A sorrow shared is a sorrow halved? Internet-based group therapy versus individual therapy for social anxiety disorder: A randomized controlled trial

Purpose: Social anxiety disorder is one of the most researched conditions in the field of Internet-based self-help. Various studies have shown that cognitive-behavioral treatments can be efficacious to reduce social phobic symptoms. Most of the interventions tested include some form of support, whereas the efficacy of a web-based group format has yet to be investigated. The present study aims at investigating the possible added value of therapist-guided group support in an Internet-based guided self-help treatment for SAD. Methods: A total of 150 adults with a diagnosis of SAD are randomly assigned to either a wait-list control group or one of two active treatment conditions. Participants in the two active conditions use the same Internet-based self-help program, either with individual guidance by a therapist or with the support of a therapist-guided group of 6 individuals. In the group condition, participants communicate with each other via an integrated, protected discussion forum. The primary outcome variables are symptoms of SAD and diagnostic status immediately after the intervention (12 weeks) and at 6-month follow-up. Secondary endpoints are general symptomatology, depression, quality of life and adherence to treatment. Furthermore, process variables such as group processes and the working alliance are studied. Results: Results are currently being analyzed. Results at post-treatment will be presented and discussed. Potential moderating and mediating variables of treatment success will be addressed. Conclusion: The results of this study should indicate whether therapist-guided group support could enhance the efficacy of an internet based self-help treatment for SAD. This novel treatment format, if shown efficacious, could represent a cost-effective option and could be further modified to treat other conditions.

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. ^

A qualitative assessment of the impact of Texas policy changes on nutrition in child care centers in Travis County, Texas

Background. Over half of children in the United States under age five spend 32 hours a week in child care, facilities, where they consume approximately 33-50% of their food intake. ^ Objectives. The aim of this research was to identify the effects of state nutrition policies on provision of food in child care centers. ^ Subjects. Eleven directors or their designee from ten randomly selected licensed child care centers in Travis County, Texas were interviewed. Centers included both nonprofit and for-profit centers, with enrollments ranging from 19 to 82. ^ Methods. Centers were selected using a web-based list of licensed child care providers in the Austin area. One-on-one interviews were conducted in person with center directors using a standard set of questions developed from previous pilot work. Interview items included demographic data, questions about state policies regarding provision of foods in centers, effects of policies on child care center budgets and foods offered, and changes in the provision of food. All interviews were audiotaped and transcribed, and themes were identified using standard qualitative techniques. ^ Results. Four of the centers provided both meals and snacks, four provided snacks only, and two did not provide any food. Directors of centers that provided food were more likely to report adherence to the Minimum Standards than directors of centers that did not. In general, center directors reported that the regulations were loosely enforced. In contrast, center directors were more concerned about a local city-county regulation that required food permits and new standards for kitchens. Most of these local regulations were cost prohibitive and, as a result, centers had changed the types of foods provided, which included providing less fresh produce and more prepackaged items. Although implementation of local regulations had reduced provision of fruits and vegetables to children, no adjustments were reported for allocation of resources, tuition costs or care of the children. ^ Conclusions. Qualitative data from a small sample of child care directors indicate that the implementation and accountability of food- and nutrition-related guidelines for centers is sporadic, uncoordinated, and can have unforeseen effects on the provision of food. A quantitative survey and dietary assessment methods should be conducted to verify these findings in a larger and more representative sample.^

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.^

Orbital-resolution Pliocene-Pleistocene simulations of CO2, sea level, global temperature and benthic d18O, and d11B-based proxy-CO2 data

During the past five million yrs, benthic d18O records indicate a large range of climates, from warmer than today during the Pliocene Warm Period to considerably colder during glacials. Antarctic ice cores have revealed Pleistocene glacial-interglacial CO2 variability of 60-100 ppm, while sea level fluctuations of typically 125 m are documented by proxy data. However, in the pre-ice core period, CO2 and sea level proxy data are scarce and there is disagreement between different proxies and different records of the same proxy. This hampers comprehensive understanding of the long-term relations between CO2, sea level and climate. Here, we drive a coupled climate-ice sheet model over the past five million years, inversely forced by a stacked benthic d18O record. We obtain continuous simulations of benthic d18O, sea level and CO2 that are mutually consistent. Our model shows CO2 concentrations of 300 to 470 ppm during the Early Pliocene. Furthermore, we simulate strong CO2 variability during the Pliocene and Early Pleistocene. These features are broadly supported by existing and new d11B-based proxy CO2 data, but less by alkenone-based records. The simulated concentrations and variations therein are larger than expected from global mean temperature changes. Our findings thus suggest a smaller Earth System Sensitivity than previously thought. This is explained by a more restricted role of land ice variability in the Pliocene. The largest uncertainty in our simulation arises from the mass balance formulation of East Antarctica, which governs the variability in sea level, but only modestly affects the modeled CO2 concentrations.

Video analysis based vehicle detection and tracking using an MCMC sampling framework

This article presents a probabilistic method for vehicle detection and tracking through the analysis of monocular images obtained from a vehicle-mounted camera. The method is designed to address the main shortcomings of traditional particle filtering approaches, namely Bayesian methods based on importance sampling, for use in traffic environments. These methods do not scale well when the dimensionality of the feature space grows, which creates significant limitations when tracking multiple objects. Alternatively, the proposed method is based on a Markov chain Monte Carlo (MCMC) approach, which allows efficient sampling of the feature space. The method involves important contributions in both the motion and the observation models of the tracker. Indeed, as opposed to particle filter-based tracking methods in the literature, which typically resort to observation models based on appearance or template matching, in this study a likelihood model that combines appearance analysis with information from motion parallax is introduced. Regarding the motion model, a new interaction treatment is defined based on Markov random fields (MRF) that allows for the handling of possible inter-dependencies in vehicle trajectories. As for vehicle detection, the method relies on a supervised classification stage using support vector machines (SVM). The contribution in this field is twofold. First, a new descriptor based on the analysis of gradient orientations in concentric rectangles is dened. This descriptor involves a much smaller feature space compared to traditional descriptors, which are too costly for real-time applications. Second, a new vehicle image database is generated to train the SVM and made public. The proposed vehicle detection and tracking method is proven to outperform existing methods and to successfully handle challenging situations in the test sequences.

Thermodynamical Phase Noise in Oscillators Based on L-C Resonators

Using a new Admittance-based model for electrical noise able to handle Fluctuations and Dissipations of electrical energy, we explain the phase noise of oscillators that use feedback around L-C resonators. We show that Fluctuations produce the Line Broadening of their output spectrum around its mean frequency f0 and that the Pedestal of phase noise far from f0 comes from Dissipations modified by the feedback electronics. The charge noise power 4FkT/R C2/s that disturbs the otherwise periodic fluctuation of charge these oscillators aim to sustain in their L-C-R resonator, is what creates their phase noise proportional to Leeson’s noise figure F and to the charge noise power 4kT/R C2/s of their capacitance C that today’s modelling would consider as the current noise density in A2/Hz of their resistance R. Linked with this (A2/Hz?C2/s) equivalence, R becomes a random series in time of discrete chances to Dissipate energy in Thermal Equilibrium (TE) giving a similar series of discrete Conversions of electrical energy into heat when the resonator is out of TE due to the Signal power it handles. Therefore, phase noise reflects the way oscillators sense thermal exchanges of energy with their environment.

Thermodynamical Phase Noise in Oscillators Based on L-C Resonators (Foundations)

Using a new Admittance-based model for electrical noise able to handle Fluctuations and Dissipations of electrical energy, we explain the phase noise of oscillators that use feedback around L-C resonators. We show that Fluctuations produce the Line Broadening of their output spectrum around its mean frequency f0 and that the Pedestal of phase noise far from f0 comes from Dissipations modified by the feedback electronics. The charge noise power 4FkT/R C2/s that disturbs the otherwise periodic fluctuation of charge these oscillators aim to sustain in their L-C-R resonator, is what creates their phase noise proportional to Leeson’s noise figure F and to the charge noise power 4kT/R C2/s of their capacitance C that today’s modelling would consider as the current noise density in A2/Hz of their resistance R. Linked with this (A2/Hz?C2/s) equivalence, R becomes a random series in time of discrete chances to Dissipate energy in Thermal Equilibrium (TE) giving a similar series of discrete Conversions of electrical energy into heat when the resonator is out of TE due to the Signal power it handles. Therefore, phase noise reflects the way oscillators sense thermal exchanges of energy with their environment

The use of computers for graduate education in Project Management. Improving the integration to the industry.

This paper presents an initiative for monitoring the competence acquisition by a team of students with different backgrounds facing the experience of being working by projects and in a project. These students are graduated bachelor engineering are inexperienced in the project management field and they play this course on a time-shared manner along with other activities. The goal of this experience is to increase the competence levels acquired by using an structured web based portfolio tool helping to reinforce how relevant different project management approaches can result for final products and how important it becomes to maintain the integration along the project. Monitoring is carried out by means of have a look on how the work is being done and measuring different technical parameters per participant. The use of this information could make possible to bring additional information to the students involved in terms of their individual competencies and the identification of new opportunities of personal improvement. These capabilities are strongly requested by companies in their daily work as well as they can be very convenient too for students when they try to organize their PhD work.

A user-centric approach to service creation and delivery over next generation networks

Next Generation Networks (NGN) provide Telecommunications operators with the possibility to share their resources and infrastructure, facilitate the interoperability with other networks, and simplify and unify the management, operation and maintenance of service offerings, thus enabling the fast and cost-effective creation of new personal, broadband ubiquitous services. Unfortunately, service creation over NGN is far from the success of service creation in the Web, especially when it comes to Web 2.0. This paper presents a novel approach to service creation and delivery, with a platform that opens to non-technically skilled users the possibility to create, manage and share their own convergent (NGN-based and Web-based) services. To this end, the business approach to user-generated services is analyzed and the technological bases supporting the proposal are explained.

A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

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.