Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial.

BACKGROUND: A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression. METHODS/DESIGN: The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions). Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention-to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher. DISCUSSION: Despite the large number of studies on treatment of depression, there is a clear lack of controlled research in inpatient psychotherapy during the acute phase of a major depressive episode. Research on brief therapy is important to take into account current short lengths of stay in psychiatry. The current study has the potential to scientifically inform appropriate inpatient treatment. This study is the first to address the issue of the economic evaluation of inpatient psychotherapy. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry (ACTRN12612000909820).

NFκB activation by modified vaccinia virus as a novel strategy to enhance neutrophil migration and HIV-specific T-cell responses.

Neutrophils are antigen-transporting cells that generate vaccinia virus (VACV)-specific T-cell responses, yet how VACV modulates neutrophil recruitment and its significance in the immune response are unknown. We generated an attenuated VACV strain that expresses HIV-1 clade C antigens but lacks three specific viral genes (A52R, K7R, and B15R). We found that these genes act together to inhibit the NFκB signaling pathway. Triple ablation in modified virus restored NFκB function in macrophages. After virus infection of mice, NFκB pathway activation led to expression of several cytokines/chemokines that increased the migration of neutrophil populations (Nα and Nβ) to the infection site. Nβ cells displayed features of antigen-presenting cells and activated virus-specific CD8 T cells. Enhanced neutrophil trafficking to the infection site correlated with an increased T-cell response to HIV vector-delivered antigens. These results identify a mechanism for poxvirus-induced immune response and alternatives for vaccine vector design.

Generation of biological association networks: A novel strategy to detect new targets in cancer therapy

The aim of this work was to design a novel strategy to detect new targets for anticancer treatments. The rationale was to build Biological Association Networks from differentially expressed genes in drug-resistant cells to identify important nodes within the Networks. These nodes may represent putative targets to attack in cancer therapy, as a way to destabilize the gene network developed by the resistant cells to escape from the drug pressure. As a model we used cells resistant to methotrexate (MTX), an inhibitor of DHFR. Selected node-genes were analyzed at the transcriptional level and from a genotypic point of view. In colon cancer cells, DHFR, the AKR1 family, PKC¿, S100A4, DKK1, and CAV1 were overexpressed while E-cadherin was lost. In breast cancer cells, the UGT1A family was overexpressed, whereas EEF1A1 was overexpressed in pancreatic cells. Interference RNAs directed against these targets sensitized cells towards MTX.

Structural Analysis and Overlay Design of Pavements Using the Road Rater, MLR-84-3, 1986

In recent years the Iowa DOT has shifted emphasis from the construction of new roads to the maintenance and preservation of existing highways. A need has developed for analyzing pavements structurally to select the correct rehabilitation strategy and to properly design a pavement overlay if necessary. This need has been fulfilled by Road Rater testing which has been used successfully on all types of pavements to evaluate pavement and subgrade conditions and to design asphaltic concrete overlays. The Iowa Road Rater Design Method has been simplified so that it may be easily understood and used by the widely diverse groups of individuals which may be involved in pavement restoration and management. Road Rater analysis techniques have worked well to date and have been verified by pavement coring, soils sampling and testing, and pavement removal by block sampling. Void detection testing has also been performed experimentally in Iowa, and results indicate that the Road Rater can be used to locate pavement voids and that Road Rater analysis techniques are reasonably accurate. The success of Road Rater research and development has made deflection test data one of the most important pavement management inputs.

User experience strategy

L'objectiu d'aquest projecte era desenvolupar una metodologia de user experience strategy per aconseguir que el client d'una pàgina web tingui una mateixa experiència tant si fa servir una plataforma com una altra, aplicant diferents tècniques de disseny centrades en l'usuari.

Rethinking study and management of agricultural systems for policy design

There is a concern that agriculture will no longer be able to meet, on a global scale, the growing demand for food. Facing such a challenge requires new patterns of thinking in the context of complexity and sustainability sciences. This paper, focused on the social dimension of the study and management of agricultural systems, suggests that rethinking the study of agricultural systems entails analyzing them as complex socio-ecological systems, as well as considering the differing thinking patterns of diverse stakeholders. The intersubjective nature of knowledge, as studied by different philosophical schools, needs to be better integrated into the study and management of agricultural systems than it is done so far, forcing us to accept that there are no simplistic solutions, and to seek a better understanding of the social dimension of agriculture. Different agriculture related problems require different policy and institutional approaches. Finally, the intersubjective nature of knowledge asks for the visualization of different framings and the power relations taking place in the decision-making process. Rethinking management of agricultural systems implies that policy making should be shaped by different principles: learning, flexibility, adaptation, scale-matching, participation, diversity enhancement and precaution hold the promise to significantly improve current standard management procedures.

Implementing the Mechanistic-Empirical Pavement Design Guide: Implementation Plan, TR-509, 2005

The current 1993 American Association of State Highway and Transportation Officials (AASHTO) Pavement Design Guide is based on the empirical interpretation of the results of the 1960 AASHTO Road Test. With the release of the new Mechanistic-Empirical (M-E) Pavement Design Guide, pavement design has taken a "quantum" leap forward. In order to effectively and efficiently transition to the M-E Pavement Design Guide, state DOTs need a detailed implementation and training strategy. This document is a plan for the M-E Pavement Design Guide to be implemented in Iowa.

Handbook for the design of intercultural policies: summary of the original Spanish version

Local governments need minimum common criteria to manage the social dynamics of diversity. This Handbook defends the strategy of interculturality as a public political approach, based on a way to interpret interculturality as a positive resource, as a public cultural and a collective good. It is an approach that promotes the equitative interaction as a way to generate a cohesive common public space. This Handbook provides the reader with the conceptual and practical instruments to help (and inspire) those territories which would like to integrate interculturality as an urban project.It aims to serve as a ground for discussion to jointly work in local administrations and other government levels, fororganizations and institutions, as well as for cultural, political and citizens collectives. Results are presented asan action by the Red de Ciudades Interculturales (RECI), within the Intercultural Cities framework by the Councilof Europe, with the collaboration of Obra Social "La Caixa".

Acute ischemic cerebrovascular events on antiplatelet therapy: what is the optimal prevention strategy?

Even though patients who develop ischemic stroke despite taking antiplatelet drugs represent a considerable proportion of stroke hospital admissions, there is a paucity of data from investigational studies regarding the most suitable therapeutic intervention. There have been no clinical trials to test whether increasing the dose or switching antiplatelet agents reduces the risk for subsequent events. Certain issues have to be considered in patients managed for a first or recurrent stroke while receiving antiplatelet agents. Therapeutic failure may be due to either poor adherence to treatment, associated co-morbid conditions and diminished antiplatelet effects (resistance to treatment). A diagnostic work up is warranted to identify the etiology and underlying mechanism of stroke, thereby guiding further management. Risk factors (including hypertension, dyslipidemia and diabetes) should be treated according to current guidelines. Aspirin or aspirin plus clopidogrel may be used in the acute and early phase of ischemic stroke, whereas in the long-term, antiplatelet treatment should be continued with aspirin, aspirin/extended release dipyridamole or clopidogrel monotherapy taking into account tolerance, safety, adherence and cost issues. Secondary measures to educate patients about stroke, the importance of adherence to medication, behavioral modification relating to tobacco use, physical activity, alcohol consumption and diet to control excess weight should also be implemented.

The business model ontology a proposition in a design science approach

The goal of this dissertation is to find and provide the basis for a managerial tool that allows a firm to easily express its business logic. The methodological basis for this work is design science, where the researcher builds an artifact to solve a specific problem. In this case the aim is to provide an ontology that makes it possible to explicit a firm's business model. In other words, the proposed artifact helps a firm to formally describe its value proposition, its customers, the relationship with them, the necessary intra- and inter-firm infrastructure and its profit model. Such an ontology is relevant because until now there is no model that expresses a company's global business logic from a pure business point of view. Previous models essentially take an organizational or process perspective or cover only parts of a firm's business logic. The four main pillars of the ontology, which are inspired by management science and enterprise- and processmodeling, are product, customer interface, infrastructure and finance. The ontology is validated by case studies, a panel of experts and managers. The dissertation also provides a software prototype to capture a company's business model in an information system. The last part of the thesis consists of a demonstration of the value of the ontology in business strategy and Information Systems (IS) alignment. Structure of this thesis: The dissertation is structured in nine parts: Chapter 1 presents the motivations of this research, the research methodology with which the goals shall be achieved and why this dissertation present a contribution to research. Chapter 2 investigates the origins, the term and the concept of business models. It defines what is meant by business models in this dissertation and how they are situated in the context of the firm. In addition this chapter outlines the possible uses of the business model concept. Chapter 3 gives an overview of the research done in the field of business models and enterprise ontologies. Chapter 4 introduces the major contribution of this dissertation: the business model ontology. In this part of the thesis the elements, attributes and relationships of the ontology are explained and described in detail. Chapter 5 presents a case study of the Montreux Jazz Festival which's business model was captured by applying the structure and concepts of the ontology. In fact, it gives an impression of how a business model description based on the ontology looks like. Chapter 6 shows an instantiation of the ontology into a prototype tool: the Business Model Modelling Language BM2L. This is an XML-based description language that allows to capture and describe the business model of a firm and has a large potential for further applications. Chapter 7 is about the evaluation of the business model ontology. The evaluation builds on literature review, a set of interviews with practitioners and case studies. Chapter 8 gives an outlook on possible future research and applications of the business model ontology. The main areas of interest are alignment of business and information technology IT/information systems IS and business model comparison. Finally, chapter 9 presents some conclusions.

Communicating Cost Information to Design Engineers using an Activity-based Costing Method

This paper analyzes the possibilities of integrating cost information and engineering design. Special emphasis is on finding the potential of using the activity-based costing (ABC) method when formulating cost information for the needs of design engineers. This paper suggests that ABC is more useful than the traditional job order costing, but the negative issue is the fact that ABC models become easily too complicated, i.e. expensive to build and maintain, and difficult to use. For engineering design the most suitable elements of ABC are recognizing activities of the company, constructing acitivity chains, identifying resources, activity and cost drivers, as wellas calculating accurate product costs. ABC systems including numerous cost drivers can become complex. Therefore, a comprehensive ABC based cost information system for the use of design engineers should be considered criticaly. Combining the suitable ideas of ABC with engineering oriented thinking could give competentresults.

Wiki-supported collaborative learning in primary education. How a dialogic space is created for thinking together

This paper explores how wikis may be used to support primary education students’ collaborative interaction and how such an interaction process can be characterised. The overall aim of this study is to analyse the collaborative processes of students working together in a wiki environment, in order to see how primary students can actively create a shared context for learning in the wiki. Educational literature has already reported that wikis may support collaborative knowledge-construction processes, but in our study we claim that a dialogic perspective is needed to accomplish this. Students must develop an intersubjective orientation towards each others’ perspectives, to co-construct knowledge about a topic. For this purpose, our project utilised a ‘Thinking Together’ approach to help students develop an intersubjective orientation towards one another and to support the creation of a ‘dialogic space’ to co-construct new understanding in a wiki science project. The students’ asynchronous interaction process in a primary classroom -- which led to the creation of a science text in the wiki -- was analysed and characterised, using a dialogic approach to the study of CSCL practices. Our results illustrate how the Thinking Together approach became embedded within the wiki environment and in the students’ collaborative processes. We argue that a dialogic approach for examining interaction can be used to help design more effective pedagogic approaches related to the use of wikis in education and to equip learners with the competences they need to participate in the global knowledge-construction era.

Design,implementation and use of an Internet kiosk as an an information system for CNC machinists

Tätä diplomityötä sponsoroi suuri Isobritannialainen lentokoneteollisuudessa toimiva yritys, joka huomasi että globaalin tuotantostrategian ollessa painopisteenä ja tietoteknisten järjestelmien kuten CAD/CAM ollessa merkittävänä osana tuotantoa, on löydettävä ymmärrys siitä, mitkä ovat tuotannon tietojärjestelmien tarpeet ja onko niiden kehittämisestä hyötyä yritykselle.Diplomityössä selitetään Internet teknologiaan perustuvan kioskin kehittämisestä tietotukijärjestelmäksi tuotanto-osastolle, jossa valmistetaan moottorin osia CNC-koneilla. Kioskeissa on piirteitä, jotka voisivat osoittautua hyödyllisiksi myös tuotantoympäristöissä ja siksi tässä työssä tutkitaan kioskiin perustuvaa lähestymistapaa tuotantoympäristöön sovellettuna.Diplomityö kuvaa informaatiokioskin kehittämistä alkaen alkuvaatimusten keruusta tietojärjestelmää varten, tietojärjestelmän suunnittelu- ja kehitysvaiheen sekä lopuksi analysoi kioskin onnistuneisuutta tuotantoympäristössä käytettävyystutkimuksen avulla, joka suoritettiin sen jälkeen kun kioski oli implementoitu tehtaassa.Johtopäätökset osoittavat, että kioski on hyvin implementoitavissa tuotantoympäristöön ja todistaa, että tuotantoinformaation jakelu sähköisessä muodossa on huomattavasti tehokkaampaa kuin paperilla. Käyttäjien kommentit osoittavat että kioski on sopiva heidän tietotarpeisiinsa ja siitä on hyötyä heidän työlleen. Kioski tarjoaa hyötyjä tuotantotason lisäksi myös johtotasolle.

Customer expectation study in product development process and its role in strategy formulation

Tämä työ on tehty kansainväliselle metsäteollisuusyritykselle. Työn lähtökohtana oli tarve tutkia yrityksen mahdollisuuksia laajentaa toimintaansa uudelle markkinasegmentille, eläinruokapakkausmarkkinoille. Johtuen maailmanlaajuisesta eläinruoankulutuksen kasvusta, eläinruokapakkaukset ovat yritykselle mielenkiintoinen uusi markkina-alue. Onnistunut markkinoilletulo vaatii asiakastarpeiden ja -odotusten huomioimista tuotekehitys- ja markkinastrategian muodostamisessa. Tämän työn tavoitteena oli selvittää asiakkaiden odotuksia eläinruokapakkauksille, sekä mallintaa alalla vallitsevia ostoprosesseja. Asiakastarvetutkimus suunniteltiin perustuen kirjallisuuteen ja alustaviin markkina- ja asiakasanalyyseihin. Alustavat analyysit ovat tarpeellisia lähtötilanteen ja trendien selvittämiseksi. Itse tutkimus toteutettiin semi-konstruktoituna teemahaastatteluna. Haastateltavat edustivat USA:n ja Euroopan johtavia eläinruokavalmistajia ja pakkausten jatkojalostajia. Työn tuloksena saatiin yksityiskohtaista tietoa asiakkaiden odotuksista eläinruokapakkauksille, paperin ominaisuuksille ja paperitoimittajille. Lisäksi mallinnettiin ostoprosesseja paperitoimittajien, pakkausten jalostajien ja eläinruokavalmistajien välillä. Tulosten perusteella on analysoitu yrityksen mahdollisuuksia menestyä uudella markkinasegmentillä. Lisäksi työssä annettiin ehdotuksia tuotekehitys- ja markkinastrategian muodostamiseen.

Effectiveness of a primary care-based intervention to reduce sitting time in overweight and obese patients (SEDESTACTIV): a randomized controlled trial; rationale and study design

Background: There is growing evidence suggesting that prolonged sitting has negative effects on people's weight, chronic diseases and mortality. Interventions to reduce sedentary time can be an effective strategy to increase daily energy expenditure. The purpose of this study is to evaluate the effectiveness of a six-month primary care intervention to reduce daily of sitting time in overweight and mild obese sedentary patients. Method/Design: The study is a randomized controlled trial (RCT). Professionals from thirteen primary health care centers (PHC) will randomly invite to participate mild obese or overweight patients of both gender, aged between 25 and 65 years old, who spend 6 hours at least daily sitting. A total of 232 subjects will be randomly allocated to an intervention (IG) and control group (CG) (116 individuals each group). In addition, 50 subjects with fibromyalgia will be included. Primary outcome is: (1) sitting time using the activPAL device and the Marshall questionnaire. The following parameters will be also assessed: (2) sitting time in work place (Occupational Sitting and Physical Activity Questionnaire), (3) health-related quality of life (EQ-5D), (4) evolution of stage of change (Prochaska and DiClemente's Stages of Change Model), (5) physical inactivity (catalan version of Brief Physical Activity Assessment Tool), (6) number of steps walked (pedometer and activPAL), (7) control based on analysis (triglycerides, total cholesterol, HDL, LDL, glycemia and, glycated haemoglobin in diabetic patients) and (8) blood pressure and anthropometric variables. All parameters will be assessed pre and post intervention and there will be a follow up three, six and twelve months after the intervention. A descriptive analysis of all variables and a multivariate analysis to assess differences among groups will be undertaken. Multivariate analysis will be carried out to assess time changes of dependent variables. All the analysis will be done under the intention to treat principle. Discussion: If the SEDESTACTIV intervention shows its effectiveness in reducing sitting time, health professionals would have a low-cost intervention tool for sedentary overweight and obese patients management.