrated Outreach Program

    Science.gov (United States)

    Kiyama, Judy Marquez; Lee, Jenny J.; Rhoades, Gary

    2012-01-01

    This study considers a distinct case of a college outreach program that integrates student affairs staff, academic administrators, and faculty across campus. The authors find that social networks and critical agency help to understand the integration of these various professionals and offer a critical agency network model of enacting change.…

  9. Progress and status of the integral fast reactor (IFR) development program

    International Nuclear Information System (INIS)

    Chang, Y.I.

    1992-01-01

    This paper discusses the Integral Fast Reactor (IFR) development program, in which the entire reactor system - reactor, fuel cycle, and waste process is being developed and optimized at the same time as a single integral entity. Detailed discussions on the present status of the IFR technology development activities in the areas of fuels, pyroprocessing, safety, core design, and fuel cycle demonstration are also presented

  10. Enhancing creative problem solving in an integrated visual art and geometry program: A pilot study

    NARCIS (Netherlands)

    Schoevers, E.M.; Kroesbergen, E.H.; Pitta-Pantazi, D.

    2017-01-01

    This article describes a new pedagogical method, an integrated visual art and geometry program, which has the aim to increase primary school students' creative problem solving and geometrical ability. This paper presents the rationale for integrating visual art and geometry education. Furthermore

  11. Use of a radiation therapy treatment planning computer in a hospital health physics program

    International Nuclear Information System (INIS)

    Addison, S.J.

    1984-01-01

    An onsite treatment planning computer has become state of the art in the care of radiation therapy patients, but in most installations the computer is used for therapy planning a diminutive amount of the day. At St. Mary's Hospital, arrangements have been negotiated for part time use of the treatment planning computer for health physics purposes. Computerized Medical Systems, Inc. (CMS) produces the Modulex radiotherapy planning system which is programmed in MUMPS, a user oriented language specially adapted for handling text string information. St. Mary's Hospital's CMS computer has currently been programmed to assist in data collection and write-up of diagnostic x-ray surveys, meter calibrations, and wipe/leak tests. The computer is setup to provide timely reminders of tests and surveys, and billing for consultation work. Programs are currently being developed for radionuclide inventories. Use of a therapy planning computer for health physics purposes can enhance the radiation safety program and provide additional grounds for the acquisition of such a computer system

  12. MathModelica - An Extensible Modeling and Simulation Environment with Integrated Graphics and Literate Programming

    OpenAIRE

    Fritzson, Peter; Gunnarsson, Johan; Jirstrand, Mats

    2002-01-01

    MathModelica is an integrated interactive development environment for advanced system modeling and simulation. The environment integrates Modelica-based modeling and simulation with graphic design, advanced scripting facilities, integration of program code, test cases, graphics, documentation, mathematical type setting, and symbolic formula manipulation provided via Mathematica. The user interface consists of a graphical Model Editor and Notebooks. The Model Editor is a graphical user interfa...

  13. Let's get technical: Enhancing program evaluation through the use and integration of internet and mobile technologies.

    Science.gov (United States)

    Materia, Frank T; Miller, Elizabeth A; Runion, Megan C; Chesnut, Ryan P; Irvin, Jamie B; Richardson, Cameron B; Perkins, Daniel F

    2016-06-01

    Program evaluation has become increasingly important, and information on program performance often drives funding decisions. Technology use and integration can help ease the burdens associated with program evaluation by reducing the resources needed (e.g., time, money, staff) and increasing evaluation efficiency. This paper reviews how program evaluators, across disciplines, can apply internet and mobile technologies to key aspects of program evaluation, which consist of participant registration, participant tracking and retention, process evaluation (e.g., fidelity, assignment completion), and outcome evaluation (e.g., behavior change, knowledge gain). In addition, the paper focuses on the ease of use, relative cost, and fit with populations. An examination on how these tools can be integrated to enhance data collection and program evaluation is discussed. Important limitations of and considerations for technology integration, including the level of technical skill, cost needed to integrate various technologies, data management strategies, and ethical considerations, are highlighted. Lastly, a case study of technology use in an evaluation conducted by the Clearinghouse for Military Family Readiness at Penn State is presented and illustrates how technology integration can enhance program evaluation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Evaluation of a Music Therapy Social Skills Development Program for Youth with Limited Resources.

    Science.gov (United States)

    Pasiali, Varvara; Clark, Cherie

    2018-05-21

    Children living in low-resource communities are at risk for poorer socio-emotional development and academic performance. Emerging evidence supports use of group music therapy experiences to support social development through community afterschool programming. To examine the potential benefit of a music therapy social skills development program to improve social skills and academic performance of school-aged children with limited resources in an afterschool program. We used a single-group pre/post-test design, and recruited 20 students (11 females, 9 males), ages 5 to 11 years, from an afterschool program. The music therapy social skills program consisted of eight 50-minute sessions, and we measured social competence and antisocial behavior using the Home & Community Social Behavioral Scale (HCSBS; Merrell & Caldarella, 2008), and social skills, problem behaviors, and academic competence using the Social Skills Improvement System (SSIS; Gresham & Elliot, 2008a, 2008b). Only students who attended a minimum of six sessions (N = 14) were included in data analysis. Results showed no significant change in individual HBSC subscale scores; however, the total number of low-performance/high-risk skills significantly decreased. SSIS teacher results indicated significant improvement in communication, significant decrease of hyperactivity, autistic behavioral tendencies and overall problem behaviors, and marginal decreases in internalization. Parent ratings mirrored, in part, those of the teacher. Results indicated that music therapy has the potential of being an effective intervention for promoting social competence of school-aged children with limited resources, particularly in the areas of communication and low-performance/high-risk behaviors. Teaching skills through song lyrics and improvisation emerged as salient interventions.

  15. Toward an Integrated Design, Inspection and Redundancy Research Program.

    Science.gov (United States)

    1984-01-01

    William Creelman William H. Silcox National Marine Service Standard Oil Company of California St. Louis, Missouri San Francisco, California .-- N...develop physical models and generic tools for analyzing the effects of redundancy, reserve strength, and residual strength on the system behavior of marine...probabilistic analyses to be applicable to real-world problems, this program needs to provide - the deterministic physical models and generic tools upon

  16. Adaptive HIFU noise cancellation for simultaneous therapy and imaging using an integrated HIFU/imaging transducer

    International Nuclear Information System (INIS)

    Jeong, Jong Seob; Cannata, Jonathan Matthew; Shung, K Kirk

    2010-01-01

    It was previously demonstrated that it is feasible to simultaneously perform ultrasound therapy and imaging of a coagulated lesion during treatment with an integrated transducer that is capable of high intensity focused ultrasound (HIFU) and B-mode ultrasound imaging. It was found that coded excitation and fixed notch filtering upon reception could significantly reduce interference caused by the therapeutic transducer. During HIFU sonication, the imaging signal generated with coded excitation and fixed notch filtering had a range side-lobe level of less than -40 dB, while traditional short-pulse excitation and fixed notch filtering produced a range side-lobe level of -20 dB. The shortcoming is, however, that relatively complicated electronics may be needed to utilize coded excitation in an array imaging system. It is for this reason that in this paper an adaptive noise canceling technique is proposed to improve image quality by minimizing not only the therapeutic interference, but also the remnant side-lobe 'ripples' when using the traditional short-pulse excitation. The performance of this technique was verified through simulation and experiments using a prototype integrated HIFU/imaging transducer. Although it is known that the remnant ripples are related to the notch attenuation value of the fixed notch filter, in reality, it is difficult to find the optimal notch attenuation value due to the change in targets or the media resulted from motion or different acoustic properties even during one sonication pulse. In contrast, the proposed adaptive noise canceling technique is capable of optimally minimizing both the therapeutic interference and residual ripples without such constraints. The prototype integrated HIFU/imaging transducer is composed of three rectangular elements. The 6 MHz center element is used for imaging and the outer two identical 4 MHz elements work together to transmit the HIFU beam. Two HIFU elements of 14.4 mm x 20.0 mm dimensions could

  17. Adaptive HIFU noise cancellation for simultaneous therapy and imaging using an integrated HIFU/imaging transducer.

    Science.gov (United States)

    Jeong, Jong Seob; Cannata, Jonathan Matthew; Shung, K Kirk

    2010-04-07

    It was previously demonstrated that it is feasible to simultaneously perform ultrasound therapy and imaging of a coagulated lesion during treatment with an integrated transducer that is capable of high intensity focused ultrasound (HIFU) and B-mode ultrasound imaging. It was found that coded excitation and fixed notch filtering upon reception could significantly reduce interference caused by the therapeutic transducer. During HIFU sonication, the imaging signal generated with coded excitation and fixed notch filtering had a range side-lobe level of less than -40 dB, while traditional short-pulse excitation and fixed notch filtering produced a range side-lobe level of -20 dB. The shortcoming is, however, that relatively complicated electronics may be needed to utilize coded excitation in an array imaging system. It is for this reason that in this paper an adaptive noise canceling technique is proposed to improve image quality by minimizing not only the therapeutic interference, but also the remnant side-lobe 'ripples' when using the traditional short-pulse excitation. The performance of this technique was verified through simulation and experiments using a prototype integrated HIFU/imaging transducer. Although it is known that the remnant ripples are related to the notch attenuation value of the fixed notch filter, in reality, it is difficult to find the optimal notch attenuation value due to the change in targets or the media resulted from motion or different acoustic properties even during one sonication pulse. In contrast, the proposed adaptive noise canceling technique is capable of optimally minimizing both the therapeutic interference and residual ripples without such constraints. The prototype integrated HIFU/imaging transducer is composed of three rectangular elements. The 6 MHz center element is used for imaging and the outer two identical 4 MHz elements work together to transmit the HIFU beam. Two HIFU elements of 14.4 mm x 20.0 mm dimensions could

  18. Evaluation Of Model Based Systems Engineering Processes For Integration Into Rapid Acquisition Programs

    Science.gov (United States)

    2016-09-01

    for the required simulation allowed the MK6LE project to avoid the risk of having lower level model components not integrating together. The initial...that programs that applied MBSE at the lower levels, in particular the MK54 Torpedo program, expressed regrets of limiting the re-architecture to the

  19. Program on ecosystem change and society: An international research strategy for integrated social-ecological systems

    NARCIS (Netherlands)

    Carpenter, S.R.; Folke, C.; Norström, A.V.; Olsson, O.; Schultz, L.; Agarwal, B.; Balvanera, P.; Campbell, B.; Castilla, J.C.; Cramer, W.; DeFries, R.; Eyzaguirre, P.; Hughes, T.P.; Polasky, S.; Sanusi, Z.A.; Scholes, R.J.; Spierenburg, M.J.

    2012-01-01

    The Program on Ecosystem Change and Society (PECS), a new initiative within the ICSU global change programs, aims to integrate research on the stewardship of social-ecological systems, the services they generate, and the relationships among natural capital, human wellbeing, livelihoods, inequality

  20. Program on ecosystem change and society: an international research strategy for integrated social–ecological systems

    NARCIS (Netherlands)

    Carpenter, S.R; Folke, C.; Nordström, A.; Olsson, O.; Schultz, L.; Agarwal, B.; Balvanera, P.; Campbell, B.; Castilla, J.C.; Cramer, W.; DeFries, R.; Eyzaguirre, P.; Hughes, T.P.; Polasky, S.; Sanusi, Z.; Spierenburg, M.J.

    2012-01-01

    The Program on Ecosystem Change and Society (PECS), a new initiative within the ICSU global change programs, aims to integrate research on the stewardship of social-ecological systems, the services they generate, and the relationships among natural capital, human wellbeing, livelihoods, inequality

  1. Impact of a Sustained Job-Embedded Professional Development Program on Classroom Technology Integration

    Science.gov (United States)

    Grashel, Mark A.

    2014-01-01

    The purpose of this single case study was to examine a grant-funded program of professional development (PD) at a small rural high school in Ohio. Evidence has shown that the current model of technology professional development in-service sessions has had little impact on classroom technology integration. This PD program focused on 21st Century…

  2. Shifting Views: Exploring the Potential for Technology Integration in Early Childhood Education Programs

    Science.gov (United States)

    Dietze, Beverlie; Kashin, Diane

    2013-01-01

    Using technology with children in play-based early learning programs creates questions for some within the Early Childhood Education (ECE) community. This paper presents how two faculty who teach in ECE-related degree programs integrated educational technology into their teaching pedagogy as a way to model to their students how it can be used to…

  3. Integration of Vocational and Academic Curricula through the NSF Advanced Technological Education Program (ATE).

    Science.gov (United States)

    Bailey, Thomas R.; Matsuzuka, Yukari

    A study examined the impact of the Advanced Technological Education (ATE) program on efforts in academic and vocational integration. A case study of 10 community colleges housing ATE-funded projects collected data through interviews with administrators, faculty, ATE program practitioners, and faculty and administrators at collaborating high…

  4. An Examination of the Feasibility of Integrating Motivational Interviewing Techniques into FCS Cooperative Extension Programming

    Science.gov (United States)

    Radunovich, Heidi Liss; Ellis, Sarah; Spangler, Taylor

    2017-01-01

    Demonstrating program impact through behavior change is critical for the continued success of Family and Consumer Sciences (FCS) Cooperative Extension programming. However, the literature suggests that simply providing information to participants does not necessarily lead to behavior change. This study pilot tested the integration of Motivational…

  5. Determination of Safety Performance Grade of NPP Using Integrated Safety Performance Assessment (ISPA) Program

    International Nuclear Information System (INIS)

    Chung, Dae Wook

    2011-01-01

    Since the beginning of 2000, the safety regulation of nuclear power plant (NPP) has been challenged to be conducted more reasonable, effective and efficient way using risk and performance information. In the United States, USNRC established Reactor Oversight Process (ROP) in 2000 for improving the effectiveness of safety regulation of operating NPPs. The main idea of ROP is to classify the NPPs into 5 categories based on the results of safety performance assessment and to conduct graded regulatory programs according to categorization, which might be interpreted as 'Graded Regulation'. However, the classification of safety performance categories is highly comprehensive and sensitive process so that safety performance assessment program should be prepared in integrated, objective and quantitative manner. Furthermore, the results of assessment should characterize and categorize the actual level of safety performance of specific NPP, integrating all the substantial elements for assessing the safety performance. In consideration of particular regulatory environment in Korea, the integrated safety performance assessment (ISPA) program is being under development for the use in the determination of safety performance grade (SPG) of a NPP. The ISPA program consists of 6 individual assessment programs (4 quantitative and 2 qualitative) which cover the overall safety performance of NPP. Some of the assessment programs which are already implemented are used directly or modified for incorporating risk aspects. The others which are not existing regulatory programs are newly developed. Eventually, all the assessment results from individual assessment programs are produced and integrated to determine the safety performance grade of a specific NPP

  6. Trauma Center Based Youth Violence Prevention Programs: An Integrative Review.

    Science.gov (United States)

    Mikhail, Judy Nanette; Nemeth, Lynne Sheri

    2016-12-01

    Youth violence recidivism remains a significant public health crisis in the United States. Violence prevention is a requirement of all trauma centers, yet little is known about the effectiveness of these programs. Therefore, this systematic review summarizes the effectiveness of trauma center-based youth violence prevention programs. A systematic review of articles from MEDLINE, CINAHL, and PsychINFO databases was performed to identify eligible control trials or observational studies. Included studies were from 1970 to 2013, describing and evaluating an intervention, were trauma center based, and targeted youth injured by violence (tertiary prevention). The social ecological model provided the guiding framework, and findings are summarized qualitatively. Ten studies met eligibility requirements. Case management and brief intervention were the primary strategies, and 90% of the studies showed some improvement in one or more outcome measures. These results held across both social ecological level and setting: both emergency department and inpatient unit settings. Brief intervention and case management are frequent and potentially effective trauma center-based violence prevention interventions. Case management initiated as an inpatient and continued beyond discharge was the most frequently used intervention and was associated with reduced rearrest or reinjury rates. Further research is needed, specifically longitudinal studies using experimental designs with high program fidelity incorporating uniform direct outcome measures. However, this review provides initial evidence that trauma centers can intervene with the highest of risk patients and break the youth violence recidivism cycle. © The Author(s) 2015.

  7. Manualization of Occupational Therapy Interventions: Illustrations from the Pressure Ulcer Prevention Research Program

    Science.gov (United States)

    Blanche, Erna Imperatore; Fogelberg, Donald; Diaz, Jesus; Carlson, Mike; Clark, Florence

    2011-01-01

    The manualization of a complex occupational therapy intervention is a crucial step in ensuring treatment fidelity for both clinical application and research purposes. Towards this latter end, intervention manuals are essential for assuring trustworthiness and replicability of randomized controlled trials (RCT’s) that aim to provide evidence of the effectiveness of occupational therapy. In this paper, literature on the process of intervention manualization is reviewed. The prescribed steps are then illustrated through our experience in implementing the University of Southern California/Rancho Los Amigos National Rehabilitation Center’s collaborative Pressure Ulcer Prevention Project (PUPP). In this research program, qualitative research provided the initial foundation for manualization of a multifaceted occupational therapy intervention designed to reduce incidence of medically serious pressure ulcers in people with SCI. PMID:22214116

  8. The effectiveness and cost-effectiveness of an integrated cardiometabolic risk assessment and treatment program in primary care (the INTEGRATE study).

    NARCIS (Netherlands)

    Stol, D.; Badenbroek, I.; Hollander, M.; Nielen, M.; Schellevis, F.; Wit, N. de

    2014-01-01

    The effectiveness and cost-effectiveness of an integrated cardiometabolic risk assessment and treatment program in primary care (the INTEGRATE study): a stepped-wedge randomized controlled trial protocol. Rationale: The increasing prevalence of cardiometabolic disease (CMD), including cardiovascular

  9. US/DOE Man-Machine Integration program for liquid metal reactors

    International Nuclear Information System (INIS)

    D'Zmura, A.P.; Seeman, S.E.

    1985-03-01

    The United States Department of Energy (DOE) Man-Machine Integration program was started in 1980 as an addition to the existing Liquid Metal Fast Breeder Reactor safety base technology program. The overall goal of the DOE program is to enhance the operational safety of liquid metal reactors by optimum integration of humans and machines in the overall reactor plant system and by application of the principles of human-factors engineering to the design of equipment, subsystems, facilities, operational aids, procedures and environments. In the four years since its inception the program has concentrated on understanding the control process for Liquid Metal Reactors (LMRs) and on applying advanced computer concepts to this process. This paper describes the products that have been developed in this program, present computer-related programs, and plans for the future

  10. DITTY - a computer program for calculating population dose integrated over ten thousand years

    International Nuclear Information System (INIS)

    Napier, B.A.; Peloquin, R.A.; Strenge, D.L.

    1986-03-01

    The computer program DITTY (Dose Integrated Over Ten Thousand Years) was developed to determine the collective dose from long term nuclear waste disposal sites resulting from the ground-water pathways. DITTY estimates the time integral of collective dose over a ten-thousand-year period for time-variant radionuclide releases to surface waters, wells, or the atmosphere. This document includes the following information on DITTY: a description of the mathematical models, program designs, data file requirements, input preparation, output interpretations, sample problems, and program-generated diagnostic messages

  11. Designing and implementing a physiology course for a new doctoral occupational therapy program with student feedback.

    Science.gov (United States)

    Goodman, Barbara E; Ikiugu, Moses N

    2017-09-01

    Recently, the Occupational Therapy Department requested a custom-designed medical physiology course for the students in the new occupational therapy doctoral program. The first author, a physiologist with extensive experience in teaching both undergraduate preprofessional and medical students in human physiology, was recruited to design and implement the course. The course was designed to be consistent with the constructivist philosophy that guides the occupational therapy curriculum. The course was offered for the first time during fall/spring 2015/2016 and included both first- and second-year occupational therapy doctoral students. A number of anonymous assessment tools were used to evaluate students' perceptions regarding the effectiveness of various pedagogies used in the course in enhancing their learning. A summative course assessment survey with comments was used at the end of the course. This paper describes the model of course design and the student feedback, which generated some suggestions for improvement of the course. This approach in designing a new course for a new disciplinary group of students should be helpful to other faculty involved in developing courses for health career programs populated by students with variable physiology backgrounds and different educational needs. The final relevant feedback from the course would be to have the students evaluate the usefulness of the course to their future careers immediately following their certification examinations in a year or two and during their subsequent clinical experiences; however, that information will likely be more difficult to obtain. Copyright © 2017 the American Physiological Society.

  12. Faculty perceptions of occupational therapy program directors' leadership styles and outcomes of leadership.

    Science.gov (United States)

    Snodgrass, Jeff; Shachar, Mickey

    2008-01-01

    This research study investigated the relationship between faculty perceptions of occupational therapy program directors' leadership styles and outcomes of leadership and the effects of moderating demographic and institutional characteristics. Data for this study were collected utilizing the Multifactor Leadership Questionnaire Form 5X and the self-designed Demographic and Institution Questionnaire. The study working sample included 184 graduate occupational therapy faculty members from 98 (65%) of all accredited academic occupational therapy programs in the United States for the 2005-06 academic year. Major findings from the study indicate that, in general, transformational leadership had a significant (p leadership outcomes whereas transactional leadership had a significant (p leadership attribute (although belonging to the transactional leadership construct) was found to be a positive predictor of leadership outcomes. Demographic and institutional characteristics did not have a significant (p > 0.01) influence on perceived leadership styles and leadership outcomes. The results of this research show that the most effective occupational therapy leaders in academia have been found to be those who adopt and utilize a full range of leadership styles that combine both transformational and transactional contingent reward leadership styles and suggest common effectiveness for other allied health fields.

  13. The Idaho Power Burst Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program overview

    International Nuclear Information System (INIS)

    Dorn, R.V. III; Griebenow, M.L.; Ackermann, A.L.; Miller, L.G.; Miller, D.L.; Wheeler, F.J.; Bradshaw, K.M.; Wessol, D.E.; Harker, Y.D.; Nigg, D.W.; Randolph, P.D.; Bauer, W.F.; Gavin, P.R.; Richards, T.L.

    1992-01-01

    The Power Burst Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program has been funded since 1988 to evaluate brain tumor treatment using Na 2 B 12 H 11 SH (borocaptate sodium or BSH) and epithermal neutrons. The PBF/BNCT Program pursues this goal as a comprehensive, multidisciplinary, multiorganizational endeavor applying modern program management techniques. The initial focus was to: (1) establish a representative large animal model and (2) develop the generic analytical and measurement capabilities require to control treatment repeatability and determine critical treatment parameters independent of tumor type and body location. This paper will identify the PBF/BNCT Program elements and summarize the status of some of the developed capabilities

  14. Integrating electron microscopy into nanoscience and materials engineering programs

    Science.gov (United States)

    Cormia, Robert D.; Oye, Michael M.; Nguyen, Anh; Skiver, David; Shi, Meng; Torres, Yessica

    2014-10-01

    Preparing an effective workforce in high technology is the goal of both academic and industry training, and has been the engine that drives innovation and product development in the United States for over a century. During the last 50 years, technician training has comprised a combination of two-year academic programs, internships and apprentice training, and extensive On-the-Job Training (OJT). Recently, and especially in Silicon Valley, technicians have four-year college degrees, as well as relevant hands-on training. Characterization in general, and microscopy in particular, is an essential tool in process development, manufacturing and QA/QC, and failure analysis. Training for a broad range of skills and practice is challenging, especially for community colleges. Workforce studies (SRI/Boeing) suggest that even four year colleges often do not provide the relevant training and experience in laboratory skills, especially design of experiments and analysis of data. Companies in high-tech further report difficulty in finding skilled labor, especially with industry specific experience. Foothill College, in partnership with UCSC, SJSU, and NASA-Ames, has developed a microscopy training program embedded in a research laboratory, itself a partnership between university and government, providing hands-on experience in advanced instrumentation, experimental design and problem solving, with real-world context from small business innovators, in an environment called `the collaboratory'. The program builds on AFM-SEM training at Foothill, and provides affordable training in FE-SEM and TEM through a cost recovery model. In addition to instrument and engineering training, the collaboratory also supports academic and personal growth through a multiplayer social network of students, faculty, researchers, and innovators.

  15. Integration of a Multizone Airflow Model into a Thermalsimulation Program

    DEFF Research Database (Denmark)

    Jensen, Rasmus Lund; Sørensen, Karl Grau; Heiselberg, Per

    2007-01-01

    An existing computer model for dynamic hygrothermal analysis of buildings has been extended with a multizone airflow model based on loop equations to account for the coupled thermal and airflow in natural and hybrid ventilated buildings. In water distribution network and related fields loop...... a methodology adopted from water distribution network that automatically sets up the independent loops and is easy to implement into a computer program. Finally an example of verification of the model is given which demonstrates the ability of the models to accurately predict the airflow of a simple multizone...

  16. Cognitive Behavior Therapy Compare to Campaign Advertisement Programs in Reducing Aggressive Driving Behavior

    OpenAIRE

    Ina Saraswati; Dyah T Indirasari; Dewi Maulina; Guritnaningsih A Santoso

    2011-01-01

    This study was conducted to examine the effectiveness of three intervention programs, i.e. CBT (Cognitive Behavior Therapy), humor appeal advertisements (positive ads), and fear appeal advertisements (negative ads) in reducing aggressive driving behavior. 196 young adults age between 18–35 years old, who are considered to be at risk in performing aggressive driving behavior had completed four self report inventories. The four inventories measures perception on traffic conditions, degree of fr...

  17. A Partnership Training Program: Studying Targeted Drug Delivery Using Nanoparticles In Breast Cancer Diagnosis and Therapy

    Science.gov (United States)

    2015-12-01

    Imaging 28: 698–707. 15. Newman RJ, Bore PJ, Chan L, Gadian DG, Styles P, et al. (1982) Nuclear magnetic resonance studies of forearm muscle in Duchenne...against the parental U87 cells. In morphology, cell death was obvious after exposure to DT390-BiscFv806. We further analyzed the cytotoxicity of DT390...funded) 4. NIH Exploratory/Developmental Research Grant Program ( Parent R21) Sheddable Bivalent Fold-back Format Immunotoxin for Prostate Cancer Therapy

  18. Effect of motor relearning program poststem cell therapy in chronic stroke

    Directory of Open Access Journals (Sweden)

    Jorida Fernandes

    2017-01-01

    Full Text Available A 59-year-old male, with chronic hemiplegia, received the first dose of stem cell therapy 1 year back. Physiotherapy was started immediately. The patient was evaluated using Fugl-Meyer assessment scale and functional independence measure before and after physiotherapy. After 6 months of physiotherapy intervention using motor relearning program, improvements were observed in the motor outcome with significant changes in the upper extremity, especially the hand component.

  19. Indigenous development of integrated medical Linac system for cancer therapy - Jai Vigyan programme

    International Nuclear Information System (INIS)

    Singh, G.S.; Sehgal, Vijay

    2012-01-01

    6 MV integrated medical LINAC system was developed for cancer therapy jointly by CSIR-CSIO Chandigarh and SAMEER Mumbai under the Jai Vigyan Programme of the Government of India. Six machines were originally planned to be commissioned in six cancer hospitals in the country. Two machines, namely SIDDARTH I and SIDDARTH II, have already been developed and deployed at MGIMS, Sevagram, Wardha (Maharashtra) and at Cancer Institute (WIA), Adyar, Chennai. These machines are working satisfactorily since their installation. Four more machines namely SIDDARTH III-IV, are underway which will be commissioned in four national cancer institutes by the end of next year. This paper describes in brief the scientific principles of LINAC machines and technological challenges involved in the design and development of such a system of multi-disciplinary activities. (author)

  20. Tissue engineering and cell-based therapy toward integrated strategy with artificial organs.

    Science.gov (United States)

    Gojo, Satoshi; Toyoda, Masashi; Umezawa, Akihiro

    2011-09-01

    Research in order that artificial organs can supplement or completely replace the functions of impaired or damaged tissues and internal organs has been underway for many years. The recent clinical development of implantable left ventricular assist devices has revolutionized the treatment of patients with heart failure. The emerging field of regenerative medicine, which uses human cells and tissues to regenerate internal organs, is now advancing from basic and clinical research to clinical application. In this review, we focus on the novel biomaterials, i.e., fusion protein, and approaches such as three-dimensional and whole-organ tissue engineering. We also compare induced pluripotent stem cells, directly reprogrammed cardiomyocytes, and somatic stem cells for cell source of future cell-based therapy. Integrated strategy of artificial organ and tissue engineering/regenerative medicine should give rise to a new era of medical treatment to organ failure.

  1. Manualization of Occupational Therapy Using Ayres Sensory Integration® for Autism.

    Science.gov (United States)

    Hunt, Joanne; van Hooydonk, Elke; Faller, Patricia; Mailloux, Zoe; Schaaf, Roseann

    2017-07-01

    This article reports on the development of a Stage 3 manual (following pilot effectiveness study) for implementing occupational therapy using Ayres Sensory Integration® (OT/ASI) for children with autism spectrum disorders to enhance participation in daily occupations. Three stakeholder groups were surveyed to aid in translation of manual from research to practice (i.e., Stage 3 manual) and an expert consensus meeting was held to finalize recommendations. Data indicated that the manuals usability could be improved by including a section on frequently encountered problems and solutions, and by including video case examples. Also recommended were greater chapter uniformity, improved clarity of forms and charts, and inclusion of a glossary. Changes were made and subject to expert review and consensus using modified Delphi process. The Stage 3 manual has been rigorously vetted and is ready for practice and research replication.

  2. Integrating packing and distribution problems and optimization through mathematical programming

    Directory of Open Access Journals (Sweden)

    Fabio Miguel

    2016-06-01

    Full Text Available This paper analyzes the integration of two combinatorial problems that frequently arise in production and distribution systems. One is the Bin Packing Problem (BPP problem, which involves finding an ordering of some objects of different volumes to be packed into the minimal number of containers of the same or different size. An optimal solution to this NP-Hard problem can be approximated by means of meta-heuristic methods. On the other hand, we consider the Capacitated Vehicle Routing Problem with Time Windows (CVRPTW, which is a variant of the Travelling Salesman Problem (again a NP-Hard problem with extra constraints. Here we model those two problems in a single framework and use an evolutionary meta-heuristics to solve them jointly. Furthermore, we use data from a real world company as a test-bed for the method introduced here.

  3. Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective.

    Science.gov (United States)

    Maclean, Lynne M; Clinton, Kathryn; Edwards, Nancy; Garrard, Michael; Ashley, Lisa; Hansen-Ketchum, Patti; Walsh, Audrey

    2010-05-17

    Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

  4. Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective

    Directory of Open Access Journals (Sweden)

    Ashley Lisa

    2010-05-01

    Full Text Available Abstract Background Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h integration of policy and practice in order to be maximally effective. Discussion This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Summary Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

  5. Integrating the Principles of Effective Intervention into Batterer Intervention Programming: The Case for Moving Toward More Evidence-Based Programming.

    Science.gov (United States)

    Radatz, Dana L; Wright, Emily M

    2016-01-01

    The majority of batterer intervention program (BIP) evaluations have indicated they are marginally effective in reducing domestic violence recidivism. Meanwhile, correctional programs used to treat a variety of offenders (e.g., substance users, violent offenders, and so forth) that adhere to the "principles of effective intervention" (PEI) have reported significant reductions in recidivism. This article introduces the PEI-the principles on which evidence-based practices in correctional rehabilitation are based-and identifies the degree to which they are currently integrated into BIPs. The case is made that batterer programs could be more effective if they incorporate the PEI. Recommendations for further integration of the principles into BIPs are also provided. © The Author(s) 2015.

  6. Sensitivity Analysis of the Integrated Medical Model for ISS Programs

    Science.gov (United States)

    Goodenow, D. A.; Myers, J. G.; Arellano, J.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Young, M.

    2016-01-01

    Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Standardized Rank Regression Coefficient (SRRC) are methods of conducting sensitivity analysis on nonlinear simulation models like the Integrated Medical Model (IMM). The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The partial part is so named because adjustments are made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. In SRRC, standardized regression-based coefficients measure the sensitivity of each input, adjusted for all the other inputs, on each output. Because the relative ranking of each of the inputs and outputs is used, as opposed to the values themselves, both methods accommodate the nonlinear relationship of the underlying model. As part of the IMM v4.0 validation study, simulations are available that predict 33 person-missions on ISS and 111 person-missions on STS. These simulated data predictions feed the sensitivity analysis procedures. The inputs to the sensitivity procedures include the number occurrences of each of the one hundred IMM medical conditions generated over the simulations and the associated IMM outputs: total quality time lost (QTL), number of evacuations (EVAC), and number of loss of crew lives (LOCL). The IMM team will report the results of using PRCC and SRRC on IMM v4.0 predictions of the ISS and STS missions created as part of the external validation study. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty could drive changes in overall model output uncertainty. These efforts are an integral

  7. A Standardized, Evidence-Based Massage Therapy Program for Decentralized Elite Paracyclists: Creating the Model.

    Science.gov (United States)

    Kennedy, Ann B; Trilk, Jennifer L

    2015-09-01

    Evidence suggests that para-athletes are injured more often than able-bodied athletes. The benefits of massage therapy for these disabled athletes are yet to be explored. This paper documents the process followed for creating a massage program for elite paracycling athletes with the goal to assess effects on recovery, rest, performance, and quality of life both on and off the bike. Massage therapists' private practices throughout the United States. A United States Paracycling team consisting of 9 elite athletes: 2 spinal cord injury, 2 lower limb amputation, 1 upper limb amputation, 1 transverse myelitis, 1 stroke, 1 traumatic brain injury, and 1 visually impaired. The process used to develop a massage therapy program for para-cyclists included meetings with athletes, coaching staff, team exercise physiologist, and sports massage therapists; peer-reviewed literature was also consulted to address specific health conditions of para-athletes. Team leadership and athletes identified needs for quicker recovery, better rest, and improved performance in elite paracyclists. This information was used to generate a conceptual model for massage protocols, and led to creation of the intake and exit questionnaires to assess patient health status and recovery. Forms also were created for a general health intake, therapist information, and a therapist's SOAAP notes. The conceptual model and questionnaires developed herein will help to operationalize an exploratory study investigating the feasibility of implementing a standardized massage therapy program for a decentralized elite paracycling team.

  8. Gore-Mbeki Binational Commission integrated housing program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    This report documents the work done under Grant DE-FG36-97GO10209, Innovative Renewable Energy Technology Transfer Program. PEER Consultants, PC, and its subcontractor, PEER Africa (Pty.) Ltd., received an $88,000.00 grant to plan and build two energy efficient homes in the black township of Gugulethu in Cape Town, South Africa. These demonstration homes were given to the people of South Africa as a gesture of goodwill by the US government as part of the Gore-Mbeki Binational Commission (BNC) agreements and cooperation. The BNC is the term used to describe the agreement to work together by the US and the South African governments for economic development of South Africa in the areas of energy, commerce, agriculture, housing, and transportation. The BNC was formed in 1995. This project under the auspices of the BNC started in September 1996. The DOE-funded portion was performed between January 11, 1997 and February 28, 1997.

  9. Integrated Risk and Knowledge Management Program -- IRKM-P

    Science.gov (United States)

    Lengyel, David M.

    2009-01-01

    The NASA Exploration Systems Mission Directorate (ESMD) IRKM-P tightly couples risk management and knowledge management processes and tools to produce an effective "modern" work environment. IRKM-P objectives include: (1) to learn lessons from past and current programs (Apollo, Space Shuttle, and the International Space Station); (2) to generate and share new engineering design, operations, and management best practices through preexisting Continuous Risk Management (CRM) procedures and knowledge-management practices; and (3) to infuse those lessons and best practices into current activities. The conceptual framework of the IRKM-P is based on the assumption that risks highlight potential knowledge gaps that might be mitigated through one or more knowledge management practices or artifacts. These same risks also serve as cues for collection of knowledge particularly, knowledge of technical or programmatic challenges that might recur.

  10. Aging Evaluation Programs for Jet Transport Aircraft Structural Integrity

    Directory of Open Access Journals (Sweden)

    Borivoj Galović

    2012-10-01

    Full Text Available The paper deals with criteria and procedures in evaluationof timely preventive maintenance recommendations that willsupport continued safe operation of aging jet transports untiltheir retirement from service. The active service life of commercialaircraft has increased in recent years as a result of low fuelcost, and increasing costs and delivery times for fleet replacements.Air transport industry consensus is that older jet transportswill continue in service despite anticipated substantial increasesin required maintenance. Design concepts, supportedby testing, have worked well due to the system that is used to ensureflying safety. Continuing structural integrity by inspectionand overhaul recommendation above the level contained inmaintenance and service bulletins is additional requirement, insuch cases. Airplane structural safety depends on the performanceof all participants in the system and the responsibility forsafety cannot be delegated to a single participant. This systemhas three major participants: the manufacturers who design,build and support airplanes in service, the airlines who operate,inspect and mantain airplanes and the airworthiness authoritieswho establish rules and regulations, approve the design andpromote airline maintenance performance.

  11. Transforming traditional Tai Ji Quan techniques into integrative movement therapy-Tai Ji Quan: Moving for Better Balance.

    Science.gov (United States)

    Li, Fuzhong

    2014-03-01

    Tai Ji Quan, developed as a martial art, has traditionally served multiple purposes, including self-defense, competition/performance, and health promotion. With respect to health, the benefits historically and anecdotally associated with Tai Ji Quan are now being supported by scientific and clinical research, with mounting evidence indicating its potential value in preventing and managing various diseases and improving well-being and quality of life in middle-aged and older adults. The research findings produced to date have both public health significance and clinical relevance. However, because of its roots in the martial arts, transforming traditional Tai Ji Quan movements and training approaches into contemporary therapeutic programs and functional applications is needed to maximize its ultimate utility. This paper addresses this issue by introducing Tai Ji Quan: Moving for Better Balance , a functional therapy that involves the use of Tai Ji Quan principles and Yang-style-based movements to form an innovative, contemporary therapeutic approach that integrates motor, sensory, and cognitive components to improve postural control, gait, and mobility for older adults and those who have neurodegenerative movement impairments. It provides a synergy of traditional and contemporary Tai Ji Quan practice with the ultimate goal of improving balance and gait, enhancing performance of daily functional tasks, and reducing incidence of falls among older adults.

  12. Haptic/graphic rehabilitation: integrating a robot into a virtual environment library and applying it to stroke therapy.

    Science.gov (United States)

    Sharp, Ian; Patton, James; Listenberger, Molly; Case, Emily

    2011-08-08

    Recent research that tests interactive devices for prolonged therapy practice has revealed new prospects for robotics combined with graphical and other forms of biofeedback. Previous human-robot interactive systems have required different software commands to be implemented for each robot leading to unnecessary developmental overhead time each time a new system becomes available. For example, when a haptic/graphic virtual reality environment has been coded for one specific robot to provide haptic feedback, that specific robot would not be able to be traded for another robot without recoding the program. However, recent efforts in the open source community have proposed a wrapper class approach that can elicit nearly identical responses regardless of the robot used. The result can lead researchers across the globe to perform similar experiments using shared code. Therefore modular "switching out"of one robot for another would not affect development time. In this paper, we outline the successful creation and implementation of a wrapper class for one robot into the open-source H3DAPI, which integrates the software commands most commonly used by all robots.

  13. The Development of a Postgraduate Orthopaedic Manual Therapy Residency Program in Nairobi, Kenya

    Directory of Open Access Journals (Sweden)

    Shala Cunningham

    2017-06-01

    Full Text Available IntroductionThere are very few opportunities for long-term, comprehensive postgraduate education in developing countries because of fiscal and human resource constraints. Therefore, physiotherapists have little opportunity following graduation to advance their skills through the improvement of clinical reasoning and treatment planning and application.BackgroundTo address the need for sustainable advanced instruction in physiotherapy within the country, a postgraduate Residency program was initiated in Nairobi, Kenya in 2012. The mission of the program is to graduate advanced orthopedic practitioners who can lead their communities and local profession in the advancement of clinical care and education. Since its inception, six cohorts have been initiated for a total of 90 resident participants. In addition, six program graduates are being trained to continue the Residency program and are serving as teaching assistants for the on campus modules. This training will result in a self-sustaining program by 2020.DiscussionThe manual therapy Residency education model allowed for advancement of the participating physiotherapists professional development utilizing evidence-based practice. This was done without altering the current education system within the country, or accessing expensive equipment.Concluding remarksThe Residency program was developed and established with the cooperation of a local education institution and a non-profit corporation in the United States. This collaboration has facilitated the advancement of orthopedic clinical standards in the country and will, hopefully, one day serve an as a template for future programs.

  14. The Development of a Postgraduate Orthopaedic Manual Therapy Residency Program in Nairobi, Kenya.

    Science.gov (United States)

    Cunningham, Shala; Jackson, Richard; Muli, Daniel Kangutu; McFelea, Joni

    2017-01-01

    There are very few opportunities for long-term, comprehensive postgraduate education in developing countries because of fiscal and human resource constraints. Therefore, physiotherapists have little opportunity following graduation to advance their skills through the improvement of clinical reasoning and treatment planning and application. To address the need for sustainable advanced instruction in physiotherapy within the country, a postgraduate Residency program was initiated in Nairobi, Kenya in 2012. The mission of the program is to graduate advanced orthopedic practitioners who can lead their communities and local profession in the advancement of clinical care and education. Since its inception, six cohorts have been initiated for a total of 90 resident participants. In addition, six program graduates are being trained to continue the Residency program and are serving as teaching assistants for the on campus modules. This training will result in a self-sustaining program by 2020. The manual therapy Residency education model allowed for advancement of the participating physiotherapists professional development utilizing evidence-based practice. This was done without altering the current education system within the country, or accessing expensive equipment. The Residency program was developed and established with the cooperation of a local education institution and a non-profit corporation in the United States. This collaboration has facilitated the advancement of orthopedic clinical standards in the country and will, hopefully, one day serve an as a template for future programs.

  15. Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement - A Qualitative Study.

    Science.gov (United States)

    Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M

    2017-11-01

    Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.

  16. The Library of Integrated Network-Based Cellular Signatures NIH Program: System-Level Cataloging of Human Cells Response to Perturbations.

    Science.gov (United States)

    Keenan, Alexandra B; Jenkins, Sherry L; Jagodnik, Kathleen M; Koplev, Simon; He, Edward; Torre, Denis; Wang, Zichen; Dohlman, Anders B; Silverstein, Moshe C; Lachmann, Alexander; Kuleshov, Maxim V; Ma'ayan, Avi; Stathias, Vasileios; Terryn, Raymond; Cooper, Daniel; Forlin, Michele; Koleti, Amar; Vidovic, Dusica; Chung, Caty; Schürer, Stephan C; Vasiliauskas, Jouzas; Pilarczyk, Marcin; Shamsaei, Behrouz; Fazel, Mehdi; Ren, Yan; Niu, Wen; Clark, Nicholas A; White, Shana; Mahi, Naim; Zhang, Lixia; Kouril, Michal; Reichard, John F; Sivaganesan, Siva; Medvedovic, Mario; Meller, Jaroslaw; Koch, Rick J; Birtwistle, Marc R; Iyengar, Ravi; Sobie, Eric A; Azeloglu, Evren U; Kaye, Julia; Osterloh, Jeannette; Haston, Kelly; Kalra, Jaslin; Finkbiener, Steve; Li, Jonathan; Milani, Pamela; Adam, Miriam; Escalante-Chong, Renan; Sachs, Karen; Lenail, Alex; Ramamoorthy, Divya; Fraenkel, Ernest; Daigle, Gavin; Hussain, Uzma; Coye, Alyssa; Rothstein, Jeffrey; Sareen, Dhruv; Ornelas, Loren; Banuelos, Maria; Mandefro, Berhan; Ho, Ritchie; Svendsen, Clive N; Lim, Ryan G; Stocksdale, Jennifer; Casale, Malcolm S; Thompson, Terri G; Wu, Jie; Thompson, Leslie M; Dardov, Victoria; Venkatraman, Vidya; Matlock, Andrea; Van Eyk, Jennifer E; Jaffe, Jacob D; Papanastasiou, Malvina; Subramanian, Aravind; Golub, Todd R; Erickson, Sean D; Fallahi-Sichani, Mohammad; Hafner, Marc; Gray, Nathanael S; Lin, Jia-Ren; Mills, Caitlin E; Muhlich, Jeremy L; Niepel, Mario; Shamu, Caroline E; Williams, Elizabeth H; Wrobel, David; Sorger, Peter K; Heiser, Laura M; Gray, Joe W; Korkola, James E; Mills, Gordon B; LaBarge, Mark; Feiler, Heidi S; Dane, Mark A; Bucher, Elmar; Nederlof, Michel; Sudar, Damir; Gross, Sean; Kilburn, David F; Smith, Rebecca; Devlin, Kaylyn; Margolis, Ron; Derr, Leslie; Lee, Albert; Pillai, Ajay

    2018-01-24

    The Library of Integrated Network-Based Cellular Signatures (LINCS) is an NIH Common Fund program that catalogs how human cells globally respond to chemical, genetic, and disease perturbations. Resources generated by LINCS include experimental and computational methods, visualization tools, molecular and imaging data, and signatures. By assembling an integrated picture of the range of responses of human cells exposed to many perturbations, the LINCS program aims to better understand human disease and to advance the development of new therapies. Perturbations under study include drugs, genetic perturbations, tissue micro-environments, antibodies, and disease-causing mutations. Responses to perturbations are measured by transcript profiling, mass spectrometry, cell imaging, and biochemical methods, among other assays. The LINCS program focuses on cellular physiology shared among tissues and cell types relevant to an array of diseases, including cancer, heart disease, and neurodegenerative disorders. This Perspective describes LINCS technologies, datasets, tools, and approaches to data accessibility and reusability. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Evaluation of a brief treatment program of cognitive behavior therapy for insomnia in older adults.

    Science.gov (United States)

    Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

    2014-01-01

    To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behavior therapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sleep. The brief group-administered CBT-I program produced improvements in the timing and quality of sleep including later bedtimes, earlier out-of-bed times, reduced wake after sleep onset, and improved sleep efficiency. Participants also reported a reduction of the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. The treatment program used in the current study has demonstrated potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population.

  18. A 12-Week Exercise Therapy Program in Middle-Aged Patients With Degenerative Meniscus Tears

    DEFF Research Database (Denmark)

    Stensrud, Silje; Roos, Ewa M.; Risberg, May Arna

    2012-01-01

    Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 STUDY DESIGN: Case Series. BACKGROUND: Exercise is a viable treatment alternative to arthroscopic partial meniscectomy in patients with degenerative meniscus tears. No study has reported in detail type of exercises, progres......Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 STUDY DESIGN: Case Series. BACKGROUND: Exercise is a viable treatment alternative to arthroscopic partial meniscectomy in patients with degenerative meniscus tears. No study has reported in detail type of exercises......, progression, tolerance, and potential benefit from an exercise therapy program in these patients who have not had surgery. This study describes a progressive exercise therapy program aiming at improving neuromuscular function and muscle strength in middle-aged patients with degenerative meniscus tears...... had undergone surgery. DISCUSSION: The described neuromuscular- and strength-training program should be considered for rehabilitation of middle-aged individuals with degenerative meniscus tears. Head-to-head comparison of programs in a randomized design is however needed to be able to answer...

  19. SU-G-TeP4-06: An Integrated Application for Radiation Therapy Treatment Plan Directives, Management, and Reporting

    Energy Technology Data Exchange (ETDEWEB)

    Matuszak, M; Anderson, C; Lee, C; Vineberg, K; Green, M; Younge, K; Moran, J; Mayo, C [University of Michigan, Ann Arbor, MI (United States)

    2016-06-15

    Purpose: With electronic medical records, patient information for the treatment planning process has become disseminated across multiple applications with limited quality control and many associated failure modes. We present the development of a single application with a centralized database to manage the planning process. Methods: The system was designed to replace current functionalities of (i) static directives representing the physician intent for the prescription and planning goals, localization information for delivery, and other information, (ii) planning objective reports, (iii) localization and image guidance documents and (iv) the official radiation therapy prescription in the medical record. Using the Eclipse Scripting Application Programming Interface, a plug-in script with an associated domain-specific SQL Server database was created to manage the information in (i)–(iv). The system’s user interface and database were designed by a team of physicians, clinical physicists, database experts, and software engineers to ensure usability and robustness for clinical use. Results: The resulting system has been fully integrated within the TPS via a custom script and database. Planning scenario templates, version control, approvals, and logic-based quality control allow this system to fully track and document the planning process as well as physician approval of tradeoffs while improving the consistency of the data. Multiple plans and prescriptions are supported along with non-traditional dose objectives and evaluation such as biologically corrected models, composite dose limits, and management of localization goals. User-specific custom views were developed for the attending physician review, physicist plan checks, treating therapists, and peer review in chart rounds. Conclusion: A method was developed to maintain cohesive information throughout the planning process within one integrated system by using a custom treatment planning management application that

  20. Risk assessment to an integrated planning model for UST programs

    International Nuclear Information System (INIS)

    Ferguson, K.W.

    1993-01-01

    The US Postal Service maintains the largest civilian fleet in the United States totaling approximately 180,000 vehicles. To support the fleets daily energy requirements, the Postal Service also operates one of the largest networks of underground storage tanks nearly 7,500 nationwide. A program to apply risk assessment to planning, budget development and other management actions was implemented during September, 1989. Working closely with a consultant, the postal service developed regulatory and environmental risk criteria and weighting factors for a ranking model. The primary objective was to identify relative risks for each underground tank at individual facilities. Relative risks at each facility were determined central to prioritizing scheduled improvements to the tank network. The survey was conducted on 302 underground tanks in the Northeast Region of the US. An environmental and regulatory risk score was computed for each UST. By ranking the tanks according to their risk score, tanks were classified into management action categories including, but the limited to, underground tank testing, retrofit, repair, replacement and closure

  1. Regulatory analysis of the Underground Storage Tank-Integrated Demonstration Program

    International Nuclear Information System (INIS)

    Smith, E.H.

    1992-01-01

    The Underground Storage Tank-Integrated Demonstration (UST-ID) Program has been developed to identify, demonstrate, test, and evaluate technologies that will provide alternatives to the current underground storage tank remediation program. The UST-ID Program is a national program that consists of five participating US Department of Energy (DOE) sites where technologies can be developed an ultimately demonstrated. Once these technologies are demonstrated, the UST-ID Program will transfer the developed technology system to industry (governmental or industrial) for application or back to Research and Development for further evaluation and modification, as necessary. In order to ensure that the UST-ID Program proceeds without interruption, it will be necessary to identify regulatory requirements along with associated permitting and notification requirements early in the technology development process. This document serves as a baseline for identifying certain federal and state regulatory requirements that may impact the UST-ID Program and the demonstration of any identified technologies

  2. The biology of lysine acetylation integrates transcriptional programming and metabolism

    Directory of Open Access Journals (Sweden)

    Mujtaba Shiraz

    2011-03-01

    Full Text Available Abstract The biochemical landscape of lysine acetylation has expanded from a small number of proteins in the nucleus to a multitude of proteins in the cytoplasm. Since the first report confirming acetylation of the tumor suppressor protein p53 by a lysine acetyltransferase (KAT, there has been a surge in the identification of new, non-histone targets of KATs. Added to the known substrates of KATs are metabolic enzymes, cytoskeletal proteins, molecular chaperones, ribosomal proteins and nuclear import factors. Emerging studies demonstrate that no fewer than 2000 proteins in any particular cell type may undergo lysine acetylation. As described in this review, our analyses of cellular acetylated proteins using DAVID 6.7 bioinformatics resources have facilitated organization of acetylated proteins into functional clusters integral to cell signaling, the stress response, proteolysis, apoptosis, metabolism, and neuronal development. In addition, these clusters also depict association of acetylated proteins with human diseases. These findings not only support lysine acetylation as a widespread cellular phenomenon, but also impel questions to clarify the underlying molecular and cellular mechanisms governing target selectivity by KATs. Present challenges are to understand the molecular basis for the overlapping roles of KAT-containing co-activators, to differentiate between global versus dynamic acetylation marks, and to elucidate the physiological roles of acetylated proteins in biochemical pathways. In addition to discussing the cellular 'acetylome', a focus of this work is to present the widespread and dynamic nature of lysine acetylation and highlight the nexus that exists between epigenetic-directed transcriptional regulation and metabolism.

  3. Development of engineering program for integrity evaluation of pipes with local wall thinned defects

    International Nuclear Information System (INIS)

    Park, Chi Yong; Lee, Sung Ho; Kim, Tae Ryong; Park, Sang Kyu

    2008-01-01

    Integrity evaluation of pipes with local wall thinning by erosion and corrosion is increasingly important in maintenance of wall thinned carbon steel pipes in nuclear power plants. Though a few program for integrity assessment of wall thinned pipes have been developed in domestic nuclear field, however those are limited to straight pipes and methodology proposed in ASME Sec.XI Code Case N-597. Recently, the engineering program for integrity evaluation of pipes with all kinds of local wall defects such as straight, elbow, reducer and branch pipes was developed successfully. The program was designated as PiTEP (Pipe Thinning Evaluation Program), which name was registered as a trademark in the Korea Intellectual Property Office. A developed program is carried out by sequential step of four integrity evaluation methodologies, which are composed of construction code, code case N-597, its engineering method and two developed owner evaluation method. As PiTEP program will be performed through GUI (Graphic User Interface) with user's familiarity, it would be conveniently used by plant engineers with only measured thickness data, basic operation conditions and pipe data

  4. A linear programming computational framework integrates phosphor-proteomics and prior knowledge to predict drug efficacy.

    Science.gov (United States)

    Ji, Zhiwei; Wang, Bing; Yan, Ke; Dong, Ligang; Meng, Guanmin; Shi, Lei

    2017-12-21

    In recent years, the integration of 'omics' technologies, high performance computation, and mathematical modeling of biological processes marks that the systems biology has started to fundamentally impact the way of approaching drug discovery. The LINCS public data warehouse provides detailed information about cell responses with various genetic and environmental stressors. It can be greatly helpful in developing new drugs and therapeutics, as well as improving the situations of lacking effective drugs, drug resistance and relapse in cancer therapies, etc. In this study, we developed a Ternary status based Integer Linear Programming (TILP) method to infer cell-specific signaling pathway network and predict compounds' treatment efficacy. The novelty of our study is that phosphor-proteomic data and prior knowledge are combined for modeling and optimizing the signaling network. To test the power of our approach, a generic pathway network was constructed for a human breast cancer cell line MCF7; and the TILP model was used to infer MCF7-specific pathways with a set of phosphor-proteomic data collected from ten representative small molecule chemical compounds (most of them were studied in breast cancer treatment). Cross-validation indicated that the MCF7-specific pathway network inferred by TILP were reliable predicting a compound's efficacy. Finally, we applied TILP to re-optimize the inferred cell-specific pathways and predict the outcomes of five small compounds (carmustine, doxorubicin, GW-8510, daunorubicin, and verapamil), which were rarely used in clinic for breast cancer. In the simulation, the proposed approach facilitates us to identify a compound's treatment efficacy qualitatively and quantitatively, and the cross validation analysis indicated good accuracy in predicting effects of five compounds. In summary, the TILP model is useful for discovering new drugs for clinic use, and also elucidating the potential mechanisms of a compound to targets.

  5. The MICA Case Conference Program at Tewksbury Hospital, Mass.: an integrated treatment model.

    Science.gov (United States)

    Clodfelter, Reynolds C; Albanese, Mark J; Baker, Gregg; Domoto, Katherine; Gui, Amy L; Khantzian, Edward J

    2003-01-01

    This report describes the MICA (Mentally Ill Chemically Abusing) Program at the Tewksbury Hospital campus in Tewksbury, Massachusetts. Several campus facilities collaborate in the MICA Program. Through Expert Case Conferences, principles of integrated psychosocial treatment with dual diagnosis patients are demonstrated. An expert clinician focuses on the interplay between psychological pain, characterological traits, defenses, and the patient's drug of choice. Patients who have participated in the program have reported positive experiences. The staff reported that the program has resulted in facility improvement in assessment and treatment of complex dual diagnosis patients.

  6. Integrated Management Program for Radioactive Sealed Sources in Egypt IMPRSS

    International Nuclear Information System (INIS)

    Hasan, A.; El-Adham, K.

    2004-01-01

    Sealed sources are usually in capsules made of stainless steel. They are the size of a pen or a finger and contain one of hundreds of radioactive elements (e.g., Iridium, Radium) or their isotopes. They are air-tight and very durable, contain the radioactive material but not radiation. They are used in the health sector, industry, military, and universities. Incidents occurred in Met Halfa, Egypt, 2000 (Iridium-192); Goiania, Brazil, 1987 (Cesium-137); Mexico and Southwest U.S., 1977 -1984 (Cobalt-60); Peru, 1999 (Iridium-1992); Poland 2001 (Cobalt-60). The IMPRSS Mission is based on a joined partnership between the Egyptian Atomic Energy Authority, the Egyptian Ministry of Health, the Sandia National Laboratories, the International Atomic Energy Agency and others. The IMPRSS Mission protects human health and the environment in Egypt from mismanaged sealed sources, is developed jointly with MOH and EAEA, provides capabilities for managing radioactive sealed sources in Egypt, increases public awareness, provides education and training, improves emergency response capabilities, develops a permanent disposal facility, ensures the program is self-sustaining and ensures close coordination with the IAEA. Infrastructure how to manage sealed sources is discussed. It includes awareness, tracking and inventory control, security, recovery, conditioning and storage, recycling and disposal. Emergency response, regulatory reform, education and training and its targets are provided. The government of Egypt can protect the people of Egypt and is ready for emergencies. Prevention is the first line of defence and detection is the second line of defence. Adequate Emergency Response saves lives and adequate control reduces risk of mismanaged uses or deliberate misuses of sources. A Cradle-to-Grave approach is built on existing capabilities at EAEA and MOH

  7. High-dose-rate intraoperative radiation therapy: the nuts and bolts of starting a program

    Science.gov (United States)

    Moningi, Shalini; Armour, Elwood P.; Terezakis, Stephanie A.; Efron, Jonathan E.; Gearhart, Susan L.; Bivalacqua, Trinity J.; Kumar, Rachit; Le, Yi; Kien Ng, Sook; Wolfgang, Christopher L.; Zellars, Richard C.; Ellsworth, Susannah G.; Ahuja, Nita

    2014-01-01

    High-dose-rate intraoperative radiation therapy (HDR-IORT) has historically provided effective local control (LC) for patients with unresectable and recurrent tumors. However, IORT is limited to only a few specialized institutions and it can be difficult to initiate an HDR-IORT program. Herein, we provide a brief overview on how to initiate and implement an HDR-IORT program for a selected group of patients with gastrointestinal and pelvic solid tumors using a multidisciplinary approach. Proper administration of HDR-IORT requires institutional support and a joint effort among physics staff, oncologists, surgeons, anesthesiologists, and nurses. In order to determine the true efficacy of IORT for various malignancies, collaboration among institutions with established IORT programs is needed. PMID:24790628

  8. Integrated agriculture programs to address malnutrition in northern Malawi

    Directory of Open Access Journals (Sweden)

    Rachel Bezner Kerr

    2016-11-01

    agriculture and food security, alongside involving male leaders were some of the reasons that respondents named for changed gender norms. Conclusions Participatory education that explicitly addresses hegemonic masculinities related to child nutrition, such as women’s roles in child care, can begin to change dominant gender norms. Involving male leaders, participatory methods and integrating agriculture and food security concerns with nutrition appear to be key components in the context of agrarian communities.

  9. Integrated agriculture programs to address malnutrition in northern Malawi.

    Science.gov (United States)

    Kerr, Rachel Bezner; Chilanga, Emmanuel; Nyantakyi-Frimpong, Hanson; Luginaah, Isaac; Lupafya, Esther

    2016-11-28

    were some of the reasons that respondents named for changed gender norms. Participatory education that explicitly addresses hegemonic masculinities related to child nutrition, such as women's roles in child care, can begin to change dominant gender norms. Involving male leaders, participatory methods and integrating agriculture and food security concerns with nutrition appear to be key components in the context of agrarian communities.

  10. Performance planning and measurement for DOE EM-International Technology Integration Program. A report on a performance measurement development workshop for DOE's environmental management international technology integration program

    International Nuclear Information System (INIS)

    Jordan, G.B.; Reed, J.H.; Wyler, L.D.

    1997-03-01

    This report describes the process and results from an effort to develop metrics for program accomplishments for the FY 1997 budget submission of the U.S. Department of Energy Environmental Management International Technology Integration Program (EM-ITI). The four-step process included interviews with key EM-ITI staff, the development of a strawman program logic chart, and all day facilitated workshop with EM-ITI staff during which preliminary performance plans and measures were developed and refined, and a series of follow-on discussions and activities including a cross-organizational project data base. The effort helped EM-ITI to crystallize and develop a unified vision of their future which they can effectively communicate to their own management and their internal and external customers. The effort sets the stage for responding to the Government Performance and Results Act. The metrics developed may be applicable to other international technology integration programs. Metrics were chosen in areas of eight general performance goals for 1997-1998: (1) number of forums provided for the exchange of information, (2) formal agreements signed, (3) new partners identified, (4) customers reached and satisfied, (5, 6) dollars leveraged by EM technology focus area and from foreign research, (7) number of foreign technologies identified for potential use in remediation of DOE sites, and (8) projects advanced through the pipeline

  11. Melatonin Therapy Prevents Programmed Hypertension and Nitric Oxide Deficiency in Offspring Exposed to Maternal Caloric Restriction

    Directory of Open Access Journals (Sweden)

    You-Lin Tain

    2014-01-01

    Full Text Available Nitric oxide (NO deficiency is involved in the development of hypertension, a condition that can originate early in life. We examined whether NO deficiency contributed to programmed hypertension in offspring from mothers with calorie-restricted diets and whether melatonin therapy prevented this process. We examined 3-month-old male rat offspring from four maternal groups: untreated controls, 50% calorie-restricted (CR rats, controls treated with melatonin (0.01% in drinking water, and CR rats treated with melatonin (CR + M. The effect of melatonin on nephrogenesis was analyzed using next-generation sequencing. The CR group developed hypertension associated with elevated plasma asymmetric dimethylarginine (ADMA, a nitric oxide synthase inhibitor, decreased L-arginine, decreased L-arginine-to-ADMA ratio (AAR, and decreased renal NO production. Maternal melatonin treatment prevented these effects. Melatonin prevented CR-induced renin and prorenin receptor expression. Renal angiotensin-converting enzyme 2 protein levels in the M and CR + M groups were also significantly increased by melatonin therapy. Maternal melatonin therapy had long-term epigenetic effects on global gene expression in the kidneys of offspring. Conclusively, we attributed these protective effects of melatonin on CR-induced programmed hypertension to the reduction of plasma ADMA, restoration of plasma AAR, increase of renal NO level, alteration of renin-angiotensin system, and epigenetic changes in numerous genes.

  12. Business process modeling for the Virginia Department of Transportation : a demonstration with the integrated six-year improvement program and the statewide transportation improvement program.

    Science.gov (United States)

    2005-01-01

    This effort demonstrates business process modeling to describe the integration of particular planning and programming activities of a state highway agency. The motivations to document planning and programming activities are that: (i) resources for co...

  13. Business process modeling for the Virginia Department of Transportation : a demonstration with the integrated six-year improvement program and the statewide transportation improvement program : executive summary.

    Science.gov (United States)

    2005-01-01

    This effort demonstrates business process modeling to describe the integration of particular planning and programming activities of a state highway agency. The motivations to document planning and programming activities are that: (i) resources for co...

  14. Effects of mirror therapy integrated with task-oriented exercise on the balance function of patients with poststroke hemiparesis: a randomized-controlled pilot trial.

    Science.gov (United States)

    Cha, Hyun-Gyu; Oh, Duck-Won

    2016-03-01

    This study aimed to explore the effects of mirror therapy integrated with task-oriented exercise on balance function in poststroke hemiparesis. Twenty patients with poststroke hemiparesis were assigned randomly to an experimental group (EG) and a control group (CG), with 10 individuals each. Participants of the EG and CG received a task-oriented exercise program with a focus on the strengthening of the lower limb and the practice of balance-related functional tasks. An additional option for the EG was front and side wall mirrors to provide visual feedback for their own movements while performing the exercise. The program was performed for 30 min, twice a day, five times per week for 4 weeks. Outcome measures included the Berg balance scale, the timed up-and-go test, and quantitative data (balance index and dynamic limits of stability). In the EG and CG, all variables showed significant differences between pretest and post-test (Phemiparesis.

  15. CAREGIVER COMPLIANCE WITH PHYSICAL THERAPY HOME PROGRAM: A PILOT STUDY IN PEDIATRIC OUTPATIENT CLINICS IN KUWAIT

    Directory of Open Access Journals (Sweden)

    Maryam M. Almandil

    2017-06-01

    Full Text Available Background: Compliance depends on the caregiver and the health care professional committing to the same objectives.Compliance with the prescribed physical therapy (PT home program is a significant contributor to treatment success. Methods: One hundred caregivers were invited to fill in a questionnaire after the explanation of the procedure, and signing the consent form. The questionnaire explored factors affecting compliance including nature of the exercise, physical and emotional stresses on the caregiver, and the role of PT in teaching and counseling the caregiver. Result: Ninety-one participants out of the 100 were committed to administering the exercises with their children. Despite this, there was a discrepancy in either the frequency of repeating the exercises per day or the content of the exercise program when compared with the exercise program prescribed by the therapist. Some of the primary reasons for these differences were the pain experienced by the child when exercising (71%, having other family commitments (57%, not having the time to administer the home program (37%, and lacking skills or equipment to administer the exercises (34%. Conclusion: Adherence to treatment is a complex act that requires an understanding of treatment approach, having the confidence in one’s skills to administer the unsupervised home program and the existence of a support system both in the hospital and at home that can provide aid when needed. It is the PT role to address all these issues when prescribing a home program to meet treatment objectives.

  16. Implementing preventive chemotherapy through an integrated National Neglected Tropical Disease Control Program in Mali.

    Directory of Open Access Journals (Sweden)

    Massitan Dembélé

    Full Text Available BACKGROUND: Mali is endemic for all five targeted major neglected tropical diseases (NTDs. As one of the five 'fast-track' countries supported with the United States Agency for International Development (USAID funds, Mali started to integrate the activities of existing disease-specific national control programs on these diseases in 2007. The ultimate objectives are to eliminate lymphatic filariasis, onchocerciasis and trachoma as public health problems and to reduce morbidity caused by schistosomiasis and soil-transmitted helminthiasis through regular treatment to eligible populations, and the specific objectives were to achieve 80% program coverage and 100% geographical coverage yearly. The paper reports on the implementation of the integrated mass drug administration and the lessons learned. METHODOLOGY/PRINCIPAL FINDINGS: The integrated control program was led by the Ministry of Health and coordinated by the national NTD Control Program. The drug packages were designed according to the disease endemicity in each district and delivered through various platforms to eligible populations involving the primary health care system. Treatment data were recorded and reported by the community drug distributors. After a pilot implementation of integrated drug delivery in three regions in 2007, the treatment for all five targeted NTDs was steadily scaled up to 100% geographical coverage by 2009, and program coverage has since been maintained at a high level: over 85% for lymphatic filariasis, over 90% for onchocerciasis and soil-transmitted helminthiasis, around 90% in school-age children for schistosomiasis, and 76-97% for trachoma. Around 10 million people have received one or more drug packages each year since 2009. No severe cases of adverse effects were reported. CONCLUSIONS/SIGNIFICANCE: Mali has scaled up the drug treatment to national coverage through integrated drug delivery involving the primary health care system. The successes and lessons

  17. A Review of Ocean Management and Integrated Resource Management Programs from Around the World

    OpenAIRE

    , Seaplan

    2018-01-01

    This draft report is one of several prepared under contract to the Massachusetts Ocean Partnership (MOP) to support the Massachusetts Executive Office of Energy and Environmental Affairs (EOEEA) in its development of the integrated coastal ocean management plan mandated by the Massachusetts Oceans Act of 2008. The purpose of this report was to inventory and review ocean management and integrated resource management programs from around the world, including the United States, Europe, Australia...

  18. Integration of intracellular telomerase monitoring by electrochemiluminescence technology and targeted cancer therapy by reactive oxygen species.

    Science.gov (United States)

    Zhang, Huairong; Li, Binxiao; Sun, Zhaomei; Zhou, Hong; Zhang, Shusheng

    2017-12-01

    Cancer therapies based on reactive oxygen species (ROS) have emerged as promising clinical treatments. Electrochemiluminescence (ECL) technology has also attracted considerable attention in the field of clinical diagnosis. However, studies about the integration of ECL diagnosis and ROS cancer therapy are very rare. Here we introduce a novel strategy that employs ECL technology and ROS to fill the above vacancy. Briefly, an ITO electrode was electrodeposited with polyluminol-Pt NPs composite films and modified with aptamer DNA to capture HL-60 cancer cells with high specificity. After that, mesoporous silica nanoparticles (MSNs) filled with phorbol 12-myristate 13-acetate (PMA) were closed by the telomerase primer DNA (T-primer DNA) and aptamer. After aptamer on MSN@PMA recognized and combined with the HL-60 cancer cells with high specificity, T-primer DNA on MSN@PMA could be moved away from the MSN@PMA surface after extension by telomerase in the HL-60 cancer cells and PMA was released to induce the production of ROS by the HL-60 cancer cells. After that, the polyluminol-Pt NPs composite films could react with hydrogen peroxide (a major ROS) and generate an ECL signal. Thus the intracellular telomerase activity of the HL-60 cancer cells could be detected in situ . Besides, ROS could induce apoptosis in the HL-60 cancer cells with high efficacy by causing oxidative damage to the lipids, protein, and DNA. Above all, the designed platform could not only detect intracellular telomerase activity instead of that of extracted telomerase, but could also kill targeted tumors by ECL technology and ROS.

  19. Improved Adherence Rates and Clinical Outcomes of an Integrated, Closed-Loop, Pharmacist-Led Oral Chemotherapy Management Program.

    Science.gov (United States)

    Muluneh, Benyam; Schneider, Molly; Faso, Aimee; Amerine, Lindsey; Daniels, Rowell; Crisp, Brett; Valgus, John; Savage, Scott

    2018-06-01

    To address the growing use of oral anticancer therapy, an integrated, closed-loop, pharmacist-led oral chemotherapy management program was created within an academic medical center. An integrated, closed-loop, pharmacy-led oral chemotherapy management program was established. From September 2014 until June 2015, demographic information, rates of adherence, patient understanding of treatment, pharmacist interventions, patient and provider satisfaction, and molecular response rates in patients with chronic myeloid leukemia (CML) were collected. After full implementation, 107 patients were enrolled in our oral chemotherapy management program from September 2014 until June 2015. All patients were educated before starting oral chemotherapy, and using pre- and postassessment tests, comprehension of oral chemotherapy treatment increased from 43% to 95%. Patient-reported adherence was 86% and 94.7% for the GI/breast and malignant hematology patient populations, respectively, and these were validated with medication possession ratio, revealing adherence rates of 85% and 93.9% for the GI/breast and malignant hematology patient populations, respectively. A total of 350 encounters with a clinical pharmacist and 318 adverse effects were reported, which led to 235 interventions. This program led to a higher major molecular response rate (83%) in our CML population compared with published clinical trials (average major molecular response rates, 40% and 60% with 1- and 2-year follow-up, respectively). An innovative model was developed and resulted in improved patient knowledge regarding oral chemotherapy, improved adherence rates that exceeded nationally established thresholds, and superior major molecular response outcomes for patients with CML compared with published literature. As a result, this model has produced the gold standard in managing patients receiving oral chemotherapy.

  20. Sleep and aggression in substance-abusing adolescents: results from an integrative behavioral sleep-treatment pilot program.

    Science.gov (United States)

    Haynes, Patricia L; Bootzin, Richard R; Smith, Leisha; Cousins, Jennifer; Cameron, Michael; Stevens, Sally

    2006-04-01

    To examine whether change in total sleep time during an integrative, behavioral sleep intervention is associated with aggression. Specifically, we tested whether adolescents who reported experiencing aggressive thoughts or actions after treatment had worse treatment trajectories (e.g., less total sleep time across treatment) than adolescents with no aggressive thoughts or actions after treatment. Nonpharmacologic open trial with 9 weeks of weekly assessment. University of Arizona Sleep Research Laboratory Twenty-three adolescents recently treated for substance abuse in outpatient community centers. Six-week integrative, behavioral sleep intervention. Weekly sleep-summary indexes were calculated from daily sleep diaries and entered as dependent variables in a series of growth-curve analyses. Statistically significant Session x Post-treatment Aggressive Ideation interactions emerged when predicting changes in total sleep time, gamma13 = 9.76 (SE = 4.12), p aggressive ideation and the frequency of substance use, as assessed at baseline. A similar pattern of results was seen for self-reported aggressive actions occurring during conflicts. These pilot data suggest that inadequate sleep in substance-abusing adolescents may contribute to the experiencing of aggressive thoughts and actions. Limitations include a small sample size and a restricted assessment of aggression. Nonetheless, these findings lend preliminary support to the breadth of therapeutic effectiveness of an integrative, behavioral sleep-therapy program for adolescents with a history of substance abuse and related behaviors.

  1. In Situ Remediation Integrated Program, Evaluation and assessment of containment technology

    International Nuclear Information System (INIS)

    Gerber, M.A.; Fayer, M.J.

    1994-04-01

    The In Situ Remediation Integrated Program (ISRIP) was established by the US Department of Energy (DOE) to advance the state-of-the art of innovative in situ remediation technologies to the point of demonstration and to broaden the applicability of these technologies to the widely varying site remediation requirements throughout the DOE complex. This program complements similar ongoing integrated demonstration programs being conducted at several DOE sites. The ISRIP has been conducting baseline assessments on in situ technologies to support program planning. Pacific Northwest Laboratory conducted an assessment and evaluation of subsurface containment barrier technology in support of ISRIP's Containment Technology Subprogram. This report summarizes the results of that activity and provides a recommendation for priortizing areas in which additional research and development is needed to advance the technology to the point of demonstration in support of DOE's site restoration activities

  2. Discrepancies between Patients' Preferences and Educational Programs on Oral Anticoagulant Therapy: A Survey in Community Pharmacies and Hospital Consultations.

    Directory of Open Access Journals (Sweden)

    Diane Macquart de Terline

    Full Text Available Oral anticoagulation therapy is increasingly used for the prevention and treatment of thromboembolic complications in various clinical situations. Nowadays, education programs for patients treated with anticoagulants constitute an integrated component of their management. However, such programs are usually based on the healthcare providers' perceptions of what patients should know, rather than on patients' preferences.To investigate patients' viewpoints on educational needs and preferred modalities of information delivery.We conducted an observational study based on a self-administered questionnaire. To explore several profiles of patients, the study was designed for enrolling patients in two settings: during outpatient consultations in a cardiology department (Saint Antoine Hospital, Paris, France and in community pharmacies throughout France.Of the 371 patients who completed the questionnaire, 187 (50.4% were recruited during an outpatient consultation and 184 (49.6% were recruited in community pharmacies. 84.1% of patients were receiving a vitamin K antagonist and 15.6% a direct oral anticoagulant. Patients ranked 16 of 21 (76.2% questionnaire items on information about their treatment as important or essential; information on adverse effects of treatment was the highest ranked domain (mean score 2.38, 95% CI 2.30-2.46. Pharmacists (1.69, 1.58-1.80, nurses (1.05, 0.95-1.16, and patient associations (0.36, 0.29-0.44, along with group sessions (0.85, 0.75-0.95, the internet (0.77, 0.67-0.88, and delivery of material at the patient's home (1.26, 1.14-1.38, were ranked poorly in terms of delivering educational material.This study revealed substantial discrepancies between patient preferences and current educational programs. These findings should be useful for tailoring future educational programs that are better adapted to patients, with a potential associated enhancement of their effectiveness.

  3. Development of the image registration program for portal and DRR images in radiation therapy

    International Nuclear Information System (INIS)

    Watanabe, Hiroyuki; Ito, Takeshi; Nakazeko, Kazuma; Tachibana, Atsuhi; Hashimoto, Takeyuki; Shinohara, Hiroyuki

    2012-01-01

    In this article, the authors propose an image registration program of portal images and digitally reconstructed radiography (DRR) images used as simulation images for external beam radiation therapy planning. First, the center of the radiation field in a portal image taken using a computed radiograhy cassette is matched to the center of the portal image. Then scale points projected on a DRR image and the portal image are deleted, and the portal image with the radiation field is extracted. Registration of the DRR and portal images is performed using mutual information as the registration criterion. It was found that the absolute displacement misregistrations in two directions (x, y) were 1.2±0.7 mm and 0.5±0.3 mm, respectively, and rotation disagreement about the z axis 0.3±0.3deg. It was concluded the proposed method was applicable to image registration of portal and DRR images in radiation therapy. (author)

  4. A program on quality assurance and dose calibration for radiation therapy units in Venezuela

    International Nuclear Information System (INIS)

    Padilla, M.C. de; Carrizales, L.; Diaz, J.; Gutt, F.; Cozman, A.

    1996-01-01

    The results of a five year program (1988-90-91-92-93) on quality assurance and dose calibration for 12 Cobalt-60 units from public hospitals, which represents 30% of total radiation therapy units in Venezuela, are presented. The remarkable improvement in the general performance of these units can be seen in the IAEA/WHO Postal TLD Intercomparison results which gave 100% within ± 5% in 1990 and 1992, while 63% in 1990 and 44% in 1992, with errors up to 37% were obtained for the participants not included in the program. The difference between the two groups lead the government to decrete through the Gaceta Oficial de la Republica de Venezuela, Resolution G-1397 on March 3, 1993, the quality assurance and dose calibration programs shall be established for all radiation therapy installations in Venezuela. The project for the standards was developed by the SSDL physicists and it was already approbated by the Health Ministry. It is expected that the Norms will enter into effect by the end of 1994. (author). 14 refs, 1 fig., 3 tabs

  5. A program on quality assurance and dose calibration for radiation therapy units in Venezuela

    Energy Technology Data Exchange (ETDEWEB)

    Padilla, M.C. de; Carrizales, L; Diaz, J; Gutt, F; Cozman, A [Instituto Venezolano de Investigaciones Cientificas, Caracas (Venezuela). Lab. de Calibracion Dosimetrica

    1996-08-01

    The results of a five year program (1988-90-91-92-93) on quality assurance and dose calibration for 12 Cobalt-60 units from public hospitals, which represents 30% of total radiation therapy units in Venezuela, are presented. The remarkable improvement in the general performance of these units can be seen in the IAEA/WHO Postal TLD Intercomparison results which gave 100% within {+-} 5% in 1990 and 1992, while 63% in 1990 and 44% in 1992, with errors up to 37% were obtained for the participants not included in the program. The difference between the two groups lead the government to decrete through the Gaceta Oficial de la Republica de Venezuela, Resolution G-1397 on March 3, 1993, the quality assurance and dose calibration programs shall be established for all radiation therapy installations in Venezuela. The project for the standards was developed by the SSDL physicists and it was already approbated by the Health Ministry. It is expected that the Norms will enter into effect by the end of 1994. (author). 14 refs, 1 fig., 3 tabs.

  6. Religiously Integrated Cognitive Behavioral Therapy: A New Method of Treatment for Major Depression in Patients With Chronic Medical Illness

    Science.gov (United States)

    Pearce, Michelle J.; Koenig, Harold G.; Robins, Clive J.; Nelson, Bruce; Shaw, Sally F.; Cohen, Harvey J.; King, Michael B.

    2015-01-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients’ spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive–behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  7. Integrating Corporate Social Responsability Programs into the Ethical Dimension of the Organization

    OpenAIRE

    Ibrian CARAMIDARU; Sabina IRIMIE

    2011-01-01

    The purpose of this paper is to indicate the need to integrate corporate social responsibility programs into the global ethical vision of organizations. Such an approach requires the definition of the corporation in relation to the moral values it assumes and the ways in which moral values occur within the organization. On this foundation, the authors examined the various implications that moral values have on the initiation and conduct of corporate social responsibility programs.

  8. Integrated ultrasound and magnetic resonance imaging for simultaneous temperature and cavitation monitoring during focused ultrasound therapies.

    Science.gov (United States)

    Arvanitis, Costas D; McDannold, Nathan

    2013-11-01

    Ultrasound can be used to noninvasively produce different bioeffects via viscous heating, acoustic cavitation, or their combination, and these effects can be exploited to develop a wide range of therapies for cancer and other disorders. In order to accurately localize and control these different effects, imaging methods are desired that can map both temperature changes and cavitation activity. To address these needs, the authors integrated an ultrasound imaging array into an MRI-guided focused ultrasound (MRgFUS) system to simultaneously visualize thermal and mechanical effects via passive acoustic mapping (PAM) and MR temperature imaging (MRTI), respectively. The system was tested with an MRgFUS system developed for transcranial sonication for brain tumor ablation in experiments with a tissue mimicking phantom and a phantom-filled ex vivo macaque skull. In experiments on cavitation-enhanced heating, 10 s continuous wave sonications were applied at increasing power levels (30-110 W) until broadband acoustic emissions (a signature for inertial cavitation) were evident. The presence or lack of signal in the PAM, as well as its magnitude and location, were compared to the focal heating in the MRTI. Additional experiments compared PAM with standard B-mode ultrasound imaging and tested the feasibility of the system to map cavitation activity produced during low-power (5 W) burst sonications in a channel filled with a microbubble ultrasound contrast agent. When inertial cavitation was evident, localized activity was present in PAM and a marked increase in heating was observed in MRTI. The location of the cavitation activity and heating agreed on average after registration of the two imaging modalities; the distance between the maximum cavitation activity and focal heating was -3.4 ± 2.1 mm and -0.1 ± 3.3 mm in the axial and transverse ultrasound array directions, respectively. Distortions and other MRI issues introduced small uncertainties in the PAM

  9. Analysis to develop a program for energy-integrated farm systems

    Energy Technology Data Exchange (ETDEWEB)

    Eakin, D.E.; Clark, M.A.; Inaba, L.K.; Johnson, K.I.

    1981-09-01

    A program to use renewable energy resources and possibly develop decentralization of energy systems for agriculture is discussed. The purpose of the research presented is to establish the objective of the program and identify guidelines for program development. The program's objective is determined by: (1) an analysis of the technologies that could be utilized to transform renewable farm resources to energy by the year 2000, (2) the quantity of renewable farm resources that are available, and (3) current energy-use patterns. Individual research, development, and demonstration projects are fit into a national program of energy-integrated farm systems on the basis of: (1) market need, (2) conversion potential, (3) technological opportunities, and (4) acceptability. Quantification of these factors for the purpose of establishing program guidelines is conducted using the following four precepts: (1) market need is identified by current use of energy for agricultural production; (2) conversion potential is determined by the availability of renewable resources; and (3) technological opportunities are determined by the state-of-the-art methods, techniques, and processes that can convert renewable resources into farm energy. Each of these factors is analyzed in Chapters 2 to 4. Chapter 5 draws on the analysis of these factors to establish the objective of the program and identify guidelines for the distribution of program funds. Chapter 6 then discusses the acceptability of integrated farm systems, which can not be quantified like the other factors.

  10. Working together – integration of information literacy in educational programs at Blekinge Institute of Technology

    Directory of Open Access Journals (Sweden)

    Jenny Gunnarsson

    2013-12-01

    • The library can, together with the Schools, create and offer IL modules adapted to the educational programs Today IL education at BTH is quite extensive, but also irregular and highly dependent on contacts with individual teachers, which makes IL education vulnerable. In order to bring this problem to light, and inspired by the Borås model (presented at Creating knowledge VI, as well as Sydostmodellen, the library at BTH contacted the Board of Education during the winter of 2012, and presented a plan on how the library and Schools at BTH could cooperate in order to integrate IL education within all educational programs. Suggestions regarding content, extent, progression, timing, assessment and learning outcomes of the IL education are the focal point of the presented plan. As the first result of the proposal, the library has been commissioned by the BTH Quality Assurance Council to review the situation regarding IL education at BTH together with the educational program directors. In cooperation with the programs, the library should also make a plan for each program on how to integrate IL education as a part of generic skills. At the conference, the following themes were addressed and discussed during our presentation: sustainability of IL education, collaboration within the academy regarding IL education and how integration of IL education at university educational programs is reflected in research on IL in general.

  11. Dosimetric evaluation of simultaneous integrated boost during stereotactic body radiation therapy for pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Wensha, E-mail: wensha.yang@cshs.org [Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA (United States); Reznik, Robert; Fraass, Benedick A. [Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA (United States); Nissen, Nicholas [Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA (United States); Hendifar, Andrew [Department of Gastrointestinal Oncology, Cedars Sinai Medical Center, Los Angeles, CA (United States); Wachsman, Ashley [Department of Cross-Sectional Imaging Interventional Oncology, Cedars Sinai Medical Center, Los Angeles, CA (United States); Sandler, Howard; Tuli, Richard [Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA (United States)

    2015-04-01

    Stereotactic body radiation therapy (SBRT) provides a promising way to treat locally advanced pancreatic cancer and borderline resectable pancreatic cancer. A simultaneous integrated boost (SIB) to the region of vessel abutment or encasement during SBRT has the potential to downstage otherwise likely positive surgical margins. Despite the potential benefit of using SIB-SBRT, the ability to boost is limited by the local geometry of the organs at risk (OARs), such as stomach, duodenum, and bowel (SDB), relative to tumor. In this study, we have retrospectively replanned 20 patients with 25 Gy prescribed to the planning target volume (PTV) and 33~80 Gy to the boost target volume (BTV) using an SIB technique for all patients. The number of plans and patients able to satisfy a set of clinically established constraints is analyzed. The ability to boost vessels (within the gross target volume [GTV]) is shown to correlate with the overlap volume (OLV), defined to be the overlap between the GTV + a 1(OLV1)- or 2(OLV2)-cm margin with the union of SDB. Integral dose, boost dose contrast (BDC), biologically effective BDC, tumor control probability for BTV, and normal tissue complication probabilities are used to analyze the dosimetric results. More than 65% of the cases can deliver a boost to 40 Gy while satisfying all OAR constraints. An OLV2 of 100 cm{sup 3} is identified as the cutoff volume: for cases with OLV2 larger than 100 cm{sup 3}, it is very unlikely the case could achieve 25 Gy to the PTV while successfully meeting all the OAR constraints.

  12. The Stoplight Program: A Proactive Physical Therapy Intervention for Children With Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Tanner, Lynn; Sencer, Susan; Hooke, Mary C

    Chemotherapy may cause neuromuscular impairments that can have life-long effects. The Stoplight Program (SLP) was developed as a proactive physical therapy (PT) intervention directed at impairments in children with acute lymphoblastic leukemia (ALL). In this program evaluation, we assessed the feasibility of the SLP delivered as part of standard care and identified body function and activity patterns in patients who received the intervention. Children ages 1 to 22 years, diagnosed with ALL, received an assessment by a physical therapist as part of usual care. The SLP intervention used 3 levels to categorize the impairment levels and intensity of PT. Of the children (n = 135) screened, 46% completed 5 intervention visits and 32% completed the program and met discharge criteria. At initial assessment, 46% of children ages 1 to 5 years and 67% of children ages 6 to 22 years had abnormal motor function. Those completing the program tested within the healthy norms. Research is needed on variables that influence adherence to a PT program and the range of functional impairment and activity limitations in this population.

  13. Model for implementing cognitive behavioural therapy for smartphone app based smoking cessation program

    Directory of Open Access Journals (Sweden)

    Abdullah Alsharif

    2015-11-01

    Full Text Available Smoking cessation programs are widely implemented to assist smokers in the process of quitting smoking. Cognitive Behavioural Therapy (CBT is a psychological approach that is increasingly used in smoking cessation programs. CBT has also been implemented for smoking cessation programs and has been successful in helping smokers to quit. Another advantage of CBT is that it can be combined with different tools and technologies and hence made to deliver effective health intervention programs. The recent advancements in smartphone technologies have been widely explored to develop smoking cessation apps as tools to assist with quitting smoking. However, most existing smartphone apps lack follow-up and adherence to clinical guidelines for treatment. To date, there are no studies which have explored implementing CBT modules into smoking cessation apps. Therefore, there is a need for implementing behavioural change mechanisms in smoking cessation apps to help smokers quit effectively. In this study, we propose a new approach that combines mobile health technology and CBT methods to provide an effective smoking cessation program. The ubiquitous presence of smartphones and the various communication benefits they provide are utilized by our proposed system to provide a CBT paradigm into smoking cessation app systems and hence enhance their success potential. Currently, the proposed system is at the implementation stage, which is soon to be followed by a clinical trial to study the impact of this system on smoking cessation.

  14. Cultivations...and potting on a strategic plan for a social and horticultural therapy program.

    Science.gov (United States)

    Smilski, Andrea

    2008-01-01

    This research endeavored to develop a strategic growth plan for St. Ann's Garden Club (SAGC), a Non-Profit Social and Horticultural Therapy program, located at Providence Farm in Duncan, British Columbia. SAGC is a day program for older adults with mental illness and/or drug/alcohol addiction. The aim of the program is to be sustainable within the context of stakeholders needs, preferences, and resources and therefore they sought a strategic analysis prior to launching a growth strategy. SAGC has valuable intangible resources that contribute to strong core competencies and effectiveness despite facing many program issues requiring change in order for them to be sustainable. These same issues are shared by many public and non-profit health and wellness programs as they struggle to remain relevant in today's changing healthscape. To adequately focus the study and provide sound direction, the strategic analysis highlighted SAGC's environment, opportunities, issues, priorities, and requirements and was conducted through multiple iterations of the action research cycle. Data was gathered using surveys, interviews, and a focus group. The findings supported a capital campaign to build as new larger clubhouse and establish a more diverse sustainable funding base. Using a resource based perspective, a three year strategic plan was formulated for SAGC to help them cultivate growth and sustainability.

  15. Integrated cancer therapy combined radiotherapy and immunotherapy. The challenge of using Gc protein-derived macrophage activating factor (GcMAF) as a key molecule

    International Nuclear Information System (INIS)

    Uto, Yoshihiro; Hori, Hitoshi

    2013-01-01

    Radiation oncologists know the conflict between radiotherapy and immunotherapy, but now challenged trails of the integrative cancer therapies combined radiation therapy and various immunoreaction/immune therapies begin. We therefore review the recent results of basic research and clinical trial of the integrated cancer therapies which combined radiotherapy and various immune therapies/immunoreaction, and the challenged studies of combined use of radiotherapy and our developed cancer immunotherapy using serum GcMAF which is human serum containing Gc protein-derived macrophage activating factor (GcMAF). (author)

  16. Introduction of Vertical Integration and Case-Based Learning in Anatomy for Undergraduate Physical Therapy and Occupational Therapy Students

    Science.gov (United States)

    Parmar, Suresh K.; Rathinam, Bertha A. D.

    2011-01-01

    The purpose of the present pilot study was to evaluate the benefits of innovative teaching methodologies introduced to final year occupational and physical therapy students in Christian Medical College in India. Students' satisfactions along the long-term retention of knowledge and clinical application of the respiratory anatomy have been…

  17. Integrated safety assessment report, Haddam Neck Plant (Docket No. 50-213): Integrated Safety Assessment Program: Draft report

    International Nuclear Information System (INIS)

    1987-07-01

    The integrated assessment is conducted on a plant-specific basis to evaluate all licensing actions, licensee initiated plant improvements and selected unresolved generic/safety issues to establish implementation schedules for each item. Procedures allow for a periodic updating of the schedules to account for licensing issues that arise in the future. The Haddam Neck Plant is one of two plants being reviewed under the pilot program. This report indicates how 82 topics selected for review were addressed, and presents the staff's recommendations regarding the corrective actions to resolve the 82 topics and other actions to enhance plant safety. 135 refs., 4 figs., 5 tabs

  18. Immunological indices of blood and interstitial fluid in estimation of a program of therapy of upper limb secondary edemas

    International Nuclear Information System (INIS)

    Kuz'mina, E.G.; Degtyareva, A.A.; Doroshenko, L.N.; Rogova, N.M.; Zorina, L.N.

    1990-01-01

    The efficacy of therapy of upper limb secondary edemas after 4 programs was compared among 83 patients. The methods were as follows: traditional method (TM) including routine conservative therapy, acupuncture (AP), He-Ne laser OKG-13 and semiconductor laser against a background of traditional therapy. A study was made of the time course of the extent of edema, total protein, IG, G, A and M and circulating immune complexes (CIC) during therapy of such patients. Blood serum and interstitial fluid indices were compared. It was shown that the application of both lasers led to increasing efficacy of TM and AP

  19. Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

    Science.gov (United States)

    Stefano, George B; Esch, Tobias

    2005-10-01

    Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

  20. Integrated Behavior Therapy for Selective Mutism: a randomized controlled pilot study.

    Science.gov (United States)

    Bergman, R Lindsey; Gonzalez, Araceli; Piacentini, John; Keller, Melody L

    2013-10-01

    To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech. A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains. Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up. IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers. Copyright © 2013 Elsevier Ltd. All rights reserved.