A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT] — Effects of Three Different Strategies of Implementation

BACKGROUND: Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). METHODS: For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. FINDINGS: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. INTERPRETATION: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. FUNDING: Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF. KEYWORDS: Cognitive behavioral therapy; Evidence-based treatment; Implementation strategies; Randomized controlled trial

How to be in a good shape? The influence of clone morphology on cell competition

Cell competition is a conserved mechanism where slow proliferating cells (so called losers) are eliminated by faster proliferating neighbors (so called winners) through apoptosis.(1) It is an important process which prevents developmental malformations and maintains tissue fitness in aging adults.(2) Recently, we have shown that the probability of elimination of loser cells correlates with the surface of contact between losers and winners in Myc-induced competition.(3) Moreover, we have characterized an active mechanism that increases the surface of contact between losers and winners, hence accelerating the elimination of loser cells. This is the first indication that cell shape and mechanics can influence cell competition. Here, we will discuss the consequence of the relationship between shape and competition, as well as the relevance of this model for other modes of competition.

Minimizing the Price of Tranquility: How to Discourage Scotland's Secession from the United Kingdom

What some view as overly-generous funding of the Scottish parliament results from Scotland.s credible threat to secede from the United Kingdom. Scotland is shown to benefit from a second mover advantage in a non-cooperative sequential game over the allocation of public funds. Various reform proposals are criticized for not recognizing that reform of Scottish government finances must be consistent with Scotland.s credible threat. Fiscal autonomy -- in which the Scottish parliament finances a much greater proportion of its spending from Scottish-sourced taxes, is demonstrated to be a viable reform within the existing political context and, in some circumstances, could remove Scotland.s second mover advantage. We also use a cooperative bargaining game model to demonstrate that an Australian style grants commission would not be a viable reform in the British context.

TNCs in Perplexity over How to Meet Local Suppliers: The Case of Philippine Export Processing Zone

Transnational Corporations (TNCs) have played a vital role in fostering rapid industrialisation in many developing countries. The Philippines is the case. However, the country has been far lagging behind other ASEAN members in economic performance. The present study examines this issue, mainly focusing on the linkage formation between TNCs affiliates and Philippine local suppliers. Three factors are proposed to determine the overall performance of linkage formation; i.e., outsourcing strategies of TNCs’ local affiliates, local entrepreneurial response, and host government policies. An economic enclave structure is clearly identified in the Philippines, in which only a few locally-owned suppliers have emerged.　Extremely weak local entrepreneurship in the Philippines is identified to explain the poor performance of linkage formation.

Riding out of the storm: How to deal with the complexity of grid and cloud management

Over the last decade, Grid computing paved the way for a new level of large scale distributed systems. This infrastructure made it possible to securely and reliably take advantage of widely separated computational resources that are part of several different organizations. Resources can be incorporated to the Grid, building a theoretical virtual supercomputer. In time, cloud computing emerged as a new type of large scale distributed system, inheriting and expanding the expertise and knowledge that have been obtained so far. Some of the main characteristics of Grids naturally evolved into clouds, others were modified and adapted and others were simply discarded or postponed. Regardless of these technical specifics, both Grids and clouds together can be considered as one of the most important advances in large scale distributed computing of the past ten years; however, this step in distributed computing has came along with a completely new level of complexity. Grid and cloud management mechanisms play a key role, and correct analysis and understanding of the system behavior are needed. Large scale distributed systems must be able to self-manage, incorporating autonomic features capable of controlling and optimizing all resources and services. Traditional distributed computing management mechanisms analyze each resource separately and adjust specific parameters of each one of them. When trying to adapt the same procedures to Grid and cloud computing, the vast complexity of these systems can make this task extremely complicated. But large scale distributed systems complexity could only be a matter of perspective. It could be possible to understand the Grid or cloud behavior as a single entity, instead of a set of resources. This abstraction could provide a different understanding of the system, describing large scale behavior and global events that probably would not be detected analyzing each resource separately. In this work we define a theoretical framework that combines both ideas, multiple resources and single entity, to develop large scale distributed systems management techniques aimed at system performance optimization, increased dependability and Quality of Service (QoS). The resulting synergy could be the key 350 J. Montes et al. to address the most important difficulties of Grid and cloud management.

How to optimize the use of available OCW resources?

Como optimizar el uso de los recursos disponibles

On subjective impressions or how to put numbers to visual illusions

This paper presents a simple theory to analyze some of the more common visual illusions. The reported mathematical model is able to give some numerical results concerning well known phenomena as the Zollner, Muller-Lyer or Wundt illusions. We present two different approaches, the first one related with the symmetrical operations present in each image and the second one concerning a proposed vector field related with the lines present at the image

Dendrogeomorphological research applied to flood hazard analysis in the Caldera de Taburiente National Park (La Palma, Canary Islands, Spain).

Se ha realizado un estudio dendrogeomorfológico utilizando las heridas de los árboles como indicadores de paleoinundaciones.

Recent advances on dendrogeomorphological research applied to flood hazard analysis in Spain.

Estudios dendroecológicos para el análisis de regímentes torrenciales y avenidas