Online solving of economic dispatch problem using neural network approach and comparing it with classical method

International Nuclear Information System (INIS)

Mohammadi, A.; Varahram, M.H.

2007-01-01

In this study, two methods for solving economic dispatch problems, namely Hopfield neural network and lambda iteration method are compared. Three sample of power system with 3, 6 and 20 units have been considered. The time required for CPU, for solving economic dispatch of these two systems has been calculated. It has been Shown that for on-line economic dispatch, Hopfield neural network is more efficient and the time required for Convergence is considerably smaller compared to classical methods. (author)

Reading aloud and solving simple arithmetic calculation intervention (Learning therapy improves inhibition, verbal episodic memory, focus attention, and processing speed in healthy elderly people: Evidence from a randomized controlled trial

Directory of Open Access Journals (Sweden)

Rui eNouchi

2016-05-01

Full Text Available BackgroundPrevious reports have described that simple cognitive training using reading aloud and solving simple arithmetic calculations, so-called learning therapy, can improve executive functions and processing speed in the older adults. Nevertheless, it is not well-known whether learning therapy improve a wide range of cognitive functions or not. We investigated the beneficial effects of learning therapy on various cognitive functions in healthy older adults.MethodsWe used a single-blinded intervention with two groups (learning therapy group: LT and waiting list control group: WL. Sixty-four elderly were randomly assigned to LT or WL. In LT, participants performed reading Japanese aloud and solving simple calculations training tasks for 6 months. WL did not participate in the intervention. We measured several cognitive functions before and after 6 months intervention periods.ResultsCompared to WL, results revealed that LT improved inhibition performance in executive functions (Stroop: LT (Mean = 3.88 vs. WL (Mean = 1.22, adjusted p =.013 and reverse Stroop LT (Mean = 3.22 vs. WL (Mean = 1.59, adjusted p =.015, verbal episodic memory (logical memory: LT (Mean = 4.59 vs. WL (Mean = 2.47, adjusted p =.015, focus attention(D-CAT: LT (Mean = 2.09 vs. WL (Mean = -0.59, adjusted p =.010 and processing speed compared to the waiting list control group (digit symbol coding: LT (Mean = 5.00 vs. WL (Mean = 1.13, adjusted p =.015 and symbol search: LT (Mean = 3.47 vs. WL (Mean = 1.81, adjusted p =.014.DiscussionThis RCT can showed the benefit of learning therapy on inhibition of executive functions, verbal episodic memory, focus attention, and processing speed in healthy elderly people. Our results were discussed under overlapping hypothesis.Trial registrationThis trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000006998.

Manual therapy compared with physical therapy in patients with non-specific neck pain : A randomized controlled trial

NARCIS (Netherlands)

Groeneweg, Ruud; van Assen, Luite; Kropman, Hans; Leopold, Huco; Mulder, Jan; Smits-Engelsman, Bouwien C.M.; Ostelo, Raymond W.J.G.; Oostendorp, R.A.B.; van Tulder, Maurits W.

2017-01-01

Background: Manual therapy according to the School of Manual Therapy Utrecht (MTU) is a specific type of passive manual joint mobilization. MTU has not yet been systematically compared to other manual therapies and physical therapy. In this study the effectiveness of MTU is compared to physical

Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life: Randomized Controlled Trial.

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Visser, Marieke M; Heijenbrok-Kal, Majanka H; Van't Spijker, Adriaan; Lannoo, Engelien; Busschbach, Jan J V; Ribbers, Gerard M

2016-01-01

This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke. In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale. Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90-10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months. PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509. © 2015 American Heart Association, Inc.

Comparative Risk Predictions of Second Cancers After Carbon-Ion Therapy Versus Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Eley, John G., E-mail: jeley@som.umaryland.edu [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); University of Texas Graduate School of Biomedical Sciences, Houston, Texas (United States); Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Friedrich, Thomas [GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt (Germany); Homann, Kenneth L.; Howell, Rebecca M. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); University of Texas Graduate School of Biomedical Sciences, Houston, Texas (United States); Scholz, Michael; Durante, Marco [GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt (Germany); Newhauser, Wayne D. [Department of Physics and Astronomy, Louisiana State University and Agricultural and Mechanical College, Baton Rouge, Louisiana (United States); Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana (United States)

2016-05-01

Purpose: This work proposes a theoretical framework that enables comparative risk predictions for second cancer incidence after particle beam therapy for different ion species for individual patients, accounting for differences in relative biological effectiveness (RBE) for the competing processes of tumor initiation and cell inactivation. Our working hypothesis was that use of carbon-ion therapy instead of proton therapy would show a difference in the predicted risk of second cancer incidence in the breast for a sample of Hodgkin lymphoma (HL) patients. Methods and Materials: We generated biologic treatment plans and calculated relative predicted risks of second cancer in the breast by using two proposed methods: a full model derived from the linear quadratic model and a simpler linear-no-threshold model. Results: For our reference calculation, we found the predicted risk of breast cancer incidence for carbon-ion plans-to-proton plan ratio, , to be 0.75 ± 0.07 but not significantly smaller than 1 (P=.180). Conclusions: Our findings suggest that second cancer risks are, on average, comparable between proton therapy and carbon-ion therapy.

Assessment of Cognitive Behavioral Therapy on Quality of Life of Patients with Chronic War-related Post-traumatic Stress Disorder.

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Ahmadizadeh, Mohammadjavad; Ahmadi, Khodabakhsh; Anisi, Jafar; Ahmadi, Amir Bahrami

2013-10-01

Post-traumatic stress disorder (PTSD) is the one of the most commonly observed psychiatric disorder in veterans. The condition can lead to considerable social, occupational, and interpersonal dysfunction. PTSD occurring after combat injury appears to be strongly correlated with the extent of injury, and develops over several months. Present study was designed for assessing the cognitive behavioral therapy in the quality of life (QOL) of war-related PTSD in veterans compared to control group and compare applied treatments with each other. In the present study, we assessment effects of cognitive behavioral therapy such as problem solving, exposure therapy and their combination on QOL in 120 Iranian PTSD patients veterans after Iran-Iraq war. They were randomly allocated to one of four equal interventional groups: (a) Problem solving therapy (b) exposure therapy (c) combined therapy (exposure therapy plus problem solving) (d) control group. Before and after study intervention, patients were evaluated by short form-36 (SF-36) questionnaire. Post-test and follow-up SF-36 scores were 55.6±4 and 55.1±3.6 in exposure therapy, 50±4.4 and 56.1±3.8 in problem solving, and 48.73±3.8 and 50.9±4.2 in combined therapy. In comparing to control group, all intervention showed significant improvement in QOL in PTSD patients. According to the results of the present study, behavioral therapy can improve QOL in PTSD patients.

Psychoeducation with problem-solving (PEPS) therapy for adults with personality disorder: a pragmatic randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of a manualised intervention to improve social functioning.

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McMurran, Mary; Crawford, Mike J; Reilly, Joe; Delport, Juan; McCrone, Paul; Whitham, Diane; Tan, Wei; Duggan, Conor; Montgomery, Alan A; Williams, Hywel C; Adams, Clive E; Jin, Huajie; Lewis, Matthew; Day, Florence

2016-07-01

If effective, less intensive treatments for people with personality disorder have the potential to serve more people. To compare the clinical effectiveness and cost-effectiveness of psychoeducation with problem-solving (PEPS) therapy plus usual treatment against usual treatment alone in improving social problem-solving with adults with personality disorder. Multisite two-arm, parallel-group, pragmatic randomised controlled superiority trial. Community mental health services in three NHS trusts in England and Wales. Community-dwelling adults with any personality disorder recruited from community mental health services. Up to four individual sessions of psychoeducation, a collaborative dialogue about personality disorder, followed by 12 group sessions of problem-solving therapy to help participants learn a process for solving interpersonal problems. The primary outcome was measured by the Social Functioning Questionnaire (SFQ). Secondary outcomes were service use (general practitioner records), mood (measured via the Hospital Anxiety and Depression Scale) and client-specified three main problems rated by severity. We studied the mechanism of change using the Social Problem-Solving Inventory. Costs were identified using the Client Service Receipt Inventory and quality of life was identified by the European Quality of Life-5 Dimensions questionnaire. Research assistants blinded to treatment allocation collected follow-up information. There were 739 people referred for the trial and 444 were eligible. More adverse events in the PEPS arm led to a halt to recruitment after 306 people were randomised (90% of planned sample size); 154 participants received PEPS and 152 received usual treatment. The mean age was 38 years and 67% were women. Follow-up at 72 weeks after randomisation was completed for 62% of participants in the usual-treatment arm and 73% in the PEPS arm. Intention-to-treat analyses compared individuals as randomised, regardless of treatment received or

Effects of Worked Examples, Example-Problem Pairs, and Problem-Example Pairs Compared to Problem Solving

NARCIS (Netherlands)

Van Gog, Tamara; Kester, Liesbeth; Paas, Fred

2010-01-01

Van Gog, T., Kester, L., & Paas, F. (2010, August). Effects of worked examples, example-problem pairs, and problem-example pairs compared to problem solving. Paper presented at the Biannual EARLI SIG meeting of Instructional design and Learning and instruction with computers, Ulm, Germany.

Photodynamic Therapy Plus Chemotherapy Compared with Photodynamic Therapy Alone in Hilar Nonresectable Cholangiocarcinoma.

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Wentrup, Robert; Winkelmann, Nicola; Mitroshkin, Andrey; Prager, Matthias; Voderholzer, Winfried; Schachschal, Guido; Jürgensen, Christian; Büning, Carsten

2016-05-23

Standard treatments are not available for hilar nonresectable cholangiocarcinoma (NCC). It is unknown whether combination therapy of photodynamic therapy (PDT) plus systemic chemotherapy is superior to PDT alone. We retrospectively reviewed 68 patients with hilar NCC treated with either PDT plus chemotherapy (PTD-C) or PDT monotherapy (PDT-M). The primary endpoint was the mean overall survival rate. Secondary endpoints included the 1-year survival rate, risk of cholangitic complications, and outcomes, which were evaluated according to the chemotherapy protocol. More than 90% of the study population had advanced hilar NCC Bismuth type III or IV. In the PDT-M group (n=35), the mean survival time was 374 days compared with 520 days in the PDT-C group (n=33, p=0.021). The 1-year survival rate was significantly higher in the PDT-C group compared with the PDT-M group (88% vs 58%, p=0.001) with a significant reduction of mortality (hazard ratio, 0.20; 95% confidence interval, 0.07 to 0.58; p=0.003). Gemcitabine monotherapy resulted in a shorter survival time compared with the gemcitabine combination therapy (mean, 395 days vs 566 days; p=0.09). Cholangitic complications were observed at a similar frequency in the PDT-C and PDT-M groups. Combining repeated PDT with a gemcitabine-based combination therapy might offer a significant survival benefit in patients with hilar NCC.

Social problem solving among depressed adolescents is enhanced by structured psychotherapies

Science.gov (United States)

Dietz, Laura J.; Marshal, Michael P.; Burton, Chad M.; Bridge, Jeffrey A.; Birmaher, Boris; Kolko, David; Duffy, Jamira N.; Brent, David A.

2014-01-01

Objective Changes in adolescent interpersonal behavior before and after an acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescents’ interpersonal behavior. Method Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% Caucasian) engaged in videotaped interactions with their mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST), and after 12–16 weeks of treatment. Adolescent involvement, problem solving and dyadic conflict were examined. Results Improvements in adolescent problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on adolescents’ problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive symptoms. Improvements in adolescents’ problem solving were associated with higher rates of remission across treatment conditions, but there were no significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low. Conclusions Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and suggest one Pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT. PMID:24491077

A Comparative Study of Three Different Mathematical Methods for Solving the Unit Commitment Problem

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Mehmet Kurban

2009-01-01

Full Text Available The unit commitment (UC problem which is an important subject in power system engineering is solved by using Lagragian relaxation (LR, penalty function (PF, and augmented Lagrangian penalty function (ALPF methods due to their higher solution quality and faster computational time than metaheuristic approaches. This problem is considered to be a nonlinear programming-(NP- hard problem because it is nonlinear, mixed-integer, and nonconvex. These three methods used for solving the problem are based on dual optimization techniques. ALPF method which combines the algorithmic aspects of both LR and PF methods is firstly used for solving the UC problem. These methods are compared to each other based on feasible schedule for each stage, feasible cost, dual cost, duality gap, duration time, and number of iterations. The numerical results show that the ALPF method gives the best duality gap, feasible and dual cost instead of worse duration time and the number of iterations. The four-unit Tuncbilek thermal plant which is located in Kutahya region in Turkey is chosen as a test system in this study. The programs used for all the analyses are coded and implemented using general algebraic modeling system (GAMS.

Comparing genetic algorithm and particle swarm optimization for solving capacitated vehicle routing problem

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Iswari, T.; Asih, A. M. S.

2018-04-01

In the logistics system, transportation plays an important role to connect every element in the supply chain, but it can produces the greatest cost. Therefore, it is important to make the transportation costs as minimum as possible. Reducing the transportation cost can be done in several ways. One of the ways to minimizing the transportation cost is by optimizing the routing of its vehicles. It refers to Vehicle Routing Problem (VRP). The most common type of VRP is Capacitated Vehicle Routing Problem (CVRP). In CVRP, the vehicles have their own capacity and the total demands from the customer should not exceed the capacity of the vehicle. CVRP belongs to the class of NP-hard problems. These NP-hard problems make it more complex to solve such that exact algorithms become highly time-consuming with the increases in problem sizes. Thus, for large-scale problem instances, as typically found in industrial applications, finding an optimal solution is not practicable. Therefore, this paper uses two kinds of metaheuristics approach to solving CVRP. Those are Genetic Algorithm and Particle Swarm Optimization. This paper compares the results of both algorithms and see the performance of each algorithm. The results show that both algorithms perform well in solving CVRP but still needs to be improved. From algorithm testing and numerical example, Genetic Algorithm yields a better solution than Particle Swarm Optimization in total distance travelled.

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

NARCIS (Netherlands)

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

2011-01-01

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

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

NARCIS (Netherlands)

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

2011-01-01

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

Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

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... to Surgery for Many Patients Spotlight on Research Physical Therapy to Treat Torn Meniscus Comparable to Surgery ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded ...

Solving Differential Equations in R: Package deSolve

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Karline Soetaert

2010-02-01

Full Text Available In this paper we present the R package deSolve to solve initial value problems (IVP written as ordinary differential equations (ODE, differential algebraic equations (DAE of index 0 or 1 and partial differential equations (PDE, the latter solved using the method of lines approach. The differential equations can be represented in R code or as compiled code. In the latter case, R is used as a tool to trigger the integration and post-process the results, which facilitates model development and application, whilst the compiled code significantly increases simulation speed. The methods implemented are efficient, robust, and well documented public-domain Fortran routines. They include four integrators from the ODEPACK package (LSODE, LSODES, LSODA, LSODAR, DVODE and DASPK2.0. In addition, a suite of Runge-Kutta integrators and special-purpose solvers to efficiently integrate 1-, 2- and 3-dimensional partial differential equations are available. The routines solve both stiff and non-stiff systems, and include many options, e.g., to deal in an efficient way with the sparsity of the Jacobian matrix, or finding the root of equations. In this article, our objectives are threefold: (1 to demonstrate the potential of using R for dynamic modeling, (2 to highlight typical uses of the different methods implemented and (3 to compare the performance of models specified in R code and in compiled code for a number of test cases. These comparisons demonstrate that, if the use of loops is avoided, R code can efficiently integrate problems comprising several thousands of state variables. Nevertheless, the same problem may be solved from 2 to more than 50 times faster by using compiled code compared to an implementation using only R code. Still, amongst the benefits of R are a more flexible and interactive implementation, better readability of the code, and access to R’s high-level procedures. deSolve is the successor of package odesolve which will be deprecated in

Comparability of Conflict Opportunities in Human-to-Human and Human-to-Agent Online Collaborative Problem Solving

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Rosen, Yigal

2014-01-01

Students' performance in human-to-human and human-to-agent collaborative problem solving assessment task is investigated in this paper. A secondary data analysis of the research reported by Rosen and Tager (2013) was conducted in order to investigate the comparability of the opportunities for conflict situations in human-to-human and…

Effects of Problem-Solving Therapy and Clinical Case Management on Disability in Low-Income Older Adults.

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Areán, Patricia A; Raue, Patrick J; McCulloch, Charles; Kanellopoulos, Dora; Seirup, Joanna K; Banerjee, Samprit; Kiosses, Dimitris N; Dwyer, Eleanor; Alexopoulos, George S

2015-12-01

To test the following hypotheses: (1) Clinical case management integrated with problem-solving therapy (CM-PST) is more effective than clinical case management alone (CM) in improving functional outcomes in disabled, impoverished patients and (2) improvement in depression, self-efficacy, and problem-solving skills mediates improvement of disability. Using a randomized controlled trial with a parallel design, 271 individuals were screened and 171 were randomized to 12 weekly sessions of either CM or CM-PST at 1:1 ratio. Raters were blind to patients' assignments. Participants were at least age 60 years with major depression, had at least one disability, were eligible for home-based meals services, and had income no more than 30% of their counties' median. The WHO Disability Assessment Scale was used. Both interventions resulted in improved functioning by 12 weeks (t = 4.28, df = 554, p = 0.001), which was maintained until 24 weeks. Contrary to hypothesis, CM was noninferior to CM-PST (one-sided p = 0.0003, t = -3.5, df = 558). Change in disability was not affected by baseline depression severity, cognitive function, or number of unmet social service needs. Improvements in self efficacy (t = -2.45, df = 672, p = 0.021), problem-solving skill (t = -2.44, df = 546, p = 0.015), and depression symptoms (t = 2.25, df = 672, p = .025) by week 9 predicted improvement in function across groups by week 12. CM is noninferior to CM-PST for late-life depression in low-income populations. The effect of these interventions occur early, with benefits in functional status maintained as long as 24 weeks after treatment initiation (clinicaltrials.gov; NCT00540865). Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

The effectiveness of problem solving therapy in deprived South African communities: results from a pilot study

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Marks Isaac

2011-09-01

Full Text Available Abstract Background The majority of South Africans with a DSM-IV diagnosis receive no treatment for their mental health problems. There is a move to simplify treatment for common mental disorders (CMDs in order to ease access. Brief problem solving therapy (PST might fill the treatment gap for CMD's in deprived communities in South Africa. This pilot study evaluates the feasibility, acceptability and effectiveness of this PST program for CMD's in deprived communities around Cape Town. Methods A Dutch problem solving program was adapted and translated into English, Xhosa and Afrikaans and thereafter implemented in townships around Cape Town. An initial attempt to recruit participants for online PST proved difficult, and so the program was adapted to a booklet format. Volunteers experiencing psychological distress were invited to participate in the either individually or group delivered 5-week during self-help program. To evaluate the effectiveness, psychological distress was administered through self-report questionnaires. After completion of the intervention participants also rated the program on various acceptability aspects. Results Of 103 participants, 73 completed 5 weeks of brief PST in a booklet/workshop format. There were significantly more dropouts in those who used the booklet individually than in the group. Psychological distress measured on the K-10 and SRQ fell significantly and the program was evaluated positively. Conclusions The results suggest that brief problem solving in a booklet/workshop format may be an effective, feasible and acceptable short-term treatment for people with CMD's in deprived communities. In this setting, group delivery of PST had lower drop-out rates than individual delivery, and was more feasible and acceptable. Randomized controlled trials are needed to evaluate the effect of brief self-help PST more rigorously.

Comparative study of heuristics algorithms in solving flexible job shop scheduling problem with condition based maintenance

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Yahong Zheng

2014-05-01

Full Text Available Purpose: This paper focuses on a classic optimization problem in operations research, the flexible job shop scheduling problem (FJSP, to discuss the method to deal with uncertainty in a manufacturing system.Design/methodology/approach: In this paper, condition based maintenance (CBM, a kind of preventive maintenance, is suggested to reduce unavailability of machines. Different to the simultaneous scheduling algorithm (SSA used in the previous article (Neale & Cameron,1979, an inserting algorithm (IA is applied, in which firstly a pre-schedule is obtained through heuristic algorithm and then maintenance tasks are inserted into the pre-schedule scheme.Findings: It is encouraging that a new better solution for an instance in benchmark of FJSP is obtained in this research. Moreover, factually SSA used in literature for solving normal FJSPPM (FJSP with PM is not suitable for the dynamic FJSPPM. Through application in the benchmark of normal FJSPPM, it is found that although IA obtains inferior results compared to SSA used in literature, it performs much better in executing speed.Originality/value: Different to traditional scheduling of FJSP, uncertainty of machines is taken into account, which increases the complexity of the problem. An inserting algorithm (IA is proposed to solve the dynamic scheduling problem. It is stated that the quality of the final result depends much on the quality of the pre-schedule obtained during the procedure of solving a normal FJSP. In order to find the best solution of FJSP, a comparative study of three heuristics is carried out, the integrated GA, ACO and ABC. In the comparative study, we find that GA performs best in the three heuristic algorithms. Meanwhile, a new better solution for an instance in benchmark of FJSP is obtained in this research.

Group therapy compared with individual desensitization for dental anxiety

DEFF Research Database (Denmark)

Moore, R.; Brødsgaard, I.

1994-01-01

Results of group therapy (GT) for extreme dental anxiety were compared with individual treatment (IT). Scales used measured dental anxiety, beliefs or trust in dentists, and fear of the next dentist after specialist treatment which showed reduced dental anxiety and improved dental beliefs compared...... with a static control group of 45 patients. The 30 GT patients showed no significant difference in dropouts during training compared with the 68 IT patients, but for patients who completed treatment, GT (n = 24) had greater dental anxiety reduction than IT subjects (n = 60). GT patients required fewer therapist...... hours per patients than did either of the two IT methods, but time saved in GT did not reach significance over clinical rehearsal IT. Results at 1- yr follow-up after specialist treatment indicated that dropouts were significantly greater in group therapy. Rehearsal IT performed best for sustained...

Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial.

Science.gov (United States)

Groeneweg, Ruud; van Assen, Luite; Kropman, Hans; Leopold, Huco; Mulder, Jan; Smits-Engelsman, Bouwien C M; Ostelo, Raymond W J G; Oostendorp, Rob A B; van Tulder, Maurits W

2017-01-01

Manual therapy according to the School of Manual Therapy Utrecht (MTU) is a specific type of passive manual joint mobilization. MTU has not yet been systematically compared to other manual therapies and physical therapy. In this study the effectiveness of MTU is compared to physical therapy, particularly active exercise therapy (PT) in patients with non-specific neck pain. Patients neck pain, aged between 18-70 years, were included in a pragmatic randomized controlled trial with a one-year follow-up. Primary outcome measures were global perceived effect and functioning (Neck Disability Index), the secondary outcome was pain intensity (Numeric Rating Scale for Pain). Outcomes were measured at 3, 7, 13, 26 and 52 weeks. Multilevel analyses (intention-to-treat) were the primary analyses for overall between-group differences. Additional to the primary and secondary outcomes the number of treatment sessions of the MTU group and PT group was analyzed. Data were collected from September 2008 to February 2011. A total of 181 patients were included. Multilevel analyses showed no statistically significant overall differences at one year between the MTU and PT groups on any of the primary and secondary outcomes. The MTU group showed significantly lower treatment sessions compared to the PT group (respectively 3.1 vs. 5.9 after 7 weeks; 6.1 vs. 10.0 after 52 weeks). Patients with neck pain improved in both groups without statistical significantly or clinically relevant differences between the MTU and PT groups during one-year follow-up. ClinicalTrials.gov Identifier: NCT00713843.

Tangram solved? Prefrontal cortex activation analysis during geometric problem solving.

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Ayaz, Hasan; Shewokis, Patricia A; Izzetoğlu, Meltem; Çakır, Murat P; Onaral, Banu

2012-01-01

Recent neuroimaging studies have implicated prefrontal and parietal cortices for mathematical problem solving. Mental arithmetic tasks have been used extensively to study neural correlates of mathematical reasoning. In the present study we used geometric problem sets (tangram tasks) that require executive planning and visuospatial reasoning without any linguistic representation interference. We used portable optical brain imaging (functional near infrared spectroscopy--fNIR) to monitor hemodynamic changes within anterior prefrontal cortex during tangram tasks. Twelve healthy subjects were asked to solve a series of computerized tangram puzzles and control tasks that required same geometric shape manipulation without problem solving. Total hemoglobin (HbT) concentration changes indicated a significant increase during tangram problem solving in the right hemisphere. Moreover, HbT changes during failed trials (when no solution found) were significantly higher compared to successful trials. These preliminary results suggest that fNIR can be used to assess cortical activation changes induced by geometric problem solving. Since fNIR is safe, wearable and can be used in ecologically valid environments such as classrooms, this neuroimaging tool may help to improve and optimize learning in educational settings.

In defense of shock therapy: Post-socialist transition of the Czech Republic

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Scott A. Beaulier

2012-06-01

Full Text Available Popov (2007, 2000, Kolodko (2000, and Stiglitz (1999 argue that a shock therapy approach has a negative effect on post-socialist transition. Their benchmark for shock therapy, however, refers to the debate on the speed of market reforms. We propose that a more meaningful benchmark is the experience of the Czech Republic, Russia, and other transition economies which share similar approach to the market reforms, but have solved political economy problems of credibility and commitment differently. We compare the Czech Republic’s economic, political, and social performance to these benchmarks in all other post-socialist countries since they began their transitions. We find that the Czech transition is a consistent success because the Havel shock therapy has solved the political economy problems of reform’s credibility and state’s commitment to reform.

Dysphagia management: an analysis of patient outcomes using VitalStim therapy compared to traditional swallow therapy.

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Kiger, Mary; Brown, Catherine S; Watkins, Lynn

2006-10-01

This study compares the outcomes using VitalStim therapy to outcomes using traditional swallowing therapy for deglutition disorders. Twenty-two patients had an initial and a followup videofluoroscopic swallowing study or fiberoptic endoscopic evaluation of swallowing and were divided into an experimental group that received VitalStim treatments and a control group that received traditional swallowing therapy. Outcomes were analyzed for changes in oral and pharyngeal phase dysphagia severity, dietary consistency restrictions, and progression from nonoral to oral intake. Results of chi(2) analysis showed no statistically significant difference in outcomes between the experimental and control groups.

Comparative analysis of 60Co intensity-modulated radiation therapy

International Nuclear Information System (INIS)

Fox, Christopher; Romeijn, H Edwin; Lynch, Bart; Dempsey, James F; Men, Chunhua; Aleman, Dionne M

2008-01-01

In this study, we perform a scientific comparative analysis of using 60 Co beams in intensity-modulated radiation therapy (IMRT). In particular, we evaluate the treatment plan quality obtained with (i) 6 MV, 18 MV and 60 Co IMRT; (ii) different numbers of static multileaf collimator (MLC) delivered 60 Co beams and (iii) a helical tomotherapy 60 Co beam geometry. We employ a convex fluence map optimization (FMO) model, which allows for the comparison of plan quality between different beam energies and configurations for a given case. A total of 25 clinical patient cases that each contain volumetric CT studies, primary and secondary delineated targets, and contoured structures were studied: 5 head-and-neck (H and N), 5 prostate, 5 central nervous system (CNS), 5 breast and 5 lung cases. The DICOM plan data were anonymized and exported to the University of Florida optimized radiation therapy (UFORT) treatment planning system. The FMO problem was solved for each case for 5-71 equidistant beams as well as a helical geometry for H and N, prostate, CNS and lung cases, and for 3-7 equidistant beams in the upper hemisphere for breast cases, all with 6 MV, 18 MV and 60 Co dose models. In all cases, 95% of the target volumes received at least the prescribed dose with clinical sparing criteria for critical organs being met for all structures that were not wholly or partially contained within the target volume. Improvements in critical organ sparing were found with an increasing number of equidistant 60 Co beams, yet were marginal above 9 beams for H and N, prostate, CNS and lung. Breast cases produced similar plans for 3-7 beams. A helical 60 Co beam geometry achieved similar plan quality as static plans with 11 equidistant 60 Co beams. Furthermore, 18 MV plans were initially found not to provide the same target coverage as 6 MV and 60 Co plans; however, adjusting the trade-offs in the optimization model allowed equivalent target coverage for 18 MV. For plans with comparable

Combined anti-tumor necrosis factor-α therapy and DMARD therapy in rheumatoid arthritis patients reduces inflammatory gene expression in whole blood compared to DMARD therapy alone

Directory of Open Access Journals (Sweden)

Carl K Edwards

2012-12-01

Full Text Available Periodic assessment of gene expression for diagnosis and monitoring in rheumatoid arthritis (RA may provide a readily available and useful method to detect subclinical disease progression and follow responses to therapy with disease modifying anti-rheumatic agents (DMARDs or anti-TNF-α therapy. We used quantitative real-time PCR to compare peripheral blood gene expression profiles in active ("unstable" RA patients on DMARDs, stable RA patients on DMARDs, and stable RA patients treated with a combination of a DMARD and an anti-TNF-α agent (infliximab or etanercept to healthy human controls. The expression of 48 inflammatory genes were compared between healthy controls (N=122, unstable DMARD patients (N=18, stable DMARD patients (N=26, and stable patients on combination therapy (N=20. Expression of 13 genes was very low or undetectable in all study groups. Compared to healthy controls, patients with unstable RA on DMARDs exhibited increased expression of 25 genes, stable DMARD patients exhibited increased expression of 14 genes and decreased expression of five genes, and combined therapy patients exhibited increased expression of six genes and decreased expression of 10 genes. These findings demonstrate that active RA is associated with increased expression of circulating inflammatory markers whereas increases in inflammatory gene expression are diminished in patients with stable disease on either DMARD or anti-TNF-α therapy. Furthermore, combination DMARD and anti-TNF-α therapy is associated with greater reductions in circulating inflammatory gene expression compared to DMARD therapy alone. These results suggest that assessment of peripheral blood gene expression may prove useful to monitor disease progression and response to therapy.

A randomized trial of teen online problem solving: efficacy in improving caregiver outcomes after brain injury.

Science.gov (United States)

Wade, Shari L; Walz, Nicolay C; Carey, JoAnne; McMullen, Kendra M; Cass, Jennifer; Mark, Erin; Yeates, Keith Owen

2012-11-01

To examine the results of a randomized clinical trial (RCT) of Teen Online Problem Solving (TOPS), an online problem solving therapy model, in increasing problem-solving skills and decreasing depressive symptoms and global distress for caregivers of adolescents with traumatic brain injury (TBI). Families of adolescents aged 11-18 who sustained a moderate to severe TBI between 3 and 19 months earlier were recruited from hospital trauma registries. Participants were assigned to receive a web-based, problem-solving intervention (TOPS, n = 20), or access to online resources pertaining to TBI (Internet Resource Comparison; IRC; n = 21). Parent report of problem solving skills, depressive symptoms, global distress, utilization, and satisfaction were assessed pre- and posttreatment. Groups were compared on follow-up scores after controlling for pretreatment levels. Family income was examined as a potential moderator of treatment efficacy. Improvement in problem solving was examined as a mediator of reductions in depression and distress. Forty-one participants provided consent and completed baseline assessments, with follow-up assessments completed on 35 participants (16 TOPS and 19 IRC). Parents in both groups reported a high level of satisfaction with both interventions. Improvements in problem solving skills and depression were moderated by family income, with caregivers of lower income in TOPS reporting greater improvements. Increases in problem solving partially mediated reductions in global distress. Findings suggest that TOPS may be effective in improving problem solving skills and reducing depressive symptoms for certain subsets of caregivers in families of adolescents with TBI.

Comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: a randomized trial

Science.gov (United States)

Background: Few remedies effectively treat long-term pain and disability from knee osteoarthritis. Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis. Objective: To compare Tai Chi with standard physical therapy f...

Group therapy compared with individual desensitization for dental anxiety

DEFF Research Database (Denmark)

Moore, R.; Brødsgaard, I.

1994-01-01

Results of group therapy (GT) for extreme dental anxiety were compared with individual treatment (IT). Scales used measured dental anxiety, beliefs or trust in dentists, and fear of the next dentist after specialist treatment which showed reduced dental anxiety and improved dental beliefs compared...... with a static control group of 45 patients. The 30 GT patients showed no significant difference in dropouts during training compared with the 68 IT patients, but for patients who completed treatment, GT (n = 24) had greater dental anxiety reduction than IT subjects (n = 60). GT patients required fewer therapist...

Effect of vibration versus suspension therapy on balance in children ...

African Journals Online (AJOL)

Most cerebral palsy children have deficits in balance, co-ordination, and gait throughout childhood and adulthood. So, it is essential to seek an ideal physical therapy program to help in solving such widespread problem. The present study was conducted to compare between the effect of vibration training and suspension ...

Comparative Study on a Solving Model and Algorithm for a Flush Air Data Sensing System

Directory of Open Access Journals (Sweden)

Yanbin Liu

2014-05-01

Full Text Available With the development of high-performance aircraft, precise air data are necessary to complete challenging tasks such as flight maneuvering with large angles of attack and high speed. As a result, the flush air data sensing system (FADS was developed to satisfy the stricter control demands. In this paper, comparative stuides on the solving model and algorithm for FADS are conducted. First, the basic principles of FADS are given to elucidate the nonlinear relations between the inputs and the outputs. Then, several different solving models and algorithms of FADS are provided to compute the air data, including the angle of attck, sideslip angle, dynamic pressure and static pressure. Afterwards, the evaluation criteria of the resulting models and algorithms are discussed to satisfy the real design demands. Futhermore, a simulation using these algorithms is performed to identify the properites of the distinct models and algorithms such as the measuring precision and real-time features. The advantages of these models and algorithms corresponding to the different flight conditions are also analyzed, furthermore, some suggestions on their engineering applications are proposed to help future research.

Combined intravenous and intra-arterial thrombolytic therapy for acute ischemic stroke: a comparative study with simple intra-arterial thrombolytic therapy

International Nuclear Information System (INIS)

Xu Haowen; Li Minghua; Guan Sheng; Song Bo; Wang Jianbo; Gu Binxian

2011-01-01

Objective: to evaluate the feasibility, efficacy, safety and risk of combined intravenous and local intra-arterial thrombolytic therapy (IV + IA) for ischemic stroke and to compare the results with those obtained by simple intra-arterial thrombolytic therapy (IA). Methods: A total of 46 consecutive patients with ischemic strokes, who were suitable candidates for thrombolytic therapy, were randomly divided into (IV + IA) group (n=24) and IA group (n=22). After the treatment, the arterial recanalization rates, the early clinical improvement, the occurrence of symptomatic intracerebral hemorrhage, the favourable outcome rate and the mortality were evaluated, and the results were compared between the two groups. Results: The average interval between the onset of symptoms and the start of thrombolytic therapy in (IV + IA) group was 255 minutes, which was remarkably lower than that in IA group (310 minutes) with P=0.012. After the thrombolytic therapy, the arterial recanalization rate for (IV + IA) group and IA group was 54.1% and 40.9% respectively (P=0.226). The occurrence of symptomatic intracerebral hemorrhage for (IV + IA) group and IA group was 16.7% and 22.7% respectively (P=0.361). There months after the treatment the favourable outcome rate (modified Rankin Scale, 0 to 2) of (IV + IA) group was 54.2%, which was higher than that of IA group (36.4%), and the mortality in (IV + IA) group and IA group was 8.3% and 9.1% (P=0.927) respectively. No statistically significant difference in recanalization rate and mortality existed between the two groups. Conclusion: This pilot indicates that both (IV + IA) thrombolytic therapy and simple IA thrombolytic therapy are clinically feasible and safe in treating acute ischemic stroke. Compared to simple IA thrombolytic therapy, (IV + IA) thrombolytic therapy is more effective with rather minimal risks. The conclusion of this study needs to be further proved by double-blind and controlled studies with large sample. (authors)

[Out of hopelessness--problem solving training in suicide prevention].

Science.gov (United States)

Perczel Forintos, Dóra; Póos, Judit

2008-01-01

Psychological studies have great importance in suicide prevention since psychological factors belong to the modifiable risk factors in suicide. These are the negative cognitive triad and hopelessness which are related to vague, over-generalized autobiographical memory and lead to poor problem solving abilities. In this paper we review the most relevant clinical psychology studies and models such as the cognitive model of suicide as well as the entrapment theory by Williams (2004). In the second part we describe the frequently used method of problem solving training/therapy which can be used in either individual or group format. We hope that the problem solving skill training will soon become a part of suicide prevention in Hungary also, since short,focused and evidence based interventions are much needed in psychiatric care.

Comparative analysis of {sup 60}Co intensity-modulated radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Fox, Christopher [Sun Nuclear Corporation, 425-A Pineda Court, Melbourne, FL 32940 (United States); Romeijn, H Edwin; Lynch, Bart; Dempsey, James F [Department of Radiation Oncology, University of Florida, Gainesville, FL 32610-0385 (United States); Men, Chunhua [Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL 32611-6595 (United States); Aleman, Dionne M [Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario (Canada)], E-mail: chrisfox@sunnuclear.com, E-mail: romeijn@ise.ufl.edu, E-mail: lynchb@ufl.edu, E-mail: chhmen@ufl.edu, E-mail: aleman@mie.utoronto.edu, E-mail: dempsey@ufl.edu

2008-06-21

In this study, we perform a scientific comparative analysis of using {sup 60}Co beams in intensity-modulated radiation therapy (IMRT). In particular, we evaluate the treatment plan quality obtained with (i) 6 MV, 18 MV and {sup 60}Co IMRT; (ii) different numbers of static multileaf collimator (MLC) delivered {sup 60}Co beams and (iii) a helical tomotherapy {sup 60}Co beam geometry. We employ a convex fluence map optimization (FMO) model, which allows for the comparison of plan quality between different beam energies and configurations for a given case. A total of 25 clinical patient cases that each contain volumetric CT studies, primary and secondary delineated targets, and contoured structures were studied: 5 head-and-neck (H and N), 5 prostate, 5 central nervous system (CNS), 5 breast and 5 lung cases. The DICOM plan data were anonymized and exported to the University of Florida optimized radiation therapy (UFORT) treatment planning system. The FMO problem was solved for each case for 5-71 equidistant beams as well as a helical geometry for H and N, prostate, CNS and lung cases, and for 3-7 equidistant beams in the upper hemisphere for breast cases, all with 6 MV, 18 MV and {sup 60}Co dose models. In all cases, 95% of the target volumes received at least the prescribed dose with clinical sparing criteria for critical organs being met for all structures that were not wholly or partially contained within the target volume. Improvements in critical organ sparing were found with an increasing number of equidistant {sup 60}Co beams, yet were marginal above 9 beams for H and N, prostate, CNS and lung. Breast cases produced similar plans for 3-7 beams. A helical {sup 60}Co beam geometry achieved similar plan quality as static plans with 11 equidistant {sup 60}Co beams. Furthermore, 18 MV plans were initially found not to provide the same target coverage as 6 MV and {sup 60}Co plans; however, adjusting the trade-offs in the optimization model allowed equivalent target

Comparing systemic therapy and cognitive behavioral therapy for social anxiety disorders: study protocol for a randomized controlled pilot trial.

Science.gov (United States)

Hunger, Christina; Hilzinger, Rebecca; Koch, Theresa; Mander, Johannes; Sander, Anja; Bents, Hinrich; Schweitzer, Jochen

2016-03-31

Social anxiety disorders are among the most prevalent anxiety disorders in the general population. The efficacy of cognitive behavioral therapy (CBT) for social anxiety disorders is well demonstrated. However, only three studies point to the efficacy of systemic therapy (ST) in anxiety disorders, and only two of them especially focus on social anxiety disorders. These ST studies either do not use a good comparator but minimal supportive therapy, they do not use a multi-person ST but a combined therapy, or they do not especially focus on social anxiety disorders but mood and anxiety disorders in general. Though ST was approved as evidence based in Germany for a variety of disorders in 2008, evidence did not include anxiety disorders. This is the first pilot study that will investigate multi-person ST, integrating a broad range of systemic methods, specifically for social anxiety disorders and that will compare ST to the "gold standard" CBT. This article describes the rationale and protocol of a prospective, open, interventive, balanced, bi-centric, pilot randomized controlled trial (RCT). A total of 32 patients with a primary SCID diagnosis of social anxiety disorder will be randomized to either CBT or ST. Both treatments will be manualized. The primary outcome will include social anxiety symptoms at the end of therapy. Therapy will be restricted to no more than 26 hours (primary endpoint). Secondary outcomes will include psychological, social systems and interpersonal functioning, symptom adjustment, and caregiver burden, in addition to change measures, therapist variables and treatment adherence. At the secondary endpoints, 9 and 12 months after the beginning of therapy, we will again assess all outcomes. The study is expected to pilot test a RCT which will be the first to directly compare CBT and multi-person ST, integrating a broad range of systemic methods, for social anxiety disorders, and it will provide empirical evidence for the calculation of the number of

The synergistic effect of nanoparticles in photodynamic therapy and radiation therapy

International Nuclear Information System (INIS)

Chen Na; Tu Yu; Zhang Xuguang

2010-01-01

This paper describes a novel treatment: based on nanoparticles that combines radiotherapy and photodynamic therapy. With this approach, the application of traditional photodynamic therapies only to surface treatment can be solved, so that the therapeutic effect can be improved; the approach also could guarantee the effectiveness of treatment and reduce radiation doses, so it can effectively control the complications of radiotherapy, This new modality will open a new chapter for cancer therapy. (authors)

Interpersonal Problem-Solving Deficits in Self-Poisoning Patients.

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McLeavey, Breda C.; And Others

1987-01-01

Compared self-poisoning patients with psychiatric patients and nonpatient controls on problem-solving skills and locus of control. The psychiatric and self-poisoning groups showed deficits on interpersonal problem solving compared with nonpatient controls. The self-poisoning group performed below or at the level of the psychiatric group. Locus of…

Testing After Worked Example Study Does Not Enhance Delayed Problem-Solving Performance Compared to Restudy

NARCIS (Netherlands)

T.A.J.M. van Gog (Tamara); L. Kester (Liesbeth); K. Dirkx (Kim); V. Hoogerheide (Vincent); J. Boerboom (Joris); P.P.J.L. Verkoeijen (Peter)

2015-01-01

textabstractFour experiments investigated whether the testing effect also applies to the acquisition of problem-solving skills from worked examples. Experiment 1 (n = 120) showed no beneficial effects of testing consisting of isomorphic problem solving or example recall on final test performance,

Testing After Worked Example Study Does Not Enhance Delayed Problem-Solving Performance Compared to Restudy

NARCIS (Netherlands)

Van Gog, Tamara; Kester, Liesbeth; Dirkx, Kim; Hoogerheide, Vincent; Boerboom, Joris; Verkoeijen, Peter P. J. L.

2016-01-01

Four experiments investigated whether the testing effect also applies to the acquisition of problem-solving skills from worked examples. Experiment 1 (n=120) showed no beneficial effects of testing consisting of isomorphic problem solving or example recall on final test performance, which

Testing After Worked Example Study Does Not Enhance Delayed Problem-Solving Performance Compared to Restudy

NARCIS (Netherlands)

van Gog, Tamara; Kester, Liesbeth; Dirkx, Kim; Hoogerheide, Vincent; Boerboom, Joris; Verkoeijen, Peter P J L

Four experiments investigated whether the testing effect also applies to the acquisition of problem-solving skills from worked examples. Experiment 1 (n = 120) showed no beneficial effects of testing consisting of isomorphic problem solving or example recall on final test performance, which

[Investigation of problem solving skills among psychiatric patients].

Science.gov (United States)

Póos, Judit; Annus, Rita; Perczel Forintos, Dóra

2008-01-01

According to our present knowledge depression and hopelessness play an important role in attempted suicide and the development of hopelessness seems to be closely associated with poor problem solving skills. In the present study we have used the internationally well-known MEPS (Means-Ends Problem Solving Test; a measure of social problem solving ability) in Hungary for the first time and combined with other tests. We intended to explore the cognitive risk factors that potentially play a role in the suicidal behavior in clinical population. In our study we compared a group of individuals who had attempted suicide to a nonsuicidal psychiatric control group and a normal control group (61 subjects in each group). Our results confirm the findings of others that psychiatric patients have difficulties in social problem solving compared to normal controls. Moreover, they generate less and poorer solutions. According to our data problem solving skills of the two clinical groups were similar. A strong positive correlation was found between poor problem solving skills, depression and hopelessness which may suggest that the development of problem solving skills could help to reduce negative mood.

Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression

Directory of Open Access Journals (Sweden)

Cape John

2010-06-01

Full Text Available Abstract Background Psychological therapies provided in primary care are usually briefer than in secondary care. There has been no recent comprehensive review comparing their effectiveness for common mental health problems. We aimed to compare the effectiveness of different types of brief psychological therapy administered within primary care across and between anxiety, depressive and mixed disorders. Methods Meta-analysis and meta-regression of randomized controlled trials of brief psychological therapies of adult patients with anxiety, depression or mixed common mental health problems treated in primary care compared to primary care treatment as usual. Results Thirty-four studies, involving 3962 patients, were included. Most were of brief cognitive behaviour therapy (CBT; n = 13, counselling (n = 8 or problem solving therapy (PST; n = 12. There was differential effectiveness between studies of CBT, with studies of CBT for anxiety disorders having a pooled effect size [d -1.06, 95% confidence interval (CI -1.31 to -0.80] greater than that of studies of CBT for depression (d -0.33, 95% CI -0.60 to -0.06 or studies of CBT for mixed anxiety and depression (d -0.26, 95% CI -0.44 to -0.08. Counselling for depression and mixed anxiety and depression (d -0.32, 95% CI -0.52 to -0.11 and problem solving therapy (PST for depression and mixed anxiety and depression (d -0.21, 95% CI -0.37 to -0.05 were also effective. Controlling for diagnosis, meta-regression found no difference between CBT, counselling and PST. Conclusions Brief CBT, counselling and PST are all effective treatments in primary care, but effect sizes are low compared to longer length treatments. The exception is brief CBT for anxiety, which has comparable effect sizes.

The TOPSHOCK study: Effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial

Directory of Open Access Journals (Sweden)

Diercks Ron L

2011-10-01

Full Text Available Abstract Background Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of the rehabilitation program for patellar tendinopathy. Extracorporeal Shockwave Therapy originally used focused shockwaves. Several years ago a new kind of shockwave therapy was introduced: radial shockwave therapy. Studies that investigate the effectiveness of radial shockwave therapy as treatment for patellar tendinopathy are scarce. Therefore the aim of this study is to compare the effectiveness of focussed shockwave therapy and radial shockwave therapy as treatments for patellar tendinopathy. Methods/design The TOPSHOCK study (Tendinopathy Of Patella SHOCKwave is a two-armed randomised controlled trial in which the effectiveness of focussed shockwave therapy and radial shockwave therapy are directly compared. Outcome assessors and patients are blinded as to which treatment is given. Patients undergo three sessions of either focused shockwave therapy or radial shockwave therapy at 1-week intervals, both in combination with eccentric decline squat training. Follow-up measurements are scheduled just before treatments 2 and 3, and 1, 4, 7 and 12 weeks after the final treatment. The main outcome measure is the Dutch VISA-P questionnaire, which asks for pain, function and sports participation in subjects with patellar tendinopathy. Secondary outcome measures are pain determined with a VAS during ADL, sports and decline squats, rating of subjective improvement and overall satisfaction with the treatment. Patients will also record their sports activities, pain during and after these activities, and concurrent medical treatment on a weekly basis in a web-based diary. Results will be analysed according to the intention-to-treat principle. Discussion

The TOPSHOCK study: effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial.

Science.gov (United States)

van der Worp, Henk; Zwerver, Johannes; van den Akker-Scheek, Inge; Diercks, Ron L

2011-10-11

Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of the rehabilitation program for patellar tendinopathy. Extracorporeal Shockwave Therapy originally used focused shockwaves. Several years ago a new kind of shockwave therapy was introduced: radial shockwave therapy. Studies that investigate the effectiveness of radial shockwave therapy as treatment for patellar tendinopathy are scarce. Therefore the aim of this study is to compare the effectiveness of focussed shockwave therapy and radial shockwave therapy as treatments for patellar tendinopathy. The TOPSHOCK study (Tendinopathy Of Patella SHOCKwave) is a two-armed randomised controlled trial in which the effectiveness of focussed shockwave therapy and radial shockwave therapy are directly compared. Outcome assessors and patients are blinded as to which treatment is given. Patients undergo three sessions of either focused shockwave therapy or radial shockwave therapy at 1-week intervals, both in combination with eccentric decline squat training. Follow-up measurements are scheduled just before treatments 2 and 3, and 1, 4, 7 and 12 weeks after the final treatment. The main outcome measure is the Dutch VISA-P questionnaire, which asks for pain, function and sports participation in subjects with patellar tendinopathy. Secondary outcome measures are pain determined with a VAS during ADL, sports and decline squats, rating of subjective improvement and overall satisfaction with the treatment. Patients will also record their sports activities, pain during and after these activities, and concurrent medical treatment on a weekly basis in a web-based diary. Results will be analysed according to the intention-to-treat principle. The TOPSHOCK study is the first randomised controlled trial that

Decision-Making Styles and Problem-Solving Appraisal.

Science.gov (United States)

Phillips, Susan D.; And Others

1984-01-01

Compared decision-making style and problem-solving appraisal in 243 undergraduates. Results suggested that individuals who employ rational decision-making strategies approach problematic situations, while individuals who endorse dependent decisional strategies approach problematic situations without confidence in their problem-solving abilities.…

Testing after Worked Example Study Does Not Enhance Delayed Problem-Solving Performance Compared to Restudy

Science.gov (United States)

van Gog, Tamara; Kester, Liesbeth; Dirkx, Kim; Hoogerheide, Vincent; Boerboom, Joris; Verkoeijen, Peter P. J. L.

2015-01-01

Four experiments investigated whether the testing effect also applies to the acquisition of problem-solving skills from worked examples. Experiment 1 (n?=?120) showed no beneficial effects of testing consisting of "isomorphic" problem solving or "example recall" on final test performance, which consisted of isomorphic problem…

Laser therapy and comparative therapy methods in parodontology

International Nuclear Information System (INIS)

Schauer, P

1997-02-01

This two studies aim to examine application of a diode-laser in periodontal therapy. The aim of the pilot-study was to examine the immediate effect of the diode-laser in reducing the bacterial concentration in periodontal pockets. 50 patients were randomly subdivided into two groups (laser group, control group) and microbiologic samples were collected. One week after the therapy (1 st group: scaling and laser, 2 nd group: scaling) there were taken further more samples from the same periodontal pockets treated before. The microbiologic samples were evaluated to verify bacterial elimination from the periodontal pockets, especially Actinobacillus actinomycetemcomitans could be considerably eliminated from periodontal pockets by the diode laser. In the long-term study, there were two groups, one laser-group and one control-group. All 50 patients were required to have periodontal pockets with a minimum depth of 4 mm in each quadrate. The bacterial reduction, the change of bleeding on probing and the pocket depth had been evaluated six months after therapy. The irradiation with the diode laser allows considerable bacterial elimination, the index of bleeding on probing came out to be significantly better than in the control group. The reduction of pocket depth was also greater than in the control group. (author)

Alleviating Communication Apprehension through Rational Emotive Therapy: A Comparative Evaluation.

Science.gov (United States)

Watson, Arden K.; Dodd, Carley H.

Albert Ellis's Rational Emotive Therapy (RET), which assumes that a person can change an emotional disturbance by discovering and disputing the irrational ideas giving rise to that emotion, has been used effectively in treating public speaking anxiety. To compare RET with other treatments for communication apprehension, 52 high communication…

Treatment planning study comparing proton therapy, RapidArc and intensity modulated radiation therapy for a synchronous bilateral lung cancer case

Directory of Open Access Journals (Sweden)

Suresh Rana

2014-03-01

Full Text Available Purpose: The main purpose of this study is to perform a treatment planning study on a synchronous bilateral non-small cell lung cancer case using three treatment modalities: uniform scanning proton therapy, RapidArc, and intensity modulated radiation therapy (IMRT. Methods: The maximum intensity projection (MIP images obtained from the 4 dimensional-computed tomography (4DCT scans were used for delineation of tumor volumes in the left and right lungs. The average 4D-CT was used for the treatment planning among all three modalities with identical patient contouring and treatment planning goal. A proton therapy plan was generated in XiO treatment planning system (TPS using 2 fields for each target. For a comparative purpose, IMRT and RapidArc plans were generated in Eclipse TPS. Treatment plans were generated for a total dose of 74 CGE or Gy prescribed to each planning target volume (PTV (left and right with 2 CGE or Gy per fraction. In IMRT and RapidArc plans, normalization was done based on PTV coverage values in proton plans. Results: The mean PTV dose deviation from the prescription dose was lower in proton plan (within 3.4%, but higher in IMRT (6.5% to 11.3% and RapidArc (3.8% to 11.5% plans. Proton therapy produced lower mean dose to the total lung, heart, and esophagus when compared to IMRT and RapidArc. The relative volume of the total lung receiving 20, 10, and 5 CGE or Gy (V20, V10, and V5, respectively were lower using proton therapy than using IMRT, with absolute differences of 9.71%, 22.88%, and 39.04%, respectively. The absolute differences in the V20, V10, and V5 between proton and RapidArc plans were 4.84%, 19.16%, and 36.8%, respectively, with proton therapy producing lower dosimetric values. Conclusion: Based on the results presented in this case study, uniform scanning proton therapy has a dosimetric advantage over both IMRT and RapidArc for a synchronous bi-lateral NSCLC, especially for the normal lung tissue, heart, and

Solving Differential Equations in R: Package deSolve

Science.gov (United States)

In this paper we present the R package deSolve to solve initial value problems (IVP) written as ordinary differential equations (ODE), differential algebraic equations (DAE) of index 0 or 1 and partial differential equations (PDE), the latter solved using the method of lines appr...

Investor Outlook: Solving Gene Therapy Pricing…with a Cures Voucher?

Science.gov (United States)

Schimmer, Joshua; Breazzano, Steven

2016-12-01

Gene therapy reimbursement continues to be an intense topic of discussion in the field given the unique and durable benefits from a single administration and generally small patient populations against a reimbursement framework that is not optimized for such "cures" or long-lived benefits. As more gene therapy programs enter the market and late-stage development, it is increasingly important for the field to define a reimbursement model that works for all stakeholders in order to encourage the next wave of innovation. To add to the discussion around new payment models and potential solutions, we propose a flexible voucher system that takes advantage of existing infrastructure, precedent, and regulatory frameworks.

Improving mathematical problem solving skills through visual media

Science.gov (United States)

Widodo, S. A.; Darhim; Ikhwanudin, T.

2018-01-01

The purpose of this article was to find out the enhancement of students’ mathematical problem solving by using visual learning media. The ability to solve mathematical problems is the ability possessed by students to solve problems encountered, one of the problem-solving model of Polya. This preliminary study was not to make a model, but it only took a conceptual approach by comparing the various literature of problem-solving skills by linking visual learning media. The results of the study indicated that the use of learning media had not been appropriated so that the ability to solve mathematical problems was not optimal. The inappropriateness of media use was due to the instructional media that was not adapted to the characteristics of the learners. Suggestions that can be given is the need to develop visual media to increase the ability to solve problems.

Solving Differential Equations in R: Package deSolve

NARCIS (Netherlands)

Soetaert, K.E.R.; Petzoldt, T.; Setzer, R.W.

2010-01-01

In this paper we present the R package deSolve to solve initial value problems (IVP) written as ordinary differential equations (ODE), differential algebraic equations (DAE) of index 0 or 1 and partial differential equations (PDE), the latter solved using the method of lines approach. The

A randomized, comparative study of dual therapy (doxycycline-rifampin) versus triple therapy (doxycycline-rifampin-levofloxacin) for treating acute/subacute brucellosis.

Science.gov (United States)

Hasanain, Ahmad; Mahdy, Reem; Mohamed, Asmaa; Ali, Mostafa

2016-01-01

The aim of this study was to compare both the efficacy and safety profile of the WHO-recommended, dual therapy (doxycycline-rifampin) to a quinolone-based, triple therapy (doxycycline-rifampin-levofloxacin) for treating acute/subacute brucellosis. We studied 107 consecutive, naïve patients with acute/subacute brucellosis admitted to Assiut University Hospital. Patients were randomly allocated to receive the dual therapy of doxycycline-rifampin (group-A) or to receive the triple therapy of doxycycline-rifampin-levofloxacin (group-B). Acute/subacute brucellosis was diagnosed based on the presence of: (1) contact with animals or fresh animal products, (2) suggestive clinical manifestations of less than one-year duration, and (3) positive antibody titer (1:160) by standard tube agglutination test. There was no significant difference between the two groups regarding their demographic data. Fever was the most frequent manifestation (96.3%). Epigastric pain was the most frequent adverse effect of treatment (12.1%). Group-A patients had a significantly higher relapse rate compared to group-B patients (22.6% versus 9.3%, p-value=0.01). The rate of treatment adverse effects was higher among group-B patients, although not reaching statistical significance (20.4% versus 11.3%, p-value=0.059). Adding levofloxacin to the dual therapy for acute/subacute brucellosis (doxycycline-rifampin) may increase its efficacy in terms of lowering the relapse rate of the disease. Further, larger scale studies are needed before considering modifying the standard, dual therapy for brucellosis. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

The effect of nurse-led problem-solving therapy on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease: a randomised controlled trial.

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Lee, Haejung; Yoon, Ju Young; Lim, Yeonjung; Jung, HeeYoung; Kim, Sungmin; Yoo, Younja; Kim, Yunseong; Ahn, Jong-Joon; Park, Hye-Kyung

2015-05-01

to examine the effects of nurse-led, problem-solving therapy (PST) on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease (COPD) using a randomised controlled trial. a total of 254 patients with COPD were recruited, screened and randomly allocated into the intervention group with nurse-led PST or the comparison group with usual care. A total of 151 patients (intervention = 78 and comparison = 73) completed the study for 6 months. the nurse-led PST was an individualised and patient-centred intervention to improve patients' problem-solving skills related to symptom management and lifestyle modification. Twelve telephone-based PST sessions were provided to the intervention group, while the control group received usual care from their primary care providers. there were no group differences of post-test scores in problem-oriented coping, self-efficacy and depressive symptoms between the two groups. However, despite the lack of group differences, the nurse-led PST was effective for clinically depressed patients with COPD, who experienced decreased depressive symptoms (mean difference = 6.8, P = 0.009) and increased self-efficacy (mean difference = -0.6, P = 0.041) in the intervention group (n = 12). the nurse-led PST offered to patients with COPD did not demonstrate any different effects compared with usual care over 6 months; however, a subgroup analysis with clinically depressed subjects showed improved self-efficacy and decreased depressive symptoms in the intervention group. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PSQP: Puzzle Solving by Quadratic Programming.

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Andalo, Fernanda A; Taubin, Gabriel; Goldenstein, Siome

2017-02-01

In this article we present the first effective method based on global optimization for the reconstruction of image puzzles comprising rectangle pieces-Puzzle Solving by Quadratic Programming (PSQP). The proposed novel mathematical formulation reduces the problem to the maximization of a constrained quadratic function, which is solved via a gradient ascent approach. The proposed method is deterministic and can deal with arbitrary identical rectangular pieces. We provide experimental results showing its effectiveness when compared to state-of-the-art approaches. Although the method was developed to solve image puzzles, we also show how to apply it to the reconstruction of simulated strip-shredded documents, broadening its applicability.

Comparative study between manual therapy and TENS Burst in patients with tension-type cephalalgia

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Denise Vasconcelos Fernandes

Full Text Available Introduction Cephalgia or cephalalgia is one of the most common symptoms in the general population. Objective To compare the efficacy of physical therapy modalities, through manual therapy and the effect of Transcutaneous Nerve Stimulation (TENS for tension-type cephalalgia. Materials and methods The study was compounded by 60 subjects, but only 40 of them completed it, due to the exclusion criteria. These were divided into control group and intervention group. The control group received treatment — manual therapy. The intervention group received TENS Burst. Patients underwent ten sessions of treatment, made at every two days on a week, lasting 30 minutes each session. Results The characteristics related to lifestyle, postural issues and range of motion are responsible for the main causes of tension-type cephalalgia. Discussion treatments showed effective results in all cases in relation to pain intensity, but the use of manual therapy techniques give the patient a better quality of life compared to the use of TENS. Final considerations The treatment of this condition deserves analysis and studies; however, there are only a few studying physical therapy techniques, especially regarding to the use of TENS.

Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial.

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Firoozabadi, Mohammad Dehghani; Navabzadeh, Maryam; Roudsari, Mohammad Khodashenas; Zahmatkash, Mohsen

2014-12-01

Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients) and conventional treatment group (30 patients). An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months). Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6) and 32.6 (±12.7) years, respectively (P = 0.45). After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80), frequency of migraine attacks (P = 0.63) and duration of attacks per hours (P = 0.48) were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

Comparative effectiveness of injection therapies in lateral epicondylitis

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Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell Juulsgaad

2013-01-01

Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available.......Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available....

Infliximab effects compared to conventional therapy in the management of retinal vasculitis in Behçet disease.

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Tabbara, Khalid F; Al-Hemidan, Amal I

2008-12-01

To assess the outcome of retinal vasculitis in patients with Behçet disease treated with infliximab compared to treatment with conventional therapy. Nonrandomized, retrospective comparative clinical study. Patients with Behçet disease with all four major criteria were included in this study. Patients had recurrent episodes of uveitis and retinal vasculitis. Thirty-three patients (Group 1) were treated with oral prednisone, cyclosporine, and azathioprine or methotrexate for a minimum period of three months. Ten patients (Group 2) who failed to respond to conventional therapy were given infliximab at a dose of 5 mg/kg in a single intravenous infusion on day 1 and every two weeks for a total of six doses. Patients were given the same treatment during each subsequent relapse. The main outcome measures were the number of relapses, visual outcome, and ocular complications. The mean follow-up period was 36 months in Group 1 and 30 months in Group 2. The mean number of relapses was significantly reduced and the duration of remission was longer in the infliximab therapy group compared to conventional therapy group (P < .0001). The visual acuity at 24 months follow-up was significantly better in patients treated with infliximab (Group 2) when compared to conventional therapy (Group 1) (P = .0059). Patients with Behçet disease had significant decrease in inflammation, improvement of visual acuity, and reduced ocular complications following infliximab when compared to conventional therapy. The number of relapses was less in the infliximab treatment group than the conventional therapy group.

Comparative Cost-Effectiveness of Stereotactic Body Radiation Therapy Versus Intensity-Modulated and Proton Radiation Therapy for Localized Prostate Cancer

International Nuclear Information System (INIS)

Parthan, Anju; Pruttivarasin, Narin; Davies, Diane; Taylor, Douglas C. A.; Pawar, Vivek; Bijlani, Akash; Lich, Kristen Hassmiller; Chen, Ronald C.

2012-01-01

Objective: To determine the cost-effectiveness of several external beam radiation treatment modalities for the treatment of patients with localized prostate cancer. Methods: A lifetime Markov model incorporated the probabilities of experiencing treatment-related long-term toxicity or death. Toxicity probabilities were derived from published sources using meta-analytical techniques. Utilities and costs in the model were obtained from publicly available secondary sources. The model calculated quality-adjusted life expectancy and expected lifetime cost per patient, and derived ratios of incremental cost per quality-adjusted life year (QALY) gained between treatments. Analyses were conducted from both payer and societal perspectives. One-way and probabilistic sensitivity analyses were performed. Results: Compared to intensity-modulated radiation therapy (IMRT) and proton beam therapy (PT), stereotactic body radiation therapy (SBRT) was less costly and resulted in more QALYs. Sensitivity analyses showed that the conclusions in the base-case scenario were robust with respect to variations in toxicity and cost parameters consistent with available evidence. At a threshold of $50,000/QALY, SBRT was cost-effective in 75% and 94% of probabilistic simulations compared to IMRT and PT, respectively, from a payer perspective. From a societal perspective, SBRT was cost-effective in 75% and 96% of simulations compared to IMRT and PT, respectively, at a threshold of $50,000/QALY. In threshold analyses, SBRT was less expensive with better outcomes compared to IMRT at toxicity rates 23% greater than the SBRT base-case rates. Conclusion: Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer.

Working memory dysfunctions predict social problem solving skills in schizophrenia.

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Huang, Jia; Tan, Shu-ping; Walsh, Sarah C; Spriggens, Lauren K; Neumann, David L; Shum, David H K; Chan, Raymond C K

2014-12-15

The current study aimed to examine the contribution of neurocognition and social cognition to components of social problem solving. Sixty-seven inpatients with schizophrenia and 31 healthy controls were administrated batteries of neurocognitive tests, emotion perception tests, and the Chinese Assessment of Interpersonal Problem Solving Skills (CAIPSS). MANOVAs were conducted to investigate the domains in which patients with schizophrenia showed impairments. Correlations were used to determine which impaired domains were associated with social problem solving, and multiple regression analyses were conducted to compare the relative contribution of neurocognitive and social cognitive functioning to components of social problem solving. Compared with healthy controls, patients with schizophrenia performed significantly worse in sustained attention, working memory, negative emotion, intention identification and all components of the CAIPSS. Specifically, sustained attention, working memory and negative emotion identification were found to correlate with social problem solving and 1-back accuracy significantly predicted the poor performance in social problem solving. Among the dysfunctions in schizophrenia, working memory contributed most to deficits in social problem solving in patients with schizophrenia. This finding provides support for targeting working memory in the development of future social problem solving rehabilitation interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

On the Efficacy of Solving LWE by Reduction to Unique-SVP

DEFF Research Database (Denmark)

Albrecht, Martin Roland; Fitzpatrick, Robert; Göpfert, Florian

2014-01-01

We present a study of the concrete complexity of solving instances of the unique shortest vector problem (uSVP). In particular, we study the complexity of solving the Learning with Errors (LWE) problem by reducing the Bounded-Distance Decoding (BDD) problem to uSVP and attempting to solve...... such instances using the ‘embedding’ approach. We experimentally derive a model for the success of the approach, compare to alternative methods and demonstrate that for the LWE instances considered in this work, reducing to uSVP and solving via embedding compares favorably to other approaches....

Comparing conventional physical therapy rehabilitation with neuromuscular electrical stimulation after TKA.

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Levine, Michael; McElroy, Karen; Stakich, Valerie; Cicco, Jodie

2013-03-01

Rehabilitation following total knee arthroplasty (TKA) is a costly, cumbersome, and often painful process. Physical therapy contributes to the successful outcome of TKA but can be expensive. Alternative methods of obtaining good functional results that help minimize costs are desirable. Neuromuscular electrical stimulation (NMES) is a potential option. Neuromuscular electrical stimulation has been shown to increase quadriceps muscle strength and activation following TKA. Functional scores also improve following TKA when NMES is added to conventional therapy protocols vs therapy alone. The authors hypothesized that rehabilitation managed by a physical therapist would not result in a functional advantage for patients undergoing TKA when compared with NMES and an unsupervised at-home range of motion exercise program and that patient satisfaction would not differ between the 2 groups. Seventy patients were randomized into a postoperative protocol of conventional physical therapy with a licensed therapist, including range of motion exercises and strengthening exercises, or into a program of NMES and range of motion exercises performed at home without therapist supervision. Noninferiority of the NMES program was obtained 6 weeks postoperatively (Knee Society pain/function scores, Western Ontario and McMaster Universities Osteoarthritis Index, flexion). Noninferiority was shown 6 months postoperatively for all parameters. The results suggest that rehabilitation managed by a physical therapist results in no functional advantage or difference in patient satisfaction when compared with NMES and an unsupervised at-home range of motion program. Neuromuscular electrical stimulation and unsupervised at-home range of motion exercises may provide an option for reducing the cost of the postoperative TKA recovery process without compromising quadriceps strength or patient satisfaction. Copyright 2013, SLACK Incorporated.

Comparative Outcome Analysis of Penicillin-Based Versus Fluoroquinolone-Based Antibiotic Therapy for Community-Acquired Pneumonia

Science.gov (United States)

Wang, Chi-Chuan; Lin, Chia-Hui; Lin, Kuan-Yin; Chuang, Yu-Chung; Sheng, Wang-Huei

2016-01-01

Abstract Community-acquired pneumonia (CAP) is a common but potentially life-threatening condition, but limited information exists on the effectiveness of fluoroquinolones compared to β-lactams in outpatient settings. We aimed to compare the effectiveness and outcomes of penicillins versus respiratory fluoroquinolones for CAP at outpatient clinics. This was a claim-based retrospective cohort study. Patients aged 20 years or older with at least 1 new pneumonia treatment episode were included, and the index penicillin or respiratory fluoroquinolone therapies for a pneumonia episode were at least 5 days in duration. The 2 groups were matched by propensity scores. Cox proportional hazard models were used to compare the rates of hospitalizations/emergence service visits and 30-day mortality. A logistic model was used to compare the likelihood of treatment failure between the 2 groups. After propensity score matching, 2622 matched pairs were included in the final model. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy (adjusted odds ratio [AOR], 0.88; 95% confidence interval [95%CI], 0.77–0.99), but no differences were found in hospitalization/emergence service (ES) visits (adjusted hazard ratio [HR], 1.27; 95% CI, 0.92–1.74) and 30-day mortality (adjusted HR, 0.69; 95% CI, 0.30–1.62) between the 2 groups. The likelihood of treatment failure of fluoroquinolone-based therapy was lower than that of penicillin-based therapy for CAP on an outpatient clinic basis. However, this effect may be marginal. Further investigation into the comparative effectiveness of these 2 treatment options is warranted. PMID:26871827

Toward Solving the Problem of Problem Solving: An Analysis Framework

Science.gov (United States)

Roesler, Rebecca A.

2016-01-01

Teaching is replete with problem solving. Problem solving as a skill, however, is seldom addressed directly within music teacher education curricula, and research in music education has not examined problem solving systematically. A framework detailing problem-solving component skills would provide a needed foundation. I observed problem solving…

Conceptual problem solving in high school physics

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Docktor, Jennifer L.; Strand, Natalie E.; Mestre, José P.; Ross, Brian H.

2015-12-01

Problem solving is a critical element of learning physics. However, traditional instruction often emphasizes the quantitative aspects of problem solving such as equations and mathematical procedures rather than qualitative analysis for selecting appropriate concepts and principles. This study describes the development and evaluation of an instructional approach called Conceptual Problem Solving (CPS) which guides students to identify principles, justify their use, and plan their solution in writing before solving a problem. The CPS approach was implemented by high school physics teachers at three schools for major theorems and conservation laws in mechanics and CPS-taught classes were compared to control classes taught using traditional problem solving methods. Information about the teachers' implementation of the approach was gathered from classroom observations and interviews, and the effectiveness of the approach was evaluated from a series of written assessments. Results indicated that teachers found CPS easy to integrate into their curricula, students engaged in classroom discussions and produced problem solutions of a higher quality than before, and students scored higher on conceptual and problem solving measures.

Conceptual problem solving in high school physics

Directory of Open Access Journals (Sweden)

Jennifer L. Docktor

2015-09-01

Full Text Available Problem solving is a critical element of learning physics. However, traditional instruction often emphasizes the quantitative aspects of problem solving such as equations and mathematical procedures rather than qualitative analysis for selecting appropriate concepts and principles. This study describes the development and evaluation of an instructional approach called Conceptual Problem Solving (CPS which guides students to identify principles, justify their use, and plan their solution in writing before solving a problem. The CPS approach was implemented by high school physics teachers at three schools for major theorems and conservation laws in mechanics and CPS-taught classes were compared to control classes taught using traditional problem solving methods. Information about the teachers’ implementation of the approach was gathered from classroom observations and interviews, and the effectiveness of the approach was evaluated from a series of written assessments. Results indicated that teachers found CPS easy to integrate into their curricula, students engaged in classroom discussions and produced problem solutions of a higher quality than before, and students scored higher on conceptual and problem solving measures.

Cost-effectiveness of vedolizumab compared with conventional therapy for ulcerative colitis patients in the UK

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Wilson MR

2017-10-01

Full Text Available Michele R Wilson,1 Ismail Azzabi Zouraq,2 Helene Chevrou-Severac,2 Ross Selby,3 Matthew C Kerrigan4 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Takeda Pharmaceuticals International AG, Zurich, Switzerland; 3Takeda UK Ltd., Bucks, UK; 4PHMR Limited, London, UK Objective: To examine the clinical and economic impact of vedolizumab compared with conventional therapy in the treatment of moderately-to-severely active ulcerative colitis (UC in the UK based on results of the GEMINI I trial. Methods: A decision-analytic model in Microsoft Excel was used to compare vedolizumab with conventional therapy (aminosalicylates, corticosteroids, immunomodulators for the treatment of patients with UC in the UK. We considered the following three populations: the overall intent-to-treat population from the GEMINI I trial, patients naïve to anti-TNF therapy, and those who had failed anti-TNF-therapy. Population characteristics and efficacy data were obtained from the GEMINI I trial. Other inputs (eg, unit costs, probability of surgery, mortality were obtained from published literature. Time horizon was a lifetime horizon, with costs and outcomes discounted by 3.5% per year. One-way and probabilistic sensitivity analyses were conducted to measure the impact of parameter uncertainty. Results: Vedolizumab had incremental cost-effectiveness ratios of £4,095/quality-adjusted life-year (QALY, £4,423/QALY, and £5,972/QALY compared with conventional therapy in the intent-to-treat, anti-TNF-naïve, and anti-TNF-failure populations, respectively. Patients on vedolizumab accrued more QALYs while incurring more costs than patients on conventional therapy. The sensitivity analyses showed that the results were most sensitive to induction response and transition probabilities for each treatment. Conclusion: The results suggest that vedolizumab results in more QALYs and may be a cost-effective treatment option compared with conventional therapy for both anti

Comparative study of esomeprazole and lansoprazole in triple therapy for eradication of Helicobacter pylori in Japan.

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Nishida, Tsutomu; Tsujii, Masahiko; Tanimura, Hirohisa; Tsutsui, Shusaku; Tsuji, Shingo; Takeda, Akira; Inoue, Atsuo; Fukui, Hiroyuki; Yoshio, Toshiyuki; Kishida, Osamu; Ogawa, Hiroyuki; Oshita, Masahide; Kobayashi, Ichizo; Zushi, Shinichiro; Ichiba, Makoto; Uenoyama, Naoto; Yasunaga, Yuichi; Ishihara, Ryu; Yura, Mamoru; Komori, Masato; Egawa, Satoshi; Iijima, Hideki; Takehara, Tetsuo

2014-04-21

To evaluate the efficacy and safety of esomeprazole-based triple therapy compared with lansoprazole therapy as first-line eradication therapy for patients with Helicobacter pylori (H. pylori) in usual post-marketing use in Japan, where the clarithromycin (CAM) resistance rate is 30%. For this multicenter, randomized, open-label, non-inferiority trial, we recruited patients (≥ 20 years of age) with H. pylori infection from 20 hospitals in Japan. We randomly allocated patients to esomeprazole therapy (esomeprazole 20 mg, CAM 400 mg, amoxicillin (AC) 750 mg for the first 7 d, with all drugs given twice daily) or lansoprazole therapy (lansoprazole 30 mg, CAM 400 mg, AC 750 mg for the first 7 d, with all drugs given twice daily) using a minimization method with age, sex, and institution as adjustment factors. Our primary outcome was the eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses. H. pylori eradication was confirmed by a urea breath test from 4 to 8 wk after cessation of therapy. ITT analysis revealed the eradication rates of 69.4% (95%CI: 61.2%-76.6%) for esomeprazole therapy and 73.9% (95%CI: 65.9%-80.6%) for lansoprazole therapy (P = 0.4982). PP analysis showed eradication rate of 76.9% (95%CI: 68.6%-83.5%) for esomeprazole therapy and 79.8% (95%CI: 71.9%-86.0%) for lansoprazole therapy (P = 0.6423). There were no differences in adverse effects between the two therapies. Esomeprazole showed non-inferiority and safety in a 7 day-triple therapy for eradication of H. pylori compared with lansoprazole.

Compare the effectiveness of Dialectical Behavior Therapy and Cognitive Behavioral Group Therapy in Reducing Depression in Mothers of Children with Disabilities

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Zamani N

2015-04-01

Full Text Available Abstract Background: Depression is on the top list of mental disorders which account for about 25 percent of patients referred to health centers in your world. So, is presented in different ways to treat it. Therefore, the aim of this study is to compare the effectiveness of Dialectical Behavior Therapy and Cognitive Behavioral Group Therapy in reducing depression in mothers of children with disabilities Materials and Methods: This study is quasi-experimental and consists of experimental and control groups. This study population was mothers referred to mobility, occupational therapy and physiotherapy centers who had depressive symptoms. 8 patients in each group were selected by convenience sampling. The research instrument were the Structured Clinical Interview for DSM-IV Axis I disorders and the revised Beck Depression Inventory form (1996. Dialectical behavior therapy and cognitive behavior therapy groups were instructured for 2 months (8 sessions of 2 to 2.5 hours. But the control group did not receive intervention. Results: The results showed that there were significant differences between the mean depression scores of dialectical behavior therapy and cognitive therapy group with control group (p<0.001. Also, there is a significant difference between the mean depression scores of dialectical behavior therapy with cognitive therapy (p<0.001. Conclusion: In the area of treatment and working with depressed people and those who are in crisis mode, it seems that dialectical behavior therapy and cognitive therapy group in view of its nature is very efficient and promising.

Comparative assessment of beneficial effects of intracoronary and systemic thrombolytic therapy of acute myocardial infarction

International Nuclear Information System (INIS)

Khalfen, Eh.Sh.; Shtern, S.V.; Shvarts, I.L.; Bezrukova, G.A.; Zolotarev, V.A.; Rakovskij, M.E.

1989-01-01

Comparative study was made on clinical efficiency of introcoronary thrombolytic therapy with streptokinase and systematic thrombolytic therapy with streptodekase for 189 patients with transmural myocardial infarction. Intravenous digital subtraction ventriculography was conducted to obtain indices of hemodynamics and contractility of the left venricle

Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial

Directory of Open Access Journals (Sweden)

Mohammad Dehghani Firoozabadi

2014-01-01

Full Text Available Background: Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. Materials and Methods: This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients and conventional treatment group (30 patients. An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months. Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Results: Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6 and 32.6 (±12.7 years, respectively (P = 0.45. After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80, frequency of migraine attacks (P = 0.63 and duration of attacks per hours (P = 0.48 were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P < 0.001. Conclusion: There was no significant difference between cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

A comparative study of the effects of problem-solving skills training and relaxation on the score of self-esteem in women with postpartum depression.

Science.gov (United States)

Nasiri, Saeideh; Kordi, Masoumeh; Gharavi, Morteza Modares

2015-01-01

Self-esteem is a determinant factor of mental health. Individuals with low self-esteem have depression, and low self-esteem is one of main symptoms of depression. Aim of this study is to compare the effects of problem-solving skills and relaxation on the score of self-esteem in women with postpartum depression. This clinical trial was performed on 80 women. Sampling was done in Mashhad healthy centers from December 2009 to June 2010. Women were randomly divided and assigned to problem-solving skills (n = 26), relaxation (n = 26), and control groups (n = 28). Interventions were implemented for 6 weeks and the subjects again completed Eysenck self-esteem scale 9 weeks after delivery. Data analysis was done by descriptive statistics, Kruskal-Wallis test, and analysis of variance (ANOVA) test by SPSS software. The findings showed that the mean of self-esteem scale scores was 117.9 ± 9.7 after intervention in the problem-solving group, 117.0 ± 11.8 in the relaxation group, and 113.5 ± 10.4 in the control group and there was significant difference between the groups of relaxation and problem solving, and also between intervention groups and control group. According to the results, problem-solving skills and relaxation can be used to prevent and recover from postpartum depression.

Comparative cost-effectiveness of stereotactic body radiation therapy versus intensity-modulated and proton radiation therapy for localized prostate cancer.

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Anju eParthan

2012-08-01

Full Text Available Objective. To determine the cost-effectiveness of several external beam radiation treatment modalities for the treatment of patients with localized prostate cancer.Methods. A lifetime Markov model incorporated the probabilities of experiencing treatment-related long-term toxicity or death. Toxicity probabilities were derived from published sources using meta-analytical techniques. Utilities and costs in the model were obtained from publically available secondary sources. The model calculated quality-adjusted life expectancy and expected lifetime cost per patient, and derived ratios of incremental cost per quality-adjusted life year (QALY gained between treatments. Analyses were conducted from both a payer and societal perspectives. One-way and probabilistic sensitivity analyses were performed.Results. Compared to intensity modulated radiation therapy (IMRT and proton beam therapy (PT, stereotactic body radiation therapy (SBRT was less costly and resulted in more QALYs. Sensitivity analyses showed that the conclusions in the base-case scenario were robust with respect to variations in toxicity and cost parameters consistent with available evidence. At a threshold of $50,000/QALY, SBRT was cost effective in 75%, and 94% of probabilistic simulations compared to IMRT and PT, respectively, from a payer perspective. From a societal perspective, SBRT was cost-effective in 75%, and 96% of simulations compared to IMRT and PT, respectively, at a threshold of $50,000/QALY. In threshold analyses, SBRT was less expensive with better outcomes compared to IMRT at toxicity rates 23% greater than the SBRT base-case rates. Conclusions. Based on the assumption that each treatment modality results in equivalent long-term efficacy, SBRT is a cost-effective strategy resulting in improved quality-adjusted survival compared to IMRT and PT for the treatment of localized prostate cancer.

Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

DEFF Research Database (Denmark)

Maack, Carola

2013-01-01

To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery and M....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy.......To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... and Music (GIM), another group received 50 hours of outpatient trauma therapy with Psychodynamic Imaginative Trauma Therapy (PITT). The third group was a waiting-list control group of women who had to wait at least nine months for therapy. The participants filled out questionnaires measuring symptoms...

Comparative performance of an elitist teaching-learning-based optimization algorithm for solving unconstrained optimization problems

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R. Venkata Rao

2013-01-01

Full Text Available Teaching-Learning-based optimization (TLBO is a recently proposed population based algorithm, which simulates the teaching-learning process of the class room. This algorithm requires only the common control parameters and does not require any algorithm-specific control parameters. In this paper, the effect of elitism on the performance of the TLBO algorithm is investigated while solving unconstrained benchmark problems. The effects of common control parameters such as the population size and the number of generations on the performance of the algorithm are also investigated. The proposed algorithm is tested on 76 unconstrained benchmark functions with different characteristics and the performance of the algorithm is compared with that of other well known optimization algorithms. A statistical test is also performed to investigate the results obtained using different algorithms. The results have proved the effectiveness of the proposed elitist TLBO algorithm.

A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

Science.gov (United States)

Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

2015-01-01

Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P videogames were equally effective as traditional therapy for overall ROM gains and resulted in quicker recovery of motion with less pain experienced. Such videogames are a useful adjunct to therapy and should be considered as part of a holistic approach to rehabilitation within the hospital and at home after discharge in pediatric patients recovering from burn injury.

Problem Solving Frameworks for Mathematics and Software Development

Science.gov (United States)

McMaster, Kirby; Sambasivam, Samuel; Blake, Ashley

2012-01-01

In this research, we examine how problem solving frameworks differ between Mathematics and Software Development. Our methodology is based on the assumption that the words used frequently in a book indicate the mental framework of the author. We compared word frequencies in a sample of 139 books that discuss problem solving. The books were grouped…

Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: a randomized controlled trial.

Science.gov (United States)

Garand, Linda; Rinaldo, Donna E; Alberth, Mary M; Delany, Jill; Beasock, Stacey L; Lopez, Oscar L; Reynolds, Charles F; Dew, Mary Amanda

2014-08-01

Interventions directed at the mental health of family dementia caregivers may have limited impact when focused on caregivers who have provided care for years and report high burden levels. We sought to evaluate the mental health effects of problem-solving therapy (PST), designed for caregivers of individuals with a recent diagnosis of Mild Cognitive Impairment (MCI) or early dementia. Seventy-three (43 MCI and 30 early dementia) family caregivers were randomly assigned to receive PST or a comparison condition (nutritional education). Depression, anxiety, and problem-solving orientation were assessed at baseline and at 1, 3, 6, and 12 months post intervention. In general, the PST caregiver intervention was feasible and acceptable to family caregivers of older adults with a new cognitive diagnosis. Relative to nutritional education, PST led to significantly reduced depression symptoms, particularly among early dementia caregivers. PST also lowered caregivers' anxiety levels, and led to lessening of negative problem orientation. Enhanced problem-solving skills, learned early after a loved one's cognitive diagnosis (especially dementia), results in positive mental health outcomes among new family caregivers. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Comparing the Effectiveness of Cognitive Behavioral Therapy and Hypnosis Therapy Pain Self-Efficacy and Pain Severity in Girls with Primary Dysmenorrhea

OpenAIRE

F Farshbaf Manei Sefat; A Abolghasemi; U Barahmand; N Hajloo

2017-01-01

ABSTRACT   Background & aim: Menstruation as an important issue in adolescence and menstrual pain is a common problem in adolescents. Regarding the relationship between pain severity and  pain self-efficacy, this study aimed to investigate and compare the efficacy of cognitive-behavioral therapy and hypnosis therapy on pain and pain self-efficacy in girls with primary dysmenorrhea.   Methods: The method of research is Quasi experimental and research design is pretes...

COMPARATIVE STUDIES OF EFFICACY OF PHOTODYNAMIC THERAPY AND CRYOTHERAPY FOR TREATMENT OF ACTINIC KERATOSIS

Directory of Open Access Journals (Sweden)

T. E. Sukhova

2016-01-01

Full Text Available The results of a study on the effectiveness of photodynamic therapy with a photosensitizer fotoditazin and cryotherapy for actinic keratosis are represented in the article. The study included 80 patients with 215 lesions, among them erythematous form of actinic keratosis was diagnosed in 151 (70.2% cases, hyperkeratotic form – in 46 (21.4% cases, a pigmented form – in 12 (5.6% and an atypical variant of the disease – in 6 (2.8% cases. According to histological type the distribution of tumor was as follows: 19 (54.3% cases were diagnosed as hypertrophic type, 6 (17.1% – atrophic, 8 (22.9% – bowenoid and 2 (5.7% – pigmented type. Patients from the study group received one session of photodynamic therapy using laser unit "LAMI" (662 nm after 2 hours of application of fotoditazin 0.5% gel at dose of 0,2-0,3 ml per 1 cm2 of actinic keratosis focus with the following parameters: the energy density of the laser radiation – 200 J/cm2, power density – 0.14–0.48 W/cm2. In the control group patients underwent cryotherapy with liquid nitrogen with an exposure of 30-60 sec. The comparative analysis of the immediate results showed a tendency for the efficacy of photodynamic therapy to increase (the rate of complete regression was 92.5% compared with cryotherapy (85.0% (p>0,05. There were also a tendency for long-term results after photodynamic therapy to improve: three-year recurrence-free survival was 94.6% and 88.2%, respectively. For the photodynamic therapy there were significantly fewer adverse reactions, the epithelization time in lesions was significantly shorter. Compared with cryotherapy the photodynamic therapy provided significantly better cosmetic results (p <0.01, and can be used for out-patient treatment of patients with actinic keratosis.><0.01 and can be used for out-patient treatment of patients with actinic keratosis.

Biological Considerations When Comparing Proton Therapy. With Photon Therapy

NARCIS (Netherlands)

Paganetti, Harald; van Luijk, Peter

Owing to the limited availability of data on the outcome of proton therapy, treatments are generally optimized based on broadly available data on photon-based treatments. However, the microscopic pattern of energy deposition of protons differs from that of photons, leading to a different biological

Randomized Controlled Double-blind Trial Comparing Haloperidol Combined With Conventional Therapy to Conventional Therapy Alone in Patients With Symptomatic Gastroparesis.

Science.gov (United States)

Roldan, Carlos J; Chambers, Kimberly A; Paniagua, Linda; Patel, Sonali; Cardenas-Turanzas, Marylou; Chathampally, Yashwant

2017-11-01

Gastroparesis is a debilitating condition that causes nausea, vomiting, and abdominal pain. Management includes analgesics and antiemetics, but symptoms are often refractory. Haloperidol has been utilized in the palliative care setting for similar symptoms. The study objective was to determine whether haloperidol as an adjunct to conventional therapy would improve symptoms in gastroparesis patients presenting to the emergency department (ED). This was a randomized, double-blind, placebo-controlled trial of adult ED patients with acute exacerbation of previously diagnosed gastroparesis. The treatment group received 5 mg of haloperidol plus conventional therapy (determined by the treating physician). The control group received a placebo plus conventional therapy. The severity of each subject's abdominal pain and nausea were assessed before intervention and every 15 minutes thereafter for 1 hour using a 10-point scale for pain and a 5-point scale for nausea. Primary outcomes were decreased pain and nausea 1 hour after treatment. Of the 33 study patients, 15 were randomized to receive haloperidol. Before treatment, the mean intensity of pain was 8.5 in the haloperidol group and 8.28 in the placebo group; mean pretreatment nausea scores were 4.53 and 4.11, respectively. One hour after therapy, the mean pain and nausea scores in the haloperidol group were 3.13 and 1.83 compared to 7.17 and 3.39 in the placebo group. The reduction in mean pain intensity therapy was 5.37 in the haloperidol group (p ≤ 0.001) compared to 1.11 in the placebo group (p = 0.11). The reduction in mean nausea score was 2.70 in the haloperidol group (p ≤ 0.001) and 0.72 in the placebo group (p = 0.05). Therefore, the reductions in symptom scores were statistically significant in the haloperidol group but not in the placebo group. No adverse events were reported. Haloperidol as an adjunctive therapy is superior to placebo for acute gastroparesis symptoms. © 2017 by the Society for Academic

Inquiry-based problem solving in introductory physics

Science.gov (United States)

Koleci, Carolann

What makes problem solving in physics difficult? How do students solve physics problems, and how does this compare to an expert physicist's strategy? Over the past twenty years, physics education research has revealed several differences between novice and expert problem solving. The work of Chi, Feltovich, and Glaser demonstrates that novices tend to categorize problems based on surface features, while experts categorize according to theory, principles, or concepts1. If there are differences between how problems are categorized, then are there differences between how physics problems are solved? Learning more about the problem solving process, including how students like to learn and what is most effective, requires both qualitative and quantitative analysis. In an effort to learn how novices and experts solve introductory electricity problems, a series of in-depth interviews were conducted, transcribed, and analyzed, using both qualitative and quantitative methods. One-way ANOVA tests were performed in order to learn if there are any significant problem solving differences between: (a) novices and experts, (b) genders, (c) students who like to answer questions in class and those who don't, (d) students who like to ask questions in class and those who don't, (e) students employing an interrogative approach to problem solving and those who don't, and (f) those who like physics and those who dislike it. The results of both the qualitative and quantitative methods reveal that inquiry-based problem solving is prevalent among novices and experts, and frequently leads to the correct physics. These findings serve as impetus for the third dimension of this work: the development of Choose Your Own Adventure Physics(c) (CYOAP), an innovative teaching tool in physics which encourages inquiry-based problem solving. 1Chi, M., P. Feltovich, R. Glaser, "Categorization and Representation of Physics Problems by Experts and Novices", Cognitive Science, 5, 121--152 (1981).

Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study.

Science.gov (United States)

Pagoto, Sherry; Tulu, Bengisu; Agu, Emmanuel; Waring, Molly E; Oleski, Jessica L; Jake-Schoffman, Danielle E

2018-06-20

Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. ClinicalTrials.gov NCT

Exploring problem solving strategies on multiple-choice science items: Comparing native Spanish-speaking English Language Learners and mainstream monolinguals

Science.gov (United States)

Kachchaf, Rachel Rae

The purpose of this study was to compare how English language learners (ELLs) and monolingual English speakers solved multiple-choice items administered with and without a new form of testing accommodation---vignette illustration (VI). By incorporating theories from second language acquisition, bilingualism, and sociolinguistics, this study was able to gain more accurate and comprehensive input into the ways students interacted with items. This mixed methods study used verbal protocols to elicit the thinking processes of thirty-six native Spanish-speaking English language learners (ELLs), and 36 native-English speaking non-ELLs when solving multiple-choice science items. Results from both qualitative and quantitative analyses show that ELLs used a wider variety of actions oriented to making sense of the items than non-ELLs. In contrast, non-ELLs used more problem solving strategies than ELLs. There were no statistically significant differences in student performance based on the interaction of presence of illustration and linguistic status or the main effect of presence of illustration. However, there were significant differences based on the main effect of linguistic status. An interaction between the characteristics of the students, the items, and the illustrations indicates considerable heterogeneity in the ways in which students from both linguistic groups think about and respond to science test items. The results of this study speak to the need for more research involving ELLs in the process of test development to create test items that do not require ELLs to carry out significantly more actions to make sense of the item than monolingual students.

Decision-Making and Problem-Solving Approaches in Pharmacy Education.

Science.gov (United States)

Martin, Lindsay C; Donohoe, Krista L; Holdford, David A

2016-04-25

Domain 3 of the Center for the Advancement of Pharmacy Education (CAPE) 2013 Educational Outcomes recommends that pharmacy school curricula prepare students to be better problem solvers, but are silent on the type of problems they should be prepared to solve. We identified five basic approaches to problem solving in the curriculum at a pharmacy school: clinical, ethical, managerial, economic, and legal. These approaches were compared to determine a generic process that could be applied to all pharmacy decisions. Although there were similarities in the approaches, generic problem solving processes may not work for all problems. Successful problem solving requires identification of the problems faced and application of the right approach to the situation. We also advocate that the CAPE Outcomes make explicit the importance of different approaches to problem solving. Future pharmacists will need multiple approaches to problem solving to adapt to the complexity of health care.

Learning problem-solving skills in a distance education physics course

Science.gov (United States)

Rampho, G. J.; Ramorola, M. Z.

2017-10-01

In this paper we present the results of a study on the effectiveness of combinations of delivery modes of distance education in learning problem-solving skills in a distance education introductory physics course. A problem-solving instruction with the explicit teaching of a problem-solving strategy and worked-out examples were implemented in the course. The study used the ex post facto research design with stratified sampling to investigate the effect of the learning of a problem-solving strategy on the problem-solving performance. The number of problems attempted and the mean frequency of using a strategy in solving problems in the three course presentation modes were compared. The finding of the study indicated that combining the different course presentation modes had no statistically significant effect in the learning of problem-solving skills in the distance education course.

A comparative study of the A* heuristic search algorithm used to solve efficiently a puzzle game

Science.gov (United States)

Iordan, A. E.

2018-01-01

The puzzle game presented in this paper consists in polyhedra (prisms, pyramids or pyramidal frustums) which can be moved using the free available spaces. The problem requires to be found the minimum number of movements in order the game reaches to a goal configuration starting from an initial configuration. Because the problem is enough complex, the principal difficulty in solving it is given by dimension of search space, that leads to necessity of a heuristic search. The improving of the search method consists into determination of a strong estimation by the heuristic function which will guide the search process to the most promising side of the search tree. The comparative study is realized among Manhattan heuristic and the Hamming heuristic using A* search algorithm implemented in Java. This paper also presents the necessary stages in object oriented development of a software used to solve efficiently this puzzle game. The modelling of the software is achieved through specific UML diagrams representing the phases of analysis, design and implementation, the system thus being described in a clear and practical manner. With the purpose to confirm the theoretical results which demonstrates that Manhattan heuristic is more efficient was used space complexity criterion. The space complexity was measured by the number of generated nodes from the search tree, by the number of the expanded nodes and by the effective branching factor. From the experimental results obtained by using the Manhattan heuristic, improvements were observed regarding space complexity of A* algorithm versus Hamming heuristic.

Cost-of-illness in psoriasis: comparing inpatient and outpatient therapy.

Directory of Open Access Journals (Sweden)

Sabine I B Steinke

Full Text Available Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time- and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €. Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs, whereas outpatient treatment with classic systemic antipsoriatic medications was less cost-intense than other alternatives.

Modeling visual problem solving as analogical reasoning.

Science.gov (United States)

Lovett, Andrew; Forbus, Kenneth

2017-01-01

We present a computational model of visual problem solving, designed to solve problems from the Raven's Progressive Matrices intelligence test. The model builds on the claim that analogical reasoning lies at the heart of visual problem solving, and intelligence more broadly. Images are compared via structure mapping, aligning the common relational structure in 2 images to identify commonalities and differences. These commonalities or differences can themselves be reified and used as the input for future comparisons. When images fail to align, the model dynamically rerepresents them to facilitate the comparison. In our analysis, we find that the model matches adult human performance on the Standard Progressive Matrices test, and that problems which are difficult for the model are also difficult for people. Furthermore, we show that model operations involving abstraction and rerepresentation are particularly difficult for people, suggesting that these operations may be critical for performing visual problem solving, and reasoning more generally, at the highest level. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The semantic system is involved in mathematical problem solving.

Science.gov (United States)

Zhou, Xinlin; Li, Mengyi; Li, Leinian; Zhang, Yiyun; Cui, Jiaxin; Liu, Jie; Chen, Chuansheng

2018-02-01

Numerous studies have shown that the brain regions around bilateral intraparietal cortex are critical for number processing and arithmetical computation. However, the neural circuits for more advanced mathematics such as mathematical problem solving (with little routine arithmetical computation) remain unclear. Using functional magnetic resonance imaging (fMRI), this study (N = 24 undergraduate students) compared neural bases of mathematical problem solving (i.e., number series completion, mathematical word problem solving, and geometric problem solving) and arithmetical computation. Direct subject- and item-wise comparisons revealed that mathematical problem solving typically had greater activation than arithmetical computation in all 7 regions of the semantic system (which was based on a meta-analysis of 120 functional neuroimaging studies on semantic processing). Arithmetical computation typically had greater activation in the supplementary motor area and left precentral gyrus. The results suggest that the semantic system in the brain supports mathematical problem solving. Copyright © 2017 Elsevier Inc. All rights reserved.

Music therapy internship supervisors and preinternship students: a comparative analysis of questionnaires.

Science.gov (United States)

Knight, Andrew J

2008-01-01

The purpose of this study was to compare perceptions of professional competency between preinternship music therapy students and internship supervisors. Preinternship music therapy students and internship supervisors were asked to fill out the Internship Concerns Questionnaire (ICQ-ST, student; ICQ-SU, supervisor). Participants (N = 106) included 85 students at 16 AMTA-approved universities (n = 85), and 21 internship supervisors at active AMTA national roster internship sites (n = 21). Twenty items on the ICQ were rated on a Likert-type scale, and 1 item (Part B) asked the participant to indicate any other concerns not addressed in the ICQ. Music therapy interns and supervisors differed significantly in their mean ratings on 2 of the 20 items: "Communicating with facility staff" (p = .025) and "Maintaining client confidence" (p = .016). In both cases the student interns reported a significantly lower mean level of concern about getting assistance in these areas than did their supervisors. The present study suggests that music therapy educators may better prepare music therapy students for a successful internship by evaluating the perceptual gaps in professional training expectations between students and supervisors prior to the internship. Internship supervisors may also benefit from student's own perceptions of their knowledge and skills upon beginning the internship. Ultimately, the student is responsible for being prepared to begin the process from intern to beginning professional at the start of the internship, and to commit to gaining as much as possible from the combination of academic and clinical experiences available to them.

Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score Method.

Science.gov (United States)

Eeren, Hester V; Goossens, Lucas M A; Scholte, Ron H J; Busschbach, Jan J V; van der Rijken, Rachel E A

2018-01-09

Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.

Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym.

Science.gov (United States)

Bustamante Valles, Karla; Montes, Sandra; Madrigal, Maria de Jesus; Burciaga, Adan; Martínez, María Elena; Johnson, Michelle J

2016-09-15

Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the

Transformational and transactional leadership and problem solving in restaurant industry

OpenAIRE

Huhtala, Nina

2013-01-01

The study tries to give information on the leadership behavior of restaurant managers in their problem solving. The results of the study were collected by evaluating three restaurant managers by interviewing them. The restaurant managers’ answers were compared to transformational and transactional leadership model and the aspects of it. Their problem solving skills were evaluated by the help of a rational and creative problem solving model. The study showed that restaurant managers have both ...

Acute Toxicity After Image-Guided Intensity Modulated Radiation Therapy Compared to 3D Conformal Radiation Therapy in Prostate Cancer Patients

NARCIS (Netherlands)

Wortel, Ruud C.; Incrocci, Luca; Pos, Floris J.; Lebesque, Joos V.; Witte, Marnix G.; van der Heide, Uulke A.; van Herk, Marcel; Heemsbergen, Wilma D.

2015-01-01

Purpose: Image-guided intensity modulated radiation therapy (IG-IMRT) allows significant dose reductions to organs at risk in prostate cancer patients. However, clinical data identifying the benefits of IG-IMRT in daily practice are scarce. The purpose of this study was to compare dose distributions

Hypnosis compared with group therapy and individual desensitization for dental anxiety

DEFF Research Database (Denmark)

Moore, Rod; Abrahamsen, Randi; Brødsgaard, I

1996-01-01

Effects of hypnotherapy (HT) and self-hypnosis training on extreme dental anxiety in adults aged 19-65 years were compared with group therapy (GT) and individual desensitization (SD) using scales of dental anxiety, dental beliefs, and fear of a next dentist (after specialist treatment). All...... experimental groups were demographically comparable and showed reduced anxiety and improved dental beliefs compared with 51 control patients. The 25 HT patients did not differ significantly in numbers of dropouts during training compared with the 30 GT patients or 68 SD patients. For patients completing...... (8/32), but not GT (15/30). Hypnotizability was found to vary from patient to patient, with a direct relationship to time saved. But hypnotizability had an inverse relationship to STAI general anxiety level for those who went on to dentists after 1 year. Transference effects were noted for most HT...

Development of a problem solving evaluation instrument; untangling of specific problem solving assets

Science.gov (United States)

Adams, Wendy Kristine

The purpose of my research was to produce a problem solving evaluation tool for physics. To do this it was necessary to gain a thorough understanding of how students solve problems. Although physics educators highly value problem solving and have put extensive effort into understanding successful problem solving, there is currently no efficient way to evaluate problem solving skill. Attempts have been made in the past; however, knowledge of the principles required to solve the subject problem are so absolutely critical that they completely overshadow any other skills students may use when solving a problem. The work presented here is unique because the evaluation tool removes the requirement that the student already have a grasp of physics concepts. It is also unique because I picked a wide range of people and picked a wide range of tasks for evaluation. This is an important design feature that helps make things emerge more clearly. This dissertation includes an extensive literature review of problem solving in physics, math, education and cognitive science as well as descriptions of studies involving student use of interactive computer simulations, the design and validation of a beliefs about physics survey and finally the design of the problem solving evaluation tool. I have successfully developed and validated a problem solving evaluation tool that identifies 44 separate assets (skills) necessary for solving problems. Rigorous validation studies, including work with an independent interviewer, show these assets identified by this content-free evaluation tool are the same assets that students use to solve problems in mechanics and quantum mechanics. Understanding this set of component assets will help teachers and researchers address problem solving within the classroom.

Development of a Positive Youth Development Program: Promoting the Mental Health of Stressful Adolescents Using Principles of Problem Solving Therapy

Directory of Open Access Journals (Sweden)

Daniel T.L. Shek

2006-01-01

Full Text Available This paper outlines the proposal for the development, implementation, and evaluation of a positive youth development program that attempts to promote the mental health of stressful Chinese adolescents using principles of Problem Solving Therapy (PST. There are two general aims of PST: to help clients identify life difficulties and resolve them, as well as to teach them skills on how to deal with future problems. The proposed project will utilize the principles of PST as the guiding framework to run two mental health promotion courses for adolescents who are experiencing disturbing stressful responses and students who want to improve their stress management style. Both objective and subjective outcome evaluation strategies will be carried out to assess the effectiveness of the intervention to promote the psychological well-being in adolescents who are experiencing stress. A related sample proposal is described that can give social workers some insight on how to prepare a proposal for developing the Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programs.

STOSS THERAPY AND WEEKLY VITAMIN D THERAPY IN THE MANAGEMENT OF NUTRITIONAL RICKETS IN CHILDREN- A COMPARATIVE STUDY

Directory of Open Access Journals (Sweden)

Madhava Vijayakumar

2017-01-01

Full Text Available BACKGROUND The Aim of the study is to study the risk factors of nutritional rickets in children of age 1-5 years and to compare the effectiveness of classical single mega dose vitamin D administration (stoss therapy and weekly cholecalciferol administration. METHODS 50 children of age group 1-5 year with clinical, biochemical and radiological features of nutritional rickets and an equal number of age and gender matched control were included in the study. Their risk factors were compared. Those children with rickets were divided randomly into two groups of equal numbers. For one group, single oral dose of 6,00,000 IU of vitamin D and for the other group, weekly oral dose of 60,000 IU of vitamin D was administered for 8 weeks. All children were given calcium supplementation. Regular follow up was done at 1, 2, 6, 9 and 12 months and the improvement was assessed clinically, radiologically and as per the laboratory results. RESULTS Major risk factors for the development of nutritional rickets were prematurity, low birth weight, high birth order, consumption of complementary feeds poor in calcium, lack of adequate sunlight exposure and prolonged exclusive breast feeding. Response to treatment was comparable both clinically and as per the investigation results among those who received single massive dose and those on weekly vitamin D therapy. CONCLUSION Increased birth order, prematurity and low birth weight were important risk factors for rickets. Inadequate dietary calcium and inadequate sunlight exposure increased chance of getting rickets. Supplementation of vitamin D and calcium were protective. Inadequate maternal sunlight exposure, lack of antenatal and post-natal calcium and vitamin D supplementation showed a significant association with rickets. The most common clinical feature of rickets was bow legs. Both massive single dose therapy and weekly vitamin D administration were equally effective and revealed no significant difference in clinical

The efficacy of maggot debridement therapy - a review of comparative clinical trials

DEFF Research Database (Denmark)

Zarchi, K.; Jemec, G.B.

2012-01-01

in a variety of ulcers. However, comparative clinical trials and in particular randomized controlled trials investigating the efficacy of MDT are sparse. A systematic search in the literature showed three randomized clinical trials and five non randomized studies evaluating the efficacy of sterile Lucilia......, including hydrocolloid, hydrogel and saline moistened gauze. However, the design of the studies was suboptimal, with important differences in the use of other therapies, such as compression, that may influence both debridement and healing between the compared groups, as well as inappropriately short follow...

ADM For Solving Linear Second-Order Fredholm Integro-Differential Equations

Science.gov (United States)

Karim, Mohd F.; Mohamad, Mahathir; Saifullah Rusiman, Mohd; Che-Him, Norziha; Roslan, Rozaini; Khalid, Kamil

2018-04-01

In this paper, we apply Adomian Decomposition Method (ADM) as numerically analyse linear second-order Fredholm Integro-differential Equations. The approximate solutions of the problems are calculated by Maple package. Some numerical examples have been considered to illustrate the ADM for solving this equation. The results are compared with the existing exact solution. Thus, the Adomian decomposition method can be the best alternative method for solving linear second-order Fredholm Integro-Differential equation. It converges to the exact solution quickly and in the same time reduces computational work for solving the equation. The result obtained by ADM shows the ability and efficiency for solving these equations.

Comparing Mixed & Integer Programming vs. Constraint Programming by solving Job-Shop Scheduling Problems

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Renata Melo e Silva de Oliveira

2015-03-01

Full Text Available Scheduling is a key factor for operations management as well as for business success. From industrial Job-shop Scheduling problems (JSSP, many optimization challenges have emerged since de 1960s when improvements have been continuously required such as bottlenecks allocation, lead-time reductions and reducing response time to requests.  With this in perspective, this work aims to discuss 3 different optimization models for minimizing Makespan. Those 3 models were applied on 17 classical problems of examples JSSP and produced different outputs.  The first model resorts on Mixed and Integer Programming (MIP and it resulted on optimizing 60% of the studied problems. The other models were based on Constraint Programming (CP and approached the problem in two different ways: a model CP1 is a standard IBM algorithm whereof restrictions have an interval structure that fail to solve 53% of the proposed instances, b Model CP-2 approaches the problem with disjunctive constraints and optimized 88% of the instances. In this work, each model is individually analyzed and then compared considering: i Optimization success performance, ii Computational processing time, iii Greatest Resource Utilization and, iv Minimum Work-in-process Inventory. Results demonstrated that CP-2 presented best results on criteria i and ii, but MIP was superior on criteria iii and iv and those findings are discussed at the final section of this work.

Clock Math — a System for Solving SLEs Exactly

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Jakub Hladík

2013-01-01

Full Text Available In this paper, we present a GPU-accelerated hybrid system that solves ill-conditioned systems of linear equations exactly. Exactly means without rounding errors due to using integer arithmetics. First, we scale floating-point numbers up to integers, then we solve dozens of SLEs within different modular arithmetics and then we assemble sub-solutions back using the Chinese remainder theorem. This approach effectively bypasses current CPU floating-point limitations. The system is capable of solving Hilbert’s matrix without losing a single bit of precision, and with a significant speedup compared to existing CPU solvers.

Humanistic therapies versus other psychological therapies for depression

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

2014-01-01

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 humanistic therapies compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of different humanistic therapy models (person-centred, gestalt, process-experiential, transactional analysis, existential and non-directive therapies) compared with all other psychological therapy approaches for acute depression.To examine the effectiveness and acceptability of all humanistic therapies compared with different psychological therapy approaches (psychodynamic, behavioural, humanistic, integrative, cognitive-behavioural) for acute depression. PMID:25278809

The effects of music therapy on oncological patients

OpenAIRE

Virbalienė, Akvilė; Račkauskienė, Skaidrė; Kasnauskienė, Jolanta; Šumskienė, Aldona

2016-01-01

The research shows the effects of music therapy on oncological patients. Music therapy is one of the tools that help patients to cope with the stress and improves self-confidence, encourages them to live valuable life. It also has a dramatic effect on quality of life as patients who participate in music therapy sessions start to express their feelings in a more active way and also start to solve their own problems. Moreover, music therapy reduces the level of stress and anxiety in the minds a...

Solving the SAT problem using Genetic Algorithm

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Arunava Bhattacharjee

2017-08-01

Full Text Available In this paper we propose our genetic algorithm for solving the SAT problem. We introduce various crossover and mutation techniques and then make a comparative analysis between them in order to find out which techniques are the best suited for solving a SAT instance. Before the genetic algorithm is applied to an instance it is better to seek for unit and pure literals in the given formula and then try to eradicate them. This can considerably reduce the search space, and to demonstrate this we tested our algorithm on some random SAT instances. However, to analyse the various crossover and mutation techniques and also to evaluate the optimality of our algorithm we performed extensive experiments on benchmark instances of the SAT problem. We also estimated the ideal crossover length that would maximise the chances to solve a given SAT instance.

Radiation biology and radiation therapy

International Nuclear Information System (INIS)

Wideroee, R.

1975-01-01

Radiation biology and radiation therapy can be compared with investigations in different layers of earth. Radiation biology works upwards from the elementary foundations, therapy works downwards with roots to secure and improve the clinical 'surface work'. The Ellis formula (Strandquist), which is a collection of clinical experience, is suited to form connections with radiobiology in the middle layers, and cooperation can give impulses for research. The structure and conditions of tumours and the complicated problems met with are discussed, based on the Carmel symposium of 1969. The oxygen problem in anoxic tumours is not yet solved. Experimental investigations of the effect itself give partly contradictory results. From a clinical viewpoint reoxygenation is of the utmost significance for obtaining control over the primary tumour, and advanced irradiation programmes will here give better results than the traditional ones. New chemicals, e.g. R 0 -07-0582, appear to reduce the OER value to 1.5, thereby making neutron therapy superfluous. Finally a problem from fundamental research is dealt with, wherein two hypotheses explaining the β-effect are described. The repair hypothesis gives a simple explanation but leaves many questions unanswered. The other hypothesis explains the β-effect as two neighbouring single breaks of the DNA molecule. It still presents difficulties, and is scarcely the correct explanation. (JIW)

Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review

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Diederik C Bervoets

2015-07-01

Full Text Available Question: Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? Design: Systematic review of randomised clinical trials. Participants: People with musculoskeletal disorders. Interventions: Massage therapy (manual manipulation of the soft tissues as a stand-alone intervention. Outcome: The primary outcomes were pain and function. Results: The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579 per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain. Conclusions: Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident. [Bervoets DC, Luijsterburg PAJ, Alessie JJN, Buijs MJ, Verhagen AP (2015 Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review. Journal of Physiotherapy 61: 106–116

Comparative Effectiveness of Three Occupational Therapy Sleep Interventions: A Randomized Controlled Study.

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Gutman, Sharon A; Gregory, Kristin A; Sadlier-Brown, Megan M; Schlissel, Marcy A; Schubert, Allison M; Westover, Lee Ann; Miller, Richard C

2017-01-01

Although sleep intervention is within the domain of occupational therapy, few studies exist supporting practice. Effectiveness of three sleep interventions was compared: Dreampad Pillow®, iRest® meditation, and sleep hygiene. Twenty-nine participants were randomly assigned to the Dreampad Pillow® ( n = 10), iRest® meditation ( n = 9), and sleep hygiene ( n = 10) groups. In Phase 1, all participants used a 7-day sleep hygiene regimen to reduce poor sleep habits. In Phase 2 (14 days), 10 participants used the Dreampad Pillow® and sleep hygiene, nine used the iRest meditation and sleep hygiene, and 10 continued sleep hygiene only. At intervention-end, the iRest meditation group experienced statistically greater time asleep than both the Dreampad Pillow® ( p meditation ( p occupational therapy's domain.

Comparative analysis of cost and efficacy for mono and dual therapy of antiepileptics among children

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Easwaran Vigneshwaran

2017-01-01

Full Text Available Introduction: Developing countries contribute to major number of patients living with epilepsy, around five million people are living with epilepsy in India alone. Most of the epileptic children may require multiple antiepileptic therapy due to the failure of monotherapy. Basic research evidence suggest that sodium valproate and carbamazepine (CBZ may have synergistic anticonvulsant effects when they are used together. In addition to that, chronic disorders make the patients economically weak and produce more burden. Aim and Objective: Therefore, this study was designed to compare the efficacy of valproate monotherapy with valproate and CBZ dual therapy. Methodology: It is a prospective, comparative study conducted at a secondary care referral hospital and private clinic. A nonprobabilistic convenient sampling was done to recruit the study subjects. A total of fifty subjects were recruited into the present study, and they were divided into two groups, i.e., monotherapy group (CBZ and dual therapy group (CBZ and valproate. After providing appropriate counseling, subjects were interviewed to estimate the quality of life (QOL using child version of TNO-AZL Children's Quality of Life questionnaire. Hospital patient records, prescription data from the pharmacy were also used to obtain the direct and indirect cost of treatment. Results: Our study results showed that monotherapy has a potential to produce a higher level of QOL than dual therapy. It also involved with decreased seizure frequency. Although there was no statistically significant difference in terms of cost for both the treatment groups, still dual therapy is associated with higher cost burden. The average costs per QOL and changes in the frequency of seizure are also identified to produce higher economic burden to the patients.Conclusion: Thus, the present study has concluded that monotherapy may be considered as better cost-effective treatment in partial seizures than dual therapy

Problem-solving skills training for parents of children with chronic pain: a pilot randomized controlled trial.

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Palermo, Tonya M; Law, Emily F; Bromberg, Maggie; Fales, Jessica; Eccleston, Christopher; Wilson, Anna C

2016-06-01

This pilot randomized controlled trial aimed to determine the feasibility, acceptability, and preliminary efficacy of parental problem-solving skills training (PSST) compared with treatment as usual on improving parental mental health symptoms, physical health and well-being, and parenting behaviors. Effects of parent PSST on child outcomes (pain, emotional, and physical functioning) were also examined. Participants included 61 parents of children aged 10 to 17 years with chronic pain randomized to PSST (n = 31) or treatment as usual (n = 30) groups. Parents receiving PSST participated in 4 to 6 individual sessions of training in problem-solving skills. Outcomes were assessed at pretreatment, immediately after treatment, and at a 3-month follow-up. Feasibility was determined by therapy session attendance, therapist ratings, and parent treatment acceptability ratings. Feasibility of PSST delivery in this population was demonstrated by high compliance with therapy attendance, excellent retention, high therapist ratings of treatment engagement, and high parent ratings of treatment acceptability. PSST was associated with posttreatment improvements in parental depression (d = -0.68), general mental health (d = 0.64), and pain catastrophizing (d = -0.48), as well as in child depression (d = -0.49), child general anxiety (d = -0.56), and child pain-specific anxiety (d = -0.82). Several effects were maintained at the 3-month follow-up. Findings demonstrate that PSST is feasible and acceptable to parents of youths with chronic pain. Treatment outcome analyses show promising but mixed patterns of effects of PSST on parent and child mental health outcomes. Further rigorous trials of PSST are needed to extend these pilot results.

Comparing the effects of rehabilitation swallowing therapy vs. neuromuscular electrical stimulation therapy among stroke patients with persistent pharyngeal dysphagia: a randomized controlled study.

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Permsirivanich, Wutichai; Tipchatyotin, Suttipong; Wongchai, Manit; Leelamanit, Vitoon; Setthawatcharawanich, Suwanna; Sathirapanya, Pornchai; Phabphal, Kanitpong; Juntawises, Uma; Boonmeeprakob, Achara

2009-02-01

Dysphagia after stroke is associated with increased mortality, higher dependence, and longer hospitalization. Different therapeutic strategies have been introduced to improve swallowing impairment. There are no current studies that compare rehabilitation swallowing therapy (RST) and neuromuscular electrical stimulation therapy (NMES). To compare treatment outcomes between RST and NMES intervention in stroke patients with pharyngeal dysphagia. A randomized controlled study. Twenty-three stroke patients with persistent pharyngeal dysphagia (RST 11, NMES 12) were enrolled in the present study. The subjects received 60 minutes of either RST or NMES treatment for five consecutive days, had two days off and then five more consecutive days of treatment for a four-week period or until they reached functional oral intake scale (FOIS) level 7. The outcome measures assessed were change in FOIS, complications related to the treatment and number of therapy sessions. There were no significant differences in the stroke characteristics and the VFSS results between the two groups. At the end of treatment, the average numbers of therapy sessions per subject in the RST and NMES groups were 18.36 +/- 3.23 and 17.25 +/- 5.64, respectively, a non-significant difference. Average changes in FOIS scores were 2.46 +/- 1.04 for the RST group and 3.17 +/- 1.27 for the NMES group, statistically significant at p stroke patients, NMES was significantly superior.

HIV Therapy Simulator: a graphical user interface for comparing the effectiveness of novel therapy regimens.

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Lim, Huat Chye; Curlin, Marcel E; Mittler, John E

2011-11-01

Computer simulation models can be useful in exploring the efficacy of HIV therapy regimens in preventing the evolution of drug-resistant viruses. Current modeling programs, however, were designed by researchers with expertise in computational biology, limiting their accessibility to those who might lack such a background. We have developed a user-friendly graphical program, HIV Therapy Simulator (HIVSIM), that is accessible to non-technical users. The program allows clinicians and researchers to explore the effectiveness of various therapeutic strategies, such as structured treatment interruptions, booster therapies and induction-maintenance therapies. We anticipate that HIVSIM will be useful for evaluating novel drug-based treatment concepts in clinical research, and as an educational tool. HIV Therapy Simulator is freely available for Mac OS and Windows at http://sites.google.com/site/hivsimulator/. jmittler@uw.edu. Supplementary data are available at Bioinformatics online.

Comparative study on radon effects and thermal effects on humans in radon hot spring therapy

International Nuclear Information System (INIS)

Yamaoka, K.; Mitsunobu, F.; Hanamoto, K.; Tanizaki, Y.; Sugita, K.; Kohima, S.

2003-01-01

Full text: The radon therapy is used radon ( 222 Rn) gas, which mainly emits alpha-rays, and induces a small amount of active oxygen in the body. Because most of the diseases to which the radon therapy as well as the thermal therapy is applied are related to activated oxygen, in this study the effects of the radioactivity of radon and thermal effects were compared under the room or the hot spring condition with the similar chemical component, using as the parameters which are closely involved in the clinical for radon therapy. In the results, the radon and thermal therapy enhanced the antioxidation function, such as the activities of superoxide dismutase (SOD) and catalase, which inhibit lipid peroxidation and total cholesterol produce in the body. Moreover the therapy enhanced concanavalin A (ConA)-induced mitogen response, and increased the level of CD4, which is the marker of helper T cell, and decreased the level of CD8, which is the common marker of killer T cell and supresser T cell, in the white cell differentiation antigen (CD4/CD8) assay. Furthermore, the therapy increased the levels of alpha atrial natriuretic polypeptide (alpha ANP), beta endorphin, adrenocorticotropic hormone (ACTH), insulin and glucose-phosphate dehydrogenase (G-6-PDH), and decreased the vasopression level. The results were on the whole larger in the radon group than in the thermal group. The findings suggest that the radon therapy more contributes to the prevention of life style-related diseases related to peroxidation reactions and immune depression than thermal therapy. Moreover these indicate what may be a part of the mechanism for the alleviation of hypertension, osteoarthritis (pain) and diabetes mellitus brought about more radon therapy than thermal therapy

[A comparative evaluation of the efficacy of magneto- and laser therapy in patients with osteoarthrosis deformans].

Science.gov (United States)

Selivonenko, V G; Syvolap, V D; Porada, L V; Medvedeva, V N; Boev, S S; Morozov, A I; Slin'ko, V G; Berest, S M; Garbuz, L N; Sholokh, S G

1997-01-01

A comparative evaluation of efficacy of magneto- and laser therapy was carried out in 82 patients with osteoarthrosis deformans. The magnetic field and laser irradiation dispelled the pain syndrome and synovitis manifestations. It is recommendable that the multiple-modality therapy of patients with osteoarthrosis deformans should involve magneto- and laser therapy (15 to 20 procedures per one course) that improve results of the treatment being received and allow the time of hospitalization to be reduced at an average by 5 bed-days. Laser appeared to be a very effective mode of treatment. No unfavourable side effects were recordable.

The association of minor and major depression with health problem-solving and diabetes self-care activities in a clinic-based population of adults with type 2 diabetes mellitus.

Science.gov (United States)

Shin, Na; Hill-Briggs, Felicia; Langan, Susan; Payne, Jennifer L; Lyketsos, Constantine; Golden, Sherita Hill

2017-05-01

We examined whether problem-solving and diabetes self-management behaviors differ by depression diagnosis - major depressive disorder (MDD) and minor depressive disorder (MinDD) - in adults with Type 2 diabetes (T2DM). We screened a clinical sample of 702 adults with T2DM for depression, identified 52 positive and a sample of 51 negative individuals, and performed a structured diagnostic psychiatric interview. MDD (n=24), MinDD (n=17), and no depression (n=62) were diagnosed using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria. Health Problem-Solving Scale (HPSS) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaires determined problem-solving and T2DM self-management skills, respectively. We compared HPSS and SDSCA scores by depression diagnosis, adjusting for age, sex, race, and diabetes duration, using linear regression. Total HPSS scores for MDD (β=-4.38; pdepression. Total SDSCA score for MDD (β=-10.1; pdepression, and was partially explained by total HPSS. MinDD and MDD individuals with T2DM have impaired problem-solving ability. MDD individuals had impaired diabetes self-management, partially explained by impaired problem-solving. Future studies should assess problem-solving therapy to treat T2DM and MinDD and integrated problem-solving with diabetes self-management for those with T2DM and MDD. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparative Study of Multimodal and Pharmacological Therapy in Treating School Aged Children with ADHD

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Susana Bogdana MILEA

2012-09-01

Full Text Available The attention deficit hyperactivity disorder (ADHD, one of the most commonly diagnosed psychiatric disorders among school aged children, continues to create disputes between specialists, upon the best treatment to be used. The herby study aims to bring forward some differences that may exist between the efficacy of the multimodal treatment compared to the drug treatment of ADHD. The novelty component of this study, unfolded February 2010-July 2012, is that the children, their parents and also their teachers were included in the multimodality treatment. The children included in this research (n=63, aged 6-14 and ADHD diagnosed, were randomly assigned in two groups. In the medication (Med group (n=32 the children only received the specific pharmacological treatment (Atomoxetine or Methylphenidate, and for the multimodality (MM group (n=31 the therapy included psychosocial interventions besides the drug therapy. All children were evaluated, both pre and post intervention, with the Achenbach System of Empirically Based Assessment – ASEBA, for the 6-18 aged category. We have compared the influence of therapy on the core symptoms, on the adaptive functionality and academic performance and on the competences and social functioning of the children in the two groups. The multimodal intervention proved to be more effective (p<0.05 than medication alone, firstly in ameliorating the child’s social behavior in both family and school environment, than in what concerns the main ADHD symptoms. The children’s academic performance was little impacted by either of the two therapies.

Enhancing memory and imagination improves problem solving among individuals with depression.

Science.gov (United States)

McFarland, Craig P; Primosch, Mark; Maxson, Chelsey M; Stewart, Brandon T

2017-08-01

Recent work has revealed links between memory, imagination, and problem solving, and suggests that increasing access to detailed memories can lead to improved imagination and problem-solving performance. Depression is often associated with overgeneral memory and imagination, along with problem-solving deficits. In this study, we tested the hypothesis that an interview designed to elicit detailed recollections would enhance imagination and problem solving among both depressed and nondepressed participants. In a within-subjects design, participants completed a control interview or an episodic specificity induction prior to completing memory, imagination, and problem-solving tasks. Results revealed that compared to the control interview, the episodic specificity induction fostered increased detail generation in memory and imagination and more relevant steps on the problem-solving task among depressed and nondepressed participants. This study builds on previous work by demonstrating that a brief interview can enhance problem solving among individuals with depression and supports the notion that episodic memory plays a key role in problem solving. It should be noted, however, that the results of the interview are relatively short-lived.

An economic evaluation of VAC therapy compared with wound dressings in the treatment of diabetic foot ulcers.

Science.gov (United States)

Flack, S; Apelqvist, J; Keith, M; Trueman, P; Williams, D

2008-02-01

To determine the cost-effectiveness ofVacuum Assisted Closure (VAC) therapy (KCI Medical), based on a comparison with both traditional and advanced wound dressings, for the treatment of diabetic foot ulcers in the US. A Markov model was designed to estimate the cost per amputation avoided and the cost per quality-adjusted life year (QALY) of VAC therapy, compared with both traditional and advanced dressings. Over a one-year period the Markov model simulated 1000 patients using transition probabilities obtained from the literature. The health states used in the model were: uninfected ulcer; infected ulcer; infected ulcer post-amputation; healed; healed post-amputation; amputation; and death. Patients initially treated with VAC switched to the advanced dressing after three months of treatment if their wound remained unhealed. Patients treated with traditional or advanced dressings were assumed to continue with their treatment for the full 12 months if they remained unhealed. The model results demonstrate improved healing rates (61% versus 59%), more QALYs (0.54 versus 0.53) and an overall lower cost of care ($52,830 versus $61,757 per person) for patients treated with VAC therapy compared with advanced dressings. Vacuum Assisted Closure was also shown to be a dominant intervention when compared with traditional dressings. The model results indicate thatVAC therapy is less costly and more effective than both traditional and advanced dressings. The results are robust to changes in key parameters, including the transition probabilities, the cost ofVAC therapy and the utility weights applied to health states.

GPU-based high-performance computing for radiation therapy

International Nuclear Information System (INIS)

Jia, Xun; Jiang, Steve B; Ziegenhein, Peter

2014-01-01

Recent developments in radiotherapy therapy demand high computation powers to solve challenging problems in a timely fashion in a clinical environment. The graphics processing unit (GPU), as an emerging high-performance computing platform, has been introduced to radiotherapy. It is particularly attractive due to its high computational power, small size, and low cost for facility deployment and maintenance. Over the past few years, GPU-based high-performance computing in radiotherapy has experienced rapid developments. A tremendous amount of study has been conducted, in which large acceleration factors compared with the conventional CPU platform have been observed. In this paper, we will first give a brief introduction to the GPU hardware structure and programming model. We will then review the current applications of GPU in major imaging-related and therapy-related problems encountered in radiotherapy. A comparison of GPU with other platforms will also be presented. (topical review)

Comparative Effectiveness of Family Problem-Solving Therapy (F-PST) for Adolescent TBI

Science.gov (United States)

2018-01-25

Tbi; Intracranial Edema; Brain Edema; Craniocerebral Trauma; Head Injury; Brain Hemorrhage, Traumatic; Subdural Hematoma; Brain Concussion; Head Injuries, Closed; Epidural Hematoma; Cortical Contusion; Wounds and Injuries; Disorders of Environmental Origin; Trauma, Nervous System; Brain Injuries

Rumination decreases parental problem-solving effectiveness in dysphoric postnatal mothers.

Science.gov (United States)

O'Mahen, Heather A; Boyd, Alex; Gashe, Caroline

2015-06-01

Postnatal depression is associated with poorer parenting quality, but there are few studies examining maternal-specific cognitive processes that may impact on parenting quality. In this study, we examined the impact of rumination on parental problem-solving effectiveness in dysphoric and non-dysphoric postnatal mothers. Fifty-nine mothers with a infant aged 12 months and under, 20 of whom had a Beck Depression Score II (BDI-II) score ≥ 14, and 39 who scored less than 14 on the BDI-II were randomly assigned to either a rumination or distraction condition. Problem-solving effectiveness was assessed post-induction with the "Postnatal Parental Problem-Solving Task" (PPST), which was adapted from the Means Ends Problem-solving task. Parental problem-solving confidence was also assessed. Dysphoric ruminating mothers exhibited poorer problem-solving effectiveness and poorer confidence regarding their problem-solving compared to dysphoric distracting, non-dysphoric distracting, and non-dysphoric ruminating mothers. A self-report measure of depressed mood was used. Rumination may be a key mechanism associated with both depressive mood and maternal parenting quality during the postnatal period. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment.

Science.gov (United States)

Imani, Saeed; Atef Vahid, Mohammad Kazem; Gharraee, Banafsheh; Noroozi, Alireza; Habibi, Mojtaba; Bowen, Sarah

2015-06-01

This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program. The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

Directory of Open Access Journals (Sweden)

Saeed Imani

2015-11-01

Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: A systematic review

NARCIS (Netherlands)

D.C. Bervoets (Diederik C.); P.A.J. Luijsterburg (Pim); J.J.N. Alessie (Jeroen J.N.); M.J. Buijs (Martijn J.); A.P. Verhagen (Arianne)

2015-01-01

textabstractQuestion: Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? Design: Systematic review of randomised clinical trials. Participants: People with musculoskeletal disorders. Interventions: Massage therapy (manual

The effects of cumulative practice on mathematics problem solving.

Science.gov (United States)

Mayfield, Kristin H; Chase, Philip N

2002-01-01

This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving.

Effection of percutaneous coronary intenvention compared with intravenous thrombolysis therapy of acute myocardial infarction

International Nuclear Information System (INIS)

Lu Jianhui; Hong Xiaosu; Xu Weiting

2006-01-01

Objective: To evaluate the curative effect of the two successful therapeatic methods on myocardial infarction in the acute and long-term stage: percutaneous coronary intenvention(PCI) and intravenous thrombolysis therapy. Methods: Fifty-six patients of acute myocardial infarction were studied. There was no record of heart failure occurence in the case history for all of them. We randomly assigned them to receive PCI or intravenous thrombolysis therapy, and all of them are treated successfully. Left ventricule ejection fraction (LVEF) and left ventricule end diastole diameter(LVEDD) measured by echocardiography were analyzed. Clinical information about death caused by cardial origin problems were collected and the mean survival days of the patients were 548.7 ± 48.9. Results: The total of 27 patients were assigned to undergo PCI and 29 patients received intravenous thrombolysis therapy. LVEF patients with PCI were 57.6% ± 2.3%, and patients with intravenous thrombolysis therapy were 49.9% ± 1.9%. There were significant difference between the two groups(P 0.5). 548.7 ± 48.9 days survival was accounted for 85.2% in the PCI group, and 79.3% in the intravenous thrombolysis therapy (P>0.5). Multivariate analysis showed that older age, LVEF, were related to 548.7 ± 48.9 days mortality. Conclusion: The results of this study show more acute stage benefit patients treated with PCI using bare stant than those treated with intravenous thrombolysis therapy; But it indicates that there is no more long-term survival for patients treated with PCI by using bare stant compared with those who received intravenous thrombolysis therapy in the patients with light or medium acute myocardial infarction. (authors)

A Preliminary Report of Short-Term Cognitive-Behavioral Group Therapy for Inpatients With Personality Disorders

Science.gov (United States)

SPRINGER, TAMAR; LOHR, NAOMI E.; BUCHTEL, HENRY A.; SILK, KENNETH R.

1996-01-01

A randomized, controlled study evaluated the effectiveness of a cognitive-behavioral therapy group, based on Linehan’s dialectical behavior therapy, for inpatients with personality disorders. The treatment, a problem-solving skills group focused on parasuicidality, was compared with a discussion control group. Change was assessed by self-report measures and behavioral observations on the unit. Subjects in both groups improved significantly on most change measures, although no significant between-group differences were found. However, the treatment group patients viewed the intervention as more beneficial to them in their lives outside the hospital. The usefulness of this type of group on a short-term unit is discussed. PMID:22700265

A distance learning model in a physical therapy curriculum.

Science.gov (United States)

English, T; Harrison, A L; Hart, A L

1998-01-01

In response to the rural health initiative established in 1991, the University of Kentucky has developed an innovative distance learning program of physical therapy instruction that combines classroom lecture and discussion via compressed video technology with laboratory experiences. The authors describe the process of planning, implementing, and evaluating a specific distance learning course in pathomechanics for the professional-level master's-degree physical therapy students at the University of Kentucky. This presentation may serve as a model for teaching distance learning. Descriptions of optimal approaches to preclass preparation, scheduling, course delivery, use of audiovisual aids, use of handout material, and video production are given. Special activities that may enhance or deter the achievement of the learning objectives are outlined, and a problem-solving approach to common problems encountered is presented. An approach to evaluating and comparing course outcomes for the distance learnere is presented. For this particular course, there was no statistically significant difference in the outcome measures utilized to compare the distance learners with the on-site learners.

Text Comprehension and Oral Language as Predictors of Word-Problem Solving: Insights into Word-Problem Solving as a Form of Text Comprehension.

Science.gov (United States)

Fuchs, Lynn S; Gilbert, Jennifer K; Fuchs, Douglas; Seethaler, Pamela M; Martin, BrittanyLee N

2018-01-01

This study was designed to deepen insights on whether word-problem (WP) solving is a form of text comprehension (TC) and on the role of language in WPs. A sample of 325 second graders, representing high, average, and low reading and math performance, was assessed on (a) start-of-year TC, WP skill, language, nonlinguistic reasoning, working memory, and foundational skill (word identification, arithmetic) and (b) year-end WP solving, WP-language processing (understanding WP statements, without calculation demands), and calculations. Multivariate, multilevel path analysis, accounting for classroom and school effects, indicated that TC was a significant and comparably strong predictor of all outcomes. Start-of-year language was a significantly stronger predictor of both year-end WP outcomes than of calculations, whereas start-of-year arithmetic was a significantly stronger predictor of calculations than of either WP measure. Implications are discussed in terms of WP solving as a form of TC and a theoretically coordinated approach, focused on language, for addressing TC and WP-solving instruction.

Local Strategy Improvement for Parity Game Solving

Directory of Open Access Journals (Sweden)

Oliver Friedmann

2010-06-01

Full Text Available The problem of solving a parity game is at the core of many problems in model checking, satisfiability checking and program synthesis. Some of the best algorithms for solving parity game are strategy improvement algorithms. These are global in nature since they require the entire parity game to be present at the beginning. This is a distinct disadvantage because in many applications one only needs to know which winning region a particular node belongs to, and a witnessing winning strategy may cover only a fractional part of the entire game graph. We present a local strategy improvement algorithm which explores the game graph on-the-fly whilst performing the improvement steps. We also compare it empirically with existing global strategy improvement algorithms and the currently only other local algorithm for solving parity games. It turns out that local strategy improvement can outperform these others by several orders of magnitude.

Solving Large Clustering Problems with Meta-Heuristic Search

DEFF Research Database (Denmark)

Turkensteen, Marcel; Andersen, Kim Allan; Bang-Jensen, Jørgen

In Clustering Problems, groups of similar subjects are to be retrieved from data sets. In this paper, Clustering Problems with the frequently used Minimum Sum-of-Squares Criterion are solved using meta-heuristic search. Tabu search has proved to be a successful methodology for solving optimization...... problems, but applications to large clustering problems are rare. The simulated annealing heuristic has mainly been applied to relatively small instances. In this paper, we implement tabu search and simulated annealing approaches and compare them to the commonly used k-means approach. We find that the meta-heuristic...

Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review.

Science.gov (United States)

Bervoets, Diederik C; Luijsterburg, Pim A J; Alessie, Jeroen J N; Buijs, Martijn J; Verhagen, Arianne P

2015-07-01

Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? Systematic review of randomised clinical trials. People with musculoskeletal disorders. Massage therapy (manual manipulation of the soft tissues) as a stand-alone intervention. The primary outcomes were pain and function. The 26 eligible randomised trials involved 2565 participants. The mean sample size was 95 participants (range 16 to 579) per study; 10 studies were considered to be at low risk of bias. Overall, low-to-moderate-level evidence indicated that massage reduces pain in the short term compared to no treatment in people with shoulder pain and osteoarthritis of the knee, but not in those with low back pain or neck pain. Furthermore, low-to-moderate-level evidence indicated that massage improves function in the short term compared to no treatment in people with low back pain, knee arthritis or shoulder pain. Low-to-very-low-level evidence from single studies indicated no clear benefits of massage over acupuncture, joint mobilisation, manipulation or relaxation therapy in people with fibromyalgia, low back pain and general musculoskeletal pain. Massage therapy, as a stand-alone treatment, reduces pain and improves function compared to no treatment in some musculoskeletal conditions. When massage is compared to another active treatment, no clear benefit was evident. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy

International Nuclear Information System (INIS)

Gunther, Jillian R.; Sato, Mariko; Chintagumpala, Murali; Ketonen, Leena; Jones, Jeremy Y.; Allen, Pamela K.; Paulino, Arnold C.; Okcu, M. Fatih; Su, Jack M.; Weinberg, Jeffrey; Boehling, Nicholas S.; Khatua, Soumen; Adesina, Adekunle; Dauser, Robert; Whitehead, William E.; Mahajan, Anita

2015-01-01

Purpose: The clinical significance of magnetic resonance imaging (MRI) changes after radiation therapy (RT) in children with ependymoma is not well defined. We compared imaging changes following proton beam radiation therapy (PBRT) to those after photon-based intensity modulated RT (IMRT). Methods and Materials: Seventy-two patients with nonmetastatic intracranial ependymoma who received postoperative RT (37 PBRT, 35 IMRT) were analyzed retrospectively. MRI images were reviewed by 2 neuroradiologists. Results: Sixteen PBRT patients (43%) developed postradiation MRI changes at 3.8 months (median) with resolution by 6.1 months. Six IMRT patients (17%) developed changes at 5.3 months (median) with 8.3 months to resolution. Mean age at radiation was 4.4 and 6.9 years for PBRT and IMRT, respectively (P=.06). Age at diagnosis (>3 years) and time of radiation (≥3 years) was associated with fewer imaging changes on univariate analysis (odds ratio [OR]: 0.35, P=.048; OR: 0.36, P=.05). PBRT (compared to IMRT) was associated with more frequent imaging changes, both on univariate (OR: 3.68, P=.019) and multivariate (OR: 3.89, P=.024) analyses. Seven (3 IMRT, 4 PBRT) of 22 patients with changes had symptoms requiring intervention. Most patients were treated with steroids; some PBRT patients also received bevacizumab and hyperbaric oxygen therapy. None of the IMRT patients had lasting deficits, but 2 patients died from recurrent disease. Three PBRT patients had persistent neurological deficits, and 1 child died secondarily to complications from radiation necrosis. Conclusions: Postradiation MRI changes are more common with PBRT and in patients less than 3 years of age at diagnosis and treatment. It is difficult to predict causes for development of imaging changes that progress to clinical significance. These changes are usually self-limiting, but some require medical intervention, especially those involving the brainstem

Manufacturing models permitting roll out/scale out of clinically led autologous cell therapies: regulatory and scientific challenges for comparability.

Science.gov (United States)

Hourd, Paul; Ginty, Patrick; Chandra, Amit; Williams, David J

2014-08-01

Manufacturing of more-than-minimally manipulated autologous cell therapies presents a number of unique challenges driven by complex supply logistics and the need to scale out production to multiple manufacturing sites or near the patient within hospital settings. The existing regulatory structure in Europe and the United States imposes a requirement to establish and maintain comparability between sites. Under a single market authorization, this is likely to become an unsurmountable burden beyond two or three sites. Unless alternative manufacturing approaches can be found to bridge the regulatory challenge of comparability, realizing a sustainable and investable business model for affordable autologous cell therapy supply is likely to be extremely demanding. Without a proactive approach by the regulators to close this "translational gap," these products may not progress down the development pipeline, threatening patient accessibility to an increasing number of clinician-led autologous cellular therapies that are already demonstrating patient benefits. We propose three prospective manufacturing models for the scale out/roll out of more-than-minimally manipulated clinically led autologous cell therapy products and test their prospects for addressing the challenge of product comparability with a selected expert reference panel of US and UK thought leaders. This paper presents the perspectives and insights of the panel and identifies where operational, technological and scientific improvements should be prioritized. The main purpose of this report is to solicit feedback and seek input from key stakeholders active in the field of autologous cell therapy in establishing a consensus-based manufacturing approach that may permit the roll out of clinically led autologous cell therapies. Copyright © 2014 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Problem Solving Skills Training for Parents of Children with Chronic Pain: A Pilot Randomized Controlled Trial

Science.gov (United States)

Palermo, Tonya M.; Law, Emily F.; Bromberg, Maggie; Fales, Jessica; Eccleston, Christopher; Wilson, Anna C.

2016-01-01

This pilot randomized controlled trial aimed to determine the feasibility, acceptability, and preliminary efficacy of parental problem solving skills training (PSST) compared to treatment as usual (TAU) on improving parental mental health symptoms, physical health and well-being, and parenting behaviors. Effects of parent PSST on child outcomes (pain, emotional and physical functioning) were also examined. Participants included 61 parents of children aged 10–17 years with chronic pain randomized to PSST (n = 31) or TAU (n = 30). Parents receiving PSST participated in 4–6 individual sessions of training in problem solving skills. Outcomes were assessed at pre-treatment, immediately post-treatment, and at 3-month follow up. Feasibility was determined by therapy session attendance, therapist ratings, and parent treatment acceptability ratings. Feasibility of PSST delivery in this population was demonstrated by high compliance with therapy attendance, excellent retention, high therapist ratings of treatment engagement, and high parent ratings of treatment acceptability. PSST was associated with post-treatment improvements in parental depression (d = −0.68), general mental health (d = 0.64), and pain catastrophizing (d = −0.48), as well as in child depression (d = −0.49), child general anxiety (d = −0.56), and child pain-specific anxiety (d = −0.82). Several effects were maintained at 3-month follow-up. Findings demonstrate that PSST is feasible and acceptable to parents of youth with chronic pain. Treatment outcome analyses show promising but mixed patterns of effects of PSST on parent and child mental health outcomes. Further rigorous trials of PSST are needed to extend these pilot results. PMID:26845525

A pilot study of myofascial release therapy compared to Swedish massage in Fibromyalgia

Science.gov (United States)

Liptan, Ginevra; Mist, Scott; Wright, Cheryl; Arzt, Anna; Jones, Kim Dupree

2017-01-01

Summary Fibromyalgia (FM) is characterized by widespread muscle pain and soft tissue tenderness. However, a lack of definitive muscle pathology has made FM both a diagnostic and a treatment puzzle. Much of the evidence for pathology in FM lies in the central nervous system – in particular abnormal amplification of pain signals in the spinal cord – a manifestation of central sensitization. An emerging body of evidence posits that peripheral pain generated from the muscles and fascia may trigger and maintain central sensitization in FM. Since FM patients so frequently seek manual therapy to relieve muscle symptoms, the present study compared two different manual therapy techniques in a parallel study of women with FM. Eight subjects received myofascial release (MFR) while four subjects received Swedish massage, 90 min weekly for four weeks. Overall symptom burden and physical function were assessed by the Fibromyalgia Impact Questionnaire Revised (FIQ-R). A unique challenge for the manual therapist in treating conditions involving central sensitization is to determine if localized pain reduction can be achieved with targeted therapy in the context of ongoing widespread pain. Localized pain improvement was measured by a novel questionnaire developed for this study, the modified Nordic Musculoskeletal Questionnaire (NMQ). Between-group differences in FIQ-R did not reach statistical significance, but the total change scores on FIQ-R for the MFR group (mean = 10.14, SD = 16.2) trended in the hypothesized and positive direction compared to the Swedish massage group (mean = 0.33, SD = 4.93) yielding a positive Aikin separation test. Although overall modified NMQ scores improved in both groups there were no consistent focal areas of improvement for the Swedish massage group. In contrast, the MFR group reported consistent pain reductions in the neck and upper back regions on the NMQ. These data support the need for larger randomized controlled trials of MFR versus other

Functional outcome after primary endovascular therapy or IV thrombolysis alone for stroke. An observational, comparative effectiveness study.

Science.gov (United States)

Abilleira, Sònia; Ribera, Aida; Dávalos, Antonio; Ribó, Marc; Chamorro, Angel; Cardona, Pere; Molina, Carlos A; Martínez-Yélamos, Antonio; Urra, Xabier; Dorado, Laura; Roquer, Jaume; Martí-Fàbregas, Joan; Aja, Lucía; Tomasello, Alejandro; Castaño, Carlos; Blasco, Jordi; Cánovas, David; Castellanos, Mar; Krupinski, Jerzy; Guimaraens, Leopoldo; Perendreu, Joan; Ustrell, Xavier; Purroy, Francisco; Gómez-Choco, Manuel; Baiges, Joan Josep; Cocho, Dolores; Saura, Júlia; Gallofré, Miquel

2014-01-01

Among the acute ischemic stroke patients with large vessel occlusions and contraindications for the use of IV thrombolysis, mainly on oral anticoagulation or presenting too late, primary endovascular therapy is often performed as an alternative to the standard therapy even though evidence supporting the use of endovascular reperfusion therapies is not yet established. Using different statistical approaches, we compared the functional independence rates at 3 months among patients undergoing primary endovascular therapy and patients treated only with IV thrombolysis. We used data from a prospective, government-mandated and externally audited registry of reperfusion therapies for ischemic stroke (January 2011 to November 2012). Patients were selected if treated with either IV thrombolysis alone (n = 1,582) or primary endovascular thrombectomy (n = 250). A series of exclusions were made to homogenize the clinical characteristics among the two groups. We then carried out multivariate logistic regression and propensity score matching analyses on the final study sample (n = 1,179) to compare functional independence at 3 months, as measured by the modified Rankin scale scores 0-2, between the two groups. The unadjusted likelihood of good outcome was poorer among the endovascular group (OR: 0.69; 95% CI: 0.47-1.0). After adjustment, no differences by treatment modality were seen (OR: 1.51; 95% CI: 0.93-2.43 for primary endovascular therapy). Patients undergoing endovascular thrombectomy within 180-270 min (OR: 2.89; 95% CI: 1.17-7.15) and patients with severe strokes (OR: 1.84; 95% CI: 1.02-3.35) did better than their intravenous thrombolysis counterparts. The propensity score-matched analyses with and without adjustment by additional covariates showed that endovascular thrombectomy was as effective as intravenous thrombolysis alone in achieving functional independence (OR for unadjusted propensity score matched: 1.35; 95% CI: 0.9-2.02, OR for adjusted propensity score

It's about Me Solving My Problems: Clients' Assessments of Dialectical Behavior Therapy

Science.gov (United States)

Cunningham, Kiran; Wolbert, Randall; Lillie, Becky

2004-01-01

While the existing research consistently points to the effectiveness of Dialectical Behavior Therapy (DBT) in treating borderline personality disorder, little qualitative research has been conducted to ascertain the reasons for its success, especially from the perspective of those undergoing the treatment. Our qualitative investigation was…

Cognitive Behavioral Therapy Compared with Non-specialized Therapy for Alleviating the Effect of Auditory Hallucinations in People with Reoccurring Schizophrenia: A Systematic Review and Meta-analysis.

Science.gov (United States)

Kennedy, Laura; Xyrichis, Andreas

2017-02-01

Cognitive behavioral therapy (CBT) is recommended as a psychological intervention for those diagnosed with schizophrenia. The prevalence of auditory hallucinations is high among this group, many of whom are cared for by community mental health teams that may not have easy access to qualified CBT practitioners. This systematic review examined the evidence for the superiority of CBT compared to non-specialized therapy in alleviating auditory hallucinations in community patients with schizophrenia. Two RCTs met the inclusion criteria totaling 105 participants. The Positive and Negative Syndrome Scale (PANSS)-Positive Scale was the outcome measure examined. A meta-analysis revealed a pooled mean difference of -0.86 [95 % CI -2.38, 0.65] in favor of CBT, although this did not reach statistical significance. This systematic review concluded there is no clinically significant difference in the reduction of positive symptoms of schizophrenia when treated by CBT compared to a non-specialized therapy for adults experiencing auditory hallucinations.

Comparative cost-effectiveness of antiviral therapies in patients with chronic hepatitis B: a systematic review of economic evidence.

Science.gov (United States)

Sun, Xin; Qin, Wen-Xia; Li, You-Ping; Jiang, Xu-Hua

2007-09-01

Economic efficiency of the alternative antiviral therapies for chronic hepatitis B has not been systematically investigated and their quality remains unknown. The aim of the present study was to systematically overview economic evidence of antiviral therapies for chronic hepatitis B. We searched six databases and eight major journals supplemented with screening references of eligible studies. Full economic evaluations comparing alternative antiviral therapies in patients with chronic hepatitis B virus infection were included. Two investigators assessed the study quality and transferability, independently. Data were analyzed qualitatively with adjustment when appropriate. Fourteen studies (six modeling vs eight trials and database analyses) were included. Quality was high in five studies, moderate in one US and five Chinese studies, and low in three Chinese studies. The major problems of quality are costing methods and analysis and the presentation of results. In Australia and Poland, lamivudine-preferred strategies dominated interferon (IFN)-alpha and its related strategy from the health-care sector perspective. In the US, adefovir salvage produced US$8446 per additional quality-adjusted life years (QALY) compared with IFN-alpha. In Spain, the cost of adefovir was US$34,840 for additional virological response. In Taiwan, the use of pegylated IFN-alpha (pegIFN-alpha) produced US$11,711.4 per additional QALY, compared with lamivudine. In China, the incremental cost-effectiveness ratios of combination therapy lamivudine ranged from US$2860 to US$22,160 per additional loss of hepatitis B e antigen (HBeAg), and IFN-alpha versus lamivudine ranged from US$2490 to US$8890 per additional loss of HBeAg. The cost-effectiveness frontiers of treatment alternatives vary and are influenced by the comparators and socioeconomic conditions of countries. Lamivudine-containing therapy is cost-effective when newer antiviral agents (e.g. adefovir/pegIFN-alpha) were not available

An Analysis of Students Error in Solving PISA 2012 and Its Scaffolding

OpenAIRE

Sari, Yurizka Melia; Valentino, Erik

2016-01-01

Based on PISA survey in 2012, Indonesia was only placed on 64 out of 65 participating countries. The survey suggest that the students’ ability of reasoning, spatial orientation, and problem solving are lower compare with other participants countries, especially in Shouth East Asia. Nevertheless, the result of PISA does not elicit clearly on the students’ inability in solving PISA problem such as the location and the types of student’s errors. Therefore, analyzing students’ error in solving PI...

Multistage Spectral Relaxation Method for Solving the Hyperchaotic Complex Systems

Directory of Open Access Journals (Sweden)

Hassan Saberi Nik

2014-01-01

Full Text Available We present a pseudospectral method application for solving the hyperchaotic complex systems. The proposed method, called the multistage spectral relaxation method (MSRM is based on a technique of extending Gauss-Seidel type relaxation ideas to systems of nonlinear differential equations and using the Chebyshev pseudospectral methods to solve the resulting system on a sequence of multiple intervals. In this new application, the MSRM is used to solve famous hyperchaotic complex systems such as hyperchaotic complex Lorenz system and the complex permanent magnet synchronous motor. We compare this approach to the Runge-Kutta based ode45 solver to show that the MSRM gives accurate results.

Proton linacs for boron neutron capture therapy

International Nuclear Information System (INIS)

Lennox, A.J.

1993-08-01

Recent advances in the ability to deliver boron-containing drugs to brain tumors have generated interest in ∼4 MeV linacs as sources of epithermal neutrons for radiation therapy. In addition, fast neutron therapy facilities have been studying methods to moderate their beams to take advantage of the high cross section for epithermal neutrons on boron-10. This paper describes the technical issues involved in each approach and presents the motivation for undertaking such studies using the Fermilab linac. the problems which must be solved before therapy can begin are outlined. Status of preparatory work and results of preliminary measurements are presented

Rational approximatons for solving cauchy problems

Directory of Open Access Journals (Sweden)

Veyis Turut

2016-08-01

Full Text Available In this letter, numerical solutions of Cauchy problems are considered by multivariate Padé approximations (MPA. Multivariate Padé approximations (MPA were applied to power series solutions of Cauchy problems that solved by using He’s variational iteration method (VIM. Then, numerical results obtained by using multivariate Padé approximations were compared with the exact solutions of Cauchy problems.

Text Comprehension and Oral Language as Predictors of Word-Problem Solving: Insights into Word-Problem Solving as a Form of Text Comprehension

Science.gov (United States)

Fuchs, Lynn S.; Gilbert, Jennifer K.; Fuchs, Douglas; Seethaler, Pamela M.; Martin, BrittanyLee N.

2018-01-01

This study was designed to deepen insights on whether word-problem (WP) solving is a form of text comprehension (TC) and on the role of language in WPs. A sample of 325 second graders, representing high, average, and low reading and math performance, was assessed on (a) start-of-year TC, WP skill, language, nonlinguistic reasoning, working memory, and foundational skill (word identification, arithmetic) and (b) year-end WP solving, WP-language processing (understanding WP statements, without calculation demands), and calculations. Multivariate, multilevel path analysis, accounting for classroom and school effects, indicated that TC was a significant and comparably strong predictor of all outcomes. Start-of-year language was a significantly stronger predictor of both year-end WP outcomes than of calculations, whereas start-of-year arithmetic was a significantly stronger predictor of calculations than of either WP measure. Implications are discussed in terms of WP solving as a form of TC and a theoretically coordinated approach, focused on language, for addressing TC and WP-solving instruction. PMID:29643723

Writing and mathematical problem solving in Grade 3

Directory of Open Access Journals (Sweden)

Belinda Petersen

2017-06-01

Full Text Available This article looks at writing tasks as a methodology to support learners’ mathematical problemsolving strategies in the South African Foundation Phase context. It is a qualitative case study and explores the relation between the use of writing in mathematics and development of learners’ problem-solving strategies and conceptual understanding. The research was conducted in a suburban Foundation Phase school in Cape Town with a class of Grade 3 learners involved in a writing and mathematics intervention. Writing tasks were modelled to learners and implemented by them while they were engaged in mathematical problem solving. Data were gathered from a sample of eight learners of different abilities and included written work, interviews, field notes and audio recordings of ability group discussions. The results revealed an improvement in the strategies and explanations learners used when solving mathematical problems compared to before the writing tasks were implemented. Learners were able to reflect critically on their thinking through their written strategies and explanations. The writing tasks appeared to support learners in providing opportunities to construct and apply mathematical knowledge and skills in their development of problem-solving strategies.

Development and validation of a physics problem-solving assessment rubric

Science.gov (United States)

Docktor, Jennifer Lynn

Problem solving is a complex process that is important for everyday life and crucial for learning physics. Although there is a great deal of effort to improve student problem solving throughout the educational system, there is no standard way to evaluate written problem solving that is valid, reliable, and easy to use. Most tests of problem solving performance given in the classroom focus on the correctness of the end result or partial results rather than the quality of the procedures and reasoning leading to the result, which gives an inadequate description of a student's skills. A more detailed and meaningful measure is necessary if different curricular materials or pedagogies are to be compared. This measurement tool could also allow instructors to diagnose student difficulties and focus their coaching. It is important that the instrument be applicable to any problem solving format used by a student and to a range of problem types and topics typically used by instructors. Typically complex processes such as problem solving are assessed by using a rubric, which divides a skill into multiple quasi-independent categories and defines criteria to attain a score in each. This dissertation describes the development of a problem solving rubric for the purpose of assessing written solutions to physics problems and presents evidence for the validity, reliability, and utility of score interpretations on the instrument.

Comparison of mathematical problem solving strategies of primary school pupils

OpenAIRE

Wasilewská, Eliška

2016-01-01

The aim of this dissertation is to describe the role of educational strategy especially in field of the teaching of mathematics and to compare the mathematical problem solving strategies of primary school pupils which are taught by using different educational strategies. In the theoretical part, the main focus is on divergent educational strategies and their characteristics, next on factors affected teaching/learning process and finally on solving the problems. The empirical part of the disse...

Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy.

Science.gov (United States)

Westra, Henny A

2011-02-01

Self-report measures of motivation for changing anxiety have been weakly and inconsistently related to outcome in cognitive behavioral therapy (CBT). While clients may not be able to accurately report their motivation, ambivalence about change may nonetheless be expressed in actual therapy sessions as opposition to the direction set by the therapist (i.e., resistance). In the context of CBT for generalized anxiety disorder, the present study compared the ability of observed in-session resistance in CBT session 1 and two self-report measures of motivation for changing anxiety (the Change Questionnaire & the Client Motivational for Therapy Scale) to (1) predict client and therapist rated homework compliance (2) predict post-CBT and one-year post-treatment worry reduction, and (3) differentiate those who received motivational interviewing prior to CBT from those who received no pre-treatment. Observed in-session resistance performed very well on each index, compared to the performance of self-reported motivation which was inconsistent and weaker relative to observed resistance. These findings strongly support both clinician sensitivity to moments of client resistance in actual therapy sessions as early as session 1, and the inclusion of observational process measures in CBT research. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

IDEAL Problem Solving dalam Pembelajaran Matematika

Directory of Open Access Journals (Sweden)

Eny Susiana

2012-01-01

Full Text Available Most educators agree that problem solving is among the most meaningful and importantkinds of learning and thingking. That is, the central focus of learning and instructionshould be learning to solve problems. There are several warrants supporting that claims.They are authenticity, relevance, problem solving engages deeper learning angtherefore enhances meaning making, and constructed to represent problems (problemsolving is more meaningful. It is the reason why we must provide teaching and learningto make student’s problem solving skill in progress. There are many informationprocessingmodels of problem solving, such as simplified model of the problem-solvingprocess by Gicks, Polya’s problem solving process etc. One of them is IDEAL problemsolving. Each letter of IDEAL is stand for an aspect of thinking that is important forproblem solving. IDEAL is identify problem, Define Goal, Explore possible strategies,Anticipate outcme and Act, and Look back and learn. Using peer interaction andquestion prompt in small group in IDEAL problem solving teaching and Learning canimprove problem solving skill.Kata kunci: IDEAL Problem Solving, Interaksi Sebaya, Pertanyaan Penuntun, KelompokKecil.

Ozone therapy in postgraduate theses in Egypt: systematic review.

Science.gov (United States)

AlBedah, Abdullah M N; Khalil, Mohamed K M; Elolemy, Ahmed T; Alrasheid, Mohamed H S; Al Mudaiheem, Abdullah; Elolemy, Tawfik M B

2013-08-01

Systematic reviews of the studies published in the major medical data bases have not shown solid support for the use of ozone therapy. Unpublished or grey literature, including postgraduate theses, may solve this controversy. To review the postgraduate theses published in Egypt in order to assess the clinical safety and effectiveness of ozone therapy in specific medical conditions. The databases of the Egyptian Universities' Library Consortium and the databases of each university were searched for postgraduate theses that evaluated ozone therapy as an intervention for any disease or condition in any age group, compared with any or no other intervention and published before September 2010. A total of 28 quasi trials were included. The theses did not report any safety issues in terms of ozone therapy. With respect to its effectiveness, the studies suggested some benefits of ozone in the treatment of dental infection and recovery, musculoskeletal disorders, diabetes mellitus, chronic diseases, and obstetrics and gynaecology. However, the number of studies included was small and they were of limited quality. There is insufficient evidence to recommend the use of ozone in the treatment of dental infections, in facilitating faster dental recovery after extraction or implantation, in diabetes mellitus, musculoskeletal disorders, or obstetrics and gynaecology.

Learning Matlab a problem solving approach

CERN Document Server

Gander, Walter

2015-01-01

This comprehensive and stimulating introduction to Matlab, a computer language now widely used for technical computing, is based on an introductory course held at Qian Weichang College, Shanghai University, in the fall of 2014.  Teaching and learning a substantial programming language aren’t always straightforward tasks. Accordingly, this textbook is not meant to cover the whole range of this high-performance technical programming environment, but to motivate first- and second-year undergraduate students in mathematics and computer science to learn Matlab by studying representative problems, developing algorithms and programming them in Matlab. While several topics are taken from the field of scientific computing, the main emphasis is on programming. A wealth of examples are completely discussed and solved, allowing students to learn Matlab by doing: by solving problems, comparing approaches and assessing the proposed solutions.

Gastroesophageal Acid Reflux Control 5 Years After Antireflux Surgery, Compared With Long-term Esomeprazole Therapy.

Science.gov (United States)

Hatlebakk, Jan G; Zerbib, Frank; Bruley des Varannes, Stanislas; Attwood, Stephen E; Ell, Christian; Fiocca, Roberto; Galmiche, Jean-Paul; Eklund, Stefan; Långström, Göran; Lind, Tore; Lundell, Lars R

2016-05-01

We compared the ability of laparoscopic antireflux surgery (LARS) and esomeprazole to control esophageal acid exposure, over a 5-year period, in patients with chronic gastroesophageal reflux disease (GERD). We also studied whether intraesophageal and intragastric pH parameters off and on therapy were associated with long-term outcomes. We analyzed data from a prospective, randomized, open-label trial comparing the efficacy and safety of LARS vs esomeprazole (20 or 40 mg/d) over 5 years in patients with chronic GERD. Ambulatory intraesophageal and intragastric 24-hour pH monitoring data were compared between groups before LARS or the start of esomeprazole treatment, and 6 months and 5 years afterward. A secondary aim was to evaluate the association between baseline and 6-month pH parameters and esomeprazole dose escalation, reappearance of GERD symptoms, and treatment failure over 5 years in patients receiving LARS or esomeprazole. In the LARS group (n = 116), the median 24-hour esophageal acid exposure was 8.6% at baseline and 0.7% after 6 months and 5 years (P acid exposure was 8.8% at baseline, 2.1% after 6 months, and 1.9% after 5 years (P acidity was stable in both groups. Patients who required a dose increase to 40 mg/d had more severe supine reflux at baseline, and decreased esophageal acid exposure (P acidity after dose escalation. Esophageal and intragastric pH parameters, off and on therapy, did not predict long-term symptom breakthrough. In a prospective study of patients with chronic GERD, esophageal acid reflux was reduced greatly by LARS or esomeprazole therapy. However, patients receiving LARS had significantly greater reductions in 24-hour esophageal acid exposure after 6 months and 5 years. Esophageal and gastric pH, off and on therapy, did not predict long-term outcomes of patients. Abnormal supine acid exposure predicted esomeprazole dose escalation. ClinicalTrials.Gov identifier: NCT00251927 (available: http://clinicaltrials.gov/ct2/show

Teaching Problem Solving without Modeling through "Thinking Aloud Pair Problem Solving."

Science.gov (United States)

Pestel, Beverly C.

1993-01-01

Reviews research relevant to the problem of unsatisfactory student problem-solving abilities and suggests a teaching strategy that addresses the issue. Author explains how she uses teaching aloud problem solving (TAPS) in college chemistry and presents evaluation data. Among the findings are that the TAPS class got fewer problems completely right,…

The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies.

Science.gov (United States)

Pybis, Jo; Saxon, David; Hill, Andy; Barkham, Michael

2017-06-09

Cognitive Behaviour Therapy (CBT) is the front-line psychological intervention for step 3 within UK psychological therapy services. Counselling is recommended only when other interventions have failed and its effectiveness has been questioned. A secondary data analysis was conducted of data collected from 33,243 patients across 103 Improving Access to Psychological Therapies (IAPT) services as part of the second round of the National Audit of Psychological Therapies (NAPT). Initial analysis considered levels of pre-post therapy effect sizes (ESs) and reliable improvement (RI) and reliable and clinically significant improvement (RCSI). Multilevel modelling was used to model predictors of outcome, namely patient pre-post change on PHQ-9 scores at last therapy session. Counselling received more referrals from patients experiencing moderate to severe depression than CBT. For patients scoring above the clinical cut-off on the PHQ-9 at intake, the pre-post ES (95% CI) for CBT was 1.59 (1.58, 1.62) with 46.6% making RCSI criteria and for counselling the pre-post ES was 1.55 (1.52, 1.59) with 44.3% of patients meeting RCSI criteria. Multilevel modelling revealed a significant site effect of 1.8%, while therapy type was not a predictor of outcome. A significant interaction was found between the number of sessions attended and therapy type, with patients attending fewer sessions on average for counselling [M = 7.5 (5.54) sessions and a median (IQR) of 6 (3-10)] than CBT [M = 8.9 (6.34) sessions and a median (IQR) of 7 (4-12)]. Only where patients had 18 or 20 sessions was CBT significantly more effective than counselling, with recovery rates (95% CIs) of 62.2% (57.1, 66.9) and 62.4% (56.5, 68.0) respectively, compared with 44.4% (32.7, 56.6) and 42.6% (30.0, 55.9) for counselling. Counselling was significantly more effective at two sessions with a recovery rate of 34.9% (31.9, 37.9) compared with 22.2% (20.5, 24.0) for CBT. Outcomes for counselling and CBT in the

The Effect of Self-Regulation Training on Social Problem Solving of Male and Female Preschoolers

Directory of Open Access Journals (Sweden)

*A. Jelvegar

2014-12-01

Full Text Available Since self-regulation is important for development of cognitive and social skills in children and the role of gender differences in the relation is notable, this study was conducted for this purpose. Initially, 40 children (20 girls and 20 boys from two pre-schools of Meybod city were randomly chosen and assigned to two experimental and control groups. After performing Wally Child Social Problem-Solving Detective Game Test (WCSPD as the pre-test on all the children, a self-regulation training program was taught for 20 hours over a month to the experimental group with techniques of play and story therapy. Wally Child Social Problem-Solving Detective Game Test was then used as the post-test measure. The results of analysis of covariance showed that the difference between the means of the two grpups was significant (p0.0001, that is, the training group did better but the difference between the means of boys and girls in social problem solving was not significant. It was suggested that self-regulatory training during childhood be provided for both boys and girls to promote their social problem solving skills.

Do occupational therapy and physical therapy curricula teach critical thinking skills?

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Vogel, Kimberly A; Geelhoed, Michael; Grice, Kimatha O; Murphy, Douglas

2009-01-01

This study evaluated whether critical thinking ability can be improved through participation in occupational therapy (OT) and physical therapy (PT) curricula. The researchers compared levels of the critical thinking skills of OT and PT students at the beginning and end of their programs to determine whether changes occurred and to examine facets of the curricula that may have caused the differences. The curricula include teaching strategies of problem-based learning modules, small group discussion and problem-solving, case studies, clinical observation, and evidence-based practice assignments, as well as teaching about critical thinking as a process in itself. Fifty OT and PT students completed the Watson-Glaser Critical Thinking Appraisal at the beginning and end of 20 mos of the academic phase of their master's degree programs. Researchers analyzed the data using a one-way repeated-measures ANOVA. Results showed no differences between OT and PT students on the pretest or post-test and no differences for PT students between the pretest and post-test. OT students' scores increased significantly from pretest to post-test. The influence of the timing of teaching critical thinking skills in the resulting differences between the two curricula, as well as the validity of the Watson-Glaser Critical Thinking Appraisal is a valid measure of critical thinking changes in allied health students are discussed.

Brief Cognitive Behavioural Therapy compared to optimised general practitioners’ care for depression : A randomised trial

NARCIS (Netherlands)

Schene, A.H.; Baas, K.D.; Koeter, M.W.J.; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K.A.; Huyser, J.; van Weert, H.C.

2014-01-01

Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

NARCIS (Netherlands)

Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.|info:eu-repo/dai/nl/258267992; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.

2014-01-01

Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

Goals and everyday problem solving: examining the link between age-related goals and problem-solving strategy use.

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Hoppmann, Christiane A; Coats, Abby Heckman; Blanchard-Fields, Fredda

2008-07-01

Qualitative interviews on family and financial problems from 332 adolescents, young, middle-aged, and older adults, demonstrated that developmentally relevant goals predicted problem-solving strategy use over and above problem domain. Four focal goals concerned autonomy, generativity, maintaining good relationships with others, and changing another person. We examined both self- and other-focused problem-solving strategies. Autonomy goals were associated with self-focused instrumental problem solving and generative goals were related to other-focused instrumental problem solving in family and financial problems. Goals of changing another person were related to other-focused instrumental problem solving in the family domain only. The match between goals and strategies, an indicator of problem-solving adaptiveness, showed that young individuals displayed the greatest match between autonomy goals and self-focused problem solving, whereas older adults showed a greater match between generative goals and other-focused problem solving. Findings speak to the importance of considering goals in investigations of age-related differences in everyday problem solving.

Problem-Solving After Traumatic Brain Injury in Adolescence: Associations With Functional Outcomes.

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Wade, Shari L; Cassedy, Amy E; Fulks, Lauren E; Taylor, H Gerry; Stancin, Terry; Kirkwood, Michael W; Yeates, Keith O; Kurowski, Brad G

2017-08-01

To examine the association of problem-solving with functioning in youth with traumatic brain injury (TBI). Cross-sectional evaluation of pretreatment data from a randomized controlled trial. Four children's hospitals and 1 general hospital, with level 1 trauma units. Youth, ages 11 to 18 years, who sustained moderate or severe TBI in the last 18 months (N=153). Problem-solving skills were assessed using the Social Problem-Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories. Everyday functioning was assessed based on a structured clinical interview using the Child and Adolescent Functional Assessment Scale (CAFAS) and via adolescent ratings on the Youth Self Report (YSR). Correlations and multiple regression analyses were used to examine associations among measures. The TBI group endorsed lower levels of maladaptive problem-solving (negative problem orientation, careless/impulsive responding, and avoidant style) and lower levels of rational problem-solving, resulting in higher total problem-solving scores for the TBI group compared with a normative sample (Pproblem-solving composites were associated with overall functioning on the CAFAS, only maladaptive problem-solving (PProblem-solving after TBI differs from normative samples and is associated with functional impairments. The relation of problem-solving deficits after TBI with global functioning merits further investigation, with consideration of the potential effects of problem-solving interventions on functional outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Canonical Primal-Dual Method for Solving Non-convex Minimization Problems

OpenAIRE

Wu, Changzhi; Li, Chaojie; Gao, David Yang

2012-01-01

A new primal-dual algorithm is presented for solving a class of non-convex minimization problems. This algorithm is based on canonical duality theory such that the original non-convex minimization problem is first reformulated as a convex-concave saddle point optimization problem, which is then solved by a quadratically perturbed primal-dual method. %It is proved that the popular SDP method is indeed a special case of the canonical duality theory. Numerical examples are illustrated. Comparing...

Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis

Science.gov (United States)

Zhou, Xinyu; Hetrick, Sarah E; Cuijpers, Pim; Qin, Bin; Barth, Jürgen; Whittington, Craig J; Cohen, David; Del Giovane, Cinzia; Liu, Yiyun; Michael, Kurt D; Zhang, Yuqing; Weisz, John R; Xie, Peng

2015-01-01

Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from −0.47 to −0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from −0.26 to −1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy

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.

Job-Related Stress in Forensic Interviewers of Children with Use of Therapy Dogs Compared with Facility Dogs or No Dogs

Directory of Open Access Journals (Sweden)

Diane Walsh

2018-03-01

Full Text Available Sexually abused children providing essential testimony regarding crimes in forensic interviews now sometimes are provided facility dogs or therapy dogs for comfort. Facility dogs are extensively trained to work with forensic interviewers; when using therapy dogs in interviews, volunteers are the dog handlers. Interviews can impact child welfare workers’ mental health causing secondary traumatic stress (STS. To investigate this stress, first data were gathered on stress retrospectively for when interviewers initially started the job prior to working with a dog, and then currently, from forensic interviewers using a facility dog, a therapy or pet dog, or no dog. These retrospective and secondary traumatic stress scale (STSS data compared job stress among interviewers of children using: a certified, workplace facility dog (n = 16, a volunteer’s trained therapy dog or the interviewer’s pet dog (n = 13/3, or no dog (n = 198. Retrospective scores of therapy dog and no dog interviewers’ stress were highest for the first interviewing year 1 and then declined. Extremely or very stressful retrospective scores differed among the three groups in year 1 (p < 0.038, and were significantly elevated for the therapy dog group as compared with the facility dog group (p < 0.035. All interviewing groups had elevated STSS scores; when compared with other healthcare groups that have been studied, sub-scores were especially high for Avoidance: a psychological coping mechanism to avoid dealing with a stressor. STSS scores differed among groups (p < 0.016, primarily due to Avoidance sub-scores (p < 0.009, reflecting higher Avoidance scores for therapy dog users than no dog users (p < 0.009. Facility dog users more consistently used dogs during interviews and conducted more interviews than therapy/pet dog users; both groups favored using dogs. Interviewers currently working with therapy dogs accompanied by their volunteers reported

Comparing the quality of life in insulin recipient and refusal patients with type 2 diabetes.

Science.gov (United States)

Khalili, Mitra; Sabouhi, Fakhri; Abazari, Parvaneh; Aminorroaya, Ashraf

2016-01-01

Better control of blood sugar and reduction of diabetes complications through insulin therapy could convince people to choose this method. However, patients might refuse insulin therapy due to its painful injection, limitations in daily activities, and hypoglycemia. Thus, insulin therapy could have both positive and negative effects on patients' quality of life (QOL). Therefore, the aim of this study was to compare the QOL of insulin recipient and insulin refusal patients with type 2 diabetes. This study was a descriptive and comparative research conducted on 126 patients; 63 were insulin recipients and 63 had refused insulin therapy. Participants were under the care of the Endocrine and Metabolism Research Center of Isfahan, Iran. Data were gathered using the Diabetes Quality of Life (DQOL) questionnaire. In this tool, higher scores indicated lower QOL in patients. Data were analyzed using independent t-test, analysis of covariance, Mann-Whitney, Chi-square, and Pearson and Spearman's correlation. There was a significant difference (P refusal patients (mean = 1.74, SD = 0.41) in terms of mean QOL score. In addition, men and participants with higher educational levels reported a better QOL (P refusal patients had a better QOL. It seems that QOL is associated with the acceptance or refusal of insulin therapy. Therefore, enhancement of QOL could be related to all aspects of the disease, especially its treatment method and solving the therapeutic problems.

Catching-up: Children with developmental coordination disorder compared to healthy children before and after sensorimotor therapy.

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Mats Niklasson

Full Text Available The aims of the present study were to (a compare healthy children in terms of sensorimotor maturity to untreated children diagnosed with developmental coordination disorder (DCD and (b compare healthy children to diagnosed children following completed treatment with sensorimotor therapy. Participants were 298 children, 196 boys and 102 girls, distributed into a Norm group of healthy children (n = 99 and a group of children diagnosed with DCD (n = 199 with a total mean age of 8.77 years (SD = 2.88. Participants in both groups were assessed on instruments aimed to detect sensorimotor deviations. The children in the DCD group completed, during on average 36 months, sensorimotor therapy which comprised stereotypical fetal- and infant movements, vestibular stimulation, tactile stimulation, auditory stimulation, complementary play exercises, gross motor milestones, and sports-related gross motor skills. At the final visit a full assessment was once more performed. Results showed that the Norm group performed better on all sensorimotor tests as compared to the untreated children from the DCD group, with the exception of an audiometric test where both groups performed at the same level. Girls performed better on tests assessing proprioceptive and balance abilities. Results also showed, after controls for natural maturing effects, that the children from the DCD group after sensorimotor therapy did catch up with the healthy children. The concept of "catching-up" is used within developmental medicine but has not earlier been documented with regard to children and youth in connection with DCD.

MACEDONIAN ADMINISTRATIVE JUDICIAL SYSTEM FOR SOLVING ADMINISTRATIVE DISPUTES COMPARABLE TO EUROPEAN SYSTEMS

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Sladjana Eftimova

2015-07-01

Full Text Available The structure of the legal system, through history until today mostly depends on law and policy which is conducted by the country. In European countries, there is position for historical and cultural conceptions for administrative judicature, differences and similarity that leave mark for solving administrative disputes. The obligation – an internal judicial reform to be established in legal system, is conducted by each of the countries after the breaking down and division of Social Federative Republic of Yugoslavia or SFRY due to following the European law for constitution of legitimacy and constitutionality of acts as well as implementing of independent administrative judicature. Analyze of the current condition regarding the independency and objectiveness of the judicature is necessary in our country and it is important to be seen how the conditions for working of the administrative judicature can be improved.

Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy.

Science.gov (United States)

Lopes, Rodrigo T; Gonçalves, Miguel M; Fassnacht, Daniel B; Machado, Paulo P P; Sousa, Inês

2014-01-01

In a previous clinical controlled trial (Lopes et al., 2014), narrative therapy (NT) showed promising results in ameliorating depressive symptoms with comparable outcomes to cognitive-behavioral therapy (CBT) when patients completed treatment. This paper aims to assess depressive symptoms and interpersonal problems in this clinical sample at follow-up. Using the Beck Depression Inventory-II and Outcome Questionnaire-45.2 Interpersonal Relations Scale, naturalistic prospective follow-up assessment was conducted at 21 and 31 months after the last treatment session. At follow-up, patients kept improving in terms of depressive symptoms and interpersonal problems. The odds that a patient maintained recovery from depressive symptoms at follow-up were five times higher than the odds that a patient maintained recovery from interpersonal problems. In the same way, the odds of a patient never recovering from interpersonal problems were five times higher than the odds of never recovering from depressive symptoms. The study did not control for the natural course of depression or treatment continuation. For depressed patients with greater interpersonal disabilities, longer treatment plans and alternative continuation treatments should be considered. Copyright © 2014 Elsevier B.V. All rights reserved.

Students’ difficulties in probabilistic problem-solving

Science.gov (United States)

Arum, D. P.; Kusmayadi, T. A.; Pramudya, I.

2018-03-01

There are many errors can be identified when students solving mathematics problems, particularly in solving the probabilistic problem. This present study aims to investigate students’ difficulties in solving the probabilistic problem. It focuses on analyzing and describing students errors during solving the problem. This research used the qualitative method with case study strategy. The subjects in this research involve ten students of 9th grade that were selected by purposive sampling. Data in this research involve students’ probabilistic problem-solving result and recorded interview regarding students’ difficulties in solving the problem. Those data were analyzed descriptively using Miles and Huberman steps. The results show that students have difficulties in solving the probabilistic problem and can be divided into three categories. First difficulties relate to students’ difficulties in understanding the probabilistic problem. Second, students’ difficulties in choosing and using appropriate strategies for solving the problem. Third, students’ difficulties with the computational process in solving the problem. Based on the result seems that students still have difficulties in solving the probabilistic problem. It means that students have not able to use their knowledge and ability for responding probabilistic problem yet. Therefore, it is important for mathematics teachers to plan probabilistic learning which could optimize students probabilistic thinking ability.

Solving of L0 norm constrained EEG inverse problem.

Science.gov (United States)

Xu, Peng; Lei, Xu; Hu, Xiao; Yao, Dezhong

2009-01-01

l(0) norm is an effective constraint used to solve EEG inverse problem for a sparse solution. However, due to the discontinuous and un-differentiable properties, it is an open issue to solve the l(0) norm constrained problem, which is usually instead solved by using some alternative functions like l(1) norm to approximate l(0) norm. In this paper, a continuous and differentiable function having the same form as the transfer function of Butterworth low-pass filter is introduced to approximate l(0) norm constraint involved in EEG inverse problem. The new approximation based approach was compared with l(1) norm and LORETA solutions on a realistic head model using simulated sources. The preliminary results show that this alternative approximation to l(0) norm is promising for the estimation of EEG sources with sparse distribution.

SHA-1, SAT-solving, and CNF

CSIR Research Space (South Africa)

Motara, YM

2017-09-01

Full Text Available the intersection between the SHA-1 preimage problem, the encoding of that problem for SAT-solving, and SAT-solving. The results demonstrate that SAT-solving is not yet a viable approach to take to solve the preimage problem, and also indicate that some...

Mammographic changes in postmenopausal women : comparative effects between continuous combined hormone and single estrogen replacement therapy

Energy Technology Data Exchange (ETDEWEB)

Oh, Sug; Choi, Jong Tae; Jung, Kyoon Soon; Jung, Seung Hye [Jeil Women' s Hospital, Seoul (Korea, Republic of)

1997-06-01

As the use of hormone replacement therapy for the menopausal women increases, some caution is advised, since there is an increased risk of breast cancer. Accordingly, the importance of regular mammography has been addressed. This cross-setional study analyzed the effects of different hormone therapies on mammographic density. Sixty-seven postemenopausal women who had completed one year of hormone therapy and had undergone follow-up mammography, were divided into two groups : Group I : continuous conjugated equine estrogen, 0.625mg, plus continuous medroxyprogesterone acetate, 2.5mg (n=48), Group II : continuous conjugated equine estrogen 0.625mg (n=19). The mammograms were read by two radiologists. With regard to the radiologists involved, interobserver reliabillity (kappa) was 0.70 and intraobserver reliability (kappa) was 0.51 and 0.67. Before hormone therapy, factors related to decreased mammographic density were age and number of full term pregnancies (p<0.05). After one year of hormone therapy, body fat showed a significant increase (p<0.05), but in spite of this, increased mammographic density induced by hormone therapy remained significantly high (p<0.05). Compared with Group II, Group I showed a significant increase in mammographic density (p<0.05). In Group I, mammographic density increased from P2 to DY pattern in two cases, but there was no such change in Group II. The increase of mammographic density seen in Group II was much more significant statistically than that seen in Group I. The mammograms of women who have undergone continuous combined hormone therapy should therefore be interpreted very cautiously.

Mammographic changes in postmenopausal women : comparative effects between continuous combined hormone and single estrogen replacement therapy

International Nuclear Information System (INIS)

Oh, Sug; Choi, Jong Tae; Jung, Kyoon Soon; Jung, Seung Hye

1997-01-01

As the use of hormone replacement therapy for the menopausal women increases, some caution is advised, since there is an increased risk of breast cancer. Accordingly, the importance of regular mammography has been addressed. This cross-setional study analyzed the effects of different hormone therapies on mammographic density. Sixty-seven postemenopausal women who had completed one year of hormone therapy and had undergone follow-up mammography, were divided into two groups : Group I : continuous conjugated equine estrogen, 0.625mg, plus continuous medroxyprogesterone acetate, 2.5mg (n=48), Group II : continuous conjugated equine estrogen 0.625mg (n=19). The mammograms were read by two radiologists. With regard to the radiologists involved, interobserver reliabillity (kappa) was 0.70 and intraobserver reliability (kappa) was 0.51 and 0.67. Before hormone therapy, factors related to decreased mammographic density were age and number of full term pregnancies (p<0.05). After one year of hormone therapy, body fat showed a significant increase (p<0.05), but in spite of this, increased mammographic density induced by hormone therapy remained significantly high (p<0.05). Compared with Group II, Group I showed a significant increase in mammographic density (p<0.05). In Group I, mammographic density increased from P2 to DY pattern in two cases, but there was no such change in Group II. The increase of mammographic density seen in Group II was much more significant statistically than that seen in Group I. The mammograms of women who have undergone continuous combined hormone therapy should therefore be interpreted very cautiously

Assertiveness and problem solving in midwives.

Science.gov (United States)

Yurtsal, Zeliha Burcu; Özdemir, Levent

2015-01-01

Midwifery profession is required to bring solutions to problems and a midwife is expected to be an assertive person and to develop midwifery care. This study was planned to examine the relationship between assertiveness and problem-solving skills of midwives. This cross-sectional study was conducted with 201 midwives between July 2008 and February 2009 in the city center of Sivas. The Rathus Assertiveness Schedule (RAS) and Problem Solving Inventory (PSI) were used to determine the level of assertiveness and problem-solving skills of midwives. Statistical methods were used as mean, standard deviation, percentage, Student's T, ANOVA and Tukey HSD, Kruskal Wallis, Fisher Exact, Pearson Correlation and Chi-square tests and P problem-solving skills training. A statistically significant negative correlation was found between the RAS and PSI scores. The RAS scores decreased while the problem-solving scores increased (r: -0451, P problem solving skills of midwives, and midwives who were assertive solved their problems better than did others. Assertiveness and problem-solving skills training will contribute to the success of the midwifery profession. Midwives able to solve problems, and display assertive behaviors will contribute to the development of midwifery profession.

Job-Related Stress in Forensic Interviewers of Children with Use of Therapy Dogs Compared with Facility Dogs or No Dogs.

Science.gov (United States)

Walsh, Diane; Yamamoto, Mariko; Willits, Neil H; Hart, Lynette A

2018-01-01

Sexually abused children providing essential testimony regarding crimes in forensic interviews now sometimes are provided facility dogs or therapy dogs for comfort. Facility dogs are extensively trained to work with forensic interviewers; when using therapy dogs in interviews, volunteers are the dog handlers. Interviews can impact child welfare workers' mental health causing secondary traumatic stress (STS). To investigate this stress, first data were gathered on stress retrospectively for when interviewers initially started the job prior to working with a dog, and then currently, from forensic interviewers using a facility dog, a therapy or pet dog, or no dog. These retrospective and secondary traumatic stress scale (STSS) data compared job stress among interviewers of children using: a certified, workplace facility dog ( n  = 16), a volunteer's trained therapy dog or the interviewer's pet dog ( n  = 13/3), or no dog ( n  = 198). Retrospective scores of therapy dog and no dog interviewers' stress were highest for the first interviewing year 1 and then declined. Extremely or very stressful retrospective scores differed among the three groups in year 1 ( p  therapy dog group as compared with the facility dog group ( p  therapy dog users than no dog users ( p  dog users more consistently used dogs during interviews and conducted more interviews than therapy/pet dog users; both groups favored using dogs. Interviewers currently working with therapy dogs accompanied by their volunteers reported they had experienced heightened stress when they began their jobs; their high stress levels still persisted, indicating lower inherent coping skills and perhaps greater empathy among interviewers who later self-selected to work with therapy dogs. Results reveal extreme avoidant stress for interviewers witnessing children who are suffering and their differing coping approaches.

Pedagogy and/or technology: Making difference in improving students' problem solving skills

Science.gov (United States)

Hrepic, Zdeslav; Lodder, Katherine; Shaw, Kimberly A.

2013-01-01

Pen input computers combined with interactive software may have substantial potential for promoting active instructional methodologies and for facilitating students' problem solving ability. An excellent example is a study in which introductory physics students improved retention, conceptual understanding and problem solving abilities when one of three weekly lectures was replaced with group problem solving sessions facilitated with Tablet PCs and DyKnow software [1,2]. The research goal of the present study was to isolate the effect of the methodology itself (using additional time to teach problem solving) from that of the involved technology. In Fall 2011 we compared the performance of students taking the same introductory physics lecture course while enrolled in two separate problem-solving sections. One section used pen-based computing to facilitate group problem solving while the other section used low-tech methods for one third of the semester (covering Kinematics), and then traded technologies for the middle third of the term (covering Dynamics). Analysis of quiz, exam and standardized pre-post test results indicated no significant difference in scores of the two groups. Combining this result with those of previous studies implies primacy of pedagogy (collaborative problem solving itself) over technology for student learning in problem solving recitations.

Modified Sequential Therapy Regimen versus Conventional Triple Therapy for Helicobacter pylori Eradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study

Directory of Open Access Journals (Sweden)

Ying-Qun Zhou

2012-01-01

Full Text Available Objective. Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. To observe the effect of eradicating Helicobacter pylori (H. pylori and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy. Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy and H. pylori positive confirmed by rapid urease test, serum anti-H. pylori antibody (ELASE, or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases and group B (70 cases were provided 10-day modified sequential therapy; group C (70 cases was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily. H. pylori eradication rate was checked four to eight weeks after taking the medicine by using a 13C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously. Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that the H. pylori eradication rate of each group was as follows: group A 92.5% (62/67, group B 86.8% (59/68, and group C 78.8% (52/66. The H. pylori

Nonsurgical treatment for cancer using radiation therapy

International Nuclear Information System (INIS)

Ogi, Yasuo

2012-01-01

The number of people who are dying from cancer has been increasing in association with population aging. Radiation therapy is now one of the three major cancer treatment methods, along with surgery and chemotherapy. People used to consider radiation therapy only as a ''noninvasive cancer treatment''; however, with the ceaseless effort by medical experts and corporations, different radiation therapy types and techniques including the latest technical advances have come out one after another, and the improvements in radiation therapies have provided treatments that are not only less traumatizing to patients but also as effective and therapeutic as surgery in certain body regions. The importance of radiation therapy has become and will become even greater in the society with more elderly cancer patients who do not have the physical strength to undergo surgery. In this article, the history of radiation therapy, rapidly developed high-precision radiation therapy techniques, and unsolved issues are discussed, and then, ''MHI vero4DRT'', which is the high-precision image-guided radiation therapy equipment developed for solving such issues, is introduced. (author)

Synthesizing Huber's Problem Solving and Kolb's Learning Cycle: A Balanced Approach to Technical Problem Solving

Science.gov (United States)

Kamis, Arnold; Khan, Beverly K.

2009-01-01

How do we model and improve technical problem solving, such as network subnetting? This paper reports an experimental study that tested several hypotheses derived from Kolb's experiential learning cycle and Huber's problem solving model. As subjects solved a network subnetting problem, they mapped their mental processes according to Huber's…

Pre-Service Class Teacher' Ability in Solving Mathematical Problems and Skills in Solving Daily Problems

Science.gov (United States)

Aljaberi, Nahil M.; Gheith, Eman

2016-01-01

This study aims to investigate the ability of pre-service class teacher at University of Petrain solving mathematical problems using Polya's Techniques, their level of problem solving skills in daily-life issues. The study also investigates the correlation between their ability to solve mathematical problems and their level of problem solving…

A comparative study of the effects of problem-solving skills training and relaxation on the score of self-esteem in women with postpartum depression

OpenAIRE

Nasiri, Saeideh; Kordi, Masoumeh; Gharavi, Morteza Modares

2015-01-01

Background: Self-esteem is a determinant factor of mental health. Individuals with low self-esteem have depression, and low self-esteem is one of main symptoms of depression. Aim of this study is to compare the effects of problem-solving skills and relaxation on the score of self-esteem in women with postpartum depression. Materials and Methods: This clinical trial was performed on 80 women. Sampling was done in Mashhad healthy centers from December 2009 to June 2010. Women were randomly divi...

The effect of constructing versus solving virtual patient cases on transfer of learning

DEFF Research Database (Denmark)

Tolsgaard, Martin G; Jepsen, Rikke M H G; Rasmussen, Maria B

2016-01-01

standardized patients representing cardiopulmonary cases. Performances on the transfer test were video-recorded and assessed by two blinded raters using the Reporter, Interpreter, Manager, Educator (RIME) framework. Thirty-nine participants completed the transfer test. The VP-construction group spent......The purpose of this study was to explore the effect of actively constructing virtual patient (VP) cases compared with solving VP cases on knowledge gains, skills transfer and time spent on cases. Forty-five fourth-year medical students were randomized to constructing (VP-construction, n = 23......) or solving (VP-solving, n = 22) four cardiopulmonary VP cases. Whereas the VP-solving group solved the cases, the VP-construction group only received the final diagnosis and had to complete the history, physical findings, and lab results. After a week, participants completed a transfer test involving two...

Effects of the SOLVE Strategy on the Mathematical Problem Solving Skills of Secondary Students with Learning Disabilities

Science.gov (United States)

Freeman-Green, Shaqwana M.; O'Brien, Chris; Wood, Charles L.; Hitt, Sara Beth

2015-01-01

This study examined the effects of explicit instruction in the SOLVE Strategy on the mathematical problem solving skills of six Grade 8 students with specific learning disabilities. The SOLVE Strategy is an explicit instruction, mnemonic-based learning strategy designed to help students in solving mathematical word problems. Using a multiple probe…

Pulsatile gonadotropin-releasing hormone therapy is associated with earlier spermatogenesis compared to combined gonadotropin therapy in patients with congenital hypogonadotropic hypogonadism

Directory of Open Access Journals (Sweden)

Jiang-Feng Mao

2017-01-01

Full Text Available Both pulsatile gonadotropin-releasing hormone (GnRH infusion and combined gonadotropin therapy (human chorionic gonadotropin and human menopausal gonadotropin [HCG/HMG] are effective to induce spermatogenesis in male patients with congenital hypogonadotropic hypogonadism (CHH. However, evidence is lacking as to which treatment strategy is better. This retrospective cohort study included 202 patients with CHH: twenty had received pulsatile GnRH and 182 had received HCG/HMG. Patients had received therapy for at least 12 months. The total follow-up time was 15.6 ± 5.0 months (range: 12-27 months for the GnRH group and 28.7 ± 13.0 months (range: 12-66 months for the HCG/HMG group. The median time to first sperm appearance was 6 months (95% confidence interval [CI]: 1.6-10.4 in the GnRH group versus 18 months (95% CI: 16.4-20.0 in the HCG/HMG group (P 1 × 10 6 ml−1 was 43.7% ± 20.4% (16 samples in the GnRH group versus 43.2% ± 18.1% (153 samples in the HCG/HMG group (P = 0.921. Notably, during follow-up, the GnRH group had lower serum testosterone levels than the HCG/HMG group (8.3 ± 4.6 vs 16.2 ± 8.2 nmol l−1 , P < 0.001. Our study found that pulsatile GnRH therapy was associated with earlier spermatogenesis and larger testicular size compared to combined gonadotropin therapy. Additional prospective randomized studies would be required to confirm these findings.

Problem Solving and Learning

Science.gov (United States)

Singh, Chandralekha

2009-07-01

One finding of cognitive research is that people do not automatically acquire usable knowledge by spending lots of time on task. Because students' knowledge hierarchy is more fragmented, "knowledge chunks" are smaller than those of experts. The limited capacity of short term memory makes the cognitive load high during problem solving tasks, leaving few cognitive resources available for meta-cognition. The abstract nature of the laws of physics and the chain of reasoning required to draw meaningful inferences makes these issues critical. In order to help students, it is crucial to consider the difficulty of a problem from the perspective of students. We are developing and evaluating interactive problem-solving tutorials to help students in the introductory physics courses learn effective problem-solving strategies while solidifying physics concepts. The self-paced tutorials can provide guidance and support for a variety of problem solving techniques, and opportunity for knowledge and skill acquisition.

EISPACK-J: subprogram package for solving eigenvalue problems

International Nuclear Information System (INIS)

Fujimura, Toichiro; Tsutsui, Tsuneo

1979-05-01

EISPACK-J, a subprogram package for solving eigenvalue problems, has been developed and subprograms with a variety of functions have been prepared. These subprograms can solve standard problems of complex matrices, general problems of real matrices and special problems in which only the required eigenvalues and eigenvectors are calculated. They are compared to existing subprograms, showing their features through benchmark tests. Many test problems, including realistic scale problems, are provided for the benchmark tests. Discussions are made on computer core storage and computing time required for each subprogram, and accuracy of the solution. The results show that the subprograms of EISPACK-J, based on Householder, QR and inverse iteration methods, are the best in computing time and accuracy. (author)

Comparative effectiveness research (CER): a summary of AHRQ's CER on therapies for rheumatoid arthritis.

Science.gov (United States)

Oderda, Gary M; Balfe, Lisa M

2011-01-01

In recent years, the U.S. government has designated funding of several large-scale initiatives for comparative effectiveness research (CER) in health care. The American Recovery and Reinvestment Act (ARRA) of 2009 apportioned more than $1 billion to support CER programs administered by the Department of Health and Human Services (DHHS), the National Institutes of Health (NIH), and the Agency for Healthcare Research and Quality (AHRQ). CER is generally defined as the undertaking of original research or systematic reviews of published literature in order to compare the benefits and risks of different approaches to preventing, diagnosing, or treating diseases. These approaches may include diagnostic tests, medications, medical devices, and surgeries. The overall goals of CER are to support informed health care decisions by patients, clinicians, payers, and policy makers and to apply its evidence to ultimately improve the quality, effectiveness, and efficiency of health care. To (a) provide managed care professionals with general definitions of CER, specifically as it is administered by AHRQ; (b) discuss the importance of CER to clinical and managed care pharmacists; and (c) summarize key methods and findings from AHRQ's 2007 comparative effectiveness review on therapies for rheumatoid arthritis (RA). As supported by AHRQ, CER is conducted in order to synthesize comprehensive evidence on the comparative benefits and harms of treatment interventions. The findings from comparative effectiveness reviews can thus contribute to informing therapeutic strategies and treatment decisions. In 2007, a multitude of RA treatment options and studies motivated AHRQ to commission a systematic comparative effectiveness review. Conducted by investigators at the RTI-University of North Carolina Evidence-Based Practice Center, the review included comparisons of synthetic disease-modifying antirheumatic drugs (DMARDs), biologic agents, synthetic DMARDs versus biologic agents, and various

Late Side Effects After Image Guided Intensity Modulated Radiation Therapy Compared to 3D-Conformal Radiation Therapy for Prostate Cancer: Results From 2 Prospective Cohorts

Energy Technology Data Exchange (ETDEWEB)

Wortel, Ruud C.; Incrocci, Luca [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Pos, Floris J.; Heide, Uulke A. van der; Lebesque, Joos V. [Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Aluwini, Shafak [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Witte, Marnix G. [Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Heemsbergen, Wilma D., E-mail: w.heemsbergen@nki.nl [Department of Radiation Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

2016-06-01

Purpose: Technical developments in the field of external beam radiation therapy (RT) enabled the clinical introduction of image guided intensity modulated radiation therapy (IG-IMRT), which improved target conformity and allowed reduction of safety margins. Whether this had an impact on late toxicity levels compared to previously applied three-dimensional conformal radiation therapy (3D-CRT) is currently unknown. We analyzed late side effects after treatment with IG-IMRT or 3D-CRT, evaluating 2 prospective cohorts of men treated for localized prostate cancer to investigate the hypothesized reductions in toxicity. Methods and Materials: Patients treated with 3D-CRT (n=189) or IG-IMRT (n=242) to 78 Gy in 39 fractions were recruited from 2 Dutch randomized trials with identical toxicity scoring protocols. Late toxicity (>90 days after treatment) was derived from self-assessment questionnaires and case report forms, according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG-EORTC) scoring criteria. Grade ≥2 endpoints included gastrointestinal (GI) rectal bleeding, increased stool frequency, discomfort, rectal incontinence, proctitis, and genitourinary (GU) obstruction, increased urinary frequency, nocturia, urinary incontinence, and dysuria. The Cox proportional hazards regression model was used to compare grade ≥2 toxicities between both techniques, adjusting for other modifying factors. Results: The 5-year cumulative incidence of grade ≥2 GI toxicity was 24.9% for IG-IMRT and 37.6% following 3D-CRT (adjusted hazard ratio [HR]: 0.59, P=.005), with significant reductions in proctitis (HR: 0.37, P=.047) and increased stool frequency (HR: 0.23, P<.001). GU grade ≥2 toxicity levels at 5 years were comparable with 46.2% and 36.4% following IG-IMRT and 3D-CRT, respectively (adjusted HR: 1.19, P=.33). Other strong predictors (P<.01) of grade ≥2 late toxicity were baseline complaints, acute toxicity, and age

Late Side Effects After Image Guided Intensity Modulated Radiation Therapy Compared to 3D-Conformal Radiation Therapy for Prostate Cancer: Results From 2 Prospective Cohorts

International Nuclear Information System (INIS)

Wortel, Ruud C.; Incrocci, Luca; Pos, Floris J.; Heide, Uulke A. van der; Lebesque, Joos V.; Aluwini, Shafak; Witte, Marnix G.; Heemsbergen, Wilma D.

2016-01-01

Purpose: Technical developments in the field of external beam radiation therapy (RT) enabled the clinical introduction of image guided intensity modulated radiation therapy (IG-IMRT), which improved target conformity and allowed reduction of safety margins. Whether this had an impact on late toxicity levels compared to previously applied three-dimensional conformal radiation therapy (3D-CRT) is currently unknown. We analyzed late side effects after treatment with IG-IMRT or 3D-CRT, evaluating 2 prospective cohorts of men treated for localized prostate cancer to investigate the hypothesized reductions in toxicity. Methods and Materials: Patients treated with 3D-CRT (n=189) or IG-IMRT (n=242) to 78 Gy in 39 fractions were recruited from 2 Dutch randomized trials with identical toxicity scoring protocols. Late toxicity (>90 days after treatment) was derived from self-assessment questionnaires and case report forms, according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG-EORTC) scoring criteria. Grade ≥2 endpoints included gastrointestinal (GI) rectal bleeding, increased stool frequency, discomfort, rectal incontinence, proctitis, and genitourinary (GU) obstruction, increased urinary frequency, nocturia, urinary incontinence, and dysuria. The Cox proportional hazards regression model was used to compare grade ≥2 toxicities between both techniques, adjusting for other modifying factors. Results: The 5-year cumulative incidence of grade ≥2 GI toxicity was 24.9% for IG-IMRT and 37.6% following 3D-CRT (adjusted hazard ratio [HR]: 0.59, P=.005), with significant reductions in proctitis (HR: 0.37, P=.047) and increased stool frequency (HR: 0.23, P<.001). GU grade ≥2 toxicity levels at 5 years were comparable with 46.2% and 36.4% following IG-IMRT and 3D-CRT, respectively (adjusted HR: 1.19, P=.33). Other strong predictors (P<.01) of grade ≥2 late toxicity were baseline complaints, acute toxicity, and age

Comparison the Executive Functions of Inhibition and Problem Solving in Adolescents with and Without Substance Abuse

Directory of Open Access Journals (Sweden)

Tahereh masoomi mofrad

2015-03-01

Full Text Available Executive functions are self-regulated functions and show the ability to inhibition, self-changing, planning, organization, using the working memory, solving problems and targeting for homework and school activities. This study compares the executive functions of inhibition and problem solving in adolescents with and without substance abuse. In this causal-comparative study, 15 adolescents with substance abuse and 15 normal adolescents were selected which matched each other with the same age, sex and education. The research tools were Wisconsin Card, was used for assessing the inhibition executive functions, and Heppner and Petersen Questionnaires for problem solving. The results showed that there were statistically significant differences between groups between average score of inhibition executive functions and solving problem (except trend– avoid component. There were not statistically significant differences in the average score of inhibition executive functions and solving problem according to age, sex and education. It is concluded that the drug addicts are weaker than those without substance abuse based on the inhibition executive function and problem solving. These findings can be used for the prevention program.

Factors Influencing Problem-Solving in Middle-Aged and Elderly Adults

Science.gov (United States)

Kesler, Mary S.; And Others

1976-01-01

Groups of middle-aged and elderly men and women were compared on three problem solving tasks, including written problems, the 20-questions procedure, and problems administered on a Heuristic Evaluation Problem Programmer. (MS)

An analysis of the Six Sigma DMAIC method from the perspective of problem solving

NARCIS (Netherlands)

de Mast, J.; Lokkerbol, J.

2012-01-01

The DMAIC (Define-Measure-Analyze-Improve-Control) method in Six Sigma is often described as an approach for problem solving. This paper compares critically the DMAIC method with insights from scientific theories in the field of problem solving. As a single authoritative account of the DMAIC method

Finite element method for solving neutron transport problems

International Nuclear Information System (INIS)

Ferguson, J.M.; Greenbaum, A.

1984-01-01

A finite element method is introduced for solving the neutron transport equations. Our method falls into the category of Petrov-Galerkin solution, since the trial space differs from the test space. The close relationship between this method and the discrete ordinate method is discussed, and the methods are compared for simple test problems

Personality-dependent differences in problem-solving performance in a social context reflect foraging strategies.

Science.gov (United States)

Zandberg, Lies; Quinn, John L; Naguib, Marc; van Oers, Kees

2017-01-01

Individuals develop innovative behaviours to solve foraging challenges in the face of changing environmental conditions. Little is known about how individuals differ in their tendency to solve problems and in their subsequent use of this solving behaviour in social contexts. Here we investigated whether individual variation in problem-solving performance could be explained by differences in the likelihood of solving the task, or if they reflect differences in foraging strategy. We tested this by studying the use of a novel foraging skill in groups of great tits (Parus major), consisting of three naive individuals with different personality, and one knowledgeable tutor. We presented them with multiple, identical foraging devices over eight trials. Though birds of different personality type did not differ in solving latency; fast and slow explorers showed a steeper increase over time in their solving rate, compared to intermediate explorers. Despite equal solving potential, personality influenced the subsequent use of the skill, as well as the pay-off received from solving. Thus, variation in the tendency to solve the task reflected differences in foraging strategy among individuals linked to their personality. These results emphasize the importance of considering the social context to fully understand the implications of learning novel skills. Copyright © 2016 Elsevier B.V. All rights reserved.

Distributed Problem-Solving

DEFF Research Database (Denmark)

Chemi, Tatiana

2016-01-01

This chapter aims to deconstruct some persistent myths about creativity: the myth of individualism and of the genius. By looking at literature that approaches creativity as a participatory and distributed phenomenon and by bringing empirical evidence from artists’ studios, the author presents a p......, what can educators at higher education learn from the ways creative groups solve problems? How can artists contribute to inspiring higher education?......This chapter aims to deconstruct some persistent myths about creativity: the myth of individualism and of the genius. By looking at literature that approaches creativity as a participatory and distributed phenomenon and by bringing empirical evidence from artists’ studios, the author presents...... a perspective that is relevant to higher education. The focus here is on how artists solve problems in distributed paths, and on the elements of creative collaboration. Creative problem-solving will be looked at as an ongoing dialogue that artists engage with themselves, with others, with recipients...

Social problem solving, autobiographical memory, trauma, and depression in women with borderline personality disorder and a history of suicide attempts.

Science.gov (United States)

Maurex, Liselotte; Lekander, Mats; Nilsonne, Asa; Andersson, Eva E; Asberg, Marie; Ohman, Arne

2010-09-01

The primary aim of this study was to compare the retrieval of autobiographical memory and the social problem-solving performance of individuals with borderline personality disorder (BPD) and a history of suicide attempts, with and without concurrent diagnoses of depression and/or post-traumatic stress disorder (PTSD), to that of controls. Additionally, the relationships between autobiographical memory, social problem-solving skills, and various clinical characteristics were examined in the BPD group. Individuals with BPD who had made at least two suicide attempts were compared to controls with regard to specificity of autobiographical memory and social problem-solving skills. Autobiographical memory specificity and social problem-solving skills were further studied in the BPD group by comparing depressed participants to non-depressed participants; and autobiographical memory specificity was also studied by comparing participants with and without PTSD. A total of 47 women with a diagnosis of BPD and 30 controls completed the Autobiographical Memory Test, assessing memory specificity, and the means-end problem solving-procedure, measuring social problem-solving skills. The prevalence of suicidal/self-injurious behaviour, and the exposure to violence, was also assessed in the BPD group. Compared to controls, participants with BPD showed reduced specificity of autobiographical memory, irrespective of either concurrent depression, previous depression, or concurrent PTSD. The depressed BPD group displayed poor problem-solving skills. Further, an association between unspecific memory and poor problem-solving was displayed in the BPD group. Our results confirmed that reduced specificity of autobiographical memory is an important characteristic of BPD individuals with a history of suicide attempt, independent of depression, or PTSD. Reduced specificity of autobiographical memory was further related to poor social problem-solving capacity in the BPD group.

Diagrams benefit symbolic problem-solving.

Science.gov (United States)

Chu, Junyi; Rittle-Johnson, Bethany; Fyfe, Emily R

2017-06-01

The format of a mathematics problem often influences students' problem-solving performance. For example, providing diagrams in conjunction with story problems can benefit students' understanding, choice of strategy, and accuracy on story problems. However, it remains unclear whether providing diagrams in conjunction with symbolic equations can benefit problem-solving performance as well. We tested the impact of diagram presence on students' performance on algebra equation problems to determine whether diagrams increase problem-solving success. We also examined the influence of item- and student-level factors to test the robustness of the diagram effect. We worked with 61 seventh-grade students who had received 2 months of pre-algebra instruction. Students participated in an experimenter-led classroom session. Using a within-subjects design, students solved algebra problems in two matched formats (equation and equation-with-diagram). The presence of diagrams increased equation-solving accuracy and the use of informal strategies. This diagram benefit was independent of student ability and item complexity. The benefits of diagrams found previously for story problems generalized to symbolic problems. The findings are consistent with cognitive models of problem-solving and suggest that diagrams may be a useful additional representation of symbolic problems. © 2017 The British Psychological Society.

Could HPS Improve Problem-Solving?

Science.gov (United States)

Coelho, Ricardo Lopes

2013-05-01

It is generally accepted nowadays that History and Philosophy of Science (HPS) is useful in understanding scientific concepts, theories and even some experiments. Problem-solving strategies are a significant topic, since students' careers depend on their skill to solve problems. These are the reasons for addressing the question of whether problem solving could be improved by means of HPS. Three typical problems in introductory courses of mechanics—the inclined plane, the simple pendulum and the Atwood machine—are taken as the object of the present study. The solving strategies of these problems in the eighteenth and nineteenth century constitute the historical component of the study. Its philosophical component stems from the foundations of mechanics research literature. The use of HPS leads us to see those problems in a different way. These different ways can be tested, for which experiments are proposed. The traditional solving strategies for the incline and pendulum problems are adequate for some situations but not in general. The recourse to apparent weights in the Atwood machine problem leads us to a new insight and a solving strategy for composed Atwood machines. Educational implications also concern the development of logical thinking by means of the variety of lines of thought provided by HPS.

Solving rational expectations models using Excel

DEFF Research Database (Denmark)

Strulik, Holger

2004-01-01

Problems of discrete time optimal control can be solved using backward iteration and Microsoft Excel. The author explains the method in general and shows how the basic models of neoclassical growth and real business cycles are solved......Problems of discrete time optimal control can be solved using backward iteration and Microsoft Excel. The author explains the method in general and shows how the basic models of neoclassical growth and real business cycles are solved...

The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia: a randomised controlled trial.

Science.gov (United States)

Vink, A C; Zuidersma, M; Boersma, F; de Jonge, P; Zuidema, S U; Slaets, J P J

2013-10-01

This study aimed to compare the effects of music therapy with general recreational day activities in reducing agitation in people with dementia, residing in nursing home facilities. In a randomised controlled design, residents with dementia (n = 94) were allocated to either music therapy or recreational activities. Both music therapy and general activities were offered twice weekly for 4 months. Changes in agitation were measured with a modified Cohen-Mansfield Agitation Inventory (CMAI) at four intervals on each intervention day. A mixed model analysis was used to evaluate the effectiveness of music therapy, compared with general activities, on CMAI scores at 4 h after the intervention, controlled for CMAI scores at 1 h before the session and session number. Data were analysed for 77 residents (43 randomised to music therapy and 34 to general activities). In both groups, the intervention resulted in a decrease in agitated behaviours from 1 h before to 4 h after each session. This decrease was somewhat greater in the music therapy group than in the general activities group, but this difference was statistically not significant (F = 2.885, p = 0.090) and disappeared completely after adjustment for Global Deterioration Scale stage (F = 1.500; p = 0.222). Both music therapy and recreational activities lead to a short-term decrease in agitation, but there was no additional beneficial effect of music therapy over general activities. More research is required to provide insight in the effects of music therapy in reducing agitation in demented older people. Copyright © 2012 John Wiley & Sons, Ltd.

Solving the 0/1 Knapsack Problem by a Biomolecular DNA Computer

Directory of Open Access Journals (Sweden)

Hassan Taghipour

2013-01-01

Full Text Available Solving some mathematical problems such as NP-complete problems by conventional silicon-based computers is problematic and takes so long time. DNA computing is an alternative method of computing which uses DNA molecules for computing purposes. DNA computers have massive degrees of parallel processing capability. The massive parallel processing characteristic of DNA computers is of particular interest in solving NP-complete and hard combinatorial problems. NP-complete problems such as knapsack problem and other hard combinatorial problems can be easily solved by DNA computers in a very short period of time comparing to conventional silicon-based computers. Sticker-based DNA computing is one of the methods of DNA computing. In this paper, the sticker based DNA computing was used for solving the 0/1 knapsack problem. At first, a biomolecular solution space was constructed by using appropriate DNA memory complexes. Then, by the application of a sticker-based parallel algorithm using biological operations, knapsack problem was resolved in polynomial time.

Comparative evaluation of therapy with L-thyroxine versus no treatment in children with idiopathic and mild subclinical hypothyroidism.

Science.gov (United States)

Wasniewska, Malgorzata; Corrias, Andrea; Aversa, Tommaso; Valenzise, Mariella; Mussa, Alessandro; De Martino, Lucia; Lombardo, Fortunato; De Luca, Filippo; Salerno, Mariacarolina

2012-01-01

The question of whether children with subclinical hypothyroidism (SH) should be treated or not is controversial due to the lack of studies on outcomes of SH children treated with L-thyroxine (L-T(4)) versus those receiving no therapy. (a) To evaluate thyroid tests under L-T(4) and after therapy withdrawal in 69 SH children (group A) and (b) to compare our results with those recorded in 92 untreated children (group B). Group A children were treated for 24 months and TSH and FT(4) levels 3 months after therapy withdrawal were compared with those measured in group B at the end of follow-up in order to investigate treatment effects. The prevalence of children who had normalized TSH at the end of follow-up was higher in group A, but the prevalence of those who had normalized or maintained unchanged TSH was similar in the two groups, as was the prevalence of children who exhibited a TSH increase >10 mU/l. In group A, TSH values at 27 months were associated with baseline values. (a) Two-year treatment in SH children is unable to modify posttherapy outcome of hyperthyrotropinemia; (b) therapy is unable to prevent the risk of further TSH increase after treatment withdrawal, and (c) posttherapy TSH outcome is conditioned by baseline TSH. Copyright © 2012 S. Karger AG, Basel.

Differences in problem-solving between canid populations: Do domestication and lifetime experience affect persistence?

Science.gov (United States)

Brubaker, Lauren; Dasgupta, Sandipan; Bhattacharjee, Debottam; Bhadra, Anindita; Udell, Monique A R

2017-07-01

Past research has suggested that a variety of factors, phylogenetic and ontogenetic, play a role in how canines behave during problem-solving tasks and the degree to which the presence of a human influences their problem-solving behaviour. While comparisons between socialized wolves and domestic dogs have commonly been used to tease apart these predictive factors, in many cases a single dog population, often pets, have been used for these comparisons. Less is understood about how different populations of dogs may behave when compared with wolves, or with each other, during an independent problem-solving task. This experiment compared the independent persistence of four populations of canines (two groups of pet domestic dogs, a group of free-ranging domestic dogs, and human-socialized wolves) on an independent problem-solving task in the presence of an on looking human. Results showed that wolves persisted the most at the task while free-ranging dogs persisted the least. Free-ranging dogs gazed at the human experimenter for the longest durations during the task. While further research is needed to understand why these differences exist, this study demonstrates that dogs, even those living outside human homes as scavengers, show comparatively low levels of persistence when confronted with a solvable task in the presence of a human as well as significantly greater duration of human-directed gaze when compared with wolves.

How does routinely delivered cognitive-behavioural therapy for gambling disorder compare to "gold standard" clinical trial?

Science.gov (United States)

Smith, David P; Fairweather-Schmidt, A Kate; Harvey, Peter W; Battersby, Malcolm W

2018-03-01

Currently, it is unknown whether treatment outcomes derived from randomized controlled trials (RCTs) of cognitive-behavioural therapy (CBT) for problem gamblers still hold when applied to patients seen in routine practice. Thus, data from an RCT of cognitive therapy versus exposure therapy for problem gambling versus patients of a gambling help service were compared. Assessments of problem gambling severity, psychosocial impairment, and alcohol use were undertaken at baseline and post-treatment and evaluated within a counterfactual framework. Findings showed that the contrast between routine CBT for pokies and horse betting had a significant effect, indicative of a 62% lower gambling urge score if routine CBT recipients had all been horse/track betters opposed to gambling with "pokies." However, the majority of contrasts indicated therapeutic outcomes achieved in routine CBT treatments were of equivalent robustness relative to RCT conditions. The present findings infer routine practice treatment outcomes are as efficacious as those generated in RCT contexts. Copyright © 2017 John Wiley & Sons, Ltd.

Encouraging Sixth-Grade Students' Problem-Solving Performance by Teaching through Problem Solving

Science.gov (United States)

Bostic, Jonathan D.; Pape, Stephen J.; Jacobbe, Tim

2016-01-01

This teaching experiment provided students with continuous engagement in a problem-solving based instructional approach during one mathematics unit. Three sections of sixth-grade mathematics were sampled from a school in Florida, U.S.A. and one section was randomly assigned to experience teaching through problem solving. Students' problem-solving…

A Population-Based Comparative Effectiveness Study of Radiation Therapy Techniques in Stage III Non-Small Cell Lung Cancer

Energy Technology Data Exchange (ETDEWEB)

Harris, Jeremy P. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Murphy, James D. [Department of Radiation Medicine and Applied Science, University of California– San Diego, Moores Cancer Center, La Jolla, California (United States); Hanlon, Alexandra L. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Loo, Billy W., E-mail: BWLoo@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Diehn, Maximilian, E-mail: diehn@Stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California (United States); Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California (United States)

2014-03-15

Purpose: Concerns have been raised about the potential for worse treatment outcomes because of dosimetric inaccuracies related to tumor motion and increased toxicity caused by the spread of low-dose radiation to normal tissues in patients with locally advanced non-small cell lung cancer (NSCLC) treated with intensity modulated radiation therapy (IMRT). We therefore performed a population-based comparative effectiveness analysis of IMRT, conventional 3-dimensional conformal radiation therapy (3D-CRT), and 2-dimensional radiation therapy (2D-RT) in stage III NSCLC. Methods and Materials: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify a cohort of patients diagnosed with stage III NSCLC from 2002 to 2009 treated with IMRT, 3D-CRT, or 2D-RT. Using Cox regression and propensity score matching, we compared survival and toxicities of these treatments. Results: The proportion of patients treated with IMRT increased from 2% in 2002 to 25% in 2009, and the use of 2D-RT decreased from 32% to 3%. In univariate analysis, IMRT was associated with improved overall survival (OS) (hazard ratio [HR] 0.90, P=.02) and cancer-specific survival (CSS) (HR 0.89, P=.02). After controlling for confounders, IMRT was associated with similar OS (HR 0.94, P=.23) and CSS (HR 0.94, P=.28) compared with 3D-CRT. Both techniques had superior OS compared with 2D-RT. IMRT was associated with similar toxicity risks on multivariate analysis compared with 3D-CRT. Propensity score matched model results were similar to those from adjusted models. Conclusions: In this population-based analysis, IMRT for stage III NSCLC was associated with similar OS and CSS and maintained similar toxicity risks compared with 3D-CRT.

Problem solving performance and learning strategies of undergraduate students who solved microbiology problems using IMMEX educational software

Science.gov (United States)

Ebomoyi, Josephine Itota

The objectives of this study were as follows: (1) Determine the relationship between learning strategies and performance in problem solving, (2) Explore the role of a student's declared major on performance in problem solving, (3) Understand the decision making process of high and low achievers during problem solving. Participants (N = 65) solved problems using the Interactive multimedia exercise (IMMEX) software. All participants not only solved "Microquest," which focuses on cellular processes and mode of action of antibiotics, but also "Creeping Crud," which focuses on the cause, origin and transmission of diseases. Participants also responded to the "Motivated Strategy Learning Questionnaire" (MSLQ). Hierarchical multiple regression was used for analysis with GPA (Gracie point average) as a control. There were 49 (78.6%) that successfully solved "Microquest" while 52 (82.5%) successfully solved "Creeping Crud". Metacognitive self regulation strategy was significantly (p low achievers. Common strategies and attributes included metacognitive skills, writing to keep track, using prior knowledge. Others included elements of frustration/confusion and self-esteem problems. The implications for educational and relevance to real life situations are discussed.

New method for solving three-dimensional Schroedinger equation

International Nuclear Information System (INIS)

Melezhik, V.S.

1990-01-01

The method derived recently for solving a multidimensional scattering problem is applied to a three-dimensional Schroedinger equation. As compared with direct three-dimensional calculations of finite elements and finite differences, this approach gives sufficiently accurate upper and lower approximations to the helium-atom binding energy, which demonstrates its efficiency. 15 refs.; 1 fig.; 2 tabs

Comparative effectiveness of oral drug therapies for lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and network meta-analysis.

Directory of Open Access Journals (Sweden)

Xinghuan Wang

Full Text Available Lower urinary tract symptoms (LUTS due to benign prostatic hyperplasia (BPH are common in elder men and a number of drugs alone or combined are clinically used for this disorder. But available studies investigating the comparative effects of different drug therapies are limited. This study was aimed to compare the efficacy of different drug therapies for LUTS/BPH with network meta-analysis.An electronic search of PubMed, Cochrane Library and Embase was performed to identify randomized controlled trials (RCTs comparing different drug therapies for LUTS/BPH within 24 weeks. Comparative effects were calculated using Aggregate Data Drug Information System. Consistency models of network meta-analysis were created and cumulative probability was used to rank different therapies.A total 66 RCTs covering seven different therapies with 29384 participants were included. We found that α-blockers (ABs plus phosphodiesterase 5 inhibitors (PDE5-Is ranked highest in the test of IPSS total score, storage subscore and voiding subscore. The combination therapy of ABs plus 5α-reductase inhibitors was the best for increasing maximum urinary flow rate (Qmax with a mean difference (MD of 1.98 (95% CI, 1.12 to 2.86 as compared to placebo. ABs plus muscarinic receptor antagonists (MRAs ranked secondly on the reduction of IPSS storage subscore, although monotherapies including MRAs showed no effect on this aspect. Additionally, PDE5-Is alone showed great effectiveness for LUTS/BPH except Qmax.Based on our novel findings, combination therapy, especially ABs plus PDE5-Is, is recommended for short-term treatment for LUTS/BPH. There was also evidence that PDE5-Is used alone was efficacious except on Qmax. Additionally, it should be cautious when using MRAs. However, further clinical studies are required for longer duration which considers more treatment outcomes such as disease progression, as well as basic research investigating mechanisms involving PDE5-Is and other

Solving Environmental Problems

DEFF Research Database (Denmark)

Ørding Olsen, Anders; Sofka, Wolfgang; Grimpe, Christoph

2017-01-01

for Research and Technological Development (FP7), our results indicate that the problem-solving potential of a search strategy increases with the diversity of existing knowledge of the partners in a consortium and with the experience of the partners involved. Moreover, we identify a substantial negative effect...... dispersed. Hence, firms need to collaborate. We shed new light on collaborative search strategies led by firms in general and for solving environmental problems in particular. Both topics are largely absent in the extant open innovation literature. Using data from the European Seventh Framework Program...

Infusion dose requirement of rocuronium in patients on phenytoin therapy - A prospective comparative study.

Science.gov (United States)

Sheshadri, Veena; Radhakrishnan, Arathi; Halemani, Kusuma; Keshavan, Venkatesh H

2017-10-01

Patients with intracranial tumour are usually on anticonvulsants. Patients on phenytoin therapy demonstrate rapid metabolism of nondepolarising muscle relaxants secondary to enzyme induction. Infusion dose requirement of rocuronium in such patients has been sparingly studied. We studied the continuous infusion dose requirement of rocuronium bromide in patients on phenytoin therapy and its correlation with serum levels of phenytoin. Seventy-five patients scheduled for supratentorial tumour surgery were included in the study. Patients not on phenytoin were taken as control. The primary outcome variable studied was the infusion dose requirement of rocuronium in patients on phenytoin. Based on pre-operative serum phenytoin levels, study group patients were divided into two groups: sub-therapeutic level group (phenytoin level 10 μg/mL). Following anaesthesia induction, rocuronium bromide 0.6 mg/kg was administered to achieve tracheal intubation. Rocuronium infusion was titrated to maintain zero response on the train-of-four response. Demographic data were comparable. Patients receiving phenytoin required higher infusion dose compared to the control group (0.429 ± 0.2 mg/kg/h vs. 0.265 ± 0.15 mg/kg/h, P rocuronium (0.429 ± 0.205 mg/kg/h vs. 0.429 ± 0.265 mg/kg/h ( P = 0.815). The recovery was faster in the phenytoin group compared to the control group. Haowever, it was not clinically significant. The infusion dose requirement of rocuronium bromide in patients on phenytoin is higher and the serum levels of phenytoin does not influence the dose required.

Comparing Physical Therapy Accompanying Exercise with Only Exercise Treatments in Patients with Chronic Mechanical Low Back Pain

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Özlem Yılmaz

2015-08-01

Full Text Available Objective: Investigating and comparing the effects of exercise and physical therapy accompanying exercise treatments in patients with chronic low back pain. Materials and Methods: Twenty three patients with mechanical type low back existing more than 3 months were included one of the exercise or the physical therapy+exercise groups according to their application sequence. Both of the groups performed lumbar flexion and extension exercises, strengthening of the lumbar and abdominal muscle exercises and iliopsoas, hamstring and quadriceps stretching exercises two times a day for 14 days. The physical therapy group was given hot pack+therapeutic ultrasound+ interferential current for 10 days additionally. Degree of the low back pain was evaluated with visual analog scale (VAS, range of joint motion was evaluated with hand finger floor distance (HFFD and Modified Schober test, functional status was evaluated with Modified Oswestry Low Back Pain Scale and quality of life was evaluated with Short form-36 (SF-36 before and a month after the treatments. Results: In both groups (exercise group: average age 59 years, 21 females, 2 males; physical therapy group: average age 60 years, 20 females, 3 males pain intensity and HFFD decreased and Modified Schober increased, functionality recovered, pain and physical functions of SF-36 improved after the treatments. SF-36-physical role difficulty also improved in the exercise group. Decrease in pain, increase in HFFD andimproving of the functional status were all significantly more in the physical therapy group. There were no difference between the groups in terms of Modified Schober measurement and changes of the quality of life. Conclusions: Exercises and exercise+physical therapy are both effective in chronic low back pain. Successful results can be taken by addition of the physical therapy in patients who do not benefit sufficiently from exercise therapy. (Turkish Journal of Osteoporosis 2015;21: 73-8

Comparison of dose-volume histograms for Tomo therapy, linear accelerator-based 3D conformal radiation therapy, and intensity-modulated radiation therapy

International Nuclear Information System (INIS)

Ji, Youn-Sang; Dong, Kyung-Rae; Kim, Chang-Bok; Choi, Seong-Kwan; Chung, Woon-Kwan; Lee, Jong-Woong

2011-01-01

Highlights: → Evaluation of DVH from 3D CRT, IMRT and Tomo therapy was conducted for tumor therapy. → The doses of GTV and CTV were compared using DVHs from 3D CRT, IMRT and Tomo therapy. → The GTV was higher when Tomo therapy was used, while the doses of critical organ were low. → They said that Tomo therapy satisfied the goal of radiation therapy more than the others. - Abstract: Evaluation of dose-volume histograms from three-dimensional conformal radiation therapy (3D CRT), intensity-modulated radiation therapy (IMRT), and Tomo therapy was conducted. These three modalities are among the diverse treatment systems available for tumor therapy. Three patients who received tumor therapy for a malignant oligodendroglioma in the cranium, nasopharyngeal carcinoma in the cervical neck, and prostate cancer in the pelvis were selected as study subjects. Therapy plans were made for the three patients before dose-volume histograms were obtained. The doses of the gross tumor volume (GTV) and the clinical target volume (CTV) were compared using the dose-volume histograms obtained from the LINAC-based 3D CRT, IMRT planning station (Varian Eclipse-Varian, version 8.1), and Tomo therapy planning station. In addition, the doses of critical organs in the cranium, cervix, and pelvis that should be protected were compared. The GTV was higher when Tomo therapy was used compared to 3D CRT and the LINAC-based IMRT, while the doses of critical organ tissues that required protection were low. These results demonstrated that Tomo therapy satisfied the ultimate goal of radiation therapy more than the other therapies.

Outcomes of specific interpersonal problems for binge eating disorder: comparing group psychodynamic interpersonal psychotherapy and group cognitive behavioral therapy.

Science.gov (United States)

Tasca, Giorgio A; Balfour, Louise; Presniak, Michelle D; Bissada, Hany

2012-04-01

We assessed whether an attachment-based treatment, Group Psychodynamic Interpersonal Psychotherapy (GPIP) had a greater impact compared to Group Cognitive Behavioral Therapy (GCBT) on Cold/Distant and Intrusive/Needy interpersonal problems. Ninety-five individuals with Binge Eating Disorder (BED) were randomized to GPIP or GCBT and assessed at pre-, post-, and six months post-treatment. Both therapies resulted in a significant decrease in all eight interpersonal problem subscales except the Nonassertive subscale. GPIP resulted in a greater reduction in the Cold/Distant subscale compared to GCBT, but no differences were found for changes in the Intrusive/Needy subscale. GPIP may be most relevant for those with BED who have Cold/Distant interpersonal problems and attachment avoidance.

Algorithms for solving common fixed point problems

CERN Document Server

Zaslavski, Alexander J

2018-01-01

This book details approximate solutions to common fixed point problems and convex feasibility problems in the presence of perturbations. Convex feasibility problems search for a common point of a finite collection of subsets in a Hilbert space; common fixed point problems pursue a common fixed point of a finite collection of self-mappings in a Hilbert space. A variety of algorithms are considered in this book for solving both types of problems, the study of which has fueled a rapidly growing area of research. This monograph is timely and highlights the numerous applications to engineering, computed tomography, and radiation therapy planning. Totaling eight chapters, this book begins with an introduction to foundational material and moves on to examine iterative methods in metric spaces. The dynamic string-averaging methods for common fixed point problems in normed space are analyzed in Chapter 3. Dynamic string methods, for common fixed point problems in a metric space are introduced and discussed in Chapter ...

Solving Accounting Problems: Differences between Accounting Experts and Novices.

Science.gov (United States)

Marshall, P. Douglas

2002-01-01

Performance of 90 accounting experts (faculty and practitioners) and 60 novices (senior accounting majors) was compared. Experts applied more accounting principles to solving problems. There were no differences in types of principles applied and no correlation between (1) principles applied and number of breadth comments or (2) importance placed…

Cost-Effectiveness Analysis of Stereotactic Body Radiation Therapy Compared With Radiofrequency Ablation for Inoperable Colorectal Liver Metastases

Energy Technology Data Exchange (ETDEWEB)

Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Gill, Beant; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Roberts, Mark S. [Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

2016-07-15

Purpose: To conduct a cost-effectiveness analysis to determine whether stereotactic body radiation therapy (SBRT) is a cost-effective therapy compared with radiofrequency ablation (RFA) for patients with unresectable colorectal cancer (CRC) liver metastases. Methods and Materials: A cost-effectiveness analysis was conducted using a Markov model and 1-month cycle over a lifetime horizon. Transition probabilities, quality of life utilities, and costs associated with SBRT and RFA were captured in the model on the basis of a comprehensive literature review and Medicare reimbursements in 2014. Strategies were compared using the incremental cost-effectiveness ratio, with effectiveness measured in quality-adjusted life years (QALYs). To account for model uncertainty, 1-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay threshold of $100,000 per QALY gained. Results: In base case analysis, treatment costs for 3 fractions of SBRT and 1 RFA procedure were $13,000 and $4397, respectively. Median survival was assumed the same for both strategies (25 months). The SBRT costs $8202 more than RFA while gaining 0.05 QALYs, resulting in an incremental cost-effectiveness ratio of $164,660 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of median survival from both treatments. Stereotactic body radiation therapy was economically reasonable if better survival was presumed (>1 month gain) or if used for large tumors (>4 cm). Conclusions: If equal survival is assumed, SBRT is not cost-effective compared with RFA for inoperable colorectal liver metastases. However, if better local control leads to small survival gains with SBRT, this strategy becomes cost-effective. Ideally, these results should be confirmed with prospective comparative data.

Cost-Effectiveness Analysis of Stereotactic Body Radiation Therapy Compared With Radiofrequency Ablation for Inoperable Colorectal Liver Metastases

International Nuclear Information System (INIS)

Kim, Hayeon; Gill, Beant; Beriwal, Sushil; Huq, M. Saiful; Roberts, Mark S.; Smith, Kenneth J.

2016-01-01

Purpose: To conduct a cost-effectiveness analysis to determine whether stereotactic body radiation therapy (SBRT) is a cost-effective therapy compared with radiofrequency ablation (RFA) for patients with unresectable colorectal cancer (CRC) liver metastases. Methods and Materials: A cost-effectiveness analysis was conducted using a Markov model and 1-month cycle over a lifetime horizon. Transition probabilities, quality of life utilities, and costs associated with SBRT and RFA were captured in the model on the basis of a comprehensive literature review and Medicare reimbursements in 2014. Strategies were compared using the incremental cost-effectiveness ratio, with effectiveness measured in quality-adjusted life years (QALYs). To account for model uncertainty, 1-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay threshold of $100,000 per QALY gained. Results: In base case analysis, treatment costs for 3 fractions of SBRT and 1 RFA procedure were $13,000 and $4397, respectively. Median survival was assumed the same for both strategies (25 months). The SBRT costs $8202 more than RFA while gaining 0.05 QALYs, resulting in an incremental cost-effectiveness ratio of $164,660 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of median survival from both treatments. Stereotactic body radiation therapy was economically reasonable if better survival was presumed (>1 month gain) or if used for large tumors (>4 cm). Conclusions: If equal survival is assumed, SBRT is not cost-effective compared with RFA for inoperable colorectal liver metastases. However, if better local control leads to small survival gains with SBRT, this strategy becomes cost-effective. Ideally, these results should be confirmed with prospective comparative data.

Assessing Algebraic Solving Ability: A Theoretical Framework

Science.gov (United States)

Lian, Lim Hooi; Yew, Wun Thiam

2012-01-01

Algebraic solving ability had been discussed by many educators and researchers. There exists no definite definition for algebraic solving ability as it can be viewed from different perspectives. In this paper, the nature of algebraic solving ability in terms of algebraic processes that demonstrate the ability in solving algebraic problem is…

Manipulation of biliary lipids by gene therapy: potential consequences for patients with progressive familial intrahepatic cholestasis

NARCIS (Netherlands)

Oude Elferink, Ronald P. J.

2005-01-01

Gene therapy constitutes a great promise for the treatment of inherited diseases as well as cancer. Although the principle is extremely elegant, reality proves that several important problems remain to be solved before gene therapy becomes a standard application for these conditions. Meanwhile, and

Thought Field Therapy Compared to Cognitive Behavioral Therapy and Wait-List for Agoraphobia: A Randomized, Controlled Study with a 12-Month Follow-up

Directory of Open Access Journals (Sweden)

Audun C. Irgens

2017-06-01

Full Text Available Background: Thought field therapy (TFT is used for many psychiatric conditions, but its efficacy has not been sufficiently documented. Hence, there is a need for studies comparing TFT to well-established treatments. This study compares the efficacy of TFT and cognitive behavioral therapy (CBT for patients with agoraphobia.Methods: Seventy-two patients were randomized to CBT (N = 24, TFT (N = 24 or a wait-list condition (WLC (N = 24 after a diagnostic procedure including the MINI PLUS that was performed before treatment or WLC. Following a 3 months waiting period, the WL patients were randomized to CBT (n = 12 or TFT (n = 12, and all patients were reassessed after treatment or waiting period and at 12 months follow-up. At first we compared the three groups CBT, TFT, and WL. After the post WL randomization, we compared CBT (N = 12 + 24 = 36 to TFT (N = 12 + 24 = 36, applying the pre-treatment scores as baseline for all patients. The primary outcome measure was a symptom score from the Anxiety Disorders Interview Scale that was performed by an interviewer blinded to the treatment condition. For statistical comparisons, we used the independent sample’s t-test, the Fisher’s exact test and the ANOVA and ANCOVA tests.Results: Both CBT and TFT showed better results than the WLC (p < 0.001 at post-treatment. Post-treatment and at the 12-month follow-up, there were not significant differences between CBT and TFT (p = 0.33 and p = 0.90, respectively.Conclusion: This paper reports the first study comparing TFT to CBT for any disorder. The study indicated that TFT may be an efficient treatment for patients with agoraphobia.Trial Registration:https://clinicaltrials.gov/, identifier NCT00932919.

Finer Distinctions: Variability in Satisfied Older Couples' Problem-Solving Behaviors.

Science.gov (United States)

Rauer, Amy; Williams, Leah; Jensen, Jakob

2017-06-01

This study utilized observational and self-report data from 64 maritally satisfied and stable older couples to explore if there were meaningful differences in how couples approached marital disagreements. Using a typology approach to classify couples based on their behaviors in a 15-minute problem-solving interaction, findings revealed four types of couples: (1) problem solvers (characterized by both spouses' higher problem-solving skills and warmth), (2) supporters (characterized by both spouses' notable warmth), (3) even couples (characterized by both spouses' moderate problem-solving skills and warmth), and (4) cool couples (characterized by both spouses' greater negativity and lower problem-solving skills and warmth). Despite the differences in these behaviors, all couples had relatively high marital satisfaction and functioning. However, across nearly all indices, spouses in the cool couple cluster reported poorer marital functioning, particularly when compared to the problem solvers and supporters. These findings suggest that even modest doses of negativity (e.g., eye roll) may be problematic for some satisfied couples later in life. The implications of these typologies are discussed as they pertain to practitioners' efforts to tailor their approaches to a wider swath of the population. © 2015 Family Process Institute.

[Cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of rheumatoid arthritis].

Science.gov (United States)

Salinas-Escudero, Guillermo; Vargas-Valencia, Juan; García-García, Erika Gabriela; Munciño-Ortega, Emilio; Galindo-Suárez, Rosa María

2013-01-01

to conduct cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of moderate or severe rheumatoid arthritis in patients with previous unresponse to immune selective anti-inflammatory derivatives failure. a pharmacoeconomic model based on decision analysis to assess the clinical outcome after giving etanercept, infliximab, adalimumab or tocilizumab to treat moderate or severe rheumatoid arthritis was employed. Effectiveness of medications was assessed with improvement rates of 20 % or 70 % of the parameters established by the American College of Rheumatology (ACR 20 and ACR 70). the model showed that etanercept had the most effective therapeutic response rate: 79.7 % for ACR 20 and 31.4 % for ACR 70, compared with the response to other treatments. Also, etanercept had the lowest cost ($149,629.10 per patient) and had the most cost-effective average ($187,740.40 for clinical success for ACR 20 and $476,525.80 for clinical success for ACR 70) than the other biologic therapies. we demonstrated that treatment with etanercept is more effective and less expensive compared to the other drugs, thus making it more efficient therapeutic option both in terms of means and incremental cost-effectiveness ratios for the treatment of rheumatoid arthritis.

Increasing self-efficacy in learning to program: exploring the benefits of explicit instruction for problem solving

Directory of Open Access Journals (Sweden)

Irene Govender

2014-07-01

Full Text Available The difficulty of learning to program has long been identified amongst novices. This study explored the benefits of teaching a problem solving strategy by comparing students’ perceptions and attitudes towards problem solving before and after the strategy was implemented in secondary schools. Based on self-efficacy theory, students’ problem solving self-efficacy as well as teachers’ self-efficacy were investigated, showing that both students’ and teachers’ self-efficacy may have benefited from the explicit instruction. This would imply that teaching problem solving explicitly should be encouraged to increase self-efficacy to program.

Induction concurrent chemoradiation therapy for invading apical non-small cell lung cancer

International Nuclear Information System (INIS)

Miyoshi, Shinichiro; Nakamura, Kenji

2004-01-01

Although non-small cell lung cancer (NSCLC) involving the superior sulcus has been generally treated with radiation therapy (RT) followed by surgery, local recurrence is still a big problem to be solved. We investigated a role of induction therapy, especially induction concurrent chemoradiation therapy (CRT), on the surgical results of this type of NSCLC. We retrospectively reviewed 30 patients with NSCLC invading the apex of the chest wall who underwent surgery from 1987 to 1996. Ten patients (57±8 years) received surgery alone, 9 (55±13 years) received RT (42±7 Gy) followed by surgery and 11 (51±9 years) received cisplatin based chemotherapy and RT (47±5 Gy) as an induction therapy. Two and 4-year survival rates were 30% and 20% in patients with surgery alone, 22% and 11% in patients with induction RT, and 73% and 53% in patients with induction CRT, respectively. The survival was significantly better in patients with induction CRT than those with induction RT or surgery alone. Univariate analysis demonstrated that curability (yes versus no: p=0.027) and induction therapy (surgery alone and RT versus CRT: p=0.0173) were significant prognostic factors. Multivariate analysis revealed that only induction therapy (p=0.0238) was a significant prognostic factor. Induction CRT seems to improve the survival in patients with NSCLC invading the apex of the chest wall compared with induction RT or surgery alone. (author)

The effect of problem-based and lecture-based instructional strategies on learner problem solving performance, problem solving processes, and attitudes

Science.gov (United States)

Visser, Yusra Laila

This study compared the effect of lecture-based instruction to that of problem-based instruction on learner performance (on near-transfer and far-transfer problems), problem solving processes (reasoning strategy usage and reasoning efficiency), and attitudes (overall motivation and learner confidence) in a Genetics course. The study also analyzed the effect of self-regulatory skills and prior-academic achievement on performance for both instructional strategies. Sixty 11th grade students at a public math and science academy were assigned to either a lecture-based instructional strategy or a problem-based instructional strategy. Both treatment groups received 18 weeks of Genetics instruction through the assigned instructional strategy. In terms of problem solving performance, results revealed that the lecture-based group performed significantly better on near-transfer post-test problems. The problem-based group performed significantly better on far-transfer post-test problems. In addition, results indicated the learners in the lecture-based instructional treatment were significantly more likely to employ data-driven reasoning in the solving of problems, whereas learners in the problem-based instructional treatment were significantly more likely to employ hypothesis-driven reasoning in problem solving. No significant differences in reasoning efficiency were uncovered between treatment groups. Preliminary analysis of the motivation data suggested that there were no significant differences in motivation between treatment groups. However, a post-research exploratory analysis suggests that overall motivation was significantly higher in the lecture-based instructional treatment than in the problem-based instructional treatment. Learner confidence was significantly higher in the lecture-based group than in the problem-based group. A significant positive correlation was detected between self-regulatory skills scores and problem solving performance scores in the problem

Photodynamic therapy and diagnosis: Principles and comparative aspects.

Science.gov (United States)

Dobson, Jane; de Queiroz, Genilson Fernandes; Golding, Jon P

2018-03-01

Photodynamic therapy (PDT) is an evolving method of treating superficial tumours that is non-invasive and carries minimal risk of toxicity. It combines tumour-selective photosensitiser dyes, tissue oxygen and targeted illumination to generate cytotoxic reactive oxygen species (ROS) within the tumour. In addition to directly acting on tumour cells, PDT damages and restricts tumour microvasculature, and causes a local inflammatory response that stimulates an immune response against the tumour. Unlike surgery or radiotherapy, the surrounding extracellular matrix is unaffected by PDT; thus, tissue healing is excellent and PDT seldom causes scars. This, combined with the ease of light application, has made PDT a popular treatment for cancers and pre-cancerous conditions in human beings. Moreover, because photosensitiser dyes are fluorescent and selectively accumulate in tumour tissues, they can additionally be used to visualise and discriminate tumour from normal tissues, thereby improving the accuracy of tumour surgery. In veterinary practice, PDT has been used successfully for treatment of superficial squamous cell carcinomas of the feline nasal planum; urinary tract, urinary bladder and prostate neoplasia in dogs; and equine sarcoids. The purpose of this article is to provide a comparative review of the current literature on PDT in human and veterinary medicine, and to establish a basis for future development of PDT in veterinary medicine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Experimental tumor therapy - annual report 1982

International Nuclear Information System (INIS)

1983-08-01

The present annual report is the fifth in a regular series and documents the continuity of the investigations in the field of experimental tumor therapy. The main points of emphasis of the activities relate above all to problems of dose fractionation and combination treatment. But if the present volume is compared with the previous ones the reader may be struck by the wider range of model systems used, especially of the tumors and normal tissues in which chronic radiation effects are investigated, and also by a concentration on those investigations that are important for solving clinical problems and that make use of many small fractions. Moreover, experiments were carried through in 1982 on the neutron beam set up at the Garching research reactor in order to characterise its biologic effect, which was a preparative measure in view of the planned clinical use. (orig./MG) [de

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...

Adventures in Exercise Physiology: Enhancing Problem Solving and Assessment

Science.gov (United States)

FitzPatrick, Kathleen A.

2004-01-01

I altered the format of an exercise physiology course from traditional lecture to emphasizing daily reading quizzes and group problem-solving activities. I used the SALGains evaluation to compare the two approaches and saw significant improvements in the evaluation ratings of students who were taught using the new format. Narrative responses…

Enhancing Problem-Solving Capabilities Using Object-Oriented Programming Language

Science.gov (United States)

Unuakhalu, Mike F.

2009-01-01

This study integrated object-oriented programming instruction with transfer training activities in everyday tasks, which might provide a mechanism that can be used for efficient problem solving. Specifically, a Visual BASIC embedded with everyday tasks group was compared to another group exposed to Visual BASIC instruction only. Subjects were 40…

Comparative efficacy of different schemes for the therapy of rotavirus gastroenteritis in children. Case–control study

Directory of Open Access Journals (Sweden)

S. V. Khaliullina

2017-01-01

Full Text Available Objective research: compare the efficacy of different types of therapy for rotavirus gastroenteritis in children.Materials and methods. A study was carried out, the design of which corresponded to the case–control type. The main group is children hospitalized in a hospital with laboratory confirmed rotavirus infection (35 cases, who were prescribed a modern regimen of therapy that included a low-carbohydrate diet, rehydration with low osmolar oral solutions, dioctahedral smectite, probiotic containing Saccharomyces boulardii. For each child of the main group was selected another patient (control, the corresponding sex, age, the period from the onset of the disease to admission to hospital, and the degree of dehydration. Patients of the control group (n=35 were assigned a traditional «old» therapy regimen, including a diet corresponding to Table No. 4 in Pevznur, oral rehydration solutions with osmolality of 282 mOsm/l, anthibacterial therapy (ceftriaxone, dioctahedral smectite and pancreatin at age-dependent doses. The duration of the observation was 5 days. Results: By the 5th day of treatment, the normalization of the stool was recorded in 91.4% [95% CI 82.1–100.7], 32/35 in the main group and 71.4% [95% CI 56.5–86.3], 25/35 children in the control (p <0.05, OR 4.27 [95% CI 1.06–17.2]. The timing of relief of excess meteorism also had statistically significant differences and was shorter in patients receiving a «new» therapy regimen (OR 2.8 [95% CI 1.01–8]. The positive effect of the proposed scheme was also observed when assessing the duration of dehydration symptoms and the timing of hospitalization.Conclusions: The conducted study case–control showed the advantage of modern schemes of therapy of rotavirus infections in children.

Rational-Emotive Therapy and Youth: Some New Techniques for Counselors.

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Roush, David W.

1984-01-01

Derived from experience with cognitively and emotionally impaired juvenile offenders, several techniques are presented to increase the effectiveness of Rational Emotive Therapy with youth. The techniques provide young people with useful tools for building an effective personal problem solving approach to life. (JAC)

A virtual clinical trial comparing static versus dynamic PET imaging in measuring response to breast cancer therapy

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Wangerin, Kristen A.; Muzi, Mark; Peterson, Lanell M.; Linden, Hannah M.; Novakova, Alena; Mankoff, David A.; E Kinahan, Paul

2017-05-01

We developed a method to evaluate variations in the PET imaging process in order to characterize the relative ability of static and dynamic metrics to measure breast cancer response to therapy in a clinical trial setting. We performed a virtual clinical trial by generating 540 independent and identically distributed PET imaging study realizations for each of 22 original dynamic fluorodeoxyglucose (18F-FDG) breast cancer patient studies pre- and post-therapy. Each noise realization accounted for known sources of uncertainty in the imaging process, such as biological variability and SUV uptake time. Four definitions of SUV were analyzed, which were SUVmax, SUVmean, SUVpeak, and SUV50%. We performed a ROC analysis on the resulting SUV and kinetic parameter uncertainty distributions to assess the impact of the variability on the measurement capabilities of each metric. The kinetic macro parameter, K i , showed more variability than SUV (mean CV K i   =  17%, SUV  =  13%), but K i pre- and post-therapy distributions also showed increased separation compared to the SUV pre- and post-therapy distributions (mean normalized difference K i   =  0.54, SUV  =  0.27). For the patients who did not show perfect separation between the pre- and post-therapy parameter uncertainty distributions (ROC AUC  dynamic imaging outperformed SUV in distinguishing metabolic change in response to therapy, ranging from 12 to 14 of 16 patients over all SUV definitions and uptake time scenarios (p  PET imaging.

Increasing self-efficacy in learning to program : Exploring the benefits of explicit instruction for problem solving

NARCIS (Netherlands)

Govender, I.; Govender, D.; Havenga, M.; Mentz, E.; Breed, B.; Dignum, F.; Dignum, V.

2014-01-01

The difficulty of learning to program has long been identified amongst novices. This study explored the benefits of teaching a problem solving strategy by comparing students’ perceptions and attitudes towards problem solving before and after the strategy was implemented in secondary schools. Based

Toward High-Performance Communications Interfaces for Science Problem Solving

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Oviatt, Sharon L.; Cohen, Adrienne O.

2010-12-01

From a theoretical viewpoint, educational interfaces that facilitate communicative actions involving representations central to a domain can maximize students' effort associated with constructing new schemas. In addition, interfaces that minimize working memory demands due to the interface per se, for example by mimicking existing non-digital work practice, can preserve students' attentional focus on their learning task. In this research, we asked the question: What type of interface input capabilities provide best support for science problem solving in both low- and high- performing students? High school students' ability to solve a diverse range of biology problems was compared over longitudinal sessions while they used: (1) hardcopy paper and pencil (2) a digital paper and pen interface (3) pen tablet interface, and (4) graphical tablet interface. Post-test evaluations revealed that time to solve problems, meta-cognitive control, solution correctness, and memory all were significantly enhanced when using the digital pen and paper interface, compared with tablet interfaces. The tangible pen and paper interface also was the only alternative that significantly facilitated skill acquisition in low-performing students. Paradoxically, all students nonetheless believed that the tablet interfaces provided best support for their performance, revealing a lack of self-awareness about how to use computational tools to best advantage. Implications are discussed for how pen interfaces can be optimized for future educational purposes, and for establishing technology fluency curricula to improve students' awareness of the impact of digital tools on their performance.

Perspectives on Problem Solving and Instruction

Science.gov (United States)

van Merrienboer, Jeroen J. G.

2013-01-01

Most educators claim that problem solving is important, but they take very different perspective on it and there is little agreement on how it should be taught. This article aims to sort out the different perspectives and discusses problem solving as a goal, a method, and a skill. As a goal, problem solving should not be limited to well-structured…

[Comparing effectivity of VAC therapy for treatment of infections following arthroplasty or soft-tissue surgery].

Science.gov (United States)

Schmal, H; Oberst, M; Hansen, S; Six-Merker, J; Südkamp, N P; Izadpanah, K

2013-08-01

Although vacuum-assisted wound closure (VAC) has been developed into a standard technique in septic surgery, reliable data about the efficacy of the treatment are still lacking. Postoperative infections after arthroplasty or soft-tissue surgery were identified using a prospective database for complications (Critical Incidence Reporting System) which was retrospectively supplemented with items for evaluation of VAC therapy. Eradication success of infection was analysed considering epidemiological parameters, course of treatment, and characteristics of causing bacterial strains. Furthermore, serological C-reactive protein (CRP) concentrations were evaluated for diagnostic and prognostic reliability. 92 patients with an average age of 60 ± 4 years were included in the study. Patients with soft tissue infections (STI, n = 53) were statistically significant younger compared to patients with infections following arthroplasty (AI, n = 39) (53 ± 6 vs. 70 ± 4 years; p infected endoprostheses were longer treated on intensive care units (6.1 ± 8.4 vs. 3.5 ± 6.5 days; p infection was with 81 % statistically significant higher in the STI group compared to 38 % in the AI group (p infections in the AI group were associated with a better healing success when compared to chronic infections (p infections (p infection, the probability for eradication of infection was impaired (p infection was reached. CRP values were higher in the AI group and associated with the prognosis (p VAC therapy is higher after soft-tissue infections compared to infections following arthroplasty. Accordingly, mortality is higher in this group. Chronic courses have worse chances for healing in both groups. For serological CRP values a prognostic relevance could be shown. Georg Thieme Verlag KG Stuttgart · New York.

Concept mapping improves academic performance in problem solving questions in biochemistry subject.

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Baig, Mukhtiar; Tariq, Saba; Rehman, Rehana; Ali, Sobia; Gazzaz, Zohair J

2016-01-01

To assess the effectiveness of concept mapping (CM) on the academic performance of medical students' in problem-solving as well as in declarative knowledge questions and their perception regarding CM. The present analytical and questionnaire-based study was carried out at Bahria University Medical and Dental College (BUMDC), Karachi, Pakistan. In this analytical study, students were assessed with problem-solving questions (A-type MCQs), and declarative knowledge questions (short essay questions), and 50% of the questions were from the topics learned by CM. Students also filled a 10-item, 3-point Likert scale questionnaire about their perception regarding the effectiveness of the CM approach, and two open-ended questions were also asked. There was a significant difference in the marks obtained in those problem-solving questions, which were learned by CM as compared to those topics which were taught by the traditional lectures (pacademic performance in problem solving but not in declarative knowledge questions. Students' perception about the effectiveness of CM was overwhelmingly positive.

Neural bases for basic processes in heuristic problem solving: Take solving Sudoku puzzles as an example.

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Qin, Yulin; Xiang, Jie; Wang, Rifeng; Zhou, Haiyan; Li, Kuncheng; Zhong, Ning

2012-12-01

Newell and Simon postulated that the basic steps in human problem-solving involve iteratively applying operators to transform the state of the problem to eventually achieve a goal. To check the neural basis of this framework, the present study focused on the basic processes in human heuristic problem-solving that the participants identified the current problem state and then recalled and applied the corresponding heuristic rules to change the problem state. A new paradigm, solving simplified Sudoku puzzles, was developed for an event-related functional magnetic resonance imaging (fMRI) study in problem solving. Regions of interest (ROIs), including the left prefrontal cortex, the bilateral posterior parietal cortex, the anterior cingulated cortex, the bilateral caudate nuclei, the bilateral fusiform, as well as the bilateral frontal eye fields, were found to be involved in the task. To obtain convergent evidence, in addition to traditional statistical analysis, we used the multivariate voxel classification method to check the accuracy of the predictions for the condition of the task from the blood oxygen level dependent (BOLD) response of the ROIs, using a new classifier developed in this study for fMRI data. To reveal the roles that the ROIs play in problem solving, we developed an ACT-R computational model of the information-processing processes in human problem solving, and tried to predict the BOLD response of the ROIs from the task. Advances in human problem-solving research after Newell and Simon are then briefly discussed. © 2012 The Institute of Psychology, Chinese Academy of Sciences and Blackwell Publishing Asia Pty Ltd.

The effect of problem-solving skill training on mental health and the success of treatment of infertile women under intrauterine insemination treatment

Science.gov (United States)

Gojani, Marziyeh Ghasemi; Kordi, Masoume; Asgharipour, Negar; Esmaeili, Habibollah; Amirian, Maliheh; Eskandarnia, Elnaze

2017-01-01

INTRODUCTION: Using fertility treatment will cause high levels of anxiety and depression. The study was carried out with the objective of determining the effect of problem-solving skills (PSS) training on mental health and the success of treatment of infertile women under intrauterine insemination (IUI) treatment. MATERIALS AND METHODS: this randomized clinical trial was carried out on 72 women referring to Milad Infertility Center in Mashhad. Individuals were randomly assigned into control and intervention groups. PSS were taught in three sessions in the intervention group, and the control group received usual care. The success rate of therapy and the mean of anxiety and depression on the day of IUI operation were compared using the Beck Depression Inventory and Spielberger Anxiety Inventory in both groups. t-test, Mann–Whitney, paired t-test, Wilcoxon, and Chi-square tests were used to analyze the data. RESULTS: on the day of IUI operation, the mean score of state anxiety in the control group(5 0. 11 ± 8.51) and PSS (68.12 ± 11.49) was significant (P effect of problem-solving on reducing anxiety and depression, it is suggested that infertility center of this intervention should be used. PMID:29296608

Comparative study of trichloroacetic acid vs. photodynamic therapy with topical 5-aminolevulinic acid for actinic keratosis of the scalp.

Science.gov (United States)

Di Nuzzo, Sergio; Cortelazzi, Chiara; Boccaletti, Valeria; Zucchi, Alfredo; Conti, Maria Luisa; Montanari, Paola; Feliciani, Claudio; Fabrizi, Giuseppe; Pagliarello, Calogero

2015-09-01

Photodynamic therapy with 5-methyl-aminolevulinate and photodynamic therapy with trichloroacetic acid 50% are the two techniques utilized in the management of actinic keratosis. This study was planned to compare the efficacy, adverse effects, recurrence and cosmetic outcome of these option therapies in patients with multiple actinic keratosis of the scalp. Thirteen patients with multiple actinic keratosis were treated with one of the two treatments on half of the scalp at baseline, while the other treatment was performed on the other half 15 days apart, randomly. Efficacy, adverse effects, cosmetic outcome and recurrence were recorded at follow-up visit at 1, 3, 6 and 12 months. Photodynamic therapy with 5 methyl-aminolevulinate was more effective than trichloroacetic acid although less tolerated by patients as it was more painful. Early adverse effects were almost the same even if trichloroacetic acid leads also to crust formation and to a worse cosmetic outcome characterized by hypopigmentation. Recurrence was lower in the area treated with photodynamic therapy. Trichloroacetic acid 50% is less effective than photodynamic therapy with 5 methyl-aminolevulinate in the treatment of multiple actinic keratosis of the scalp although better tolerated by patients. As this technique is less painful and less expensive than photodynamic therapy, we hypothesize and suggest that more sequential treatments could lead to better results. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Solving Assembly Sequence Planning using Angle Modulated Simulated Kalman Filter

Science.gov (United States)

Mustapa, Ainizar; Yusof, Zulkifli Md.; Adam, Asrul; Muhammad, Badaruddin; Ibrahim, Zuwairie

2018-03-01

This paper presents an implementation of Simulated Kalman Filter (SKF) algorithm for optimizing an Assembly Sequence Planning (ASP) problem. The SKF search strategy contains three simple steps; predict-measure-estimate. The main objective of the ASP is to determine the sequence of component installation to shorten assembly time or save assembly costs. Initially, permutation sequence is generated to represent each agent. Each agent is then subjected to a precedence matrix constraint to produce feasible assembly sequence. Next, the Angle Modulated SKF (AMSKF) is proposed for solving ASP problem. The main idea of the angle modulated approach in solving combinatorial optimization problem is to use a function, g(x), to create a continuous signal. The performance of the proposed AMSKF is compared against previous works in solving ASP by applying BGSA, BPSO, and MSPSO. Using a case study of ASP, the results show that AMSKF outperformed all the algorithms in obtaining the best solution.

Brief Behavioral Activation and Problem-Solving Therapy for Depressed Breast Cancer Patients: Randomized Trial

Science.gov (United States)

Hopko, Derek R.; Armento, Maria E. A.; Robertson, Sarah M. C.; Ryba, Marlena M.; Carvalho, John P.; Colman, Lindsey K.; Mullane, Christen; Gawrysiak, Michael; Bell, John L.; McNulty, James K.; Lejuez, Carl W.

2011-01-01

Objective: Major depression is the most common psychiatric disorder among breast cancer patients and is associated with substantial impairment. Although some research has explored the utility of psychotherapy with breast cancer patients, only 2 small trials have investigated the potential benefits of behavior therapy among patients with…

Difficulties in Genetics Problem Solving.

Science.gov (United States)

Tolman, Richard R.

1982-01-01

Examined problem-solving strategies of 30 high school students as they solved genetics problems. Proposes a new sequence of teaching genetics based on results: meiosis, sex chromosomes, sex determination, sex-linked traits, monohybrid and dihybrid crosses (humans), codominance (humans), and Mendel's pea experiments. (JN)

The Comparison of Personality Characteristics and Problem Solving Styles in Addicted And Non-Addicted Men

Directory of Open Access Journals (Sweden)

Fatemeh Saber

2011-11-01

Full Text Available introduction: The goal of this study was to compare the personality characteristics and problem solving styles of addicted and non-addicted men. Method: This study is a causal comparative design survey. In this study 180 addicted men was selected through convenience sampling method from addicted men that refered to addiction treatment centers of Rasht city and matched in gender, age, education and job with 180 non addicted men and then two groups compared with each other. All participants completed the NEO-FFI-R and problem solving styles questionnaires. The gathered data were analyzed through SPSS software. Findings: The results showed that an addicted man in comparison with non-addicted men was upper in neuroticism and lower in agreeableness, extraversion and consciousness dimensions. Also there was no difference in openness dimension between two groups. Conclusion: The finding of present study suggests that educating efficient problem solving styles to people to cope with life stressful events could restrain and prevent addiction and other psychosocial disorders.

General approach for solving the density gradient theory in the interfacial tension calculations

DEFF Research Database (Denmark)

Liang, Xiaodong; Michelsen, Michael Locht

2017-01-01

Within the framework of the density gradient theory, the interfacial tension can be calculated by finding the density profiles that minimize an integral of two terms over the system of infinite width. It is found that the two integrands exhibit a constant difference along the interface for a finite...... property evaluations compared to other methods. The performance of the algorithm with recommended parameters is analyzed for various systems, and the efficiency is further compared with the geometric-mean density gradient theory, which only needs to solve nonlinear algebraic equations. The results show...... that the algorithm is only 5-10 times less efficient than solving the geometric-mean density gradient theory....

Model Drawing Strategy for Fraction Word Problem Solving of Fourth-Grade Students with Learning Disabilities

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Sharp, Emily; Shih Dennis, Minyi

2017-01-01

This study used a multiple probe across participants design to examine the effects of a model drawing strategy (MDS) intervention package on fraction comparing and ordering word problem-solving performance of three Grade 4 students. MDS is a form of cognitive strategy instruction for teaching word problem solving that includes explicit instruction…

Galerkin projection methods for solving multiple related linear systems

Energy Technology Data Exchange (ETDEWEB)

Chan, T.F.; Ng, M.; Wan, W.L.

1996-12-31

We consider using Galerkin projection methods for solving multiple related linear systems A{sup (i)}x{sup (i)} = b{sup (i)} for 1 {le} i {le} s, where A{sup (i)} and b{sup (i)} are different in general. We start with the special case where A{sup (i)} = A and A is symmetric positive definite. The method generates a Krylov subspace from a set of direction vectors obtained by solving one of the systems, called the seed system, by the CG method and then projects the residuals of other systems orthogonally onto the generated Krylov subspace to get the approximate solutions. The whole process is repeated with another unsolved system as a seed until all the systems are solved. We observe in practice a super-convergence behaviour of the CG process of the seed system when compared with the usual CG process. We also observe that only a small number of restarts is required to solve all the systems if the right-hand sides are close to each other. These two features together make the method particularly effective. In this talk, we give theoretical proof to justify these observations. Furthermore, we combine the advantages of this method and the block CG method and propose a block extension of this single seed method. The above procedure can actually be modified for solving multiple linear systems A{sup (i)}x{sup (i)} = b{sup (i)}, where A{sup (i)} are now different. We can also extend the previous analytical results to this more general case. Applications of this method to multiple related linear systems arising from image restoration and recursive least squares computations are considered as examples.

Problem Solving, Scaffolding and Learning

Science.gov (United States)

Lin, Shih-Yin

2012-01-01

Helping students to construct robust understanding of physics concepts and develop good solving skills is a central goal in many physics classrooms. This thesis examine students' problem solving abilities from different perspectives and explores strategies to scaffold students' learning. In studies involving analogical problem solving…

Environmental problem-solving: Psychosocial factors

Science.gov (United States)

Miller, Alan

1982-11-01

This is a study of individual differences in environmental problem-solving, the probable roots of these differences, and their implications for the education of resource professionals. A group of student Resource Managers were required to elaborate their conception of a complex resource issue (Spruce Budworm management) and to generate some ideas on management policy. Of particular interest was the way in which subjects dealt with the psychosocial aspects of the problem. A structural and content analysis of responses indicated a predominance of relatively compartmentalized styles, a technological orientation, and a tendency to ignore psychosocial issues. A relationship between problem-solving behavior and personal (psychosocial) style was established which, in the context of other evidence, suggests that problem-solving behavior is influenced by more deep seated personality factors. The educational implication drawn was that problem-solving cannot be viewed simply as an intellectual-technical activity but one that involves, and requires the education of, the whole person.

Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis.

Directory of Open Access Journals (Sweden)

Jürgen Barth

Full Text Available BACKGROUND: Previous meta-analyses comparing the efficacy of psychotherapeutic interventions for depression were clouded by a limited number of within-study treatment comparisons. This study used network meta-analysis, a novel methodological approach that integrates direct and indirect evidence from randomised controlled studies, to re-examine the comparative efficacy of seven psychotherapeutic interventions for adult depression. METHODS AND FINDINGS: We conducted systematic literature searches in PubMed, PsycINFO, and Embase up to November 2012, and identified additional studies through earlier meta-analyses and the references of included studies. We identified 198 studies, including 15,118 adult patients with depression, and coded moderator variables. Each of the seven psychotherapeutic interventions was superior to a waitlist control condition with moderate to large effects (range d = -0.62 to d = -0.92. Relative effects of different psychotherapeutic interventions on depressive symptoms were absent to small (range d = 0.01 to d = -0.30. Interpersonal therapy was significantly more effective than supportive therapy (d = -0.30, 95% credibility interval [CrI] [-0.54 to -0.05]. Moderator analysis showed that patient characteristics had no influence on treatment effects, but identified aspects of study quality and sample size as effect modifiers. Smaller effects were found in studies of at least moderate (Δd = 0.29 [-0.01 to 0.58]; p = 0.063 and large size (Δd = 0.33 [0.08 to 0.61]; p = 0.012 and those that had adequate outcome assessment (Δd = 0.38 [-0.06 to 0.87]; p = 0.100. Stepwise restriction of analyses by sample size showed robust effects for cognitive-behavioural therapy, interpersonal therapy, and problem-solving therapy (all d>0.46 compared to waitlist. Empirical evidence from large studies was unavailable or limited for other psychotherapeutic interventions. CONCLUSIONS: Overall our

Efficacy and safety of statins and exercise combination therapy compared to statin monotherapy in patients with dyslipidaemia: A systematic review and meta-analysis.

Science.gov (United States)

Gui, Ya-Jun; Liao, Cai-Xiu; Liu, Qiong; Guo, Yuan; Yang, Tao; Chen, Jing-Yuan; Wang, Ya-Ting; Hu, Jia-Hui; Xu, Dan-Yan

2017-06-01

Background Statin treatment in association with physical exercise can substantially reduce mortality in dyslipidaemic individuals. However, the available data to compare the efficacy and safety of statins and exercise combination therapy with statin monotherapy are limited. Design Systematic review and meta-analysis. Methods We systematically searched PubMed, Embase and the Cochrane Library from database inception until December 2016. We included randomised and non-randomised studies that compared the efficacy and safety of statins and exercise combination therapy with statin monotherapy in patients with dyslipidaemia. Standardised mean differences were calculated and pooled by means of fixed effects models. The risk of bias and heterogeneity among trials was also assessed. Seven articles were assessed in terms of the efficacy of therapy and 13 from the viewpoint of therapeutic safety. Results In terms of efficacy, statins and exercise combination decreased the incidence of diabetes mellitus, improved insulin sensitivity and inflammation, but caused no change in lipid profile compared to statins alone. In terms of safety, statins and exercise combination increased peak oxygen uptake (standardised mean difference 1.01, 95% confidence interval 0.46 to 1.57) compared to statins alone. In contrast to statin-induced myopathy, chronic exercise training prior to statin treatment could counteract statin-induced adverse effects in skeletal muscle. Conclusion Statins and exercise combination therapy is more effective than statin monotherapy in terms of insulin sensitivity, inflammation and exercise capacity. The small number of studies warrants the need for more randomised controlled trials evaluating the efficacy and safety of combination therapy.

Report of a randomized trial of d(15)+Be neutrons compared with megavoltage X ray therapy of bladder cancer

International Nuclear Information System (INIS)

Duncan, W.; Arnott, S.J.; Jack, W.J.; MacDougall, R.H.; Quilty, P.M.; Rodger, A.; Kerr, G.R.; Williams, J.R.

1985-01-01

The results of a randomized trial of d(15)+Be neutrons compared with 4 or 6 MV photons for the treatment of transitional cell carcinoma of the bladder. Between December 1978 and December 1981, 113 patients were accrued, 53 allocated to be treated by neutrons and 60 by photons. Complete local tumor regression was observed in 64% of patients treated by neutrons and 62% treated by photons. Recurrent cancer was subsequently confirmed in 31% of patients, similar in both treatment groups. There was no significant difference in the control rates by T stage between the two treatment groups. Late morbidity was significantly worse in patients treated by neutrons. Following neutron therapy, 78% of patients had serious late morbidity in at least one tissue compared with 38% in the group treated by photons. Survival was significantly better in the photon treated group 45.3% (+/- 11%) at 5 years compared with 12% (+/- 6%) after neutron therapy

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

Energy Technology Data Exchange (ETDEWEB)

Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

2015-03-01

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

International Nuclear Information System (INIS)

Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

2015-01-01

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

International Nuclear Information System (INIS)

Nithya, L.; Arulraj, Kumar; Rathinamuthu, Sasikumar; Pandey, Manish Bhushan; Nambi Raj, N. Arunai

2014-01-01

The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC) intensity modulated radiation therapy (IMRT) plans with volumetric modulated arc therapy (VMAT) plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV) for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI) and the conformity index (CI) of the PTV 70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV) cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU) required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases. (author)

Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

Directory of Open Access Journals (Sweden)

L Nithya

2014-01-01

Full Text Available The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC intensity modulated radiation therapy (IMRT plans with volumetric modulated arc therapy (VMAT plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI and the conformity index (CI of the PTV 70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases.

Student’s scheme in solving mathematics problems

Science.gov (United States)

Setyaningsih, Nining; Juniati, Dwi; Suwarsono

2018-03-01

The purpose of this study was to investigate students’ scheme in solving mathematics problems. Scheme are data structures for representing the concepts stored in memory. In this study, we used it in solving mathematics problems, especially ratio and proportion topics. Scheme is related to problem solving that assumes that a system is developed in the human mind by acquiring a structure in which problem solving procedures are integrated with some concepts. The data were collected by interview and students’ written works. The results of this study revealed are students’ scheme in solving the problem of ratio and proportion as follows: (1) the content scheme, where students can describe the selected components of the problem according to their prior knowledge, (2) the formal scheme, where students can explain in construct a mental model based on components that have been selected from the problem and can use existing schemes to build planning steps, create something that will be used to solve problems and (3) the language scheme, where students can identify terms, or symbols of the components of the problem.Therefore, by using the different strategies to solve the problems, the students’ scheme in solving the ratio and proportion problems will also differ.

Problem-solving skills and hardiness as protective factors against stress in Iranian nurses.

Science.gov (United States)

Abdollahi, Abbas; Talib, Mansor Abu; Yaacob, Siti Nor; Ismail, Zanariah

2014-02-01

Nursing is a stressful occupation, even when compared with other health professions; therefore, it is necessary to advance our knowledge about the protective factors that can help reduce stress among nurses. The present study sought to investigate the associations among problem-solving skills and hardiness with perceived stress in nurses. The participants, 252 nurses from six private hospitals in Tehran, completed the Personal Views Survey, the Perceived Stress Scale, and the Problem-Solving Inventory. Structural Equation Modeling (SEM) was used to analyse the data and answer the research hypotheses. As expected, greater hardiness was associated with low levels of perceived stress, and nurses low in perceived stress were more likely to be considered approachable, have a style that relied on their own sense of internal personal control, and demonstrate effective problem-solving confidence. These findings reinforce the importance of hardiness and problem-solving skills as protective factors against perceived stress among nurses, and could be important in training future nurses so that hardiness ability and problem-solving skills can be imparted, allowing nurses to have more ability to control their perceived stress.

Problem Solving on a Monorail.

Science.gov (United States)

Barrow, Lloyd H.; And Others

1994-01-01

This activity was created to address a lack of problem-solving activities for elementary children. A "monorail" activity from the Evening Science Program for K-3 Students and Parents program is presented to illustrate the problem-solving format. Designed for performance at stations by groups of two students. (LZ)

Solving complex fisheries management problems

DEFF Research Database (Denmark)

Petter Johnsen, Jahn; Eliasen, Søren Qvist

2011-01-01

A crucial issue for the new EU common fisheries policy is how to solve the discard problem. Through a study of the institutional set up and the arrangements for solving the discard problem in Denmark, the Faroe Islands, Iceland and Norway, the article identifies the discard problem as related...

Spontaneous gestures influence strategy choices in problem solving.

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Alibali, Martha W; Spencer, Robert C; Knox, Lucy; Kita, Sotaro

2011-09-01

Do gestures merely reflect problem-solving processes, or do they play a functional role in problem solving? We hypothesized that gestures highlight and structure perceptual-motor information, and thereby make such information more likely to be used in problem solving. Participants in two experiments solved problems requiring the prediction of gear movement, either with gesture allowed or with gesture prohibited. Such problems can be correctly solved using either a perceptual-motor strategy (simulation of gear movements) or an abstract strategy (the parity strategy). Participants in the gesture-allowed condition were more likely to use perceptual-motor strategies than were participants in the gesture-prohibited condition. Gesture promoted use of perceptual-motor strategies both for participants who talked aloud while solving the problems (Experiment 1) and for participants who solved the problems silently (Experiment 2). Thus, spontaneous gestures influence strategy choices in problem solving.

Everyday problem solving in African Americans and European Americans with Alzheimer's disease: an exploratory study.

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Ripich, Danielle N; Fritsch, Thomas; Ziol, Elaine

2002-03-01

In this exploratory study, we compared the performance of 10 African American and 26 European American persons with early- to mid-stage Alzheimer's disease (AD) to 20 nondemented elderly (NE), using a shortened version of the Test of Problem Solving (TOPS). The TOPS measures verbal reasoning to solve everyday problems in five areas: explaining inferences, determining causes, answering negative why questions, determining solutions, and avoiding problems. Six linguistic measures were also examined: total utterances, abandoned utterances, length of utterances, maze words, questions, and total words. NE performed better than AD subjects on all but one measure of verbal reasoning ability. AD subjects also showed a trend to use more total utterances and abandoned utterances than NE. For the AD group, no ethnic differences were found for verbal reasoning or linguistic measures. The findings from this preliminary investigation suggest that, compared to European Americans, African American persons with AD demonstrate similar everyday problem solving and linguistic skills. Thus, assessments such as TOPS that examine everyday problem solving may be a useful nonbiased evaluation tool for persons with AD in these two ethnic groups.

Individual cognitive-behavioral therapy and behavioral couples therapy in alcohol use disorder: a comparative evaluation in community-based addiction treatment centers.

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Vedel, Ellen; Emmelkamp, Paul M G; Schippers, Gerard M

2008-01-01

Alcohol abuse serves as a chronic stressor between partners and has a deleterious effect on relationship functioning. Behavioral Couples Therapy (BCT) for alcohol dependence, studied as an adjunct to individual outpatient counseling, has shown to be effective in decreasing alcohol consumption and enhancing marital functioning, but no study has directly tested the comparative effectiveness of stand-alone BCT versus an individually focused cognitive-behavioral therapy (CBT) in a clinical community sample. The present study is a randomized clinical trial evaluating the effectiveness of stand-alone BCT (n = 30) compared to individual CBT (n = 34) in the treatment of alcohol use disorders in community treatment centers in Dutch male and female alcoholics and their partners. Results show both BCT and CBT to be effective in changing drinking behavior after treatment. BCT was not found to be superior to CBT. Marital satisfaction of the spouse increased significantly in the BCT condition but not in the CBT condition, the differences being significant at the post-test. Patients' self-efficacy to withstand alcohol-related high-risk situations increased significantly in both treatment conditions, but more so in CBT than in BCT after treatment. Treatment involvement of the spouse did not increase retention. Regular practitioners in community treatment centers can effectively deliver both treatments. Stand-alone BCT is as effective as CBT in terms of reduced drinking and to some extent more effective in terms of enhancing relationship satisfaction. However, BCT is a more costly intervention, given that treatment sessions lasted almost twice as long as individual CBT sessions. Copyright 2008 S. Karger AG, Basel.

Individualized Positron Emission Tomography–Based Isotoxic Accelerated Radiation Therapy Is Cost-Effective Compared With Conventional Radiation Therapy: A Model-Based Evaluation

Energy Technology Data Exchange (ETDEWEB)

Bongers, Mathilda L., E-mail: ml.bongers@vumc.nl [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); Coupé, Veerle M.H. [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); De Ruysscher, Dirk [Radiation Oncology University Hospitals Leuven/KU Leuven, Leuven (Belgium); Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands); Oberije, Cary; Lambin, Philippe [Department of Radiation Oncology, GROW Research Institute, Maastricht University Medical Center, Maastricht (Netherlands); Uyl-de Groot, Cornelia A. [Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam (Netherlands); Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam (Netherlands)

2015-03-15

Purpose: To evaluate long-term health effects, costs, and cost-effectiveness of positron emission tomography (PET)-based isotoxic accelerated radiation therapy treatment (PET-ART) compared with conventional fixed-dose CT-based radiation therapy treatment (CRT) in non-small cell lung cancer (NSCLC). Methods and Materials: Our analysis uses a validated decision model, based on data of 200 NSCLC patients with inoperable stage I-IIIB. Clinical outcomes, resource use, costs, and utilities were obtained from the Maastro Clinic and the literature. Primary model outcomes were the difference in life-years (LYs), quality-adjusted life-years (QALYs), costs, and the incremental cost-effectiveness and cost/utility ratio (ICER and ICUR) of PET-ART versus CRT. Model outcomes were obtained from averaging the predictions for 50,000 simulated patients. A probabilistic sensitivity analysis and scenario analyses were carried out. Results: The average incremental costs per patient of PET-ART were €569 (95% confidence interval [CI] €−5327-€6936) for 0.42 incremental LYs (95% CI 0.19-0.61) and 0.33 QALYs gained (95% CI 0.13-0.49). The base-case scenario resulted in an ICER of €1360 per LY gained and an ICUR of €1744 per QALY gained. The probabilistic analysis gave a 36% probability that PET-ART improves health outcomes at reduced costs and a 64% probability that PET-ART is more effective at slightly higher costs. Conclusion: On the basis of the available data, individualized PET-ART for NSCLC seems to be cost-effective compared with CRT.

Advances of reporter gene monitoring stem cell therapy

International Nuclear Information System (INIS)

Zhou Xiang; Yin Hongyan; Zhang Yifan

2010-01-01

Stem cell therapy research has made great progress, demonstrating a broad application prospects. However, stem cell therapy as a new disease treatment, there are still many problems to be solved. Reporter gene imaging is a rapid development in recent years, a non-invasive, sensitive method of monitoring of stem cells, in particular radionuclide reporter gene imaging has high sensitivity and specificity of the advantages of strong and can carry out imaging of deep tissue and repeat imaging, is a tracer in vivo conditions, the most promising stem cell transplantation technique, showing good prospects for development. (authors)

Peningkatan Kemampuan Problem Solving Mahasiswa Sebagai Calon Guru Fisika Menggunakan Socratic Dialogue

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Nurita Apridiana Lestari

2017-03-01

Full Text Available Mastery of the concepts of physics students can be measured by its ability to solve the problems of physics. Problem solving ability is one component that must be owned by the students as a physics teacher candidates. Based on the results of initial observations, it is known that the problem solving ability of students is still low, especially associated with the use of physics concepts to solve problems. Therefore, the ability of problem solving should be trained in teaching as a form of scaffolding for students. Scaffolding can be done through the method of Socratic dialogue which is the provision of structured questions to help students find answers to the problems of physics using the right concept. This type of research is the Classroom Action Research  with two cycles were performed on physics student teachers in the subjects Physics 1 with a fluid material. Improved problem solving ability was measured using test items at the end of the cycle. The results qualitatively show their developments and increased activity in the classroom compared to learning before the action. These results are supported quantitatively by an increase in average test scores of the first cycle of 70.00 into 75.86 in the second cycle. Keywords: problem solving, socratic dialogue Penguasaan konsep fisika mahasiswa dapat diukur dari kemampuannya dalam memecahkan permasalahan fisika (problem solving. Kemampuan problem solving merupakan salah satu komponen yang harus dimiliki oleh mahasiswa sebagai calon guru fisika. Berdasarkan hasil observasi awal, diketahui bahwa kemampuan problem solving mahasiswa masih rendah, khususnya terkait dengan penggunaan konsep fisika untuk memecahkan masalah. Oleh karena itu, kemampuan problem solving perlu dilatihkan dalam pembelajaran sebagai bentuk scaffolding bagi mahasiswa. Scaffolding dapat dilakukan melalui metode socratic dialogue yang merupakan pemberian pertanyaan terstruktur untuk membantu mahasiswa menemukan jawaban

A comparison of problem-based and traditional education on nursing students' locus of control and problem-solving skills.

Science.gov (United States)

Günüşen, Neslihan Partlak; Serçekuş, Pınar; Edeer, Aylin Durmaz

2014-06-01

The purpose of this study is to compare the locus of control and problem-solving skills of nursing students studying with the problem-based learning method with those of nursing students studying with the traditional method. This is a descriptive and comparative study. For data collection, the Problem-Solving Skills Inventory and the Locus of Control Scale were used. The study sample included 680 nursing students. It was determined that the problem-based learning method was more effective in the development of problem-solving skills and internal locus of control than was the traditional method. © 2014 NANDA International.

Nice or effective? Social problem solving strategies in patients with major depressive disorder.

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Thoma, Patrizia; Schmidt, Tobias; Juckel, Georg; Norra, Christine; Suchan, Boris

2015-08-30

Our study addressed distinct aspects of social problem solving in 28 hospitalized patients with Major Depressive Disorder (MDD) and 28 matched healthy controls. Three scenario-based tests assessed the ability to infer the mental states of story characters in difficult interpersonal situations, the capacity to freely generate good strategies for dealing with such situations and the ability to identify the best solutions among less optimal alternatives. Also, standard tests assessing attention, memory, executive function and trait empathy were administered. Compared to controls, MDD patients showed impaired interpretation of other peoples' sarcastic remarks but not of the mental states underlying other peoples' actions. Furthermore, MDD patients generated fewer strategies that were socially sensitive and practically effective at the same time or at least only socially sensitive. Overall, while the free generation of adequate strategies for difficult social situations was impaired, recognition of optimal solutions among alternatives was spared in MDD patients. Higher generation scores were associated with higher trait empathy and cognitive flexibility scores. We suggest that this specific pattern of impairments ought to be considered in the development of therapies addressing impaired social skills in MDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of CPAP therapy on cognitive and psychomotor performances in patients with severe obstructive sleep apnea: a prospective 1-year study.

Science.gov (United States)

Pecotic, Renata; Dodig, Ivana Pavlinac; Valic, Maja; Galic, Tea; Kalcina, Linda Lusic; Ivkovic, Natalija; Dogas, Zoran

2018-02-16

We prospectively investigated the effects of continuous positive airway pressure (CPAP) on long-term cognitive and psychomotor performances, and excessive daytime sleepiness in severe obstructive sleep apnea (OSA) patients. A total of 40 patients were recruited and 23 patients with severe OSA fully completed the study protocol to investigate the effects of CPAP therapy on psychomotor performance at 1, 3, and 6 months and 1 year following initiation of the therapy. Psychomotor CRD-series tests measuring reaction times of light stimulus perception, solving simple arithmetic operations, and complex psychomotor limb coordination, were used in this study. The data collected following CPAP therapy were compared to baseline values prior to the CPAP treatment for each patient. All of the measured variables improved following CPAP treatment. However, the most pronounced effect was observed in improvement of reaction times to complex psychomotor limb coordination test (p CPAP therapy. The CPAP therapy improved cognitive and psychomotor performance on CRD-series tests with the most significant improvement observed in complex psychomotor limb coordination of severe OSA patients.

PISA 2012 Analysis of School Variables Affecting Problem-Solving Competency: Turkey-Serbia Comparison

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Emine YAVUZ

2017-12-01

Full Text Available According to the OECD's PISA 2012 Turkey problem-solving report, Turkey and Serbia are at the same mathematical literacy level. However, Serbia's average of problem-solving competency is said to be higher than Turkey's. In this study, school variables that affect problem-solving competency of the two countries were examined and compared. The method of the study was causal comparison method, and HLM analysis was performed on data of 4494 students from 147 schools in Turkey sample and 4059 students from 132 schools in Serbia sample separately. As a result of HLM analysis, "obstacle and family donation" variable for Serbia and "abandon, teacher morale and mathematics competition" variable for Turkey were statistically significant. Although it was found that for each countries different variables influence the problem-solving competency, it was quite remarkable that these variables are in common in that they are components of the school climate concept.

A treatment planning study comparing whole breast radiation therapy against conformal, IMRT and tomotherapy for accelerated partial breast irradiation

International Nuclear Information System (INIS)

Oliver, Mike; Chen, Jeff; Wong, Eugene; Van Dyk, Jake; Perera, Francisco

2007-01-01

Purpose and background: Conventional early breast cancer treatment consists of a lumpectomy followed by whole breast radiation therapy. Accelerated partial breast irradiation (APBI) is an investigational approach to post-lumpectomy radiation for early breast cancer. The purpose of this study is to compare four external beam APBI techniques, including tomotherapy, with conventional whole breast irradiation for their radiation conformity index, dose homogeneity index, and dose to organs at risk. Methods and materials: Small-field tangents, three-dimensional conformal radiation therapy, intensity-modulated radiation therapy and helical tomotherapy were compared for each of 15 patients (7 right, 8 left). One radiation conformity and two dose homogeneity indices were used to evaluate the dose to the target. The mean dose to organs at risk was also evaluated. Results: All proposed APBI techniques improved the conformity index significantly over whole breast tangents while maintaining dose homogeneity and without a significant increase in dose to organs at risk. Conclusion: The four-field IMRT plan produced the best dosimetric results; however this technique would require appropriate respiratory motion management. An alternative would be to use a four-field conformal technique that is less sensitive to the effects of respiratory motion

Self-affirmation improves problem-solving under stress.

Science.gov (United States)

Creswell, J David; Dutcher, Janine M; Klein, William M P; Harris, Peter R; Levine, John M

2013-01-01

High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings.

Schema-Based Instruction with Concrete and Virtual Manipulatives to Teach Problem Solving to Students with Autism

Science.gov (United States)

Root, Jenny R.; Browder, Diane M.; Saunders, Alicia F.; Lo, Ya-yu

2017-01-01

The current study evaluated the effects of modified schema-based instruction on the mathematical word problem solving skills of three elementary students with autism spectrum disorders and moderate intellectual disability. Participants learned to solve compare problem type with themes that related to their interests and daily experiences. In…

The Effect of Learning Environments Based on Problem Solving on Students' Achievements of Problem Solving

Science.gov (United States)

Karatas, Ilhan; Baki, Adnan

2013-01-01

Problem solving is recognized as an important life skill involving a range of processes including analyzing, interpreting, reasoning, predicting, evaluating and reflecting. For that reason educating students as efficient problem solvers is an important role of mathematics education. Problem solving skill is the centre of mathematics curriculum.…

Regressive Imagery in Creative Problem-Solving: Comparing Verbal Protocols of Expert and Novice Visual Artists and Computer Programmers

Science.gov (United States)

Kozbelt, Aaron; Dexter, Scott; Dolese, Melissa; Meredith, Daniel; Ostrofsky, Justin

2015-01-01

We applied computer-based text analyses of regressive imagery to verbal protocols of individuals engaged in creative problem-solving in two domains: visual art (23 experts, 23 novices) and computer programming (14 experts, 14 novices). Percentages of words involving primary process and secondary process thought, plus emotion-related words, were…

Behaviour therapy for obesity treatment considering approved drug therapy

Directory of Open Access Journals (Sweden)

Wasem, Jürgen

2008-05-01

Full Text Available Introduction: Obesity is a worldwide health problem whose prevalence is on the increase. Many obesity-associated diseases require intensive medical treatment and are the cause of a large proportion of health-related expenditures in Germany. Treatment of obesity includes nutritional, exercise and behaviour therapy, usually in combination. The goal of behaviour therapy for obesity is to bring about a long-term alteration in the eating and exercise habits of overweight and obese individuals. Under certain circumstances, drug treatment may be indicated. Objectives: What is the effectiveness of behaviour therapy for obesity considering approved drugs reduce weight under medical, economic, ethical-social and legal aspects? Methods: A systematic review was conducted using relevant electronic literature databases. Publications chosen according to predefined criteria are evaluated by approved methodical standards of the evidence-based medicine systematically and qualitatively. Results: In total 18 studies, included one HTA and one meta-analysis could be identified according to the predefined inclusion criteria. Three studies compare behaviour therapy to other therapy forms (advice or instruction on nutritional changes, physical activity or a combination of the two, six studies evaluate different forms of behaviour therapy, four studies and four studies compare behaviour therapies mediated by Internet or telephone. Three studies could be identified examining the effect of the combination of behaviour and drug therapy. Furthermore one HTA and one meta-analysis could be included in the evaluation. The behaviour therapy in comparison with other therapy forms reveals a higher effectiveness. In comparison of the different therapeutic approaches of the behaviour therapy intensive behaviour therapy forms and group therapy show a higher effectiveness. Studies related to behaviour therapy based on media support demonstrate a weight reduction both through the

An efficient numerical technique for solving navier-stokes equations for rotating flows

International Nuclear Information System (INIS)

Haroon, T.; Shah, T.M.

2000-01-01

This paper simulates an industrial problem by solving compressible Navier-Stokes equations. The time-consuming tri-angularization process of a large-banded matrix, performed by memory economical Frontal Technique. This scheme successfully reduces the time for I/O operations even for as large as (40, 000 x 40, 000) matrix. Previously, this industrial problem can solved by using modified Newton's method with Gaussian elimination technique for the large matrix. In the present paper, the proposed Frontal Technique is successfully used, together with Newton's method, to solve compressible Navier-Stokes equations for rotating cylinders. By using the Frontal Technique, the method gives the solution within reasonably acceptance computational time. Results are compared with the earlier works done, and found computationally very efficient. Some features of the solution are reported here for the rotating machines. (author)

Chasing red herrings: Memory of distractors causes fixation in creative problem solving.

Science.gov (United States)

Beda, Zsolt; Smith, Steven M

2018-03-07

Two experiments tested the red herring retrieval hypothesis, which states that fixation in creative problem solving is worse when memory for red herrings (i.e., inappropriate or incorrect solutions) is strengthened. In Experiment 1, when associations between Remote Associates Test (RAT) problem words (e.g., COTTAGE, SWISS, CAKE) and related red herring words (e.g., hut, chocolate, icing) were strengthened via repetition, an encoding variable, fixation was found to increase. In Experiment 2, when associations were formed between RAT problem contexts and red herrings, then subsequent reinstatement of problem contexts during RAT problem solving trials (as compared with showing new contexts) also worsened fixation effects. Our results add to the increasing body of research that connects memory with creative problem solving, and they suggest possible ways for overcoming fixation effects.

Examining the Relationship of Scientific Reasoning with Physics Problem Solving

Science.gov (United States)

Fabby, Carol; Koenig, Kathleen

2015-01-01

Recent research suggests students with more formal reasoning patterns are more proficient learners. However, little research has been done to establish a relationship between scientific reasoning and problem solving abilities by novices. In this exploratory study, we compared scientific reasoning abilities of students enrolled in a college level…

A meta-heuristic method for solving scheduling problem: crow search algorithm

Science.gov (United States)

Adhi, Antono; Santosa, Budi; Siswanto, Nurhadi

2018-04-01

Scheduling is one of the most important processes in an industry both in manufacturingand services. The scheduling process is the process of selecting resources to perform an operation on tasks. Resources can be machines, peoples, tasks, jobs or operations.. The selection of optimum sequence of jobs from a permutation is an essential issue in every research in scheduling problem. Optimum sequence becomes optimum solution to resolve scheduling problem. Scheduling problem becomes NP-hard problem since the number of job in the sequence is more than normal number can be processed by exact algorithm. In order to obtain optimum results, it needs a method with capability to solve complex scheduling problems in an acceptable time. Meta-heuristic is a method usually used to solve scheduling problem. The recently published method called Crow Search Algorithm (CSA) is adopted in this research to solve scheduling problem. CSA is an evolutionary meta-heuristic method which is based on the behavior in flocks of crow. The calculation result of CSA for solving scheduling problem is compared with other algorithms. From the comparison, it is found that CSA has better performance in term of optimum solution and time calculation than other algorithms.

Comparison of problem solving tools in lean organizations

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Iuga Maria Virginia

2017-01-01

Full Text Available As global market competition is getting fiercer, and companies are looking at ways to stay on top, more and more organizations are looking at Lean Manufacturing and lean tools to support them in achieving their goals. Especially within the automotive industry, lean practices are very well received. The speed at which the automotive industry is evolving, especially but not only, in countries like Romania, leads to the need to carefully analyze lean manufacturing concepts, examine them against local production conditions, and to develop and standardize them. One of the most important things to take into consideration here is the application of an adequate problem solving technique to avoid waste. The objective of this research paper lies in analyzing and comparing the problem-solving methods recommended by the Toyota Production System, and to propose their appropriate application at shop floor, in relation to the specific problem type.

S -ketamine compared to etomidate during electroconvulsive therapy in major depression.

Science.gov (United States)

Zavorotnyy, Maxim; Kluge, Ina; Ahrens, Kathrin; Wohltmann, Thomas; Köhnlein, Benjamin; Dietsche, Patricia; Dannlowski, Udo; Kircher, Tilo; Konrad, Carsten

2017-12-01

Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0.96 (0.26) mg/kg. Right unilateral brief pulse ECTs were performed. The number of ECTs was individually adjusted to clinical needs, mean (SD) = 13.0 (4.3). Seizure characteristics, adverse events, and the clinical global impression (CGI) scores were compared between the both groups during ECT series. In the S-ketamine group, a lower initial seizure threshold (p = 0.014), stimulation charge (p ketamine might hold a potential to become a clinically favorable anesthetic agent during ECT. However, the current findings should be interpreted with caution, and further prospective randomized clinical trials are required. Also, specific adverse effects profile of S-ketamine, especially with regard to the cardiovascular risk, needs to be taken into account.

Carbapenem therapy is associated with improved survival compared with piperacillin-tazobactam for patients with extended-spectrum β-lactamase bacteremia.

Science.gov (United States)

Tamma, Pranita D; Han, Jennifer H; Rock, Clare; Harris, Anthony D; Lautenbach, Ebbing; Hsu, Alice J; Avdic, Edina; Cosgrove, Sara E

2015-05-01

The effectiveness of piperacillin-tazobactam (PTZ) for the treatment of extended-spectrum β-lactamase (ESBL) bacteremia is controversial. We compared 14-day mortality of PTZ vs carbapenems as empiric therapy in a cohort of patients with ESBL bacteremia who all received definitive therapy with a carbapenem. Patients hospitalized between January 2007 and April 2014 with monomicrobial ESBL bacteremia were included. A decrease of >3 doubling dilutions in the minimum inhibitory concentration for third-generation cephalosporins tested in combination with 4 µg/mL of clavulanic acid was used to confirm ESBL status. The primary exposure was empiric therapy, defined as antibiotic therapy administered to a patient before ESBL status was known. Patients were excluded if they did not receive a carbapenem after ESBL production was identified. The primary outcome was time to death from the first day of bacteremia. Propensity scores using inverse probability of exposure weighting (IPW) were used to estimate the probability that a patient would receive PTZ vs carbapenems empirically. We calculated overall hazard ratios for mortality censored at 14 days using Cox proportional hazards models on an IPW-adjusted cohort. A total of 331 unique patients with ESBL bacteremia were identified. One hundred three (48%) patients received PTZ empirically and 110 (52%) received carbapenems empirically. The adjusted risk of death was 1.92 times higher for patients receiving empiric PTZ compared with empiric carbapenem therapy (95% confidence interval, 1.07-3.45). PTZ appears inferior to carbapenems for the treatment of ESBL bacteremia. For patients at high risk of invasive ESBL infections, early carbapenem therapy should be considered. Our findings should not be extended to β-lactam/β-lactamase inhibitor combinations in development, as limited clinical data are available for these agents. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of

Self-affirmation improves problem-solving under stress.

Directory of Open Access Journals (Sweden)

J David Creswell

Full Text Available High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings.

Post-traumatic stress disorder symptoms in emotionally distressed individuals referred for a depression prevention intervention: relationship to problem-solving skills.

Science.gov (United States)

Kasckow, J; Brown, C; Morse, J; Begley, A; Bensasi, S; Reynolds, C F

2012-11-01

This study examined the rates of syndromal and subthreshold post-traumatic stress disorder (PTSD) and PTSD symptom scores in participants with symptoms of emotional distress, subsyndromal depression, and a history of traumatic exposure. Participants had been referred to a study of an indicated depression prevention intervention using problem-solving therapy in primary care. We hypothesized that higher severity of PTSD symptom scores would predict poorer problem-solving skills. In addition, some reports have suggested that there are higher rates of PTSD in minority populations relative to Caucasians; thus we hypothesized that race would also predict problem-solving skills in these individuals. We examined the rates of traumatic exposure, syndromal, and subthreshold PTSD. In those exposed to trauma, we performed a multiple linear regression to examine the effects of PTSD symptoms, depression symptoms, race, age, and gender on social problem-solving skills. Of the 244 participants, 64 (26.2%) reported a traumatic event; 6/234 (2.6%) had syndromal PTSD, and 14/234 (6.0%) had subthreshold PTSD. By way of regression analysis, higher PTSD symptom scores predicted poorer problem-solving skills. In addition, racial status (Caucasian vs. African American) predicted problem-solving skills; Caucasians exhibited lower levels of problem-solving skills. Individuals presenting with subsyndromal depressive symptoms may also have a history of traumatic exposure, subthreshold and syndromal PTSD. Thus, screening these individuals for PTSD symptoms is important and may inform clinical management decisions because problem-solving skills are lower in those with more severe PTSD symptoms (even after adjusting for race, age, gender, and depressive symptoms). Copyright © 2011 John Wiley & Sons, Ltd.

An Analysis of Students Error In Solving PISA 2012 And Its Scaffolding

Directory of Open Access Journals (Sweden)

Yurizka Melia Sari

2017-08-01

Full Text Available Based on PISA survey in 2012, Indonesia was only placed on 64 out of 65 participating countries. The survey suggest that the students’ ability of reasoning, spatial orientation, and problem solving are lower compare with other participants countries, especially in Shouth East Asia. Nevertheless, the result of PISA does not elicit clearly on the students’ inability in solving PISA problem such as the location and the types of student’s errors. Therefore, analyzing students’ error in solving PISA problem would be essential countermeasure to help the students in solving mathematics problems and to develop scaffolding. Based on the data analysis, it is found that there are 5 types of error which is made by the subject. They consist of reading error, comprehension error, transformation error, process skill error, and encoding error. The most common mistake that subject do is encoding error with a percentage of 26%. While reading is the fewest errors made by the subjects that is only 12%. The types of given scaffolding was explaining the problem carefully and making a summary of new words and find the meaning of them, restructuring problem-solving strategies and reviewing the results of the completion of the problem.

Solving the Helmholtz equation in conformal mapped ARROWstructures using homotopy perturbation method

DEFF Research Database (Denmark)

Reck, Kasper; Thomsen, Erik Vilain; Hansen, Ole

2011-01-01

. The solution of the mapped Helmholtz equation is found by solving an infinite series of Poisson equations using two dimensional Fourier series. The solution is entirely based on analytical expressions and is not mesh dependent. The analytical results are compared to a numerical (finite element method) solution......The scalar wave equation, or Helmholtz equation, describes within a certain approximation the electromagnetic field distribution in a given system. In this paper we show how to solve the Helmholtz equation in complex geometries using conformal mapping and the homotopy perturbation method...

A matrix formalism to solve interface condition equations in a reactor system

Energy Technology Data Exchange (ETDEWEB)

Matausek, M V [Boris Kidric Institute of Nuclear Sciences Vinca, Beograd (Yugoslavia)

1970-05-15

When a nuclear reactor or a reactor lattice cell is treated by an approximate procedure to solve the neutron transport equation, as the last computational step often appears a problem of solving systems of algebraic equations stating the interface and boundary conditions for the neutron flux moments. These systems have usually the coefficient matrices of the block-bi diagonal type, containing thus a large number of zero elements. In the present report it is shown how such a system can be solved efficiently accounting for all the zero elements both in the coefficient matrix and in the free term vector. The procedure is presented here for the case of multigroup P{sub 3} calculation of neutron flux distribution in a cylindrical reactor lattice cell. Compared with the standard gaussian elimination method, this procedure is more advantageous both in respect to the number of operations needed to solve a given problem and in respect to the computer memory storage requirements. A similar formalism can also be applied for other approximate methods, for instance for multigroup diffusion treatment of a multi zone reactor. (author)

Lesion mapping of social problem solving.

Science.gov (United States)

Barbey, Aron K; Colom, Roberto; Paul, Erick J; Chau, Aileen; Solomon, Jeffrey; Grafman, Jordan H

2014-10-01

Accumulating neuroscience evidence indicates that human intelligence is supported by a distributed network of frontal and parietal regions that enable complex, goal-directed behaviour. However, the contributions of this network to social aspects of intellectual function remain to be well characterized. Here, we report a human lesion study (n = 144) that investigates the neural bases of social problem solving (measured by the Everyday Problem Solving Inventory) and examine the degree to which individual differences in performance are predicted by a broad spectrum of psychological variables, including psychometric intelligence (measured by the Wechsler Adult Intelligence Scale), emotional intelligence (measured by the Mayer, Salovey, Caruso Emotional Intelligence Test), and personality traits (measured by the Neuroticism-Extraversion-Openness Personality Inventory). Scores for each variable were obtained, followed by voxel-based lesion-symptom mapping. Stepwise regression analyses revealed that working memory, processing speed, and emotional intelligence predict individual differences in everyday problem solving. A targeted analysis of specific everyday problem solving domains (involving friends, home management, consumerism, work, information management, and family) revealed psychological variables that selectively contribute to each. Lesion mapping results indicated that social problem solving, psychometric intelligence, and emotional intelligence are supported by a shared network of frontal, temporal, and parietal regions, including white matter association tracts that bind these areas into a coordinated system. The results support an integrative framework for understanding social intelligence and make specific recommendations for the application of the Everyday Problem Solving Inventory to the study of social problem solving in health and disease. © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved

Comparison of steroid pulse therapy and conventional oral steroid therapy as initial treatment for autoimmune pancreatitis

International Nuclear Information System (INIS)

Tomiyama, Takashi; Uchida, Kazushige; Matsushita, Mitsunobu; Ikeura, Tsukasa; Fukui, Toshiro; Takaoka, Makoto; Nishio, Akiyoshi; Okazaki, Kazuichi

2011-01-01

The efficacy of oral steroid therapy for autoimmune pancreatitis (AIP) is well known, and oral prednisolone treatment is most usually commenced at 30-40 mg/day, but there have been few reports about comparative studies of oral steroid therapy and steroid pulse therapy as the initial treatment for AIP. We studied the clinical course and image findings to estimate the utility of steroid pulse therapy for AIP, comparing it with oral steroid therapy. Laboratory and image findings were assessed retrospectively in 11 patients who received steroid pulse therapy, and the findings were compared to those in 10 patients who received conventional oral steroid therapy. Change in pancreatic size showed no significant difference between the therapies after 2 weeks of treatment. Significant improvement of lower bile duct strictures after 2 weeks of treatment and that of immunoglobulin values within 6 months were shown with both therapies. However, steroid pulse therapy showed significant improvement of γ-guanosine triphosphate (GTP) in 2 weeks and of alanine aminotransferase (ALT) in 2 and 8 weeks, compared with oral steroid therapy. Moreover, there was one patient in whom the lower bile duct stricture was not improved by oral steroid therapy, but it did show improvement with steroid pulse therapy. Initial steroid pulse therapy is a beneficial alternative to oral steroid therapy for the improvement of bile duct lesions. In future, the accumulation of a larger number of patients receiving steroid pulse therapy is needed, and prospective studies will be required. (author)

Volumetric modulated arc therapy versus step-and-shoot intensity modulated radiation therapy in the treatment of large nerve perineural spread to the skull base: a comparative dosimetric planning study

Energy Technology Data Exchange (ETDEWEB)

Gorayski, Peter; Fitzgerald, Rhys; Barry, Tamara [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Burmeister, Elizabeth [Nursing Practice Development Unit, Princess Alexandra Hospital and Research Centre for Clinical and Community Practice Innovation, Griffith University, Brisbane, Queensland (Australia); Foote, Matthew [Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Diamantina Institute, University of Queensland, Brisbane, Queensland (Australia)

2014-06-15

Cutaneous squamous cell carcinoma with large nerve perineural (LNPN) infiltration of the base of skull is a radiotherapeutic challenge given the complex target volumes to nearby organs at risk (OAR). A comparative planning study was undertaken to evaluate dosimetric differences between volumetric modulated arc therapy (VMAT) versus intensity modulated radiation therapy (IMRT) in the treatment of LNPN. Five consecutive patients previously treated with IMRT for LNPN were selected. VMAT plans were generated for each case using the same planning target volumes (PTV), dose prescriptions and OAR constraints as IMRT. Comparative parameters used to assess target volume coverage, conformity and homogeneity included V95 of the PTV (volume encompassed by the 95% isodose), conformity index (CI) and homogeneity index (HI). In addition, OAR maximum point doses, V20, V30, non-target tissue (NTT) point max doses, NTT volume above reference dose, monitor units (MU) were compared. IMRT and VMAT plans generated were comparable for CI (P = 0.12) and HI (P = 0.89). VMAT plans achieved better V95 (P = < 0.001) and reduced V20 and V30 by 652 cubic centimetres (cc) (28.5%) and 425.7 cc (29.1%), respectively. VMAT increased MU delivered by 18% without a corresponding increase in NTT dose. Compared with IMRT plans for LNPN, VMAT achieved comparable HI and CI.

LEGO Robotics: An Authentic Problem Solving Tool?

Science.gov (United States)

Castledine, Alanah-Rei; Chalmers, Chris

2011-01-01

With the current curriculum focus on correlating classroom problem solving lessons to real-world contexts, are LEGO robotics an effective problem solving tool? This present study was designed to investigate this question and to ascertain what problem solving strategies primary students engaged with when working with LEGO robotics and whether the…

Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials.

Science.gov (United States)

Krogh, Thøger Persson; Bartels, Else Marie; Ellingsen, Torkell; Stengaard-Pedersen, Kristian; Buchbinder, Rachelle; Fredberg, Ulrich; Bliddal, Henning; Christensen, Robin

2013-06-01

Injection therapy with glucocorticoids has been used since the 1950s as a treatment strategy for lateral epicondylitis (tennis elbow). Lately, several novel injection therapies have become available. To assess the comparative effectiveness and safety of injection therapies in patients with lateral epicondylitis. Systematic review and meta-analysis. Randomized controlled trials comparing different injection therapies for lateral epicondylitis were included provided they contained data for change in pain intensity (primary outcome). Trials were assessed using the Cochrane risk of bias tool. Network (random effects) meta-analysis was applied to combine direct and indirect evidence within and across trial data using the final end point reported in the trials, and results for the arm-based network analyses are reported as standardized mean differences (SMDs). Seventeen trials (1381 participants; 3 [18%] at low risk of bias) assessing injection with 8 different treatments-glucocorticoid (10 trials), botulinum toxin (4 trials), autologous blood (3 trials), platelet-rich plasma (2 trials), and polidocanol, glycosaminoglycan, prolotherapy, and hyaluronic acid (1 trial each)-were included. Pooled results (SMD [95% confidence interval]) showed that beyond 8 weeks, glucocorticoid injection was no more effective than placebo (-0.04 [-0.45 to 0.35]), but only 1 trial (which did not include a placebo arm) was at low risk of bias. Although botulinum toxin showed marginal benefit (-0.50 [-0.91 to -0.08]), it caused temporary paresis of finger extension, and all trials were at high risk of bias. Both autologous blood (-1.43 [-2.15 to -0.71]) and platelet-rich plasma (-1.13 [-1.77 to -0.49]) were also statistically superior to placebo, but only 1 trial was at low risk of bias. Prolotherapy (-2.71 [-4.60 to -0.82]) and hyaluronic acid (-5.58 [-6.35 to -4.82]) were both more efficacious than placebo, whereas polidocanol (0.39 [-0.42 to 1.20]) and glycosaminoglycan (-0.32 [-1.02 to 0

Applying Cooperative Techniques in Teaching Problem Solving

Directory of Open Access Journals (Sweden)

Krisztina Barczi

2013-12-01

Full Text Available Teaching how to solve problems – from solving simple equations to solving difficult competition tasks – has been one of the greatest challenges for mathematics education for many years. Trying to find an effective method is an important educational task. Among others, the question arises as to whether a method in which students help each other might be useful. The present article describes part of an experiment that was designed to determine the effects of cooperative teaching techniques on the development of problem-solving skills.

Transport equation solving methods

International Nuclear Information System (INIS)

Granjean, P.M.

1984-06-01

This work is mainly devoted to Csub(N) and Fsub(N) methods. CN method: starting from a lemma stated by Placzek, an equivalence is established between two problems: the first one is defined in a finite medium bounded by a surface S, the second one is defined in the whole space. In the first problem the angular flux on the surface S is shown to be the solution of an integral equation. This equation is solved by Galerkin's method. The Csub(N) method is applied here to one-velocity problems: in plane geometry, slab albedo and transmission with Rayleigh scattering, calculation of the extrapolation length; in cylindrical geometry, albedo and extrapolation length calculation with linear scattering. Fsub(N) method: the basic integral transport equation of the Csub(N) method is integrated on Case's elementary distributions; another integral transport equation is obtained: this equation is solved by a collocation method. The plane problems solved by the Csub(N) method are also solved by the Fsub(N) method. The Fsub(N) method is extended to any polynomial scattering law. Some simple spherical problems are also studied. Chandrasekhar's method, collision probability method, Case's method are presented for comparison with Csub(N) and Fsub(N) methods. This comparison shows the respective advantages of the two methods: a) fast convergence and possible extension to various geometries for Csub(N) method; b) easy calculations and easy extension to polynomial scattering for Fsub(N) method [fr

Capturing Problem-Solving Processes Using Critical Rationalism

Science.gov (United States)

Chitpin, Stephanie; Simon, Marielle

2012-01-01

The examination of problem-solving processes continues to be a current research topic in education. Knowing how to solve problems is not only a key aspect of learning mathematics but is also at the heart of cognitive theories, linguistics, artificial intelligence, and computers sciences. Problem solving is a multistep, higher-order cognitive task…

Automated Volumetric Modulated Arc Therapy Treatment Planning for Stage III Lung Cancer: How Does It Compare With Intensity-Modulated Radio Therapy?

Energy Technology Data Exchange (ETDEWEB)

Quan, Enzhuo M. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Joe Y.; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Xia Tingyi [Department of Radiation Oncology, Beijing 301 Hospital, Beijing (China); Yuan Zhiyong [Department of Radiation Oncology, Tianjin Medical University Cancer Hospital and Institute, Tianjin (China); Liu Hui [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Zhongshan University Hospital, Guangzhou (China); Li, Xiaoqiang; Wages, Cody A.; Mohan, Radhe [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhang Xiaodong, E-mail: xizhang@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2012-09-01

Purpose: To compare the quality of volumetric modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) plans generated by an automated inverse planning system with that of dosimetrist-generated IMRT treatment plans for patients with stage III lung cancer. Methods and Materials: Two groups of 8 patients with stage III lung cancer were randomly selected. For group 1, the dosimetrists spent their best effort in designing IMRT plans to compete with the automated inverse planning system (mdaccAutoPlan); for group 2, the dosimetrists were not in competition and spent their regular effort. Five experienced radiation oncologists independently blind-reviewed and ranked the three plans for each patient: a rank of 1 was the best and 3 was the worst. Dosimetric measures were also performed to quantitatively evaluate the three types of plans. Results: Blind rankings from different oncologists were generally consistent. For group 1, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.6, 2.13, and 2.18, respectively. The auto-VMAT plans in group 1 had 10% higher planning tumor volume (PTV) conformality and 24% lower esophagus V70 (the volume receiving 70 Gy or more) than the manual IMRT plans; they also resulted in more than 20% higher complication-free tumor control probability (P+) than either type of IMRT plans. The auto- and manual IMRT plans in this group yielded generally comparable dosimetric measures. For group 2, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.55, 1.75, and 2.75, respectively. Compared to the manual IMRT plans in this group, the auto-VMAT plans and auto-IMRT plans showed, respectively, 17% and 14% higher PTV dose conformality, 8% and 17% lower mean lung dose, 17% and 26% lower mean heart dose, and 36% and 23% higher P+. Conclusions: mdaccAutoPlan is capable of generating high-quality VMAT and IMRT treatment plans for stage III lung cancer. Manual IMRT plans could achieve quality

Automated Volumetric Modulated Arc Therapy Treatment Planning for Stage III Lung Cancer: How Does It Compare With Intensity-Modulated Radio Therapy?

International Nuclear Information System (INIS)

Quan, Enzhuo M.; Chang, Joe Y.; Liao Zhongxing; Xia Tingyi; Yuan Zhiyong; Liu Hui; Li, Xiaoqiang; Wages, Cody A.; Mohan, Radhe; Zhang Xiaodong

2012-01-01

Purpose: To compare the quality of volumetric modulated arc therapy (VMAT) or intensity-modulated radiation therapy (IMRT) plans generated by an automated inverse planning system with that of dosimetrist-generated IMRT treatment plans for patients with stage III lung cancer. Methods and Materials: Two groups of 8 patients with stage III lung cancer were randomly selected. For group 1, the dosimetrists spent their best effort in designing IMRT plans to compete with the automated inverse planning system (mdaccAutoPlan); for group 2, the dosimetrists were not in competition and spent their regular effort. Five experienced radiation oncologists independently blind-reviewed and ranked the three plans for each patient: a rank of 1 was the best and 3 was the worst. Dosimetric measures were also performed to quantitatively evaluate the three types of plans. Results: Blind rankings from different oncologists were generally consistent. For group 1, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.6, 2.13, and 2.18, respectively. The auto-VMAT plans in group 1 had 10% higher planning tumor volume (PTV) conformality and 24% lower esophagus V70 (the volume receiving 70 Gy or more) than the manual IMRT plans; they also resulted in more than 20% higher complication-free tumor control probability (P+) than either type of IMRT plans. The auto- and manual IMRT plans in this group yielded generally comparable dosimetric measures. For group 2, the auto-VMAT, auto-IMRT, and manual IMRT plans received average ranks of 1.55, 1.75, and 2.75, respectively. Compared to the manual IMRT plans in this group, the auto-VMAT plans and auto-IMRT plans showed, respectively, 17% and 14% higher PTV dose conformality, 8% and 17% lower mean lung dose, 17% and 26% lower mean heart dose, and 36% and 23% higher P+. Conclusions: mdaccAutoPlan is capable of generating high-quality VMAT and IMRT treatment plans for stage III lung cancer. Manual IMRT plans could achieve quality

Cost-effectiveness of single-dose tamsulosin and dutasteride combination therapy compared with tamsulosin monotherapy in patients with benign prostatic hyperplasia in the UK.

Science.gov (United States)

Walker, Anna; Doyle, Scott; Posnett, John; Hunjan, Manjit

2013-09-01

To estimate the long-term cost-effectiveness of single-dose dutasteride/tamsulosin combination therapy as a first-line treatment for benign prostatic hyperplasia (BPH) from the perspective of the UK National Health Service (NHS). A Markov state transition model was developed to estimate healthcare costs and patient outcomes, measured by quality-adjusted life years (QALYs), for patients aged ≥50 years with diagnosed BPH and moderate to severe symptoms. Costs and outcomes were estimated for two treatment comparators: oral, daily, single-dose combination therapy (dutasteride 0.5 mg + tamsulosin 0.4 mg), and oral daily tamsulosin (0.4 mg) over a period up to 25 years. The efficacy of comparators was taken from results of the Combination of Avodart and Tamsulosin (CombAT) trial. Cumulative discounted costs per patient were higher with combination therapy than with tamsulosin, but QALYs were also higher. After 25 years, the incremental cost-effectiveness ratio for combination therapy was £12,219, well within the threshold range (£20,000-£30,000 per QALY) typically applied in the NHS. Probabilistic sensitivity analysis showed that the probability of combination therapy being cost-effective given the threshold range is between 78% and 88%. Single-dose combination dutasteride/tamsulosin therapy has a high probability of being cost-effective in comparison to tamsulosin monotherapy in the UK's NHS. © 2013 BJU International.

Design and Application of Interactive Simulations in Problem-Solving in University-Level Physics Education

Science.gov (United States)

Ceberio, Mikel; Almudí, José Manuel; Franco, Ángel

2016-08-01

In recent years, interactive computer simulations have been progressively integrated in the teaching of the sciences and have contributed significant improvements in the teaching-learning process. Practicing problem-solving is a key factor in science and engineering education. The aim of this study was to design simulation-based problem-solving teaching materials and assess their effectiveness in improving students' ability to solve problems in university-level physics. Firstly, we analyze the effect of using simulation-based materials in the development of students' skills in employing procedures that are typically used in the scientific method of problem-solving. We found that a significant percentage of the experimental students used expert-type scientific procedures such as qualitative analysis of the problem, making hypotheses, and analysis of results. At the end of the course, only a minority of the students persisted with habits based solely on mathematical equations. Secondly, we compare the effectiveness in terms of problem-solving of the experimental group students with the students who are taught conventionally. We found that the implementation of the problem-solving strategy improved experimental students' results regarding obtaining a correct solution from the academic point of view, in standard textbook problems. Thirdly, we explore students' satisfaction with simulation-based problem-solving teaching materials and we found that the majority appear to be satisfied with the methodology proposed and took on a favorable attitude to learning problem-solving. The research was carried out among first-year Engineering Degree students.

The effectiveness of neuro-music therapy according to the Heidelberg model compared to a single session of educational counseling as treatment for tinnitus: a controlled trial.

Science.gov (United States)

Argstatter, Heike; Grapp, Miriam; Hutter, Elisabeth; Plinkert, Peter K; Bolay, Hans-Volker

2015-03-01

Tinnitus is a very common symptom, yet the quest for an effective treatment is challenging. Results from several clinical trials support the notion that neuro-music therapy is an effective means to reduce tinnitus distress with short duration and long lasting effect. However, until now, the effectiveness has not been tested in a controlled trial against an active comparator. The trial was designed as two-center, parallel intervention group controlled study with two intervention groups: Counseling (50minute individualized personal instruction) or neuro-music therapy (counseling plus eight 50-minute sessions of individualized music therapy). Data of n=290 patients suffering from chronic tinnitus were analyzed. Outcome measure was the change in Tinnitus Questionnaire Total Scores (TQ) from baseline (admission) to end of treatment. Both treatment groups achieved a statistically relevant reduction in TQ scores, though 66% of patients in the music therapy group attained a clinically meaningful improvement compared to 33% in the counseling group. A binary logistic regression revealed two variables significantly influencing therapy outcome: initial tinnitus score and type of therapy with an OR for the music therapy compared to the counseling of 4.34 (CI 2.33-8.09). Counseling is an appropriate treatment option with well above chance of improvement. The neuro-music therapy outperformed the counseling. This treatment targets the tinnitus sound itself, is short in duration, intrinsically motivating and easy to operate and thus presents a possible complement to the therapeutic spectrum in chronic tinnitus. The trial was registered at the ClinicalTrials.gov registry (ID: NCT01845155). Copyright © 2014 Elsevier Inc. All rights reserved.

Customer-centered problem solving.

Science.gov (United States)

Samelson, Q B

1999-11-01

If there is no single best way to attract new customers and retain current customers, there is surely an easy way to lose them: fail to solve the problems that arise in nearly every buyer-supplier relationship, or solve them in an unsatisfactory manner. Yet, all too frequently, companies do just that. Either we deny that a problem exists, we exert all our efforts to pin the blame elsewhere, or we "Band-Aid" the problem instead of fixing it, almost guaranteeing that we will face it again and again.

Comparative Evaluation of the Complementary and Alternative Medicine Therapy and Conventional Therapy Use for Musculoskeletal Disorders Management and Its Association with Job Satisfaction among Dentists of West India.

Science.gov (United States)

Gupta, Devanand; Batra, Renu; Mahajan, Shveta; Bhaskar, Dara John; Jain, Ankita; Shiju, Mohammed; Yadav, Ankit; Chaturvedi, Mudita; Gill, Shruti; Verma, Renuka; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar

2014-10-01

Musculoskeletal problems have become a significant issue in the profession of dentistry. There are currently no recommended effective disease-preventing and modifying remedies. High prevalence rates for musculoskeletal disorders (MSDs) among dentists have been reported in the literature. Complementary and alternative medicine can be helpful in managing and preventing the MSDs. The purpose of this study was to determine if dentists in the western part of India are using complementary and alternative medicine therapies for MSDs, and also to find if those who use complementary and alternative medicine therapies have greater job/career satisfaction compared to conventional therapy (CT) users. Dentists of western India registered under the Dental Council of India (N = 2166) were recruited for the study. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 73% (n = 1581) was obtained, of which 79% (n = 1249) was suffering from MSDs. The use of complementary and alternative medicine or CT was reported by 90% (n = 1124) of dentists with MSDs. Dentists using complementary and alternative medicine reported greater health (P alternative medicine therapies may improve the quality of life and enhance job satisfaction for a dentist who suffers from MSDs.

Multivariate Padé Approximation for Solving Nonlinear Partial Differential Equations of Fractional Order

Directory of Open Access Journals (Sweden)

Veyis Turut

2013-01-01

Full Text Available Two tecHniques were implemented, the Adomian decomposition method (ADM and multivariate Padé approximation (MPA, for solving nonlinear partial differential equations of fractional order. The fractional derivatives are described in Caputo sense. First, the fractional differential equation has been solved and converted to power series by Adomian decomposition method (ADM, then power series solution of fractional differential equation was put into multivariate Padé series. Finally, numerical results were compared and presented in tables and figures.

Neural pathway in the right hemisphere underlies verbal insight problem solving.

Science.gov (United States)

Zhao, Q; Zhou, Z; Xu, H; Fan, W; Han, L

2014-01-03

Verbal insight problem solving means to break mental sets, to select the novel semantic information and to form novel, task-related associations. Although previous studies have identified the brain regions associated with these key processes, the interaction among these regions during insight is still unclear. In the present study, we explored the functional connectivity between the key regions during solving Chinese 'chengyu' riddles by using event-related functional magnetic resonance imaging. Results showed that both insight and noninsight solutions activated the bilateral inferior frontal gyri, middle temporal gyri and hippocampi, and these regions constituted a frontal to temporal to hippocampal neural pathway. Compared with noninsight solution, insight solution had a stronger functional connectivity between the inferior frontal gyrus and middle temporal gyrus in the right hemisphere. Our study reveals the neural pathway of information processing during verbal insight problem solving, and supports the right-hemisphere advantage theory of insight. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

The use of cell-sheet technique eliminates arrhythmogenicity of skeletal myoblast-based therapy to the heart with enhanced therapeutic effects.

Science.gov (United States)

Narita, Takuya; Shintani, Yasunori; Ikebe, Chiho; Kaneko, Masahiro; Harada, Narumi; Tshuma, Nomathamsanqa; Takahashi, Kunihiko; Campbell, Niall G; Coppen, Steven R; Yashiro, Kenta; Sawa, Yoshiki; Suzuki, Ken

2013-09-20

Clinical application of skeletal myoblast transplantation has been curtailed due to arrhythmogenicity and inconsistent therapeutic benefits observed in previous studies. However, these issues may be solved by the use of a new cell-delivery mode. It is now possible to generate "cell-sheets" using temperature-responsive dishes without artificial scaffolds. This study aimed to validate the safety and efficacy of epicardial placement of myoblast-sheets (myoblast-sheet therapy) in treating heart failure. After coronary artery ligation in rats, the same numbers of syngeneic myoblasts were transplanted by intramyocardial injection or cell-sheet placement. Continuous radio-telemetry monitoring detected increased ventricular arrhythmias, including ventricular tachycardia, after intramyocardial injection compared to the sham-control, while these were abolished in myoblast-sheet therapy. This effect was conjunct with avoidance of islet-like cell-cluster formation that disrupts electrical conduction, and with prevention of increased arrhythmogenic substrates due to exaggerated inflammation. Persistent ectopic donor cells were found in the lung only after intramyocardial injection, strengthening the improved safety of myoblast-sheet therapy. In addition, myoblast-sheet therapy enhanced cardiac function, corresponding to a 9.2-fold increase in donor cell survival, compared to intramyocardial injection. Both methods achieved reduced infarct size, decreased fibrosis, attenuated cardiomyocyte hypertrophy, and increased neovascular formation, in association with myocardial upregulation of a group of relevant molecules. The pattern of these beneficial changes was similar between two methods, but the degree was more substantial after myoblast-sheet therapy. The cell-sheet technique enhanced safety and therapeutic efficacy of myoblast-based therapy, compared to the current method, thereby paving the way for clinical application. Copyright © 2012 Elsevier Ireland Ltd. All rights

How do they solve it? An insight into the learner’s approach to the mechanism of physics problem solving

Directory of Open Access Journals (Sweden)

Balasubrahmanya Hegde

2012-03-01

Full Text Available A perceived difficulty is associated with physics problem solving from a learner’s viewpoint, arising out of a multitude of reasons. In this paper, we have examined the microstructure of students’ thought processes during physics problem solving by combining the analysis of responses to multiple-choice questions and semistructured student interviews. Design of appropriate scaffoldings serves as pointers to the identification of student problem solving difficulties. An analysis of the results suggests the necessity of identification of the skill sets required for developing better problem solving abilities.

Verbal Problem-Solving Difficulties in Autism Spectrum Disorders and Atypical Language Development

Science.gov (United States)

Alderson-Day, Ben

2018-01-01

Children with autism spectrum disorders (ASDs) adopt less efficient strategies than typically developing (TD) peers on the Twenty Questions Task (TQT), a measure of verbal problem-solving skills. Although problems with the TQT are typically associated with executive dysfunction, they have also been reported in children who are deaf, suggesting a role for atypical language development. To test the contribution of language history to ASD problem solving, TQT performance was compared in children with high-functioning autism (HFA), children with Asperger syndrome (AS) and TD children. The HFA group used significantly less efficient strategies than both AS and TD children. No group differences were evident on tests of question understanding, planning or verbal fluency. Potential explanations for differences in verbal problem-solving skill are discussed with reference to the development of inner speech and use of visual strategies in ASD. PMID:25346354

Gamma knife therapy for craniopharyngioma

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, Tatsuya; Kida, Yoshihisa; Tanaka, Takayuki; Yoshida, Kazuo; Yoshimoto, Masayuki; Maezawa, Satoshi; Hasegawa, Toshinori [Komaki Hospital, Aichi (Japan)

1997-01-01

Gamma knife therapy in stereotactic radiosurgery was evaluated as a tool to solve problems raised in therapy for craniopharyngioma. Subjects were 9 childhood patients (<16 y, mean age 9.75 y) and 16 adult patients (mean age 43.9 y), 23 cases of whom had been treated with surgery before gamma knife. Planning of irradiation to the solid part of the tumor was based on their T1-weighted MRI images of 3 mm-thick slice. The mean size of the tumors was 20.7 (9.6-31.2) mm in diameter. The mean central dose of 23.3 (20-30) Gy was irradiated with the mean marginal dose of 11.8 (18-11.3) Gy through the mean shot of 4.8. Results were followed in every 3-6 months by MRI, neurological and endocrinological examinations for 7-52 (mean 23.3) months. Reduction of tumor size including its disappearance (7 cases) were observed in 22 cases (88%) with adverse effects of hypopituitarism (3 cases) and hemianopsia (1). Gamma knife therapy was thus safe and effective. (K.H.)

Review on solving the forward problem in EEG source analysis

Directory of Open Access Journals (Sweden)

Vergult Anneleen

2007-11-01

Full Text Available Abstract Background The aim of electroencephalogram (EEG source localization is to find the brain areas responsible for EEG waves of interest. It consists of solving forward and inverse problems. The forward problem is solved by starting from a given electrical source and calculating the potentials at the electrodes. These evaluations are necessary to solve the inverse problem which is defined as finding brain sources which are responsible for the measured potentials at the EEG electrodes. Methods While other reviews give an extensive summary of the both forward and inverse problem, this review article focuses on different aspects of solving the forward problem and it is intended for newcomers in this research field. Results It starts with focusing on the generators of the EEG: the post-synaptic potentials in the apical dendrites of pyramidal neurons. These cells generate an extracellular current which can be modeled by Poisson's differential equation, and Neumann and Dirichlet boundary conditions. The compartments in which these currents flow can be anisotropic (e.g. skull and white matter. In a three-shell spherical head model an analytical expression exists to solve the forward problem. During the last two decades researchers have tried to solve Poisson's equation in a realistically shaped head model obtained from 3D medical images, which requires numerical methods. The following methods are compared with each other: the boundary element method (BEM, the finite element method (FEM and the finite difference method (FDM. In the last two methods anisotropic conducting compartments can conveniently be introduced. Then the focus will be set on the use of reciprocity in EEG source localization. It is introduced to speed up the forward calculations which are here performed for each electrode position rather than for each dipole position. Solving Poisson's equation utilizing FEM and FDM corresponds to solving a large sparse linear system. Iterative

Feminist Therapy: A Comparative Study of Therapists and Clients.

Science.gov (United States)

Curtin, Catherine A.

Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical…

Problem Solving in Physics: Undergraduates' Framing, Procedures, and Decision Making

Science.gov (United States)

Modir, Bahar

In this dissertation I will start with the broad research question of what does problem solving in upper division physics look like? My focus in this study is on students' problem solving in physics theory courses. Some mathematical formalisms are common across all physics core courses such as using the process of separation of variables, doing Taylor series, or using the orthogonality properties of mathematical functions to set terms equal to zero. However, there are slight differences in their use of these mathematical formalisms across different courses, possibly because of how students map different physical systems to these processes. Thus, my first main research question aims to answer how students perform these recurring processes across upper division physics courses. I break this broad question into three particular research questions: What knowledge pieces do students use to make connections between physics and procedural math? How do students use their knowledge pieces coherently to provide reasoning strategies in estimation problems? How do students look ahead into the problem to read the information out of the physical scenario to align their use of math in physics? Building on the previous body of the literature, I will use the theory family of Knowledge in Pieces and provide evidence to expand this theoretical foundation. I will compare my study with previous studies and provide suggestions on how to generalize these theory expansions for future use. My experimental data mostly come from video-based classroom data. Students in groups of 2-4 students solve in-class problems in quantum mechanics and electromagnetic fields 1 courses collaboratively. In addition, I will analyze clinical interviews to demonstrate how a single case study student plays an epistemic game to estimate the total energy in a hurricane. My second research question is more focused on a particular instructional context. How do students frame problem solving in quantum mechanics? I

Using qualitative problem-solving strategies to highlight the role of conceptual knowledge in solving problems

Science.gov (United States)

Leonard, William J.; Dufresne, Robert J.; Mestre, Jose P.

1996-12-01

We report on the use of qualitative problem-solving strategies in teaching an introductory, calculus-based physics course as a means of highlighting the role played by conceptual knowledge in solving problems. We found that presenting strategies during lectures and in homework solutions provides an excellent opportunity to model for students the type of concept-based, qualitative reasoning that is valued in our profession, and that student-generated strategies serve a diagnostic function by providing instructors with insights on students' conceptual understanding and reasoning. Finally, we found strategies to be effective pedagogical tools for helping students both to identify principles that could be applied to solve specific problems, as well as to recall the major principles covered in the course months after it was over.

Genetics problem solving and worldview

Science.gov (United States)

Dale, Esther

The research goal was to determine whether worldview relates to traditional and real-world genetics problem solving. Traditionally, scientific literacy emphasized content knowledge alone because it was sufficient to solve traditional problems. The contemporary definition of scientific literacy is, "The knowledge and understanding of scientific concepts and processes required for personal decision-making, participation in civic and cultural affairs and economic productivity" (NRC, 1996). An expanded definition of scientific literacy is needed to solve socioscientific issues (SSI), complex social issues with conceptual, procedural, or technological associations with science. Teaching content knowledge alone assumes that students will find the scientific explanation of a phenomenon to be superior to a non-science explanation. Formal science and everyday ways of thinking about science are two different cultures (Palmer, 1999). Students address this rift with cognitive apartheid, the boxing away of science knowledge from other types of knowledge (Jedege & Aikenhead, 1999). By addressing worldview, cognitive apartheid may decrease and scientific literacy may increase. Introductory biology students at the University of Minnesota during fall semester 2005 completed a written questionnaire-including a genetics content-knowledge test, four genetic dilemmas, the Worldview Assessment Instrument (WAI) and some items about demographics and religiosity. Six students responded to the interview protocol. Based on statistical analysis and interview data, this study concluded the following: (1) Worldview, in the form of metaphysics, relates to solving traditional genetic dilemmas. (2) Worldview, in the form of agency, relates to solving traditional genetics problems. (3) Thus, worldview must be addressed in curriculum, instruction, and assessment.

Integrating video and animation with physics problem- solving exercises on the World Wide Web

Science.gov (United States)

Titus, Aaron Patrick

1998-10-01

Problem solving is of paramount importance in teaching and learning physics. An important step in solving a problem is visualization. To help students visualize a problem, we included video clips with homework questions delivered via the World Wide Web. Although including video with physics problems has a positive effect with some problems, we found that this may not be the best way to integrate multimedia with physics problems since improving visualization is probably not as helpful as changing students' approach. To challenge how students solve problems and to help them develop a more expert-like approach, we developed a type of physics exercise called a multimedia-focused problem where students take data from an animation in order to solve a problem. Because numbers suggestive of a solution are not given in the text of the question, students have to consider the problem conceptually before analyzing it mathematically. As a result, we found that students had difficulty solving such problems compared to traditional textbook-like problems. Students' survey responses showed that students indeed had difficulty determining what was needed to solve a problem when it was not explicitly given to them in the text of the question. Analyzing think-aloud interviews where students verbalized their thoughts while solving problems, we found that multimedia-focused problems indeed required solid conceptual understanding in order for them to be solved correctly. As a result, we believe that when integrated with instruction, multimedia-focused problems can be a valuable tool in helping students develop better conceptual understanding and more expert-like problem solving skills by challenging novice beliefs and problem solving approaches. Multimedia-focused problems may also be useful for diagnosing conceptual understanding and problem skills.

Comparing Active and Passive Distraction-Based Music Therapy Interventions on Preoperative Anxiety in Pediatric Patients and Their Caregivers.

Science.gov (United States)

Millett, Christopher R; Gooding, Lori F

2018-01-13

Young children who experience high levels of preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Active and passive music therapy interventions addressing anxiety prior to invasive procedures have been met with success. The purpose of this study was to investigate the comparative effectiveness of two distraction-based music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers. A total of 40 pediatric patient and caregiver dyads undergoing ambulatory surgery were included in this study. Pediatric preoperative anxiety was measured pre- and post-intervention using the modified Yale Pediatric Anxiety Scale, while caregiver anxiety was measured through self-report using the short-form Strait-Trait Anxiety Inventory-Y6. Participants were randomized to either an active or passive intervention group for a preoperative music therapy session. Results indicated a significant reduction in preoperative anxiety for both patients and their caregivers regardless of intervention type. Neither active nor passive music therapy interventions were significantly more effective than the other. For future studies, the researchers recommend an increased sample size, controlling for various factors such as sedative premedication use, and testing interventions with patients in various stages of development. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Problem solving strategies integrated into nursing process to promote clinical problem solving abilities of RN-BSN students.

Science.gov (United States)

Wang, Jing-Jy; Lo, Chi-Hui Kao; Ku, Ya-Lie

2004-11-01

A set of problem solving strategies integrated into nursing process in nursing core courses (PSNP) was developed for students enrolled in a post-RN baccalaureate nursing program (RN-BSN) in a university in Taiwan. The purpose of this study, therefore, was to evaluate the effectiveness of PSNP on students' clinical problem solving abilities. The one-group post-test design with repeated measures was used. In total 114 nursing students with 47 full-time students and 67 part-time students participated in this study. The nursing core courses were undertaken separately in three semesters. After each semester's learning, students would start their clinical practice, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. The overall score of problem solving indicated that score on the post-test III was significantly better than that on post-test I and II, meaning both full-time and part-time students' clinical problem solving abilities improved at the last semester. In conclusion, problem-solving strategies integrated into nursing process designed for future RN-BSN students are recommendable.

Adherence to CPAP therapy: comparing the effect of three educational approaches in patients with obstructive sleep apnoea.

Science.gov (United States)

Delanote, Isabelle; Borzée, Pascal; Belge, Catharina; Buyse, Bertien; Testelmans, Dries

2018-01-01

Continuous positive airway pressure (CPAP)-therapy is the first-line treatment for moderate to severe obstructive sleep apnoea (OSA). A significant limitation of CPAP treatment is the poor therapy adherence, compromising the beneficial effects. This study evaluates three different educational approaches and their effect on therapy adherence. This single-center, retrospective study compared three groups of 100 consecutive, CPAP-naive patients with moderate to severe OSA who were started on CPAP therapy. Group 1 and 2 received the same individual structured education on two consecutive days with an extra phone call 7 to 10 days after CPAP start in group 2. Group 3 received individual structured education on the first day and participated in a group education using a slide presentation open for discussion on the second day. Re-evaluation was performed after 24 weeks. Baseline characteristics did not differ significantly between groups. During the 24 weeks follow-up there was a drop-out rate of 16% (group 1), 12% (group 2) and 5% (group 3). In the patients still on CPAP after 24 weeks, the mean nightly CPAP usage was, respectively, 4.7 ± 1.8, 5.2 ± 2.3 and 5.7 ± 2.1 h/night. In group 3 both the drop-out rate and mean CPAP usage were significantly different (P values, respectively, P CPAP adherence is an ongoing challenge. This study shows that a multi-modality approach, using a combination of individual and group education using a slide presentation open for discussion resulted in improved therapy adherence. © 2016 John Wiley & Sons Ltd.

Simon on Problem-Solving

DEFF Research Database (Denmark)

Foss, Kirsten; Foss, Nicolai Juul

as a general approach to problem solving. We apply these Simonian ideas to organizational issues, specifically new organizational forms. Specifically, Simonian ideas allow us to develop a morphology of new organizational forms and to point to some design problems that characterize these forms.Keywords: Herbert...... Simon, problem-solving, new organizational forms. JEL Code: D23, D83......Two of Herbert Simon's best-known papers are "The Architecture of Complexity" and "The Structure of Ill-Structured Problems." We discuss the neglected links between these two papers, highlighting the role of decomposition in the context of problems on which constraints have been imposed...

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

Science.gov (United States)

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

2017-02-01

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

Threshold Effects of Creative Problem-Solving Attributes on Creativity in the Math Abilities of Taiwanese Upper Elementary Students

OpenAIRE

Lin, Chia-Yi

2017-01-01

This study aimed to help determine what the typology of math creative problem-solving is. Different from studies that have discussed the threshold effect between creativity and intelligence, this research investigated the threshold effect between creativity and other attributes. The typology of the math creative problem-solving abilities of 409 fifth- and sixth-grade Taiwanese students was identified and compared in this study. A Creative Problem-Solving Attribute Instrument was devised for t...

[The application of new technologies to solving maths problems for students with learning disabilities: the 'underwater school'].

Science.gov (United States)

Miranda-Casas, A; Marco-Taverner, R; Soriano-Ferrer, M; Melià de Alba, A; Simó-Casañ, P

2008-01-01

Different procedures have demonstrated efficacy to teach cognitive and metacognitive strategies to problem solving in mathematics. Some studies have used computer-based problem solving instructional programs. To analyze in students with learning disabilities the efficacy of a cognitive strategies training for problem solving, with three instructional delivery formats: a teacher-directed program (T-D), a computer-assisted instructional (CAI) program, and a combined program (T-D + CAI). Forty-four children with mathematics learning disabilities, between 8 and 10 years old participated in this study. The children were randomly assigned to one of the three instructional formats and a control group without cognitive strategies training. In the three instructional conditions which were compared all the students learnt problems solving linguistic and visual cognitive strategies trough the self-instructional procedure. Several types of measurements were used for analysing the possible differential efficacy of the three instructional methods implemented: solving problems tests, marks in mathematics, internal achievement responsibility scale, and school behaviours teacher ratings. Our findings show that the T-D training group and the T-D + CAI group improved significantly on math word problem solving and on marks in Maths from pre- to post-testing. In addition, the results indicated that the students of the T-D + CAI group solved more real-life problems and developed more internal attributions compared to both control and CAI groups. Finally, with regard to school behaviours, improvements in school adjustment and learning problems were observed in the students of the group with a combined instructional format (T-D + CAI).

Volumetric Modulated Arc Therapy for Spine Radiosurgery: Superior Treatment Planning and Delivery Compared to Static Beam Intensity Modulated Radiotherapy.

Science.gov (United States)

Zach, Leor; Tsvang, Lev; Alezra, Dror; Ben Ayun, Maoz; Harel, Ran

2016-01-01

Spine stereotactic radiosurgery (SRS) delivers an accurate and efficient high radiation dose to vertebral metastases in 1-5 fractions. We aimed to compare volumetric modulated arc therapy (VMAT) to static beam intensity modulated radiotherapy (IMRT) for spine SRS. Ten spine lesions of previously treated SRS patients were planned retrospectively using both IMRT and VMAT with a prescribed dose of 16 Gy to 100% of the planning target volume (PTV). The plans were compared for conformity, homogeneity, treatment delivery time, and safety (spinal cord dose). All evaluated parameters favored the VMAT plan over the IMRT plans. D min in the IMRT was significantly lower than in the VMAT plan (7.65 Gy/10.88 Gy, p DSC) was found to be significantly better for the VMAT plans compared to the IMRT plans (0.77/0.58, resp., p  value < 0.01), and an almost 50% reduction in the net treatment time was calculated for the VMAT compared to the IMRT plans (6.73 min/12.96 min, p < 0.001). In our report, VMAT provides better conformity, homogeneity, and safety profile. The shorter treatment time is a major advantage and not only provides convenience to the painful patient but also contributes to the precision of this high dose radiation therapy.

Conceptual problem solving in high school physics

OpenAIRE

Jennifer L. Docktor; Natalie E. Strand; José P. Mestre; Brian H. Ross

2015-01-01

Problem solving is a critical element of learning physics. However, traditional instruction often emphasizes the quantitative aspects of problem solving such as equations and mathematical procedures rather than qualitative analysis for selecting appropriate concepts and principles. This study describes the development and evaluation of an instructional approach called Conceptual Problem Solving (CPS) which guides students to identify principles, justify their use, and plan their solution in w...

A Danish randomized trial comparing breast-preserving therapy with mastectomy in mammary carcinoma

International Nuclear Information System (INIS)

Blichert-Toft, M.; Brincker, H.; Andersen, J.A.; Andersen, K.W.; Axelsson, C.K.; Mouridsen, H.T.; Dombernowsky, P.; Overgaard, M.; Gadeberg, C.; Knudsen, G.; Borgeskov, S.; Bertelsen, S.; Knudsen, J.B.; Hansen, J.B.; Poulsen, P.E.; Willumsen, H.; Schousen, P.; Froberg, D.; Oernsholt, J.; Andersen, M.; Olesen, S.; Skovgaard, S.; Oester, M.; Schumacher, H.; Lynderup, E.K.; Holm, C.N.

1988-01-01

The present study comprises 847 women operated upon for invasive breast carcinoma at 19 surgical departments and enrolled in protocol DBCG-82TM from January 1983 to November 1987. Among them 662 (78%) were allocated for breast-preserving therapy or mastectomy by randomization, while 185 patients (22%) did not accept randomization. Within the randomized group 6% could not be entered into adjuvant protocols, i.e. subsequent programmes of postoperative therapy and follow-up. This left 619 evaluable patients. In the non-randomized series 26% did not fulfil the demands for entrance into the adjuvant protocols, leaving 136 evaluable patients, 60 of whom had chosen a breast-preserving operation and 76 mastectomy. In the randomized series the patients in the two treatment arms were comparable in age, menopausal status, site of tumour, pathoanatomical diameter of the tumour, number of removed axillary lymph nodes, number of metastatic axillary lymph nodes, and distribution on adjuvant regimens. Ninety per cent of the patients in the randomized group accepted the method offered, whereas 10% declined and wanted the alternate form of operation. The median follow-up period was approximately 1.75 years. The cumulative recurrence rate in the randomized group was 13% and in the non-randomized group 7%. These results are preliminary. Life-table analyses have not so far demonstrated differences in recurrence-free survival either in the randomized or the non-randomized series. (orig.)

Numerical analysis for the conjugate heat transfer of skin under various temperature conditions of contrast therapy

Energy Technology Data Exchange (ETDEWEB)

Park, Da Ae; Oh, Han Nah; Choi, Hyoung Gwon [Dept. of Mechanical and Automotive Engineering, Seoul National University of Science and Technology, Seoul (Korea, Republic of); Jeon, Byoung Jin; Kim, Eun Jeoung; Lee, Seung Deok [Yonsei University, Seoul (Korea, Republic of)

2015-11-15

In this paper, the contrast therapy of skin was numerically investigated by solving the conjugate heat transfer problem. A finite volume method based on the SIMPLE algorithm was adopted to solve the axisymmetric incompressible Navier-Stokes equations, coupled with an energy equation. These equations are strongly coupled with the Pennes bio-heat equation in order to consider the effect of blood perfusion rate. We investigated the thermal response of skin at some selected depths for various input temperature profiles of a stimulator for contrast therapy. From the numerical simulations, the regions with cold/hot threshold temperatures were found for five input temperature profiles. It was shown that the temperature varies mildly for different input profiles as the depth increases, owing to the Pennes effect. The input temperatures for effective hot/cold stimulation of dermis layer were found to be 47 degrees C and 7 degrees C, respectively. The present numerical results will be used for finding an optimal temperature profile of a stimulator for contrast therapy.

Verbal problem-solving difficulties in autism spectrum disorders and atypical language development.

Science.gov (United States)

Alderson-Day, Ben

2014-12-01

Children with autism spectrum disorders (ASDs) adopt less efficient strategies than typically developing (TD) peers on the Twenty Questions Task (TQT), a measure of verbal problem-solving skills. Although problems with the TQT are typically associated with executive dysfunction, they have also been reported in children who are deaf, suggesting a role for atypical language development. To test the contribution of language history to ASD problem solving, TQT performance was compared in children with high-functioning autism (HFA), children with Asperger syndrome (AS) and TD children. The HFA group used significantly less efficient strategies than both AS and TD children. No group differences were evident on tests of question understanding, planning or verbal fluency. Potential explanations for differences in verbal problem-solving skill are discussed with reference to the development of inner speech and use of visual strategies in ASD. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

Iterative Adaptive Dynamic Programming for Solving Unknown Nonlinear Zero-Sum Game Based on Online Data.

Science.gov (United States)

Zhu, Yuanheng; Zhao, Dongbin; Li, Xiangjun

2017-03-01

H ∞ control is a powerful method to solve the disturbance attenuation problems that occur in some control systems. The design of such controllers relies on solving the zero-sum game (ZSG). But in practical applications, the exact dynamics is mostly unknown. Identification of dynamics also produces errors that are detrimental to the control performance. To overcome this problem, an iterative adaptive dynamic programming algorithm is proposed in this paper to solve the continuous-time, unknown nonlinear ZSG with only online data. A model-free approach to the Hamilton-Jacobi-Isaacs equation is developed based on the policy iteration method. Control and disturbance policies and value are approximated by neural networks (NNs) under the critic-actor-disturber structure. The NN weights are solved by the least-squares method. According to the theoretical analysis, our algorithm is equivalent to a Gauss-Newton method solving an optimization problem, and it converges uniformly to the optimal solution. The online data can also be used repeatedly, which is highly efficient. Simulation results demonstrate its feasibility to solve the unknown nonlinear ZSG. When compared with other algorithms, it saves a significant amount of online measurement time.

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.

Intensity Modulated Proton Therapy Versus Intensity Modulated Photon Radiation Therapy for Oropharyngeal Cancer: First Comparative Results of Patient-Reported Outcomes

Energy Technology Data Exchange (ETDEWEB)

Sio, Terence T. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States); Lin, Huei-Kai; Shi, Qiuling [Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gunn, G. Brandon [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cleeland, Charles S. [Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lee, J. Jack; Hernandez, Mike [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Blanchard, Pierre; Thaker, Nikhil G.; Phan, Jack; Rosenthal, David I.; Garden, Adam S.; Morrison, William H.; Fuller, C. David [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mendoza, Tito R. [Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wang, Xin Shelley [Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Frank, Steven J., E-mail: sjfrank@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

2016-07-15

Purpose: We hypothesized that patients with oropharyngeal cancer treated with intensity modulated proton therapy (IMPT) would have lower symptom burdens, as measured by patient-reported outcome (PRO) surveys, than patients treated with intensity modulated photon therapy (IMRT). Methods and Materials: Patients were treated for oropharyngeal cancer from 2006 to 2015 through prospective registries with concurrent chemotherapy and IMPT or chemotherapy and IMRT and completed the MD Anderson Symptom Inventory for Head and Neck Cancer (MDASI-HN) module at various times before treatment (baseline), during treatment (acute phase), within the first 3 months after treatment (subacute phase), and afterward (chronic phase). Individual symptoms and the top 5 and top 11 most severe symptoms were summarized and compared between the radiation therapy modalities. Results: PRO data were collected and analyzed from 35 patients treated with chemotherapy and IMPT and from 46 treated with chemotherapy and IMRT. The baseline symptom burdens were similar between both groups. The overall top 5 symptoms were food taste problems (mean score 4.91 on a 0-10 scale), dry mouth (4.49), swallowing/chewing difficulties (4.26), lack of appetite (4.08), and fatigue (4.00). Among the top 11 symptoms, changes in taste and appetite during the subacute and chronic phases favored IMPT (all P<.048). No differences in symptom burden were detected between modalities during the acute and chronic phases by top-11 symptom scoring. During the subacute phase, the mean (±standard deviation) top 5 MDASI scores were 5.15 ± 2.66 for IMPT versus 6.58 ± 1.98 for IMRT (P=.013). Conclusions: According to the MDASI-HN, symptom burden was lower among the IMPT patients than among the IMRT patients during the subacute recovery phase after treatment. A prospective randomized clinical trial is underway to define the value of IMPT for the management of head and neck tumors.

Intensity Modulated Proton Therapy Versus Intensity Modulated Photon Radiation Therapy for Oropharyngeal Cancer: First Comparative Results of Patient-Reported Outcomes

International Nuclear Information System (INIS)

Sio, Terence T.; Lin, Huei-Kai; Shi, Qiuling; Gunn, G. Brandon; Cleeland, Charles S.; Lee, J. Jack; Hernandez, Mike; Blanchard, Pierre; Thaker, Nikhil G.; Phan, Jack; Rosenthal, David I.; Garden, Adam S.; Morrison, William H.; Fuller, C. David; Mendoza, Tito R.; Mohan, Radhe; Wang, Xin Shelley; Frank, Steven J.

2016-01-01

Purpose: We hypothesized that patients with oropharyngeal cancer treated with intensity modulated proton therapy (IMPT) would have lower symptom burdens, as measured by patient-reported outcome (PRO) surveys, than patients treated with intensity modulated photon therapy (IMRT). Methods and Materials: Patients were treated for oropharyngeal cancer from 2006 to 2015 through prospective registries with concurrent chemotherapy and IMPT or chemotherapy and IMRT and completed the MD Anderson Symptom Inventory for Head and Neck Cancer (MDASI-HN) module at various times before treatment (baseline), during treatment (acute phase), within the first 3 months after treatment (subacute phase), and afterward (chronic phase). Individual symptoms and the top 5 and top 11 most severe symptoms were summarized and compared between the radiation therapy modalities. Results: PRO data were collected and analyzed from 35 patients treated with chemotherapy and IMPT and from 46 treated with chemotherapy and IMRT. The baseline symptom burdens were similar between both groups. The overall top 5 symptoms were food taste problems (mean score 4.91 on a 0-10 scale), dry mouth (4.49), swallowing/chewing difficulties (4.26), lack of appetite (4.08), and fatigue (4.00). Among the top 11 symptoms, changes in taste and appetite during the subacute and chronic phases favored IMPT (all P<.048). No differences in symptom burden were detected between modalities during the acute and chronic phases by top-11 symptom scoring. During the subacute phase, the mean (±standard deviation) top 5 MDASI scores were 5.15 ± 2.66 for IMPT versus 6.58 ± 1.98 for IMRT (P=.013). Conclusions: According to the MDASI-HN, symptom burden was lower among the IMPT patients than among the IMRT patients during the subacute recovery phase after treatment. A prospective randomized clinical trial is underway to define the value of IMPT for the management of head and neck tumors.

Impact of ageing on problem size and proactive interference in arithmetic facts solving.

Science.gov (United States)

Archambeau, Kim; De Visscher, Alice; Noël, Marie-Pascale; Gevers, Wim

2018-02-01

Arithmetic facts (AFs) are required when solving problems such as "3 × 4" and refer to calculations for which the correct answer is retrieved from memory. Currently, two important effects that modulate the performance in AFs have been highlighted: the problem size effect and the proactive interference effect. The aim of this study is to investigate possible age-related changes of the problem size effect and the proactive interference effect in AF solving. To this end, the performance of young and older adults was compared in a multiplication production task. Furthermore, an independent measure of proactive interference was assessed to further define the architecture underlying this effect in multiplication solving. The results indicate that both young and older adults were sensitive to the effects of interference and of the problem size. That is, both interference and problem size affected performance negatively: the time needed to solve a multiplication problem increases as the level of interference and the size of the problem increase. Regarding the effect of ageing, the problem size effect remains constant with age, indicating a preserved AF network in older adults. Interestingly, sensitivity to proactive interference in multiplication solving was less pronounced in older than in younger adults suggesting that part of the proactive interference has been overcome with age.

Racing Sampling Based Microimmune Optimization Approach Solving Constrained Expected Value Programming

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Kai Yang

2016-01-01

Full Text Available This work investigates a bioinspired microimmune optimization algorithm to solve a general kind of single-objective nonlinear constrained expected value programming without any prior distribution. In the study of algorithm, two lower bound sample estimates of random variables are theoretically developed to estimate the empirical values of individuals. Two adaptive racing sampling schemes are designed to identify those competitive individuals in a given population, by which high-quality individuals can obtain large sampling size. An immune evolutionary mechanism, along with a local search approach, is constructed to evolve the current population. The comparative experiments have showed that the proposed algorithm can effectively solve higher-dimensional benchmark problems and is of potential for further applications.

Excess Mortality Associated With Colistin-Tigecycline Compared With Colistin-Carbapenem Combination Therapy for Extensively Drug-Resistant Acinetobacter baumannii Bacteremia: A Multicenter Prospective Observational Study.

Science.gov (United States)

Cheng, Aristine; Chuang, Yu-Chung; Sun, Hsin-Yun; Sheng, Wang-Huei; Yang, Chia-Jui; Liao, Chun-Hsing; Hsueh, Po-Ren; Yang, Jia-Ling; Shen, Ni-Jiin; Wang, Jann-Tay; Hung, Chien-Ching; Chen, Yee-Chun; Chang, Shan-Chwen

2015-06-01

Since few therapeutic options exist for extensively drug resistant Acinetobacter baumannii, an emerging threat in ICUs worldwide, and comparative prospective studies of colistin-based combination therapies are lacking, our objective was to compare the outcomes of patients with extensively drug-resistant A. baumannii bacteremia, treated with colistin-carbapenem and colistin-tigecycline combinations. Prospective, observational, multicenter study. Adults with extensively drug-resistant A. baumannii bacteremia were prospectively followed from 2010 to 2013 at three hospitals in Taiwan. Extensively drug-resistant A. baumannii was defined as A. baumannii (genospecies 2) nonsusceptible to all drug classes except for colistin and tigecycline, and standard combination therapy as use of parenteral colistin-carbapenem or colistin-tigecycline for at least 48 hours after onset of bacteremia. Primary outcome measure was 14-day mortality. Of the 176 episodes of extensively drug-resistant A. baumannii bacteremia evaluated, 55 patients with a median (interquartile range) age of 62 years (44-79 yr) and Sequential Organ Failure Assessment score of 9 (5-13) points received standard combination therapy: colistin-tigecycline in 29 patients and colistin-carbapenem in 26. Crude 14-day and in-hospital mortality rates for patients receiving colistin-tigecycline versus patients receiving colistin-carbapenem were 35% versus 15% (p=0.105) and 69% versus 50% (p=0.152), respectively. Breakthrough extensively drug-resistant A. baumannii bacteremia under steady state concentrations of combination therapy for colistin-tigecycline group was 18% and for colistin-carbapenem group was 0% (p=0.059). Eleven patients (20.0%) developed nephrotoxicity. After adjusting for age, sex, comorbidity, initial disease severity, loading colistin dose, polymicrobial infection, and primary infection site, excess 14-day mortality was associated with the use of colistin-tigecycline in the subgroup with tigecycline

Improving of Junior High School Visual Thinking Representation Ability in Mathematical Problem Solving by CTL

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Edy Surya

2013-01-01

Full Text Available The students’  difficulty which was found is in the problem of understanding, drawing diagrams, reading the charts correctly, conceptual formal  mathematical understanding, and  mathematical problem solving. The appropriate problem representation is the basic way in order to understand the problem itself and make a plan to solve it. This research was the experimental classroom design with a pretest-posttest control in order to increase the representation of visual thinking ability on mathematical problem solving approach  with  contextual learning. The research instrument was a test, observation and interviews. Contextual approach increases of mathematical representations ability increases in students with high initial category, medium, and low compared to conventional approaches. Keywords: Visual Thinking Representation, Mathematical  Problem Solving, Contextual Teaching Learning Approach DOI: http://dx.doi.org/10.22342/jme.4.1.568.113-126

Students' Errors in Solving the Permutation and Combination Problems Based on Problem Solving Steps of Polya

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Sukoriyanto; Nusantara, Toto; Subanji; Chandra, Tjang Daniel

2016-01-01

This article was written based on the results of a study evaluating students' errors in problem solving of permutation and combination in terms of problem solving steps according to Polya. Twenty-five students were asked to do four problems related to permutation and combination. The research results showed that the students still did a mistake in…

Comparative effectiveness of cognitive therapies delivered face-to-face or over the telephone: an observational study using propensity methods.

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Geoffrey C Hammond

Full Text Available To compare the clinical and cost-effectiveness of face-to-face (FTF with over-the-telephone (OTT delivery of low intensity cognitive behavioural therapy.Observational study following SROBE guidelines. Selection effects were controlled using propensity scores. Non-inferiority comparisons assessed effectiveness.IAPT (improving access to psychological therapies services in the East of England.39,227 adults referred to IAPT services. Propensity score strata included 4,106 individuals; 147 pairs participated in 1:1 matching.Two or more sessions of computerised cognitive behavioural therapy (CBT.Patient-reported outcomes: Patient Health Questionnaire (PHQ-9 for depression; Generalised Anxiety Disorder questionnaire (GAD-7; Work and Social Adjustment Scale (WSAS. Differences between groups were summarised as standardised effect sizes (ES, adjusted mean differences and minimally important difference for PHQ-9. Cost per session for OTT was compared with FTF.Analysis of covariance controlling for number of assessments, provider site, and baseline PHQ-9, GAD-7 and WSAS indicated statistically significantly greater reductions in scores for OTT treatment with moderate (PHQ-9: ES: 0.14; GAD-7: ES: 0.10 or small (WSAS: ES: 0.03 effect sizes. Non-inferiority in favour of OTT treatment for symptom severity persisted as small to moderate effects for all but individuals with the highest symptom severity. In the most stringent comparison, the one-to-one propensity matching, adjusted mean differences in treatment outcomes indicated non-inferiority between OTT versus FTF treatments for PHQ-9 and GAD-7, whereas the evidence was moderate for WSAS. The per-session cost for OTT was 36.2% lower than FTF.The clinical effectiveness of low intensity CBT-based interventions delivered OTT was not inferior to those delivered FTF except for people with more severe illness where FTF was superior. This provides evidence for better targeting of therapy, efficiencies for patients

Affect and mathematical problem solving a new perspective

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Adams, Verna

1989-01-01

Research on cognitive aspects of mathematical problem solving has made great progress in recent years, but the relationship of affective factors to problem-solving performance has been a neglected research area. The purpose of Affect and Mathematical Problem Solving: A New Perspective is to show how the theories and methods of cognitive science can be extended to include the role of affect in mathematical problem solving. The book presents Mandler's theory of emotion and explores its implications for the learning and teaching of mathematical problem solving. Also, leading researchers from mathematics, education, and psychology report how they have integrated affect into their own cognitive research. The studies focus on metacognitive processes, aesthetic influences on expert problem solvers, teacher decision-making, technology and teaching problem solving, and beliefs about mathematics. The results suggest how emotional factors like anxiety, frustration, joy, and satisfaction can help or hinder performance in...

The impact of perceived self-efficacy on mental time travel and social problem solving.

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Brown, Adam D; Dorfman, Michelle L; Marmar, Charles R; Bryant, Richard A

2012-03-01

Current models of autobiographical memory suggest that self-identity guides autobiographical memory retrieval. Further, the capacity to recall the past and imagine one's self in the future (mental time travel) can influence social problem solving. We examined whether manipulating self-identity, through an induction task in which students were led to believe they possessed high or low self-efficacy, impacted episodic specificity and content of retrieved and imagined events, as well as social problem solving. Compared to individuals in the low self efficacy group, individuals in the high self efficacy group generated past and future events with greater (a) specificity, (b) positive words, and (c) self-efficacious statements, and also performed better on social problem solving indices. A lack of episodic detail for future events predicted poorer performance on social problem solving tasks. Strategies that increase perceived self-efficacy may help individuals to selectively construct a past and future that aids in negotiating social problems. Copyright © 2011 Elsevier Inc. All rights reserved.

Intelligence-Augmented Rat Cyborgs in Maze Solving.

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Yipeng Yu

Full Text Available Cyborg intelligence is an emerging kind of intelligence paradigm. It aims to deeply integrate machine intelligence with biological intelligence by connecting machines and living beings via neural interfaces, enhancing strength by combining the biological cognition capability with the machine computational capability. Cyborg intelligence is considered to be a new way to augment living beings with machine intelligence. In this paper, we build rat cyborgs to demonstrate how they can expedite the maze escape task with integration of machine intelligence. We compare the performance of maze solving by computer, by individual rats, and by computer-aided rats (i.e. rat cyborgs. They were asked to find their way from a constant entrance to a constant exit in fourteen diverse mazes. Performance of maze solving was measured by steps, coverage rates, and time spent. The experimental results with six rats and their intelligence-augmented rat cyborgs show that rat cyborgs have the best performance in escaping from mazes. These results provide a proof-of-principle demonstration for cyborg intelligence. In addition, our novel cyborg intelligent system (rat cyborg has great potential in various applications, such as search and rescue in complex terrains.

Intelligence-Augmented Rat Cyborgs in Maze Solving.

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Yu, Yipeng; Pan, Gang; Gong, Yongyue; Xu, Kedi; Zheng, Nenggan; Hua, Weidong; Zheng, Xiaoxiang; Wu, Zhaohui

2016-01-01

Cyborg intelligence is an emerging kind of intelligence paradigm. It aims to deeply integrate machine intelligence with biological intelligence by connecting machines and living beings via neural interfaces, enhancing strength by combining the biological cognition capability with the machine computational capability. Cyborg intelligence is considered to be a new way to augment living beings with machine intelligence. In this paper, we build rat cyborgs to demonstrate how they can expedite the maze escape task with integration of machine intelligence. We compare the performance of maze solving by computer, by individual rats, and by computer-aided rats (i.e. rat cyborgs). They were asked to find their way from a constant entrance to a constant exit in fourteen diverse mazes. Performance of maze solving was measured by steps, coverage rates, and time spent. The experimental results with six rats and their intelligence-augmented rat cyborgs show that rat cyborgs have the best performance in escaping from mazes. These results provide a proof-of-principle demonstration for cyborg intelligence. In addition, our novel cyborg intelligent system (rat cyborg) has great potential in various applications, such as search and rescue in complex terrains.

Metacognition: Student Reflections on Problem Solving

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Wismath, Shelly; Orr, Doug; Good, Brandon

2014-01-01

Twenty-first century teaching and learning focus on the fundamental skills of critical thinking and problem solving, creativity and innovation, and collaboration and communication. Metacognition is a crucial aspect of both problem solving and critical thinking, but it is often difficult to get students to engage in authentic metacognitive…

Problem Solving Methods in Engineering Design

DEFF Research Database (Denmark)

Hartvig, Susanne C

1999-01-01

This short paper discusses typical engineering tasks and problem solving methods, based on a field study of engineering tasks at a Danish engineering firm. The field study has identified ten classes of design tasks and in this paper these classes are related to problem solving methods. The descri...

A literature review of expert problem solving using analogy

OpenAIRE

Mair, C; Martincova, M; Shepperd, MJ

2009-01-01

We consider software project cost estimation from a problem solving perspective. Taking a cognitive psychological approach, we argue that the algorithmic basis for CBR tools is not representative of human problem solving and this mismatch could account for inconsistent results. We describe the fundamentals of problem solving, focusing on experts solving ill-defined problems. This is supplemented by a systematic literature review of empirical studies of expert problem solving of non-trivial pr...

Comments on new iterative methods for solving linear systems

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Wang Ke

2017-06-01

Full Text Available Some new iterative methods were presented by Du, Zheng and Wang for solving linear systems in [3], where it is shown that the new methods, comparing to the classical Jacobi or Gauss-Seidel method, can be applied to more systems and have faster convergence. This note shows that their methods are suitable for more matrices than positive matrices which the authors suggested through further analysis and numerical examples.

New numerical method for solving the solute transport equation

International Nuclear Information System (INIS)

Ross, B.; Koplik, C.M.

1978-01-01

The solute transport equation can be solved numerically by approximating the water flow field by a network of stream tubes and using a Green's function solution within each stream tube. Compared to previous methods, this approach permits greater computational efficiency and easier representation of small discontinuities, and the results are easier to interpret physically. The method has been used to study hypothetical sites for disposal of high-level radioactive waste

Improve Problem Solving Skills through Adapting Programming Tools

Science.gov (United States)

Shaykhian, Linda H.; Shaykhian, Gholam Ali

2007-01-01

There are numerous ways for engineers and students to become better problem-solvers. The use of command line and visual programming tools can help to model a problem and formulate a solution through visualization. The analysis of problem attributes and constraints provide insight into the scope and complexity of the problem. The visualization aspect of the problem-solving approach tends to make students and engineers more systematic in their thought process and help them catch errors before proceeding too far in the wrong direction. The problem-solver identifies and defines important terms, variables, rules, and procedures required for solving a problem. Every step required to construct the problem solution can be defined in program commands that produce intermediate output. This paper advocates improved problem solving skills through using a programming tool. MatLab created by MathWorks, is an interactive numerical computing environment and programming language. It is a matrix-based system that easily lends itself to matrix manipulation, and plotting of functions and data. MatLab can be used as an interactive command line or a sequence of commands that can be saved in a file as a script or named functions. Prior programming experience is not required to use MatLab commands. The GNU Octave, part of the GNU project, a free computer program for performing numerical computations, is comparable to MatLab. MatLab visual and command programming are presented here.

A Meshfree Quasi-Interpolation Method for Solving Burgers’ Equation

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Mingzhu Li

2014-01-01

Full Text Available The main aim of this work is to consider a meshfree algorithm for solving Burgers’ equation with the quartic B-spline quasi-interpolation. Quasi-interpolation is very useful in the study of approximation theory and its applications, since it can yield solutions directly without the need to solve any linear system of equations and overcome the ill-conditioning problem resulting from using the B-spline as a global interpolant. The numerical scheme is presented, by using the derivative of the quasi-interpolation to approximate the spatial derivative of the dependent variable and a low order forward difference to approximate the time derivative of the dependent variable. Compared to other numerical methods, the main advantages of our scheme are higher accuracy and lower computational complexity. Meanwhile, the algorithm is very simple and easy to implement and the numerical experiments show that it is feasible and valid.

Comparison of Problem Solving from Engineering Design to Software Design

DEFF Research Database (Denmark)

Ahmed-Kristensen, Saeema; Babar, Muhammad Ali

2012-01-01

Observational studies of engineering design activities can inform the research community on the problem solving models that are employed by professional engineers. Design is defined as an ill-defined problem which includes both engineering design and software design, hence understanding problem...... solving models from other design domains is of interest to the engineering design community. For this paper an observational study of two software design sessions performed for the workshop on “Studying professional Software Design” is compared to analysis from engineering design. These findings provide...... useful insights of how software designers move from a problem domain to a solution domain and the commonalities between software designers’ and engineering designers’ design activities. The software designers were found to move quickly to a detailed design phase, employ co-.evolution and adopt...

Comparison of Problem Solving from Engineering Design to Software Design

DEFF Research Database (Denmark)

Ahmed-Kristensen, Saeema; Babar, Muhammad Ali

2012-01-01

solving models from other design domains is of interest to the engineering design community. For this paper an observational study of two software design sessions performed for the workshop on “Studying professional Software Design” is compared to analysis from engineering design. These findings provide......Observational studies of engineering design activities can inform the research community on the problem solving models that are employed by professional engineers. Design is defined as an ill-defined problem which includes both engineering design and software design, hence understanding problem...... useful insights of how software designers move from a problem domain to a solution domain and the commonalities between software designers’ and engineering designers’ design activities. The software designers were found to move quickly to a detailed design phase, employ co-.evolution and adopt...

Derivative free Davidon-Fletcher-Powell (DFP) for solving symmetric systems of nonlinear equations

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Mamat, M.; Dauda, M. K.; Mohamed, M. A. bin; Waziri, M. Y.; Mohamad, F. S.; Abdullah, H.

2018-03-01

Research from the work of engineers, economist, modelling, industry, computing, and scientist are mostly nonlinear equations in nature. Numerical solution to such systems is widely applied in those areas of mathematics. Over the years, there has been significant theoretical study to develop methods for solving such systems, despite these efforts, unfortunately the methods developed do have deficiency. In a contribution to solve systems of the form F(x) = 0, x ∈ Rn , a derivative free method via the classical Davidon-Fletcher-Powell (DFP) update is presented. This is achieved by simply approximating the inverse Hessian matrix with {Q}k+1-1 to θkI. The modified method satisfied the descent condition and possess local superlinear convergence properties. Interestingly, without computing any derivative, the proposed method never fail to converge throughout the numerical experiments. The output is based on number of iterations and CPU time, different initial starting points were used on a solve 40 benchmark test problems. With the aid of the squared norm merit function and derivative-free line search technique, the approach yield a method of solving symmetric systems of nonlinear equations that is capable of significantly reducing the CPU time and number of iteration, as compared to its counterparts. A comparison between the proposed method and classical DFP update were made and found that the proposed methodis the top performer and outperformed the existing method in almost all the cases. In terms of number of iterations, out of the 40 problems solved, the proposed method solved 38 successfully, (95%) while classical DFP solved 2 problems (i.e. 05%). In terms of CPU time, the proposed method solved 29 out of the 40 problems given, (i.e.72.5%) successfully whereas classical DFP solves 11 (27.5%). The method is valid in terms of derivation, reliable in terms of number of iterations and accurate in terms of CPU time. Thus, suitable and achived the objective.

Contextualized teaching on the problem solving performance of students

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Rolando V. Obiedo

2017-12-01

Full Text Available This study investigated the effect of contextualized teaching on students’ problem solving skills in physics through a quasi-experimental approach. Problem solving performance of students was described quantitatively through their mean problem solving scores and problem solving skills level. A unit plan patterned from the cognitive apprenticeship approach and contextualized using maritime context of ship stability was implemented on the experimental group while the control group had the conventional lecture method. Pre and post assessment, which is a researcher-developed word problem assessment, was administered to both groups. Results indicated increased problem solving mean scores (p < 0.001, problem solving skill level (p < 0.001 of the experimental group while the control group increased only their problem solving skill level (p = 0.008. Thus, contextualized teaching can improve the problem solving performance of students. This study recommends using contextualization using other physics topics where other contexts can be applied.

Social problem-solving among adolescents treated for depression.

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Becker-Weidman, Emily G; Jacobs, Rachel H; Reinecke, Mark A; Silva, Susan G; March, John S

2010-01-01

Studies suggest that deficits in social problem-solving may be associated with increased risk of depression and suicidality in children and adolescents. It is unclear, however, which specific dimensions of social problem-solving are related to depression and suicidality among youth. Moreover, rational problem-solving strategies and problem-solving motivation may moderate or predict change in depression and suicidality among children and adolescents receiving treatment. The effect of social problem-solving on acute treatment outcomes were explored in a randomized controlled trial of 439 clinically depressed adolescents enrolled in the Treatment for Adolescents with Depression Study (TADS). Measures included the Children's Depression Rating Scale-Revised (CDRS-R), the Suicidal Ideation Questionnaire--Grades 7-9 (SIQ-Jr), and the Social Problem-Solving Inventory-Revised (SPSI-R). A random coefficients regression model was conducted to examine main and interaction effects of treatment and SPSI-R subscale scores on outcomes during the 12-week acute treatment stage. Negative problem orientation, positive problem orientation, and avoidant problem-solving style were non-specific predictors of depression severity. In terms of suicidality, avoidant problem-solving style and impulsiveness/carelessness style were predictors, whereas negative problem orientation and positive problem orientation were moderators of treatment outcome. Implications of these findings, limitations, and directions for future research are discussed. Copyright 2009 Elsevier Ltd. All rights reserved.

Does Solving Insight-Based Problems Differ from Solving Learning-Based Problems? Some Evidence from an ERP Study

Science.gov (United States)

Leikin, Roza; Waisman, Ilana; Leikin, Mark

2016-01-01

We asked: "What are the similarities and differences in mathematical processing associated with solving learning-based and insight-based problems?" To answer this question, the ERP research procedure was employed with 69 male adolescent subjects who solved specially designed insight-based and learning-based tests. Solutions of…

Long-term survival benefit of revascularization compared with medical therapy in patients with coronary chronic total occlusion and well-developed collateral circulation.

Science.gov (United States)

Jang, Woo Jin; Yang, Jeong Hoon; Choi, Seung-Hyuk; Song, Young Bin; Hahn, Joo-Yong; Choi, Jin-Ho; Kim, Wook Sung; Lee, Young Tak; Gwon, Hyeon-Cheol

2015-02-01

The purpose of this study was to compare the long-term clinical outcomes of patients with chronic total occlusion (CTO) and well-developed collateral circulation treated with revascularization versus medical therapy. Little is known about the clinical outcomes and optimal treatment strategies of CTO with well-developed collateral circulation. We screened 2,024 consecutive patients with at least 1 CTO detected on coronary angiogram. Of these, we analyzed data from 738 patients with Rentrop 3 grade collateral circulation who were treated with medical therapy alone (n = 236), coronary artery bypass grafting (n = 170) or percutaneous coronary intervention (n = 332; 80.1% successful). Patients who underwent revascularization and medical therapy (revascularization group, n = 502) were compared with those who underwent medical therapy alone (medication group, n = 236) in terms of cardiac death and major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction, and repeat revascularization. During a median follow-up duration of 42 months, multivariate analysis revealed a significantly lower incidence of cardiac death (hazard ratio [HR]: 0.29; 95% confidence interval [CI]: 0.15 to 0.58; p collateral circulation, aggressive revascularization may reduce the risk of cardiac mortality and MACE. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

How do they solve it? An insight into the learner’s approach to the mechanism of physics problem solving

OpenAIRE

Balasubrahmanya Hegde; B. N. Meera

2012-01-01

A perceived difficulty is associated with physics problem solving from a learner’s viewpoint, arising out of a multitude of reasons. In this paper, we have examined the microstructure of students’ thought processes during physics problem solving by combining the analysis of responses to multiple-choice questions and semistructured student interviews. Design of appropriate scaffoldings serves as pointers to the identification of student problem solving difficulties. An analysis of the results ...

Worry in Children: Changing Associations with Fear, Thinking, and Problem-Solving

Science.gov (United States)

Carr, Imogen; Szabó, Marianna

2015-01-01

Worry in adults has been conceptualized as a thinking process involving problem-solving attempts about anticipated negative outcomes. This process is related to, though distinct from, fear. Previous research suggested that compared to adults, children's experience of worry is less strongly associated with thinking and more closely related to fear.…

Job-Related Stress in Forensic Interviewers of Children with Use of Therapy Dogs Compared with Facility Dogs or No Dogs

Science.gov (United States)

Walsh, Diane; Yamamoto, Mariko; Willits, Neil H.; Hart, Lynette A.

2018-01-01

Sexually abused children providing essential testimony regarding crimes in forensic interviews now sometimes are provided facility dogs or therapy dogs for comfort. Facility dogs are extensively trained to work with forensic interviewers; when using therapy dogs in interviews, volunteers are the dog handlers. Interviews can impact child welfare workers’ mental health causing secondary traumatic stress (STS). To investigate this stress, first data were gathered on stress retrospectively for when interviewers initially started the job prior to working with a dog, and then currently, from forensic interviewers using a facility dog, a therapy or pet dog, or no dog. These retrospective and secondary traumatic stress scale (STSS) data compared job stress among interviewers of children using: a certified, workplace facility dog (n = 16), a volunteer’s trained therapy dog or the interviewer’s pet dog (n = 13/3), or no dog (n = 198). Retrospective scores of therapy dog and no dog interviewers’ stress were highest for the first interviewing year 1 and then declined. Extremely or very stressful retrospective scores differed among the three groups in year 1 (p pet dog users; both groups favored using dogs. Interviewers currently working with therapy dogs accompanied by their volunteers reported they had experienced heightened stress when they began their jobs; their high stress levels still persisted, indicating lower inherent coping skills and perhaps greater empathy among interviewers who later self-selected to work with therapy dogs. Results reveal extreme avoidant stress for interviewers witnessing children who are suffering and their differing coping approaches. PMID:29594160

The Missing Curriculum in Physics Problem-Solving Education

Science.gov (United States)

Williams, Mobolaji

2018-05-01

Physics is often seen as an excellent introduction to science because it allows students to learn not only the laws governing the world around them, but also, through the problems students solve, a way of thinking which is conducive to solving problems outside of physics and even outside of science. In this article, we contest this latter idea and argue that in physics classes, students do not learn widely applicable problem-solving skills because physics education almost exclusively requires students to solve well-defined problems rather than the less-defined problems which better model problem solving outside of a formal class. Using personal, constructed, and the historical accounts of Schrödinger's development of the wave equation and Feynman's development of path integrals, we argue that what is missing in problem-solving education is practice in identifying gaps in knowledge and in framing these knowledge gaps as questions of the kind answerable using techniques students have learned. We discuss why these elements are typically not taught as part of the problem-solving curriculum and end with suggestions on how to incorporate these missing elements into physics classes.

ACTIVE AND PARTICIPATORY METHODS IN BIOLOGY: PROBLEM-SOLVING

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Adela NEMEŞ

2010-01-01

Full Text Available We face with considerable challenge of developing students’ problem solving skills in our difficult environment. Good problem solving skills empower managers in their professional and personal lives. Problem solving skills are valued by academics and employers. The informations in Biology are often presented in abstract forms without contextualisation. Creative problem-solving process involves a few steps, which together provide a structured procedure for identifying challenges, generating ideas and implementing innovative solutions: identifying the problem, searching for possible solutions, selecting the most optimal solution and implementing a possible solution. Each aspect of personality has a different orientation to problem solving, different criteria for judging the effectiveness of the process and different associated strengths. Using real-world data in sample problems will also help facilitate the transfer process, since students can more easily identify with the context of a given situation. The paper describes the use of the Problem-Solving in Biology and the method of its administration. It also presents the results of a study undertaken to evaluate the value in teaching Biology. Problem-solving is seen as an essential skill that is developed in biology education.

Parallel Algorithm Solves Coupled Differential Equations

Science.gov (United States)

Hayashi, A.

1987-01-01

Numerical methods adapted to concurrent processing. Algorithm solves set of coupled partial differential equations by numerical integration. Adapted to run on hypercube computer, algorithm separates problem into smaller problems solved concurrently. Increase in computing speed with concurrent processing over that achievable with conventional sequential processing appreciable, especially for large problems.

Creativity and Insight in Problem Solving

Science.gov (United States)

Golnabi, Laura

2016-01-01

This paper analyzes the thought process involved in problem solving and its categorization as creative thinking as defined by psychologist R. Weisberg (2006). Additionally, the notion of insight, sometimes present in unconscious creative thinking and often leading to creative ideas, is discussed in the context of geometry problem solving. In…

The Process of Solving Complex Problems

Science.gov (United States)

Fischer, Andreas; Greiff, Samuel; Funke, Joachim

2012-01-01

This article is about Complex Problem Solving (CPS), its history in a variety of research domains (e.g., human problem solving, expertise, decision making, and intelligence), a formal definition and a process theory of CPS applicable to the interdisciplinary field. CPS is portrayed as (a) knowledge acquisition and (b) knowledge application…

Mathematical problem solving in primary school

NARCIS (Netherlands)

Kolovou, A.

2011-01-01

A student is engaged in (non-routine) problem solving when there is no clear pathway to the solution. In contrast to routine problems, non-routine ones cannot be solved through the direct application of a standard procedure. Consider the following problem: In a quiz you get two points for each

A comprehensive formulation for volumetric modulated arc therapy planning

Energy Technology Data Exchange (ETDEWEB)

Nguyen, Dan; Lyu, Qihui; Ruan, Dan; O’Connor, Daniel; Low, Daniel A.; Sheng, Ke, E-mail: ksheng@mednet.ucla.edu [Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California 90024 (United States)

2016-07-15

Purpose: Volumetric modulated arc therapy (VMAT) is a widely employed radiation therapy technique, showing comparable dosimetry to static beam intensity modulated radiation therapy (IMRT) with reduced monitor units and treatment time. However, the current VMAT optimization has various greedy heuristics employed for an empirical solution, which jeopardizes plan consistency and quality. The authors introduce a novel direct aperture optimization method for VMAT to overcome these limitations. Methods: The comprehensive VMAT (comVMAT) planning was formulated as an optimization problem with an L2-norm fidelity term to penalize the difference between the optimized dose and the prescribed dose, as well as an anisotropic total variation term to promote piecewise continuity in the fluence maps, preparing it for direct aperture optimization. A level set function was used to describe the aperture shapes and the difference between aperture shapes at adjacent angles was penalized to control MLC motion range. A proximal-class optimization solver was adopted to solve the large scale optimization problem, and an alternating optimization strategy was implemented to solve the fluence intensity and aperture shapes simultaneously. Single arc comVMAT plans, utilizing 180 beams with 2° angular resolution, were generated for a glioblastoma multiforme case, a lung (LNG) case, and two head and neck cases—one with three PTVs (H&N{sub 3PTV}) and one with foue PTVs (H&N{sub 4PTV})—to test the efficacy. The plans were optimized using an alternating optimization strategy. The plans were compared against the clinical VMAT (clnVMAT) plans utilizing two overlapping coplanar arcs for treatment. Results: The optimization of the comVMAT plans had converged within 600 iterations of the block minimization algorithm. comVMAT plans were able to consistently reduce the dose to all organs-at-risk (OARs) as compared to the clnVMAT plans. On average, comVMAT plans reduced the max and mean OAR dose by 6

Hybrid subgroup decomposition method for solving fine-group eigenvalue transport problems

International Nuclear Information System (INIS)

Yasseri, Saam; Rahnema, Farzad

2014-01-01

Highlights: • An acceleration technique for solving fine-group eigenvalue transport problems. • Coarse-group quasi transport theory to solve coarse-group eigenvalue transport problems. • Consistent and inconsistent formulations for coarse-group quasi transport theory. • Computational efficiency amplified by a factor of 2 using hybrid SGD for 1D BWR problem. - Abstract: In this paper, a new hybrid method for solving fine-group eigenvalue transport problems is developed. This method extends the subgroup decomposition method to efficiently couple a new coarse-group quasi transport theory with a set of fixed-source transport decomposition sweeps to obtain the fine-group transport solution. The advantages of the quasi transport theory are its high accuracy, straight-forward implementation and numerical stability. The hybrid method is analyzed for a 1D benchmark problem characteristic of boiling water reactors (BWR). It is shown that the method reproduces the fine-group transport solution with high accuracy while increasing the computational efficiency up to 12 times compared to direct fine-group transport calculations

Solving the Container Stowage Problem (CSP) using Particle Swarm Optimization (PSO)

Science.gov (United States)

Matsaini; Santosa, Budi

2018-04-01

Container Stowage Problem (CSP) is a problem of containers arrangement into ships by considering rules such as: total weight, weight of one stack, destination, equilibrium, and placement of containers on vessel. Container stowage problem is combinatorial problem and hard to solve with enumeration technique. It is an NP-Hard Problem. Therefore, to find a solution, metaheuristics is preferred. The objective of solving the problem is to minimize the amount of shifting such that the unloading time is minimized. Particle Swarm Optimization (PSO) is proposed to solve the problem. The implementation of PSO is combined with some steps which are stack position change rules, stack changes based on destination, and stack changes based on the weight type of the stacks (light, medium, and heavy). The proposed method was applied on five different cases. The results were compared to Bee Swarm Optimization (BSO) and heuristics method. PSO provided mean of 0.87% gap and time gap of 60 second. While BSO provided mean of 2,98% gap and 459,6 second to the heuristcs.

Anticipating students' reasoning and planning prompts in structured problem-solving lessons

Science.gov (United States)

Vale, Colleen; Widjaja, Wanty; Doig, Brian; Groves, Susie

2018-02-01

Structured problem-solving lessons are used to explore mathematical concepts such as pattern and relationships in early algebra, and regularly used in Japanese Lesson Study research lessons. However, enactment of structured problem-solving lessons which involves detailed planning, anticipation of student solutions and orchestration of whole-class discussion of solutions is an ongoing challenge for many teachers. Moreover, primary teachers have limited experience in teaching early algebra or mathematical reasoning actions such as generalising. In this study, the critical factors of enacting the structured problem-solving lessons used in Japanese Lesson Study to elicit and develop primary students' capacity to generalise are explored. Teachers from three primary schools participated in two Japanese Lesson Study teams for this study. The lesson plans and video recordings of teaching and post-lesson discussion of the two research lessons along with students' responses and learning are compared to identify critical factors. The anticipation of students' reasoning together with preparation of supporting and challenging prompts was critical for scaffolding students' capacity to grasp and communicate generality.

Assignment refusal and its relation to outcome in a randomized controlled trial comparing Cognitive Therapy and Fluvoxamine in treatment-resistant patients with obsessive compulsive disorder

NARCIS (Netherlands)

Landsheer, Johannes A.; Smit, Johannes H.; van Oppen, Patricia; van Balkom, Anton J L M

2015-01-01

The effectiveness of Fluvoxamine was compared to that of Cognitive Therapy (CT) in a 12-week randomized controlled trial (RCT) in 48 patients with obsessive-compulsive disorder (OCD), who were treatment-resistant to a previous behavior therapy (BT). A considerable amount of patients did not comply

Current Experimental Studies of Gene Therapy in Parkinson's Disease

Directory of Open Access Journals (Sweden)

Jing-ya Lin

2017-05-01

Full Text Available Parkinson's disease (PD was characterized by late-onset, progressive dopamine neuron loss and movement disorders. The progresses of PD affected the neural function and integrity. To date, most researches had largely addressed the dopamine replacement therapies, but the appearance of L-dopa-induced dyskinesia hampered the use of the drug. And the mechanism of PD is so complicated that it's hard to solve the problem by just add drugs. Researchers began to focus on the genetic underpinnings of Parkinson's disease, searching for new method that may affect the neurodegeneration processes in it. In this paper, we reviewed current delivery methods used in gene therapies for PD, we also summarized the primary target of the gene therapy in the treatment of PD, such like neurotrophic factor (for regeneration, the synthesis of neurotransmitter (for prolong the duration of L-dopa, and the potential proteins that might be a target to modulate via gene therapy. Finally, we discussed RNA interference therapies used in Parkinson's disease, it might act as a new class of drug. We mainly focus on the efficiency and tooling features of different gene therapies in the treatment of PD.

Some Applications of Algebraic System Solving

Science.gov (United States)

Roanes-Lozano, Eugenio

2011-01-01

Technology and, in particular, computer algebra systems, allows us to change both the way we teach mathematics and the mathematical curriculum. Curiously enough, unlike what happens with linear system solving, algebraic system solving is not widely known. The aim of this paper is to show that, although the theory lying behind the "exact…

Solving applied mathematical problems with Matlab

CERN Document Server

Xue, Dingyu

2008-01-01

Computer Mathematics Language-An Overview. Fundamentals of MATLAB Programming. Calculus Problems. MATLAB Computations of Linear Algebra Problems. Integral Transforms and Complex Variable Functions. Solutions to Nonlinear Equations and Optimization Problems. MATLAB Solutions to Differential Equation Problems. Solving Interpolations and Approximations Problems. Solving Probability and Mathematical Statistics Problems. Nontraditional Solution Methods for Mathematical Problems.

Using Systemic Problem Solving (SPS) to Assess Student ...

African Journals Online (AJOL)

This paper focuses on the uses of systemic problem solving in chemistry at the tertiary level. Traditional problem solving (TPS) is a useful tool to help teachers examine recall of information, comprehension, and application. However, systemic problem solving (SPS) can challenge students and probe higher cognitive skills ...

Matrimonial therapy as a mean of assistance to the institution of family within modern conditions

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Staniszewska Alisandra

2017-07-01

Full Text Available The article discusses the value of matrimonial therapy in the context of domestic conflicts and in prevention of the mass disintegration of marriages. The author describes the basic methods of psychological assistance to spouses and analyzes the core principles of the therapist’s work with married couples. The main task of the work is to underline the value of matrimonial therapy in solving the problems between married couples. The implementation and the spreading of matrimonial therapy may have positive influence on the family in modern environment.

GPs' use of problem solving therapy for depression: a qualitative study of barriers to and enablers of evidence based care

Directory of Open Access Journals (Sweden)

Gunn Jane

2007-04-01

Full Text Available Abstract Background Depression is a major health concern, predominantly treated by general practitioners (GPs. Problem solving therapy (PST is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. Method Qualitative methodology was used including individual and focus group interviews of GPs, PST experts and consumers. Analysis was undertaken using the Theory of Planned Behaviour (TPB as a framework. Results A spectrum of potential influences, on GPs' use of PST emerged. Both barriers and enablers were identified. PST was perceived as being close to current practice approaches and potentially beneficial to both doctor and patient. In addition to a broadly positive attitude to PST, expressed by those with previous experience of its use, potential solutions to perceived barriers emerged. By contrast some GPs expressed fear that the use of PST would result in loss of doctor control of consultations and associated potential adverse patient outcomes. Patient expectations, which emerged as not always coinciding with GPs' perception of those expectations, were identified as a potential influence on GPs' decision concerning adoption of PST. In addition specific factors, including GP skill and confidence, consultation time constraints and technical issues related to PST were noted as potential concerns. Conclusion This research contributes to our knowledge of the factors that may influence GPs' decisions regarding use of PST as a treatment for depression. It recognises both barriers and enablers. It suggests that for many GPs, PST is viewed in a positive light, providing encouragement to those seeking to increase the provision of PST by GPs. In identifying a number of potential barriers, along with associated options to address many of these barriers, it provides insights which may assist in the planning of GP training in PST.

A new modified conjugate gradient coefficient for solving system of linear equations

Science.gov (United States)

Hajar, N.; ‘Aini, N.; Shapiee, N.; Abidin, Z. Z.; Khadijah, W.; Rivaie, M.; Mamat, M.

2017-09-01

Conjugate gradient (CG) method is an evolution of computational method in solving unconstrained optimization problems. This approach is easy to implement due to its simplicity and has been proven to be effective in solving real-life application. Although this field has received copious amount of attentions in recent years, some of the new approaches of CG algorithm cannot surpass the efficiency of the previous versions. Therefore, in this paper, a new CG coefficient which retains the sufficient descent and global convergence properties of the original CG methods is proposed. This new CG is tested on a set of test functions under exact line search. Its performance is then compared to that of some of the well-known previous CG methods based on number of iterations and CPU time. The results show that the new CG algorithm has the best efficiency amongst all the methods tested. This paper also includes an application of the new CG algorithm for solving large system of linear equations

Results of 131I-therapy of autonomous adenomas of the thyroid

International Nuclear Information System (INIS)

Swoboda, G.

1978-01-01

185 adenoma patients were re-examined after 131 I therapy. The examinations comprised an anamnesis, physical examinations, and scintiscanning. Further, the volume of the former adenoma was determined by planimetry and its weight calculated. For a diagnosis of the thyroid function, T 4 and T 3 levels were determined, the T 3 /T 4 ratio was calculated, a T 3 -in-vitro test was carried out, and the fT 4 index was calculated. TRH functional tests were carried out including radioimmunological TSH determination. Therapeutic success was judged on the basis of hot node disappearance in the scintigraphic picture and TSH level normalisation after TRH administration. Retrospective calculations were carried out in order to determine the dose received by the adenoma if its weight had been determined by planimetry. The problem of how to remove the surplus thyroid hormone formed before therapy could be solved by this functional diagnosis. Further, the author studied the correlation between the disappearance of the autonomous adenoma from the scintigraphic picture on the one hand and the restitution of the normal thyroid shape and a measurable TSH increase on the other. Special attention was paid to a relative or absolute shortage of thyroid hormone and to changes in the T 4 /T 3 ratio. Finally, the thyroid function after 131 I therapy was compared with that of normal subjects and struma patients. (orig./MG) [de

Solving Complex Problems to Create Charter Extension Options

DEFF Research Database (Denmark)

Tippmann, Esther; Nell, Phillip Christopher

undertaken by 29 subsidiary units supports our hypotheses, demonstrating that these activities are a means to systematically reduce inherent problem solving biases. This study contributes to problem solving theory, the literature on headquarters’ roles in complex organizations, as well as the literature......This study examines subsidiary-driven problem solving processes and their potential to create advanced solutions for charter extension options. Problem solving theory suggests that biases in problem formulation and solution search can confine problem solving potential. We thus argue that balanced...... solution search, or activities to reconcile the need for some solution features to be locally-tailored while others can be internationally standardized, mediates the relationships between problem complexity/headquarters involvement and the capacity to create advanced solutions. An analysis of 67 projects...

Benefits of Laser Therapy in Postmenopausal Vaginal Atrophy

Science.gov (United States)

Brînzan, Daniela; Pǎiuşan, Lucian; Daşcǎu, Voicu; Furǎu, Gheorghe

2011-08-01

Maybe the worst aspect of menopause is the decline of the quality of the sexual life. The aim of the study is to demonstrate the beneficial effects of laser therapy in comparison with topical application of estrogen preparations, for the treatment of vaginal atrophy and sexual dysfunctions induced by menopause. A total of 50 menopausal patients were examined during a one year period. The methods used for objectifying vaginal atrophy and sexual dysfunctions were history taking, local clinical exam and PAP smear. From this group, 40 patients had vaginal atrophy with sexual dysfunctions. They have been treated differently, being included in four groups: patients treated with local estrogens, patients treated with intravaginal laser therapy, patients treated with both laser therapy and estrogens, patients treated with estrogens and placebo laser therapy. Therapeutic benefit, improvement of vaginal atrophy and quality of sexual life, were objectified by anamnesis (questionnaire), local and general clinical examination and PAP smear. The best results have been obtained, by far, in the 3rd group, followed by the women treated only with laser. In conclusion, we can say that laser therapy is the best way for solving the sexual inconveniences of menopause.

A Four-Stage Fifth-Order Trigonometrically Fitted Semi-Implicit Hybrid Method for Solving Second-Order Delay Differential Equations

Directory of Open Access Journals (Sweden)

Sufia Zulfa Ahmad

2016-01-01

Full Text Available We derived a two-step, four-stage, and fifth-order semi-implicit hybrid method which can be used for solving special second-order ordinary differential equations. The method is then trigonometrically fitted so that it is suitable for solving problems which are oscillatory in nature. The methods are then used for solving oscillatory delay differential equations. Numerical results clearly show the efficiency of the new method when compared to the existing explicit and implicit methods in the scientific literature.

Comparing two strategies of dynamic intensity modulated radiation therapy (dIMRT with 3-dimensional conformal radiation therapy (3DCRT in the hypofractionated treatment of high-risk prostate cancer

Directory of Open Access Journals (Sweden)

Yartsev Slav

2008-01-01

Full Text Available Abstract Background To compare two strategies of dynamic intensity modulated radiation therapy (dIMRT with 3-dimensional conformal radiation therapy (3DCRT in the setting of hypofractionated high-risk prostate cancer treatment. Methods 3DCRT and dIMRT/Helical Tomotherapy(HT planning with 10 CT datasets was undertaken to deliver 68 Gy in 25 fractions (prostate and simultaneously delivering 45 Gy in 25 fractions (pelvic lymph node targets in a single phase. The paradigms of pelvic vessel targeting (iliac vessels with margin are used to target pelvic nodes and conformal normal tissue avoidance (treated soft tissues of the pelvis while limiting dose to identified pelvic critical structures were assessed compared to 3DCRT controls. Both dIMRT/HT and 3DCRT solutions were compared to each other using repeated measures ANOVA and post-hoc paired t-tests. Results When compared to conformal pelvic vessel targeting, conformal normal tissue avoidance delivered more homogenous PTV delivery (2/2 t-test comparisons; p dose, 1–3 Gy over 5/10 dose points; p Conclusion dIMRT/HT nodal and pelvic targeting is superior to 3DCRT in dose delivery and critical structure sparing in the setting of hypofractionation for high-risk prostate cancer. The pelvic targeting paradigm is a potential solution to deliver highly conformal pelvic radiation treatment in the setting of nodal location uncertainty in prostate cancer and other pelvic malignancies.

Systematic Problem Solving in Production: The NAX Approach

DEFF Research Database (Denmark)

Axelsdottir, Aslaug; Nygaard, Martin; Edwards, Kasper

2017-01-01

This paper outlines the NAX problem solving approach developed by a group of problem solving experts at a large Danish Producer of medical equipment. The company, “Medicmeter” is one of Denmark’s leading companies when it comes to lean and it has developed a strong problem solving culture. The ma...

Systematic Versus Semantic Desensitization and Implosive Therapy: A Comparative Study

Science.gov (United States)

Hekmat, Hamid

1973-01-01

In this study, both the semantic and systematic desensitization methods were found to be significantly more effective than the implosive therapy and the control treatments in the modification of phobic behavior among the college student population. (Author)

Using Analogy to Solve a Three-Step Physics Problem

Science.gov (United States)

Lin, Shih-Yin; Singh, Chandralekha

2010-10-01

In a companion paper, we discuss students' ability to take advantage of what they learn from a solved problem and transfer their learning to solve a quiz problem that has different surface features but the same underlying physics principles. Here, we discuss students' ability to perform analogical reasoning between another pair of problems. Both the problems can be solved using the same physics principles. However, the solved problem provided was a two-step problem (which can be solved by decomposing it into two sub-problems) while the quiz problem was a three-step problem. We find that it is challenging for students to extend what they learned from a two-step problem to solve a three-step problem.

A systematic review and meta-analysis of nutrition therapy compared with dietary advice in patients with type 2 diabetes

DEFF Research Database (Denmark)

Møller, Grith; Andersen, Henning Keinke; Snorgaard, Ole

2017-01-01

Background: Despite recommendations, many patients with type 2 diabetes receive dietary advice from nurses or doctors instead of individualized nutrition therapy (INT) that is provided by a dietitian. Objective: We performed a meta-analysis to compare the effect of INT that is provided...... diabetes, but further randomized studies are warranted....

Problem-Solving Training: Effects on the Problem-Solving Skills and Self-Efficacy of Nursing Students

OpenAIRE

Ancel, Gulsum

2016-01-01

Problem Statement: Problem-Solving (PS) skills have been determined to be an internationally useful strategy for better nursing. That is why PS skills underlie all nursing practice, teamwork, and health care management, and are a main topic in undergraduate nursing education. Thus, there is a need to develop effective methods to teach problem-solving skills. The present study, as a first study in Turkey, may provide valuable insight for nurse academicians employed at üniversities. Purpose of ...

Counterfactual Problem Solving and Situated Cognition

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Glebkin V.V.,

2017-08-01

Full Text Available The paper describes and interprets data of a study on counterfactual problem solving in representatives of modern industrial culture. The study was inspired by similar experiments carried out by A.R. Luria during his expedition to Central Asia. The hypothesis of our study was that representatives of modern industrial culture would solve counterfactual puzzles at a slower rate and with higher numbers of mistakes than similar non-counterfactual tasks. The experiments we conducted supported this hypothesis as well as provided us with some insights as to how to further develop it. For instance, we found no significant differences in time lag in solving counterfactual and ‘realistic’ tasks between the subjects with mathematical and the ones with liberal arts education. As an interpretation of the obtained data, we suggest a two-stage model of counterfactual problem solving: on the first stage, where situated cognition dominates, the realistic situation is transferred into the system of symbols unrelated to this very situation; on the second stage, operations are carried out within the framework of this new system of symbols.

Volumetric Modulated Arc Therapy for Spine Radiosurgery: Superior Treatment Planning and Delivery Compared to Static Beam Intensity Modulated Radiotherapy

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Leor Zach

2016-01-01

Full Text Available Purpose. Spine stereotactic radiosurgery (SRS delivers an accurate and efficient high radiation dose to vertebral metastases in 1–5 fractions. We aimed to compare volumetric modulated arc therapy (VMAT to static beam intensity modulated radiotherapy (IMRT for spine SRS. Methods and Materials. Ten spine lesions of previously treated SRS patients were planned retrospectively using both IMRT and VMAT with a prescribed dose of 16 Gy to 100% of the planning target volume (PTV. The plans were compared for conformity, homogeneity, treatment delivery time, and safety (spinal cord dose. Results. All evaluated parameters favored the VMAT plan over the IMRT plans. Dmin in the IMRT was significantly lower than in the VMAT plan (7.65 Gy/10.88 Gy, p<0.001, the Dice Similarity Coefficient (DSC was found to be significantly better for the VMAT plans compared to the IMRT plans (0.77/0.58, resp., p  value<0.01, and an almost 50% reduction in the net treatment time was calculated for the VMAT compared to the IMRT plans (6.73 min/12.96 min, p<0.001. Conclusions. In our report, VMAT provides better conformity, homogeneity, and safety profile. The shorter treatment time is a major advantage and not only provides convenience to the painful patient but also contributes to the precision of this high dose radiation therapy.

Investigating a Proposed Problem Solving Theory in the Context of Mathematical Problem Solving: A Multi-Case Study

Science.gov (United States)

Mills, Nadia Monrose

2015-01-01

The ability to succeed in Science, Technology, Engineering, and Mathematics (STEM) careers is contingent on a student's ability to engage in mathematical problem solving. As a result, there has been increased focus on students' ability to think critically by providing them more with problem solving experiences in the classroom. Much research has…

Physical Therapy and Manual Physical Therapy: Differences in Patient Characteristics.

NARCIS (Netherlands)

van Ravensberg, C. D. Dorine; Oostendorp, Rob A B; van Berkel, Lonneke M.; Scholten-Peeters, Gwendolijne G M; Pool, Jan J.M.; Swinkels, Raymond A. H. M.; Huijbregts, Peter A.

2005-01-01

This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis

Physical therapy and manual physical therapy: Differences in patient characteristics

NARCIS (Netherlands)

van Ravensberg, C. D. Dorine; Oostendorp, R.A.B.; van Berkel, Lonneke M.; Scholten-Peeters, G.G.M.; Pool, J.J.M.; Swinkels, Raymond A. H. M.; Huijbregts, Peter A.

2005-01-01

This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis

Physical Therapy and Manual Physical Therapy: Differences in Patient Characteristics

NARCIS (Netherlands)

van Ravensberg, C. D. Dorine; Oostendorp, Rob A B; van Berkel, Lonneke M.; Scholten-Peeters, Gwendolijne G. M.; Pool, Jan J.M.; Swinkels, Raymond A. H. M.; Huijbregts, Peter A.

2005-01-01

This study compared socio-demographic characteristics, health problem characteristics, and primary process data between database samples of patients referred to physical therapy (PT) versus a sample of patients referred to manual physical therapy (MPT) in the Netherlands. Statistical analysis

New Efficient Fourth Order Method for Solving Nonlinear Equations

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Farooq Ahmad

2013-12-01

Full Text Available In a paper [Appl. Math. Comput., 188 (2 (2007 1587--1591], authors have suggested and analyzed a method for solving nonlinear equations. In the present work, we modified this method by using the finite difference scheme, which has a quintic convergence. We have compared this modified Halley method with some other iterative of fifth-orders convergence methods, which shows that this new method having convergence of fourth order, is efficient.

On Solving the Lorenz System by Differential Transformation Method

International Nuclear Information System (INIS)

Al-Sawalha, M. Mossa; Noorani, M. S. M.

2008-01-01

The differential transformation method (DTM) is employed to solve a nonlinear differential equation, namely the Lorenz system. Numerical results are compared to those obtained by the Runge–Kutta method to illustrate the preciseness and effectiveness of the proposed method. In particular, we examine the accuracy of the (DTM) as the Lorenz system changes from a non-chaotic system to a chaotic one. It is shown that the (DTM) is robust, accurate and easy to apply

Children's expression through play therapy

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Ljubomirović Nataša

2015-01-01

Full Text Available Play as a child's expression, is a skill through which children speaks to adults. Play therapy is a broad field of therapeutic intervention based on the play in order to help the child to cope with problems. Through play, children learn to communicate with others, to express their feelings. Through play they learn and can improve their cognitive, emotional and social capabilities. Play therapy is a nondirective technique focused on the child. It is not focused on the problem, at present even the past, but focused on the expression of the child feelings, accepting the child, rather than correction. The focus has been on the wisdom of a child, not on expertise therapists, guiding the child through play rather than instructing. The aim of play therapy is to encourage healthy growth and development, developing skills in problem solving, reduction of undesirable behavior, confidence building and the development of self-control. This method is effective for a wide range of children's problems, such as the state of stress, anxiety, problem behavior, hyperkinetic syndrome, depression, loss, trauma, the problem of bonding situations parents divorced, somatic disorders, autism spectrum disorders, social problems.

Internet Computer Coaches for Introductory Physics Problem Solving

Science.gov (United States)

Xu Ryan, Qing

2013-01-01

The ability to solve problems in a variety of contexts is becoming increasingly important in our rapidly changing technological society. Problem-solving is a complex process that is important for everyday life and crucial for learning physics. Although there is a great deal of effort to improve student problem solving skills throughout the…

Translation among Symbolic Representations in Problem-Solving. Revised.

Science.gov (United States)

Shavelson, Richard J.; And Others

This study investigated the relationships among the symbolic representation of problems given to students to solve, the mental representations they use to solve the problems, and the accuracy of their solutions. Twenty eleventh-grade science students were asked to think aloud as they solved problems on the ideal gas laws. The problems were…

Solving global optimization problems on GPU cluster

Energy Technology Data Exchange (ETDEWEB)

Barkalov, Konstantin; Gergel, Victor; Lebedev, Ilya [Lobachevsky State University of Nizhni Novgorod, Gagarin Avenue 23, 603950 Nizhni Novgorod (Russian Federation)

2016-06-08

The paper contains the results of investigation of a parallel global optimization algorithm combined with a dimension reduction scheme. This allows solving multidimensional problems by means of reducing to data-independent subproblems with smaller dimension solved in parallel. The new element implemented in the research consists in using several graphic accelerators at different computing nodes. The paper also includes results of solving problems of well-known multiextremal test class GKLS on Lobachevsky supercomputer using tens of thousands of GPU cores.

Immune control of HIV-1 infection after therapy interruption: immediate versus deferred antiretroviral therapy

Directory of Open Access Journals (Sweden)

Bernaschi Massimo

2009-10-01

Full Text Available Abstract Background The optimal stage for initiating antiretroviral therapies in HIV-1 bearing patients is still a matter of debate. Methods We present computer simulations of HIV-1 infection aimed at identifying the pro et contra of immediate as compared to deferred Highly Active Antiretroviral Therapy (HAART. Results Our simulations highlight that a prompt specific CD8+ cytotoxic T lymphocytes response is detected when therapy is delayed. Compared to very early initiation of HAART, in deferred treated patients CD8+ T cells manage to mediate the decline of viremia in a shorter time and, at interruption of therapy, the virus experiences a stronger immune pressure. We also observe, however, that the immunological effects of the therapy fade with time in both therapeutic regimens. Thus, within one year from discontinuation, viral burden recovers to the value at which it would level off in the absence of therapy. In summary, simulations show that immediate therapy does not prolong the disease-free period and does not confer a survival benefit when compared to treatment started during the chronic infection phase. Conclusion Our conclusion is that, since there is no therapy to date that guarantees life-long protection, deferral of therapy should be preferred in order to minimize the risk of adverse effects, the occurrence of drug resistances and the costs of treatment.

Modified Chebyshev Collocation Method for Solving Differential Equations

Directory of Open Access Journals (Sweden)

M Ziaul Arif

2015-05-01

Full Text Available This paper presents derivation of alternative numerical scheme for solving differential equations, which is modified Chebyshev (Vieta-Lucas Polynomial collocation differentiation matrices. The Scheme of modified Chebyshev (Vieta-Lucas Polynomial collocation method is applied to both Ordinary Differential Equations (ODEs and Partial Differential Equations (PDEs cases. Finally, the performance of the proposed method is compared with finite difference method and the exact solution of the example. It is shown that modified Chebyshev collocation method more effective and accurate than FDM for some example given.

Relationship Between Radiation Therapy Dose and Outcome in Patients Treated With Neoadjuvant Chemoradiation Therapy and Surgery for Stage IIIA Non-Small Cell Lung Cancer: A Population-Based, Comparative Effectiveness Analysis

International Nuclear Information System (INIS)

Sher, David J.; Fidler, Mary Jo; Seder, Christopher W.; Liptay, Michael J.; Koshy, Matthew

2015-01-01

Purpose: To compare, using the National Cancer Database, survival, pathologic, and surgical outcomes in patients with stage IIIA non-small cell lung cancer treated with differential doses of neoadjuvant chemoradiation therapy, with the aim to discern whether radiation dose escalation was associated with a comparative effectiveness benefit and/or toxicity risk. Methods and Materials: Patients in the National Cancer Database with stage IIIA non-small cell lung cancer treated with neoadjuvant chemoradiation therapy and surgery between 1998 and 2005 were analyzed. Dose strata were divided between 36 to 45 Gy (low-dose radiation therapy, LD-RT), 45 to 54 Gy (inclusive, standard-dose, SD-RT), and 54 to 74 Gy (high-dose, HD-RT). Outcomes included overall survival, residual nodal disease, positive surgical margin status, hospital length of stay, and adverse surgical outcomes (30-day mortality or readmission). Results: The cohort consisted of 1041 patients: 233 (22%) LD-RT, 584 (56%) SD-RT, and 230 (22%) HD-RT. The median, 3-year, and 5-year overall survival outcomes were 34.9 months, 48%, and 37%, respectively. On univariable analysis, patients treated with SD-RT experienced prolonged overall survival (median 38.3 vs 31.8 vs 29.0 months for SD-RT, LD-RT, and HD-RT, respectively, P=.0089), which was confirmed on multivariable analysis (hazard ratios 0.77 and 0.81 vs LD and HD, respectively). Residual nodal disease was seen less often after HD-RT (25.5% vs 31.8% and 37.5% for HD-RT, LD-RT, and SD-RT, respectively, P=.0038). Patients treated with SD-RT had fewer prolonged hospital stays. There were no differences in positive surgical margin status or adverse surgical outcomes between the cohorts. Conclusions: Neoadjuvant chemoradiation therapy between 45 and 54 Gy was associated with superior survival in comparison with doses above and below this threshold. Although this conclusion is limited by selection bias, clear candidates for trimodality therapy do not seem to

Relationship Between Radiation Therapy Dose and Outcome in Patients Treated With Neoadjuvant Chemoradiation Therapy and Surgery for Stage IIIA Non-Small Cell Lung Cancer: A Population-Based, Comparative Effectiveness Analysis

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Sher, David J., E-mail: david_sher@rush.edu [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Fidler, Mary Jo [Section of Medical Oncology, Rush University Medical Center, Chicago, Illinois (United States); Seder, Christopher W.; Liptay, Michael J. [Department of Cardiothoracic Surgery, Rush University Medical Center, Chicago, Illinois (United States); Koshy, Matthew [Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois (United States)

2015-06-01

Purpose: To compare, using the National Cancer Database, survival, pathologic, and surgical outcomes in patients with stage IIIA non-small cell lung cancer treated with differential doses of neoadjuvant chemoradiation therapy, with the aim to discern whether radiation dose escalation was associated with a comparative effectiveness benefit and/or toxicity risk. Methods and Materials: Patients in the National Cancer Database with stage IIIA non-small cell lung cancer treated with neoadjuvant chemoradiation therapy and surgery between 1998 and 2005 were analyzed. Dose strata were divided between 36 to 45 Gy (low-dose radiation therapy, LD-RT), 45 to 54 Gy (inclusive, standard-dose, SD-RT), and 54 to 74 Gy (high-dose, HD-RT). Outcomes included overall survival, residual nodal disease, positive surgical margin status, hospital length of stay, and adverse surgical outcomes (30-day mortality or readmission). Results: The cohort consisted of 1041 patients: 233 (22%) LD-RT, 584 (56%) SD-RT, and 230 (22%) HD-RT. The median, 3-year, and 5-year overall survival outcomes were 34.9 months, 48%, and 37%, respectively. On univariable analysis, patients treated with SD-RT experienced prolonged overall survival (median 38.3 vs 31.8 vs 29.0 months for SD-RT, LD-RT, and HD-RT, respectively, P=.0089), which was confirmed on multivariable analysis (hazard ratios 0.77 and 0.81 vs LD and HD, respectively). Residual nodal disease was seen less often after HD-RT (25.5% vs 31.8% and 37.5% for HD-RT, LD-RT, and SD-RT, respectively, P=.0038). Patients treated with SD-RT had fewer prolonged hospital stays. There were no differences in positive surgical margin status or adverse surgical outcomes between the cohorts. Conclusions: Neoadjuvant chemoradiation therapy between 45 and 54 Gy was associated with superior survival in comparison with doses above and below this threshold. Although this conclusion is limited by selection bias, clear candidates for trimodality therapy do not seem to

Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy

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J Charles Henry

2008-10-01

Full Text Available J Charles Henry1, James H Peace2, Jeanette A Stewart3,4, William C Stewart3,41Little Rock Eye Clinic, Little Rock, AR, USA; 2Diabetic Eye Medical Clinic, Inglewood, CA, USA; 3PRN Pharmaceutical Research Network, LLC, Dallas,TX, USA; 4Carolina Eye Institute, University of South Carolina, School of Medicine, Columbia, SC, USAPurpose: To evaluate the efficacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension.Design: Prospective, multi-center, historical control study.Methods: Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later.Results: In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p < 0.0001. Patients having any baseline OSD symptoms (n = 235 demonstrated significant improvement after switching to travoprost BAK-free (p < 0.0001. In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP was significantly decreased (p < 0.0001. Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy. Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p < 0.0001.Conclusions: Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically significant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control.Keywords: glaucoma, prostaglandin analog, travoprost, latanoprost, bimatoprost, preservative, benzalkonium chloride

Counselor-Assisted Problem Solving (CAPS) Improves Behavioral Outcomes in Older Adolescents with Complicated Mild to Severe TBI

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Wade, Shari L.; Stancin, Terry; Kirkwood, Michael; Brown, Tanya Maines; Rochester, Mayo Clinic; McMullen, Kendra M.; Taylor, H. Gerry

2013-01-01

Objective To test the efficacy of Counselor-Assisted Problem Solving (CAPS) versus an internet resources comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI). Design Randomized clinical trial with interviewers naïve to treatment condition. Setting Three large tertiary children's hospitals and two general hospitals with pediatric commitment. Participants 132 children ages 12-17 years hospitalized during the previous 6 months for moderate to severe TBI. Interventions Participants in CAPS (n = 65) completed 8-12 online modules providing training in problem solving, communication skills, and self-regulation and subsequent synchronous videoconferences with a therapist. Participants in the IRC group (n = 67) received links to internet resources about pediatric TBI. Main Outcome Measures Child Behavior Checklist (CBCL) administered before and after completion of treatment (i.e., approximately six months after treatment initiation). Results Post hoc analysis of covariance (ANCOVA), controlling for pre-treatment scores, was used to examine group differences in behavior problems in the entire sample and among older (n=59) and younger adolescents (n=53). Among older but not younger adolescents, CAPS resulted in greater improvements on multiple dimensions of externalizing behavior problems than did IRC. Conclusion Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI. PMID:23640543

NEOCENT: a randomised feasibility and translational study comparing neoadjuvant endocrine therapy with chemotherapy in ER-rich postmenopausal primary breast cancer.

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Palmieri, C; Cleator, S; Kilburn, L S; Kim, S B; Ahn, S-H; Beresford, M; Gong, G; Mansi, J; Mallon, E; Reed, S; Mousa, K; Fallowfield, L; Cheang, M; Morden, J; Page, K; Guttery, D S; Rghebi, B; Primrose, L; Shaw, J A; Thompson, A M; Bliss, J M; Coombes, R C

2014-12-01

Neoadjuvant endocrine therapy is an alternative to chemotherapy for women with oestrogen receptor (ER)-positive early breast cancer (BC). We aimed to assess feasibility of recruiting patients to a study comparing chemotherapy versus endocrine therapy in postmenopausal women with ER-rich primary BC, and response as well as translational endpoints were assessed. Patients requiring neoadjuvant therapy were randomised to chemotherapy: 6 × 3-weekly cycles FE₁₀₀C or endocrine therapy: letrozole 2.5 mg, daily for 18-23 weeks. Primary endpoints were recruitment feasibility and tissue collection. Secondary endpoints included clinical, radiological and pathological response rates, quality of life and translational endpoints. 63/80 patients approached were eligible, of those 44 (70, 95% CI 57-81) were randomised. 12 (54.5, 95% CI 32.2-75.6) chemotherapy patients showed radiological objective response compared with 13 (59.1, 95% CI 36.4-79.3) letrozole patients. Compared with baseline, mean Ki-67 levels fell in both groups at days 2-4 and at surgery [fold change: 0.24 (95% CI 0.12-0.51) and 0.24; (95% CI 0.15-0.37), respectively]. Plasma total cfDNA levels rose from baseline to week 8 [fold change: chemotherapy 2.10 (95% CI 1.47-3.00), letrozole 1.47(95% CI 0.98-2.20)], and were maintained at surgery in the chemotherapy group [chemotherapy 2.63; 95% CI 1.56-4.41), letrozole 0.95 (95% CI 0.71-1.26)]. An increase in plasma let-7a miRNA was seen at surgery for patients with objective radiological response to chemotherapy. Recruitment and tissue collection endpoints were met; however, a larger trial was deemed unfeasible due to slow accrual. Both regimens were equally efficacious. Dynamic changes were seen in Ki-67 and circulating biomarkers in both groups with increases in cfDNA and let-7a miRNA persisting until surgery for chemotherapy patients.

Algorithms for the optimization of RBE-weighted dose in particle therapy.

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Horcicka, M; Meyer, C; Buschbacher, A; Durante, M; Krämer, M

2013-01-21

We report on various algorithms used for the nonlinear optimization of RBE-weighted dose in particle therapy. Concerning the dose calculation carbon ions are considered and biological effects are calculated by the Local Effect Model. Taking biological effects fully into account requires iterative methods to solve the optimization problem. We implemented several additional algorithms into GSI's treatment planning system TRiP98, like the BFGS-algorithm and the method of conjugated gradients, in order to investigate their computational performance. We modified textbook iteration procedures to improve the convergence speed. The performance of the algorithms is presented by convergence in terms of iterations and computation time. We found that the Fletcher-Reeves variant of the method of conjugated gradients is the algorithm with the best computational performance. With this algorithm we could speed up computation times by a factor of 4 compared to the method of steepest descent, which was used before. With our new methods it is possible to optimize complex treatment plans in a few minutes leading to good dose distributions. At the end we discuss future goals concerning dose optimization issues in particle therapy which might benefit from fast optimization solvers.

Flexibility in Mathematics Problem Solving Based on Adversity Quotient

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Dina, N. A.; Amin, S. M.; Masriyah

2018-01-01

Flexibility is an ability which is needed in problem solving. One of the ways in problem solving is influenced by Adversity Quotient (AQ). AQ is the power of facing difficulties. There are three categories of AQ namely climber, camper, and quitter. This research is a descriptive research using qualitative approach. The aim of this research is to describe flexibility in mathematics problem solving based on Adversity Quotient. The subjects of this research are climber student, camper student, and quitter student. This research was started by giving Adversity Response Profile (ARP) questioner continued by giving problem solving task and interviews. The validity of data measurement was using time triangulation. The results of this research shows that climber student uses two strategies in solving problem and doesn’t have difficulty. The camper student uses two strategies in solving problem but has difficulty to finish the second strategies. The quitter student uses one strategy in solving problem and has difficulty to finish it.

Trial Protocol: Cognitive functional therapy compared with combined manual therapy and motor control exercise for people with non-specific chronic low back pain: protocol for a randomised, controlled trial.

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Belache, Fabiana Terra Cunha; Souza, Cíntia Pereira de; Fernandez, Jessica; Castro, Julia; Ferreira, Paula Dos Santos; Rosa, Elizana Rodrigues de Sousa; Araújo, Nathalia Cristina Gimenez de; Reis, Felipe José Jandre; Almeida, Renato Santos de; Nogueira, Leandro Alberto Calazans; Correia, Luís Cláudio Lemos; Meziat-Filho, Ney

2018-06-11

Chronic low back pain is a public health problem, and there is strong evidence that it is associated with a complex interaction of biopsychosocial factors. Cognitive functional therapy is an intervention that deals with potentially modifiable multidimensional aspects of pain (eg, provocative cognitive, movement and lifestyle behaviours). There is evidence (from a single randomised, controlled trial) that cognitive functional therapy is better than combined manual therapy and motor control exercise. However, this study had significant methodological shortcomings including the failure to carry out an intention-to-treat analysis and a considerable loss of follow-up of participants. It is important to replicate this study in another domain through a randomised clinical trial with similar objectives but correcting these methodological shortcomings. To investigate the efficacy of cognitive functional therapy compared to combined manual therapy and exercise on pain and disability at 3 months in patients with chronic non-specific low back pain. Two-group, randomised, multicentre controlled trial with blinded assessors. One hundred and forty-eight participants with chronic low back pain that has persisted for >3months and no specific spinal pathology will be recruited from the school clinic of the Centro Universitário Augusto Motta and a private clinic in the city of Rio de Janeiro, Brazil. Four to 10 sessions of cognitive functional therapy. The physiotherapists who will treat the participants in the cognitive functional therapy group have previously attended 2 workshops with two different tutors of the method. Such physiotherapists have completed 106 hours of training, including workshops and patient examinations, as well as conducting a pilot study under the supervision of another physiotherapist with>3 years of clinical experience in cognitive functional therapy. Four to 10 sessions of combined manual therapy and motor control exercises. Participants in the combined

Using a general problem-solving strategy to promote transfer.

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Youssef-Shalala, Amina; Ayres, Paul; Schubert, Carina; Sweller, John

2014-09-01

Cognitive load theory was used to hypothesize that a general problem-solving strategy based on a make-as-many-moves-as-possible heuristic could facilitate problem solutions for transfer problems. In four experiments, school students were required to learn about a topic through practice with a general problem-solving strategy, through a conventional problem solving strategy or by studying worked examples. In Experiments 1 and 2 using junior high school students learning geometry, low knowledge students in the general problem-solving group scored significantly higher on near or far transfer tests than the conventional problem-solving group. In Experiment 3, an advantage for a general problem-solving group over a group presented worked examples was obtained on far transfer tests using the same curriculum materials, again presented to junior high school students. No differences between conditions were found in Experiments 1, 2, or 3 using test problems similar to the acquisition problems. Experiment 4 used senior high school students studying economics and found the general problem-solving group scored significantly higher than the conventional problem-solving group on both similar and transfer tests. It was concluded that the general problem-solving strategy was helpful for novices, but not for students that had access to domain-specific knowledge. PsycINFO Database Record (c) 2014 APA, all rights reserved.

An episodic specificity induction enhances means-end problem solving in young and older adults.

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Madore, Kevin P; Schacter, Daniel L

2014-12-01

Episodic memory plays an important role not only in remembering past experiences, but also in constructing simulations of future experiences and solving means-end social problems. We recently found that an episodic specificity induction-brief training in recollecting details of past experiences-enhances performance of young and older adults on memory and imagination tasks. Here we tested the hypothesis that this specificity induction would also positively impact a means-end problem-solving task on which age-related changes have been linked to impaired episodic memory. Young and older adults received the specificity induction or a control induction before completing a means-end problem-solving task, as well as memory and imagination tasks. Consistent with previous findings, older adults provided fewer relevant steps on problem solving than did young adults, and their responses also contained fewer internal (i.e., episodic) details across the 3 tasks. There was no difference in the number of other (e.g., irrelevant) steps on problem solving or external (i.e., semantic) details generated on the 3 tasks as a function of age. Critically, the specificity induction increased the number of relevant steps and internal details (but not other steps or external details) that both young and older adults generated in problem solving compared with the control induction, as well as the number of internal details (but not external details) generated for memory and imagination. Our findings support the idea that episodic retrieval processes are involved in means-end problem solving, extend the range of tasks on which a specificity induction targets these processes, and show that the problem-solving performance of older adults can benefit from a specificity induction as much as that of young adults. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer.

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Bishop, J F; Dewar, J; Toner, G C; Smith, J; Tattersall, M H; Olver, I N; Ackland, S; Kennedy, I; Goldstein, D; Gurney, H; Walpole, E; Levi, J; Stephenson, J; Canetta, R

1999-08-01

To determine the place of single-agent paclitaxel compared with nonanthracycline combination chemotherapy as front-line therapy in metastatic breast cancer. Patients with previously untreated metastatic breast cancer were randomized to receive either paclitaxel 200 mg/m(2) intravenously (IV) over 3 hours for eight cycles (24 weeks) or standard cyclophosphamide 100 mg/m(2)/d orally on days 1 to 14, methotrexate 40 mg/m(2) IV on days 1 and 8, fluorouracil 600 mg/m(2) IV on days 1 and 8, and prednisone 40 mg/m(2)/d orally on days 1 to 14 (CMFP) for six cycles (24 weeks) with epirubicin recommended as second-line therapy. A total of 209 eligible patients were randomized with a median survival duration of 17.3 months for paclitaxel and 13.9 months for CMFP. Multivariate analysis showed that patients who received paclitaxel survived significantly longer than those who received CMFP (P =.025). Paclitaxel produced significantly less severe leukopenia, thrombocytopenia, mucositis, documented infections (all P = .07). Initial paclitaxel was associated with significantly less myelosuppression and fewer infections, with longer survival and similar quality of life and control of metastatic breast cancer compared with CMFP.