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Sample records for measuring therapeutic alliance

  1. Therapeutic alliance.

    PubMed

    Fox, Valerie

    2002-01-01

    I have been very fortunate in my journey of mental illness. I respond well to medication, but I don't think that is the complete answer to living successfully with serious, persistent mental illness. I believe a person's environment is also of utmost importance, enabling the person suffering with mental illness to continually grow in life. I found early in my struggle with mental illness a psychiatrist with whom I have always had a very good rapport. Until recently I didn't know that what I have with this psychiatrist is professionally known as a therapeutic alliance. Over the years, when I need someone to talk over anything that is troubling to me, I seek my psychiatrist. A therapeutic alliance is non-judgmental; it is nourishing; and finally it is a relationship of complete trust. Perhaps persons reading this article who have never experienced this alliance will seek it. I believe it can make an insecure person secure; a frightened person less frightened; and allow a person to continue the journey of mental health with a sense of belief in oneself. PMID:12433224

  2. Measuring Therapeutic Alliance with Children in Residential Treatment and Therapeutic Day Care

    ERIC Educational Resources Information Center

    Roest, Jesse; van der Helm, Peer; Strijbosch, Eefje; van Brandenburg, Mariëtte; Stams, Geert Jan

    2016-01-01

    Purpose: This study examined the construct validity and reliability of a therapeutic alliance measure (Children's Alliance Questionnaire [CAQ]) for children with psychosocial and/or behavioral problems, receiving therapeutic residential care or day care in the Netherlands. Methods: Confirmatory factor analysis of a one-factor model ''therapeutic…

  3. Therapeutic alliance in a randomized clinical trial for bulimia nervosa

    PubMed Central

    Accurso, Erin C.; Fitzsimmons-Craft, Ellen E.; Ciao, Anna; Cao, Li; Crosby, Ross D.; Smith, Tracey L.; Klein, Marjorie H.; Mitchell, James E.; Crow, Scott J.; Wonderlich, Stephen A.; Peterson, Carol B.

    2015-01-01

    Objective This study examined the temporal relation between therapeutic alliance and outcome in two treatments for bulimia nervosa (BN). Method Eighty adults with BN symptoms were randomized to 21 sessions of integrative cognitive-affective therapy (ICAT) or enhanced cognitive-behavioral therapy (CBT-E). Bulimic symptoms (i.e., frequency of binge eating and purging) were assessed at each session and post-treatment. Therapeutic alliance (Working Alliance Inventory) was assessed at sessions 2, 8, 14, and post-treatment. Repeated-measures analyses using linear mixed models with random intercepts were conducted to determine differences in alliance growth by treatment and patient characteristics. Mixed-effects models examined the relation between alliance and symptom improvement. Results Overall, patients in both treatments reported strong therapeutic alliances. Regardless of treatment, greater therapeutic alliance between (but not within) subjects predicted greater reductions in bulimic behavior; reductions in bulimic behavior also predicted improved alliance. Patients with higher depression, anxiety, or emotion dysregulation had a stronger therapeutic alliance in CBT-E than ICAT, while those with more intimacy problems had greater improvement in therapeutic alliance in ICAT compared to CBT-E. Conclusions Therapeutic alliance has a unique impact on outcome, independent of the impact of symptom improvement on alliance. Within- and between-subject effects revealed that changes in alliance over time did not predict symptom improvement, but rather that individuals who had a stronger alliance overall had better bulimic symptom outcomes. These findings indicate that therapeutic alliance is an important predictor of outcome in the treatment of BN. PMID:25894667

  4. The Role of Therapeutic Alliance in Mindfulness Interventions

    PubMed Central

    Goldberg, Simon B.; Davis, James M.; Hoyt, William T.

    2013-01-01

    Objective Mindfulness-based interventions have enjoyed a marked increase in support within biomedical and psychological research and practice in the past two decades. Despite the widespread application of these treatments for a range of psychological and medical conditions, there remains a lack of consensus regarding mechanisms through which these interventions effect change. One plausible yet underexplored mechanism is the therapeutic alliance between participants and mindfulness instructors. Methods In this report, data are presented on therapeutic alliance from the mindfulness arm (n = 37) of a randomized controlled trial of a mindfulness-based smoking cessation treatment. Results Results suggest that client-reported therapeutic alliance measured mid-treatment did not significantly predict primary smoking outcomes. Alliance did predict improvement in post-treatment scores on several outcome variables linked to mindfulness practice, including emotion regulation (β =−.24, p = .042), mindfulness (β = .33, p = .007), negative affect (β = −.33, p = .040), as well as treatment compliance (β = .39, p = .011). Conclusion Implications of these relationships and the possible role of therapeutic alliance in mindfulness treatments are explored. PMID:23775222

  5. Therapeutic alliance and binge-eating outcomes in a group therapy context.

    PubMed

    Tasca, Giorgio A; Compare, Angelo; Zarbo, Cristina; Brugnera, Agostino

    2016-07-01

    The therapeutic alliance in individual and group psychotherapy is associated with treatment outcomes for a variety of disorders. However, debate persists about the centrality of the alliance in determining positive outcomes. We examined the alliance-outcome relationship across 20 sessions of emotionally focused group therapy (EFGT) for binge-eating disorder (BED). We hypothesized that (1) previous session alliance increase will predict lower subsequent session binge eating level while controlling for previous session binge eating level; and (2) previous session binge eating decline will predict higher subsequent session alliance level while controlling previous session alliance level. Participants were 118 individuals with BED who received 20 sessions of EFGT in 8 groups. Levels of binge eating and therapeutic alliance to the therapist were measured weekly. Linear growth in alliance during group therapy was associated with reduced binge eating at 6 months' posttreatment. We also found that the group's and the individual's alliance scores and binge-eating episodes were significantly associated across treatment, suggesting a mutual influence of the group's and individual's experience of the alliance with the therapist. Regarding the first hypothesis, previous session alliance increase was significantly associated with lower subsequent session binge eating. Regarding the second hypothesis, previous session binge-eating decline was not significantly related to higher subsequent session alliance. The findings provide evidence in a group therapy context for a model in which alliance change influences subsequent symptom levels, but not the other way around. (PsycINFO Database Record PMID:27182894

  6. Therapeutic alliance, expressed emotion, and treatment outcome for anorexia nervosa in a family-based partial hospitalization program.

    PubMed

    Rienecke, Renee D; Richmond, Rebekah; Lebow, Jocelyn

    2016-08-01

    Adolescent therapeutic alliance has been found to be associated with improvements in eating disorder cognitions and with early weight gain. The current study assessed patient and parent therapeutic alliance, correlates of parent alliance, and relationship between alliance and treatment outcome. Fifty-six patients with anorexia nervosa completed measures of therapeutic alliance and eating disorder symptoms. Patients' parents completed measures of therapeutic alliance, expressed emotion, and psychopathology. Patients' alliance predicted cognitive and behavioral symptomatology at end of treatment (β=-0.39, p=0.001), though it was not related to changes in weight (β=0.12, p=0.377). Maternal hostility was associated with lower maternal alliance (r=-0.34, p=0.05). Findings suggest that maternal hostility should be addressed in treatment, and that patient alliance may be important in achieving psychological recovery from disordered eating. PMID:27289048

  7. Child, caregiver, and therapist perspectives on therapeutic alliance in usual care child psychotherapy

    PubMed Central

    Accurso, Erin C.; Garland, Ann F.

    2014-01-01

    This study examined the temporal stability and cross-informant agreement on multiple perspectives of child and caregiver alliance with therapists in usual care psychotherapy. Baseline predictors of alliance were also examined. Children with disruptive behavior problems (n=209) and their caregivers were followed for up to 16 months after initiating psychotherapy at a community-based clinic. Alliance was rated by children, caregivers, and therapists every four months for as long as families participated in treatment. Repeated-measures analyses using linear mixed models with random intercepts were conducted to determine whether child and caregiver alliance differed across time, as well to examine factors associated with each perspective on alliance. Intraclass correlations (ICCs) between child, caregiver, and therapist reports of alliance were also examined. Alliance was rated relatively high overall across perspectives. Clients (children and caregivers) tended to report the strongest and most stable alliance, while therapists reported the weakest alliance and perceived deteriorations in child alliance over time. Inter-informant agreement was variable for child and caregiver alliance; agreement was moderate between clients and therapists. Several predictors of alliance emerged, including child gender, anxiety diagnosis, caregiver race/ethnicity, and therapist experience. This study provides methodological information about reports of therapeutic alliance across time and informants that can inform current efforts to understand the alliance-outcome association. PMID:25314097

  8. Patient-Rated Alliance as a Measure of Therapist Performance in Two Clinical Settings

    ERIC Educational Resources Information Center

    Imel, Zac E.; Hubbard, Rebecca A.; Rutter, Carolyn M.; Simon, Gregory

    2013-01-01

    Objective: The ability to form a strong therapeutic alliance is considered a foundational skill across psychotherapies. Patient-rated measures of the alliance are now being used to make judgments about a therapist's tendency to build alliances with their patients. However, whether a patient-rated alliance measure provides a useful index of a…

  9. The Therapeutic Alliance: Clients' Categorization of Client-Identified Factors

    ERIC Educational Resources Information Center

    Simpson, Arlene J.; Bedi, Robinder P.

    2012-01-01

    Clients' perspectives on the therapeutic alliance were examined using written descriptions of factors that clients believed to be helpful in developing a strong alliance. Fifty participants sorted previously collected statements into thematically similar piles and then gave each set of statements a title. Multivariate concept mapping statistical…

  10. The therapeutic alliance in the treatment of personality disorders.

    PubMed

    Bender, Donna S

    2005-03-01

    Because personality disorders are associated with significant impairment in interpersonal relationships, special issues and problems arise in the formation of a therapeutic alliance in the treatment of patients with these disorders. In particular, patients with narcissistic, borderline, and paranoid personality traits are likely to have troubled interpersonal attitudes and behaviors that will complicate the patient's engagement with the therapist. While a strong positive therapeutic alliance is predictive of more successful treatment outcomes, strains and ruptures in the alliance may lead to premature termination of treatment. Therefore, clinicians need to consider the patient's characteristic way of relating in order to select appropriate interventions to effectively retain and involve the patient in treatment. Research has shown not only the importance of building an alliance but also that this alliance is vital in the earliest phase of treatment. The author first reviews several definitions of the therapeutic alliance with reference to how they apply to the treatment of patients with personality disorders. Issues relevant to forming a therapeutic alliance with patients with personality disorders are then discussed in terms of the three DSM-IV-TR personality disorder clusters. However, the author notes that these categories do not adequately capture the complexity of character pathology and that clinicians also need to consider which aspects of a patient's personality pathology are dominant at the moment in considering salient elements of the therapeutic alliance. In dealing with Cluster A personality disorders (schizotypal, schizoid, and paranoid personality disorders), what is most relevant for alliance building is the profound impairment in interpersonal relationships. The Cluster B "dramatic" personality disorders (antisocial, borderline, histrionic, and narcissistic) are all associated with pushing the limits. Consequently, clinicians need to exercise great

  11. Examining the Relationship between Choice, Therapeutic Alliance and Outcomes in Mental Health Services

    PubMed Central

    Stanhope, Victoria; Barrenger, Stacey L.; Salzer, Mark S.; Marcus, Stephen C.

    2013-01-01

    Background: Self-determination within mental health services is increasingly recognized as an ethical imperative, but we still know little about the impact of choice on outcomes among people with severe mental illnesses. This study examines whether choice predicts outcomes and whether this relationship is mediated by therapeutic alliance. Method: The study sample of 396 participants completed a survey measuring choice, therapeutic alliance, recovery, quality of life and functioning. Multivariate analyses examined choice as a predictor of outcomes, and Sobel tests assessed alliance as a mediator. Results: Choice variables predicted recovery, quality of life and perceived outcomes. Sobel tests indicated that the relationship between choice and outcome variables was mediated by therapeutic alliance. Implications: The study demonstrates that providing more choice and opportunities for collaboration within services does improve consumer outcomes. The results also show that collaboration is dependent on the quality of the relationship between the provider and consumer. PMID:25562652

  12. A study of the differential effects of Tomm's questioning styles on therapeutic alliance.

    PubMed

    Ryan, D; Carr, A

    2001-01-01

    To replicate and extend Dozier's (1992) test of Tomm's hypothesis about the differential effects of questioning styles on therapeutic alliance, an analogue study was conducted. Twenty-eight family triads, each including a son and his parents, viewed four videotaped, simulated family therapy scenarios in which Tomm's four questioning styles were separately portrayed. Participants were asked to identify with the client whose role corresponded to theirs (that is, father, mother, or son) and, on the basis of this, to rate the client's alliance with the therapist. They were also asked to rate the overall alliance between the family and the therapist. Finally, having viewed all four scenarios, they were invited to rate comparatively the quality of the therapeutic alliance across the four questioning styles. Compared with strategic and lineal questioning styles, circular and reflexive questions led to higher ratings of therapeutic alliance on all three measures. The results of this study support Tomm's hypothesis that questioning styles based on circular assumptions lead to a better therapeutic alliance at an individual and systemic level than do questions based on lineal assumptions. PMID:11288371

  13. The Importance of Empathy in the Therapeutic Alliance.

    ERIC Educational Resources Information Center

    Feller, Candi P.; Cottone, R. Rocco

    2003-01-01

    In this investigation of the construct of empathy, the authors report that the literature reflects strong evidence that empathy is an essential component of the therapeutic alliance across theories and that empathy is necessary in the counseling process. The concept of empathy continues to be a central component of new forms of counseling and…

  14. The Resolution of Ruptures in the Therapeutic Alliance.

    ERIC Educational Resources Information Center

    Safran, Jeremy D.; Muran, J. Christopher

    1996-01-01

    A rupture in the therapeutic alliance is a deterioration in the quality of the relationship between patient and therapist; it is an interpersonal marker that indicates an opportunity for exploring and understanding the processes that maintain a maladaptive interpersonal schema. Outlines features of a research program on ruptures in the therapeutic…

  15. Interpersonal problems as predictors of therapeutic alliance and symptom improvement in cognitive therapy for depression

    PubMed Central

    Renner, Fritz; Jarrett, Robin B.; Vittengl, Jeffrey R.; Barrett, Marna S.; Clark, Lee Anna; Thase, Michael E.

    2012-01-01

    Background The degree to which interpersonal problems of depressed patients improve over the course of cognitive therapy (CT) and relate to the quality of the therapeutic alliance and to symptom improvement, remain unclear. Methods We analyzed data of adult outpatients (N = 523) with major depressive disorder participating in a clinical trial to determine the factor structure of the Inventory of Interpersonal Problems-Circumplex (IIP-C) and to relate the observed factor scores to the quality of the therapeutic alliance and symptom improvement over the course of CT. Patients received 16–20 sessions protocol (50–60 minutes each) of individual CT according to the treatment manual by Beck et al. (1979). Results We found a three-factor structure (interpersonal distress, agency, and communion) of interpersonal problems. Interpersonal distress decreased (d = .90), but interpersonal style did not change substantively during CT (communion d = .03; agency d = .14). High initial agency scores related negatively to the therapeutic alliance (β = −.12), whereas high initial communion scores related positively to the therapeutic alliance (β = .15). Elevated pre-treatment interpersonal distress scores were related to both weaker therapeutic alliances (β = .13) and higher symptom levels throughout treatment (β = .10). Limitations All patients in this study had recurrent MDD and it is therefore uncertain whether the results would generalize to patients with other psychiatric disorders. Conclusions This study supports the use of the IIP-C as a comprehensive measure of patients' interpersonal style and interpersonal distress. The IIP-C measured before CT showed some predictive validity with respect to therapeutic alliance measured at the midpoint and therapy outcome. The clinical importance of these findings is discussed. PMID:22306232

  16. The Role of Therapeutic Alliance in Treatment for People with Mild to Moderate Alcohol Dependence

    ERIC Educational Resources Information Center

    Richardson, Deirdre F.; Adamson, Simon J.; Deering, Daryle E. A.

    2012-01-01

    In an exploratory study of Therapeutic Alliance (TA) in brief outpatient treatment for alcohol dependence the relationship was investigated between TA and treatment outcome (measured at 6 weeks and 6 months) for 69 alcohol dependent clients participating in a randomised control trial between Motivational Enhancement Therapy and Non Directive…

  17. The Relationship of Perfectionism, Depression, and Therapeutic Alliance during Treatment for Depression: Latent Difference Score Analysis

    ERIC Educational Resources Information Center

    Hawley, Lance L.; Ho, Moon-Ho Ringo; Zuroff, David C.; Blatt, Sidney J.

    2006-01-01

    The authors examined the longitudinal relationship of patient-rated perfectionism, clinician-rated depression, and observer-rated therapeutic alliance using the latent difference score (LDS) analytic framework. Outpatients involved in the Treatment for Depression Collaborative Research Program completed measures of perfectionism and depression at…

  18. Within treatment therapeutic alliance ratings profiles predict posttreatment frequency of alcohol use

    PubMed Central

    Prince, Mark A.; Connors, Gerard J.; Maisto, Stephen A.; Dearing, Ronda L.

    2016-01-01

    While past research has demonstrated a positive relationship between the therapeutic alliance (TA) and improved drinking outcomes, specific aspects of the alliance have received less attention. In this study, we examined the association between alliance characteristics during treatment and 4-month follow-up drinking reports. 65 treatment-seeking alcohol dependent clients who participated in 12 weeks of individual outpatient treatment provided weekly TA ratings during treatment and reported on pre-treatment, during treatment, and post-treatment alcohol use. Latent profile analysis was conducted to discern distinct profiles of client and therapist ratings of therapeutic alliance with similar alliance characteristics. TA profiles were based on clients’ and therapists’ mean alliance rating, minimum alliance rating, maximum alliance rating, the range of alliance ratings, and the difference in session number between maximum and minimum alliance ratings. 1- through 4- class models were fit to the data. Model fit was judged by comparative fit indices, substantive interpretability, and parsimony. Wald tests of mean equality determined whether classes differed on follow-up percentage of days abstinent (PDA) at 4 months posttreatment. 3-profile solutions provided the best fit for both client and therapist ratings of the therapeutic alliance. Client alliance rating profiles predicted drinking in the follow-up period, but therapist rating profiles did not. These results suggest that distinct profiles of the therapeutic alliance can be identified and that client alliance rating profiles are associated with frequency of alcohol use following outpatient treatment. PMID:26999350

  19. Interpersonal predictors of early therapeutic alliance in a transdiagnostic cognitive-behavioral treatment for adolescents with anxiety and depression.

    PubMed

    Levin, Laura; Henderson, Heather A; Ehrenreich-May, Jill

    2012-06-01

    The importance of therapeutic alliance in predicting treatment success is well established, but less is known about client characteristics that predict alliance. This study examined alliance predictors in adolescents with anxiety and/or depressive disorders (n=31) who received a transdiagnostic cognitive-behavioral treatment, the Unified Protocol for the Treatment of Emotional Disorders in Youth (Ehrenreich, Buzzella, Trosper, Bennett, & Barlow, 2008) in the context of a larger randomized controlled trial. Alliance was assessed at session three by therapists, clients, and independent observers. Results indicated that alliance ratings across the three informant perspectives were significantly associated with one another, but that pretreatment interpersonal variables (e.g., social support, attachment security, and social functioning in current family and peer relationships) were differentially associated with varying informant perspectives. Adolescent and observer ratings of alliance were both predicted by adolescent self-reports on measures reflecting how they perceive their interpersonal relationships. In addition, adolescent-reported symptom severity at pretreatment predicted observer ratings of alliance such that adolescents who indicated greater anxiety and depressive symptoms were rated as having stronger early alliances by independent observers. Therapists perceived having weaker early alliances with adolescents evidencing clinically significant depression at intake as compared with adolescents diagnosed with anxiety disorders alone. Future research is needed to examine whether identification of relevant interpersonal factors at intake can help improve initial therapeutic engagement and resulting outcomes for the psychosocial treatment of adolescents with anxiety and depressive disorders. PMID:22642525

  20. The impact of thought disorder on therapeutic alliance and personal recovery in schizophrenia and schizoaffective disorder: An exploratory study.

    PubMed

    Cavelti, Marialuisa; Homan, Philipp; Vauth, Roland

    2016-05-30

    Thought and language disorders are a main feature of schizophrenia. The aim of the study is to explore the impact of thought disorder on therapeutic alliance and personal recovery because of its interference with verbal communication. Thought disorder, positive and negative symptoms (Positive and Negative Syndrome Scale), functioning (Modified Global Assessment of Functioning scale), insight (Scale to Assess Unawareness of Mental Disorder), attachment insecurity (Psychosis Attachment Measure), therapeutic alliance (Scale to Assess the Therapeutic Relationship), and personal recovery (Recovery Assessment Scale, Integration Sealing-Over Scale) were assessed in 133 outpatients with schizophrenia or schizoaffective disorder at baseline and twelve months later. The data were analyzed by hierarchical multiple linear regression. Higher levels of thought disorder were significantly associated with lower clinicians' ratings, but not with patients' ratings of therapeutic alliance. In addition, lower clinicians' ratings of therapeutic alliance were significantly linked to a more sealing over and less integrative recovery style. In fact, the lower therapeutic alliance ratings mediated the association between thought disorder and a sealing over recovery style. The results highlight the importance of considering thought disorder in treatment of schizophrenia and schizoaffective disorder which may interfere with therapeutic alliance and treatment efforts towards recovery. PMID:27137967

  1. Early Therapeutic Alliance and Treatment Outcome in Individual and Family Therapy for Adolescent Behavior Problems

    ERIC Educational Resources Information Center

    Hogue, Aaron; Dauber, Sarah; Stambaugh, Leyla Faw; Cecero, John J.; Liddle, Howard A.

    2006-01-01

    The impact of early therapeutic alliance was examined in 100 clients receiving either individual cognitive-behavioral therapy (CBT) or family therapy for adolescent substance abuse. Observational ratings of adolescent alliance in CBT and adolescent and parent alliance in family therapy were used to predict treatment retention (in CBT only) and…

  2. Therapeutic Alliance in Telephone-Administered Cognitive-Behavioral Therapy for Hematopoietic Stem Cell Transplant Survivors

    ERIC Educational Resources Information Center

    Applebaum, Allison J.; DuHamel, Katherine N.; Winkel, Gary; Rini, Christine; Greene, Paul B.; Mosher, Catherine E.; Redd, William H.

    2012-01-01

    Objective: A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in…

  3. Correlates of Therapeutic Alliance and Treatment Outcomes among Israeli Female Methadone Patients

    ERIC Educational Resources Information Center

    Schiff, Miriam; Levit, Shabtay

    2010-01-01

    Objectives: This study examines potential predictors (e.g., attachment style, frequency of therapeutic treatment sessions) of client-rated therapeutic alliance between the social worker and client. The relationship between therapeutic alliance and client's psychological outcomes (hope and posttraumatic stress symptoms [PTS's]) was also assessed.…

  4. Treatment Preferences Affect the Therapeutic Alliance: Implications for Randomized Controlled Trials

    ERIC Educational Resources Information Center

    Iacoviello, Brian M.; McCarthy, Kevin Scott; Barrett, Marna S.; Rynn, Moira; Gallop, Robert; Barber, Jacques P.

    2007-01-01

    The influence of treatment preferences on the development of the therapeutic alliance was investigated. Seventy-five patients were followed while participating in a randomized controlled trial comparing supportive-expressive psychotherapy with sertraline or pill placebo in the treatment of major depressive disorder. Therapeutic alliance was…

  5. Enhancing Therapeutic Impact and Therapeutic Alliance Through Electronic Mail Homework Assignments

    PubMed Central

    Murdoch, Janice W.; Connor-Greene, Patricia A.

    2000-01-01

    Homework assignments can enhance therapeutic impact and increase therapy effectiveness by encouraging patients to focus on therapy-related issues between sessions. Computer technology provides a new avenue for reporting, monitoring, and feedback of patient homework assignments through electronic mail (e- mail). In two case examples, e-mail was used as an extension of therapy to enhance patient involvement in treatment. In both cases, patient reports suggest that therapeutic alliance and therapeutic impact improved with the use of e-mail homework reporting. The costs and benefits of the use of e-mail as an adjunct to therapy are discussed. PMID:11069136

  6. Relation of Patient Pretreatment Characteristics to the Therapeutic Alliance in Diverse Psychotherapies.

    ERIC Educational Resources Information Center

    Gaston, Louise; And Others

    1988-01-01

    Investigated prediction of therapeutic alliance from patient pretreatment characteristics among 60 elderly depressed outpatients treated in behavioral, cognitive, and brief dynamic psychotherapy. Found that higher degree of patient defensiveness was related to lower patient contribution to alliance as reflected in patient commitment and working…

  7. Patients with borderline personality disorder who are chronically suicidal: therapeutic alliance and therapeutic limits.

    PubMed

    Jimenez, Xavier F

    2013-01-01

    Therapeutic work with patients who are chronically suicidal and have borderline personality disorder (BPD) is challenging, and clinicians often resort to setting firm limits or excessively cautious interventions in efforts to prevent manipulation, regression, or over-dependence. Litigation and malpractice fears reinforce these stances, and reduced compensation for additional time and energy devoted to patients adds further disincentives to sole providers. However, elements of the working alliance and therapeutic limits are within the therapist's control. A case vignette illustrates an individual therapist's modification of usual therapeutic limits while working with a chronically suicidal patient with BPD within a dialectical behavior therapy (DBT) framework over a 16-week period. Discussions regarding the case, interventions used, DBT, and legality concerns follow. PMID:23909059

  8. The therapeutic alliance in a naturalistic psychiatric setting: Temporal relations with depressive symptom change

    PubMed Central

    Webb, Christian A.; Beard, Courtney; Auerbach, Randy P.; Menninger, Eliza; Björgvinsson, Thröstur

    2014-01-01

    Objective Numerous studies have reported associations between the therapeutic alliance and depressive symptom improvement in outpatient samples. However, little is known regarding the temporal relationship between the alliance and symptom change among relatively severely depressed patients receiving treatment in naturalistic, psychiatric hospital settings. Method Adult patients with major depression (n = 103) receiving combined cognitive behavioral therapy and pharmacological treatment at a psychiatric hospital completed repeated assessments of the therapeutic alliance and depressive symptoms, as well as a pretreatment assessment of their expectation of symptom improvement. Results Results indicated that the alliance and treatment outcome expectancies significantly predicted subsequent depressive symptom change. However, in a model in which prior symptom change and treatment outcome expectancies were statistically controlled, the alliance-outcome association was rendered nonsignificant. The alliance was significantly associated with prior symptom improvement. Conclusions Findings highlight the importance of controlling for plausible third variable and temporal confounds to minimize biased estimates of alliance-outcome associations in future studies. Overall, results were more consistent with the alliance being a consequence, rather than a cause, of symptom change. Finally, findings contribute to a growing body of evidence supporting the role of treatment outcome expectancies in predicting symptom improvement, even within our relatively severely depressed sample. PMID:25156322

  9. Role of pill-taking, expectation and therapeutic alliance in the placebo response in clinical trials for major depression

    PubMed Central

    Leuchter, Andrew F.; Hunter, Aimee M.; Tartter, Molly; Cook, Ian A.

    2014-01-01

    Background Pill-taking, expectations and therapeutic alliance may account for much of the benefit of medication and placebo treatment for major depressive disorder (MDD). Aims To examine the effects of medication, placebo and supportive care on treatment outcome, and the relationships of expectations and therapeutic alliance to improvement. Method A total of 88 participants were randomised to 8 weeks of treatment with supportive care alone or combined with double-blind treatment with placebo or antidepressant medication. Expectations of medication effectiveness, general treatment effectiveness and therapeutic alliance were measured (trial registration at ClinicalTrials.gov: NCT00200902). Results Medication or placebo plus supportive care were not significantly different but had significantly better outcome than supportive care alone. Therapeutic alliance predicted response to medication and placebo; expectations of medication effectiveness at enrolment predicted only placebo response. Conclusions Pill treatment yielded better outcome than supportive care alone. Medication expectations uniquely predicted placebo treatment outcome and were formed by time of enrolment, suggesting that they were shaped by prior experiences outside the clinical trial. PMID:25213159

  10. Therapist Effects and the Impact of Early Therapeutic Alliance on Symptomatic Outcome in Chronic Fatigue Syndrome

    PubMed Central

    Dunn, Graham; Bentall, Richard P.; Lewis, Shôn W.

    2015-01-01

    Few studies have examined therapist effects and therapeutic alliance (TA) in treatments for chronic fatigue syndrome (CFS). Therapist effects are the differences in outcomes achieved by different therapists. TA is the quality of the bond and level of agreement regarding the goals and tasks of therapy. Prior research suffers the methodological problem that the allocation of therapist was not randomized, meaning therapist effects may be confounded with selection effects. We used data from a randomized controlled treatment trial of 296 people with CFS. The trial compared pragmatic rehabilitation (PR), a nurse led, home based self-help treatment, a counselling-based treatment called supportive listening (SL), with general practitioner treatment as usual. Therapist allocation was randomized. Primary outcome measures, fatigue and physical functioning were assessed blind to treatment allocation. TA was measured in the PR and SL arms. Regression models allowing for interactions were used to examine relationships between (i) therapist and therapeutic alliance, and (ii) therapist and average treatment effect (the difference in mean outcomes between different treatment conditions). We found no therapist effects. We found no relationship between TA and the average treatment effect of a therapist. One therapist formed stronger alliances when delivering PR compared to when delivering SL (effect size 0.76, SE 0.33, 95% CI 0.11 to 1.41). In these therapies for CFS, TA does not influence symptomatic outcome. The lack of significant therapist effects on outcome may result from the trial’s rigorous quality control, or random therapist allocation, eliminating selection effects. Further research is needed. Trial Registration: ISRCTN74156610 PMID:26657793

  11. Therapeutic alliance in Enhanced Cognitive Behavioural Therapy for bulimia nervosa: probably necessary but definitely insufficient.

    PubMed

    Raykos, Bronwyn C; McEvoy, Peter M; Erceg-Hurn, David; Byrne, Susan M; Fursland, Anthea; Nathan, Paula

    2014-06-01

    The present paper assessed therapeutic alliance over the course of Enhanced Cognitive Behavioural Therapy (CBT-E) in a community-based sample of 112 patients with a diagnosis of bulimia nervosa (BN) or atypical BN. Temporal assessment of alliance was conducted at three time points (the start, middle and end of treatment) and the relationship between alliance and treatment retention and outcome was explored. Results indicated that the alliance between patient and therapist was strong at all stages of CBT-E, and even improved in the early stages of treatment when behaviour change was initiated (weekly in-session weighing, establishing regular eating, and ceasing binge-eating and compensatory behaviours). The present study found no evidence that alliance was related to treatment retention or outcomes, or that symptom severity or problematic interpersonal styles interacted with alliance to influence outcomes. Alliance was also unrelated to baseline emotional or interpersonal difficulties. The study provides no evidence that alliance has clinical utility for the prediction of treatment retention or outcome in CBT-E for BN, even for individuals with severe symptoms or problematic interpersonal styles. Early symptom change was the best predictor of outcome in CBT-E. Further research is needed to determine whether these results are generalizable to patients with anorexia nervosa. PMID:24841726

  12. Therapeutic Alliance With a Fully Automated Mobile Phone and Web-Based Intervention: Secondary Analysis of a Randomized Controlled Trial

    PubMed Central

    Parker, Gordon; Manicavasagar, Vijaya; Hadzi-Pavlovic, Dusan; Fogarty, Andrea

    2016-01-01

    Background Studies of Internet-delivered psychotherapies suggest that clients report development of a therapeutic alliance in the Internet environment. Because a majority of the interventions studied to date have been therapist-assisted to some degree, it remains unclear whether a therapeutic alliance can develop within the context of an Internet-delivered self-guided intervention with no therapist support, and whether this has consequences for program outcomes. Objective This study reports findings of a secondary analysis of data from 90 participants with mild-to-moderate depression, anxiety, and/or stress who used a fully automated mobile phone and Web-based cognitive behavior therapy (CBT) intervention called “myCompass” in a recent randomized controlled trial (RCT). Methods Symptoms, functioning, and positive well-being were assessed at baseline and post-intervention using the Depression, Anxiety and Stress Scale (DASS), the Work and Social Adjustment Scale (WSAS), and the Mental Health Continuum-Short Form (MHC-SF). Therapeutic alliance was measured at post-intervention using the Agnew Relationship Measure (ARM), and this was supplemented with qualitative data obtained from 16 participant interviews. Extent of participant engagement with the program was also assessed. Results Mean ratings on the ARM subscales were above the neutral midpoints, and the interviewees provided rich detail of a meaningful and collaborative therapeutic relationship with the myCompass program. Whereas scores on the ARM subscales did not correlate with treatment outcomes, participants’ ratings of the quality of their emotional connection with the program correlated significantly and positively with program logins, frequency of self-monitoring, and number of treatment modules completed (r values between .32-.38, P≤.002). The alliance (ARM) subscales measuring perceived empowerment (r=.26, P=.02) and perceived freedom to self-disclose (r=.25, P=.04) also correlated significantly

  13. The Association Between Patient Characteristics and the Therapeutic Alliance in Cognitive-Behavioral and Interpersonal Therapy for Bulimia Nervosa

    ERIC Educational Resources Information Center

    Constantino, Michael J.; Arnow, Bruce A.; Blasey, Christine; Agras, W. Stewart

    2005-01-01

    The therapeutic alliance is an established predictor of psychotherapy outcome. However, alliance research in the treatment of eating disorders has been scant, with even less attention paid to correlates of alliance development. The goal of this study was to examine the relation between specific patient characteristics and the development of the…

  14. Negotiating therapeutic alliances with a family at impasse.

    PubMed

    Friedlander, Myrna L; Lee, Hsin-Hua; Shaffer, Katharine S; Cabrera, Patricia

    2014-03-01

    To bridge the science-practice gap, the APA Presidential Task Force endorsed the publication of evidence-based case studies, but to date, there have been few such investigations of conjoint family therapy. To fill this gap, we studied a successful case of treatment-as-usual in a community agency. Owing to the complexity of the working alliance in conjoint therapy, we examined how an experienced family therapist managed to develop and sustain multiple alliances over time with an estranged couple in crisis. The outcome data showed clinically meaningful changes as well as high satisfaction levels and notable declines in the target complaint discomfort levels of all family members. Alliance indicators showed that the therapist worked diligently over time to connect emotionally with each family member and to foster and maintain safety. Session impact scores showed consistently deep sessions but more variability in smoothness. By working toward the only shared treatment goal-to repair each parent's individual relationship with their very angry daughter-the therapist was able to reduce the effect of the marital estrangement on the child. At the end of the 10 contracted family sessions, the parents agreed to begin working on their relationship in couples therapy, which led shortly thereafter to a reconciliation. PMID:24059731

  15. Relationship Between Patient SWAP-200 Personality Characteristics and Therapist-Rated Therapeutic Alliance Early in Treatment.

    PubMed

    Smith, Scott W; Levy, Saryn R; Hilsenroth, Mark J; Fiori, Katherine; Bornstein, Robert F

    2016-06-01

    In the present study, we assess the extent to which patient personality features and prototypes are associated with early treatment therapist-rated alliance. The study sample consisted of 94 patients receiving psychodynamic psychotherapy at an outpatient clinic. Clinicians completed the Working Alliance Inventory (J Couns Psychol 36:223-233; Psychother Res 9:405-423) to assess their views of early alliance and the Shedler-Westen Assessment Procedure 200 (SWAP-200; Assessment 5:333-353, Am J Psychiatry 161:1350-1365, 1743-1754; Am J Psychiatry 156:258-272, 273-285) to assess patient personality. The SWAP-200 Narcissistic Clinical Prototype, Dysphoric Q-Factor, and Dysphoric/High-Functioning Neurotic Q-Subfactor significantly correlated with early therapist-rated alliance. Correlations that trended toward significance were also found. Also identified were specific SWAP-200 items that were found to relate to high early therapist-rated alliance scores. These results demonstrate some relationship, albeit small, between patient personality characteristics and therapists' views of the alliance that may serve to further a conceptual understanding of the alliance, specific personality syndromes, and the associated impact on the therapeutic interaction. PMID:27176789

  16. Therapeutic Alliance and Retention in Brief Strategic Family Therapy: A Mixed-Methods Study.

    PubMed

    Sheehan, Alyson H; Friedlander, Myrna L

    2015-10-01

    We explored how the therapeutic alliance contributed to retention in Brief Strategic Family Therapy by analyzing videotapes of eight-first sessions in which four therapists worked with one family that stayed in treatment and one family that dropped out. Although behavioral exchange patterns between clients and therapists did not differ by retention status, positive therapist alliance-related behavior followed negative client alliance behavior somewhat more frequently in the retained cases. In the qualitative aspect of the study, four family therapy experts each viewed two randomly assigned sessions and commented on their quality without knowing the families' retention status. A qualitative analysis of the audiotaped commentaries revealed 18 alliance-related themes that were more characteristic of either the retained or the nonretained cases. PMID:25640754

  17. New Developments of the Therapeutic Alliance (TA): Good News for Psychodynamic Psychiatry.

    PubMed

    Auchincloss, Elizabeth L

    2016-03-01

    Clinicians have long known that successful psychotherapy, including successful psychodynamic psychotherapy, depends upon the interaction between therapist and patient. In other words, it is important to have a strong therapeutic alliance. This article presents the history of the concept of the therapeutic alliance (TA). It also explores three areas of research that have bearing on the TA. The importance of the TA and the extensive research work that pertains to it hold promise for psychodynamic psychiatry, both in terms of understanding, and in the treatment of mental suffering. PMID:26938802

  18. Working alliance inventory applied to virtual and augmented reality (WAI-VAR): psychometrics and therapeutic outcomes.

    PubMed

    Miragall, Marta; Baños, Rosa M; Cebolla, Ausiàs; Botella, Cristina

    2015-01-01

    This study examines the psychometric properties of the Working Alliance Inventory-Short (WAI-S) adaptation to Virtual Reality (VR) and Augmented Reality (AR) therapies (WAI-VAR). The relationship between the therapeutic alliance (TA) with VR and AR and clinically significant change (CSC) is also explored. Seventy-five patients took part in this study (74.7% women, M age = 34.41). Fear of flying and adjustment disorder patients received VR therapy, and cockroach phobia patients received AR therapy. Psychometric properties, CSC, one-way ANOVA, Spearman's Correlations and Multiple Regression were calculated. The WAI-VAR showed a unidimensional structure, high internal consistency and adequate convergent validity. "Not changed" patients scored lower on the WAI-VAR than "improved" and "recovered" patients. Correlation between the WAI-VAR and CSC was moderate. The best fitting model for predicting CSC was a linear combination of the TA with therapist (WAI-S) and the TA with VR and AR (WAI-VAR), due to the latter variable slightly increased the percentage of variability accounted for in CSC. The WAI-VAR is the first validated instrument to measure the TA with VR and AR in research and clinical practice. This study reveals the importance of the quality of the TA with technologies in achieving positive outcomes in the therapy. PMID:26500589

  19. Working alliance inventory applied to virtual and augmented reality (WAI-VAR): psychometrics and therapeutic outcomes

    PubMed Central

    Miragall, Marta; Baños, Rosa M.; Cebolla, Ausiàs; Botella, Cristina

    2015-01-01

    This study examines the psychometric properties of the Working Alliance Inventory-Short (WAI-S) adaptation to Virtual Reality (VR) and Augmented Reality (AR) therapies (WAI-VAR). The relationship between the therapeutic alliance (TA) with VR and AR and clinically significant change (CSC) is also explored. Seventy-five patients took part in this study (74.7% women, Mage = 34.41). Fear of flying and adjustment disorder patients received VR therapy, and cockroach phobia patients received AR therapy. Psychometric properties, CSC, one-way ANOVA, Spearman’s Correlations and Multiple Regression were calculated. The WAI-VAR showed a unidimensional structure, high internal consistency and adequate convergent validity. “Not changed” patients scored lower on the WAI-VAR than “improved” and “recovered” patients. Correlation between the WAI-VAR and CSC was moderate. The best fitting model for predicting CSC was a linear combination of the TA with therapist (WAI-S) and the TA with VR and AR (WAI-VAR), due to the latter variable slightly increased the percentage of variability accounted for in CSC. The WAI-VAR is the first validated instrument to measure the TA with VR and AR in research and clinical practice. This study reveals the importance of the quality of the TA with technologies in achieving positive outcomes in the therapy. PMID:26500589

  20. In-Session Exposure Tasks and Therapeutic Alliance across the Treatment of Childhood Anxiety Disorders

    ERIC Educational Resources Information Center

    Kendall, Philip C.; Comer, Jonathan S.; Marker, Craig D.; Creed, Torrey A.; Puliafico, Anthony C.; Hughes, Alicia A.; Martin, Erin D.; Suveg, Cynthia; Hudson, Jennifer

    2009-01-01

    The study examined the shape of therapeutic alliance using latent growth curve modeling and data from multiple informants (therapist, child, mother, father). Children (n = 86) with anxiety disorders were randomized to family-based cognitive-behavioral treatment (FCBT; N = 47) with exposure tasks or to family education, support, and attention…

  1. Effects of Transference Work in the Context of Therapeutic Alliance and Quality of Object Relations

    ERIC Educational Resources Information Center

    Hoglend, Per; Hersoug, Anne Grete; Bogwald, Kjell-Petter; Amlo, Svein; Marble, Alice; Sorbye, Oystein; Rossberg, Jan Ivar; Ulberg, Randi; Gabbard, Glen O.; Crits-Christoph, Paul

    2011-01-01

    Objective: Transference interpretation is considered as a core active ingredient in dynamic psychotherapy. In common clinical theory, it is maintained that more mature relationships, as well as a strong therapeutic alliance, may be prerequisites for successful transference work. In this study, the interaction between quality of object relations,…

  2. Therapeutic Alliance in Family Therapy for Adolescents with Epilepsy: An Exploratory Study.

    ERIC Educational Resources Information Center

    Glueckauf, Robert L.; Liss, Heidi J.; McQuillen, Diane E.; Webb, Pat M.; Dairaghi, Jeanne; Carter, Carol B.

    2002-01-01

    Adolescents (N=19) with epilepsy and their families assigned to either issue-specific single-family counseling (IFCM) or to a multi-family psychoeducational group (PG) were studied for problem improvement through therapeutic alliance. While no overall differences were found between IFCM and PG, IFCM adolescents reported significantly stronger…

  3. Therapeutic Alliance, Negative Mood Regulation, and Treatment Outcome in Child Abuse-Related Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Cloitre, Marylene; Chase Stovall McClough,K.; Miranda, Regina; Chemtob, Claude M.

    2004-01-01

    This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic…

  4. Rules of engagement: qualitative experiences of therapeutic alliance when receiving in-patient treatment for anorexia nervosa.

    PubMed

    Sly, Richard; Morgan, John F; Mountford, Victoria A; Sawer, Francesca; Evans, Charlotte; Lacey, J Hubert

    2014-01-01

    Recent research has emphasised the importance of therapeutic alliance to treatment outcomes for anorexia nervosa. This study aimed to examine the experiences of service users in developing therapeutic alliance whilst in treatment for their eating disorders. This qualitative study, using purposive sampling, recruited a sample of service users receiving treatment at a national eating disorders service. In-depth interviews were audiotaped and transcribed, with transcriptions being subject to interpretative phenomenological analysis. Participants were eight adult women receiving tertiary level eating disorder treatment in a specialist setting. The text analysis produced four dominant categories: alliance as a key experience; being active, not passive; taboo talking; and first impressions count. The development of therapeutic alliance is a core component of treatment. This study identifies important areas that contribute to the successful cultivation of positive therapeutic alliance. PMID:24392991

  5. Contribution of Patient Defense Mechanisms and Therapist Interventions to the Development of Early Therapeutic Alliance in a Brief Psychodynamic Investigation

    PubMed Central

    Despland, Jean-Nicolas; de Roten, Yves; Despars, Josée; Stigler, Michael; Perry, J. Christopher

    2001-01-01

    This preliminary study examined how patients' defense mechanisms and psychotherapists' techniques influence early alliance formation. The authors assessed the relationships among defense mechanisms, therapist interventions, and the development of alliance in a sample of 12 patients undergoing Brief Psychodynamic Investigation (4 sessions). Alliance development occurred rapidly and was clearly established by the third session. Neither defensive functioning nor supportive or exploratory interventions alone differentiated early alliance development. However, the degree of adjustment of therapists' interventions to patients' level of defensive functioning discriminated a low alliance from both improving and high alliances. The adjustment of therapeutic interventions to patients' level of defensive functioning is a promising predictor of alliance development and should be examined further, alongside other predictors of outcome. PMID:11402078

  6. Treatment Engagement: Building Therapeutic Alliance in Home-Based Treatment with Adolescents and their Families

    PubMed Central

    Thompson, Sanna J.; Bender, Kimberly; Lantry, Janet; Flynn, Patrick M.

    2010-01-01

    Client engagement is an essential yet challenging ingredient in effective therapy. Engaged clients are more likely to bond with therapists and counselors, endorse treatment goals, participate to a greater degree, remain in treatment longer, and report higher levels of satisfaction. This study explored the process of engaging high-risk youth and their parents in a unique home-based family therapy intervention. Qualitative interviews were conducted with 19 families who completed family therapy sessions that included a core component aimed at increasing treatment engagement. Parents’ and youths’ perceptions of engagement suggest the importance of developing therapeutic alliance with therapists, who facilitated building a shared alliance among family members. Implications for improving client engagement are discussed within the context of alliance building with the therapist and among family members. PMID:20556209

  7. Interpersonal microprocesses predict cognitive-emotional processing and the therapeutic alliance in psychotherapy for depression.

    PubMed

    Altenstein, David; Krieger, Tobias; Grosse Holtforth, Martin

    2013-07-01

    Interpersonal theories of psychotherapy hypothesize that the success of therapy depends on the therapist's and patient's dominant and affiliative behaviors as well as their interplay (complementarity). This study sought to investigate (a) how in-session interpersonal microprocesses predict postsession evaluations of the therapeutic alliance as well as cognitive-emotional processing and (b) how complementarity develops over the course of a therapy session. Twenty depressed patients were treated at a university-based outpatient clinic with a variant of cognitive therapy. One session was analyzed from each therapy's middle phase using a novel real-time rating procedure (joystick method) to assess the patients' and therapists' affiliative and dominant behaviors as well as their resulting complementarity over the course of the session. The therapeutic alliance and cognitive-emotional processing were assessed by self-reports directly after the respective session. As predicted, more emotional arousal was associated with deviations from complementarity, whereas a positive alliance was related to affiliative patient behavior. Moreover, marginally significant trends suggest that refraining from answering to the pull of patient hostility might benefit both the alliance as well as cognitive-emotional processing. Overall, multilevel growth modeling revealed a significant cubic trend of complementarity over the course of the session. Implications for future research and practice are discussed. PMID:23647390

  8. The Therapeutic Alliance and Family Psychoeducation in the Treatment of Schizophrenia: An Exploratory Prospective Change Process Study

    ERIC Educational Resources Information Center

    Smerud, Phyllis E.; Rosenfarb, Irwin S.

    2008-01-01

    Although family psychoeducation has been shown to be highly efficacious in the treatment of schizophrenia, the mechanisms underlying the treatment's success are poorly understood. The therapeutic alliance in behavioral family management (BFM) was examined to determine whether the alliance plays a role in the efficacy of this treatment. One early…

  9. Understanding Factors Associated with Early Therapeutic Alliance in PTSD Treatment: Adherence, Childhood Sexual Abuse History, and Social Support

    ERIC Educational Resources Information Center

    Keller, Stephanie M.; Zoellner, Lori A.; Feeny, Norah C.

    2010-01-01

    Objective: Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as…

  10. Valuing Clients' Perspective and the Effects on the Therapeutic Alliance: A Randomized Controlled Study of an Adjunctive Instruction

    ERIC Educational Resources Information Center

    Fluckiger, Christoph; Del Re, A. C.; Wampold, Bruce E.; Znoj, Hansjorg; Caspar, Franz; Jorg, Urs

    2012-01-01

    The patterns of growth and development of the therapeutic alliance over the course of therapy have been of continued interest to psychotherapy researchers. The purpose of this study was to investigate whether a simple institutional metacommunication intervention with clients had an effect on the development of the alliance. This adjunctive…

  11. The Relationship between Therapeutic Alliance and Service User Satisfaction in Mental Health Inpatient Wards and Crisis House Alternatives: A Cross-Sectional Study

    PubMed Central

    Sweeney, Angela; Fahmy, Sarah; Nolan, Fiona; Morant, Nicola; Fox, Zoe; Lloyd-Evans, Brynmor; Osborn, David; Burgess, Emma; Gilburt, Helen; McCabe, Rosemarie; Slade, Mike; Johnson, Sonia

    2014-01-01

    Background Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses. Methods and Findings Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically. Results We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy. Conclusions and Implications We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed to investigate why acute

  12. Mutual attention and joint gaze as developmental forerunners of the therapeutic alliance.

    PubMed

    Roth, Bennett

    2014-12-01

    This paper attempts to integrate child developmental research and early childhood neural-cognitive development within the complexities of the early infant-mother relationship as described by psychoanalytic theory. Accumulating research evidence for the importance of the complex transition from mutual gaze to joint gaze calls into question the origin and analytic significance of the alliance relationship that emerges from the primary relationship between the mother and child. This paper explores the apparently neglected relationship between the respective theories of the therapeutic alliance of Zetzel, Greenson, and Brenner, and the developmental progression from mutual gaze and joint gaze, upon which important aspects of mental and cognitive development rest. Nonblind infants and children rely heavily on the ability to see in order to learn and form representations, while trauma affects these dynamics and perception. This issue is particularly relevant given the high incidence of unresolved childhood trauma in the form of neglect, loss, and abuse in those who seek out therapy. Freud's original conception of developmental phase progression has been unsubstantiated by recent researchers in terms of chronological progression and the receptors through which the infants experience the world. In this paper the author applies specific developmental lenses to this basic conception of the dyadic relationship in psychoanalytic treatment, and will reexamine and redefine both working and therapeutic alliance in the frame of an essential developmental stage of joint visual attention. A clinical example will reveal compromised normal preverbal interactive development, exposing faults in the complex transition from mutual gaze to joint gaze. PMID:25490078

  13. The therapeutic alliance in cognitive-behavioral treatment of children referred for oppositional, aggressive, and antisocial behavior.

    PubMed

    Kazdin, Alan E; Marciano, Paul L; Whitley, Moira K

    2005-08-01

    The authors examined the therapeutic alliance in evidence-based treatment for children (N = 185, 47 girls, 138 boys; ages 3-14 years) referred clinically for oppositional, aggressive, and antisocial behavior. Different alliances (child-therapist, parent-therapist) were assessed from each participant's perspective at 2 points over the course of treatment. As predicted, both child-therapist and parent-therapist alliances related to therapeutic change, family experience of barriers to participation in treatment, and treatment acceptability. Greater alliance was associated with greater therapeutic change, fewer perceived barriers, and greater treatment acceptability. The findings could not be attributed to the influence of socioeconomic disadvantage, parent psychopathology and stress, and child dysfunction or to rater effects (common rater variance in the predictors and criteria). PMID:16173860

  14. Evidence of clinically significant change: the therapeutic alliance and the possibilities of outcomes-informed care.

    PubMed

    Manning, Walter H

    2010-11-01

    This article addresses the issue of clinically significant (or meaningful) change resulting from treatment for stuttering. Research in both medical and behavioral fields indicates that clients often have their own unique perspective of meaningful clinical change and that this perspective is often different from that of the professional administering the treatment. Among the variables that the client brings to the treatment session are their progression through stages of therapeutic change and the ways in which they believe they are capable of coping with their problem. Research has shown that how an individual interprets the meaning his or her therapeutic experience is central to clinically significant change. Procedures for obtaining feedback from clients concerning clinically significant change and the quality of the therapeutic alliance are described. PMID:21080293

  15. Synchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance

    PubMed Central

    Koole, Sander L.; Tschacher, Wolfgang

    2016-01-01

    During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship– or alliance– and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in the coupling of patient and therapist’s brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another’s internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients’ emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains. PMID:27378968

  16. Measurement equivalence of the Revised Helping Alliance Questionnaire across African American and non-Latino White substance using adult outpatients.

    PubMed

    Dillon, Frank R

    2013-08-01

    Analyses of the effectiveness of substance abuse treatments across racial/ethnic groups should ensure that outcome measures have the same conceptual meaning (i.e., measurement equivalence) across groups. Because racial groups differ in perceptions and experiences of the therapeutic alliance, this study investigated measurement equivalence properties of the Revised Helping Alliance Questionnaire (HAq-II) across racial groups. The sample included 138 African American and 133 non-Latino White participants, age 18-64 years, who participated in a randomized clinical trial investigating the effectiveness of Motivational Enhancement Therapy in the National Institute on Drug Abuse Clinical Trials Network. Results demonstrated configural invariance and two forms of metric invariance (weak and strong/scalar), suggesting that conceptualizations of therapeutic alliance and overall levels of endorsement of therapeutic alliance are comparable across racial groups. The groups indicated partial, strict metric nonequivalence. No studies to date reported measurement equivalence properties of the HAq-II. Findings support valid measurement and interpretation of HAq-II outcomes. PMID:23522849

  17. An Attempt to Measure the Traffic Impact of Airline Alliances

    NASA Technical Reports Server (NTRS)

    Iatrou, Kostas; Skourias, Nikolaos

    2005-01-01

    This paper analyzes the effects of airline alliances on the allied partners output by comparing the traffic change observed between the pre- and the post-alliance period. First, a simple methodology based on traffic passenger modelling is developed, and then an empirical analysis is conducted using time series from four global strategic alliances (Wings, Star Alliance, oneworld and SkyTeam) and 124 alliance routes. The analysis concludes that, all other things being equal, strategic alliances do lead to a 9.4%, on average, improvement in passenger volume.

  18. Patients' pre-treatment interpersonal problems as predictors of therapeutic alliance in long-term psychodynamic psychotherapy.

    PubMed

    Ollila, Pekka; Knekt, Paul; Heinonen, Erkki; Lindfors, Olavi

    2016-07-30

    Information on how the patient's interpersonal problems predict alliance development during long-term therapy is lacking. The aim of this study was to explore how the patient's pre-treatment interpersonal problems predict the development of alliance in long-term psychotherapy. Altogether 128 adult outpatients experiencing mood or anxiety disorder were assigned to long-term psychodynamic psychotherapy in the Helsinki Psychotherapy Study. The Inventory of Interpersonal Problems (IIP) total score and the eight octant scores, assessed at baseline, were used as predictors. The trajectories of change in patient- and therapist-rated Working Alliance Inventory (WAI) were used as outcome measures at 7, 12, and 36 months of follow-up after baseline. Study of the changes by time showed that the patient-rated alliance was significantly improved by the 36-month follow-up, i.e. the most usual end-point of therapy, in persons with higher pre-treatment level of the IIP total score. Low total IIP score and low to moderate level of hostile type problems showed no slope of improvement of patient-rated alliance during follow-up. The therapist-rated alliance showed a similar course as the patient-rated alliance with the exception of a faster improvement for higher IIP scores. In conclusion, a higher level of patients' interpersonal problems predicted favorable alliance development. PMID:27173654

  19. Recovery Journeys of Counselors and Clients: A Case Study of the Therapeutic Alliance in a Drug Treatment and Rehabilitation Center in Malaysia

    ERIC Educational Resources Information Center

    Amat, Mohamad Isa

    2013-01-01

    The therapeutic alliance is a significant research area in counseling. The understanding of the therapeutic alliance, particularly in drug treatment settings helps counselors and clients to increase the treatment outcomes and its treatment process. The present study investigated the journeys of recovering counselors and clients in a private…

  20. Collaboration in Culturally Responsive Therapy: Establishing A Strong Therapeutic Alliance Across Cultural Lines

    PubMed Central

    Asnaani, Anu; Hofmann, Stefan G.

    2012-01-01

    Achieving effectiveness of therapeutic interventions across a diversity of patients continues to be a foremost concern of clinicians and clinical researchers alike. Further, across theoretical orientations and in all treatment modalities, therapy alliance remains a critical component to determine such favorable outcome from therapy. Yet, there remains a scarcity of empirical data testing specific features that most readily facilitate effective collaboration in a multi-cultural therapy relationship. This article reviews the literature on terminology, empirical findings, and features to enhance collaboration in multi-cultural therapy, suggesting guidelines for achieving this goal in therapy with patients (and therapists) of various cultural/racial backgrounds. This is followed by a multi-cultural case study presenting with several co-morbid Axis I disorders, to exemplify the application of these guidelines over the course of therapy. PMID:23616299

  1. Therapeutic Alliance and Treatment Adherence in Two Interventions for Bulimia Nervosa: A Study of Process and Outcome

    ERIC Educational Resources Information Center

    Loeb, Katharine L.; Wilson, G. Terence; Labouvie, Erich; Pratt, Elizabeth M.; Hayaki, Jumi; Walsh, B. Timothy; Agras, W. Stewart; Fairburn, Christopher G.

    2005-01-01

    The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome…

  2. The Therapeutic Alliance in Schema-Focused Therapy and Transference-Focused Psychotherapy for Borderline Personality Disorder

    ERIC Educational Resources Information Center

    Spinhoven, Philip; Giesen-Bloo, Josephine; van Dyck, Richard; Kooiman, Kees; Arntz, Arnoud

    2007-01-01

    This study investigated the quality and development of the therapeutic alliance as a mediator of change in schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder. Seventy-eight patients were randomly allocated to 3 years of biweekly SFT or TFP. Scores of both therapists and patients for the…

  3. The therapeutic alliance as a predictor of outcome in dialectical behavior therapy versus nonbehavioral psychotherapy by experts for borderline personality disorder.

    PubMed

    Bedics, Jamie D; Atkins, David C; Harned, Melanie S; Linehan, Marsha M

    2015-03-01

    The purpose of the present study was to explore facets of the client- and therapist-rated therapeutic alliance as predictors of suicide attempts, nonsuicidal self-injury, depression, and introject during the course of 2 psychosocial treatments for borderline personality disorder. A total of 101 women meeting Diagnostic and Statistical Manual of Mental Disorders-IV DSM-IV criteria for borderline personality disorder participated in a randomized controlled trial of dialectical behavior therapy (DBT) versus community treatment by experts. Clients and therapists rated the therapeutic alliance at 4 time points during 1 year of treatment. Multilevel models showed no significant differences in client ratings of the alliance by treatment condition. DBT therapists reported greater working strategy consensus early in treatment and an overall greater alliance during treatment. Client ratings of commitment and working capacity were associated with fewer suicide attempts in DBT. Client ratings of commitment were also associated with reduced nonsuicidal self-injury in DBT only. Therapist ratings of the alliance were predictive of reduced suicide attempts in both treatments. Therapist ratings of the alliance in community treatment by experts were predictive of increased nonsuicidal self-injury. Client and therapist ratings of the alliance were not significantly associated with changes in depression or introject across both treatments. The study supported theoretically predicted relationships between facets of the therapeutic alliance in DBT and suicidal behavior. Results are discussed in the context of recommendations for developing the therapeutic alliance in DBT. PMID:25751116

  4. Pretreatment Social Relations, Therapeutic Alliance, and Improvements in Parenting Practices in Parent Management Training

    ERIC Educational Resources Information Center

    Kazdin, Alan E.; Whitley, Moira K.

    2006-01-01

    The authors examined the parent-therapist alliance in parent management training for children (N = 218; 53 girls and 165 boys, ages 2-14) referred clinically for oppositional, aggressive, and antisocial behavior. The interrelations of pretreatment parent social relationships, the parent-therapist alliance over the course of treatment, and…

  5. A mentalization-based approach to the development of the therapeutic alliance in the treatment of schizophrenia.

    PubMed

    Brent, Benjamin K

    2015-02-01

    This article presents a clinical illustration of a mentalization-based approach to the development of a therapeutic alliance in the treatment of schizophrenia. A clinically focused overview of the attachment-based understanding of mentalization central to the mentalization-based treatment model is first provided. This is followed by a brief summary of the theory and evidence supporting the possible link between attachment disturbances and deficits of mental state understanding in schizophrenia. A case presentation then illustrates the application of core mentalization-based principles and interventions to enhance the therapeutic alliance by addressing disruptions of mentalization and reducing paranoia in the treatment of a patient with early course schizophrenia. PMID:25557537

  6. Narcissism, solitude, friendship: notes on the therapeutic alliance in the context of the Freud-Jung relationship.

    PubMed

    Carta, Stefano

    2012-09-01

    This paper deals with friendship and therapeutic alliance as a transformation of the libidinal love that structures the Oedipal complex. The author considers the relationship between Jung and Freud as a formidable test that may shed light on their personalities and on the relevance of the Oedipal complex for both of them and for their particular theories and practices. The author discusses the possibility that the Oedipal complex may be seen under a finalistic frame of reference and discusses which implicit goals it may express. Such a goal has not been reached by either Freud nor Jung, but might be the key to underline and recognize the fundamental importance of the 'therapeutic alliance' within the analytical situation, seen as a potential relationship between the selves of the patient and of the analyst springing from a transformation of libidinal love into 'friendship' as it was described by Friedrich Nietzsche. PMID:22954047

  7. Effects of language concordance and interpreter use on therapeutic alliance in Spanish-speaking integrated behavioral health care patients.

    PubMed

    Villalobos, Bianca T; Bridges, Ana J; Anastasia, Elizabeth A; Ojeda, Carlos A; Hernandez Rodriguez, Juventino; Gomez, Debbie

    2016-02-01

    The discrepancy between the growing number of Spanish speakers in the U.S. and the availability of bilingual providers creates a barrier to accessing quality mental health care. Use of interpreters provides one strategy for overcoming this linguistic barrier; however, concerns about whether sessions with interpreters, versus bilingual providers, impede therapeutic alliance remain. The current study explored associations between the use of interpreters and therapeutic alliance in a sample of 458 Spanish-speaking patients seen for integrated behavioral health visits at primary care clinics. Patients completed a brief (4 item) therapeutic alliance scale at their behavioral health appointment. In addition, to supplement the quantitative study data, a pilot study of 30 qualitative interviews was conducted with a new sample of 10 Spanish-speaking patients, 10 behavioral health consultants (BHCs), and 10 trained interpreters. Quantitative results showed that interpreter use did not relate to therapeutic alliance, even when controlling for relevant demographic variables. However, qualitative interviews suggested major themes regarding the relative benefits and challenges of using interpreters for patients, interpreters, and BHCs. In interviews, patients expressed a strong preference for bilingual providers. Benefits included greater privacy, sense of trust, and accuracy of communication. However, in their absence, interpreters were seen as increasing access to services and facilitating communication with providers, thereby addressing the behavioral health needs of patients with limited English proficiency. BHCs and interpreters emphasized the importance of interpreter training and a good collaborative relationship with interpreters to minimize negative effects on the quality of care. (PsycINFO Database Record PMID:26349073

  8. Understanding and Measuring Coach–Teacher Alliance: A Glimpse Inside the ‘Black Box’

    PubMed Central

    Pas, Elise T.; Bradshaw, Catherine P.

    2016-01-01

    Coaching models are increasingly used in schools to enhance fidelity and effectiveness of evidence-based interventions; yet, little is known about the relationship between the coach and teacher (i.e., coach–teacher alliance), which may indirectly enhance teacher and student outcomes through improved implementation quality. There is also limited research on measures of coach–teacher alliance, further hindering the field from understanding the active components for successful coaching. The current study examined the factor structure and psychometric characteristics of a measure of coach–teacher alliance as reported by both teachers and coaches and explored the extent to which teachers and coaches reliably rate their alliance. Data come from a sample of 147 teachers who received implementation support from one of four coaches; both the teacher and the coach completed an alliance questionnaire. Separate confirmatory factor analyses for each informant revealed four factors (relationship, process, investment, and perceived benefits) as well as an additional coach-rated factor (perceived teacher barriers). A series of analyses, including cross-rater correlations, intraclass correlation coefficients, and Kuder-Richardson reliability estimates suggested that teachers and coaches provide reliable, though not redundant, information about the alliance. Implications for future research and the utilization of the parallel coach–teacher alliance measures to increase the effectiveness of coaching are discussed. PMID:26872479

  9. Understanding and Measuring Coach-Teacher Alliance: A Glimpse Inside the 'Black Box'.

    PubMed

    Johnson, Stacy R; Pas, Elise T; Bradshaw, Catherine P

    2016-05-01

    Coaching models are increasingly used in schools to enhance fidelity and effectiveness of evidence-based interventions; yet, little is known about the relationship between the coach and teacher (i.e., coach-teacher alliance), which may indirectly enhance teacher and student outcomes through improved implementation quality. There is also limited research on measures of coach-teacher alliance, further hindering the field from understanding the active components for successful coaching. The current study examined the factor structure and psychometric characteristics of a measure of coach-teacher alliance as reported by both teachers and coaches and explored the extent to which teachers and coaches reliably rate their alliance. Data come from a sample of 147 teachers who received implementation support from one of four coaches; both the teacher and the coach completed an alliance questionnaire. Separate confirmatory factor analyses for each informant revealed four factors (relationship, process, investment, and perceived benefits) as well as an additional coach-rated factor (perceived teacher barriers). A series of analyses, including cross-rater correlations, intraclass correlation coefficients, and Kuder-Richardson reliability estimates suggested that teachers and coaches provide reliable, though not redundant, information about the alliance. Implications for future research and the utilization of the parallel coach-teacher alliance measures to increase the effectiveness of coaching are discussed. PMID:26872479

  10. The Development of a Measure of the Parenting Alliance.

    ERIC Educational Resources Information Center

    Abidin, Richard R.; Brunner, John F.

    The Parenting Alliance Inventory (PAI) was administered to 186 mothers and 75 fathers with a wide range of socioeconomic backgrounds who had at least one child between 2 and 6 years of age. Subjects were recruited from child care facilities, pediatric practices, and public recreational facilities in central Virginia. Extrafamilial child caregivers…

  11. Advancing the Interdisciplinary Collaborative Health Team Model: Applying Democratic Professionalism, Implementation Science, and Therapeutic Alliance to Enact Social Justice Practice.

    PubMed

    Murphy, Nancy

    2015-01-01

    This essay reframes the interdisciplinary collaborative health team model by proposing the application of 3 foundational pillars-democratic professionalism, implementation science, and therapeutic alliance to advance this practice. The aim was to address challenges to the model, enhance their functional capacity, and explicate and enact social justice practices to affect individual health outcomes while simultaneously addressing health inequities. The pillars are described and examples from the author's dissertation research illustrate how the pillars were used to bring about action. Related theories, models, and frameworks that have negotiation, capacity building, collaboration, and knowledge/task/power sharing as central concepts are presented under each of the pillars. PMID:26244478

  12. Cultural Difference and the Therapeutic Alliance: An Evidence-Based Analysis

    ERIC Educational Resources Information Center

    Vasquez, Melba J. T.

    2007-01-01

    The research on positive psychotherapy outcome consistently indicates that the quality of the alliance is important across different models of psychotherapy (D. E. Orlinsky, M. H. Ronnestad, & U. Willutzki, 2004; B. E. Wampold, 2000). Social psychological research has documented how "unintentional bias" can produce barriers to university…

  13. The Influence of Therapist Variance on the Dependability of Therapists' Alliance Scores: A Brief Comment on "The Dependability of Alliance Assessments: The Alliance-Outcome Correlation Is Larger than You Think" (Crits-Christoph et al., 2011)

    ERIC Educational Resources Information Center

    Baldwin, Scott A.; Imel, Zac E.; Atkins, David C.

    2012-01-01

    Objective: Crits-Christoph, Connolly Gibbons, Hamilton, Ring-Kurtz, and Gallop (2011) used generalizability theory to critique the measurement of the therapeutic alliance in psychotherapy research, showing that the dependability of alliance scores may be quite low, which in turn can lead to attenuated alliance-outcome correlation estimates. Method…

  14. Beyond the Therapeutic Hour: An Exploratory Pilot Study of Using Technology to Enhance Alliance and Engagement within Face-to-Face Psychotherapy

    ERIC Educational Resources Information Center

    Richards, Penelope; Simpson, Susan

    2015-01-01

    In this paper we introduce and investigate the capacity for a novel, technologically advanced system (goACT) to enhance face-to-face psychotherapy. Specifically, we explore the capacity for goACT to enhance therapeutic alliance (TA) and engagement, and reduce distress. Using a mixed-methods, multiple-baseline design we present the first study to…

  15. Angioma Alliance

    MedlinePlus

    ... Research Shop to Support Us Our Videos Angioma Alliance Night at the Cincinnati Reds Cavernous Angioma and Children Dr. Issam Awad at the Angioma Alliance Family Conference info@AngiomaAlliance.org | © Angioma Alliance | Disclaimer | ...

  16. The effects of diagnosis and non-compliance attributions on therapeutic alliance processes in adult acute psychiatric settings.

    PubMed

    Forsyth, A

    2007-02-01

    To investigate the effects of the diagnoses of borderline personality disorder (BPD) and major depressive disorder (MDD), together with reasons for client non-compliance with therapy tasks, on mental health workers' helping, empathy and anger reactions. Utilizing a 2 x 2 x 2 factorial design, mental health nurses were asked to read a series of vignettes and complete a 15-item rating scale for helping, empathy and anger reactions to each of the vignettes. Eight clinical vignettes were constructed and contained a combination of controllable/uncontrollable and stable/unstable attributional dimensions for service users who failed to complete a therapy task. The diagnoses of BPD and MDD were added to the vignettes to determine whether diagnoses affected alliance factors. A total of 26 mental health workers participated in the study and there were main effects for those workers to be angrier when causes were perceived as due to controllable factors; to be more helpful to service users' with a diagnosis of MDD; and less helpful when causes were perceived to be due to stable factors. Results show some support for Weiner's model of helping behaviour. It is suggested that there is an important role to explore the attributions of mental health workers working with service users with BPD. A role for case conceptualization is discussed to facilitate therapeutic engagement with service users with a diagnosis of BPD. PMID:17244003

  17. Nanotechnology-based cancer therapeutics--promise and challenge--lessons learned through the NCI Alliance for Nanotechnology in Cancer.

    PubMed

    Farrell, Dorothy; Ptak, Krzysztof; Panaro, Nicholas J; Grodzinski, Piotr

    2011-02-01

    The new generation of nanotechnology-based drug formulations is challenging the accepted ways of cancer treatment. Multi-functional nanomaterial constructs have the capability to be delivered directly to the tumor site and eradicate cancer cells selectively, while sparing healthy cells. Tailoring of the nano-construct design can result in enhanced drug efficacy at lower doses as compared to free drug treatment, wider therapeutic window, and lower side effects. Nanoparticle carriers can also address several drug delivery problems which could not be effectively solved in the past and include reduction of multi-drug resistance effects, delivery of siRNA, and penetration of the blood-brain-barrier. Although challenges in understanding toxicity, biodistribution, and paving an effective regulatory path must be met, nanoscale devices carry a formidable promise to change ways cancer is diagnosed and treated. This article summarizes current developments in nanotechnology-based drug delivery and discusses path forward in this field. The discussion is done in context of research and development occurring within the NCI Alliance for Nanotechnology in Cancer program. PMID:20814720

  18. Comparison of Profiling Microwave Radiometer, Aircraft, and Radiosonde Measurements From the Alliance Icing Research Study (AIRS)

    NASA Technical Reports Server (NTRS)

    Reehorst, Andrew L.

    2001-01-01

    Measurements from a profiling microwave radiometer are compared to measurements from a research aircraft and radiosondes. Data compared is temperature, water vapor, and liquid water profiles. Data was gathered at the Alliance Icing Research Study (AIRS) at Mirabel Airport outside Montreal, Canada during December 1999 and January 2000. All radiometer measurements were found to lose accuracy when the radome was wet. When the radome was not wetted, the radiometer was seen to indicate an inverted distribution of liquid water within a cloud. When the radiometer measurements were made at 15 deg. instead of the standard zenith, the measurements were less accurate.

  19. Remote “Hovering” with Individuals with Psychotic Disorders and Substance Use: Feasibility, Engagement, and Therapeutic Alliance with a Text-Messaging Mobile Interventionist

    PubMed Central

    Ben-Zeev, Dror; Kaiser, Susan M.; Krzos, Izabela

    2014-01-01

    Objective People with serious mental illnesses and substance abuse problems (i.e., dual diagnosis) constitute a particularly challenging and costly clinical group. This study evaluated the feasibility and acceptability of a novel model of care in which a mobile interventionist used mobile phone text messaging to remotely monitor and provide daily support to individuals with psychotic disorders and substance use. Methods Seventeen participants with dual diagnosis were enrolled in a twelve-week single-arm trial. A clinical social worker served as the mobile interventionist and sent daily text-messages to participants’ privately-owned mobile phones to assess their medication adherence and clinical status. The mobile interventionist provided text-message feedback and support, and suggested various coping strategies flexibly, in response to participants’ replies to prompts. At the end of the trial, participants completed a usability and satisfaction measure and two self-rated measures of therapeutic alliance with their clinicians. In one version, participants rated their relationship with their mobile interventionist; in the second version, they rated their relationship with their community-based treatment team. Results Participants received an average of 139 text messages (SD = 37.5) each from the mobile interventionist over the twelve-week trial. On average, participants responded to 87% of the mobile interventionist’s messages that required a reply. Over 90% of participants thought the intervention was useful and rewarding, and that it helped them be more effective and productive in their lives. Participants’ assessments of their relationship with the mobile interventionist were positive. Paired sample t-test found the therapeutic alliance ratings participants provided for their mobile interventionist were significantly higher than those provided for their community-based treatment team clinicians who they met with regularly. Conclusions Our findings suggest

  20. [Questionnaire for Investigating Therapeutic Alliance in Forensic Setting (FTBF): Results of a Pilot Study].

    PubMed

    Vasic, N; Dudeck, M; Knein, A M; Rasche, K; Mentel, R; Streb, J; Connemann, B J; Sosic-Vasic, Z; Otte, S

    2015-12-01

    The relation between patient and therapist has a substantial effect on the success of psychotherapy. So far, in German-speaking regions questionnaires translated from English have been used, particularly for studying outpatients. Studies investigating and concerned with specialised features of hospitalised forensic psychiatry patients are sparse. The preliminary results of this study evaluating a recently developed questionnaire aimed to investigate the quality of the therapeutic relationship in forensic psychiatry ("Fragebogen zur therapeutischen Beziehung in der Forensik, FTBF") are reported. The data were collected both in general and forensic psychiatry departments. Factor analyses yielded two essential factors, namely "positive emotional aspects" (12 items, main features trust, respect, helpfulness, harmony, and sympathy; Cronbach's α = .933) and "negative emotional aspects" (4 items, main features power divide and punishment; Cronbach's α = .805). Forensic patients experienced power divide and punishment tendencies more intensively than general psychiatry patients (p < 0.001). Our questionnaire therefore demonstrates not only excellent reliabilities but also differential validity, enabling a differentiation between general and forensic psychiatry patients. Studies with larger samples would enable conclusions about the impact of the therapists' perspective, specific diagnostic subgroups and different psychotherapeutic orientations, on the patient-therapist relationship in forensic psychiatry. PMID:26714250

  1. Client Characteristics as Moderators of the Relation Between the Therapeutic Alliance and Outcome in Cognitive Therapy for Depression

    PubMed Central

    Lorenzo-Luaces, Lorenzo; DeRubeis, Robert J.; Webb, Christian A.

    2014-01-01

    Objective Little is known about the variability of the alliance-outcome correlation across identifiable client subsets. This question was explored in a sample of 60 clients receiving cognitive therapy for depression, from which an overall correlation of .23 was observed between alliance ratings and subsequent symptom change. Methods We examined interactions between the observer-rated version of the Working Alliance Inventory (WAI-O) and client demographics, features of depression, personality and other clinical features in predicting subsequent symptom change. Results After correcting for multiple comparisons, interactions between the WAI-O and the number of prior depressive episodes, as well as the severity of baseline anxiety symptoms, were significant predictors of symptom change. When both interactions were controlled for, number of prior depressive episodes emerged as a statistically significant moderator. The alliance predicted outcome in the subgroup of clients with 0–2 prior episodes (r = .52), but not in those with 3 or more prior episodes (r = −.02). These findings were obtained despite similar univariate distributions on the alliance and symptom change in the two subgroups. Discussion Differences that were observed in the predictive relation of alliance to outcome as a function of number of prior episodes suggests that different therapy processes may account for change in these subgroups. If the pattern observed in the present study is replicated, it would suggest that the alliance-outcome association has been both under- and over-estimated. PMID:24547921

  2. Measurements for satellite validation made from R/V ``Alliance`` during October and November 1991

    SciTech Connect

    Minnett, P.J.

    1993-08-01

    Measurements of sea-surface temperature, surface meteorology and atmospheric profiles taken from the R/V Alliance between 1 October and 9 November 1991. During this time the ship sailed from Amsterdam to La Spezia and then was deployed in the western Mediterranean Sea. The measurements are presented in graphical form, and daily statistics are given as tables. True winds, net long-wave radiation and turbulent air-sea fluxes have been calculated and are also presented. The measurements were made for application to studies of the accuracies of the retrieval of sea-surface temperature and atmospheric precipitable water from satellite radiometers.

  3. The reciprocal relationship between alliance and symptom improvement across treatment of childhood anxiety

    PubMed Central

    Marker, Craig D.; Comer, Jonathan S.; Abramova, Viktoriya; Kendall, Philip C.

    2012-01-01

    Objective This study examined changes in the therapeutic alliance and in self-reported anxiety over the course of 16 weeks of manual-based family treatment for child anxiety disorders. Method 86 children (51.3% female; aged 7.15 to 14.44; 86.2% Caucasian, 14.8% minority) with a principal diagnosis of separation anxiety disorder, generalized anxiety disorder, and/or social phobia, and their parents, received family treatment for anxiety disorders in youth. Child, therapist, and parent ratings of therapeutic alliance and child ratings of state anxiety were measured each session. Latent difference score growth modeling investigated the interacting relationship. Results Therapeutic alliance change, as rated by the mother and by the therapist, was a significant predictor (medium effect) of latter change in child anxiety (with greater therapeutic alliance leading to later reduction in anxiety). However, changes in child-reported anxiety also predicted latter change in father- and therapist-reported alliance (small-to-medium effect). Prospective relationships between child-reported therapeutic alliance and child-reported symptom improvement were not significant. Conclusions Results provide partial support for a reciprocal model in which therapeutic alliance improves outcome, and anxiety reduction improves therapeutic alliance. PMID:23009693

  4. Examining the Relation between the Therapeutic Alliance, Treatment Adherence, and Outcome of Cognitive Behavioral Therapy for Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Liber, Juliette M.; McLeod, Bryce D.; Van Widenfelt, Brigit M.; Goedhart, Arnold W.; van der Leeden, Adelinde J. M.; Utens, Elisabeth M. W. J.; Treffers, Philip D. A.

    2010-01-01

    Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for…

  5. Alliance and Outcome in Cognitive-Behavioral Therapy for Adolescent Depression

    ERIC Educational Resources Information Center

    Shirk, Stephen R.; Gudmundsen, Gretchen; Kaplinski, Heather Crisp; McMakin, Dana L.

    2008-01-01

    This study examined predictive relations between therapeutic alliance and treatment outcomes in manual-guided, cognitive-behavioral therapy for adolescent depression. Fifty-four adolescents met criteria for a depressive disorder and were treated in school-based clinics. Alliance was measured after the third session from both therapist and…

  6. A Systematic Review of Therapeutic Alliance, Group Cohesion, Empathy, and Goal Consensus/Collaboration in Psychotherapeutic Interventions in Cancer: Uncommon Factors?

    PubMed Central

    Schnur, Julie B.; Montgomery, Guy H.

    2010-01-01

    The effects of four empirically supported therapeutic relationship factors (therapeutic alliance, empathy, goal consensus/collaboration, and group cohesion) on the outcome of psychotherapeutic interventions conducted with individuals living with cancer were systematically reviewed. PubMed, PsycINFO, and CINAHL were searched from their inception through November 13, 2008. Studies of psychotherapeutic interventions targeted to individuals living with cancer, which also empirically assessed the association between any of these therapeutic relationship factors and psychotherapy outcome were included in the review (8 of 742 papers initially reviewed). Information on study methodology and results were abstracted independently by the authors using a standardized form. Results indicated that therapist-rated rapport and group cohesion were significantly related to positive psychotherapeutic outcomes. No studies examined empathy. The literature on collaboration was mixed, but showed some support for increased collaboration being related to positive therapeutic outcomes. Overall the current literature on the role of therapeutic relationship factors in the context of individuals living with cancer is scant, and much more research is needed to determine the overall contribution of these four relationship elements to the outcomes of psychotherapeutic interventions for individuals living with cancer. Results of such studies could have important clinical and research implications. PMID:20006414

  7. Alliance, Technology, and Outcome in the Treatment of Anxious Youth

    ERIC Educational Resources Information Center

    Chu, Brian C.; Choudhury, Muniya S.; Shortt, Alison L.; Pincus, Donna B.; Creed, Torrey A.; Kendall, Philip C.

    2004-01-01

    A strong therapeutic alliance is intuitively important in a cognitive-behavioral treatment of anxious youth where the child must confront feared stimuli in numerous exposure tasks. Research examining alliance-outcome relationships and the specific role of the alliance is currently limited. Is the alliance supportive in nature, does it enhance…

  8. Alliance-focused training.

    PubMed

    Eubanks-Carter, Catherine; Muran, J Christopher; Safran, Jeremy D

    2015-06-01

    Alliance-focused training (AFT) aims to increase therapists' ability to recognize, tolerate, and negotiate alliance ruptures by increasing the therapeutic skills of self-awareness, affect regulation, and interpersonal sensitivity. In AFT, therapists are encouraged to draw on these skills when metacommunicating about ruptures with patients. In this article, we present the 3 main supervisory tasks of AFT: videotape analysis of rupture moments, awareness-oriented role-plays, and mindfulness training. We describe the theoretical and empirical support for each supervisory task, provide examples based on actual supervision sessions, and present feedback about the usefulness of the techniques from trainees in our program. We also note some of the challenges involved in conducting AFT and the importance of maintaining a strong supervisory alliance when using this training approach. PMID:25150677

  9. Theoretical Perspectives on the Importance of the Therapeutic Alliance and Their Implications for the Use of Technology.

    ERIC Educational Resources Information Center

    Smith, Peggy H.

    Two questions facing the therapeutic community right now are: Can machines replace therapists? and Can therapy occur without a therapist? This paper attempts to respond to these questions through an examination of some major Western and Eastern theories in the field of psychological therapy. It reviews existing writings in the field to emphasize…

  10. How central is the alliance in psychotherapy? A multilevel longitudinal meta-analysis.

    PubMed

    Flückiger, Christoph; Del Re, A C; Wampold, Bruce E; Symonds, Dianne; Horvath, Adam O

    2012-01-01

    Prior meta-analyses have found a moderate but robust relationship between alliance and outcome across a broad spectrum of treatments, presenting concerns, contexts, and measurements. However, there continues to be a lively debate about the therapeutic role of the alliance, particularly in treatments that are tested using randomized clinical trial (RCT) designs. The purpose of this present study was to examine whether research design, type of treatment, or author's allegiance variables, alone or in combination, moderate the relationship between alliance and outcome. Multilevel longitudinal analysis was used to investigate the following moderators of the alliance-outcome correlation: (a) research design (RCT or other), (b) use of disorder-specific manuals, (c) specificity of outcomes, (d) cognitive and/or behavioral therapy (CBT) or other types of treatments, (e) researcher allegiance, and (f) time of alliance assessment. RCT, disorder-specific manual use, specificity of primary and secondary outcomes, and CBT did not moderate the alliance-outcome correlation. Early alliance-outcome correlations were slightly higher in studies conducted by investigators with specific interest in alliance than were those in studies conducted by researchers without such an allegiance. Over the course of therapy, these initial differences disappeared. Apart from this trend, none of the variables previously proposed as potential moderators or mediators of the alliance-outcome relation, alone or in combination, were found to have a mediating impact. PMID:21988681

  11. The Impact of Acculturation, Motivation and the Therapeutic Alliance on Treatment Retention and Outcomes for Hispanic Drug Involved Probationers

    PubMed Central

    Brocato, Jo

    2013-01-01

    Factors associated with retention and outcomes for Hispanic offenders mandated to treatment for substance use disorders have been overlooked in the literature resulting in an impediment to providing evidence-based, culturally relevant treatment services. This project examined the roles of motivational factors, the therapeutic relationship, and acculturation in predicting treatment retention and recidivism among Hispanic male probationers mandated to residential treatment. By following a treatment cohort over one hundred and twenty days, this research identifies factors that may be targeted to improve interventions and policies. The following conclusions are supported: among Hispanic offenders, the number of days in treatment is positively related to motivation to change and level of acculturation. PMID:23976877

  12. [Therapeutic errors and dose measuring devices].

    PubMed

    García-Tornel, S; Torrent, M L; Sentís, J; Estella, G; Estruch, M A

    1982-06-01

    In order to investigate the possibilities of therapeutical error in syrups administration, authors have measured the capacity of 158 home spoons (x +/- SD). They classified spoons in four groups: group I (table spoons), 49 units (11.65 +/- 2.10 cc); group II (tea spoons), 41 units (4.70+/-1.04 cc); group III (coffee spoons), 41 units (2.60 +/- 0.59 cc), and group IV (miscellaneous), 27 units. They have compared the first three groups with theoreticals values of 15, 5 and 2.5 cc, respectively, ensuring, in the first group, significant statistical differences. In this way, they analyzed information that paediatricians receive from "vademecums", which they usually consult and have studied two points: If syrup has a meter or not, and if it indicates drug concentration or not. Only a 18% of the syrups have a meter and about 88% of the drugs indicate their concentration (mg/cc). They conclude that to prevent errors of dosage, the pharmacological industry must include meters in their products. If they haven't the safest thing is to use syringes. PMID:7125401

  13. Science Alliance.

    ERIC Educational Resources Information Center

    Baumann, Lorrie; Ribeiro, Mary

    1997-01-01

    Describes the Science Alliance project, a teacher-scientist collaboration where each teacher is given five non-consecutive days of professional development time to meet with a participating scientist, technician, engineer, mathematician, or environmentalist to develop a module of lesson plans that introduce the real world of industry into the…

  14. Predicting Spouses Perceptions of Their Parenting Alliance

    ERIC Educational Resources Information Center

    Hughes, Farrah M.; Gordon, Kristina Coop; Gaertner, Lowell

    2004-01-01

    This study used marital and individual-level variables to predict spouses perceived parenting alliance. One hundred married couples completed measures of parenting alliance, marital consensus, marital power, and depression. Analyses revealed that marital consensus was a significant predictor of parenting alliance for both parents, and that…

  15. The dynamics of empirically derived factors in the therapeutic relationship.

    PubMed

    Nuetzel, Eric J; Larsen, Randy J; Prizmic, Zvjezdana

    2007-01-01

    The therapeutic relationship is the source of major concepts in psychoanalytic clinical theory. Such concepts as resistance, transference, countertransference, and the alliance are fundamental, even though there may be shifts in meaning between theoretical schools and clinical contexts. In the clinical psychoanalytic literature, disagreement exists over the nature of the alliance and its essential components. Empirical studies using reliable patient, therapist, and observer scales to assess the alliance demonstrate a correlation with psychotherapeutic gains. In the study reported here, thirteen patients were followed for 6 to 33 months of psychodynamic psychotherapy, during which time their views of the therapeutic relationship were assessed, and several experiential measures taken, all on a weekly basis. Statistical analyses reveal that the therapeutic relationship, as reflected in the patients' weekly responses to the St. Louis Therapeutic Relationship Rating Scale, has four distinct components: therapeutic alliance, resistance, transference love, and negative transference. On a week-by-week basis, the therapeutic alliance was the strongest predictor of improvement in patient-reported general adjustment, as reflected in such areas as self-esteem, positive affect, social relations, work productivity, satisfaction, and optimism. Time plots of the variables show the typical time course for the components of the therapeutic relationship, as well as for improvement on the experiential variables. Results indicate that the therapeutic alliance, transference, and resistance are central components of the psychotherapeutic relationship, which in turn predict the ongoing life experience of the patient. PMID:18246764

  16. Child and adolescent service experience (ChASE): measuring service quality and therapeutic process.

    PubMed

    Day, Crispin; Michelson, Daniel; Hassan, Imren

    2011-11-01

    OBJECTIVES. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users' views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience DESIGN. The study comprises a non-experimental, cross-sectional design. METHODS. Participants were 132 mental health service users aged 8-18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) (Stallard, 1996) and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire. RESULTS. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test-retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes. CONCLUSIONS. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance. PMID:22003953

  17. Ambivalence and alliance ruptures in cognitive behavioral therapy for generalized anxiety.

    PubMed

    Hunter, Jennifer A; Button, Melissa L; Westra, Henny A

    2014-01-01

    Client ambivalence about change (or motivation) is regarded as central to outcomes in cognitive behavioral therapy (CBT). However, little research has been conducted to examine the impact of client ambivalence about change on therapy process variables such as the therapeutic alliance. Given the demonstrated limitations of self-report measures of key constructs such as ambivalence and motivation, the present study instead employed a newly adapted observational measure of client ambivalence. Client statements regarding change (change talk (CT) and counter-change talk (CCT)) were coded in early (session 1 or 2) therapy sessions of CBT for generalized anxiety disorder. The frequency of CT and CCT was then compared between clients who later experienced an alliance rupture with their therapist, and clients who did not. The results showed that clients in dyads who later experienced an alliance rupture expressed significantly more CCT at the outset of therapy than clients who did not later experience an alliance rupture. However, CT utterances did not significantly differ between alliance rupture and no-rupture groups. CCT may strain the alliance because clients expressing higher levels of CCT early in therapy may be less receptive to therapist direction in CBT. Consequently, it is recommended that clients and therapists work together to carefully address these key moments in therapy so as to prevent alliance rupture and preserve client engagement in therapy. PMID:24655131

  18. The role of therapists' treatment adherence, professional experience, therapeutic alliance, and clients' severity of psychological problems: Prediction of treatment outcome in eight different psychotherapy approaches. Preliminary results of a naturalistic study.

    PubMed

    Tschuschke, Volker; Crameri, Aureliano; Koehler, Miriam; Berglar, Jessica; Muth, Katharina; Staczan, Pia; Von Wyl, Agnes; Schulthess, Peter; Koemeda-Lutz, Margit

    2015-01-01

    In this naturalistic study, 262 audiotaped psychotherapy sessions--randomly drawn from 81 individual therapies from eight different psychotherapy approaches--were rated completely on treatment adherence using a newly developed rating manual. In the therapy sessions, a relatively low percentage of treatment specific interventions (ranging from 4.2% to 27.8%) was found for all eight approaches, 50% to 73% of the interventions were nonspecific or common, and approximately 18% to 27% were intervention techniques from other approaches. Different types of psychotherapy differed highly significantly in levels of treatment adherence. There was no statistically significant association between the type of psychotherapy and its outcome, or between the degree of therapists' treatment fidelity and the treatment outcome. However, there were significant associations between therapists' degree of professional experience, clients' initial psychological burden, and treatment response. Clients' severity of psychological problems prior to treatment predicted quality of therapeutic alliance while therapists' treatment adherence was predicted by therapists' professional experience and by the quality of the therapeutic alliance. We discuss the seemingly indirect importance of treatment adherence for psychotherapy outcome that we found in this study in relation to findings from other studies and in the context of the role of schools within psychotherapy. PMID:24689912

  19. Therapist and client perspectives on the alliance in the treatment of traumatized adolescents

    PubMed Central

    Ormhaug, Silje M.; Shirk, Stephen R.; Wentzel-Larsen, Tore

    2015-01-01

    Objective Client ratings of the therapeutic alliance are an important predictor of outcome in the treatment of traumatized adolescents and adults, but less is known about the therapists’ perspective. The aim of this study was to investigate how therapists’ ratings relate to the adolescents’ perspective, how individual therapist and adolescent ratings relate to change in symptoms and treatment satisfaction, and whether discrepant alliance perspectives impact treatment outcome. Method The sample consisted of 156 youth (mean age 15.1, range 10–18), randomized to trauma-focused cognitive behavioral therapy or treatment as usual, and alliance ratings from 62 therapists. Alliance was measured midtreatment with the Therapeutic Alliance Scale for Children, and the factor structure of the two scales was analyzed with exploratory factor analyses. A change in posttraumatic symptoms was assessed with the Child PTSD Symptom Scale (CPSS) and the Clinicial-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Results Therapist and client perspectives on the alliance were significantly, but moderately, associated (intraclass correlations [ICC]=0.54, p<0.001). Both scales predicted adolescent treatment satisfaction but only the client scale was significantly related to change in symptoms. Factor analyses revealed differences in factor structure with therapist ratings organized around bond and task dimensions and adolescent ratings organized by item valence. Higher therapist ratings compared to adolescent ratings predicted higher residual PTS symptoms. Discussion Although adolescent and therapist alliance ratings are moderately associated, results suggest that the ratings are differentially associated with outcomes. These findings, along with results indicating important differences in factor structure, imply that adolescent and therapist ratings are not interchangeable. Future studies should investigate how therapists can improve their judgments of adolescents

  20. Better Buildings Alliance, Advanced Rooftop Unit Campaign: Rooftop Unit Measurement and Verification (Fact Sheet)

    SciTech Connect

    Not Available

    2014-09-01

    This document provides facility managers and building owners an introduction to measurement and verification (M&V) methods to estimate energy and cost savings of rooftop units replacement or retrofit projects to estimate paybacks or to justify future projects.

  1. The Therapeutic Reactance Scale: A Measure of Psychological Reactance.

    ERIC Educational Resources Information Center

    Dowd, E. Thomas; And Others

    1991-01-01

    Describes development of the Therapeutic Reactance Scale, which was developed to measure psychological reactance as defined by Brehm (1966), factor analysis of scale into verbal and behavioral reactance subscales, and reliability and validity data from study with 130 college students. (Author/ABL)

  2. A new AMPHORA: an introduction to the project Alcohol Measures for Public Health Research Alliance.

    PubMed

    Gual, Antoni; Anderson, Peter

    2011-03-01

    The AMPHORA Project is a 4 years project funded by the 7th Framework Programme of the European Commission which aims to contribute with new evidence on scarcely explored or unexplored areas of alcohol consumption and alcohol-related harm in Europe. In this introductory article we describe the background of the Project and its main features. The research areas covered by AMPHORA are wide and diverse. Some of the most relevant are: an update on European epidemiological data; the definition of standard common indicators of alcohol consumption and harm; the measurement of the strength of alcohol policies; the study of contextual determinants of alcohol consumption, the analysis of the impact of marketing on youth; the availability of treatments at a European level; and two areas of harm reduction (contamination of illegal or surrogate alcohols and the reduction of harm in drinking venues). PMID:21324015

  3. Therapeutic magnetic microcarriers characterization by measuring magnetophoretic attributes

    NASA Astrophysics Data System (ADS)

    Vidal Ibacache, Guillermo

    Micro/nano robots are considered a promising approach to conduct minimally invasive interventions. We have proposed to embed magnetic nanoparticles in therapeutic or diagnostic agents in order to magnetically control them. A modified clinical Magnetic Resonance Imaging (MRI) scanner is used to provide the driving force that allows these magnetically embedded microcarriers to navigate the vascular human network. By using specific Magnetic Resonance (MR) gradient sequences this method has been validated in previous research works. Magnetophoresis is the term used to describe the fact that a magnetic particle changes its trajectory under the influence of a magnetic force while being carried by a fluid flow. This movement depends on the particle's magnetic characteristics, the particle's geometric shape, the fluid flow's attributes and other factors. In our proposed method, magnetic microcarriers can be produced in several different ways, and so their response will differ to the same magnetic force and fluid flow conditions. The outcome of the therapeutic treatment using our method depends on the adequate selection of the therapeutic and/or diagnosis agents to be used. The selected therapeutic and/or diagnosis magnetic microcarrier also influences the selection of the MR gradient sequence that best fit for a given treatment. This master's thesis presents the design of a device intended to assess the magnetophoretic properties of magnetic therapeutic microcarriers and/or diagnostic agents. Such characterization is essential for determining the optimal sequences of magnetic gradients to deflect their trajectory through relatively complex vascular networks in order to reach a pre-defined target. A microfluidic device was fabricated to validate the design. Magnetophoretic velocities are measured and a simple tracking method is proposed. The preliminary experimental results indicate that, despite some limitations, the proposed technique has the potential to be appropriate

  4. An Empirical Investigation of Defense Interpretation Depth, Defensive Functioning, and Alliance Strength in Psychodynamic Psychotherapy.

    PubMed

    Petraglia, Jonathan; Bhatia, Maneet; De Roten, Yves; Despland, Jean-Nicolas; Drapeau, Martin

    2015-01-01

    The present study examined the relationship between depth of defense interpretations by therapists, and patient defensive functioning, on the therapeutic alliance in a sample of 36 patients undergoing short-term dynamic psychotherapy. Defense interpretation depth was defined as the degree to which therapist interpretations contained information regarding the motivation for patient defenses and historical origins of the defensive processes (Greensen, 1967). Mean depth of interpretation was compared between sessions that were identified beforehand as either high-alliance or low-alliance sessions using the Helping Alliance Questionnaire (HAq-II: Luborsky et al., 1996). Results indicated that defensive functioning was correlated to defense interpretation depth in low-alliance sessions. Moreover, mean depth of interpretation was also higher in low-alliance sessions, pointing to the possible "destabilizing" effects that these interpretations may have on both defensive functioning and the therapeutic alliance. These results are discussed within the context of previous studies of therapeutic technique in dynamic psychotherapy. PMID:26241796

  5. Alliance through Change

    ERIC Educational Resources Information Center

    Sebalj, Darlene; Hudson, Susan; Ryan, Jan; Wight-Boycott, Juliet

    2007-01-01

    Following a landmark organisational change event within the University of Western Sydney, when the university ceased operating as a federation of four distinct, inter-related elements and merged to become a single entity, four foundation College Managers made a strategic decision to form an alliance. This alliance significantly enhanced the…

  6. Building Alliances Series: Education

    ERIC Educational Resources Information Center

    Brady, Cecilia

    2009-01-01

    Public-private partnerships done right are a powerful tool for development, providing enduring solutions to some of the greatest challenges. To help familiarize readers with the art of alliance building, the Global Development Alliance (GDA) office has created a series of practical guides that highlight proven practices in partnerships,…

  7. Alliance: a common factor of psychotherapy modeled by structural theory

    PubMed Central

    Tschacher, Wolfgang; Haken, Hermann; Kyselo, Miriam

    2015-01-01

    There is broad consensus that the therapeutic alliance constitutes a core common factor for all modalities of psychotherapy. Meta-analyses corroborated that alliance, as it emerges from therapeutic process, is a significant predictor of therapy outcome. Psychotherapy process is traditionally described and explored using two categorically different approaches, the experiential (first-person) perspective and the behavioral (third-person) perspective. We propose to add to this duality a third, structural approach. Dynamical systems theory and synergetics on the one hand and enactivist theory on the other together can provide this structural approach, which contributes in specific ways to a clarification of the alliance factor. Systems theory offers concepts and tools for the modeling of the individual self and, building on this, of alliance processes. In the enactive perspective, the self is conceived as a socially enacted autonomous system that strives to maintain identity by observing a two-fold goal: to exist as an individual self in its own right (distinction) while also being open to others (participation). Using this conceptualization, we formalized the therapeutic alliance as a phase space whose potential minima (attractors) can be shifted by the therapist to approximate therapy goals. This mathematical formalization is derived from probability theory and synergetics. We draw the conclusion that structural theory provides powerful tools for the modeling of how therapeutic change is staged by the formation, utilization, and dissolution of the therapeutic alliance. In addition, we point out novel testable hypotheses and future applications. PMID:25954215

  8. Alliance: a common factor of psychotherapy modeled by structural theory.

    PubMed

    Tschacher, Wolfgang; Haken, Hermann; Kyselo, Miriam

    2015-01-01

    There is broad consensus that the therapeutic alliance constitutes a core common factor for all modalities of psychotherapy. Meta-analyses corroborated that alliance, as it emerges from therapeutic process, is a significant predictor of therapy outcome. Psychotherapy process is traditionally described and explored using two categorically different approaches, the experiential (first-person) perspective and the behavioral (third-person) perspective. We propose to add to this duality a third, structural approach. Dynamical systems theory and synergetics on the one hand and enactivist theory on the other together can provide this structural approach, which contributes in specific ways to a clarification of the alliance factor. Systems theory offers concepts and tools for the modeling of the individual self and, building on this, of alliance processes. In the enactive perspective, the self is conceived as a socially enacted autonomous system that strives to maintain identity by observing a two-fold goal: to exist as an individual self in its own right (distinction) while also being open to others (participation). Using this conceptualization, we formalized the therapeutic alliance as a phase space whose potential minima (attractors) can be shifted by the therapist to approximate therapy goals. This mathematical formalization is derived from probability theory and synergetics. We draw the conclusion that structural theory provides powerful tools for the modeling of how therapeutic change is staged by the formation, utilization, and dissolution of the therapeutic alliance. In addition, we point out novel testable hypotheses and future applications. PMID:25954215

  9. Alliances in "The Hunger Games"

    ERIC Educational Resources Information Center

    Painter, Judith

    2012-01-01

    This lesson plan is based on "The Hunger Games" by Suzanne Collins. Characters in "The Hunger Games" form alliances both inside and outside the arena. Katniss and Gale form alliances within District 12. Katniss, Peeta, and the other tributes form alliances for a variety of reasons during the Games. An alliance means that "someone's got your back"…

  10. Predictors of child-therapist alliance in cognitive-behavioral treatment of children referred for oppositional and antisocial behavior.

    PubMed

    Kazdin, Alan E; Durbin, Kelly A

    2012-06-01

    We examined the therapeutic alliance in evidence-based treatment for children (N=97, 24 girls and 73 boys, ages 6-13 years) referred clinically for oppositional, aggressive, and antisocial behavior. We predicted that the quality of the child-therapist alliance would be related to therapeutic improvements in the children at the end of treatment and that the alliance would be predicted by alliance-relevant child characteristics (intellectual and social competencies) assessed before treatment. Multiple perspectives were obtained to evaluate child characteristics before treatment, alliance during the course of treatment, and therapeutic change at the end of treatment. The main findings were as follows: (1) the child-therapist alliance was related to therapeutic change at the end of treatment. The better the quality of the therapeutic alliance during treatment, the greater the therapeutic change among the children; (2) intellectual and social competencies of the child before treatment predicted the quality of the therapeutic alliance. Children higher in intellectual and social competencies formed a better child-therapist alliance; and (3) intellectual and social competencies did not account for or explain the connection of alliance and therapeutic change. The findings could not easily be attributed to the influence of other domains (socioeconomic disadvantage, parent psychopathology and stress, and severity and scope of child dysfunction) that plausibly might contribute to alliance and therapeutic change or to rater effects (common rater variance) among predictors and outcome criteria. We propose that the next steps for child-alliance research is to better describe factors that contribute to alliance and to explain precisely what mechanisms might be involved that connect alliance during treatment with changes in individual functioning. PMID:22642524

  11. NCI Alliance for Nanotechnology in Cancer - Alliance in the News

    Cancer.gov

    The NCI Alliance for Nanotechnology in Cancer is conducting cutting-edge research using nanotechnology to transform the diagnosis, prevention, treatment, and clinical outcomes for cancer patients. Read news stories and announcements below about the Alliance's multidisciplinary work.

  12. Further Validation of the Learning Alliance Inventory: The Roles of Working Alliance, Rapport, and Immediacy in Student Learning

    ERIC Educational Resources Information Center

    Rogers, Daniel T.

    2015-01-01

    This study further examined the reliability and validity of the Learning Alliance Inventory (LAI), a self-report measure designed to assess the working alliance between a student and a teacher. The LAI was found to have good internal consistency and test--retest reliability, and it demonstrated the predicted convergence with measures of immediacy…

  13. Women in the Farmers' Alliance.

    ERIC Educational Resources Information Center

    Wagner, MaryJo

    The involvement of women in U.S. politics of the 1890s, specifically in the Populist Party and the National Farmers' Alliance, is discussed in this paper. Women comprised a large percentage of membership in many of the sub-alliances of the National Farmers' Alliance and a number were national leaders, including Mary Elizabeth Lease, Annie LePorte…

  14. Sustaining alliances for integrity.

    PubMed

    Werhane, P H

    2000-01-01

    Research in business ethics has shown that value-grounded organizations outperform their counterparts in business terms and that industries can successfully regulate themselves. The market in health care, systems theory, and stakeholder analysis are used to generate a set of five potential core values to sustain an Ethics Alliance of Oral Health Organizations. PMID:10941225

  15. Family Caregiver Alliance

    MedlinePlus

    ... of Family Caregiver Alliance. Blog What's New HOT Weather Tips We all suffer in hot weather. However, for elderly and disabled people and those ... conditions such as vascular disease or diabetes, the weather does not have to hit 100 degrees to ...

  16. The Effects of Counselor Trainee Stress and Coping Resources on the Working Alliance and Supervisory Working Alliance

    ERIC Educational Resources Information Center

    Gnilka, Philip B.

    2010-01-01

    Counselor trainees' stress and coping resources have the potential to influence the relationships formed with supervisors and clients. Two hundred thirty two (N = 232) Master-level counselor trainees completed surveys designed to measure perceived stress, coping resources, the working alliance, and the supervisory working alliance. Participants…

  17. Examining Supervisor and Supervisee Agreement on Alliance: Is Shame a Factor?

    ERIC Educational Resources Information Center

    Bilodeau, Cynthia; Savard, Reginald; Lecomte, Conrad

    2010-01-01

    This study examined the agreement of 31 supervisee-supervisor pairs on perceived strength of working alliance throughout 5 supervision sessions and on whether the alliance differed significantly in relation to supervisee shame-proneness. The Supervisory Working Alliance Inventory (Trainee and Supervisor versions) was used to measure the working…

  18. Evaluation of Various Therapeutic Measures in Striae Rubra

    PubMed Central

    Karia, Umesh Karsandas; Padhiar, Bela Bhemabhai; Shah, Bela Jaswantbhai

    2016-01-01

    Background: Striae are linear atrophic depressions that form in areas of dermal damage in the skin. As on date, no consensus or protocol exists for the treatment of stria rubra. Topical retinoids, chemical peels, microdermabrasion, radiofrequency, photothermolysis, intense pulsed light and lasers are some of the modalities used. Aims and Objective: To compare the efficacy of various therapeutic modalities in striae rubra. Methods: This prospective cohort study comprised of a total of fifty patients from August-2012 to October-2013 in a tertiary care center in Western India, Gujarat having striae rubra. They were randomly divided into five groups of ten patients each. Patients were evaluated on the basis of visual assessment, both by doctor as well as the patient. Group I was given topical tretinoin (0.1% w/w) gel applied once at night, Group II-microdermabrasion (MDA) combined with trichloroacetic acid (TCA) (30%) peel, Group III-mesotherapy, Group IV-Q-switched Nd: YAG laser, and Group V-combination treatment of microdermabrasion, salicylic acid peel and retinol (yellow) peel. Patients were treated at an interval of 15 days for 2 months and then at monthly intervals. Objective assessment was done at 2nd month, 6th month, and at the end of 1st year. Results: Patients in Group I treated with topical tretinoin showed the least response with 80% (8) of them showing minimal clinical improvement (0–25%) as compared to patients in Group V in which 60% (6) patients showed moderate clinical improvement (50–75%). While majority of the patients in Group II, III, and IV showed mild clinical improvement (25–50%). Conclusions: Striae rubra is a common cause of concern for adolescent population. Combination treatment with microdermabrasion, salicylic acid and retinol yellow peel gave superior results as compared to other therapeutic options. Mild to moderate improvement was seen with Nd: YAG laser, mesotherapy and MDA + TCA whereas minimal improvement were seen with

  19. [Suicide in psychiatric hospitals : Results, risk factors and therapeutic measures].

    PubMed

    Wolfersdorf, M; Vogel, R; Vogl, R; Grebner, M; Keller, F; Purucker, M; Wurst, F M

    2016-05-01

    Suicide prevention is a core responsibility of psychiatry and psychotherapy. Periods of change in psychiatric inpatient treatment concepts are usually also accompanied by an increase in psychopathological behavior and with increased suicide rates in psychiatric hospitals, as seen in the 1970s and 1980s in Germany. That this represented a real increase of inpatient suicides during those years was confirmed and subsequently the number and rate of inpatient suicides has decreased from approximately 280 out of 100,000 admissions of patients in 1980 to approximately 50 in 2014. Death can also occur in psychiatric hospitals and an absolute prevention is not possible even under optimal conditions of therapy and nursing, communication and security. The suicide rate has clearly decreased over the last two decades in relation to admissions. The group of young male schizophrenic patients newly identified as having a high clinical suicide risk has decreased among the suicide victims whereas the percentage of severely depressed patients with delusions has increased. This reduction could be associated with the comprehensive improvements in educational and training programs in the field of suicide and suicide prevention, objectification of coping methods, development of diagnostic and therapeutic strategies, improvements in therapy and relationship possibilities and a general reduction in the number of suicides in Germany. PMID:27090898

  20. MEASURING THERAPEUTIC RESPONSE IN CHRONIC GRAFT-VERSUS-HOST DISEASE

    PubMed Central

    Lee, Stephanie J.; Wolff, Daniel; Kitko, Carrie; Koreth, John; Inamoto, Yoshihiro; Jagasia, Madan; Pidala, Joseph; Olivieri, Attilio; Martin, Paul J.; Przepiorka, Donna; Pusic, Iskra; Dignan, Fiona; Mitchell, Sandra A.; Lawitschka, Anita; Jacobsohn, David; Hall, Anne M.; Flowers, Mary E.D.; Schultz, Kirk R.; Vogelsang, Georgia; Pavletic, Steven

    2016-01-01

    In 2005, the NIH Chronic GVHD Consensus Response Criteria Working Group recommended several measures to document serial evaluations of chronic GVHD organ involvement. Provisional definitions of complete response, partial response, and progression were proposed for each organ and for overall outcome. Based on publications over the last nine years, the 2014 Working Group has updated its recommendations for measures and interpretation of organ and overall responses. Major changes include elimination of several clinical parameters from the determination of response, updates to or addition of new organ scales to assess response, and the recognition that progression excludes minimal, clinically insignificant worsening that does not usually warrant a change in therapy. The response definitions have been revised to reflect these changes and are expected to enhance reliability and practical utility of these measures in clinical trials. Clarification is provided about response assessment after the addition of topical or organ-targeted treatment. Ancillary measures are strongly encouraged in clinical trials. Areas suggested for additional research include criteria to identify irreversible organ damage and validation of the modified response criteria, including in the pediatric population. PMID:25796139

  1. Robustness of airline alliance route networks

    NASA Astrophysics Data System (ADS)

    Lordan, Oriol; Sallan, Jose M.; Simo, Pep; Gonzalez-Prieto, David

    2015-05-01

    The aim of this study is to analyze the robustness of the three major airline alliances' (i.e., Star Alliance, oneworld and SkyTeam) route networks. Firstly, the normalization of a multi-scale measure of vulnerability is proposed in order to perform the analysis in networks with different sizes, i.e., number of nodes. An alternative node selection criterion is also proposed in order to study robustness and vulnerability of such complex networks, based on network efficiency. And lastly, a new procedure - the inverted adaptive strategy - is presented to sort the nodes in order to anticipate network breakdown. Finally, the robustness of the three alliance networks are analyzed with (1) a normalized multi-scale measure of vulnerability, (2) an adaptive strategy based on four different criteria and (3) an inverted adaptive strategy based on the efficiency criterion. The results show that Star Alliance has the most resilient route network, followed by SkyTeam and then oneworld. It was also shown that the inverted adaptive strategy based on the efficiency criterion - inverted efficiency - shows a great success in quickly breaking networks similar to that found with betweenness criterion but with even better results.

  2. The parent-child-therapist alliance: A case study using a strategic approach.

    PubMed

    Naidu, Thirusha; Behari, Sheethal

    2010-06-01

    In this paper we present a single case study of a clinical approach that addresses the needs of parents and their children in psychotherapy. The approach begins by addressing the child's and parent's concerns separately at first by establishing strong therapeutic alliances with each, and then proceeds to address the concerns of the parent-child dyad. The basic premise is that the therapeutic alliance is the central element to successful outcomes in psychotherapy. The nature of alliance-building and its associated methods and techniques have been extensively considered for adult therapy. However, there is considerably less written on the therapeutic alliance with children and adolescents in the context of family interventions. We briefly examine some theoretical dimensions and applications of the therapeutic alliance in psychotherapy with children/adolescents and their parents. A three-phase alliance-building psychotherapy strategy, founded on the idea that each therapeutic relationship warrants an effective working alliance, is proposed. The case of a single mother and her adolescent daughter is employed to illustrate the strategy. PMID:25859699

  3. Building Alliances Series: Workforce Development

    ERIC Educational Resources Information Center

    Brady, Cecilia

    2009-01-01

    Public-private partnerships done right are a powerful tool for development, providing enduring solutions to some of the greatest challenges. To help familiarize readers with the art of alliance building, the Global Development Alliance (GDA) office has created a series of practical guides that highlight proven practices in partnerships,…

  4. Alliance for Computational Science Collaboration

    SciTech Connect

    Scheick, S. H.

    2003-04-26

    The mission of this alliance is to promote, encourage, and facilitate computational science activities at the member HBCUs and to use collaborative technologies among the alliance partners to create an environment in which students and researchers from a wide variety of applications areas can exchange ideas and share resources.

  5. Space Alliance Technology Outreach Program

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Space Alliance Technology Outreach Program (SATOP), will provide technical assistance to small businesses through the contribution of time and expertise from Space Alliance Partners and support the development and expansion of technology business incubation programs in Florida and New York. A summary of these accomplishments are given.

  6. Making the Alliance and Taking the Transference in Work With Suicidal Patients

    PubMed Central

    Plakun, Eric M.

    2001-01-01

    This article focuses on two components of psychodynamic psychotherapy with suicidal patients. First, the value and importance of establishing and maintaining a clearly defined therapeutic alliance is noted and explored. A carefully negotiated alliance can become an edge or boundary across which the survival of the therapy, as well as the patient, can be negotiated. Attention to the vicissitudes of the alliance is hypothesized to be the central initial therapeutic action with suicidal patients. Second, the author explores the importance of “taking” rather than “refusing” the transferences offered by the suicidal patient, particularly negative and erotic transferences. Case examples are offered as illustrations. PMID:11696654

  7. Strategic alliances and market risk.

    PubMed

    Havenaar, Matthias; Hiscocks, Peter

    2012-08-01

    Strategic alliances in product development and marketing are crucial to the biotechnology industry. Many alliances, however, are terminated before the drug reaches the market. In this article we make the case that strategic alliances can fail because of how they are negotiated. Alliance contracts are often inflexible and do not allow for changes in market conditions. We propose a model for contract valuation that can assist biotech and/or pharma deal makers in negotiating alliances that have a higher chance of survival in uncertain market conditions. The model makes use of variable royalties and milestone payments. Because licensing is key to the biotech and/or pharma business model this article will be of interest not only to professionals in licensing, but to all professionals active in the industry. PMID:22484547

  8. The Effectiveness of Client Feedback Measures with Adolescents in an Acute Psychiatric Inpatient Setting

    ERIC Educational Resources Information Center

    Lester, Mindy Chaky

    2012-01-01

    There is a growing need for the measurement of therapeutic outcomes and the therapeutic alliance in inpatient mental health services with the adolescent population. This dissertation extends the literature on the use of client feedback measures with adolescents by investigating the use of the Outcome Rating Scale (ORS) and the Session Rating Scale…

  9. Understanding the working alliance with clients diagnosed with anorexia nervosa.

    PubMed

    Oyer, Laura; O'Halloran, Mary Sean; Christoe-Frazier, Liesel

    2016-01-01

    The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment. PMID:25879137

  10. The Research Data Alliance

    NASA Astrophysics Data System (ADS)

    Fontaine, K. S.

    2015-12-01

    The Research Data Alliance (RDA) is an international organization created in 2012 to provide researchers with a forum for identifying and removing barriers to data sharing. Since then, RDA has gained over 3000 individual members, over three dozen organizational members, 47 Interest Groups, and 17 Working Groups, all focused on research data sharing. Interoperability is one instantiation of data sharing, but is not the only barrier to overcome. Technology limitations, discipline-specific cultures that do not support sharing, lack of best-practices, or lack of good definitions, are only three of a long list of situations preventing researchers from sharing their data. This presentation will cover how RDA has grown, some details on how the first eight solutions contribute to interoperability and sharing, and a sneak peek at what's in the pipeline.

  11. The Alliance Negotiation Scale: A psychometric investigation.

    PubMed

    Doran, Jennifer M; Safran, Jeremy D; Muran, J Christopher

    2016-08-01

    This study investigates the utility and psychometric properties of a new measure of psychotherapy process, the Alliance Negotiation Scale (ANS; Doran, Safran, Waizmann, Bolger, & Muran, 2012). The ANS was designed to operationalize the theoretical construct of negotiation (Safran & Muran, 2000), and to extend our current understanding of the working alliance concept (Bordin, 1979). The ANS was also intended to improve upon existing measures such as the Working Alliance Inventory (WAI; Horvath & Greenberg, 1986, 1989) and its short form (WAI-S; Tracey & Kokotovic, 1989) by expanding the emphasis on negative therapy process. The present study investigates the psychometric validity of the ANS test scores and interpretation-including confirming its original factor structure and evaluating its internal consistency and construct validity. Construct validity was examined through the ANS' convergence and divergence with several existing scales that measure theoretically related constructs. The results bolster and extend previous findings about the psychometric integrity of the ANS, and begin to illuminate the relationship between negotiation and other important variables in psychotherapy research. (PsycINFO Database Record PMID:26460895

  12. Helping Alliance, Retention, and Treatment Outcomes: A Secondary Analysis From the NIDA Clinical Trials Network Women and Trauma Study

    PubMed Central

    Ruglass, Lesia M.; Miele, Gloria M.; Hien, Denise A.; Campbell, Aimee N. C.; Hu, Mei-Chen; Caldeira, Nathilee; Jiang, Huiping; Litt, Lisa; Killeen, Therese; Hatch-Maillette, Mary; Najavits, Lisa; Brown, Chanda; Robinson, James A.; Brigham, Gregory S.; Nunes, Edward V.

    2013-01-01

    We examined the association between the therapeutic alliance and treatment outcomes among 223 women with posttraumatic stress disorder (PTSD) and substance use disorders who participated in a multisite clinical trial of group treatments for trauma and addictions in the United States throughout 2004 and 2005. General linear models indicated that women who received Seeking Safety, a cognitive-behavioral treatment, had significantly higher alliance ratings than those in Women's Health Education, a control group. Alliance was related to significant decreases in PTSD symptoms and higher attendance in both interventions. Alliance was not related to substance use outcomes. Implications and limitations of the findings are discussed. PMID:22475068

  13. A calculating alliance.

    PubMed

    Alanis, M; Sippel, S

    1999-01-01

    This article discusses the effects of the alliance between the Church and the Argentine state on women's reproductive rights. Several commentators have criticized how President Carlos Menem used the campaign against abortion for his own political interest. He issued a presidential decree on antiabortion campaign--the Day of the Unborn Child. This decree was announced on December 8, 1998, and the day of observance is March 25 of every coming year. Although the Argentine government does not have a law that explicitly regulates family planning method for the last two decades, many Argentines find the action of the president selfish. The initiation of this presidential decree was the culmination of Menem's manipulation of church and state to secure clerical support for his political regime. Even if statistics is providing him with data concerning the effects of unclear reproductive health laws, he and the church still has chosen not to focus on reproductive rights exclusively, but have concerned themselves primarily with other social and economic issues. While Menem uses the Vatican's pro-life rhetoric and his presidential power to protect fetal life, Argentines will have to contend with the existing Menem policies, which compromise the health of women and children. PMID:12178902

  14. Simultaneous measurements of absorbed dose and linear energy transfer in therapeutic proton beams

    NASA Astrophysics Data System (ADS)

    Granville, Dal A.; Sahoo, Narayan; Sawakuchi, Gabriel O.

    2016-02-01

    The biological response resulting from proton therapy depends on both the absorbed dose in the irradiated tissue and the linear energy transfer (LET) of the beam. Currently, optimization of proton therapy treatment plans is based only on absorbed dose. However, recent advances in proton therapy delivery have made it possible to vary the LET distribution for potential therapeutic gain, leading to investigations of using LET as an additional parameter in plan optimization. Having a method to measure and verify both absorbed dose and LET as part of a quality assurance program would be ideal for the safe delivery of such plans. Here we demonstrated the potential of an optically stimulated luminescence (OSL) technique to simultaneously measure absorbed dose and LET. We calibrated the ratio of ultraviolet (UV) to blue emission intensities from Al2O3:C OSL detectors as a function of LET to facilitate LET measurements. We also calibrated the intensity of the blue OSL emission for absorbed dose measurements and introduced a technique to correct for the LET-dependent dose response of OSL detectors exposed to therapeutic proton beams. We demonstrated the potential of our OSL technique by using it to measure LET and absorbed dose under new irradiation conditions, including patient-specific proton therapy treatment plans. In the beams investigated, we found the OSL technique to measure dose-weighted LET within 7.9% of Monte Carlo-simulated values and absorbed dose within 2.5% of ionization chamber measurements.

  15. Simultaneous measurements of absorbed dose and linear energy transfer in therapeutic proton beams.

    PubMed

    Granville, Dal A; Sahoo, Narayan; Sawakuchi, Gabriel O

    2016-02-21

    The biological response resulting from proton therapy depends on both the absorbed dose in the irradiated tissue and the linear energy transfer (LET) of the beam. Currently, optimization of proton therapy treatment plans is based only on absorbed dose. However, recent advances in proton therapy delivery have made it possible to vary the LET distribution for potential therapeutic gain, leading to investigations of using LET as an additional parameter in plan optimization. Having a method to measure and verify both absorbed dose and LET as part of a quality assurance program would be ideal for the safe delivery of such plans. Here we demonstrated the potential of an optically stimulated luminescence (OSL) technique to simultaneously measure absorbed dose and LET. We calibrated the ratio of ultraviolet (UV) to blue emission intensities from Al2O3:C OSL detectors as a function of LET to facilitate LET measurements. We also calibrated the intensity of the blue OSL emission for absorbed dose measurements and introduced a technique to correct for the LET-dependent dose response of OSL detectors exposed to therapeutic proton beams. We demonstrated the potential of our OSL technique by using it to measure LET and absorbed dose under new irradiation conditions, including patient-specific proton therapy treatment plans. In the beams investigated, we found the OSL technique to measure dose-weighted LET within 7.9% of Monte Carlo-simulated values and absorbed dose within 2.5% of ionization chamber measurements. PMID:26859539

  16. Your alliances are too stable.

    PubMed

    Ernst, David; Bamford, James

    2005-06-01

    A 2004 McKinsey survey of more than 30 companies reveals that at least 70% of them have major alliances that are underperforming and in need of restructuring. Moreover, JVs that broaden or otherwise adjust their scope have a 79% success rate, versus 33% for ventures that remain essentially unchanged. Yet most firms don't routinely evaluate the need to overhaul their alliances or intervene to correct performance problems. That means corporations are missing huge opportunities: By revamping just one large alliance, a company can generate 100 million dololars to 300 million dollars in extra income a year. Here's how to unlock more value from alliances: (1) Launch the process. Don't wait until your venture is in the middle of a crisis; regularly scan your major alliances to determine which need restructuring. Once you've targeted one, designate a restructuring team and find a senior sponsor to push the process along. Then delineate the scope of the team's work. (2) Diagnose performance. Evaluate the venture on the following performance dimensions: ownership and financials, strategy, operations, governance, and organization and talent. Identify the root causes of the venture's problems, not just the symptoms, and estimate how much each problem is costing the company. (3) Generate restructuring options. Based on the diagnosis, decide whether to fix, grow, or exit the alliance. Assuming the answer is fix or grow, determine whether fundamental or incremental changes are needed, using the five performance dimensions above as a framework. Then assemble three or four packages of restructuring options, test them with shareholders, and gain parents' approval. (4) Execute the changes. Embark on a widespread and consistent communication effort, building support among executives in the JV and the parent companies. So the process stays on track, assign accountability to certain groups or individuals. PMID:15938444

  17. Global Alliance for Tuberculosis Drug Development

    MedlinePlus

    ... to TB Medicines TB Alliance and the Medicines Patent Pool Sign Memorandum of Understanding to Improve Access ... Therapies April 20 TB Alliance and the Medicines Patent Pool Sign Memorandum of Understanding to Improve Access ...

  18. The Relationship between Supervisee Stress, Coping Resources, the Working Alliance, and the Supervisory Working Alliance

    ERIC Educational Resources Information Center

    Gnilka, Philip B.; Chang, Catherine Y.; Dew, Brian J.

    2012-01-01

    The authors examined the relationship of perceived stress, specific types of coping resources, the working alliance, and the supervisory working alliance among 232 counselor supervisees. The working alliance and the supervisory working alliance were negatively related to perceived stress and positively related to multiple coping resources. Two…

  19. The global alliance for transplantation.

    PubMed

    Groth, C G; Chapman, J R

    2006-03-01

    In 2002, The Transplantation Society proposed the creation of a Global Alliance for Transplantation, with the purpose of reducing the existing disparity regarding transplantation activities across the globe. This alliance should include major international scientific societies, international governmental organizations, and pharmaceutical companies. Consultations with each of these parties have taken place during the past 18 months and three Strategic Programs have been initiated: (1) the collection of information on transplantation; (2) the expansion of education in transplantation; and (3) the development of professional guidelines for organ donation and transplantation. PMID:16549119

  20. The Role of Setting Versus Treatment Type in Alliance within Youth Therapy

    PubMed Central

    McLeod, Bryce D.; Jensen-Doss, Amanda; Tully, Carrie B.; Southam-Gerow, Michael A.; Weisz, John R.; Kendall, Philip C.

    2016-01-01

    Objective Does the strength of the youth-therapist alliance differ across treatment settings or treatment type? We examined these questions in the context of youth therapy Method 89 youths (M age = 10.56, SD = 1.99; 63.70% Caucasian; 52.80% male) diagnosed with an anxiety disorder received (a) manual-based individual cognitive-behavioral therapy (ICBT) in a research setting, (b) manual-based ICBT in practice settings, or (c) non-manualized usual care (UC) in practice settings. Coders, using the Therapy Process Observational Coding System–Alliance scale, rated 865 sessions. Youth completed the Therapeutic Alliance Scale for Children at posttreatment. Results Youth who received ICBT in a research setting had significantly higher observer-rated alliance than youth who received either therapy delivered in practice settings. In practice settings, youth who received ICBT had significantly stronger observer-rated alliance early in treatment than youth in UC, but this difference was not observed at the end of treatment. Similarly, youth-report alliance at post-treatment was significantly higher in ICBT in the research setting, and there was no difference between ICBT and UC delivered in practice settings. Alliance differences largely held when controlling for youth characteristics; however, differences early in treatment between the ICBT groups were no longer statistically significant when controlling for anxiety severity or primary anxiety diagnosis. Conclusions Our findings suggest that (a) the alliance may be stronger in research settings, and (b) treatment manuals do not undermine alliance. Future research is required to help pinpoint whether other youth, therapist, or setting factors contribute to the lower alliance seen in practice settings. PMID:26881448

  1. Working Alliance and Its Relationship With Treatment Outcome in a Sample of Aboriginal and Non-Aboriginal Sexual Offenders.

    PubMed

    DeSorcy, Danielle R; Olver, Mark E; Wormith, J Stephen

    2016-06-01

    The relationship that develops between a client and therapist is arguably one of the most important factors toward achieving positive outcomes from therapy. The present study examined the therapeutic alliance, as measured by Horvath and Greenberg's Working Alliance Inventory (WAI), as a function of Aboriginal ancestry and the relationship of alliance to important program outcomes, in a Canadian correctional sample of 423 treated sexual offenders. The men rated their primary therapists on the WAI 3 months into treatment. Higher self-report ratings on the WAI and its Task, Bond, and Goal subscales were associated with lower rates of treatment non-completion and longer stay in treatment. Aboriginal men scored significantly lower on the WAI's Bond subscale (i.e., the emotional connection between client and therapist) than non-Aboriginal men, although by and large, the offender sample as a whole otherwise registered fairly high mean scores on the tool. Aboriginal men scoring below the median on WAI total score had the highest rates of treatment non-completion. WAI total score and scores on the three subscales were unrelated to post-program recidivism in the community. Cultural implications for correctional client engagement and service delivery within the context of the risk-needs-responsivity model are discussed. PMID:25381308

  2. Academic Consortia as Strategic Alliances.

    ERIC Educational Resources Information Center

    Cox, Charlotte

    1991-01-01

    The Association for Higher Education of North Texas is an alliance of 20 colleges and universities, 21 high-tech businesses, and civic interests in the Dallas-Fort Worth area that is modeling new ways for higher education institutions to respond to community needs. Other consortia are generally curriculum centered, service centered, or special…

  3. The ALSFRS as an outcome measure in therapeutic trials and its relationship to symptom onset

    PubMed Central

    Proudfoot, Malcolm; Jones, Ashley; Talbot, Kevin; Al-Chalabi, Ammar; Turner, Martin R.

    2016-01-01

    Abstract The reduction in ALS Functional Rating Score (ALSFRS) from reported symptom onset to diagnosis is used to estimate rate of disease progression. ALSFRS decline may be non-linear or distorted by drop-outs in therapeutic trials, reducing the reliability of change in slope as an outcome measure. The PRO-ACT database uniquely allows such measures to be explored using historical data from negative therapeutic trials. The decline of functional scores was analysed in 18 pooled trials, comparing rates of decline based on symptom onset with rates calculated between interval assessments. Strategies to mitigate the effects of trial drop-out were considered. Results showed that progression rate calculated by symptom onset underestimated the subsequent rate of disability accumulation, although it predicted survival more accurately than four-month interval estimates of δALSFRS or δFVC. Individual ALSFRS and FVC progression within a typical trial duration were linear. No simple solution to correct for trial drop-out was identified, but imputation using δALSFRS appeared least disruptive. In conclusion, there is a trade-off between the drive to recruit trial participants soon after symptom onset, and reduced reliability of the ALSFRS-derived progression rate at enrolment. The need for objective markers of disease activity as an alternative to survival-based end-points is clear and pressing. PMID:26864085

  4. Examining Patients' and Other Group Members' Agreement about Their Alliance to the Group as a Whole and Changes in Patient Symptoms Using Response Surface Analysis

    ERIC Educational Resources Information Center

    Lo Coco, Gianluca; Gullo, Salvatore; Kivlighan, Dennis M., Jr.

    2012-01-01

    There is a lack of research examining patients' and other group members' agreement about their therapeutic alliance. In the present study, the person-group (P-G) fit model was adopted to predict that the group member symptom reduction will be greater when the group member's and the other group members' perceptions of their alliance to the…

  5. Governance processes and change within organizational participants of multi-sectoral community health care alliances: the mediating role of vision, mission, strategy agreement and perceived alliance value.

    PubMed

    Hearld, Larry R; Alexander, Jeffrey A

    2014-03-01

    Multi-sectoral community health care alliances are organizations that bring together individuals and organizations from different industry sectors to work collaboratively on improving the health and health care in local communities. Long-term success and sustainability of alliances are dependent on their ability to galvanize participants to take action within their 'home' organizations and institutionalize the vision, goals, and programs within participating organizations and the broader community. The purpose of this study was to investigate two mechanisms by which alliance leadership and management processes may promote such changes within organizations participating in alliances. The findings of the study suggest that, despite modest levels of change undertaken by participating organizations, more positive perceptions of alliance leadership, decision making, and conflict management were associated with a greater likelihood of participating organizations making changes as a result of their participation in the alliance, in part by promoting greater vision, mission, and strategy agreement and higher levels of perceived value. Leadership processes had a stronger relationship with change within participating organizations than decision-making style and conflict management processes. Open-ended responses by participants indicated that participating organizations most often incorporated new measures or goals into their existing portfolio of strategic plans and activities in response to alliance participation. PMID:24415003

  6. [Therapeutic touch and anorexia nervosa].

    PubMed

    Satori, Nadine

    2016-01-01

    An innovative practice, therapeutic touch has been used for around ten years in the treatment of eating disorders. Delivered by nurse clinicians having received specific training, this approach is based on nursing diagnoses which identify the major symptoms of this pathology. The support is built around the body and its perceptions. Through the helping relationship, it mobilises the patient's resources to favour a relationship of trust, a letting-go, physical, psychological and emotional relaxation, and improves the therapeutic alliance. PMID:27615696

  7. Using measures of disease progression to determine therapeutic effect: a sirens' song.

    PubMed

    Granger, Christopher B; McMurray, John J V

    2006-08-01

    With an increasing burden of cardiovascular disease and many promising novel treatments in development, the need for efficient systems to evaluate treatments has never been greater. To understand whether a treatment should be used in practice, we need to know whether it makes patients live longer, feel better, prevents adverse events, or does these things with better tolerability or lower cost. But therapeutic development is expensive, inefficient, and is generally focused on short-term treatment effects, rather than on prevention and on long-term impact. Could measures of disease progression, combined with trends on clinical outcomes and post-marketing surveillance to assess safety, serve as the foundation for therapeutic development? Experience and principles of clinical research tell us no. Especially in the field of heart failure, numerous treatments have appeared promising based on disease markers, yet caused harm when tested in studies that assessed clinical outcomes. The intersection of complex human disease, intended and unintended targets of therapy, and overall risk and benefit make it impossible to accurately predict the effect on clinical outcomes based on impact on a disease marker. While reliable measures of disease progression are important to guide which treatments to study in trials, clinical outcome trials must remain the basis for informing clinicians on which treatments improve clinical outcomes. Improved reliability and capacity require the development of more efficient clinical trial methods, streamlined regulatory processes, rational use of privacy protection, leveraging of electronic medical records, and recruitment of a larger proportion of the clinical community to participate in clinical trials. PMID:16875965

  8. Physician equity alliances: attractive alternatives to PHOs.

    PubMed

    Goldstein, D

    1997-04-01

    Physician equity alliances are becoming attractive alternatives to PHOs as integrative models for partnering with physicians, securing managed care contracts and increasing revenue. Unlike many PHOs, these alliances provide mechanisms for asset integration and long-term relationships along with utilization management, sophisticated information systems, access to capital and opportunities for physicians to integrate clinically. There are six major types of physician equity alliances: majority physician-owned, clinic without walls, health system joint venture, publicly held physician practice management company, specialty network, and venture capital. The type of alliance that a physician group practice ultimately develops depends on vision, values, method of capitalization, initial organizer of the alliance, level of involvement of physicians in business issues, corporate structure desired, and characteristics of the managed care market in which the alliance will operate. PMID:10166285

  9. Beef alliances: motivations, extent, and future prospects.

    PubMed

    Schroeder, Ted C; Kovanda, Joseph

    2003-07-01

    With their growth, it is important to consider how alliances will impact the beef industry in the future. Alliances have the potential to make sweeping changes to cattle production, live and feeder cattle marketing, food safety protocols, use of government grades and standards, ownership structure, supply chain management, wholesale and retail product marketing, risk management, and many other industry activities. In an effort to address these issues, this article addresses the following questions: What is an alliance? What has motivated their proliferation? What have we learned from alliances? What aspects of alliances affect their likelihood of success or failure? What is the future of alliances? Are they a fad or a long-term evolving industry structural change? PMID:12951740

  10. Using Support Vector Machines to Detect Therapeutically Incorrect Measurements by the MiniMed CGMS®

    PubMed Central

    Bondia, Jorge; Tarín, Cristina; García-Gabin, Winston; Esteve, Eduardo; Fernández-Real, José Manuel; Ricart, Wifredo; Vehí, Josep

    2008-01-01

    Background Current continuous glucose monitors have limited accuracy mainly in the low range of glucose measurements. This lack of accuracy is a limiting factor in their clinical use and in the development of the so-called artificial pancreas. The ability to detect incorrect readings provided by continuous glucose monitors from raw data and other information supplied by the monitor itself is of utmost clinical importance. In this study, support vector machines (SVMs), a powerful statistical learning technique, were used to detect therapeutically incorrect measurements made by the Medtronic MiniMed CGMS®. Methods Twenty patients were monitored for three days (first day at the hospital and two days at home) using the MiniMed CGMS. After the third day, the monitor data were downloaded to the physician's computer. During the first 12 hours, the patients stayed in the hospital, and blood samples were taken every 15 minutes for two hours after meals and every 30 minutes otherwise. Plasma glucose measurements were interpolated using a cubic method for time synchronization with simultaneous MiniMed CGMS measurements every five minutes, obtaining a total of 2281 samples. A Gaussian SVM classifier trained on the monitor's electrical signal and glucose estimation was tuned and validated using multiple runs of k-fold cross-validation. The classes considered were Clarke error grid zones A+B and C+D+E. Results After ten runs of ten-fold cross-validation, an average specificity and sensitivity of 92.74% and 75.49%, respectively, were obtained (see Figure 4). The average correct rate was 91.67%. Conclusions Overall, the SVM performed well, in spite of the somewhat low sensitivity. The classifier was able to detect the time intervals when the monitor's glucose profile could not be trusted due to incorrect measurements. As a result, hypoglycemic episodes missed by the monitor were detected. PMID:19885238

  11. Therapist and Patient Perceptions of Alliance and Progress In Psychological Therapy for Women Diagnosed with Gynecological Cancers

    PubMed Central

    Manne, Sharon; Kashy, Deborah A.; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia

    2013-01-01

    Objective The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also evaluated therapist and patient characteristics that predict alliance and session progress. Methods Two hundred and three women and their therapists completed measures of alliance and session progress across a 6-session course of treatment. Participants also completed pre-intervention measures of self-esteem, depression, cancer-specific distress, emotional expressivity, and use of protective buffering. Results Patients reported higher alliance and greater progress than therapists. When therapists reported particularly strong alliance with particular patients, those patients concurred. More experienced therapists reported higher alliances and more progress but their patients did not agree. Patients who began treatment in more difficult psychosocial circumstances tended to have less positive session outcomes on average but evidenced more improvement across therapy sessions. Conclusions Patients rated their alliance and progress more positively than their therapists, although there was substantial relative agreement between therapists and patients. Alliance and progress improved over time, particularly among patients who evidenced higher levels of distress and poorer physical functioning. More experienced therapists were more confident in their abilities but their patients did not share this perception. PMID:22746145

  12. Where is the Relationship in Research on the Alliance? Two Methods for Analyzing Dyadic Data

    ERIC Educational Resources Information Center

    Kivlighan, Dennis M., Jr.

    2007-01-01

    Researchers examining the therapy relationship are encouraged "to study both patients' and therapists' contribution to the relationship and the ways in which these contributions combine to impact treatment outcome" (Steering Committee, 2002, p. 443). Research on the therapeutic alliance, however, is dominated by studies that examine the individual…

  13. Alliance in Two Telephone-Administered Treatments: Relationship with Depression and Health Outcomes

    ERIC Educational Resources Information Center

    Beckner, Victoria; Vella, Lea; Howard, Isa; Mohr, David C.

    2007-01-01

    The present study examined the relationship between therapeutic alliance and both depression and health outcomes in a randomized clinical trial of 2 telephone-administered treatments with 97 clients with multiple sclerosis (MS). The 16-week, manualized treatments compared were telephone-administered cognitive-behavioral therapy (T-CBT) and…

  14. Does the Quality of the Working Alliance Predict Treatment Outcome in Online Psychotherapy for Traumatized Patients?

    PubMed Central

    Maercker, Andreas

    2006-01-01

    Background The provision of online counseling and online therapy is steadily increasing. The results of a number of controlled trials investigating the efficacy of online approaches indicate that some of these new treatment alternatives might indeed be effective. Yet, little is known about how the therapeutic relationship (or working alliance) evolves over the Internet and whether it influences treatment outcome as it does in traditional face-to-face therapy. The working alliance has been defined as the extent to which a patient and a therapist work collaboratively and purposefully and connect emotionally. Objective The aim of the study was to investigate the quality and predictive relevance of the therapeutic alliance for patients receiving a short-term, Internet-based, cognitive-behavioral therapy program for posttraumatic stress reactions. Methods After rigorous screening for exclusion criteria of high dissociative tendencies, risk of psychosis, and suicidal tendencies, 48 patients, who had experienced a traumatic event in the past, were included in the online treatment study. The short form of the Working Alliance Inventory (WAI-S) was administered at the fourth treatment session. The relevance of the therapeutic relationship for treatment outcome was assessed in terms of residual gain from pretreatment assessment to the end of treatment. The revised Impact of Event Scale (IES-R) and the depression and anxiety subscales of the Brief Symptom Inventory (BSI) were used to assess treatment outcome. Results A total of 48 participants were included in the analysis. Overall, high alliance scores were found. In contrast to previous studies of conventional face-to-face therapy, there was only a low to modest association (.13 to .33) between the quality of the therapeutic relationship and treatment outcome. Conclusion High alliance scores indicate that it was possible to establish a stable and positive therapeutic relationship online. However, the therapeutic

  15. Distance Education Alliance Tackles FCS Teacher Shortage

    ERIC Educational Resources Information Center

    McGinnis, Gay Nell

    2004-01-01

    To address teacher supply/demand/preparation issues, the Texas Education Agency funded a project that established a statewide inter-institutional system for providing Web-based distance education courses as preparation for FCS teacher certification. The Family and Consumer Sciences Distance Education Alliance (FCS Alliance) involves voluntary…

  16. Iowa Distance Education Alliance. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Sorensen, Chris; Sweeney, Jan

    This document describes the accomplishments of the Iowa Distance Education Alliance (IDEA). The Iowa Distance Education Alliance (IDEA) is a partnership involving educational institutions across Iowa that received funding from the federal Star Schools Program to demonstrate the use of the Iowa Communication Network's (ICN) fiber optic technology…

  17. What Is the Therapeutic Alliance and Why Does It Matter?

    ERIC Educational Resources Information Center

    Manso, Ana; Rauktis, Mary Elizabeth

    2011-01-01

    The most important task of teacher-counselors in Re-ED programs is to build a trusting relationship with youth. Hobbs defined trust between child and adult as "the glue that holds teaching and learning together, the beginning point for re-education" (Hobbs, 1994, p. 22). This trusting relationship, the foundation for all other Re-ED principles,…

  18. Therapeutic Drug Monitoring

    MedlinePlus

    ... be limited. Home Visit Global Sites Search Help? Therapeutic Drug Monitoring Share this page: Was this page ... Monitored Drugs | Common Questions | Related Pages What is therapeutic drug monitoring? Therapeutic drug monitoring is the measurement ...

  19. 3rd year final contractor report for: U.S. Department of Energy Stewardship Science Academic Alliances Program Project Title: Detailed Measurements of Rayleigh-Taylor Mixing at Large and Small Atwood Numbers

    SciTech Connect

    Malcolm J. Andrews

    2006-04-14

    This project had two major tasks: Task 1. The construction of a new air/helium facility to collect detailed measurements of Rayleigh-Taylor (RT) mixing at high Atwood number, and the distribution of these data to LLNL, LANL, and Alliance members for code validation and design purposes. Task 2. The collection of initial condition data from the new Air/Helium facility, for use with validation of RT simulation codes at LLNL and LANL. This report describes work done in the last twelve (12) months of the project, and also contains a summary of the complete work done over the three (3) life of the project. As of April 1, 2006, the air/helium facility (Task 1) is now complete and extensive testing and validation of diagnostics has been performed. Initial condition studies (Task 2) is also comp lete. Detailed experiments with air/helium with Atwood numbers up to 0.1 have been completed, and Atwood numbers of 0.25. Within the last three (3) months we have been able to successfully run the facility at Atwood numbers of 0.5. The progress matches the project plan, as does the budget. We have finished the initial condition studies using the water channel, and this work has been accepted for publication on the Journal of Fluid Mechanics (the top fluid mechanics journal). Mr. Nick Mueschke and Mr. Wayne Kraft are continuing with their studies to obtain PhDs in the same field, and will also continue their collaboration visits to LANL and LLNL. Over its three (3) year life the project has supported two(2) Ph.D.’s and three (3) MSc’s, and produced nine (9) international journal publications, twenty four (24) conference publications, and numerous other reports. The highlight of the project has been our close collaboration with LLNL (Dr. Oleg Schilling) and LANL (Drs. Dimonte, Ristorcelli, Gore, and Harlow).

  20. The Alliance for Equity in Higher Education

    ERIC Educational Resources Information Center

    Merisotis, Jamie P.; Goulian, Katherine A.

    2004-01-01

    This chapter describes the organization, operations, and goals of the Alliance for Equity in Higher Education, a national coalition of associations and institutions founded to serve the emerging majority of racially diverse college students.

  1. Patient-Oncologist Alliance, Psychosocial Well-Being, and Treatment Adherence Among Young Adults With Advanced Cancer

    PubMed Central

    Trevino, Kelly M.; Fasciano, Karen; Prigerson, Holly G.

    2013-01-01

    Purpose Patients who develop a strong alliance with their health care providers have been shown to have higher levels of psychosocial well-being and rates of treatment adherence. Young adults with cancer have lower levels of psychosocial well-being and treatment adherence relative to patients with cancer in other age groups. This study sought to evaluate the relationships between the patient-oncologist alliance, psychosocial well-being, and treatment adherence in young adults with advanced cancer. Patients and Methods Ninety-five young adults (age 20 to 40 years) with advanced cancer were administered measures of alliance, psychosocial well-being, willingness to adhere to treatment, and treatment adherence. Relationships between alliance and psychosocial well-being were examined bivariately. Multiple linear regression models examined the relationship between alliance and adherence, controlling for confounding influences (eg, psychosocial well-being). Results Alliance was significantly (P ≤ .01) and positively associated with greater perceived social support and less severe illness-related grief. After controlling for significant confounding influences (ie, metastases, appraised support, and grief), alliance remained significantly (P ≤ .01) associated with greater willingness to adhere to treatment and greater adherence to oral medication. Conclusion By developing a strong alliance, oncologists may enhance psychosocial well-being and increase treatment adherence in young adult patients with advanced cancer. PMID:23530105

  2. Southern Impact Testing Alliance (SITA)

    NASA Technical Reports Server (NTRS)

    Hubbs, Whitney; Roebuck, Brian; Zwiener, Mark; Wells, Brian

    2009-01-01

    Efforts to form this Alliance began in 2008 to showcase the impact testing capabilities within the southern United States. Impact testing customers can utilize SITA partner capabilities to provide supporting data during all program phases-materials/component/ flight hardware design, development, and qualification. This approach would allow programs to reduce risk by providing low cost testing during early development to flush out possible problems before moving on to larger scale1 higher cost testing. Various SITA partners would participate in impact testing depending on program phase-materials characterization, component/subsystem characterization, full-scale system testing for qualification. SITA partners would collaborate with the customer to develop an integrated test approach during early program phases. Modeling and analysis validation can start with small-scale testing to ensure a level of confidence for the next step large or full-scale conclusive test shots. Impact Testing Facility (ITF) was established and began its research in spacecraft debris shielding in the early 1960's and played a malor role in the International Space Station debris shield development. As a result of return to flight testing after the loss of STS-107 (Columbia) MSFC ITF realized the need to expand their capabilities beyond meteoroid and space debris impact testing. MSFC partnered with the Department of Defense and academic institutions as collaborative efforts to gain and share knowledge that would benefit the Space Agency as well as the DoD. MSFC ITF current capabilities include: Hypervelocity impact testing, ballistic impact testing, and environmental impact testing.

  3. Remote Sensing and Earth System Dynamics: The Helmholtz Alliance

    NASA Astrophysics Data System (ADS)

    Hajnsek, I.; Eineder, M.; Walter, T. R.; Friedrich, A. M.; Bieber, P.; Huth, A.; Papathanassiou, K.; Montzka, C.; Wollschläger, U.; Thies, B.; Humbert, A.; Braun, M.; Krieger, G.; Moreira, A.

    2014-12-01

    The main objective of the five year funded German Helmholtz Alliance "Remote Sensing and Earth System Dynamics" is the development and evaluation of novel bio/geo-physical information products derived from data acquired by a new generation of remote sensing satellites; and their integration in Earth system models for improving understanding and modelling the ability of global environmental processes and ecosystem change. The Alliance is organized in 4 research topics, each one dedicated to a specific Earth sphere with a specific scientific goal: Biosphere: Global forest structure and biomass dynamics are evaluated for forest and biodiversity monitoring and the quantification of the global carbon cycle; Geosphere: The ability to measure topographic variations with millimeter accuracy is explored for improving the understanding of earthquake and volcano activities; Hydrosphere: The quantification of soil moisture and its variations at high spatial resolution is assessed with respect to hydrological models and the global water cycle; Cryosphere: The estimation of melting processes in snow, ice and permafrost regions is addressed in terms of global climate change. The Alliance has been founded in June 2012 and comprises around 120 scientists with a financial support for 50 PhDs and Postdocs having different backgrounds and nationalities. 18 national research centers and universities are participating which represent a unique opportunity to exploit and widen the expertise of all participating centers and to maximize their role and contribution in the international environmental change science. In this talk the objectives of the Alliance and research highlights will be presented which were obtained in the first 2.5 years of its research activities.

  4. Global Equity Gauge Alliance: reflections on early experiences.

    PubMed

    McCoy, David; Bambas, Lexi; Acurio, David; Baya, Banza; Bhuiya, Abbas; Chowdhury, A Mushtaque R; Grisurapong, Siriwan; Liu, Yuanli; Ngom, Pierre; Ngulube, Thabale J; Ntuli, Antoinette; Sanders, David; Vega, Jeanette; Shukla, Abhay; Braveman, Paula A

    2003-09-01

    The paper traces the evolution and working of the Global Equity Gauge Alliance (GEGA) and its efforts to promote health equity. GEGA places health equity squarely within a larger framework of social justice, linking findings on socioeconomic and health inequalities with differentials in power, wealth, and prestige in society. The Alliance's 11 country-level partners, called Equity Gauges, share a common action-based vision and framework called the Equity Gauge Strategy. An Equity Gauge seeks to reduce health inequities through three broad spheres of action, referred to as the 'pillars' of the Equity Gauge Strategy, which define a set of interconnected and overlapping actions. Measuring and tracking the inequalities and interpreting their ethical import are pursued through the Assessment and Monitoring pillar. This information provides an evidence base that can be used in strategic ways for influencing policy-makers through actions in the Advocacy pillar and for supporting grassroots groups and civil society through actions in the Community Empowerment pillar. The paper provides examples of strategies for promoting pro-equity policy and social change and reviews experiences and lessons, both in terms of technical success of interventions and in relation to the conceptual development and refinement of the Equity Gauge Strategy and overall direction of the Alliance. To become most effective in furthering health equity at both national and global levels, the Alliance must now reach out to and involve a wider range of organizations, groups, and actors at both national and international levels. Sustainability of this promising experiment depends, in part, on adequate resources but also on the ability to attract and develop talented leadership. PMID:14717573

  5. Strategic Alliance Poker: Demonstrating the Importance of Complementary Resources and Trust in Strategic Alliance Management

    ERIC Educational Resources Information Center

    Reutzel, Christopher R.; Worthington, William J.; Collins, Jamie D.

    2012-01-01

    Strategic Alliance Poker (SAP) provides instructors with an opportunity to integrate the resource based view with their discussion of strategic alliances in undergraduate Strategic Management courses. Specifically, SAP provides Strategic Management instructors with an experiential exercise that can be used to illustrate the value creation…

  6. Entrepreneurial Alliances: A Study of Entrepreneurship and Strategic Alliances in the Charter School Industry

    ERIC Educational Resources Information Center

    Washington, Cheryl A.

    2012-01-01

    This study investigated the practices, processes, and success rates of 15 entrepreneurial alliances in the Texas charter school industry. The research involved interdisciplinary industries (business and education) and focused on how a specific type of alliance structure utilized social innovation to exploit opportunity and impact change in the…

  7. Japanese contributions to International Planetary Data Alliance

    NASA Astrophysics Data System (ADS)

    Yamamoto, Yukio; Kasaba, Yasumasa; Hirata, Naru; Shinohara, Iku

    2012-07-01

    In this presentation, we will introduce Japanese contributions to the data archives for international collaborations. In Japan, the importance of planetary data archive was not recognized enough until early in 2000's. While NASA and ESA started their collaborations to their archives: PDS and PSA, and tried to make the new standard, JAXA was looking for the way of contributions because Japan did not have own data and archiving policy. The activities of NASA and ESA extended to the international collaborations, and International Planetary Data Alliance was established. JAXA had an opportunity to join the IPDA as an agency member. One of the contributions, the IPDA chairman was undertaken by Japanese member. The projects in IPDA were managed and were proceeded successfully during the term. For the technical part, JAXA is making several pilot systems to share planetary data. Planetary Data Access Protocol, PDAP, developed by IPDA, is implemented in JAXA's system, and provides a search system for Hayabusa and Kaguya (SELENE) data. Not only for Japanese data, but also Apollo's seismic data archives are prepared for scientific communities. The seismic data on the moon has not been measured for a long time, and Apollo's data are still precious and should be archived together with much information. The contributions to planetary data archives has just started and continues as a member of IPDA.

  8. Measuring the patient health, societal and economic benefits of US pediatric therapeutics legislation.

    PubMed

    Vernon, John A; Shortenhaus, Scott H; Mayer, Mark H; Allen, Albert J; Golec, Joseph H

    2012-10-01

    Through at least the mid-1990s, children were often referred to as 'therapeutic orphans' for whom many treatments were administered without the benefit of appropriate studies to guide drug labeling for dosing and other critical therapeutic decisions. At that time, there were no incentives for manufacturers to pursue such work, nor regulatory requirements to compel these studies. Congress addressed this by including an important provision titled the Best Pharmaceuticals for Children Act (BPCA) in the 1997 Food and Drug Administration Modernization and Accountability Act. This was complemented by another key piece of legislation, the Pediatric Research Equity Act (PREA) in 2003. The former Act and its successors created an incentive for firms to study on-patent drugs in pediatric populations by extending the market exclusivity of a medicine by 6 months. The latter was a requirement that provided the US FDA with the authority to require studies of drugs in children if an adult indication also occurs in children. In the current paper, we consider the effects of both pieces of legislation in terms of the health, societal, and economic benefits they have likely imparted and will continue to provide in the future. We conclude that the gains have been substantial - both in terms of safer and more effective use of medicines in children and in terms of new research that has been incentivized by the BPCA exclusivity provision. We estimate the gross economic benefits from the latter alone to be approximately $US360 billion. PMID:22775493

  9. Adversarial Contests or Respectful Alliances

    ERIC Educational Resources Information Center

    Seita, John R.; Brendtro, Larry K.

    2003-01-01

    Schools can become islands of stability or fields of battle for students with emotional and behavioral problems. Research on positive school climate and positive therapeutic outcomes points to the importance of replacing adversarial encounters with respectful relationships. This article discusses how this positive transformation can be achieved.…

  10. Therapeutical measures to control airway tolerance in asthma and lung cancer.

    PubMed

    Andreev, Katerina; Graser, Anna; Maier, Anja; Mousset, Stephanie; Finotto, Susetta

    2012-01-01

    Airway tolerance is a specialized immunological surveillance which is activated by the cells of the lung to deal with and distinguish between innocuous and pathogenic inhalants. However, this distinction does not always occur. Airway tolerance is necessary to avoid the development of allergic disorders, such as asthma, which is dominated by a pathological expansion of Th2 and Th17 cells in the airways. By contrast, tumor cells induce tolerogenic factors in their microenvironment to evade T-cell mediated anti-tumor-immune responses. This review updates current understandings on the effect of the cytokines TGF-β, IL-10, and IL-17A on the lung immune responses to antigen, and analyzes their involvement in allergic asthma and lung cancer. The aim of the review is to evaluate where therapeutic intervention may be feasible and where it might fail. The multifunctional role of these cytokines further complicates the decision on the timing and concentration for their use as therapeutical targets. In fact, TGF-β has suppressive activity in early tumorigenesis, but may become tumor-promoting in the later stages of the disease. This dual behavior is sometimes due to changes in the cellular target of TGF-β, and to the expansion of the induced (i)-Tregs. Similarly, IL-17A has been found to elicit pro- as well as anti-tumor properties. Thus, this pro-inflammatory cytokine induces the production of IL-6 which interferes with Treg development. Yet IL-17A could promote tumor growth in conjunction with IL-6-dependent activation of Stat3. Thus, understanding the mechanisms of airway tolerance could help to improve the therapy to both, allergic asthma and lung cancer. Hereby, asthma therapy aims to induce and maintain tolerance to inhaled allergens and therapy against lung cancer tries to inhibit the tolerogenic response surrounding the tumor. PMID:22855687

  11. Implementing and maintaining an infusion alliance.

    PubMed

    Meyer, Britt M

    2010-01-01

    Infusion therapy models are ever changing and growing in modern health care. New technologies and problems arise daily as researchers and clinicians explore our world. As technologies advance, health care costs are also skyrocketing. The vast majority of hospitalized patients will receive some form of infusion therapy during their stay, and many will continue to receive therapy after they are discharged from the inpatient setting. Infusion alliances can aid cost containment by decreasing infusion-related complication rates, affect customer satisfaction, and promote interdisciplinary collaboration. This article discusses the potential benefits of an infusion alliance, details steps for using the performance improvement process when implementing and maintaining an alliance, and outlines the components of a successful business plan. PMID:20841983

  12. Financial analysis for the infusion alliance.

    PubMed

    Perucca, Roxanne

    2010-01-01

    Providing high-quality, cost-efficient care is a major strategic initiative of every health care organization. Today's health care environment is transparent; very competitive; and focused upon providing exceptional service, safety, and quality. Establishing an infusion alliance facilitates the achievement of organizational strategic initiatives, that is, increases patient throughput, decreases length of stay, prevents the occurrence of infusion-related complications, enhances customer satisfaction, and provides greater cost-efficiency. This article will discuss how to develop a financial analysis that promotes value and enhances the financial outcomes of an infusion alliance. PMID:20841984

  13. Data Collection Strategies and Measurement Tools for Assessing Academic and Therapeutic Outcomes in Recovery Schools

    PubMed Central

    Botzet, Andria M.; McIlvaine, Patrick W.; Winters, Ken C.; Fahnhorst, Tamara; Dittel, Christine

    2014-01-01

    Accurate evaluation and documentation of the efficacy of recovery schools can be vital to the continuation and expansion of these beneficial resources. A very limited data set currently exists that examines the value of specific schools established to support adolescents and young adults in recovery; additional research is necessary. The following article outlines the methodology utilized in a current quasi-experimental study evaluating both academic and therapeutic outcomes of adolescents attending recovery high schools as compared to traditional (non-recovery-based) high schools. The developmental considerations in assessing adolescents in recovery and their parents is delineated in this article, which underscores the need for extensive knowledge of adolescent substance abuse and other mental health issues. In addition, sensitivity around privacy among adolescents, parents, schools, and health providers is highlighted, as well as the validity of assessment. Key assessment strategies, including protocol of recruitment and interviewing techniques, are also presented along with a list of parent and adolescent assessment instruments and their corresponding interpretive variables. Protocol recommendations for future research are also outlined. PMID:25018573

  14. An Overview of Strategic Alliances between Universities and Corporations

    ERIC Educational Resources Information Center

    Elmuti, Dean; Abebe, Michael; Nicolosi, Marco

    2005-01-01

    Purpose: Strategic alliances generally represent inter-firm cooperative agreements aimed at achieving competitive advantage for the partners. In recent years, there has been a dramatic increase in strategic alliances by multinational firms. This paper aims to explore the essence of these alliances and why they have become such a growing area of…

  15. Contractor Alliances and the New World of Work.

    ERIC Educational Resources Information Center

    Owen, C.; Bound, H.

    A study investigated knowledge, skills, and attitudes required to operate in new working arrangements where people operate in alliance with others. Six strategic alliances were selected across three states and different industries. Participants in contractor alliances and stakeholders in the study were interviewed. Findings indicated that all…

  16. Global University Alliances and the Creation of Collaborative Advantage

    ERIC Educational Resources Information Center

    Gunn, Andrew; Mintrom, Michael

    2013-01-01

    The past two decades have seen the development of many global university alliances. Some alliances have taken a bilateral form, others are multilateral. In a period of increasing competition among universities, such alliances represent a curious form of cooperation. They have become more common just as global competition for academic talent has…

  17. Measuring intranodal pressure and lymph viscosity to elucidate mechanisms of arthritic flare and therapeutic outcomes

    PubMed Central

    Bouta, Echoe M.; Wood, Ronald W.; Perry, Seth W.; Brown, Edward; Ritchlin, Christopher T.; Xing, Lianping; Schwarz, Edward M.

    2012-01-01

    Rheumatoid arthritis (RA) is a chronic autoimmune disease with episodic flares in affected joints, whose etiology is largely unknown. Recent studies in mice demonstrated alterations in lymphatics from affected joints precede flares. Thus, we aimed to develop novel methods for measuring lymph node pressure and lymph viscosity in limbs of mice. Pressure measurements were performed by inserting a glass micropipette connected to a pressure transducer into popliteal lymph nodes (PLN) or axillary lymph nodes (ALN) of mice and determined that the lymphatic pressures were 9 and 12 cm of water, respectively. We are also developing methods for measuring lymph viscosity in lymphatic vessels afferent to PLN, which can be measured by multi-photon fluorescence recovery after photobleaching (MP-FRAP) of FITC-BSA injected into the hind footpad. These results demonstrate the potential of lymph node pressure and lymph viscosity measurements, and warrant future studies to test these outcomes as biomarkers of arthritic flare. PMID:22172039

  18. Physiological measurements corroborate symptomatic improvement after therapeutic leukapheresis in a pregnant woman with chronic myelogenous leukemia.

    PubMed

    Galera, Pallavi; Haynes, Stefanie; Sulmasy, Paula; Bailey, Jeffrey A; Greene, Mindy; Vauthrin, Michelle; Brettler, Doreen; Liebmann, James; Mark Madison, J; Weinstein, Robert

    2016-08-01

    Therapeutic leukapheresis can control the white blood cell count (WBC) of pregnant women with chronic myelogenous leukemia (CML) who have hyperleukocytosis without leukostasis. The medical justification for this treatment has not been objectively documented. We report a 27-year-old woman, diagnosed with CML at 10-week gestation, who developed severe dyspnea on exertion. A workup that included chest CT and echocardiography with a bubble study detected no cardiopulmonary pathology to explain her symptoms, and thus she was referred for leukapheresis. Prior to her first leukapheresis, which lowered her WBC from 154 × 10(3) /μL to 133 × 10(3) /μL, her oxygen saturation (SpO2 ) on room air decreased from 98 to 93% during 100 feet of slow ambulation and she was dyspneic. Just after the leukapheresis, her dyspnea on exertion was much improved and her SpO2 remained at 98% with repeat ambulation. Spirometry and lung volume studies obtained before and after her first leukapheresis demonstrated 32 and 31% improvements in forced vital capacity and forced expiratory volume in 1 s respectively, a 25% increase in functional residual capacity, and a 142% improvement in expiratory reserve volume. Residual volume decreased by almost 20%. Three times in a week, leukapheresis was continued until her WBC was controlled with interferon α-2b approximately 4 weeks later. Her dyspnea had completely resolved. She gave birth by elective caesarean section to a healthy boy at 32 weeks. Corroboration of symptom relief by leukapheresis with physiological data may justify such treatment in pregnant patients with CML. J. Clin. Apheresis 31:393-397, 2016. © 2015 Wiley Periodicals, Inc. PMID:26053950

  19. Earth System Science Education Alliance

    NASA Astrophysics Data System (ADS)

    Myers, R.; Schwerin, T.

    2007-12-01

    The Earth System Science Education Alliance (ESSEA) professional development program is providing in-depth geoscience content and teaching methods to pre- and in-service teachers. The program is building and expanding on NASA's successful ESSEA program that was funded from 2000-2005. Now sponsored by NSF, the network has expanded to nearly 40 institutions of higher learning committed to teacher Earth system science education. The program supports participating institutions with funding, training, and standards-aligned courses and resources for pre- and in-service teachers. As a result, teachers are prepared to teach Earth system science using inquiry-based classroom methods, geoscience data and tools. From 1999-2005, the NASA funded ESSEA Program delivered online Earth system science professional development for K-12 teachers through a network of 20 colleges and universities. The program was led by the Institute for Global Environmental Strategies (IGES) and based on a trio of 16-week online courses (for elementary, middle, and high school teachers) that had been developed and piloted by NASA's Classroom of the Future at Wheeling Jesuit University. The ESSEA program's mission was to: 1) support universities, colleges, and science education organizations delivering the K-12 online graduate courses; 2) strengthen teachers' understanding of Earth system science; 3) demonstrate the ability to deliver exceptional professional development to a national audience; and 4) create a solid infrastructure to sustain the program. As of spring 2006, the courses had been used by 40 faculty at 20 institutions educating over 1,700 K-12 teachers in Earth system science. Through NSF funding beginning in late 2006, IGES is enhancing and building on the ESSEA foundation by: 1. Introducing extensive use of data, models and existing Earth system educational materials to support the courses; 2. Implementing a rigorous evaluation program designed to demonstrate growth in teachers' Earth

  20. Earth System Science Education Alliance

    NASA Astrophysics Data System (ADS)

    Myers, R.; Schwerin, T.

    2006-12-01

    The Earth System Science Education Alliance (ESSEA) professional development program is providing in- depth geoscience content and teaching methods to pre- and in-service teachers. The program is building and expanding on NASA's successful ESSEA program that was funded from 2000-2005. Beginning in 2006 NSF funding will enable ESSEA will expand to 40 institutions of higher learning that are committed to teacher education in Earth system science. The program will support participating institutions with funding, training, and standards-aligned courses and resources for pre- and in-service teachers. As a result, teachers will be prepared to teach Earth system science using inquiry-based classroom methods, geoscience data and tools. From 1999-2005, the NASA funded ESSEA Program delivered online Earth system science professional development for K-12 teachers through a network of 20 colleges and universities. The program was led by the Institute for Global Environmental Strategies (IGES) and based on a trio of 16-week online courses (for elementary, middle, and high school teachers) that had been developed and piloted by NASA's Classroom of the Future at Wheeling Jesuit University. The ESSEA program's mission was to: 1) support universities, colleges, and science education organizations delivering the K-12 online graduate courses; 2) strengthen teachers' understanding of Earth system science; 3) demonstrate the ability to deliver exceptional professional development to a national audience; and 4) create a solid infrastructure to sustain the program. As of spring 2006, the courses had been used by 40 faculty at 20 institutions educating over 1,700 k-12 teachers in Earth system science. Although NASA funding ended in late 2005, the courses continue to be offered by 17 of the original 20 institutions. Through NSF funding beginning in late 2006, IGES will enhance and build upon the ESSEA foundation by: 1.Using the ESSEA courses as a model to introduce newly upgraded Earth

  1. Cerebellar Alterations and Gait Defects as Therapeutic Outcome Measures for Enzyme Replacement Therapy in α-Mannosidosis

    PubMed Central

    Damme, Markus; Stroobants, Stijn; Walkley, Steven U.; Lüllmann-Rauch, Renate; D`Hooge, Rudi; Fogh, Jens; Saftig, Paul; Lübke, Torben; Blanz, Judith

    2011-01-01

    α-Mannosidosis is a rare lysosomal storage disease with accumulation of undegraded mannosyl-linked oligosaccharides in cells throughout the body, most notably in the CNS. This leads to a broad spectrum of neurological manifestations, including progressive intellectual impairment, disturbed motor functions and cerebellar atrophy. To develop therapeutic outcome measures for enzyme replacement therapy (ERT) that could be used for human patients, a gene knockout model of α-mannosidosis in mice was analyzed for CNS pathology and motor deficits. In the cerebellar molecular layer, α-mannosidosis mice display clusters of activated Bergman glia, infiltration of phagocytic macrophages and accumulation of free cholesterol and gangliosides (GM1), notably in regions lacking Purkinje cells. α-mannosidosis brain lysates also displayed increased expression of Lamp1 and hyperglycosylation of the cholesterol binding protein NPC2. Detailed assessment of motor function revealed age-dependent gait defects in the mice that resemble the disturbed motor function in human patients. Short-term ERT partially reversed the observed cerebellar pathology with fewer activated macrophages and astrocytes but unchanged levels of hyperglycosylated NPC2, gangliosides and cholesterol. The present study demonstrates cerebellar alterations in α-mannosidosis mice that relate to the motor deficits and pathological changes seen in human patients and can be used as therapeutic outcome measures. PMID:21157375

  2. Therapeutic Nanodevices

    NASA Astrophysics Data System (ADS)

    Lee, Stephen; Ruegsegger, Mark; Barnes, Philip; Smith, Bryan; Ferrari, Mauro

    Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'être of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multistep work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self-assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

  3. Therapeutic Nanodevices

    NASA Astrophysics Data System (ADS)

    Lee, Stephen C.; Ruegsegger, Mark; Barnes, Philip D.; Smith, Bryan R.; Ferrari, Mauro

    Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'etre of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multi-step work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

  4. Report on the Black Hills Alliance.

    ERIC Educational Resources Information Center

    Ryan, Joe

    1979-01-01

    A rally to save the Black Hills from coal- and uranium-greedy energy companies was held on July 6 and over 2,000 joined in a 15-mile walk on July 7 in Rapid City, South Dakota. The Black Hills Alliance, an Indian coalition concerned about energy development proposals in the Great Plains, sponsored the gathering. (NQ)

  5. Developing Strategic Alliances in Management Learning

    ERIC Educational Resources Information Center

    Thorne, E. Ann; Wright, Gill

    2005-01-01

    Purpose: The notion of effective strategic alliances provides the basis on which this paper proposes a framework to manage the application and outcomes of management learning. The management of key partner collaboration emerges in this paper as a major success factor in determining effective management learning. A proactive structured approach to…

  6. School-College Faculty Collaboratives: Academic Alliances.

    ERIC Educational Resources Information Center

    Gaudiani, Claire

    1985-01-01

    Discusses the Academic Alliances project and the collaboratives of faculty members who teach foreign languages and literature in universities, colleges, and schools in the United States which were a result of that project. Looks at what happens at meetings and how some groups are funded. Lists participating collaborative groups. (SED)

  7. Academic Alliances, You Can Do It Too.

    ERIC Educational Resources Information Center

    Steinmiller, Robert C.; Steinmiller, Georgine G.

    Housed at Henderson State University, the Arkansas Network of Humanities Academic Alliances is a statewide network of school and college teachers in humanities disciplines who meet regularly to promote ongoing professional development and work toward common goals. The network seeks to strengthen humanities teaching at all educational levels,…

  8. Academic Alliances: School/College Faculty Collaboratives.

    ERIC Educational Resources Information Center

    Slaughter, Debra

    1985-01-01

    Reports on the activities and accomplishments of school and college faculty groups that are part of the national network of Academic Alliances. Includes information on the Rockefeller Fellowship Program, a listing of eight new member groups, information on four new statewide networks, and a synopsis of meetings and events of some groups. (SED)

  9. The Carnegie Mellon/Sirsi Corporation Alliance.

    ERIC Educational Resources Information Center

    Troll, Denise A.; Depellegrin, Tracey A.; Myers, Melanie D.

    1999-01-01

    Describes the relationship between Carnegie Mellon University libraries and Sirsi Corporation, their integrated library-management system vendor. Topics include Carnegie Mellon's expertise in library automation research and development; and three primary elements of the alliance: research, including user protocols, surveys, and focus groups;…

  10. Acronyms and Agencies. Alliance Action Information Sheets

    ERIC Educational Resources Information Center

    Technical Assistance ALLIANCE for Parent Centers, 2007

    2007-01-01

    This paper presents acronyms related to early intervention, education, special education, and other laws important to individuals with disabilities and their families. For related information, also read Acronyms and the Law. [For related report, "Acronyms and the Law. Alliance Action Information Sheets," see ED534052.

  11. Facilitating Economic Development through Strategic Alliances.

    ERIC Educational Resources Information Center

    Noftsinger, John B., Jr.

    2002-01-01

    Discusses how colleges and universities are becoming increasingly involved in economic development, with the formation of strategic alliances that have led to programs that benefit business and higher education. Discusses example programs from the Valley of Virginia Partnership for Education, and the outreach program of James Madison University.…

  12. Novel Adherence Measures for Infusible Therapeutic Agents Indicated for Rheumatoid Arthritis

    PubMed Central

    Tkacz, Joseph; Ingham, Michael P.; Brady, Brenna L.; Meyer, Roxanne; Ruetsch, Charles

    2015-01-01

    Background Published studies on adherence to biologic medications show that many types of calculation methods are used. However, infused biologics are not well-suited to typical measures of adherence, such as proportion of days covered. Objective To construct and assess 7 novel adherence measures potentially applicable to infusible biologic agents and compare outcomes for 2 infusible biologics used for the treatment of patients with rheumatoid arthritis (RA). Methods Adults (aged ≥18 years) diagnosed with RA (ie, 2 or more 714.x claims) who received ≥24 months of continuous medical and pharmacy eligibility and who started taking abatacept or infliximab therapy were selected from a large commercial insurer database of medical and pharmacy claims. The 7 new adherence measures included cumulative amount of time with a refill gap ≥20% (CG20) beyond the expected infusion interval, cumulative time off treatment, days of uninterrupted use (DoUU), observed versus expected refill ratio (OvERR), repeated observations of underuse (RoUU), variance in time between infusions, and time to discontinuation (TTD). Mean observed infusion intervals were calculated and served as a reference measure of adherence. Results The mean maintenance intervals approximated recommended guidelines. The mean observed infusion interval for abatacept recipients was 33 days (recommended, 28 days); it was 53 days (recommended, 56 days) for patients receiving infliximab. Three measures demonstrated a significant positive relationship to the mean observed infusion interval—CG20 (r = .258), DoUU (r = .212), and TTD (r = .081; P <.05). OvERR (r = −.072) and RoUU (r = −.189; P <.05) showed significant negative correlations. Real-world comparisons showed that adherence was significantly (P <.001) greater for the infliximab group according to most measures. Conclusion New measures of adherence correlate significantly with mean maintenance intervals. Future studies should examine relationships

  13. Measurement of therapeutic photon beams-induced Cerenkov radiation generated in PMMA- and PS-based plastic optical fibers

    NASA Astrophysics Data System (ADS)

    Lee, Bongsoo; Shin, Sang Hun; Yoo, Wook Jae; Jang, Kyoung Won

    2016-07-01

    In this study, we characterized Cerenkov radiation generated in polystyrene (PS)- and polymethyl methacrylate (PMMA)-based plastic optical fibers (POFs) to select an adequate optical fiber for producing Cerenkov radiation. To determine the relationship between the absorbed dose and the intensity of Cerenkov radiation, we calculated the energy depositions of photon beams and fluxes of electrons inducing Cerenkov radiation using the Monte Carlo N-Particle eXtended code. Also, intensities of Cerenkov radiation generated in PS- and PMMA-based POFs were measured as functions of dose rate and monitor unit. At last, therapeutic photon beams-induced Cerenkov radiation in PS- and PMMA-based POFs was measured according to depths of solid water phantom.

  14. The building and sustaining of a health care partnership: the Meharry-Vanderbilt Alliance.

    PubMed

    Chatman, Vera Stevens; Buford, Juanita F; Plant, Brynne

    2003-11-01

    The ability of academic health centers (AHCs) to maintain their financial viability and mission in the face of revolutionary changes was broadly discussed during the last decade. Among the suggestions for protecting the future of AHCs was to form strategic alliances to further the missions of education, research, and service. Although the evidence indicates that 55% of strategic alliances fall apart after three years, the Meharry-Vanderbilt Alliance is now beginning its fifth year, and it appears to be growing stronger. This article presents a brief overview of the evolving historical relationship between Meharry Medical College and Vanderbilt University Medical Center-two institutions that share the same fundamental missions but have very different traditions, cultures, resources, and emphases for medical training-and their relationship with Metropolitan General Hospital at Meharry, a public hospital. The characteristics that have distinguished this strategic alliance are its organizational structure, clearly articulated and measurable objectives, an independent central office, and a shared responsibility for the management and provision of clinical services at Nashville General Hospital. The belief that the Meharry-Vanderbilt Alliance is the "right thing to do" has provided a foundation for cooperation at all levels of both AHCs. PMID:14604868

  15. Therapeutic Consequences of Variation in Intraarterial Pressure Measurements After Iliac Angioplasty

    SciTech Connect

    Tetteroo, Eric; Haaring, Cees; Engelen, Andries D. van; Graaf, Yolanda van der; Mali, Willem P.T.M.

    1997-11-15

    Purpose: To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty. Methods: In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD {+-} SD) and repeatability coefficient (2 x SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient > 10 mmHg. Results: MD {+-} SD for repeated measurements at rest and during flow augmentation were 0 {+-} 2 mmHg and 1 {+-} 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 {+-} 7 mmHg at rest and 17 {+-} 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions. Conclusion: Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty.

  16. Exit Dose Measurement in Therapeutic High Energy Photon Beams and Cobalt-60 Gamma Rays

    NASA Astrophysics Data System (ADS)

    Sathiyan, S.; Ravikumar, M.

    2007-01-01

    To estimate the skin dose to the patient from the treatment planning, the knowledge about exit dose is essential, which is calculated from the percentage depth dose. In this study 6 MV and 18 MV beams from linear accelerator and cobalt-60 beams were used. The ionometric measurements were carried out with parallel plate chamber of sensitive volume 0.16 cc. Parallel plate chamber was fitted in to 30 x 30 cm2 polystyrene phantom at a fixed FSD with the measuring entrance window facing farther from the source. The field size for this measuring condition was maintained at 10 x 10 cm2. The ionization measurements were also carried out by changing the thickness of the polystyrene phantom at the entrance side of the point of measurement. In order to find out the variation of relative exit dose (RED) with field size the measurements were carried out without and with the full back-scattering material (27.2 gm/cm2) placed beyond the entrance window of the chamber. The measurements were also done for the entrance polystyrene phantom thicknesses of 10, 20 and 30 cm for the field size ranging from 5 x 5 cm2 to 30 x 30 cm2. The dose at the exit surface with no backscatter material is about 4.4%, 3.7% and 5.8% less than the dose with the full backscatter material present beyond the point of measurement for 6 MV, 18 MV X-rays and cobalt-60 gamma rays. The reduction in exit dose does not depend much of the phantom thickness through which the beam traverses before exiting at the chamber side. Dose enhancements of about 1.03 times were observed for a field size of 5 x 5 cm2 for 6 MV, 18 MV X-rays and cobalt-60 gamma rays. The dose enhancement factor (DEF) values were noticed to vary with field size beyond 15 x 15 cm2 for all the energies studied. Also it can be observed that the dose enhancement factor (DEF) values do not depend on the thickness of the phantom material through which the beam has traversed. The DEF values were found to vary marginally for different phantom material

  17. The Empirical Analysis of Impact of Alliances on Airline Operations

    NASA Technical Reports Server (NTRS)

    Iatrou, Kostas; Alamdari, Fariba

    2003-01-01

    Airline alliances are dominating the current air transport industry with the largest carriers of the world belonging to one of the four alliance groupings - "Wings", Star Alliance, one world, SkyTeam - which represent 56% of world Revenue Passenger Kilometers. Although much research has been carried out to evaluate the impact of alliance membership on performance of airlines, it would be of interest to ascertain the degree of impact perceived by participating airlines in alliances. It is the purpose of this paper to gather the opinion of all the airlines, belonging to the four global alliance groupings on the impact alliances have had on their traffic and on their performance in general To achieve this, a comprehensive survey of the alliance management departments of airlines participating in the four global strategic alliances was carried out. With this framework the survey has examined which type of cooperation among carriers (FFP, Code Share, Strategic Alliance without antitrust immunity, Strategic Alliance with antitrust immunity) has produced the most positive impact on traffic and which type of route (short haul, long haul, hub-hub, hub-non hub, non hub-non hub) has been mostly affected. In addition, the respondent airlines quantified the effect alliances have had on specific areas of their operation, such as load factors, traffic, costs, revenue and fares. Their responses have been analysed under each global alliances grouping, under airline and under geographic region to establish which group, type of carrier and geographic region has benefited most. The results show that each of the four global alliances groupings has experienced different results according to the type of collaboration agreed amongst their member airlines.

  18. Robust spot-poled membrane hydrophones for measurement of large amplitude pressure waveforms generated by high intensity therapeutic ultrasonic transducers.

    PubMed

    Wilkens, Volker; Sonntag, Sven; Georg, Olga

    2016-03-01

    The output characterization of medical high intensity therapeutic ultrasonic devices poses several challenges for the hydrophones to be used for pressure measurements. For measurements at clinical levels in the focal region, extreme robustness, broad bandwidth, large dynamic range, and small receiving element size are all needed. Conventional spot-poled membrane hydrophones, in principle, meet some of these features and were used to detect large amplitude ultrasonic fields to investigate their applicability. Cavitation in water was the limiting effect causing damage to the electrodes and membrane. A new hydrophone design comprising a steel foil front protection layer has been developed, manufactured, characterized, tested, and optimized. The latest prototypes additionally incorporate a low absorption and acoustic impedance matched backing, and could be used for maximum peak rarefactional and peak compressional pressure measurements of 15 and 75 MPa, respectively, at 1.06 MHz driving frequency. Axial and lateral beam profiles were measured also for a higher driving frequency of 3.32 MHz to demonstrate the applicability for output beam characterization at the focal region at clinical levels. The experimental results were compared with results of numerical nonlinear sound field simulations and good agreement was found if detection bandwidth and spatial averaging were taken into account. PMID:27036269

  19. [Acute therapeutic measures for limb salvage Part 1 : Haemorrhage control, emergency revascularization, compartment syndrome].

    PubMed

    Willy, C; Stichling, M; Engelhardt, M; Vogt, D; Back, D A

    2016-05-01

    The primary care of Gustilo-Anderson type IIIC extremity injuries with relevant vessel lacerations is decisive for the success of a limb salvage procedure. This article shall present substantial emergency procedures for the salvage of the nutritive perfusion of a mangled extremity, based on the current literature. After provisory control of a peripheral haemorrhage (e. g. by manual pressure or tourniquet), an immediate decision must be made about the kind of emergency revascularization to be implemented as the limb salvage procedure. Here, the temporary intravascular shunt will be the fastest technique that can ensure a sufficient tissue perfusion in the case of vessel lacerations. Regarding the treatment of a fracture versus perfusion recovery, a shortening of ischemia time should have priority over fracture stabilization.If an acute compartment syndrome is suspected, a documented monitoring has to be performed in the limb salvage situation for 24 hours with clinical controls every 4 hours. Disproportional pain that does not respond to analgesics, and passive muscle stretching pain can be seen as cardinal symptoms. The positive predictive value of clinical findings is <15 %. During the observation period with an impending but not manifest compartment syndrome, an elevation of the extremity above heart level or its cooling are contraindicated. An intracompartmental pressure measurement is the most important instrument-based supplemental diagnostic method. The open fasciotomy of the affected compartments is the only causal therapy and should be performed as fast as possible. A decision against fasciotomy in cases of non-explicit clinical signs should not be made without a documented intracompartmental pressure measurement. PMID:27160729

  20. Drug discovery alliances in India--indications, targets, and new chemical entities.

    PubMed

    Differding, Edmond

    2014-01-01

    Global pharmaceutical and biotechnology companies have been building increasingly on the skills and services offered by Indian biotech companies through strategic collaborative partnerships and alliances to fuel their in-house discovery and development pipelines. With the exception of generic press releases, however, very little has been published on the process and progress of drug discovery itself, such as the targets or modes of action involved, nor on the scientific output of such collaborations, and therefore on new chemical entities coming out of India through research collaborations. This Essay provides an analytical review of recent patents, patent applications, and peer-reviewed publications of major research alliances. It aims at highlighting their scientific output as well as the considerable bandwidth of targets and therapeutic areas involved. PMID:24136820

  1. Recent advances from the National Cancer Institute Alliance for Nanotechnology in Cancer.

    PubMed

    Farrell, Dorothy; Alper, Joe; Ptak, Krzystof; Panaro, Nicholas J; Grodzinski, Piotr; Barker, Anna D

    2010-02-23

    Nanotechnology will have great impact on how cancer is diagnosed and treated in the future. New technologies to detect and image cancerous changes and materials that enable new methods of cancer treatment will radically alter patient outcomes. The National Cancer Institute (NCI) Alliance for Nanotechnology in Cancer sponsors research in cancer prevention, diagnosis, and therapy and promotes translation of basic science discoveries into clinical practice. The Fourth Annual NCI Alliance Principal Investigator Meeting was held in Manhattan Beach, California October 20-22, 2009. Presented here are highlights from the research presentations at the meeting, in the areas of in vitro diagnostics, targeted delivery of anticancer and contrast enhancement agents, and nanotherapeutics and therapeutic monitoring. PMID:20175564

  2. Emotional Arousal, Client Perceptual Processing, and the Working Alliance in Experiential Psychotherapy for Depression

    ERIC Educational Resources Information Center

    Missirlian, Tanya M.; Toukmanian, Shake G.; Warwar, Serine H.; Greenberg, Leslie S.

    2005-01-01

    Early-, middle-, and late-phase client emotional arousal, perceptual processing strategies, and working alliance were examined in relation to treatment outcome on 4 measures in 32 clients who previously underwent experiential therapy for depression. Hierarchical regression analyses relating these variables to outcome indicated that results varied…

  3. Creating a NASA-Wide Museum Alliance

    NASA Technical Reports Server (NTRS)

    Sohus, Anita M.

    2006-01-01

    NASA's Museum Alliance is a nationwide network of informal educators at museums, science centers, and planetariums that present NASA information to their local audiences. Begun in 2002 as the Mars Museum Visualization Alliance with advisors from a dozen museums, the network has grown to over 300 people from 200 organizations, including a dozen or so international partners. The network has become a community of practice among these informal educators who work with students, educators, and the general public on a daily basis, presenting information and fielding questions about space exploration. Communications are primarily through an active listserve, regular telecons, and a pass word protected website. Professional development is delivered via telecons and downloadable presentations. Current content offerings include Mars exploration, Cassini, Stardust, Genesis, Deep Impact, Earth observations, STEREO, and missions to explore beyond our solar system.

  4. Strategic defense and the Western alliance

    SciTech Connect

    Lakoff, S.; Willoughby, R. )

    1987-01-01

    Strategic defense has again become a major item on the agenda of the Western Alliance. Revived by President Ronald Reagan in his Star Wars speech of March 1983, and implemented in his Strategic Defense Initiative, it has achieved renewed emphasis in military spending, in alliance research efforts, and in arms control negotiations. SDI is packaged in a way that makes it the largest single item in the Department of Defense's annual budget. It engages researchers in industrial and military laboratories on both sides of the Atlantic as well as in Japan and Israel. In the arms control negotiations now under way between the United States and the USSR, the conduct of this research and its implications for the strategic balance and the reduction of offensive weapons are critical considerations. The implications of this largely unexpected development are the subject of this book.

  5. Measuring oxygen tension modulation, induced by a new pre-radiotherapy therapeutic, in a mammary window chamber mouse model

    NASA Astrophysics Data System (ADS)

    Schafer, Rachel; Gmitro, Arthur F.

    2015-03-01

    Tumor regions under hypoxic or low oxygen conditions respond less effectively to many treatment strategies, including radiation therapy. A novel investigational therapeutic, NVX-108 (NuvOx Pharma), has been developed to increase delivery of oxygen through the use of a nano-emulsion of dodecofluoropentane. By raising pO2 levels prior to delivering radiation, treatment efficacy may be improved. To aid in evaluating the novel drug, oxygen tension was quantitatively measured, spatially and temporally, to record the effect of administrating NVX-108 in an orthotopic mammary window chamber mouse model of breast cancer. The oxygen tension was measured through the use of an oxygen-sensitive coating, comprised of phosphorescent platinum porphyrin dye embedded in a polystyrene matrix. The coating, applied to the surface of the coverslip of the window chamber through spin coating, is placed in contact with the mammary fat pad to record the oxygenation status of the surface tissue layer. Prior to implantation of the window chamber, a tumor is grown in the SCID mouse model by injection of MCF-7 cells into the mammary fat pad. Two-dimensional spatial distributions of the pO2 levels were obtained through conversion of measured maps of phosphorescent lifetime. The resulting information on the spatial and temporal variation of the induced oxygen modulation could provide valuable insight into the optimal timing between administration of NVX-108 and radiation treatment to provide the most effective treatment outcome.

  6. International Planetary Data Alliance (IPDA) Information Model

    NASA Technical Reports Server (NTRS)

    Hughes, John Steven; Beebe, R.; Guinness, E.; Heather, D.; Huang, M.; Kasaba, Y.; Osuna, P.; Rye, E.; Savorskiy, V.

    2007-01-01

    This document is the third deliverable of the International Planetary Data Alliance (IPDA) Archive Data Standards Requirements Identification project. The goal of the project is to identify a subset of the standards currently in use by NASAs Planetary Data System (PDS) that are appropriate for internationalization. As shown in the highlighted sections of Figure 1, the focus of this project is the Information Model component of the Data Architecture Standards, namely the object models, a data dictionary, and a set of data formats.

  7. The NPARC Alliance Verification and Validation Archive

    NASA Technical Reports Server (NTRS)

    Slater, John W.; Dudek, Julianne C.; Tatum, Kenneth E.

    2000-01-01

    The NPARC Alliance (National Project for Applications oriented Research in CFD) maintains a publicly-available, web-based verification and validation archive as part of the development and support of the WIND CFD code. The verification and validation methods used for the cases attempt to follow the policies and guidelines of the ASME and AIAA. The emphasis is on air-breathing propulsion flow fields with Mach numbers ranging from low-subsonic to hypersonic.

  8. The clinical partnership as strategic alliance.

    PubMed

    Novotny, Jeanne M; Donahue, Moreen; Bhalla, Bharat B

    2004-01-01

    The purpose of this article is to describe a renewed partnership between a collegiate school of nursing and a community hospital. Universities and hospitals are searching for creative solutions to increase the number of registered nurses available to meet the demand for nursing care. An affiliation agreement had been in existence for many years, but health care system imperatives made it necessary to redesign the partnership between nursing education and nursing service. The model used to develop this new partnership is based on the work done in the field of management and is in the form of a strategic alliance. The success of a strategic alliance depends on two key factors: the relationship between partners and partnership performance. Identified outcomes show that this partnership is helping to meet the increasing demand for nursing care by building student capacity, satisfying mutual needs of faculty and clinical staff, and removing economic barriers. This article describes the development of the strategic alliance, its current status, and strategies for the future. PMID:15343495

  9. Person-centered Therapeutics

    PubMed Central

    Cloninger, C. Robert; Cloninger, Kevin M.

    2015-01-01

    A clinician’s effectiveness in treatment depends substantially on his or her attitude toward -- and understanding of -- the patient as a person endowed with self-awareness and the will to direct his or her own future. The assessment of personality in the therapeutic encounter is a crucial foundation for forming an effective working alliance with shared goals. Helping a person to reflect on their personality provides a mirror image of their strengths and weaknesses in adapting to life’s many challenges. The Temperament and Character Inventory (TCI) provides an effective way to describe personality thoroughly and to predict both the positive and negative aspects of health. Strengths and weaknesses in TCI personality traits allow strong predictions of individual differences of all aspects of well-being. Diverse therapeutic techniques, such as diet, exercise, mood self-regulation, meditation, or acts of kindness, influence health and personality development in ways that are largely indistinguishable from one another or from effective allopathic treatments. Hence the development of well-being appears to be the result of activating a synergistic set of mechanisms of well-being, which are expressed as fuller functioning, plasticity, and virtue in adapting to life’s challenges PMID:26052429

  10. Counselor Technical Activity in Cases with Improving Working Alliances and Continuing-Poor Working Alliances.

    ERIC Educational Resources Information Center

    Kivlighan, Dennis M., Jr.; Schmitz, Patrick J.

    1992-01-01

    Clients, 15 student volunteers paired with 15 counselors trainees for 4 sessions, rated strength of working alliance for each counseling session and scored counselor technical activity on various dimensions. Counselors were rated as relatively more challenging, thematically focused, and here-and-now oriented in improving dyads (eight dyads) than…

  11. North Carolina science and mathematics alliance

    SciTech Connect

    DuBay, D.T.

    1994-12-31

    The Alliance catalyzes building relationships among schools, parents, teachers, businesses, universities, and community colleges, government, and community leaders. A network of nine Regional Partnerships help communities build capacity to reform and support science and mathematics education, school by school. They assess needs, identify resources, and plan and coordinate activities using those resources to solve problems. Partnerships coordinate restructured systems of delivery of teacher education and student instruction in science and mathematics, such as site-based workshops for faculties; community-supported school improvement programs; professional development for school-based teams in leaderships and in science and mathematics content, and computer networking applications.

  12. The parental alliance following divorce: an overview.

    PubMed

    Whiteside, M F

    1998-01-01

    The empirical literature on the postdivorce parental alliance was reviewed with a focus on implications for clinical interventions by family therapists. Variables of cooperation and conflict between parents, individual parenting style, and personal adjustment were significantly interrelated and a range of co-parenting behaviors related to these variables was documented. A typology of divorcing families can be useful in predicting risks for child difficulties and in developing appropriate parenting plans. Clinical interventions need to be tailored to the unique characteristics and resources of a given family and can speak to multiple points of the family system. PMID:9474521

  13. Mobilizing Public Opinion for the Tobacco Industry: The Consumer Tax Alliance and Excise Taxes

    PubMed Central

    Campbell, Richard; Balbach, Edith D.

    2009-01-01

    Background Tobacco industry funding was instrumental in creating and financing the Consumer Tax Alliance in 1989 as an ostensibly organization that relied upon extensive media outreach to build opposition to excise taxes as a regressive form of taxation. By obscuring its own role in this effort, the tobacco industry undermined the public’s reasonable expectations for transparency in the policy making process. Aim To examine the formation and activities of the Consumer Tax Alliance as a “hybrid” form of interest group in order to provide tobacco control and public health advocates with a better understanding of unanticipated tobacco industry coalitions and facilitate appropriate counter measures. Methods Document searches through the Legacy Tobacco Documents Library and through Tobacco Documents Online and review of background literature. Results The Tobacco Institute actively sought liberal allies beginning in the mid-1980s in seeking to build public opposition to cigarette excise tax increases by promoting them as a regressive form of taxation. The creation of the Consumer Tax Alliance in 1989 was expressly intended to turn labor and middle class opinion against prospective excise tax increases in federal budget deficit negotiations, without divulging the tobacco industry’s role in its formation. Conclusion It is important to understand the dynamic by which trusted organizations can be induced to alter their agendas in response to funding sources. Advocates need to understand this form of interest group behavior so that they are better able to negotiate the policy arena by diagnosing and exposing this influence where it occurs and, by doing so, be better prepared to take appropriate counter measures. What this paper adds The tobacco industry’s political strategies for utilizing third party efforts to contest cigarette excise tax increases have not been extensively studied. While there has been some attention to industry sponsorship of third parties, the

  14. Representations of Parent-Child Alliances in Children's Family Drawings

    ERIC Educational Resources Information Center

    Leon, Kim; Wallace, Tamar; Rudy, Duane

    2007-01-01

    The purpose of this study was to investigate relationships between children's representations of parent-child alliances (PCA) and their peer relationship quality, using a new scale that was developed to rate representations of PCA in children's family drawings. The parent-child alliance pattern is characterized by a relationship between parent and…

  15. The social side of hydropower: Forging a new alliance

    SciTech Connect

    Cernea, M.M.

    1997-03-01

    Social issues raised by hydropower development and approaches to addressing them are discussed. The primary social problem discussed is that of population relocation. Alliances between project developers and socioeconomics experts to address this and other issues are described. Such alliances can guide appropriate social actions in developing countries which lack formal policies and legislated frameworks for resettlement.

  16. Concept Mapping the Client's Perspective on Counseling Alliance Formation

    ERIC Educational Resources Information Center

    Bedi, Robinder P.

    2006-01-01

    The purpose of the present study was to identify, categorize, and model clients' understanding of early counseling alliance formation factors. Forty participants who had received counseling services were interviewed and asked about what observable behaviors and verbalizations they thought had helped establish the alliance with their counselor.…

  17. Care and Control: Working Alliance among Adolescents in Authoritarian Settings

    ERIC Educational Resources Information Center

    Magrinelli Orsi, Mylene; Lafortune, Denis; Brochu, Serge

    2010-01-01

    This article reviews the literature published in the last 20 years on working alliance in adolescents involuntarily enrolled in intervention programs. Firstly, Bordin's adaptation of the concept of working alliance to adolescent populations is discussed. This is followed by an analysis of the main results of empirical studies on helping…

  18. The Global Research Alliance on agricultural greenhouse gases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Global Research Alliance on Agricultural Greenhouse Gases was proposed by New Zealand at the United Nations Framework Convention on Climate Change Conference of the Parties (COP) in Copenhagen in 2009 and developed in partnership with the United States. This alliance now includes 32 member count...

  19. Exploration of a Contextual Management Framework for Strategic Learning Alliances

    ERIC Educational Resources Information Center

    Dealtry, Richard

    2008-01-01

    Purpose: This article aims to take a further step forward in examining those important business factors that will shape the future of best practice in the quality management of internal and external strategic alliances. Design/methodology/approach: The article presents a speculative scenario on the future of strategic alliances in education,…

  20. Strategic Alliances in Education: The Knowledge Engineering Web

    ERIC Educational Resources Information Center

    Westera, Wim; van den Herik, Jaap; van de Vrie, Evert

    2004-01-01

    The field of higher education shows a jumble of alliances between fellow institutes. The alliances are strategic in kind and serve an economy-of-scales concept. A large scale is a prerequisite for allocating the budgets for new educational methods and technologies in order to keep the educational services up-to-date. All too often, however,…

  1. Global alliances effect in coalition forming

    NASA Astrophysics Data System (ADS)

    Vinogradova, Galina; Galam, Serge

    2014-11-01

    Coalition forming is investigated among countries, which are coupled with short range interactions, under the influence of externally-set opposing global alliances. The model extends a recent Natural Model of coalition forming inspired from Statistical Physics, where instabilities are a consequence of decentralized maximization of the individual benefits of actors. In contrast to physics where spins can only evaluate the immediate cost/benefit of a flip of orientation, countries have a long horizon of rationality, which associates with the ability to envision a way up to a better configuration even at the cost of passing through intermediate loosing states. The stabilizing effect is produced through polarization by the global alliances of either a particular unique global interest factor or multiple simultaneous ones. This model provides a versatile theoretical tool for the analysis of real cases and design of novel strategies. Such analysis is provided for several real cases including the Eurozone. The results shed a new light on the understanding of the complex phenomena of planned stabilization in the coalition forming.

  2. Library Services Alliance of New Mexico. 1994 Annual report

    SciTech Connect

    1995-09-01

    The Library Services Alliance is a unique multi-type library consortium committed to resource sharing. As a voluntary association of university and governmental laboratory libraries supporting scientific research, the Alliance has become a leader in New Mexico in using cooperative ventures to cost-effectively expand resources supporting their scientific and technical communities. During 1994, the alliance continued to expand on their strategic planning foundation to enhance access to research information for the scientific and technical communities. Significant progress was made in facilitating easy access to the on-line catalogs of member libraries via connections through the Internet. Access to Alliance resources is now available via the World Wide Web and Gopher, as well as links to other databases and electronic information. This report highlights the accomplishments of the Alliance during calendar year 1994.

  3. Direct real-time quantitative PCR for measurement of host-cell residual DNA in therapeutic proteins.

    PubMed

    Peper, Grit; Fankhauser, Alexander; Merlin, Thomas; Roscic, Ana; Hofmann, Matthias; Obrdlik, Petr

    2014-11-01

    Real-time quantitative PCR (qPCR) is important for quantification of residual host cell DNA (resDNA) in therapeutic protein preparations. Typical qPCR protocols involve DNA extraction steps complicating sample handling. Here, we describe a "direct qPCR" approach without DNA extraction. To avoid interferences of DNA polymerase with a therapeutic protein, proteins in the samples were digested with proteinase K (PK) in the presence of sodium dodecyl sulfate (SDS). Tween 20 and NaCl were included to minimize precipitation of therapeutic proteins in the PK/SDS mix. After PK treatment, the solution was applied directly for qPCR. Inhibition of DNA polymerase by SDS was prevented by adding 2% (v/v) of Tween 20 to the final qPCR mix. The direct qPCR approach was evaluated for quantification of resDNA in therapeutic proteins manufactured in Chinese hamster ovary (CHO) host cells. First, direct qPCR was compared with qPCR applied on purified DNA ("extraction qPCR"). For both qPCRs, the same CHO-specific primers and probes were used. Comparable residual DNA levels were detected with both PCR approaches in purified and highly concentrated drug proteins as well as in in-process-control samples. Finally, the CHO-specific direct qPCR protocol was validated according to ICH guidelines and applied for 25 different therapeutic proteins. The specific limits of quantification were 0.1-0.8ppb for 24 proteins, and 2.0ppb for one protein. General applicability of the direct qPCR was demonstrated by applying the sample preparation protocol for quantification of resDNA in therapeutic proteins manufactured in other hosts such as Escherichia coli and mouse cells. PMID:25151232

  4. The "educational alliance" as a framework for reconceptualizing feedback in medical education.

    PubMed

    Telio, Summer; Ajjawi, Rola; Regehr, Glenn

    2015-05-01

    Feedback has long been considered a vital component of training in the health professions. Nonetheless, it remains difficult to enact the feedback process effectively. In part, this may be because, historically, feedback has been framed in the medical education literature as a unidirectional content-delivery process with a focus on ensuring the learner's acceptance of the content. Thus, proposed solutions have been organized around mechanistic, educator-driven, and behavior-based best practices. Recently, some authors have begun to highlight the role of context and relationship in the feedback process, but no theoretical frameworks have yet been suggested for understanding or exploring this relational construction of feedback in medical education. The psychotherapeutic concept of the "therapeutic alliance" may be valuable in this regard.In this article, the authors propose that by reorganizing constructions of feedback around an "educational alliance" framework, medical educators may be able to develop a more meaningful understanding of the context-and, in particular, the relationship-in which feedback functions. Use of this framework may also help to reorient discussions of the feedback process from effective delivery and acceptance to negotiation in the environment of a supportive educational relationship.To explore and elaborate these issues and ideas, the authors review the medical education literature to excavate historical and evolving constructions of feedback in the field, review the origins of the therapeutic alliance and its demonstrated utility for psychotherapy practice, and consider implications regarding learners' perceptions of the supervisory relationship as a significant influence on feedback acceptance in medical education settings. PMID:25406607

  5. Geoscience Alliance--A National Alliance for Broadening Participation of Native Americans in the Geosciences

    NASA Astrophysics Data System (ADS)

    Dalbotten, D. M.; Pellerin, H.; Greensky, L.; Burger, A.

    2009-12-01

    The continuing underrepresentation of Native Americans in the geosciences can only mean that native voices go unheard in setting research agendas and priorities. This is particularly significant where issues such as global climate change impact the land and livelihood of Native American communities. This talk will outline progress towards a Geoscience Alliance, with participation by faculty from tribal colleges, universities, and research centers; native elders and community members; students (K12, undergraduate, and graduate); formal and informal educators; and other interested individuals. Our focus will be on defining goals for this alliance, i.e., new research in Geoscience education, defining best practices, inclusion of Native voices in Geoscience research, the potential for new collaborations, and promotion of opportunities for Native students and communities.

  6. Strategic hospital alliances: impact on financial performance.

    PubMed

    Clement, J P; McCue, M J; Luke, R D; Bramble, J D; Rossiter, L F; Ozcan, Y A; Pai, C W

    1997-01-01

    Acute care hospitals have increasingly been forming local strategic hospital alliances (SHAs), which consume considerable resources in forming and may affect the competitiveness of provider markets. This research shows that SHAs and market factors, which have been perceived to be threats to hospitals, are related to hospitals' financial performance. Among the findings are that SHA members have higher net revenues but that they are not more effective at cost control. Nor do the higher net revenues result in higher cash flow. However, increasing SHA penetration in a market is related to lower net revenues per case. In addition, the penetration of private health maintenance organizations in markets is associated with lower revenues and expenses. PMID:9444827

  7. Pilot Study Measuring the Effects of Therapeutic Horseback Riding on School-Age Children and Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Gabriels, Robin L.; Agnew, John A.; Holt, Katherine D.; Shoffner, Amy; Zhaoxing, Pan; Ruzzano, Selga; Clayton, Gerald H.; Mesibov, Gary

    2012-01-01

    This preliminary study examined the effects of 10 weekly lessons of therapeutic horseback riding (THR) on 42 participants diagnosed with an autism spectrum disorder (ages 6-16 years) compared to a subset (n=16) of the total study population who were first evaluated before and after a 10-week waitlist control condition. All participants received…

  8. Proceedings of the Inaugural Pediatric Dermatology Research Alliance (PeDRA) Conference

    PubMed Central

    Siegel, Dawn H.; Choate, Keith; Drolet, Beth A.; Frieden, Ilona J.; Teng, Joyce M.; Tom, Wynnis; Williams, Mary; Eichenfield, Lawrence F.; Paller, Amy S.

    2014-01-01

    Abstract/Statement of the problem Skin disease research involving children currently faces several major hurdles and as a result, many therapies are only available for off-label use in children and many of the most pressing clinical needs of our pediatric population remain unsolved. A strategic planning committee of the Society for Pediatric Dermatology (SPD) identified the need for an organized, inclusive research alliance to augment the resources of individual practitioners and pre-existing smaller collaborative groups and facilitate robust, multicenter basic, translational, and clinical research and therapeutic trials. A December 2011 National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Roundtable on Pediatric Dermatology further detailed the therapeutic gaps and barriers to translation of scientific advances to clinical practice. Building on these forums, in July 2012, a group of interested investigators met in Monterey, CA to develop the infrastructure for collaborative pediatric skin research, now called the Pediatric Dermatology Research Alliance (PeDRA). The vision of PeDRA is to create sustainable collaborative research networks to better understand, prevent, treat and cure dermatologic diseases in children. From that starting point, subcommittees and expert members were added, stakeholders identified, and seed funding garnered, with the first PeDRA stand-alone research meeting* realized in Chicago, IL in October 2013. PMID:25318428

  9. The role of co-parenting alliance as a mediator between trait anxiety, family system maladjustment, and parenting stress in a sample of non-clinical Italian parents.

    PubMed

    Delvecchio, Elisa; Sciandra, Andrea; Finos, Livio; Mazzeschi, Claudia; Riso, Daniela Di

    2015-01-01

    This study investigated the role of co-parenting alliance in mediating the influence of parents' trait anxiety on family system maladjustment and parenting stress. A sample of 1606 Italian parents (803 mothers and 803 fathers) of children aged one to 13 years completed measures of trait anxiety (State Trait Anxiety Inventory-Y), co-parenting alliance (Parenting Alliance Measure), family system maladjustment (Family Assessment Measure-III), and parenting stress (Parenting Stress Inventory-Short Form). These variables were investigated together comparing two structural equations model-fitting including both partners. A model for both mothers and fathers was empirically devised as a series of associations between parent trait anxiety (independent variable), family system maladjustment and parenting stress (dependent variables), mediated by co-parenting alliance, with the insertion of cross predictions between mothers and fathers and correlations between dependent variables for both parents. Results indicated that the relation between mothers and fathers' trait anxiety, family system maladjustment and parenting stress was mediated by the level of co-parenting alliance. Understanding the role of couples' co-parenting alliance could be useful during the family assessment and/or treatment, since it is an efficient and effective tool to improve the family system maladjustment and stress. PMID:26347674

  10. The Effects of Trust in Virtual Strategic-Alliance Performance Outcomes

    ERIC Educational Resources Information Center

    Preston-Ortiz, Dina

    2010-01-01

    Outsourcing increases supported by technology have led to the formation of virtual strategic partnerships. Historically, 70% to 75% of alliance partnerships fail because members are often competitors outside the alliance network. To address alliance failure, a Delphi Study was conducted to identify the role of trust and alliance performance…

  11. 77 FR 7572 - Alliance Pipeline L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... Energy Regulatory Commission Alliance Pipeline L.P.; Notice of Application Take notice that on January 25, 2012, Alliance Pipeline L.P. filed with the Federal Energy Regulatory Commission an application under... behalf of Alliance Pipeline Inc., Managing General Partner of Alliance Pipeline L.P., 800, 605--5 Ave....

  12. Science and Engineering Alliance: A new resource for the nation

    SciTech Connect

    1998-04-01

    The Lawrence Livermore National Laboratory and four major Historically Black Colleges and Universities with strong research and development capabilities in science, engineering and computer technology have formed the Science and Engineering Alliance. Located in California, Alabama, Mississippi, Louisiana and Texas, each brings to the Alliance a tradition of research and development and educational excellence. This unique consortium is now available to perform research development and training to meet the needs of the public and private sectors. The Alliance was formed to help assure an adequate supply of top-quality minority scientists in the next century, while simultaneously meeting the research and development needs of the public and private sectors.

  13. Research on Efficiency of Knowledge Transfer in Technical Innovation Alliances

    NASA Astrophysics Data System (ADS)

    Zhang-sheng, Jiang

    The knowledge transfer efficiency (KTE) is closely relative to the success or failure of technology innovation in strategic alliances. This paper takes the KTE as the essential variable to establish the benefit function model of technology innovations to explore the KTE's influences on partners' innovative decisions under two different modes: independent innovations and alliance innovations. It is found that the higher the KTE, the greater the reducing extent of production costs is. The results could provide some theoretical supports for selections of the optimal competitive-ooperative relationship and managerial flexibility in technical innovation alliances.

  14. GTI-2040. Lorus Therapeutics.

    PubMed

    Orr, R M

    2001-10-01

    Loris Therapeutics (formerly GeneSense Therapeutics) is developing the antisense oligonucleotide GTI-2040, directed against the R2 component of ribonucleotide reductase, for the potential treatment of cancer [348194]. It is in phase I/II trials [353796] and Lorus had anticipated phase II trials would be initiated in July 2001. By August 2001, GTI-2040 was undergoing a phase II trial as a monotherapy for the potential treatment of renal cell carcinoma, and was about to enter a phase II combination study for this indication with capecitabine (Hoffmann-La Roche). At this time, the company was also planning a phase II trial to study the drug's potential in the treatment of colorectal cancer [418739]. GTI-2040 has been tested in nine different tumor models, including tumors derived from colon, liver, lung, breast, kidney and ovary. Depending on the tumor model, significant inhibition of tumor growth, disease stabilization and dramatic tumor regressions was observed [347683]. Lorus filed an IND to commence phase I/II trials with GTI-2040 in the US in November 1999 [347683], and received approval for the trials in December 1999 [349623]. As of January 2000, these trials had commenced at the University of Chicago Cancer Research Center; it was reported in February 2000 that dosing to date had been well tolerated with no apparent safety concerns [357449]. Lorus has entered into a strategic supply alliance with Proligo to provide the higher volumes of drug product required for the planned multiple phase II trials [385976]. In February 1998, Genesense (now Lorus) received patent WO-09805769. Loris also received a patent (subsequently identified as WO-00047733) from the USPTO in January 2000, entitled 'Antitumor antisense sequences directed against components of ribonucleotide reductase' covering the design and use of unique antisense anticancer drugs, including GTI-2040 and GTI-2501 [353538]. PMID:11890366

  15. The role of co-parenting alliance as a mediator between trait anxiety, family system maladjustment, and parenting stress in a sample of non-clinical Italian parents

    PubMed Central

    Delvecchio, Elisa; Sciandra, Andrea; Finos, Livio; Mazzeschi, Claudia; Riso, Daniela Di

    2015-01-01

    This study investigated the role of co-parenting alliance in mediating the influence of parents’ trait anxiety on family system maladjustment and parenting stress. A sample of 1606 Italian parents (803 mothers and 803 fathers) of children aged one to 13 years completed measures of trait anxiety (State Trait Anxiety Inventory—Y), co-parenting alliance (Parenting Alliance Measure), family system maladjustment (Family Assessment Measure—III), and parenting stress (Parenting Stress Inventory—Short Form). These variables were investigated together comparing two structural equations model-fitting including both partners. A model for both mothers and fathers was empirically devised as a series of associations between parent trait anxiety (independent variable), family system maladjustment and parenting stress (dependent variables), mediated by co-parenting alliance, with the insertion of cross predictions between mothers and fathers and correlations between dependent variables for both parents. Results indicated that the relation between mothers and fathers’ trait anxiety, family system maladjustment and parenting stress was mediated by the level of co-parenting alliance. Understanding the role of couples’ co-parenting alliance could be useful during the family assessment and/or treatment, since it is an efficient and effective tool to improve the family system maladjustment and stress. PMID:26347674

  16. Traumatic events, posttraumatic stress disorder, attachment style, and working alliance in a sample of people with psychosis.

    PubMed

    Picken, Alicia L; Berry, Katherine; Tarrier, Nicholas; Barrowclough, Christine

    2010-10-01

    There is a high incidence of trauma and posttraumatic stress disorder (PTSD) in people with a diagnosis of psychosis. Sequelae of trauma may affect the ability to engage in both attachment and therapeutic relationships. This study investigated associations between trauma histories, PTSD, attachment styles, and working alliance in a sample of 110 individuals with psychosis and substance misuse. Anxious attachment was associated with number of interpersonal traumas and PTSD reported, but there were no associations between trauma and alliance. There were discrepancies in number of traumatic events reported by care coordinators and patients. The findings of this study highlight the potential use of attachment theory in working with trauma and PTSD in psychosis. PMID:20921870

  17. Networks of military alliances, wars, and international trade.

    PubMed

    Jackson, Matthew O; Nei, Stephen

    2015-12-15

    We investigate the role of networks of alliances in preventing (multilateral) interstate wars. We first show that, in the absence of international trade, no network of alliances is peaceful and stable. We then show that international trade induces peaceful and stable networks: Trade increases the density of alliances so that countries are less vulnerable to attack and also reduces countries' incentives to attack an ally. We present historical data on wars and trade showing that the dramatic drop in interstate wars since 1950 is paralleled by a densification and stabilization of trading relationships and alliances. Based on the model we also examine some specific relationships, finding that countries with high levels of trade with their allies are less likely to be involved in wars with any other countries (including allies and nonallies), and that an increase in trade between two countries correlates with a lower chance that they will go to war with each other. PMID:26668370

  18. New US philanthropy alliance picks physicist as boss

    NASA Astrophysics Data System (ADS)

    Kruesi, Liz

    2015-04-01

    Marc Kastner, a physicist at the Massachusetts Institute of Technology (MIT), has become the first president of the Science Philanthropy Alliance (SPA) - a new group of six organizations aiming to increase private funding for fundamental research in the US.

  19. National Alliance of Clean Energy Incubator Activities - Final Technical Report

    SciTech Connect

    Chris Downing, P.E.

    2004-12-14

    Summary of activity related to development of the Alliance of Clean Energy Business Incubators and incubation services provided to the clean energy sector by the Advanced Technology Development Center at the Georgia Institute of Technology.

  20. Networks of military alliances, wars, and international trade

    PubMed Central

    Jackson, Matthew O.; Nei, Stephen

    2015-01-01

    We investigate the role of networks of alliances in preventing (multilateral) interstate wars. We first show that, in the absence of international trade, no network of alliances is peaceful and stable. We then show that international trade induces peaceful and stable networks: Trade increases the density of alliances so that countries are less vulnerable to attack and also reduces countries’ incentives to attack an ally. We present historical data on wars and trade showing that the dramatic drop in interstate wars since 1950 is paralleled by a densification and stabilization of trading relationships and alliances. Based on the model we also examine some specific relationships, finding that countries with high levels of trade with their allies are less likely to be involved in wars with any other countries (including allies and nonallies), and that an increase in trade between two countries correlates with a lower chance that they will go to war with each other. PMID:26668370

  1. FROM ME TO US: THE CONSTRUCTION OF FAMILY ALLIANCE.

    PubMed

    Galdiolo, Sarah; Roskam, Isabelle

    2016-01-01

    This longitudinal prospective and multi-informant study based on a three-wave research program (pregnancy, 12 months' postpartum, and 16 months' postpartum) aimed to determine the process of construction of family alliance, as assessed by the Lausanne Trilogue Play (Fivaz-Depeursinge & Corboz-Warnery, 1999). A model using parents' individual characteristics (i.e., personality traits and attachment orientations) as distal variables, coparenting as a mediator, child's temperament as a moderator, and family alliance as outcome was tested using structural equation modeling on 62 nonreferred families. Results showed that both parents' conscientiousness was positively and mothers' avoidant attachment and fathers' anxious attachment were negatively and indirectly (via coparenting) associated with the family alliance. The discussion underlines mothers' and fathers' different roles and the importance of coparenting as a core mechanism in the development of family alliance. PMID:26715070

  2. NCI Alliance for Nanotechnology in Cancer - Tutorials and Seminar Series

    Cancer.gov

    View details about tutorials and seminars hosted by Alliance members and members of the cancer research community. These events provide a forum for sharing innovative perspectives on research and development efforts in the field of nanotechnology and their application to cancer diagnosis, treatment, and prevention. Also visit the Event Listing section to find scientific meetings and events where NCI Alliance for Nanotechnology in Cancer leaders and members are participating.

  3. What Do Chinese and Foreign Universities Value about Their Strategic Alliances? Exploring a Dimension of Higher Education Alliances in a Cross Cultural Context

    ERIC Educational Resources Information Center

    Willis, Mike

    2003-01-01

    There are now over 5,000 alliances between Chinese and foreign universities but there is little research on how managers from the two sides value the various aspects of their educational alliances. This research finds that both sides valued a range of alliance levels, types, activities, sizes and structures but there were significant differences.…

  4. A Hypothesis on Biological Protection from Space Radiation Through the Use of New Therapeutic Gases as Medical Counter Measures

    NASA Technical Reports Server (NTRS)

    Schoenfeld, Michael P.; Ansari, Rafat R.; Nakao, Atsunori; Wink, David

    2011-01-01

    Exposure to astronauts could be a significant obstacle for long duration manned space exploration because of current uncertainties regarding the extent of biological effects. Furthermore, concepts for protective shielding also pose a technically challenging issue due to the nature of cosmic radiation and current mass and power constraints with modern exploration technology. As biological damage from exposure is associated with increased oxidative stress, it would be enabling to mitigate and/or prevent stress prior to the development of clinical symptoms and disease. This paper hypothesizes a "systems biology" approach in which a combination of chemical and biological mitigation techniques are used conjunctively. It proposes using new, therapeutic, medical gases as both chemical radioprotectors for radical scavenging and biological promoters for management of the body s response to exposure. From reviewing radiochemistry of water, biological effects of CO, H2, NO, and H2S gas, and mechanisms of radiation biology, it is concluded that this approach may have great therapeutic potential for exposure. Furthermore, it also appears to have potential for curtailing the pathogenesis of other diseases in which oxidative stress has been implicated including cardiovascular disease, cancer, chronic inflammatory disease, hypertension, ischemia/reperfusion injury, acute respiratory distress syndrome, Parkinson s and Alzheimer s disease, cataracts, and aging.

  5. A Hypothesis on Biological Protection from Space Radiation Through the Use of New Therapeutic Gases as Medical Counter Measures

    NASA Technical Reports Server (NTRS)

    Schoenfeld, Michael P.; Ansari, Rafat R.; Nakao, Atsunori; Wink, David

    2012-01-01

    Radiation exposure to astronauts could be a significant obstacle for long duration manned space exploration because of current uncertainties regarding the extent of biological effects. Furthermore, concepts for protective shielding also pose a technically challenging issue due to the nature of cosmic radiation and current mass and power constraints with modern exploration technology. The concern regarding exposure to cosmic radiation is the biological damage it induces. As damage is associated with increased oxidative stress, it is important and would be enabling to mitigate and/or prevent oxidative stress prior to the development of clinical symptoms and disease. This paper hypothesizes a "systems biology" approach in which a combination of chemical and biological mitigation techniques are used conjunctively. It proposes using new, therapeutic, medical gases as both chemical radioprotectors for radical scavenging and biological signaling molecules for management of the body s response to exposure. From reviewing radiochemistry of water, biological effects of CO, H2, NO, and H2S gas, and mechanisms of radiation biology, it is concluded that this approach may have great therapeutic potential for radiation exposure. Furthermore, it also appears to have similar potential for curtailing the pathogenesis of other diseases in which oxidative stress has been implicated including cardiovascular disease, cancer, chronic inflammatory disease, hypertension, ischemia/reperfusion injury, acute respiratory distress syndrome, Parkinson s and Alzheimer s disease, cataracts, and aging.

  6. A hypothesis on biological protection from space radiation through the use of new therapeutic gases as medical counter measures.

    PubMed

    Schoenfeld, Michael P; Ansari, Rafat R; Nakao, Atsunori; Wink, David

    2012-01-01

    Radiation exposure to astronauts could be a significant obstacle for long duration manned space exploration because of current uncertainties regarding the extent of biological effects. Furthermore, concepts for protective shielding also pose a technically challenging issue due to the nature of cosmic radiation and current mass and power constraints with modern exploration technology. The concern regarding exposure to cosmic radiation is biological damage that is associated with increased oxidative stress. It is therefore important and would be enabling to mitigate and/or prevent oxidative stress prior to the development of clinical symptoms and disease. This paper hypothesizes a "systems biology" approach in which a combination of chemical and biological mitigation techniques are used conjunctively. It proposes using new, therapeutic, medical gases as chemical radioprotectors for radical scavenging and as biological signaling molecules for management of the body's response to exposure. From reviewing radiochemistry of water, biological effects of CO, H2, NO, and H2S gas, and mechanisms of radiation biology, it can be concluded that this approach may have therapeutic potential for radiation exposure. Furthermore, it also appears to have similar potential for curtailing the pathogenesis of other diseases in which oxidative stress has been implicated including cardiovascular disease, cancer, chronic inflammatory disease, hypertension, ischemia/reperfusion (IR) injury, acute respiratory distress syndrome, Parkinson's and Alzheimer's disease, cataracts, and aging. We envision applying these therapies through inhalation of gas mixtures or ingestion of water with dissolved gases. PMID:22475015

  7. A hypothesis on biological protection from space radiation through the use of new therapeutic gases as medical counter measures

    PubMed Central

    2012-01-01

    Radiation exposure to astronauts could be a significant obstacle for long duration manned space exploration because of current uncertainties regarding the extent of biological effects. Furthermore, concepts for protective shielding also pose a technically challenging issue due to the nature of cosmic radiation and current mass and power constraints with modern exploration technology. The concern regarding exposure to cosmic radiation is biological damage that is associated with increased oxidative stress. It is therefore important and would be enabling to mitigate and/or prevent oxidative stress prior to the development of clinical symptoms and disease. This paper hypothesizes a "systems biology" approach in which a combination of chemical and biological mitigation techniques are used conjunctively. It proposes using new, therapeutic, medical gases as chemical radioprotectors for radical scavenging and as biological signaling molecules for management of the body's response to exposure. From reviewing radiochemistry of water, biological effects of CO, H2, NO, and H2S gas, and mechanisms of radiation biology, it can be concluded that this approach may have therapeutic potential for radiation exposure. Furthermore, it also appears to have similar potential for curtailing the pathogenesis of other diseases in which oxidative stress has been implicated including cardiovascular disease, cancer, chronic inflammatory disease, hypertension, ischemia/reperfusion (IR) injury, acute respiratory distress syndrome, Parkinson's and Alzheimer's disease, cataracts, and aging. We envision applying these therapies through inhalation of gas mixtures or ingestion of water with dissolved gases. PMID:22475015

  8. Alliance for Sequestration Training, Outreach, Research & Education

    SciTech Connect

    Olson, Hilary

    2013-09-01

    The Sequestration Training, Outreach, Research and Education (STORE) Alliance at The University of Texas at Austin completed its activity under Department of Energy Funding (DE- FE0002254) on September 1, 2013. The program began as a partnership between the Institute for Geophysics, the Bureau of Economic Geology and the Petroleum and Geosystems Engineering Department at UT. The initial vision of the program was to promote better understanding of CO2 utilization and storage science and engineering technology through programs and opportunities centered on training, outreach, research and technology transfer, and education. With over 8,000 hrs of formal training and education (and almost 4,500 of those hours awarded as continuing education credits) to almost 1,100 people, STORE programs and activities have provided benefits to the Carbon Storage Program of the Department of Energy by helping to build a skilled workforce for the future CCS and larger energy industry, and fostering scientific public literacy needed to continue the U.S. leadership position in climate change mitigation and energy technologies and application. Now in sustaining mode, the program is housed at the Center for Petroleum and Geosystems Engineering, and benefits from partnerships with the Gulf Coast Carbon Center, TOPCORP and other programs at the university receiving industry funding.

  9. Alliances for Undergraduate Research in the Geosciences Through Collaborative Recruitment

    NASA Astrophysics Data System (ADS)

    Pandya, R.; Eriksson, S.; Haacker-Santos, R.; Calhoun, A.

    2006-12-01

    Undergraduate research is a key strategy for encouraging students to pursue graduate school and careers in science end engineering. In the geosciences, where participation by members of underrepresented groups is among the lowest of any science field, these programs must continue and strengthen their efforts to engage students from historically underrepresented groups. A significant limitation on our ability to engage students from historically underrepresented groups comes from the expense, in terms of time and resources, of promoting these career options to talented undergraduates considering a host of STEM careers. Another hurdle is our ability to match students with research projects tailored to their interests. Further complicating this is the challenge of matching students who have culturally motivated geographic constraints—for example, Native students who seek to serve their local community—to relevant opportunities. As a result, we believe that a number of highly qualified students never fully consider careers in the geosciences. To address these obstacles, we propose an alliance of undergraduate research programs in the geosciences. In this model, all members of the alliance would share recruiting, and students would submit a single application forwarded to all alliance members. The Alliance could offer applicants multiple research opportunities, from across the alliance, tailored to fit the applicant's needs and interests. This strategy has proven very effective in other fields; for example, the Leadership Alliance allows 32 member institutions to offer internships and fellowships through one central application process. SOARS and RESESS, programs in atmospheric science and geophysics, respectively, have done this co-recruiting for two years. There are many benefits to this type of alliance. First, it would allow programs to leverage and coordinate their recruiting investments. From our experience with SOARS and RESESS, much of the effort in

  10. The Therapeutic Relationship in the Brief Treatment of Depression: Contributions to Clinical Improvement and Enhanced Adaptive Capacities

    ERIC Educational Resources Information Center

    Zuroff, David C.; Blatt, Sidney J.

    2006-01-01

    Using data from the National Institute of Mental Health Treatment for Depression Collaborative Research Program, the authors examined the impact on treatment outcome of the patient's perception of the quality of the therapeutic relationship and contribution to the therapeutic alliance. Shared variance with early clinical improvement was removed…