Don't forget asking the others! - The added value of significant other's reports on patient interpersonal style for the prediction of therapy process and outcome

Theory: Interpersonal factors play a major role in causing and maintaining depression. It is unclear, however, to what degree significant others of the patient need to be involved for characterizing the patient's interpersonal style. Therefore, our study sought to investigate how impact messages as perceived by the patients' significant others add to the prediction of psychotherapy process and outcome above and beyond routine assessments, and therapist factors. Method: 143 outpatients with major depressive disorder were treated by 24 therapists with CBT or Exposure-Based Cognitive Therapy. Interpersonal style was measured pre and post therapy with the informant‐based Impact Message Inventory (IMI), in addition to the self‐report Inventory of Interpersonal Problems (IIP‐32). Indicators for the patients' dominance and affiliation as well as interpersonal distress were calculated from these measures. Depressive and general symptomatology was assessed at pre, post, and at three months follow‐up, and by process measures after every session. Results: Whereas significant other's reports did not add significantly to the prediction of the early therapeutic alliance, central mechanisms of change, or post‐therapy outcome including therapist factors, the best predictor of outcome 3 months post therapy was an increase in dominance as perceived by significant others. Conclusions: The patients' significant others seem to provide important additional information about the patients' interpersonal style and therefore should be included in the diagnostic process. Moreover, practitioners should specifically target interpersonal change as a potential mechanism of change in psychotherapy for depression.

Critical indicators associated with negative performance in a selectively manned unit

Introduction. Selectively manned units have a long, international history, both military and civilian. Some examples include SWAT teams, firefighters, the FBI, the DEA, the CIA, and military Special Operations. These special duty operators are individuals who perform a highly skilled and dangerous job in a unique environment. A significant amount of money is spent by the Department of Defense (DoD) and other federal agencies to recruit, select, train, equip and support these operators. When a critical incident or significant life event occurs, that jeopardizes an operator's performance; there can be heavy losses in terms of training, time, money, and potentially, lives. In order to limit the number of critical incidents, selection processes have been developed over time to “select out” those individuals most likely to perform below desired performance standards under pressure or stress and to "select in" those with the "right stuff". This study is part of a larger program evaluation to assess markers that identify whether a person will fail under the stresses in a selectively manned unit. The primary question of the study is whether there are indicators in the selection process that signify potential negative performance at a later date. ^ Methods. The population being studied included applicants to a selectively manned DoD organization between 1993 and 2001 as part of a unit assessment and selection process (A&S). Approximately 1900 A&S records were included in the analysis. Over this nine year period, seventy-two individuals were determined to have had a critical incident. A critical incident can come in the form of problems with the law, personal, behavioral or family problems, integrity issues, and skills deficit. Of the seventy-two individuals, fifty-four of these had full assessment data and subsequent supervisor performance ratings which assessed how an individual performed while on the job. This group was compared across a variety of variables including demographics and psychometric testing with a group of 178 individuals who did not have a critical incident and had been determined to be good performers with positive ratings by their supervisors.^ Results. In approximately 2004, an online pre-screen survey was developed in the hopes of preselecting out those individuals with items that would potentially make them ineligible for selection to this organization. This survey has aided the organization to increase its selection rates and save resources in the process. (Patterson, Howard Smith, & Fisher, Unit Assessment and Selection Project, 2008) When the same prescreen was used on the critical incident individuals, it was found that over 60% of the individuals would have been flagged as unacceptable. This would have saved the organization valuable resources and heartache.^ There were some subtle demographic differences between the two groups (i.e. those with critical incidents were almost twice as likely to be divorced compared with the positive performers). Upon comparison of Psychometric testing several items were noted to be different. The two groups were similar when their IQ levels were compared using the Multidimensional Aptitude Battery (MAB). When looking at the Minnesota Multiphasic Personality Inventory (MMPI), there appeared to be a difference on the MMPI Social Introversion; the Critical Incidence group scored somewhat higher. When analysis was done, the number of MMPI Critical Items between the two groups was similar as well. When scores on the NEO Personality Inventory (NEO) were compared, the critical incident individuals tended to score higher on Openness and on its subscales (Ideas, Actions, and Feelings). There was a positive correlation between Total Neuroticism T Score and number of MMPI critical items.^ Conclusions. This study shows that the current pre-screening process is working and would have saved the organization significant resources. ^ If one was to develop a profile of a candidate who potentially could suffer a critical incident and subsequently jeopardize the unit, mission and the safety of the public they would look like the following: either divorced or never married, score high on the MMPI in Social Introversion, score low on MMPI with an "excessive" amount of MMPI critical items; and finally scores high on the NEO Openness and subscales Ideas, Feelings, and Actions.^ Based on the results gleaned from the analysis in this study there seems to be several factors, within psychometric testing, that when taken together, will aid the evaluators in selecting only the highest quality operators in order to save resources and to help protect the public from unfortunate critical incidents which may adversely affect our health and safety.^

THE APPLICATION OF CIRRHOSIS MORTALITY AND SUICIDE MORTALITY AS INDICATORS FOR ALCOHOLISM PLANNING

This study provides a review of the current alcoholism planning process of the Houston-Galveston planning process of the Houston-Galveston Area Council, an agency carrying out planning for a thirteen county region in surrounding Houston, Texas. The four central groups involved in this planning are identified, and the role that each plays and how it effects the planning outcomes is discussed.^ The most substantive outcome of the Houston-Galveston Area Council's alcoholism planning, the Regional Alcoholism/Alcohol Abuse Plan is examined. Many of the shortcomings in the data provided, and the lack of other data necessary for planning are offered.^ A problem oriented planning model is presented as an alternative to the Houston-Galveston Area Council's current service oriented approach to alcoholism planning. Five primary phases of the model, identification of the problem, statement of objectives, selection of alternative programs, implementation, and evaluation, are presented, and an overview of the tasks involved in the application of this model to alcoholism planning is offered.^ A specific aspect of the model, the use of problem status indicators is explored using cirrhosis and suicide mortality data. A review of the literature suggests that based on five criteria, availability, subgroup identification, validity, reliability, and sensitivity, both suicide and cirrhosis are suitable as indicators of the alcohol problem when combined with other indicators.^ Cirrhosis and suicide mortality data are examined for the thirteen county Houston-Galveston Region for the years 1969 through 1976. Data limitations preclude definite conclusions concerning the alcohol problem in the region. Three hypotheses about the nature of the regional alcohol problem are presented. First, there appears to be no linear trend in the number of alcoholics that are at risk of suicide and cirrhosis mortality. Second, the number of alcoholics in the metropolitan areas seems to be greater than the number of rural areas. Third, the number of male alcoholics at risk of cirrhosis and suicide mortality is greater than the number of female alcoholics.^

Differences in performance for quality of care indicators for acute myocardial infarction (AMI) across various hospital categories in Texas

The study analyzed Hospital Compare data for Medicare Fee-for-service patients at least 65 years of age to determine whether hospital performance for AMI outcome and processes of care measures differ amongst Texas hospitals with respect to ownership status (for profit vs. not-for-profit), academic status (teaching vs. non-teaching) and geographical setting (rural vs. urban). ^ The study found a statistically significant difference between for-profit and not-for-profit hospitals in four process-of-care measures (aspirin at discharge, P=0.028; ACE or ARB inhibitor for LSVD, P=0.048; Smoking cessation advice: P=0.034; outpatients who got aspirin with 24 hours of arrival in the ED, P=0.044). No significant difference in performance was found between COTH-member teaching and non-teaching hospitals for any of the eight process-of-care measures or the two outcome measures for AMI. The study was unable to compare performance based on geographic setting of hospitals due to lack of sufficient data for rural hospitals. ^ The results of the study suggest that for-profit Texas hospitals might be slightly better than not-for –profit hospitals at providing possible heart attack patients with certain processes of care.^

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Territorial quality and sustainable development : Indicators of performance in the context of a model for participatory rural tourism certification

El turismo rural ha sido incorporado por pequeños establecimientos agropecuarios del partido de Cnel. Suárez, provincia de Buenos Aires, Argentina, como actividad alternativa para mejorar la calidad de vida de sus miembros y superar situaciones de crisis agravadas por la marginalidad productiva del SO bonaerense, región a la que pertenecen. Bajo el programa Cambio Rural del INTA (Instituto Nacional de Tecnología Agropecuaria) conforman el Grupo 'Cortaderas II', junto a otros emprendedores interesados en valorar el medio rural. Han avanzado en el proceso de reconocimiento de su identidad y puesta en valor de recursos específicos con anclaje en el territorio. Esta identidad comienza a apreciarse internamente, a raíz de la dinámica grupal lograda y la incipiente articulación con otros actores para la construcción de un partenariado público y privado que genere sinergias y contribuya al desarrollo sustentable del territorio. Sin embargo, aún no es claramente percibida por el turista, cada vez más exigente. Por lo tanto, el presente trabajo persigue proponer indicadores para evaluar el desempeño de un Sistema de Gestión de Calidad con enfoque territorial que, adaptando el modelo europeo 'Marca de Calidad Territorial', sustente una estrategia comercial de diferenciación del servicio y simultáneamente, mida el progreso hacia una mejor calidad de vida y fortalecimiento de vínculos con la cultura local y el entorno físico-natural en el marco del desarrollo sustentable. La investigación se plantea para la micro escala, ya que se trata de un estudio de caso, relevándose información primaria mediante observación directa y entrevistas semi-estructuradas, complementada con información secundaria diagnóstica utilizada por INTA. Las características del grupo y su dinámica de funcionamiento bajo el programa Cambio Rural revelan que es posible adoptar un proceso de certificación participativa propuesto para cuatro pilares de la calidad: de Bienes y Servicios, Institucional, Social y Ambiental. El modelo se integra con indicadores de evaluación de desempeño, agrupados en áreas clave para cada una de las dimensiones de la sustentabilidad, que contemplan el paisaje y la gestión de los recursos naturales; el impacto económico de la actividad, la calidad de la oferta y satisfacción del turista; así como las relaciones sociales internas y los vínculos con otros actores del territorio. Principalmente se encontraron fortalezas en la búsqueda de partenariados y debilidades en aspectos de comunicación y promoción. Se considera que este sistema de herramientas de gestión sustentable permitiría superar las dificultades de una certificación individual, pudiendo aplicarse a emprendimientos con otra ubicación geográfica

Simulation of academic performance rates, estimation of indicators of subjects and of a complete degree

The purpose of this paper is to present a program written in Matlab-Octave for the simulation of the time evolution of student curricula, i.e, how students pass their subjects along time until graduation. The program computes, from the simulations, the academic performance rates for the subjects of the study plan for each semester as well as the overall rates, which are a) the efficiency rate defined as the ratio of the number of students passing the exam to the number of students who registered for it and b) the success rate, defined as the ratio of the number of students passing the exam to the number of students who not only registered for it but also actually took it. Additionally, we compute the rates for the bachelor academic degree which are established for Spain by the National Quality Evaluation and Accreditation Agency (ANECA) and which are the graduation rate (measured as the percentage of students who finish as scheduled in the plan or taking an extra year) and the efficiency rate (measured as the percentage of credits which a student who graduated has really taken). The simulation is done in terms of the probabilities of passing all the subjects in their study plan. The application of the simulator to Polytech students in Madrid, where requirements for passing are specially stiff in first and second year subjects, is particularly relevant to analyze student cohorts and the probabilities of students finishing in the minimum of four years, or taking and extra year or two extra years, and so forth. It is a very useful tool when designing new study plans. The calculation of the probability distribution of the random variable "number of semesters a student has taken to complete the curricula and graduate" is difficult or even unfeasible to obtain analytically, and this is even truer when we incorporate uncertainty in parameter estimation. This is why we apply Monte Carlo simulation which not only provides illustration of the stochastic process but also a method for computation. The stochastic simulator is proving to be a useful tool for identification of the subjects most critical in the distribution of the number of semesters for curriculum vitae (CV) completion and subsequently for a decision making process in terms of CV planning and passing standards in the University. Simulations are performed through a graphical interface where also the results are presented in appropriate figures. The Project has been funded by the Call for Innovation in Education Projects of Universidad Politécnica de Madrid (UPM) through a Project of its school Escuela Técnica Superior de Ingenieros Industriales ETSII during the period September 2010-September 2011.

Traditional education vs modern education. What is the impact of teaching techniques' evolution on students learning process?

The main objective of this article is to focus on the analysis of teaching techniques, ranging from the use of the blackboard and chalk in old traditional classes, using slides and overhead projectors in the eighties and use of presentation software in the nineties, to the video, electronic board and network resources nowadays. Furthermore, all the aforementioned, is viewed under the different mentalities in which the teacher conditions the student using the new teaching technique, improving soft skills but maybe leading either to encouragement or disinterest, and including the lack of educational knowledge consolidation at scientific, technology and specific levels. In the same way, we study the process of adaptation required for teachers, the differences in the processes of information transfer and education towards the student, and even the existence of teachers who are not any longer appealed by their work due which has become much simpler due to new technologies and the greater ease in the development of classes due to the criteria described on the new Grade Programs adopted by the European Higher Education Area. Moreover, it is also intended to understand the evolution of students’ profiles, from the eighties to present time, in order to understand certain attitudes, behaviours, accomplishments and acknowledgements acquired over the semesters within the degree Programs. As an Educational Innovation Group, another key question also arises. What will be the learning techniques in the future?. How these evolving matters will affect both positively and negatively on the mentality, attitude, behaviour, learning, achievement of goals and satisfaction levels of all elements involved in universities’ education? Clearly, this evolution from chalk to the electronic board, the three-dimensional view of our works and their sequence, greatly facilitates the understanding and adaptation later on to the business world, but does not answer to the unknowns regarding the knowledge and the full development of achievement’s indicators in basic skills of a degree. This is the underlying question which steers the roots of the presented research.

Indicators and Estimators in P-Adaptive Boundary Elements

The paper presents the possibility of implementing a p-adaptive process with the B.E.M. Although the exemples show that good results can be obtained with a limited amount of storage and with the simple ideas explained above, more research is needed in order to improve the two main problems of the method, i.e.: the criteria of where to refine and until what degree. Mathematically based reasoning is still lacking and will be useful to simplify the decission making. Nevertheless the method seems promising and, we hope, opens a path for a series of research lines of maximum interest. Although the paper has dealt only with plane potential problem the extension to plane elasticity as well as to 3-D potential problem is straight-forward.

Modelling the relationship between urban environment and travel behaviour: policy and indicators

Due to the necessity to undertake activities, every year people increase their standards of travelling (distance and time). Urban sprawl development plays an important role in these "enlargements". Thus, governments invest money in an exhaustiva search for solutions to high levels of congestion and car-trips. The complex relationship between urban environment and travel behaviour has been studied in a number of cases. Thus, the objective of this paper is to answer the important question of which land-use attributes influence which dimensions of travel behaviour, and to verify to what extent specific urban planning measures affect the individual decision process, by exhaustiva statistical and systematic tests. This paper found that a crucial issue in the analysis of the relationship between the built environment and travel behaviour is the definition of indicators. As such, we recommend a feasible list of indicators to analyze this relationship.

Simultaneous environmental and economic process synthesis of Isobutane Alkylation

This multidisciplinary study concerns the optimal design of processes with a view to both maximizing profit and minimizing environmental impacts. This can be achieved by a combination of traditional chemical process design methods, measurements of environmental impacts and advanced mathematical optimization techniques. More to the point, this paper presents a hybrid simulation-multiobjective optimization approach that at once optimizes the production cost and minimizes the associated environmental impacts of isobutane alkylation. This approach has also made it possible to obtain the flowsheet configurations and process variables that are needed to manufacture isooctane in a way that satisfies the above-stated double aim. The problem is formulated as a Generalized Disjunctive Programming problem and solved using state-of-the-art logic-based algorithms. It is shown, starting from existing alternatives for the process, that it is possible to systematically generate a superstructure that includes alternatives not previously considered. The optimal solution, in the form a Pareto curve, includes different structural alternatives from which the most suitable design can be selected. To evaluate the environmental impact, Life Cycle Assessment based on two different indicators is employed: Ecoindicator 99 and Global Warming Potential.

A three-stage DEA model to evaluate learning-teaching technical efficiency: Key performance indicators and contextual variables

This study evaluates the technical efficiency of the learning-teaching process in higher education using a three-stage procedure that offers advances in comparison to previous studies and improves the quality of the results. First, it utilizes a multiple stage Data Envelopment Analysis (DEA) with contextual variables. Second, the levels of super efficiency are calculated in order to prioritize the efficiency units. And finally, through sensitivity analysis, the contribution of each key performance indicator (KPI) is established with respect to the efficiency levels without omission of variables. The analytical data was collected from a survey completed by 633 tourism students during the 2011/12, 2012/13 and 2013/14 academic course years. The results suggest that level of satisfaction with the course, diversity of materials and satisfaction with the teacher were the most important factors affecting teaching performance. Furthermore, the effect of the contextual variables was found to be significant.

Resource Efficiency Indicators for Policy-Making. CEPS Working Document No. 415/November 2015

In the EU, resource efficiency has been high on the political agenda since 2011, when the European Commission first included it as one of the seven flagship initiatives in its Europe 2020 Strategy for “smart, sustainable and inclusive growth”. Resource efficiency is not only considered an environmental necessity, but also a political, economic and security opportunity. This paper first stresses the benefits and opportunities for the EU of improving its resource efficiency. It then explains the added value of the www.measuring-progress.eu web tool, which aims to improve the way policy-makers and others involved in the policy process can access, understand and use indicators for resource efficiency. It provides practical examples of relevant indicators in the form of the EU Resource Efficiency Scoreboard and a case study showing how the web tool established by NETGREEN can be used in practice. The paper concludes with a number of policy messages.

Experience facilitation process e o posicionamento estratégico de unidades hoteleiras

A indústria hoteleira é hoje reconhecida como uma indústria global, com produtores e consumidores espalhados por todo o mundo. Um dos grandes desafios dos nossos dias passa por maximizar a satisfação do seu consumidor e simultaneamente garantir um crescimento exponencial da procura face à concorrência. O EFP (Experience Facilitation Process) tem levantado novos desafios na gestão do turismo e da hotelaria, associado aos novos processos de gestão de negócios turísticos e à emergência de novos produtos e atributos valorizados pelos turistas. O presente estudo visa compreender até que ponto os hotéis facilitam a experiência turística e o usufruto dos seus hóspedes, maximizando a sua satisfação. Pretende-se, neste contexto, perceber se o posicionamento estratégico preconizado pelo sector coloca o enfase no elemento mais importante de uma organização, o cliente. Para o efeito, é proposto um modelo em que a EFP (Experience Facilitation Process) influencia a recomendação do hotel. O EFP é por sua vez explicado pela easiness in performance, pela tecnologia adotada, pela qualidade de F&B e pelas facilidades. O modelo foi empiricamente testado através da aplicação de uma amostra de 299 questionários recolhidos online. Tendo o modelo conceptual sido testado a partir dum modelo de equações estruturais, por recurso ao AMOS 21. Os resultados indicam que a perceção de experiência facilitada se traduz em indicadores tangíveis tais como a easiness in performance e a tecnologia. A facilitação da experiência determina a recomendação, ainda que esta recomendação seja modesta. As implicações teóricas e de gestão foram discutidas mostrando que a facilitação da experiência é um processo determinante para a satisfação dos turistas. Estes resultados empíricos, ainda que não generalizáveis, revelam a complexidade do serviço hoteleiro ao mesmo tempo que emprestam à análise do posicionamento competitivo uma nova perspetiva.