Perspective transformation: Women in long-term recovery from alcohol abuse

Objective. The purpose of this study was to determine the meaning of personal transformation for twenty women in long term, stable recovery from alcohol abuse; to identify themes or patterns of this recovery, and; to determine the extent to which they experienced the phenomenon of perspective transformation. ^ Method. Volunteers were recruited by advertisement, word of mouth, and through a closed circuit web based broadcast. A descriptive, exploratory study, which analyzed perspective transformation from the standpoint of five action phases, was conducted. Data was collected using in-depth personal interviews and questionnaires. Subjects' responses were analyzed by qualitative methods. Triangulation was performed on the grouped data comparing the interviews to the data produced by the questionnaires. Quantitative analysis of questionnaire items explored behavioral changes experienced before and after alcoholism recovery. ^ Results. Five phases of recovery were identified. Phase I which involved recognition that alcohol was a problem and change might be possible took several years during which 3 major transitions occurred: (1) from often being alienated to having relationships with family and friends; (2) from daily upheavals to eventually a more peaceful existence, and; (3) from denial that alcohol was a problem to acceptance and willingness to change. Recovery was often seen in a spiritual context, which also required ongoing support. During Phase II there was an assessment of self, others, and the environment which revealed a pattern of intense unhappiness and negative feelings toward self and others with a disregard for cultural norms. Phase III revealed a period of desperation as life became unmanageable, but gradual willingness to accept support and guidance and a desire to improve self and help others. This led to improvement of existing role performance and the willingness to try out new roles. In Phase IV there was a pattern of personal growth which included: the establishment of boundaries, setting priorities, a willingness to place others' needs above their own, acceptance of responsibility, and learning to cope without alcohol, often with the use of tools learned in AA. During Phase V, many experienced knowledge of frailties but growing respect for self and others, with an improved ability to function in giving relationships. Implications for Prevention and Recovery: Early education concerning addiction and recovery may play a crucial role in prevention and early recovery, as it did for children of women in this study. Recovery requires persistent effort and organized support. ^

Air Force Web Preventive Health Assessment (AF WEBPHA) mental health screening effectiveness

The U.S. Air Force assesses Active Duty Air Force (ADAF) health annually using the Air Force Web-based Preventative Health Assessment (AF WebPHA). The assessment is based on a self-administered survey used to determine the overall Air Force health and readiness, as well as, the individual health of each airman. Individual survey responses as well as groups of responses generate further computer generated assessment and result in a classification of 'Critical', 'Priority', or 'Routine', depending on the need and urgency for further evaluation by a health care provider. The importance of the 'Priority' and 'Critical' classifications is to provide timely intervention to prevent or limit unfavorable outcomes that may threaten an airman. Though the USAF has been transitioning from a paper form to the online WebPHA survey for the last three years it was not made mandatory for all airmen until 2009. The survey covers many health aspects including family history, tobacco use, exercise, alcohol use, and mental health. ^ Military stressors such as deployment, change of station, and the trauma of war can aggravate and intensify the common baseline worries experienced by the general population and place airmen at additional risks for mental health concerns and illness. This study assesses the effectiveness of the AF WebPHA mental health screening questions in predicting a mental health disorder diagnosis according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes generated by physicians or their surrogates. In order to assess the sensitivity, specificity, and positive predictive value of the AF WebPHA as a screening tool for mental health, survey results were compared to ascertain if they generated any mental health disorder related diagnosis for the period from January 1, 2009 to March 31, 2010. ^ Statistical analysis of the AF WebPHA mental health responses when compared with matching ICD-9-CM codes found that the sensitivity for 'Critical' or 'Priority' responses was only 3.4% and that it would correctly predict those who had the selected mental health diagnosis 9% of the time.^

The Open Door Mission: Measuring and predicting outcomes of one community-based substance abuse treatment program

The objectives of this study were to identify and measure the average outcomes of the Open Door Mission's nine-month community-based substance abuse treatment program, identify predictors of successful outcomes, and make recommendations to the Open Door Mission for improving its treatment program.^ The Mission's program is exclusive to adult men who have limited financial resources: most of which were homeless or dependent on parents or other family members for basic living needs. Many, but not all, of these men are either chemically dependent or have a history of substance abuse.^ This study tracked a cohort of the Mission's graduates throughout this one-year study and identified various indicators of success at short-term intervals, which may be predictive of longer-term outcomes. We tracked various levels of 12-step program involvement, as well as other social and spiritual activities, such as church affiliation and recovery support.^ Twenty-four of the 66 subjects, or 36% met the Mission's requirements for success. Specific to this success criteria; Fifty-four, or 82% reported affiliation with a home church; Twenty-six, or 39% reported full-time employment; Sixty-one, or 92% did not report or were not identified as having any post-treatment arrests or incarceration, and; Forty, or 61% reported continuous abstinence from both drugs and alcohol.^ Five research-based hypotheses were developed and tested. The primary analysis tool was the web-based non-parametric dependency modeling tool, B-Course, which revealed some strong associations with certain variables, and helped the researchers generate and test several data-driven hypotheses. Full-time employment is the greatest predictor of abstinence: 95% of those who reported full time employment also reported continuous post-treatment abstinence, while 50% of those working part-time were abstinent and 29% of those with no employment were abstinent. Working with a 12-step sponsor, attending aftercare, and service with others were identified as predictors of abstinence.^ This study demonstrates that associations with abstinence and the ODM success criteria are not simply based on one social or behavioral factor. Rather, these relationships are interdependent, and show that abstinence is achieved and maintained through a combination of several 12-step recovery activities. This study used a simple assessment methodology, which demonstrated strong associations across variables and outcomes, which have practical applicability to the Open Door Mission for improving its treatment program. By leveraging the predictive capability of the various success determination methodologies discussed and developed throughout this study, we can identify accurate outcomes with both validity and reliability. This assessment instrument can also be used as an intervention that, if operationalized to the Mission’s clients during the primary treatment program, may measurably improve the effectiveness and outcomes of the Open Door Mission.^

Development of a standard sign-out procedure for clinicians in a pediatric intensive care unit

Background: Poor communication among health care providers is cited as the most common cause of sentinel events involving patients. Sign-out of patient data at the change of clinician shifts is a component of communication that is especially vulnerable to errors. Sign-outs are particularly extensive and complex in intensive care units (ICUs). There is a paucity of validated tools to assess ICU sign-outs. ^ Objective: To design a valid and reliable survey tool to assess the perceptions of Pediatric ICU (PICU) clinicians about sign-out. ^ Design: Cross-sectional, web-based survey ^ Setting: Academic hospital, 31-bed PICU ^ Subjects: Attending faculty, fellows, nurse practitioners and physician assistants. ^ Interventions: A survey was designed with input from a focus group and administered to PICU clinicians. Test-retest reliability, internal consistency and validity of the survey tool were assessed. ^ Measurements and Main Results: Forty-eight PICU clinicians agreed to participate. We had 42(88%) and 40(83%) responses in the test and retest phases. The mean scores for the ten survey items ranged from 2.79 to 3.67 on a five point Likert scale with no significant test-retest difference and a Pearson correlation between pre and post answers of 0.65. The survey item scores showed internal consistency with a Cronbach's Alpha of 0.85. Exploratory factor analysis revealed three constructs: efficacy of sign-out process, recipient satisfaction and content applicability. Seventy eight % clinicians affirmed the need for improvement of the sign-out process and 83% confirmed the need for face- to-face verbal sign-out. A system-based sign-out format was favored by fellows and advanced level practitioners while attendings preferred a problem-based format (p=0.003). ^ Conclusions: We developed a valid and reliable survey to assess clinician perceptions about the ICU sign-out process. These results can be used to design a verbal template to improve and standardize the sign-out process.^

A New End-User Composition Model to Empower Knowledge Workers to Develop Rich Internet Applications

Enabling real end-user programming development is the next logical stage in the evolution of Internetwide service-based applications. Even so, the vision of end users programming their own web-based solutions has not yet materialized. This will continue to be so unless both industry and the research community rise to the ambitious challenge of devising an end-to-end compositional model for developing a new age of end-user web application development tools. This paper describes a new composition model designed to empower programming-illiterate end users to create and share their own off-the-shelf rich Internet applications in a fully visual fashion. This paper presents the main insights and outcomes of our research and development efforts as part of a number of successful European Union research projects. A framework implementing this model was developed as part of the European Seventh Framework Programme FAST Project and the Spanish EzWeb Project and allowed us to validate the rationale behind our approach.

The Road from Community Ideas to Organisational Innovation: A Life Cycle Survey of Idea Management Systems

This paper introduces a new emerging software component, the idea management system, which helps to gather, organise, select and manage the innovative ideas provided by the communities gathered around organisations or enterprises. We define the notion of the idea life cycle, which provides a framework for characterising tools and techniques that drive the evolution of community submitted data inside idea management systems. Furthermore, we show the dependencies between the community-created information and the enterprise processes that are a result of using idea management systems and point out the possible benefits.

A Reuse-based Lightweight Method for Developing Linked Data Ontologies and Vocabularies

The uptake of Linked Data (LD) has promoted the proliferation of datasets and their associated ontologies for describing different domains. Par-ticular LD development characteristics such as agility and web-based architec-ture necessitate the revision, adaption, and lightening of existing methodologies for ontology development. This thesis proposes a lightweight method for ontol-ogy development in an LD context which will be based in data-driven agile de-velopments, existing resources to be reused, and the evaluation of the obtained products considering both classical ontological engineering principles and LD characteristics.

Debugging of constraint programs: The DiSCiPl methodology and tools

This introduction gives a general perspective of the debugging methodology and the tools developed in the ESPRIT IV project DiSCiPl Debugging Systems for Constraint Programming. It has been prepared by the editors of this volume by substantial rewriting of the DiSCiPl deliverable CP Debugging Tools [1]. This introduction is organised as follows. Section 1 outlines the DiSCiPl view of debugging, its associated debugging methodology, and motivates the kinds of tools proposed: the assertion based tools, the declarative diagnoser and the visualisation tools. Sections 2 through 4 provide a short presentation of the tools of each kind. Finally, Section 5 presents a summary of the tools developed in the project. This introduction gives only a general view of the DiSCiPl debugging methodology and tools. For details and for specific bibliographic referenees the reader is referred to the subsequent chapters.

Advanced Videoconferencing based on WebRTC

Lately, videoconference applications have experienced an evolution towards the World Wide Web. New technologies have given browsers real-time communications capabilities. In this context, WebRTC aims to provide this functionality by following and defining standards. Being a new effort, WebRTC still lacks advanced videoconferencing services such as session recording, media mixing and adjusting to varying network conditions. This paper analyzes these challenges and proposes an architecture based on a traditional communications entity, the Multipoint Control Unit or MCU as a solution.

Opportunities and Challenges of Implementing P2P Streaming Applications in the Web

P2P applications are increasingly present on the web. We have identified a gap in current proposals when it comes to the use of traditional P2P overlays for real-time multimedia streaming. We analyze the possibilities and challenges to extend WebRTC in order to implement JavaScript APIs for P2P streaming algorithms.

The dicode workbench: A flexible framework for the integration of information and web services

Aiming to address requirements concerning integration of services in the context of ?big data?, this paper presents an innovative approach that (i) ensures a flexible, adaptable and scalable information and computation infrastructure, and (ii) exploits the competences of stakeholders and information workers to meaningfully confront information management issues such as information characterization, classification and interpretation, thus incorporating the underlying collective intelligence. Our approach pays much attention to the issues of usability and ease-of-use, not requiring any particular programming expertise from the end users. We report on a series of technical issues concerning the desired flexibility of the proposed integration framework and we provide related recommendations to developers of such solutions. Evaluation results are also discussed.

On a meaningful integration of web services in data-intensive biomedical environments: The DICODE approach

This paper reports on an innovative approach that aims to reduce information management costs in data-intensive and cognitively-complex biomedical environments. Recognizing the importance of prominent high-performance computing paradigms and large data processing technologies as well as collaboration support systems to remedy data-intensive issues, it adopts a hybrid approach by building on the synergy of these technologies. The proposed approach provides innovative Web-based workbenches that integrate and orchestrate a set of interoperable services that reduce the data-intensiveness and complexity overload at critical decision points to a manageable level, thus permitting stakeholders to be more productive and concentrate on creative activities.

PREDIRCAM eHealth platform for individualized telemedical assistance for lifestyle modification in the treatment of obesity, diabetes, and cardiometabolic risk prevention: a pilot study (PREDIRCAM 1)

Background: Healthy diet and regular physical activity are powerful tools in reducing diabetes and cardiometabolic risk. Various international scientific and health organizations have advocated the use of new technologies to solve these problems. The PREDIRCAM project explores the contribution that a technological system could offer for the continuous monitoring of lifestyle habits and individualized treatment of obesity as well as cardiometabolic risk prevention. Methods: PREDIRCAM is a technological platform for patients and professionals designed to improve the effectiveness of lifestyle behavior modifications through the intensive use of the latest information and communication technologies. The platform consists of a web-based application providing communication interface with monitoring devices of physiological variables, application for monitoring dietary intake, ad hoc electronic medical records, different communication channels, and an intelligent notification system. A 2-week feasibility study was conducted in 15 volunteers to assess the viability of the platform. Results: The website received 244 visits (average time/session: 17 min 45 s). A total of 435 dietary intakes were recorded (average time for each intake registration, 4 min 42 s ± 2 min 30 s), 59 exercises were recorded in 20 heart rate monitor downloads, 43 topics were discussed through a forum, and 11 of the 15 volunteers expressed a favorable opinion toward the platform. Food intake recording was reported as the most laborious task. Ten of the volunteers considered long-term use of the platform to be feasible. Conclusions: The PREDIRCAM platform is technically ready for clinical evaluation. Training is required to use the platform and, in particular, for registration of dietary food intake.

Modeling Commercial Knowledge to Develop Advanced Agent-based Marketplaces for E-commerce

This paper argues about the utility of advanced knowledge-based techniques to develop web-based applications that help consumers in finding products within marketplaces in e-commerce. In particular, we describe the idea of model-based approach to develop a shopping agent that dynamically configures a product according to the needs and preferences of customers. Finally, the paper summarizes the advantages provided by this approach.

Impacto de las redes sociales digitales en la innovación y la ventaja competitiva : un estudio de casos

Internet y las Tecnologías de la Información y las Comunicaciones han transformado de manera notable la forma de relacionarse de las personas. Actualmente, la presencia de estas nuevas tecnologías está totalmente asumida e impacta en el día a día de millones de personas en todo el mundo. Dentro de este contexto se presentan las Redes Sociales Digitales como plataformas que han dado lugar a un cambio de mentalidad, creando una nueva forma de comprender y utilizar internet. En este proyecto se ha llevado a cabo un estudio del fenómeno de las redes sociales dentro del mundo empresarial con el fin especificar su viabilidad como herramienta profesional dentro del sector de las TIC en términos de innovación, ventaja competitiva, y riesgo. El desarrollo de este trabajo se ha abarcado en dos partes principales: en primer lugar, un análisis teórico a cerca de las ventajas competitivas que puede ofrecer esta tecnología y cómo se puede traducir en valor real para una empresa. Y en segundo lugar un estudio de casos práctico donde se ha estudiado la experiencia de distintas empresas en el uso del Social Media. Previo a la implementación de estos puntos, este estudio se ha enmarcado dentro del mundo de las TIC, presentando conceptos como la web 2.0, los tipos herramientas que pueden ser aplicadas por la empresa y modelos de negocio que se presentan en Internet. La finalidad de este trabajo consiste en presentar qué factores de los expuestos de manera teórica generan ventaja competitiva y beneficio o por el contrario, desventaja y riesgo a la empresa, apoyándose en las conclusiones obtenidas a través del estudio de casos. ABSTRACT Internet and Information and Communication Technologies have remarkably transformed the personal relationship. Thus, these technologies are completely assumed and affect to the daily life of millions of people. Under this context, is presented the Digital Social Media as platforms which have changed the global mindset triggering a new way of understanding and using the Internet. In this project, has been carried out a study of the Social Media within the professional TIC world, aimed to specify its viability as working tool in terms of innovation, competitive advantage and risk. The implementation has been covered in two main parts: First, a theoretical analysis about the competitive advantage which this technology could offer and how it can become into real value for a company. And secondly, a Case Study in order to analyze different company’s experiences in the use of Social Media and providing empirical support to the obtained conclusions in the theoretical part. In addition, before develop these two points, the project has been integrated in the TIC´s field, meeting concepts as Web 2.0, different kinds of internet-based tools which can be used by a company and business models based on the information technologies.