Integrated care in patients with schizophrenia: results of trials published between 2011 and 2013 focusing on effectiveness and efficiency

Purpose of review: Overview on integrated care trials focusing on effectiveness and efficiency published from 2011 to 2013. Recent findings: Eight randomized controlled trials (RCTs) and 21 non-RCT studies were published from 2011 to 2013. Studies differed in several methodological aspects such as study population, psychotherapeutic approaches used, outcome parameters, follow-up times, fidelities, and implementation of the integrated care model and the nation-specific healthcare context with different control conditions. This makes it difficult to draw firm conclusions. Most studies demonstrated relevant improvements regarding symptoms (P = 0.001) and functioning (P = 0.01), quality of life (P = 0.01), adherence (P <0.05) and patient's satisfaction (P = 0.01), and reduction of caregiver's stress (P < 0.05). Mean total costs were favoring or at least equalizing costs but with positive effects found on subjective health favoring integrated care models. Summary: There is an increasing interest in the effectiveness and efficiency of integrated care models in patients with mental disorders, specifically in those with severe and persistent mental illness. To increase generalizability, future trials should exactly describe rationales and content of integrated care model and control conditions.

The Meta in Meta-object Architectures

Behavioral reflection is crucial to support for example functional upgrades, on-the-fly debugging, or monitoring critical applications. However the use of reflective features can lead to severe problems due to infinite metacall recursion even in simple cases. This is especially a problem when reflecting on core language features since there is a high chance that such features are used to implement the reflective behavior itself. In this paper we analyze the problem of infinite meta-object call recursion and solve it by providing a first class representation of meta-level execution: at any point in the execution of a system it can be determined if we are operating on a meta-level or base level so that we can prevent infinite recursion. We present how meta-level execution can be represented by a meta-context and how reflection becomes context-aware. Our solution makes it possible to freely apply behavioral reflection even on system classes: the meta-context brings stability to behavioral reflection. We validate the concept with a robust implementation and we present benchmarks.

Safe Reflection Through Polymorphism

Code executed in a fully reflective system switches back and forth between application and interpreter code. These two states can be seen as contexts in which an expression is evaluated. Current language implementations obtain reflective capabilities by exposing objects to the interpreter. However, in doing so these systems break the encapsulation of the application objects. In this paper we propose safe reflection through polymorphism, \ie by unifying the interface and ensuring the encapsulation of objects from both the interpreter and application context. We demonstrate a \emphhomogeneous system that defines the execution semantics in terms of itself, thus enforcing that encapsulation is not broken.

Assimilation of Compliance Software in Highly Regulated Industries: An Empirical Multitheoretical Investigation

In this paper we follow a theory-based approach to study the assimilation of compliance software in highly regulated multinational enterprises. These relatively new software products support the automation of controls which are associated with mandatory compliance requirements. We use institutional and success factor theories to explain the assimilation of compliance software. A framework for analyzing the assimilation of Access Control Systems (ACS), a special type of compliance software, is developed and used to reflect the experiences obtained in four in-depth case studies. One result is that coercive, mimetic, and normative pressures significantly effect ACS assimilation. On the other hand, quality aspects have only a moderate impact at the beginning of the assimilation process, in later phases the impact may increase if performance and improvement objectives become more relevant. In addition, it turns out that position of the enterprises and compatibility heavily influence the assimilation process.

Prometheus Framework for Fuzzy Information Retrieval in Semantic Spaces

This paper introduces a novel vision for further enhanced Internet of Things services. Based on a variety of data (such as location data, ontology-backed search queries, in- and outdoor conditions) the Prometheus framework is intended to support users with helpful recommendations and information preceding a search for context-aware data. Adapted from artificial intelligence concepts, Prometheus proposes user-readjusted answers on umpteen conditions. A number of potential Prometheus framework applications are illustrated. Added value and possible future studies are discussed in the conclusion.

Prometheus – Fuzzy Information Retrieval for Semantic Homes and Environments

This paper introduces a novel vision for further enhanced Internet of Things services. Based on a variety of data – such as location data, ontology-backed search queries, in- and outdoor conditions – the Prometheus framework is intended to support users with helpful recommendations and information preceding a search for context-aware data. Adapted from artificial intelligence concepts, Prometheus proposes user-readjusted answers on umpteen conditions. A number of potential Prometheus framework applications are illustrated. Added value and possible future studies are discussed in the conclusion.

Individual Video Training iVT - Development of a National Infrastructure for Video-Supported Learning

Introduction: Video‐Supported Learning is particularly effective when it comes to skills and behaviors. Video registration of patient‐physician interviews, class room instruction or practical skills allow it to learners themselves, their peers, and their tutors to assess the quality of the learner's performance, to give specific feedback, and to make suggestions for improvement. Methods: In Switzerland, four pedagogical universities and two medical faculties joined to initiate the development of a national infrastructure for Video Supported Learning. The goal was to have a system that is simple to use, has most steps automated, provides the videos over the Internet, and has a sophisticated access control. Together with SWITCH, the national IT‐Support‐Organisation for Swiss Universities, the program iVT (Individual Video Training) was developed by integrating two preexisting technologies. The first technology is SWITCHcast, a podcast system. With SWITCHcast, videos are automatically uploaded to a server as soon as the registration is over. There the videos are processed and converted to different formats. The second technology is the national Single Logon System AAI (Authentification and Authorization Infrastructure) that enables iVT to link each video with the corresponding learner. The learner starts the registration with his Single Logon. Thus, the video can unambiguously be assigned. Via his institution's Learning Management System (LMS), the learner can access his video and give access to his video to peers and tutors. Results: iVT is now used at all involved institutions. The system works flawlessly. In Bern, we use iVT for the communications skills training in the forth and sixth year. Since students meet with patient actors alone, iVT is also used to certify attendance. Students are encouraged to watch the videos of the interview and the feedback of the patient actor. The offer to discuss a video with a tutor was not used by the students. Discussion: We plan to expand the use of iVT by making peer assessment compulsory. To support this, annotation capabilities are currently added to iVT. We also want to use iVT in training of practical skills, again for self as well as for peer assessment.  At present, we use iVT for quality control of patient actor's performance.

A Demonstration of Mobility Prediction as a Service in Cloudified LTE Networks

Location prediction has attracted a significant amount of research effort. Being able to predict users’ movement benefits a wide range of communication systems, including location-based service/applications, mobile access control, mobile QoS provision, and resource management for mobile computation and storage management. In this demo, we present MOBaaS, which is a cloudified Mobility and Bandwidth prediction services that can be instantiated, deployed, and disposed on-demand. Mobility prediction of MOBaaS provides location predictions of a single/group user equipments (UEs) in a future moment. This information can be used for self-adaptation procedures and optimal network function configuration during run-time operations. We demonstrate an example of real-time mobility prediction service deployment running on OpenStack platform, and the potential benefits it bring to other invoking services.

Towards moldable development tools

Developers commonly ask detailed and domain-specific questions about the software systems they are developing and maintaining. Integrated development environments (IDEs) form an essential category of tools for developing software that should support software engineering decision making. Unfortunately, rigid and generic IDEs that focus on low-level programming tasks, that promote code rather than data, and that suppress customization, offer limited support for informed decision making during software development. We propose to improve decision making within IDEs by moving from generic to context-aware IDEs through moldable tools. In this paper, we promote the idea of moldable tools, illustrate it with concrete examples, and discuss future research directions.

Bringing results to fruition through publication: An analysis of a peer-reviewed, open access and context-focused journal's editorial practice

When it comes to helping to shape sustainable development, research is most useful when it bridges the science–implementation/management gap and when it brings development specialists and researchers into a dialogue (Hurni et al. 2004); can a peer-reviewed journal contribute to this aim? In the classical system for validation and dissemination of scientific knowledge, journals focus on knowledge exchange within the academic community and do not specifically address a ‘life-world audience’. Within a North-South context, another knowledge divide is added: the peer review process excludes a large proportion of scientists from the South from participating in the production of scientific knowledge (Karlsson et al. 2007). Mountain Research and Development (MRD) is a journal whose mission is based on an editorial strategy to build the bridge between research and development and ensure that authors from the global South have access to knowledge production, ultimately with a view to supporting sustainable development in mountains. In doing so, MRD faces a number of challenges that we would like to discuss with the td-net community, after having presented our experience and strategy as editors of this journal. MRD was launched in 1981 by mountain researchers who wanted mountains to be included in the 1992 Rio process. In the late 1990s, MRD realized that the journal needed to go beyond addressing only the scientific community. It therefore launched a new section addressing a broader audience in 2000, with the aim of disseminating insights into, and recommendations for, the implementation of sustainable development in mountains. In 2006, we conducted a survey among MRD’s authors, reviewers, and readers (Wymann et al. 2007): respondents confirmed that MRD had succeeded in bridging the gap between research and development. But we realized that MRD could become an even more efficient tool for sustainability if development knowledge were validated: in 2009, we began submitting ‘development’ papers (‘transformation knowledge’) to external peer review of a kind different from the scientific-only peer review (for ‘systems knowledge’). At the same time, the journal became open access in order to increase the permeability between science and society, and ensure greater access for readers and authors in the South. We are currently rethinking our review process for development papers, with a view to creating more space for communication between science and society, and enhancing the co-production of knowledge (Roux 2008). Hopefully, these efforts will also contribute to the urgent debate on the ‘publication culture’ needed in transdisciplinary research (Kueffer et al. 2007).

[Mass culling in the context of animal disease outbreaks--veterinarians caught between ethical issues and control policies]

In recent years controversial discussions arose during major animal disease outbreaks in the EU about the ethical soundness of mass culling. In contrast to numerous publications about ethical issues and laboratory animals/animal experiments, literature concerning ethical deliberations in the case of mass culling as a means of outbreak control remain scarce. Veterinarians in charge of decision about and implementation of mass culling actions find themselves in an area of conflict in between the officially required animal disease control policy and a public that is increasingly critical. Those veterinarians are faced with the challenge to defend the relevant decisions against all stakeholders and also themselves. In this context an interdisciplinary workshop was initiated in Switzerland in October 2007 with ethicians and (official) veterinarians from Germany, Switzerland and Austria. With the aim to identify ethical components of animal disease control for official veterinarians, talks and moderated group discussions took place. This article summarizes selected discussion points and conclusions.

Electrophysiological indices of response inhibition in a Go/NoGo task predict self-control in a social context.

Recent research demonstrates that response inhibition-a core executive function-may subserve self-regulation and self-control. However, it is unclear whether response inhibition also predicts self-control in the multifaceted, high-level phenomena of social decision-making. Here we examined whether electrophysiological indices of response inhibition would predict self-control in a social context. Electroencephalography was recorded as participants completed a widely used Go/NoGo task (the cued Continuous Performance Test). Participants then interacted with a partner in an economic exchange game that requires self-control. Results demonstrated that greater NoGo-Anteriorization and larger NoGo-P300 peak amplitudes-two established electrophysiological indices of response inhibition-both predicted more self-control in this social game. These findings support continued integration of executive function and self-regulation and help extend prior research into social decision-making processes.