Sample records for management insights study

  1. Asthma Insights and Management in India: Lessons Learnt from the Asia Pacific - Asthma Insights and Management (AP-AIM) Study.

    PubMed

    Salvi, Sundeep S; Apte, Komalkirti K; Dhar, Raja; Shetty, Pradeep; Faruqi, Rab A; Thompson, Philip J; Guleria, Randeep

    2015-09-01

    Despite a better understanding of the pathophysiology of asthma, presence of reliable diagnostic tools, availability of a wide array of effective and affordable inhaled drugs and simplified national and international asthma management guidelines, asthma remains poorly managed in India. The Asia-Pacific Asthma Insight and Management (AP-AIM) study was aimed at understanding the characteristics of asthma, current management, level of asthma control and its impact on quality of life across Australia, China, Hong Kong, India, Malaysia, Singapore, South Korea, Taiwan and Thailand. This paper describes the results of asthma management issues in India in detail and provides a unique insight into asthma in India. The AP-AIM India study was conducted in eight urban cities in India, viz: Ajmer, Delhi, Kolkata, Rourkela, Chennai, Mangalore, Mumbai and Rajkot from February to July 2011. Face-to-face interviews were conducted in adult asthmatics and parents of asthmatic children between the ages of 12 and 17 years with a confirmed diagnosis or a treatment history of 1 year for asthma. Four hundred asthmatics (M:F::1:1.273), with a mean age of 50 ± 17.8 years, from across India were studied. 91% of the asthmatics in India perceived their asthma to be under control, however, none of the asthmatics had controlled asthma by objective measures. Asthmatics in India believed that their asthma was under control if they have up to 2 emergency doctor visits a year. The quality of life of these patients was significantly affected with 93% school/work absenteeism and a loss of 50% productivity. Seventy-five percent of the asthmatics have never had a lung function test. The common triggers for asthmatics in India were dust (49%) and air pollution (49%), while only 5% reported of pollen as triggers. Eighty-nine percent of Indian asthmatics reported an average use of oral steroids 10.5 times a year. Only 36% and 50% of Indian asthmatics used controller and rescue inhalers with a majority

  2. Insight: An ontology-based integrated database and analysis platform for epilepsy self-management research.

    PubMed

    Sahoo, Satya S; Ramesh, Priya; Welter, Elisabeth; Bukach, Ashley; Valdez, Joshua; Tatsuoka, Curtis; Bamps, Yvan; Stoll, Shelley; Jobst, Barbara C; Sajatovic, Martha

    2016-10-01

    We present Insight as an integrated database and analysis platform for epilepsy self-management research as part of the national Managing Epilepsy Well Network. Insight is the only available informatics platform for accessing and analyzing integrated data from multiple epilepsy self-management research studies with several new data management features and user-friendly functionalities. The features of Insight include, (1) use of Common Data Elements defined by members of the research community and an epilepsy domain ontology for data integration and querying, (2) visualization tools to support real time exploration of data distribution across research studies, and (3) an interactive visual query interface for provenance-enabled research cohort identification. The Insight platform contains data from five completed epilepsy self-management research studies covering various categories of data, including depression, quality of life, seizure frequency, and socioeconomic information. The data represents over 400 participants with 7552 data points. The Insight data exploration and cohort identification query interface has been developed using Ruby on Rails Web technology and open source Web Ontology Language Application Programming Interface to support ontology-based reasoning. We have developed an efficient ontology management module that automatically updates the ontology mappings each time a new version of the Epilepsy and Seizure Ontology is released. The Insight platform features a Role-based Access Control module to authenticate and effectively manage user access to different research studies. User access to Insight is managed by the Managing Epilepsy Well Network database steering committee consisting of representatives of all current collaborating centers of the Managing Epilepsy Well Network. New research studies are being continuously added to the Insight database and the size as well as the unique coverage of the dataset allows investigators to conduct

  3. Survey of asthma management in Thailand - the asthma insight and management study.

    PubMed

    Boonsawat, Watchara; Thompson, Philip J; Zaeoui, Uraiwan; Samosorn, Chanee; Acar, Gurbet; Faruqi, Rab; Poonnoi, Piriya

    2015-03-01

    Previous Thai surveys of asthma care have shown suboptimal management and poor control. Since then several editions of the Thailand National Asthma Guidelines have been distributed to help improve asthma control. A new survey was undertaken to see if any improvement in care had occurred. It examined patients' insights, attitudes and perceptions about their asthma and its treatment. Asthma patients (>12 years) were randomly selected and participated in face-to-face interviews. Patients answered 53 questions exploring general health, diagnosis, symptoms, exacerbations, patient burden, disease management, treatment and attitudes. The Global Initiative for Asthma guidelines were used to assess asthma control. Data were obtained from 400 asthma patients from 8,177 screened households. This showed that 36% had had exacerbations in the previous year, 17% had been hospitalized and 35% had had an unscheduled emergency visit to hospital or a doctor's office or clinic. Work or school was missed by 44% due to asthma while a similar number had had an asthma episode that made them feel their life was in danger. Only 8% had good asthma control. Patients had low expectations with respect to asthma treatment and their understanding of how to use therapies was poor. Forty-four percent of participants reported day-time symptoms and about one-third (34%) of adults and adolescents in the survey reported night-time symptoms at least once a week in the previous 4 weeks. Asthma patients in Thailand rated their average productivity when asthma was at its worst at 48%, on a scale of 0 to 100%, which equates to a 36% decline in productivity. Rescue medication during the previous four weeks had been used by 44% of asthma patients while 54% had used a controller medication. Pill controller medication is the most used form among those reporting controller medication use (67%), whereas 57% reported taking an inhaler. Oral steroids had been used in the previous 12 months by 40% of patients with

  4. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Stu Spath, InSight program manager, Lockheed Martin Space, left, and Tom Hoffman, InSight project manager, NASA JPL, discuss NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  5. Perioperative leadership: managing change with insights, priorities, and tools.

    PubMed

    Taylor, David L

    2014-07-01

    The personal leadership of the perioperative director is a critical factor in the success of any change management initiative. This article presents an approach to perioperative nursing leadership that addresses obstacles that prevent surgical departments from achieving high performance in clinical and financial outcomes. This leadership approach consists of specific insights, priorities, and tools: key insights include self-understanding of personal barriers to leadership and accuracy at understanding economic and strategic considerations related to the OR environment; key priorities include creating a customer-centered organization, focusing on process improvement, and concentrating on culture change; and key tools include using techniques (e.g., direct engagement, collaborative leadership) to align surgical organizations with leadership priorities and mitigate specific perioperative management risks. Included in this article is a leadership development plan for perioperative directors. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  6. How to maximally support local and regional biodiversity in applied conservation? Insights from pond management.

    PubMed

    Lemmens, Pieter; Mergeay, Joachim; De Bie, Tom; Van Wichelen, Jeroen; De Meester, Luc; Declerck, Steven A J

    2013-01-01

    Biodiversity and nature values in anthropogenic landscapes often depend on land use practices and management. Evaluations of the association between management and biodiversity remain, however, comparatively scarce, especially in aquatic systems. Furthermore, studies also tend to focus on a limited set of organism groups at the local scale, whereas a multi-group approach at the landscape scale is to be preferred. This study aims to investigate the effect of pond management on the diversity of multiple aquatic organism groups (e.g. phytoplankton, zooplankton, several groups of macro-invertebrates, submerged and emergent macrophytes) at local and regional spatial scales. For this purpose, we performed a field study of 39 shallow man-made ponds representing five different management types. Our results indicate that fish stock management and periodic pond drainage are crucial drivers of pond biodiversity. Furthermore, this study provides insight in how the management of eutrophied ponds can contribute to aquatic biodiversity. A combination of regular draining of ponds with efforts to keep ponds free of fish seems to be highly beneficial for the biodiversity of many groups of aquatic organisms at local and regional scales. Regular draining combined with a stocking of fish at low biomass is also preferable to infrequent draining and lack of fish stock control. These insights are essential for the development of conservation programs that aim long-term maintenance of regional biodiversity in pond areas across Europe.

  7. Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

    PubMed

    Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

    2017-03-01

    The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

  8. Mining the management literature for insights into implementing evidence-based change in healthcare.

    PubMed

    Harlos, Karen; Tetroe, Jacqueline; Graham, Ian D; Bird, Madeleine; Robinson, Nicole

    2012-08-01

    We synthesized the management and health literatures for insights into implementing evidence-based change in healthcare drawn from industry-specific data. Because change principles based on evidence often fail to be translated into organizational practice or policy, we sought studies at the nexus of organizational change and knowledge translation. We reviewed five top management journals to identify an initial pool of 3,091 studies, which yielded a final sample of 100 studies. Data were abstracted, verified by the original authors and revised before entry into a database. We employed a systematic narrative synthesis approach using words and text to distill data and explain relationships. We categorized studies by varying levels of relevance for knowledge translation as (1) primary, direct; (2) intermediate; and (3) secondary, indirect. We also identified recurring categories of change-related organizational factors. The current analysis examines these factors in studies of primary relevance to knowledge translation, which we also coded for intervention readiness to reflect how readily change can be implemented. Preliminary Results centred on five change-related categories: Tailoring the Intervention Message; Institutional Links/Social Networks; Training; Quality of Work Relationships; and Fit to Organization. In particular, networks across institutional and individual levels appeared as prominent pathways for changing healthcare organizations. Power dynamics, positive social relations and team structures also played key roles in implementing change and translating it into practice. We analyzed journals in which first authors of these studies typically publish, and found evidence that management and health sciences remain divided. Bridging these disciplines through research syntheses promises a wealth of evidence and insights, well worth mining in the search for change that works in healthcare transformation. Copyright © 2012 Longwoods Publishing.

  9. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Stu Spath, InSight program manager, Lockheed Martin Space, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  10. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Tom Hoffman, InSight project manager, NASA JPL, right, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  11. Domain Visualization Using VxInsight[R] for Science and Technology Management.

    ERIC Educational Resources Information Center

    Boyack, Kevin W.; Wylie, Brian N.; Davidson, George S.

    2002-01-01

    Presents the application of a knowledge visualization tool, VxInsight[R], to enable domain analysis for science and technology management. Uses data mining from sources of bibliographic information to define subsets of relevant information and discusses citation mapping, text mapping, and journal mapping. (Author/LRW)

  12. Mining the Management Literature for Insights into Implementing Evidence-Based Change in Healthcare

    PubMed Central

    Harlos, Karen; Tetroe, Jacqueline; Graham, Ian D.; Bird, Madeleine; Robinson, Nicole

    2012-01-01

    Objective: We synthesized the management and health literatures for insights into implementing evidence-based change in healthcare drawn from industry-specific data. Because change principles based on evidence often fail to be translated into organizational practice or policy, we sought studies at the nexus of organizational change and knowledge translation. Methods: We reviewed five top management journals to identify an initial pool of 3,091 studies, which yielded a final sample of 100 studies. Data were abstracted, verified by the original authors and revised before entry into a database. We employed a systematic narrative synthesis approach using words and text to distill data and explain relationships. We categorized studies by varying levels of relevance for knowledge translation as (1) primary, direct; (2) intermediate; and (3) secondary, indirect. We also identified recurring categories of change-related organizational factors. The current analysis examines these factors in studies of primary relevance to knowledge translation, which we also coded for intervention readiness to reflect how readily change can be implemented. Preliminary Results and Conclusions: Results centred on five change-related categories: Tailoring the Intervention Message; Institutional Links/Social Networks; Training; Quality of Work Relationships; and Fit to Organization. In particular, networks across institutional and individual levels appeared as prominent pathways for changing healthcare organizations. Power dynamics, positive social relations and team structures also played key roles in implementing change and translating it into practice. We analyzed journals in which first authors of these studies typically publish, and found evidence that management and health sciences remain divided. Bridging these disciplines through research syntheses promises a wealth of evidence and insights, well worth mining in the search for change that works in healthcare transformation. PMID

  13. InSight Media Day Preparation

    NASA Image and Video Library

    2018-04-05

    NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, is in a clean room inside the Astrotech processing facility at Vandenberg Air Force Base in California. InSight is scheduled for liftoff on a United Launch Alliance Atlas V rocket May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  14. Insights into water managers' perception and handling of uncertainties - a study of the role of uncertainty in practitioners' planning and decision-making

    NASA Astrophysics Data System (ADS)

    Höllermann, Britta; Evers, Mariele

    2017-04-01

    Planning and decision-making under uncertainty is common in water management due to climate variability, simplified models, societal developments, planning restrictions just to name a few. Dealing with uncertainty can be approached from two sites, hereby affecting the process and form of communication: Either improve the knowledge base by reducing uncertainties or apply risk-based approaches to acknowledge uncertainties throughout the management process. Current understanding is that science more strongly focusses on the former approach, while policy and practice are more actively applying a risk-based approach to handle incomplete and/or ambiguous information. The focus of this study is on how water managers perceive and handle uncertainties at the knowledge/decision interface in their daily planning and decision-making routines. How they evaluate the role of uncertainties for their decisions and how they integrate this information into the decision-making process. Expert interviews and questionnaires among practitioners and scientists provided an insight into their perspectives on uncertainty handling allowing a comparison of diverse strategies between science and practice as well as between different types of practitioners. Our results confirmed the practitioners' bottom up approach from potential measures upwards instead of impact assessment downwards common in science-based approaches. This science-practice gap may hinder effective uncertainty integration and acknowledgement in final decisions. Additionally, the implementation of an adaptive and flexible management approach acknowledging uncertainties is often stalled by rigid regulations favouring a predict-and-control attitude. However, the study showed that practitioners' level of uncertainty recognition varies with respect to his or her affiliation to type of employer and business unit, hence, affecting the degree of the science-practice-gap with respect to uncertainty recognition. The level of working

  15. InSight Media Day Preparation

    NASA Image and Video Library

    2018-04-05

    NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, is in a clean room inside the Astrotech processing facility at Vandenberg Air Force Base in California. The spacecraft's protective heat shield is in view at right. InSight is scheduled for liftoff on a United Launch Alliance Atlas V rocket May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  16. InSight Media Day Preparation

    NASA Image and Video Library

    2018-04-05

    NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, at right, is in a clean room inside the Astrotech processing facility at Vandenberg Air Force Base in California. The spacecraft's protective heat shield is in view at left. InSight is scheduled for liftoff on a United Launch Alliance Atlas V rocket May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  17. InSight Media Day Preparation

    NASA Image and Video Library

    2018-04-05

    NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, is in a clean room inside the Astrotech processing facility at Vandenberg Air Force Base in California. The spacecraft's protective heat shield is in view at left. InSight is scheduled for liftoff on a United Launch Alliance Atlas V rocket May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  18. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Annick Sylvestre-Baron, SEIS deputy project manager, CNES, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  19. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Scott Messer, United Launch Alliance program manager for NASA missions, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  20. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Jason Townsend, NASA's Deputy Social Media Manager, reads questions submitted by online social media followers during a prelaunch media briefing for NASA's InSight mission, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  1. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Scott Messer, United Launch Alliance program manager for NASA missions, is seen on a monitor as he discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  2. InSight Atlas V Tower Roll

    NASA Image and Video Library

    2018-03-22

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, the gantry is rolled back on the United Launch Alliance (ULA) Atlas V to a Centaur upper stage aft stub adapter (ASA) and interstage adapter (ISA) for NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. The next step will be arrival of InSight encapsulated in its payload faring for mating atop the rocket. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  3. Case management: a case study.

    PubMed

    Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

    2000-01-01

    This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

  4. InSight Atlas V ISA-ASA Transport

    NASA Image and Video Library

    2018-03-05

    At Vandenberg Air Force Base in California, the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V rocket is prepared for transport from Building 7525 to Space Launch Complex 3. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  5. InSight Atlas V ISA-ASA Transport

    NASA Image and Video Library

    2018-03-05

    At Vandenberg Air Force Base in California, the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V arrive at Space Launch Complex 3. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  6. InSight Atlas V ISA-ASA Transport

    NASA Image and Video Library

    2018-03-05

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V are lifted by crane for mating atop a Centaur upper stage. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  7. InSight Atlas V ISA-ASA Transport

    NASA Image and Video Library

    2018-03-05

    At Vandenberg Air Force Base in California, the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V rocket are transported to Space Launch Complex 3. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  8. InSight MARCO Installation Cubesats

    NASA Image and Video Library

    2018-03-17

    At Vandenberg Air Force Base in California, twin communications-relay CubeSats, called Mars Cube One (MarCO) are installed on an Atlas V rocket. MarCO constitutes a technology demonstration being built by NASA's Jet Propulsion Laboratory, Pasadena in California. They will launch in on the same United Launch Alliance Atlas V rocket as NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. CubeSats are a class of spacecraft based on a standardized small size and modular use of off-the-shelf technologies. Many have been made by university students, and dozens have been launched into Earth orbit using extra payload mass available on launches of larger spacecraft. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  9. Insights into sleep's role for insight: Studies with the number reduction task

    PubMed Central

    Verleger, Rolf; Rose, Michael; Wagner, Ullrich; Yordanova, Juliana; Kolev, Vasil

    2013-01-01

    In recent years, vibrant research has developed on “consolidation” during sleep: To what extent are newly experienced impressions reprocessed or even restructured during sleep? We used the number reduction task (NRT) to study if and how sleep does not only reiterate new experiences but may even lead to new insights. In the NRT, covert regularities may speed responses. This implicit acquisition of regularities may become explicitly conscious at some point, leading to a qualitative change in behavior which reflects this insight. By applying the NRT at two consecutive sessions separated by an interval, we investigated the role of sleep in this interval for attaining insight at the second session. In the first study, a night of sleep was shown to triple the number of participants attaining insight above the base rate of about 20%. In the second study, this hard core of 20% discoverers differed from other participants in their task-related EEG potentials from the very beginning already. In the third study, the additional role of sleep was specified as an effect of the deep-sleep phase of slow-wave sleep on participants who had implicitly acquired the covert regularity before sleep. It was in these participants that a specific increase of EEG during slow-wave sleep in the 10-12 Hz band was obtained. These results support the view that neuronal memory reprocessing during slow-wave sleep restructures task-related representations in the brain, and that such restructuring promotes the gain of explicit knowledge. PMID:24605175

  10. Managing aging in nuclear power plants: Insights from NRC maintenance team inspection reports

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fresco, A.; Subudhi, M.; Gunther, W.

    1993-12-01

    A plant`s maintenance program is the principal vehicle through which age-related degradation is managed. From 1988 to 1991, the NRC evaluated the maintenance program of every nuclear power plant in the United States. Forty-four out of a total of 67 of the reports issued on these in-depth team inspections were reviewed for insights into the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear plant systems, structures, and components. Relevant information was extracted from these inspection reports and sorted into several categories, including Specific Aging Insights, Preventive Maintenance,more » Predictive Maintenance and Condition Monitoring, Post Maintenance Testing, Failure Trending, Root Cause Analysis and Usage of Probabilistic Risk Assessment in the Maintenance Process. Specific examples of inspection and monitoring techniques successfully used by utilities to detect degradation due to aging have been identified. The information also was sorted according to systems and components, including: Auxiliary Feedwater, Main Feedwater, High Pressure Injection for both BWRs and PWRs, Service Water, Instrument Air, and Emergency Diesel Generator Air Start Systems, and Emergency Diesel Generators Air Start Systems, emergency diesel generators, electrical components such as switchgear, breakers, relays, and motor control centers, motor operated valves and check valves. This information was compared to insights gained from the Nuclear Plant Aging Research (NPAR) Program. Attributes of plant maintenance programs where the NRC inspectors felt that improvement was needed to properly address the aging issue also are discussed.« less

  11. Integrating Landscape Ecology into Natural Resource Management - Series: Cambridge Studies in Landscape Ecology

    NASA Astrophysics Data System (ADS)

    Jianguo Liu, Edited By; Taylor, William W.

    2002-08-01

    The rapidly increasing global population has dramatically increased the demands for natural resources and has caused significant changes in quantity and quality of natural resources. To achieve sustainable resource management, it is essential to obtain insightful guidance from emerging disciplines such as landscape ecology. This text addresses the links between landscape ecology and natural resource management. These links are discussed in the context of various landscape types, a diverse set of resources and a wide range of management issues. A large number of landscape ecology concepts, principles and methods are introduced. Critical reviews of past management practices and a number of case studies are presented. This text provides many guidelines for managing natural resources from a landscape perspective and offers useful suggestions for landscape ecologists to carry out research relevant to natural resource management. In addition, it will be an ideal supplemental text for graduate and advanced undergraduate ecology courses. Written, and rigorously reviewed, by many of the world's leading landscape ecologists and natural resource managers Contains numerous case studies and insightful guidelines for landscape ecologists and natural resource managers

  12. A Case Study of Classroom Management Practices and the Influence on Classroom Disruptions

    ERIC Educational Resources Information Center

    Rusk, Robert Brian

    2016-01-01

    This qualitative case study explored how the classroom management practices of sampled teachers in a private school in central Oregon influenced classroom disruptions. Through the study, the researcher was able to provide insight on the differences in specific classroom management processes between teachers who had a high number of Positive…

  13. Testing the Efficacy of INSIGHTS on Student Disruptive Behavior, Classroom Management, and Student Competence in Inner City Primary Grades.

    PubMed

    McClowry, Sandra Graham; Snow, David L; Tamis-Lemonda, Catherine S; Rodriguez, Eileen T

    2010-03-01

    A prevention trial tested the efficacy of INSIGHTS into Children's Temperament as compared to a Read Aloud attention control condition in reducing student disruptive behavior and enhancing student competence and teacher classroom management. Participants included 116 first and second grade students, their parents, and their 42 teachers in six inner city schools. Teachers completed the Sutter-Eyberg Student Behavior Inventory (SESBI) and the Teacher's Rating Scale of Child's Actual Competence and Social Acceptance (TRS) at baseline and again upon completion of the intervention. Boys participating in INSIGHTS, compared with those in the Read Aloud program, showed a significant decline in attentional difficulties and overt aggression toward others. Teachers in INSIGHTS, compared to those in the attention control condition, reported significantly fewer problems managing the emotional-oppositional behavior, attentional difficulties, and covert disruptive behavior of their male students. They also perceived the boys as significantly more cognitively and physically competent.

  14. InSight, a Mars MIssion Artist Concept

    NASA Image and Video Library

    2012-02-28

    This artist rendition is of the Interior exploration using Seismic Investigations, Geodesy and Heat Transport InSight Lander. InSight proposes to place a single geophysical lander on Mars to study its deep interior. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA13958

  15. InSight Atlas V ISA-ASA Lift and Mate

    NASA Image and Video Library

    2018-03-05

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, technicians and engineers mate the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V to a Centaur upper stage. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  16. InSight Atlas V ISA-ASA Lift and Mate

    NASA Image and Video Library

    2018-03-05

    At Vandenberg Air Force Base in California, the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V arrives at Space Launch Complex 3. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  17. Managing 'difficult emotions' and family life: exploring insights and social support within online self-management training.

    PubMed

    Sanders, C; Rogers, A; Gardner, C; Kennedy, A

    2011-06-01

    Previous research has demonstrated how the Internet can foster emotional support and provide a 'private' space for discussing sensitive issues. Whilst the family has been located as a primary source of support, empirical research on the dynamics of close personal relationships in chronic illness experience remains a challenge. To explore the role of family relationships in supporting self-care and the nature of social support exchanged within an online self-management training course. Qualitative thematic and narrative analysis of online discussion boards. Postings for 218 participants, divided between 11 groups were included for a course section that focused on 'difficult emotions'. Participants exchanged a high degree of emotional support and revealed much about their 'real life' relationships. The latter highlighted the complexities of managing illness within family contexts alongside additional pressures of daily life such as caring commitments and work roles. The private interactive space created within the course allowed insights into the dynamics of family life associated with illness management that are challenging to research. Simultaneously, collective support was developed amongst this group of predominantly working women. The article points to the implications for such interventions and associated evaluative research beyond this selective group.

  18. Insights from agriculture for the management of insecticide resistance in disease vectors.

    PubMed

    Sternberg, Eleanore D; Thomas, Matthew B

    2018-04-01

    Key to contemporary management of diseases such as malaria, dengue, and filariasis is control of the insect vectors responsible for transmission. Insecticide-based interventions have contributed to declines in disease burdens in many areas, but this progress could be threatened by the emergence of insecticide resistance in vector populations. Insecticide resistance is likewise a major concern in agriculture, where insect pests can cause substantial yield losses. Here, we explore overlaps between understanding and managing insecticide resistance in agriculture and in public health. We have used the Global Plan for Insecticide Resistance Management in malaria vectors, developed under the auspices of the World Health Organization Global Malaria Program, as a framework for this exploration because it serves as one of the few cohesive documents for managing a global insecticide resistance crisis. Generally, this comparison highlights some fundamental differences between insect control in agriculture and in public health. Moreover, we emphasize that the success of insecticide resistance management strategies is strongly dependent on the biological specifics of each system. We suggest that the biological, operational, and regulatory differences between agriculture and public health limit the wholesale transfer of knowledge and practices from one system to the other. Nonetheless, there are some valuable insights from agriculture that could assist in advancing the existing Global Plan for Insecticide Resistance Management framework.

  19. Optimising qualitative longitudinal analysis: Insights from a study of traumatic brain injury recovery and adaptation.

    PubMed

    Fadyl, Joanna K; Channon, Alexis; Theadom, Alice; McPherson, Kathryn M

    2017-04-01

    Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature. This article reviews three challenges encountered in a large longitudinal qualitative descriptive study about experiences of recovery and adaptation after traumatic brain injury in New Zealand, and the strategies and technologies used to address them. These were (i) tracking coding and analysis decisions during an extended analysis period; (ii) navigating interpretations over time and in response to new data; and (iii) exploiting data volume and complexity. Concept mapping during coding review, a considered combination of information technologies, employing both cross-sectional and narrative analysis, and an expectation that subanalyses would be required for key topics helped us manage the study in a way that facilitated useful and novel insights. These strategies could be applied in other qualitative longitudinal studies in healthcare inquiry to optimise data analysis and stimulate important insights. © 2016 John Wiley & Sons Ltd.

  20. InSight Atlas V MARCO Cubesats Installation

    NASA Image and Video Library

    2018-03-17

    At Vandenberg Air Force Base in California, twin communications-relay CubeSats, called Mars Cube One (MarCO) are installed on an Atlas V rocket. MarCO constitutes a technology demonstration being built by NASA's Jet Propulsion Laboratory, Pasadena in California. They will launch in on the same United Launch Alliance Atlas V rocket as NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. CubeSats are a class of spacecraft based on a standardized small size and modular use of off-the-shelf technologies. Many have been made by university students, and dozens have been launched into Earth orbit using extra payload mass available on launches of larger spacecraft. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  1. Insight in schizophrenia - a double-edged sword?

    PubMed

    Vrbova, Kristyna; Prasko, Jan; Ociskova, Marie; Latalova, Klara; Holubova, Michaela; Grambal, Ales; Slepecky, Milos

    2017-12-01

    Lack of insight is defined as a loss of ability to distinguish that one's unusual and unreal experiences should be the symptoms of the psychiatric disorder requiring treatment. Lack of insight may be considered as a core symptom of schizophrenia. The concept of insight has been regarded for a long time as necessary for treatment, which improves adherence and makes a better prognosis. Increased insight in schizophrenia has been associated not only with benefits, but also bring trouble in the form of self-stigma, low self-esteem, reduced patient's hope, diminished quality of life, and increased suicidality. Therefore, insight should be managed with sensitive monitoring of the risk factors, and be gradual, carefully supported by the encouragement of hope and confidence to managing everyday life.

  2. InSight Atlas V ISA-ASA Lift and Mate

    NASA Image and Video Library

    2018-03-05

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, a technician assists as the aft stub adapter (ASA) and interstage adapter (ISA) for a United Launch Alliance (ULA) Atlas V is lifted by crane for mating atop a Centaur upper stage. The launch vehicle will send NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for launch management.

  3. A cross-sectional study of the relationships between illness insight, internalized stigma, and suicide risk in individuals with schizophrenia.

    PubMed

    Sharaf, Amira Y; Ossman, Laila H; Lachine, Ola A

    2012-12-01

    of insight on suicide risk. The present study draws attention to the robust influence of internalized stigma in increasing suicide risk and suggests clinical approaches for managing internalized stigma and suicide risk among individuals with schizophrenia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Regional Homogeneity Predicts Creative Insight: A Resting-State fMRI Study.

    PubMed

    Lin, Jiabao; Cui, Xuan; Dai, Xiaoying; Mo, Lei

    2018-01-01

    Creative insight plays an important role in our daily life. Previous studies have investigated the neural correlates of creative insight by functional magnetic resonance imaging (fMRI), however, the intrinsic resting-state brain activity associated with creative insight is still unclear. In the present study, we used regional homogeneity (ReHo) as an index in resting-state fMRI (rs-fMRI) to identify brain regions involved in individual differences in creative insight, which was compued by the response time (RT) of creative Chinese character chunk decomposition. The findings indicated that ReHo in the anterior cingulate cortex (ACC)/caudate nucleus (CN) and angular gyrus (AG)/superior temporal gyrus (STG)/inferior parietal lobe (IPL) negatively predicted creative insight. Furthermore, these findings suggested that spontaneous brain activity in multiple regions related to breaking and establishing mental sets, goal-directed solutions exploring, shifting attention, forming new associations and emotion experience contributes to creative insight. In conclusion, the present study provides new evidence to further understand the cognitive processing and neural correlates of creative insight.

  5. Educators' insights in using chronicle diabetes: a data management system for diabetes education.

    PubMed

    Wang, Jing; Siminerio, Linda M

    2013-01-01

    Diabetes educators lack data systems to monitor diabetes self-management education processes and programs. The purpose of the study is to explore diabetes educator's insights in using a diabetes education data management program: the Chronicle Diabetes system. We conducted 1 focus group with 8 diabetes educators who use the Chronicle system in western Pennsylvania. The focus group was audiotaped and transcribed verbatim. Themes were categorized according to system facilitators and barriers in using Chronicle. Educators report 4 system facilitators and 4 barrier features. System facilitators include (1) ability to extract data from Chronicle for education program recognition, (2) central location for collecting and documenting all patient and education data, (3) capability to monitor behavioral goal setting and clinical outcomes, and (4) use of a patient snapshot report that automatically summarizes behavioral goal setting and an education plan. Barriers reported are (1) initially time-consuming for data entry, (2) Health Insurance Portability and Accountability Act privacy concerns for e-mailing or downloading report, (3) need for special features (e.g., ability to attach a food diary), and (4) need to enhance existing features to standardize goal-setting process and incorporate psychosocial content. Educators favor capabilities for documenting program requirements, goal setting, and patient summaries. Barriers that need to be overcome are the amount of time needed for data entry, privacy, and special features. Diabetes educators conclude that a data management system such as Chronicle facilitates the education process and affords ease in documentation of meeting diabetes self-management education standards and recognition requirements.

  6. Right Hemispheric Dominance of Creative Insight: An Event-Related Potential Study

    ERIC Educational Resources Information Center

    Shen, Wangbing; Liu, Chang; Zhang, Xiaojiang; Zhao, Xiaojun; Zhang, Jing; Yuan, Yuan; Chen, Yalin

    2013-01-01

    The purpose of this study was to investigate the hemispheric effect of creative insight. This study used high-density ERPs to record participants' brain activity while they performed an insight task. Results showed that both insight solutions and incomprehension solutions elicited a more negative ERP deflection (N320~550) than noninsight solutions…

  7. Insight and suicidality in first-episode psychosis: understanding the influence of suicidal history on insight dimensions at first presentation.

    PubMed

    López-Moríñigo, Javier D; Wiffen, Benjamin; O'Connor, Jennifer; Dutta, Rina; Di Forti, Marta; Murray, Robin M; David, Anthony S

    2014-05-01

    Lack of insight is a cardinal feature of psychosis with crucial implications for outcome. Concerns have been raised regarding a link between insight and suicidality. This study aimed to test the relationship between suicidal behaviour preceding first-episode psychosis (FEP) and insight dimensions at treatment onset. A total of 112 FEP inpatients were recruited. Suicidal events prior to admission were recorded. Insight was assessed multidimensionally with the Schedule for the Assessment of Insight - Expanded version shortly after admission. Suicidal and non-suicidal patients were compared regarding scores on 'total insight' and three insight domains: 'awareness of mental illness', 'relabeling of psychotic experiences as abnormal' and 'compliance'. This analysis was also adjusted for a set of sociodemographic, clinical, neurocognitive and psychopathological variables. Bivariate analyses demonstrated a direct association between previous suicidality and all insight domains. However, these associations did not survive multivariable regression models, which demonstrated gender (female), shorter duration of untreated psychosis (DUP) and psychopathological symptoms - depression and disorganization - to mediate the influence of suicidal history on insight, and therefore to underlie the latter. Insight dimensions in FEP patients are influenced by having suicidal antecedents through some mediating variables such as gender, DUP and depression. Further prospective studies are needed to clarify the potential implications of these findings on the management of insight in FEP. As suicidal history is associated with greater levels of both depression and insight at first presentation, these three variables might be useful in predicting further suicidal events. © 2013 Wiley Publishing Asia Pty Ltd.

  8. The association of lifetime insight and cognition in psychosis.

    PubMed

    Sánchez-Torres, Ana M; Zarzuela, Amalia; Peralta, Victor; Cuesta, Manuel J

    2015-03-01

    Poor insight has been related to poor course in psychosis. However, the role of cognition in insight remains unclear. The aim of this study was to examine the influence of cognition and lifetime psychopathological dimensions on insight in psychosis. We followed up 42 patients with psychotic disorders over 10years. Lifetime psychopathological dimensions and cognitive performance were assessed. Patients were divided into two groups by lifetime patterns of insight and compared with 42 healthy volunteers. Lower IQ and poorer social cognition were associated with higher risks of poorer lifetime insight of feeling ill and global insight respectively. Lifetime negative symptoms were associated with a higher risk of poorer lifetime insight into symptoms. Lifetime lack of insight is independent of cognitive impairment in specific domains, except for social cognition. Higher IQ may contribute to better lifetime awareness of illness, while better ability to manage emotions is involved in lifetime global insight. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Is creative insight task-specific? A coordinate-based meta-analysis of neuroimaging studies on insightful problem solving.

    PubMed

    Shen, Wangbing; Yuan, Yuan; Liu, Chang; Zhang, Xiaojiang; Luo, Jing; Gong, Zhe

    2016-12-01

    The question of whether creative insight varies across problem types has recently come to the forefront of studies of creative cognition. In the present study, to address the nature of creative insight, the coordinate-based activation likelihood estimation (ALE) technique was utilized to individually conduct three quantitative meta-analyses of neuroimaging experiments that used the compound remote associate (CRA) task, the prototype heuristic (PH) task and the Chinese character chunk decomposition (CCD) task. These tasks were chosen because they are frequently used to uncover the neurocognitive correlates of insight. Our results demonstrated that creative insight reliably activates largely non-overlapping brain regions across task types, with the exception of some shared regions: the CRA task mainly relied on the right parahippocampal gyrus, the superior frontal gyrus and the inferior frontal gyrus; the PH task primarily depended on the right middle occipital gyrus (MOG), the bilateral superior parietal lobule/precuneus, the left inferior parietal lobule, the left lingual gyrus and the left middle frontal gyrus; and the CCD task activated a broad cerebral network consisting of most dorsolateral and medial prefrontal regions, frontoparietal regions and the right MOG. These results provide the first neural evidence of the task dependence of creative insight. The implications of these findings for resolving conflict surrounding the different theories of creative cognition and for defining insight as a set of heterogeneous processes are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Management of carbon across sectors and scales: Insights from land use decision making

    NASA Astrophysics Data System (ADS)

    Dilling, L.; Failey, E. L.

    2008-12-01

    Carbon management is increasingly becoming a topic of interest among policy circles and business entrepreneurs alike. In the United States, while no binding regulatory framework exists, carbon management is nonetheless being pursued both by voluntary actions at a variety of levels, from the individual to the national level, and through mandatory policies at state and local levels. Controlling the amount of carbon dioxide in the atmosphere for climate purposes will ultimately require a form of governance that will ensure that the actions taken and being rewarded financially are indeed effective with respect to the global atmosphere on long time scales. Moreover, this new system of governance will need to interface with existing governance structures and decision criteria that have been established to arbitrate among various societal values and priorities. These existing institutions and expressed values will need to be examined against those proposed for effective carbon governance, such as the permanence of carbon storage, the additionality of credited activities, and the prevention of leakage, or displacement of prohibited activities to another region outside the governance boundary. The latter issue suggests that interactions among scales of decision making and governance will be extremely important in determining the ultimate success of any future system of carbon governance. The goal of our study is to understand the current context of land use decision making in different sectors and examine the potential for future carbon policy to be effective given this context. This study examined land use decision making in the U.S. state of Colorado from a variety of ownership perspectives, including US Federal land managers, individual private owners, and policy makers involved in land use at a number of different scales. This paper will report on the results of interviews with land managers and provide insight into the policy context for carbon management through land

  11. InSight Aeroshell Coming Together

    NASA Image and Video Library

    2015-08-18

    The heat shield is suspended above the rest of the InSight spacecraft in this image taken July 13, 2015, in a spacecraft assembly clean room at Lockheed Martin Space Systems, Denver. The gray cone is the back shell, which together with the heat shield forms a protective aeroshell around the stowed InSight lander. The photo was taken during preparation for vibration testing of the spacecraft. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19814

  12. Turning the InSight Lander Science Deck

    NASA Image and Video Library

    2015-05-27

    The science deck of NASA's InSight lander is being turned over in this April 29, 2015, photo from InSight assembly and testing operations inside a clean room at Lockheed Martin Space Systems, Denver. The large circular component on the deck is the protective covering to be placed over InSight's seismometer after the seismometer is placed directly onto the Martian ground. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19670

  13. Recent insights in the therapeutic management of patients with gastric cancer.

    PubMed

    de Mestier, Louis; Lardière-Deguelte, Sophie; Volet, Julien; Kianmanesh, Reza; Bouché, Olivier

    2016-09-01

    Gastric cancer remains frequent and one of the most lethal malignancies worldwide. In this article, we aimed to comprehensively review recent insights in the therapeutic management of gastric cancer, with focus on the surgical and perioperative management of resectable forms, and the latest advances regarding advanced diseases. Surgical improvements comprise the use of laparoscopic surgery including staging laparoscopy, a better definition of nodal dissection, and the development of hyperthermic intraperitoneal chemotherapy. The best individualized perioperative management should be assessed before curative-intent surgery for all patients and can consists in perioperative chemotherapy, adjuvant chemo-radiation therapy or adjuvant chemotherapy alone. The optimal timing and sequence of chemotherapy and radiation therapy with respect to surgery should be further explored. Patients with advanced gastric cancer have a poor prognosis. Nevertheless, they can benefit from doublet or triplet chemotherapy combination, including trastuzumab in HER2-positive patients. Upon progression, second-line therapy can be considered in patients with good performance status. Although anti-HER2 (trastuzumab) and anti-VEGFR (ramucirumab) may yield survival benefit, anti-EGFR and anti-HGFR therapies have failed to improve outcomes. Nevertheless, combination regimens containing cytotoxic drugs and targeted therapies should be further evaluated; keeping in mind that gastric cancer biology is different between Asia and the Western countries. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. The Science Manager's Guide to Case Studies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.

    2001-09-24

    This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

  15. USDA Climate Hubs - delivering usable information and tools to farmers, ranchers and forest land managers - Communication insights from the Regions

    NASA Astrophysics Data System (ADS)

    Johnson, R.; Steele, R.

    2016-12-01

    The USDA Climate Hubs were established in 2014 to develop and deliver science-based, region-specific information and technologies, with USDA agencies and partners, to agricultural and natural resource managers to enable climate-informed decision-making. In the two and half years of existence, our regional leads have gained insights into communicating with the agricultural and forestry communities throughout the different regions of the country. Perspectives differ somewhat among regions and sectors. This talk will share those various insights.

  16. Insights of health district managers on the implementation of primary health care outreach teams in Johannesburg, South Africa: a descriptive study with focus group discussions.

    PubMed

    Moosa, Shabir; Derese, Anselme; Peersman, Wim

    2017-01-21

    Primary health care (PHC) outreach teams are part of a policy of PHC re-engineering in South Africa. It attempts to move the deployment of community health workers (CHWs) from vertical programmes into an integrated generalised team-based approach to care for defined populations in municipal wards. There has little evaluation of PHC outreach teams. Managers' insights are anecdotal. This is descriptive qualitative study with focus group discussions with health district managers of Johannesburg, the largest city in South Africa. This was conducted in a sequence of three meetings with questions around implementation, human resources, and integrated PHC teamwork. There was a thematic content analysis of validated transcripts using the framework method. There were two major themes: leadership-management challenges and human resource challenges. Whilst there was some positive sentiment, leadership-management challenges loomed large: poor leadership and planning with an under-resourced centralised approach, poor communications both within the service and with community, concerns with its impact on current services and resistance to change, and poor integration, both with other streams of PHC re-engineering and current district programmes. Discussion by managers on human resources was mostly on the plight of CHWs and calls for formalisation of CHWs functioning and training and nurse challenges with inappropriate planning and deployment of the team structure, with brief mention of the extended team. Whilst there is positive sentiment towards intent of the PHC outreach team, programme managers in Johannesburg were critical of management of the programme in their health district. Whilst the objective of PHC reform is people-centred health care, its implementation struggles with a centralising tendency amongst managers in the health service in South Africa. Managers in Johannesburg advocated for decentralisation. The implementation of PHC outreach teams is also limited by

  17. Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care.

    PubMed

    Luckett, Tim; Davidson, Patricia M; Green, Anna; Boyle, Frances; Stubbs, John; Lovell, Melanie

    2013-08-01

    Cancer pain is a common, burdensome problem, which is not well managed despite evidence-based guidelines. To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care. We undertook a systematic review and synthesis of qualitative studies. Medline, PsycINFO, Embase, AMED, CINAHL, and Sociological Abstracts were searched from May 20 to 26, 2011. To be included, the articles had to be published in a peer-reviewed journal since 2000; written in English; and report original qualitative studies on the perspectives of patients, their significant others, or health care providers. Article quality was rated using the checklist of Kitto et al. Thematic synthesis followed a three-stage approach using Evidence for Policy and Practice Information and Co-ordinating Centre-Reviewer 4 software: 1) free line-by-line coding of "Results," 2) organization into "descriptive" themes, and 3) development of "analytical" themes informative to our objective. At Stage 3, a conceptual framework was selected from the peer-reviewed literature according to prima facie "fit" for descriptive themes. Of 659 articles screened, 70 met the criteria, reporting 65 studies with 48 patient, 19 caregiver, and 21 health care provider samples. Authors rarely reported reflexivity or negative cases. Mead and Bower's model of patient-centered care accommodated 85% of the descriptive themes; 12% more related to the caregiver and service/system factors. Three themes could not be accommodated. Findings highlight the need to integrate patient/family education within improved communication, individualize care, use more nonpharmacological strategies, empower patients/families to self-manage pain, and reorganize multidisciplinary roles around patient-centered care and outcomes. These conclusions require validation via consensus and intervention trials. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published

  18. InSight Atlas V MARCO Cubesats Installation

    NASA Image and Video Library

    2018-03-17

    At Vandenberg Air Force Base in California, twin communications-relay CubeSats, called Mars Cube One (MarCO) are prepared for installation on an Atlas V rocket. MarCO constitutes a technology demonstration being built by NASA's Jet Propulsion Laboratory, Pasadena in California. They will launch in on the same United Launch Alliance Atlas V rocket as NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft to land on Mars. CubeSats are a class of spacecraft based on a standardized small size and modular use of off-the-shelf technologies. Many have been made by university students, and dozens have been launched into Earth orbit using extra payload mass available on launches of larger spacecraft. InSight is the first mission to explore the Red Planet's deep interior. InSight is scheduled for liftoff May 5, 2018. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. NASA’s Jet Propulsion Laboratory in Pasadena, California, manages the InSight mission for the agency’s Science Mission Directorate. InSight is part of NASA's Discovery Program, managed by its Marshall Space Flight Center in Huntsville, Alabama. The spacecraft, including cruise stage and lander, was built and tested by Lockheed Martin Space in Denver. Several European partners, including France's space agency, the Centre National d'Étude Spatiales, and the German Aerospace Center, are supporting the mission. United Launch Alliance of Centennial, Colorado, is providing the Atlas V launch service. NASA’s Launch Services Program, based at its Kennedy Space Center in Florida, is responsible for

  19. Solar-Array Deployment Test for InSight

    NASA Image and Video Library

    2015-05-27

    Engineers and technicians at Lockheed Martin Space Systems, Denver, run a test of deploying the solar arrays on NASA's InSight lander in this April 30, 2015 image. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19665

  20. Testing the Efficacy of "INSIGHTS" on Student Disruptive Behavior, Classroom Management, and Student Competence in Inner City Primary Grades

    ERIC Educational Resources Information Center

    McClowry, Sandra Graham; Snow, David L.; Tamis-LeMonda, Catherine S.; Rodriguez, Eileen T.

    2010-01-01

    A prevention trial tested the efficacy of "INSIGHTS into Children's Temperament" as compared to a Read Aloud attention control condition in reducing student disruptive behavior and enhancing student competence and teacher classroom management. Participants included 116 first and second grade students, their parents, and their 42 teachers…

  1. A Study of Personal Information Management Strategies for Online Faculty

    ERIC Educational Resources Information Center

    Kearns, Lorna R.; Frey, Barbara A.; Tomer, Christinger; Alman, Susan

    2014-01-01

    The literature suggests that personal information management is a serious challenge for many computer users. Online faculty are especially challenged because of the large number of electronic files necessitated by teaching online. Those who have experience in this environment may offer valuable insights regarding information management challenges…

  2. Cognitive insight in schizophrenia patients and their biological parents: a pilot study.

    PubMed

    Raffard, Stéphane; Bortolon, Catherine; Macgregor, Alexandra; Norton, Joanna; Boulenger, Jean-Philippe; El Haj, Mohamad; Capdevielle, Delphine

    2014-11-01

    Clinical insight in schizophrenia patients is partly associated with familial environment but has been poorly studied to date. We aimed to explore (1) the relationship between parents' cognitive insight and their offspring's; (2) the relationship between parents' cognitive insight and their clinical insight into the disease of their offspring; and (3) the clinical and cognitive determinants of cognitive insight in parents. Cognitive insight was assessed in 37 patient-biological parent pairs/dyads with the Beck Cognitive Insight Scale (BCIS). Other measures included the Scale to assess Unawareness of Mental Disorder and cognitive assessments. We found no significant association between parents' cognitive insight and their offspring's. Conversely, a positive association between parents' cognitive insight and parents' insight into their offspring's symptoms was found. Better awareness of their offspring's specific symptoms was associated with lower levels of overconfidence in one's beliefs and with BCIS total score. BCIS Self-Certainty and BCIS total score were associated with better executive functioning and verbal comprehension. Better insight into their offspring's symptoms is associated with cognitive insight in biological parents of schizophrenia patients. Our results support the integration of cognitive intervention targeting parents' cognitive flexibility in family psychoeducational programs and provide an important first step towards developing a more refined understanding of the factors involved in insight into symptoms of illness in parents of schizophrenia patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Improving participant selection in disease management programmes: insights gained from propensity score stratification.

    PubMed

    Linden, Ariel; Adams, John L

    2008-10-01

    While the randomized controlled trial (RCT) remains the gold-standard study design for evaluating treatment effect, outcomes researchers turn to powerful quasi-experimental designs when only observational studies can be conducted. Within these designs, propensity score matching is one of the most popular to evaluate disease management (DM) programme effectiveness. Given that DM programmes generally have a much smaller number of participants than non-participants in the population, propensity score matching will typically result in all or nearly all participants finding successful matches, while most of the non-participants in the population remain unmatched and thereby excluded from the analysis. By excluding data from the unmatched population, the effect of non-treatment in the remaining population with the disease is not captured. In the present study, we examine changes in hospitalization rates stratified by propensity score quintiles across the entire population allowing us to gain insight as to how well the programme chose its participants, or if the programme could have been effective on those individuals not explicitly targeted for the intervention. These data indicate the presence of regression to the mean, and suggest that the DM programme may be overly limited to only the highest strata when there is evidence of a potential benefit for those in all the lower strata as well.

  4. Artist Rendition of InSight

    NASA Image and Video Library

    2012-08-20

    Artist rendition of the InSight (Interior exploration using Seismic Investigations, Geodesy and Heat Transport) Lander. InSight is based on the proven Phoenix Mars spacecraft and lander design with state-of-the-art avionics from the Mars Reconnaissance Orbiter and Gravity Recovery and Interior Laboratory missions. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA16079

  5. Suitability of customer relationship management systems for the management of study participants in biomedical research.

    PubMed

    Schwanke, J; Rienhoff, O; Schulze, T G; Nussbeck, S Y

    2013-01-01

    Longitudinal biomedical research projects study patients or participants over a course of time. No IT solution is known that can manage study participants, enhance quality of data, support re-contacting of participants, plan study visits, and keep track of informed consent procedures and recruitments that may be subject to change over time. In business settings management of personal is one of the major aspects of customer relationship management systems (CRMS). To evaluate whether CRMS are suitable IT solutions for study participant management in biomedical research. Three boards of experts in the field of biomedical research were consulted to get an insight into recent IT developments regarding study participant management systems (SPMS). Subsequently, a requirements analysis was performed with stakeholders of a major biomedical research project. The successive suitability evaluation was based on the comparison of the identified requirements with the features of six CRMS. Independently of each other, the interviewed expert boards confirmed that there is no generic IT solution for the management of participants. Sixty-four requirements were identified and prioritized in a requirements analysis. The best CRMS was able to fulfill forty-two of these requirements. The non-fulfilled requirements demand an adaption of the CRMS, consuming time and resources, reducing the update compatibility, the system's suitability, and the security of the CRMS. A specific solution for the SPMS is favored instead of a generic and commercially-oriented CRMS. Therefore, the development of a small and specific SPMS solution was commenced and is currently on the way to completion.

  6. Management of change for nurses: lessons from the discipline of organizational studies.

    PubMed

    Shanley, Chris

    2007-07-01

    This paper explores the literature on change management from the discipline of organizational studies to provide insights that nurse managers can use in their professional practice. The paper will benefit nurse managers by extending the nursing discourse on change management to include wider theoretical and academic perspectives. Important aspects of change management explored are the roles of power and political behaviour, how much change can be planned and controlled, how to combine top-down and bottom-up approaches to change, the role of emotions in the change management process, a comparison of prescriptive and analytical approaches to understanding change, and the connection between theory and practice in managing change. While nurses can draw much useful information from within the nursing discipline, they can also benefit by exploring other disciplinary areas. In the case of change management, there are many useful lessons nurses can carry over into their professional practice.

  7. InSight Lander in Mars-Surface Configuration

    NASA Image and Video Library

    2015-05-27

    The solar arrays on NASA's InSight lander are deployed in this test inside a clean room at Lockheed Martin Space Systems, Denver. This configuration is how the spacecraft will look on the surface of Mars. The image was taken on April 30, 2015. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19664

  8. Aspects and Intensity of Pediatric Palliative Case Management Provided by a Hospital-Based Case Management Team: A Comparative Study Between Children With Malignant and Nonmalignant Disease

    PubMed Central

    Colenbrander, Derk A.; Bosman, Diederik K.; Grootenhuis, Martha A.; Kars, Marijke C.; Schouten-van Meeteren, Antoinette YN

    2017-01-01

    Objectives: Anticipating case management is considered crucial in pediatric palliative care. In 2012, our children’s university hospital initiated a specialized pediatric palliative care team (PPCT) to deliver inbound and outbound case management for children with life-shortening disease. The aim of this report is to gain insight in the first 9 months of this PPCT. Methods: Aspects of care during the first 9 months of the PPCT are presented, and comparison is made between patients with malignant disease (MD) and nonmalignant disease (NMD) in a retrospective study design. Insight in the aspects of care of all patients with a life-shortening disease was retrieved from web-based files and the hour registrations from the PPCT. Results: Forty-three children were supported by the PPCT during the first 9 months: 22 with MD with a median of 50 (1-267) days and 29 minutes (4-615) of case management per patient per day and 21 patients with NMD with a median of 79.5 (5-211) days and 16 minutes of case management per day (6-64). Our data show significantly more interprofessional contacts for patients with MD and more in-hospital contacts for patients with NMD. The median number of admission days per patient was 11 (0-22) for MD (44% for anticancer therapy) and 44 (0-303) for NMD (36% for infectious diseases). Significance of Results: This overview of aspects of pediatric palliative case management shows shorter but more intensive case management for MD in comparison with NMD. This insight in palliative case management guides the design of a PPCT. PMID:28273758

  9. Exploring the link between clinical managers involvement in budgeting and performance: Insights from the Italian public health care sector.

    PubMed

    Macinati, Manuela S; Rizzo, Marco G

    2016-01-01

    The public health care sector has had an increase in initiatives, mostly inspired by New Public Management principles, aimed at assigning financial accountability to clinical managers. However, clinical managers might experience a scarce alignment between professional values and organizational requirements, which is a potentially important phenomena that may result in negative consequences on clinical managers' job performance. Building on Psychological Ownership Theory and adopting a psychology-based management accounting research approach, we focus on the managerial (nonmedical) role the clinical manager fulfills and explore the budgetary participation-performance link via the indirect effects of job-based psychological ownership, role clarity, and clinical managers' affective commitment toward managerial roles. The data were collected by a survey conducted in an Italian hospital. The research hypotheses were tested employing a path model. Our study revealed new insights that shed some light on underexplored processes through which mental states mediate the participation-performance link. Among these latter, the findings demonstrate that (a) budgetary participation has a direct effect on job-based psychological ownership; (b) role clarity mediates participation- and job-based psychological ownership link; (c) role clarity and job-based psychological ownership partially mediate the participation-commitment link; and (d) job-based psychological ownership, role clarity, and commitment fully mediate the participation-performance link. From a managerial viewpoint, an understanding of how clinical managers' feelings of ownership toward managerial roles could be enhanced is imperative in health care because ownership accounts for important attitudinal and organizational consequences. Results suggest that health care organizations that invest in budgetary participation will directly and indirectly affect clinical managers' psychological ownership, and this, along with

  10. The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.

    PubMed

    Heckemann, Birgit; Breimaier, Helga Elisabeth; Halfens, Ruud J G; Schols, Jos M G A; Hahn, Sabine

    2016-09-01

    Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits. To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training. This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively. The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent. Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams. Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively

  11. Insight and suicidality in psychosis: A cross-sectional study.

    PubMed

    Massons, Carmen; Lopez-Morinigo, Javier-David; Pousa, Esther; Ruiz, Ada; Ochoa, Susana; Usall, Judith; Nieto, Lourdes; Cobo, Jesus; David, Anthony S; Dutta, Rina

    2017-06-01

    We aimed to test whether specific insight dimensions are associated with suicidality in patients with psychotic disorders. 143 patients with schizophrenia spectrum disorders were recruited. Suicidality was assessed by item 8 of the Calgary Depression Scale for Schizophrenia (CDSS). Insight was measured by the Scale of Unawareness of Mental Disorder (SUMD) and the Markova and Berrios Insight Scale. Bivariate analyses and multivariable logistic regression models were conducted. Those subjects aware of having a mental illness and its social consequences had higher scores on suicidality than those with poor insight. Awareness of the need for treatment was not linked with suicidality. The Markova and Berrios Insight scale total score and two specific domains (awareness of "disturbed thinking and loss of control over the situation" and "having a vague feeling that something is wrong") were related to suicidality. However, no insight dimensions survived the multivariable regression model, which found depression and previous suicidal behaviour to predict suicidality. Suicidality in psychosis was linked with some insight dimensions: awareness of mental illness and awareness of social consequences, but not compliance. Depression and previous suicidal behaviour mediated the associations with insight; thus, predicting suicidality. Copyright © 2017. Published by Elsevier B.V.

  12. Insight and Figurative Language in Psychotherapy: Two Fragments of a Case Study.

    ERIC Educational Resources Information Center

    Barlow, Jack M.; And Others

    This study discusses the role figurative language can play in promoting insight in a patient undergoing psychotherapy. The first part of the study reviews some of the research into the nature of creative insight; the next section discusses some of the research relating to the value of metaphor in the treatment of schizophrenic patients. The major…

  13. InSight Lander in Assembly

    NASA Image and Video Library

    2015-05-27

    The Mars lander that NASA's InSight mission will use for investigating how rocky planets formed and evolved is being assembled by Lockheed Martin Space Systems, Denver. In this scene from January 2015, Lockheed Martin spacecraft specialists are working on the lander in a clean room. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19402

  14. Getting the Joke: Insight during Humor Comprehension - Evidence from an fMRI Study.

    PubMed

    Tian, Fang; Hou, Yuling; Zhu, Wenfeng; Dietrich, Arne; Zhang, Qinglin; Yang, Wenjing; Chen, Qunlin; Sun, Jiangzhou; Jiang, Qiu; Cao, Guikang

    2017-01-01

    As a high-level cognitive activity, humor comprehension requires incongruity detection and incongruity resolution, which then elicits an insight moment. The purpose of the study was to explore the neural basis of humor comprehension, particularly the moment of insight, by using both characters and language-free cartoons in a functional magnetic resonance imaging study. The results showed that insight involving jokes elicited greater activation in language and semantic-related brain regions as well as a variety of additional regions, such as the superior frontal gyrus (SFG), the inferior frontal gyrus (IFG), the middle temporal gyrus (MTG), the superior temporal gyrus (STG), the temporoparietal junctions (TPJ), the hippocampus and visual areas. These findings indicate that the MTG might play a role in incongruity detection, while the SFG, IFG and the TPJ might be involved in incongruity detection. The passive insight event elicited by jokes appears to be mediated by a limited number of brain areas. Our study showed that the brain regions associated with humor comprehension were not affected by the type of stimuli and that humor and insight shared common brain areas. These results indicate that one experiences a feeling of insight during humor comprehension, which contributes to the understanding of humor comprehension.

  15. A cross-sectional study of insight and family accommodation in pediatric obsessive-compulsive disorder

    PubMed Central

    2013-01-01

    Background Factors predicting treatment outcome in pediatric patients with obsessive-compulsive disorder (OCD) include disease severity, functional impairment, comorbid disorders, insight, and family accommodation (FA). Treatment of pediatric OCD is often only partly successful as some of these predictors are not targeted with conventional therapy. Among these, insight and FA were identified to be modifiable predictors of special relevance to pediatric OCD. Despite their clinical relevance, insight and FA remain understudied in youth with OCD. This study examined the clinical correlates of insight and FA and determined whether FA mediates the relationship between symptom severity and functional impairment in pediatric OCD. Methods This was a cross-sectional, outpatient study. Thirty-five treatment-naive children and adolescentswith DSM-IV diagnosis of OCD (mean age: 13.11 ± 3.16; 54.3% males) were included. Standard questionnaires were administered for assessing the study variables. Insight and comorbidities were assessed based on clinician’s interview. Subjects were categorized as belonging to a high insight or a low insight group, and the differences between these two groups were analyzed using ANOVA. Pearson’s correlation coefficients were calculated for the remaining variables of interest. Mediation analysis was carried out using structural equation modeling. Results Relative to those in the high insight group, subjects in the low insight group were younger, had more severe disease and symptoms, and were accommodated to a greater extent by their families. In addition, comorbid depression was more frequent in subjects belonging to the low insight group. Family accommodation was positively related to disease severity, symptom severity, and functional impairment. Family accommodation totally mediated the relationship between symptom severity and functional impairment. Conclusions Results support the differences in the diagnostic criteria between adult and

  16. Shipping InSight Mars Spacecraft to California for Launch

    NASA Image and Video Library

    2015-12-17

    Personnel supporting NASA's InSight mission to Mars load the crated InSight spacecraft into a C-17 cargo aircraft at Buckley Air Force Base, Denver, for shipment to Vandenberg Air Force Base, California. The spacecraft, built in Colorado by Lockheed Martin Space Systems, was shipped Dec. 16, 2015, in preparation for launch from Vandenberg in March 2016. InSight, for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is the first mission dedicated to studying the deep interior of Mars. Its findings will advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA20278

  17. Managing Organizational Commitment: Insights from Longitudinal Research

    ERIC Educational Resources Information Center

    Morrow, Paula C.

    2011-01-01

    This article summarizes what is known about the "active" management of affective organizational commitment (AOC) through a review of 58 studies employing longitudinal research designs. The review yields six broad categories of antecedents that have empirically demonstrated effects on AOC: socialization practices, organizational changes, human…

  18. Sustainable management for rangelands in a variable climate: evidence and insights from northern Australia.

    PubMed

    O'Reagain, P J; Scanlan, J C

    2013-03-01

    Inter-annual rainfall variability is a major challenge to sustainable and productive grazing management on rangelands. In Australia, rainfall variability is particularly pronounced and failure to manage appropriately leads to major economic loss and environmental degradation. Recommended strategies to manage sustainably include stocking at long-term carrying capacity (LTCC) or varying stock numbers with forage availability. These strategies are conceptually simple but difficult to implement, given the scale and spatial heterogeneity of grazing properties and the uncertainty of the climate. This paper presents learnings and insights from northern Australia gained from research and modelling on managing for rainfall variability. A method to objectively estimate LTCC in large, heterogeneous paddocks is discussed, and guidelines and tools to tactically adjust stocking rates are presented. The possible use of seasonal climate forecasts (SCF) in management is also considered. Results from a 13-year grazing trial in Queensland show that constant stocking at LTCC was far more profitable and largely maintained land condition compared with heavy stocking (HSR). Variable stocking (VAR) with or without the use of SCF was marginally more profitable, but income variability was greater and land condition poorer than constant stocking at LTCC. Two commercial scale trials in the Northern Territory with breeder cows highlighted the practical difficulties of variable stocking and provided evidence that heavier pasture utilisation rates depress reproductive performance. Simulation modelling across a range of regions in northern Australia also showed a decline in resource condition and profitability under heavy stocking rates. Modelling further suggested that the relative value of variable v. constant stocking depends on stocking rate and land condition. Importantly, variable stocking may possibly allow slightly higher stocking rates without pasture degradation. Enterprise

  19. Using economic instruments to develop effective management of invasive species: insights from a bioeconomic model.

    PubMed

    McDermott, Shana M; Irwin, Rebecca E; Taylor, Brad W

    2013-07-01

    critical. To accomplish the management and enforcement of these economic policies, we discuss modification of existing agencies and infrastructure. Finally, a sensitivity analysis revealed that lowering the economic cost of invader removal would strongly increase the probability of invader eradication. Taken together, our results provide quantitative insight into management decisions and economic policy instruments that can encourage invasive species removal across a social landscape.

  20. Good practices in health care "management experimentation models": insights from an international public-private partnership on transplantation and advanced specialized therapies.

    PubMed

    Longo, Maria Cristina

    2015-01-01

    The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations. In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC - Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable. The recognition of ISMETT's good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

  1. Integration of near-surface remote sensing and eddy covariance measurements: new insights on managed ecosystem structure and functioning

    NASA Astrophysics Data System (ADS)

    Hatala, J.; Sonnentag, O.; Detto, M.; Runkle, B.; Vargas, R.; Kelly, M.; Baldocchi, D. D.

    2009-12-01

    Ground-based, visible light imagery has been used for different purposes in agricultural and ecological research. A series of recent studies explored the utilization of networked digital cameras to continuously monitor vegetation by taking oblique canopy images at fixed view angles and time intervals. In our contribution we combine high temporal resolution digital camera imagery, eddy-covariance, and meteorological measurements with weekly field-based hyperspectral and LAI measurements to gain new insights on temporal changes in canopy structure and functioning of two managed ecosystems in California’s Sacramento-San Joaquin River Delta: a pasture infested by the invasive perennial pepperweed (Lepidium latifolium) and a rice plantation (Oryza sativa). Specific questions we address are: a) how does year-round grazing affect pepperweed canopy development, b) is it possible to identify phenological key events of managed ecosystems (pepperweed: flowering; rice: heading) from the limited spectral information of digital camera imagery, c) is a simple greenness index derived from digital camera imagery sufficient to track leaf area index and canopy development of managed ecosystems, and d) what are the scales of temporal correlation between digital camera signals and carbon and water fluxes of managed ecosystems? Preliminary results for the pasture-pepperweed ecosystem show that year-round grazing inhibits the accumulation of dead stalks causing earlier green-up and that digital camera imagery is well suited to capture the onset of flowering and the associated decrease in photosynthetic CO2 uptake. Results from our analyses are of great relevance from both a global environmental change and land management perspective.

  2. The metabolic basis of cognitive insight in psychosis: A positron emission tomography study

    PubMed Central

    Paoli, Riccardo A.; Cigliobianco, Michela; Prunas, Cecilia; Zugno, Elisa; Bottinelli, Francesca; Brambilla, Paolo; Altamura, A. Carlo

    2017-01-01

    The purpose of this study was to investigate the relationship between cognitive insight and cerebral metabolism in patients suffering from psychosis. The Beck Cognitive Insight Scale (BCIS) was administered to 63 patients with psychosis undergoing Positron Emission Tomography investigation. The sample was divided into two groups considering the BCIS score. Data were analyzed using Statistical Parametric Mapping. Results: patients with low insight, compared to those with high insight, showed decreased metabolism in the right fusiform gyrus, left precuneus, superior temporal gyrus and insula bilaterally, as well as increased metabolism in the left orbito-frontal gyrus (all p<0.005). Our results suggest that reduced posterior (occipito-temporo-insulo-parietal) and increased anterior (orbitofrontal) cerebral metabolism may sustain low cognitive insight in psychosis. PMID:28414766

  3. Insight in first-episode psychosis.

    PubMed

    McEvoy, Joseph P; Johnson, Jackie; Perkins, Diana; Lieberman, Jeffrey A; Hamer, Robert M; Keefe, Richard S E; Tohen, Mauricio; Glick, Ira D; Sharma, Tonmoy

    2006-10-01

    We report here a study examining the relationships between insight and psychopathology, cognitive performance, brain volume and co-morbid depression in 251 patients experiencing a first episode of psychosis, who were then randomly assigned to 2 years of double-blind treatment with either olanzapine or haloperidol. Repeated measures of insight were obtained at baseline and 12, 24, 52 and 104 weeks by the Insight and Treatment Attitudes Questionnaire (ITAQ). Older age, female gender and white ethnicity were associated with more insight. Higher total, positive, negative and general psychopathology scores on the Positive and Negative Syndromes Scale (PANSS) were associated with less insight. Higher depression scores were associated with more insight. Better neurocognitive function and large brain volumes were associated with more insight. More insight throughout the study was associated with longer time to medication non-adherence. However, baseline insight was not significantly related to the probability of discontinuing the study before 2 years. Insight improved significantly over the course of the study, but the improvement in insight was not significantly different between the two antipsychotic treatment groups. Multiple factors contribute to insight. Patients experiencing a first episode of psychosis who have little insight are at increased risk of discontinuing their medication.

  4. Essential activities and knowledge domains of case management: new insights from the CCMC role and functions study.

    PubMed

    Tahan, Hussein

    2006-01-01

    The Commission for Case Manager Certification (CCMC) defines case management (CM) as "a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs. [Case management] uses communication and available resources to promote quality, cost-effective outcomes." The practice of CM spans the entire health-care spectrum, including pre-acute, acute, and post-acute settings, and the involvement of varied care providers, such as nurses, social workers, rehabilitation counselors, physicians, and other allied health professionals. So what does it mean to practice as a case manager? What roles and job functions are performed and what knowledge is required of a professional in the field for effective practice? These highly relevant questions reflect the thinking of the CCMC commissioners when the latest Case Manager Role and Functions study was undertaken. The primary purpose of this research, which is conducted every 5 years by the CCMC, is to capture the current state of CM practice. This type of in-depth research is required to support an evidence-based certification examination such as the one offered by CCMC-the certified case manager (CCM) credential. Moreover, as the first and largest nationally accredited organization to certify US case managers, the CCMC recognizes its responsibility to undertake and promote scientifically conducted research in the field of CM.

  5. Competition between Public Supervision and Professional Management: An Ethnographic Study of School Governance Reforms in Switzerland

    ERIC Educational Resources Information Center

    Hangartner, Judith; Svaton, Carla Jana

    2014-01-01

    This article discusses insights from an ethnographic study of local governance practices in the Canton of Bern, Switzerland, under changing policy conditions. Recent reforms introduced and strengthened the position of head teachers, enhanced the responsibility of the municipalities and introduced new quality management procedures in local…

  6. Human taeniasis: current insights into prevention and management strategies in endemic countries

    PubMed Central

    Okello, Anna L; Thomas, Lian Francesca

    2017-01-01

    Human taeniasis is a zoonotic condition resulting from infection with the adult stages of Taenia saginata (“beef tapeworm”), Taenia solium (“pork tapeworm”) or Taenia asiatica (“Asian tapeworm”). Although these parasites have a worldwide distribution, the overwhelming burden is felt by communities in low- and middle-income countries. This is particularly true for T. solium, whereby infection of the central nervous system with the larval stage of the parasite (neurocysticercosis) is a major cause of acquired epilepsy in low-resource settings. With a focus on endemic countries, this review provides an insight into the prevention and management of human taeniasis, concluding with some recent case studies describing their implementation. Discussion of the opportunities and challenges regarding current fecal and serological diagnostic assays for detecting Taenia spp. highlights the importance of accurate and accessible diagnostic options for the field situation. The lack of long-term impact on the parasites’ lifecycle from human anthelmintic treatment, coupled with the propensity for adverse reactions, highlights the importance of a “two-pronged” approach that considers the relevant animal hosts, particularly in the case of T. solium. Aside from the therapeutic options, this review reiterates the importance of adequate assessment and consideration of the associated behavioral and policy aspects around sanitation, hygiene and meat inspection that have been shown to support parasite control, and potential elimination, in endemic regions. PMID:28615981

  7. A study of poor insight in social anxiety disorder.

    PubMed

    Vigne, Paula; de Menezes, Gabriela B; Harrison, Ben J; Fontenelle, Leonardo F

    2014-11-30

    We investigated levels of insight among patients with Social Anxiety Disorder (SAD) as compared to patients with Obsessive-Compulsive Disorder (OCD) and evaluated whether levels of insight in SAD were related to specific sociodemographic and/or clinical features. Thirty-seven SAD patients and 51 OCD patients attending a tertiary obsessive-compulsive and anxiety disorders clinic were assessed with a sociodemographic and clinical questionnaire, a structured diagnostic interview, the Brown Assessment of Beliefs Scale (BABS), the Social Phobia Inventory (SPIN), the Beck Depression Inventory (BDI), the Sheehan Disability Scale (SDS), and the Treatment Adherence Survey-patient version (TAS-P). According to the BABS, SAD patients exhibited insight levels that were as low as those exhibited by OCD patients, with up to 29.7% of them being described as "poor insight" SAD. Although poor insight SAD patients were more frequently married, less depressed and displayed a statistical trend towards greater rates of early drop-out from cognitive-behavioral therapy, their insight levels were not associated with other variables of interest, including sex, age, employment, age at onset, duration of illness, associated psychiatric disorders, SPIN and SDS scores. Patients with poor insight SAD might perceive their symptoms as being less distressful and thus report fewer depressive symptoms and high rates of treatment non-adherence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Kohler's Insight Revisited.

    ERIC Educational Resources Information Center

    Windholtz, George

    1985-01-01

    Psychology textbooks frequently present Wolfgang Kohler's two-stick experiment with chimpanzees as having demonstrated insight in learning. Studies that replicated Kohler's work support his findings but not his interpretation in terms of insightful solution. The uncritical inclusion of Kohler's insight interpretation in texts is not warranted in…

  9. Humanistic Insights into Managing Diversity: The Humanities/Management Partnership.

    ERIC Educational Resources Information Center

    Yahr, Michael A.

    Global managers of the l990s and beyond must have definitive impacts on their work environments. Among the skills they need to possess are the abilities to adapt to new and fast-changing situations and to interact with people who view the business world from varied perspectives. A humanities/management partnership offers a viable and effective…

  10. NASA InSight Lander in Spacecraft Back Shell

    NASA Image and Video Library

    2015-08-18

    In this photo, NASA's InSight Mars lander is stowed inside the inverted back shell of the spacecraft's protective aeroshell. It was taken on July 13, 2015, in a clean room of spacecraft assembly and test facilities at Lockheed Martin Space Systems, Denver, during preparation for vibration testing of the spacecraft. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19813

  11. Preparing NASA InSight Spacecraft for Vibration Test

    NASA Image and Video Library

    2015-08-18

    Spacecraft specialists at Lockheed Martin Space Systems, Denver, prepare NASA's InSight spacecraft for vibration testing as part of assuring that it is ready for the rigors of launch from Earth and flight to Mars. The spacecraft is oriented with its heat shield facing up in this July 13, 2015, photograph. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19815

  12. Getting the Joke: Insight during Humor Comprehension – Evidence from an fMRI Study

    PubMed Central

    Tian, Fang; Hou, Yuling; Zhu, Wenfeng; Dietrich, Arne; Zhang, Qinglin; Yang, Wenjing; Chen, Qunlin; Sun, Jiangzhou; Jiang, Qiu; Cao, Guikang

    2017-01-01

    As a high-level cognitive activity, humor comprehension requires incongruity detection and incongruity resolution, which then elicits an insight moment. The purpose of the study was to explore the neural basis of humor comprehension, particularly the moment of insight, by using both characters and language-free cartoons in a functional magnetic resonance imaging study. The results showed that insight involving jokes elicited greater activation in language and semantic-related brain regions as well as a variety of additional regions, such as the superior frontal gyrus (SFG), the inferior frontal gyrus (IFG), the middle temporal gyrus (MTG), the superior temporal gyrus (STG), the temporoparietal junctions (TPJ), the hippocampus and visual areas. These findings indicate that the MTG might play a role in incongruity detection, while the SFG, IFG and the TPJ might be involved in incongruity detection. The passive insight event elicited by jokes appears to be mediated by a limited number of brain areas. Our study showed that the brain regions associated with humor comprehension were not affected by the type of stimuli and that humor and insight shared common brain areas. These results indicate that one experiences a feeling of insight during humor comprehension, which contributes to the understanding of humor comprehension. PMID:29093693

  13. MOSAIC--A Modular Approach to Data Management in Epidemiological Studies.

    PubMed

    Bialke, M; Bahls, T; Havemann, C; Piegsa, J; Weitmann, K; Wegner, T; Hoffmann, W

    2015-01-01

    In the context of an increasing number of multi-centric studies providing data from different sites and sources the necessity for central data management (CDM) becomes undeniable. This is exacerbated by a multiplicity of featured data types, formats and interfaces. In relation to methodological medical research the definition of central data management needs to be broadened beyond the simple storage and archiving of research data. This paper highlights typical requirements of CDM for cohort studies and registries and illustrates how orientation for CDM can be provided by addressing selected data management challenges. Therefore in the first part of this paper a short review summarises technical, organisational and legal challenges for CDM in cohort studies and registries. A deduced set of typical requirements of CDM in epidemiological research follows. In the second part the MOSAIC project is introduced (a modular systematic approach to implement CDM). The modular nature of MOSAIC contributes to manage both technical and organisational challenges efficiently by providing practical tools. A short presentation of a first set of tools, aiming for selected CDM requirements in cohort studies and registries, comprises a template for comprehensive documentation of data protection measures, an interactive reference portal for gaining insights and sharing experiences, supplemented by modular software tools for generation and management of generic pseudonyms, for participant management and for sophisticated consent management. Altogether, work within MOSAIC addresses existing challenges in epidemiological research in the context of CDM and facilitates the standardized collection of data with pre-programmed modules and provided document templates. The necessary effort for in-house programming is reduced, which accelerates the start of data collection.

  14. Unraveling the insight paradox: One-year longitudinal study on the relationships between insight, self-stigma, and life satisfaction among people with schizophrenia spectrum disorders.

    PubMed

    Chio, Floria H N; Mak, Winnie W S; Chan, Randolph C H; Tong, Alan C Y

    2018-01-30

    The promotion of insight among people with schizophrenia spectrum disorders has posed a dilemma to service providers as higher insight has been linked to positive clinical outcomes but negative psychological outcomes. The negative meaning that people attached to the illness (self-stigma content) and the recurrence of such stigmatizing thoughts (self-stigma process) may explain why increased insight is associated with negative outcomes. The present study examined how the presence of high self-stigma content and self-stigma process may contribute to the negative association between insight and life satisfaction. A total of 181 people with schizophrenia spectrum disorders were assessed at baseline. 130 and 110 participants were retained and completed questionnaire at 6-month and 1-year follow-up, respectively. Results showed that baseline insight was associated with lower life satisfaction at 6-month when self-stigma process or self-stigma content was high. Furthermore, baseline insight was predictive of better life satisfaction at 1-year follow-up when self-stigma process was low. Findings suggested that the detrimental effects of insight can be a result from both the presence of cognitive content and habitual process of self-stigma. Future insight promotion interventions should also address self-stigma content and process among people with schizophrenia spectrum disorders so as to maximize the beneficial effects of insight. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Supply Chain Development: Insights from Strategic Niche Management

    ERIC Educational Resources Information Center

    Caniels, Marjolein C. J.; Romijn, Henny A.

    2008-01-01

    Purpose: The purpose of this paper is to contribute to the study of supply chain design from the perspective of complex dynamic systems. Unlike extant studies that use formal simulation modelling and associated methodologies rooted in the physical sciences, it adopts a framework rooted in the social sciences, strategic niche management, which…

  16. New Insights into the Surgical Management of Tetralogy of Fallot: Physiological Fundamentals and Clinical Relevance.

    PubMed

    Bove, Thierry; François, Katrien; De Wolf, Daniel

    2015-01-01

    The surgical treatment of tetralogy of Fallot can be considered as a success story in the history of congenital heart diseases. Since the early outcome is no longer the main issue, the focus moved to the late sequelae of TOF repair, i.e. the pulmonary insufficiency and the secondary adaptation of the right ventricle. This review provides recent insights into the pathophysiological alterations of the right ventricle in relation to the reconstruction of the right ventricular outflow tract after repair of tetralogy of Fallot. Its clinical relevance is documented by addressing the policy changes regarding the optimal management at the time of surgical repair as well as properly defining criteria and timing for late pulmonary valve implantation.

  17. Category III chronic prostatitis/chronic pelvic pain syndrome: insights from the National Institutes of Health Chronic Prostatitis Collaborative Research Network studies.

    PubMed

    Nickel, J Curtis; Alexander, Richard B; Anderson, Rodney; Berger, Richard; Comiter, Craig V; Datta, Nand S; Fowler, Jackson E; Krieger, John N; Landis, J Richard; Litwin, Mark S; McNaughton-Collins, Mary; O'Leary, Michael P; Pontari, Michel A; Schaeffer, Anthony J; Shoskes, Daniel A; White, Paige; Kusek, John; Nyberg, Leroy

    2008-07-01

    Chronic prostatitis/chronic pelvic pain syndrome remains an enigmatic medical condition. Creation of the National Institutes of Health-funded Chronic Prostatitis Collaborative Research Network (CPCRN) has stimulated a renewed interest in research on and clinical aspects of chronic prostatitis/chronic pelvic pain syndrome. Landmark publications of the CPCRN document a decade of progress. Insights from these CPCRN studies have improved our management of chronic prostatitis/chronic pelvic pain syndrome and offer hope for continued progress.

  18. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

    PubMed Central

    Moise, Imelda K.; Mulhall, Peter F.

    2016-01-01

    Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded

  19. Pros and Cons of Clinical Pathway Software Management: A Qualitative Study.

    PubMed

    Aarnoutse, M F; Brinkkemper, S; de Mul, M; Askari, M

    2018-01-01

    In this study we aimed to assess the perceived effectiveness of clinical pathway management software for healthcare professionals. A case study on the clinical pathway management software program Check-It was performed in three departments at an academic medical center. Four months after the implementation of the software, interviews were held with healthcare professionals who work with the system. The interview questions were posed in a semi-structured interview format and the participant were asked about the perceived positive or negative effects of Check-It, and whether they thought the software is effective for them. The interviews were recorded and transcribed based on grounded theory, using different coding techniques. Our results showed fewer overlooked tasks, pre-filled orders and letters, better overview, and increased protocol insight as positive aspects of using the software. Being not flexible enough was experienced as a negative aspect.

  20. Insights into software development in Japan

    NASA Technical Reports Server (NTRS)

    Duvall, Lorraine M.

    1992-01-01

    The interdependence of the U.S.-Japanese economies makes it imperative that we in the United States understand how business and technology developments take place in Japan. We can gain insight into these developments in software engineering by studying the context in which Japanese software is developed, the practices that are used, the problems encountered, the setting surrounding these problems, and the resolution of these problems. Context includes the technological and sociological characteristics of the software development environment, the software processes applied, personnel involved in the development process, and the corporate and social culture surrounding the development. Presented in this paper is a summary of results of a study that addresses these issues. Data for this study was collected during a three month visit to Japan where the author interviewed 20 software managers representing nine companies involved in developing software in Japan. These data are compared to similar data from the United States in which 12 managers from five companies were interviewed.

  1. Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia.

    PubMed

    Zhang, Qi; Li, Xu; Parker, Giverny J; Hong, Xiao-Hong; Wang, Yi; Lui, Simon S Y; Neumann, David L; Cheung, Eric F C; Shum, David H K; Chan, Raymond C K

    2016-03-30

    Research on the relationship between insight and social cognition, in particular Theory of Mind (ToM), in schizophrenia has yielded mixed findings to date. Very few studies, however, have assessed both clinical insight and cognitive insight when examining their relationships with ToM in schizophrenia. The current study thus investigated the relationship between clinical insight, cognitive insight, and ToM in a sample of 56 patients with schizophrenia and 30 healthy controls. Twenty-seven patients were classified as low in clinical insight according to their scores on the 'insight' item (G12) of the Positive and Negative Syndrome Scale (PANSS). Moreover, cognitive insight and ToM were assessed with the Beck Cognitive Insight Scale (BCIS) and the Yoni task, respectively. The results indicated that patients with poor clinical insight performed worse on tasks of second-order cognitive and affective ToM, while the ToM performance of patients with high clinical insight was equivalent to that of healthy controls. Furthermore, while clinical insight was correlated with ToM and clinical symptoms, cognitive insight did not correlate with clinical insight, ToM, or clinical symptoms. Clinical insight thus appears to be an important factor related to ToM in schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Insight in schizophrenia: a review.

    PubMed

    Dam, Jesper

    2006-01-01

    The issue of insight in schizophrenia must be assumed to be one of the most important aspects of the clinical examination. Comprehensive studies have shown that between 50% and 80% of all patients suffering from schizophrenia do not believe that they have a disorder. In recent years, poor insight in schizophrenia has been the subject of increasing interest, as manifested in a number of studies discussed in the present review. Some of these studies focus on insight correlated to various parameters such as psychopathology, neuropsychology, clinical relevance and compliance. Other studies refer to more theoretical implications, among these the issue of defining the concept of insight: whether insight can be seen as a "primary" phenomenon in schizophrenia, and whether insight may be graduated, dimensioned or increased. Several authors have developed rating scales in an attempt to obtain a measure for the degree or dimension of insight. Here, the range of parameters employed gives an excellent impression of the complexity of the concept of insight. In the concluding discussion, a phenomenological aspect is brought in, in an attempt to place the concept of insight in relation to disturbances of the self in schizophrenia and to primary symptoms in schizophrenia, amongst these autism.

  3. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study.

    PubMed

    Paul, Ian M; Williams, Jennifer S; Anzman-Frasca, Stephanie; Beiler, Jessica S; Makova, Kateryna D; Marini, Michele E; Hess, Lindsey B; Rzucidlo, Susan E; Verdiglione, Nicole; Mindell, Jodi A; Birch, Leann L

    2014-07-18

    Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This "parenting" intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT's central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent-child responsibility for feeding, reducing subsequent risk for overeating and overweight. 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the "parenting" or "safety" groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3-4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second

  4. Insights into enzymatic halogenation from computational studies

    PubMed Central

    Senn, Hans M.

    2014-01-01

    The halogenases are a group of enzymes that have only come to the fore over the last 10 years thanks to the discovery and characterization of several novel representatives. They have revealed the fascinating variety of distinct chemical mechanisms that nature utilizes to activate halogens and introduce them into organic substrates. Computational studies using a range of approaches have already elucidated many details of the mechanisms of these enzymes, often in synergistic combination with experiment. This Review summarizes the main insights gained from these studies. It also seeks to identify open questions that are amenable to computational investigations. The studies discussed herein serve to illustrate some of the limitations of the current computational approaches and the challenges encountered in computational mechanistic enzymology. PMID:25426489

  5. Lowering Back Shell onto Stowed InSight Lander

    NASA Image and Video Library

    2015-05-27

    In this photo, the back shell of NASA's InSight spacecraft is being lowered onto the mission's lander, which is folded into its stowed configuration. The back shell and a heat shield form the aeroshell, which will protect the lander as the spacecraft plunges into the upper atmosphere of Mars. The photo was taken on April 29, 2015, in a spacecraft assembly clean room at Lockheed Martin Space Systems, Denver. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, is scheduled for launch in March 2016 and landing in September 2016. It will study the deep interior of Mars to advance understanding of the early history of all rocky planets, including Earth. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19666

  6. Category III Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Insights from The National Institutes of Health Chronic Prostatitis Collaborative Research Network Studies

    PubMed Central

    Nickel, J. Curtis; Alexander, Richard B.; Anderson, Rodney; Berger, Richard; Comiter, Craig V.; Datta, Nand S.; Fowler, Jackson E.; Krieger, John N.; Landis, J. Richard; Litwin, Mark S.; McNaughton-Collins, Mary; O'Leary, Michael P.; Pontari, Michel A.; Schaeffer, Anthony J.; Shoskes, Daniel A.; White, Paige; Kusek, John; Nyberg, Leroy

    2010-01-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains an enigmatic medical condition. Creation of the (NIH) Chronic Prostatitis Collaborative Research Network (CPCRN) funded by the National Institutes of Health has stimulated a renewed interest in the research and clinical aspects of CP/CPPS. Landmark publications of the NIH-CPCRN over the last 10 years document a decade of progress. Insights from these CPCRN studies have improved our management of patients diagnosed with CP/CPPS and offer hope for continued progress. PMID:18765132

  7. Factors influencing exacerbation-related self-management in patients with COPD: a qualitative study.

    PubMed

    Korpershoek, Yjg; Vervoort, Scjm; Nijssen, Lit; Trappenburg, Jca; Schuurmans, M J

    2016-01-01

    In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate response to exacerbations appear to be difficult for some patients. Little is known about the underlying process of exacerbation-related self-management. Therefore, the objective of this study was to identify and explain the underlying process of exacerbation-related self-management behavior. A qualitative study using semi-structured in-depth interviews was performed according to the grounded theory approach, following a cyclic process in which data collection and data analysis alternated. Fifteen patients (male n=8; age range 59-88 years) with mild to very severe COPD were recruited from primary and secondary care settings in the Netherlands, in 2015. Several patterns in exacerbation-related self-management behavior were identified, and a conceptual model describing factors influencing exacerbation-related self-management was developed. Acceptance, knowledge, experiences with exacerbations, perceived severity of symptoms and social support were important factors influencing exacerbation-related self-management. Specific factors influencing recognition of exacerbations were heterogeneity of exacerbations and habituation to symptoms. Feelings of fear, perceived influence on exacerbation course, patient beliefs, ambivalence toward treatment, trust in health care providers and self-empowerment were identified as specific factors influencing self-management actions. This study provided insight into factors influencing exacerbation-related self-management behavior in COPD patients. The conceptual model can be used as a framework for health care professionals providing self-management support. In the development of future self-management interventions, factors influencing the process of exacerbation-related self-management should be taken into account.

  8. Project ECHO Telementoring Intervention for Managing Chronic Pain in Primary Care: Insights from a Qualitative Study.

    PubMed

    Carlin, Leslie; Zhao, Jane; Dubin, Ruth; Taenzer, Paul; Sidrak, Hannah; Furlan, Andrea

    2017-09-27

    Family physicians in Canada receive little training in chronic pain management; concomitantly, they face increasing pressure to reduce their prescribing of opioids. Project ECHO Ontario Chronic Pain/Opioid Stewardship (ECHO) is a telementoring intervention for primary care practitioners that enhances their pain management skills. This qualitative study reports participants' experiences and assessment of ECHO. An opportunistic sample of multidisciplinary primary care providers attending one of three residential weekend workshops participated in focus group discussions. University or hospital facilities in Toronto, Thunder Bay, and Kingston, Ontario, Canada. Seventeen physicians and 20 allied health professionals. Six focus group discussions were conducted at three different sites during 2014 and 2015. Transcripts were analyzed using a qualitative-descriptive approach involving analytic immersion in the data, reflection, and achieving consensus around themes discerned from transcribed discussions. Findings resolved into five main themes: 1) challenges of managing chronic pain in primary care; 2) ECHO participation and improvement in patient-provider interaction and participant knowledge; 3) the diffusion of knowledge gained through ECHO to participants' colleagues and patients; 4) ECHO participation generating a sense of community; and 5) disadvantages associated with participating in ECHO. Managing patients with chronic pain in primary care can be difficult, particularly in remote or underserved practices. Project ECHO offers guidance to primary care practitioners for their most challenging patients, promotes knowledge acquisition and diffusion, and stimulates the development of a "community of practice." © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. InSight Encapsulation

    NASA Image and Video Library

    2018-04-16

    In the Astrotech facility at Vandenberg Air Force Base in California, NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander is encapsulated in its payload fairing. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  10. Insight and Action Analytics: Three Case Studies to Consider

    ERIC Educational Resources Information Center

    Milliron, Mark David; Malcolm, Laura; Kil, David

    2014-01-01

    Civitas Learning was conceived as a community of practice, bringing together forward-thinking leaders from diverse higher education institutions to leverage insight and action analytics in their ongoing efforts to help students learn well and finish strong. We define insight and action analytics as drawing, federating, and analyzing data from…

  11. Insights into managed care--operational, legal and actuarial.

    PubMed

    Melek, S P; Johnson, B A; Schryver, D

    1997-01-01

    Understanding the operational, legal and actuarial dimensions of managed care is essential to developing managed care contracts between managed care organizations and individual health care providers or groups such as provider-sponsored organizations or independent practice associations. Operationally, it is important to understand managed care and its trends, emphasizing business issues, knowing your practice and defining acceptable levels of reimbursement and risk. Legally, there are a number of common themes or issues relevant to all managed care contracts, including primary care vs. specialist contracts, services offered, program policies and procedures, utilization review, physician reimbursement and compensation, payment schedule, terms and conditions, term and termination, continuation of care requirements, indemnification, amendment of contract and program policies, and stop-loss insurance. Actuarial issues include membership, geography, age-gender distribution, degree of health care management, local managed care utilization levels, historical utilization levels, health plan benefit design, among others.

  12. Concepts of health and well-being in managers: An organizational study

    PubMed Central

    Boness, Christian

    2011-01-01

    Global changes and new managerial challenges require new concepts of health and well-being in organizational contexts. In the South African context, health and well-being of managers have gained relevance in organizations and in management sciences. International organizations, in particular, attempt to address the increasing demand for health care and the delivery of health services to their managers. Careful and appropriate health management requires research to evaluate context-specific health concepts and strategies. The purpose and aim of this article is to assess managerial concepts on health and well-being that could be used by the organization to contribute to managerial well-being by implementing health promotion according to managerial needs. At the same time, this article contributes to salutogenetic health research that is very rare with regard to the South African organizational management research. This study is a multi-method research study conducted in a selected international organization in South Africa. However, in this article, selected qualitative findings will only be presented. This organizational study presents selected research findings on health concepts and strategies employed by managers. Findings demonstrate that the managerial concepts of health and strategies mainly refer to not only physical but also to mental and spiritual aspects, with a priority on physical health and well-being. The findings presented are based on qualitative research methods and their research criteria. This assessment serves as a foundation for new approaches to health management within the international work context in South Africa. It also contributes to a paradigm shift from pathogenetic to salutogenetic concepts of health and well-being within the South African organizational work context. The article produces new insights into the qualitative health concepts of South African managers and expatriates and contributes to promoting salutogenesis in

  13. InSight Encapsulation

    NASA Image and Video Library

    2018-04-16

    In the Astrotech facility at Vandenberg Air Force Base in California, technicians and engineers encapsulate NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander in its payload fairing. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  14. Association between insight, cognitive insight, positive symptoms and violence in patients with schizophrenia.

    PubMed

    Ekinci, Okan; Ekinci, Asli

    2013-04-01

    Violence is a significant clinical and public concern and is a frequent occurrence in patients with schizophrenia. The relationship between insight and violence remains controversial. In addition, there is a lack of research on insight, cognitive insight, demographic and psychopathologic variables in violent versus nonviolent schizophrenia patients. We aimed to compare insight, cognitive insight, psychopathological and demographic variables in violent and nonviolent subjects suffering from schizophrenia. In addition, we aimed to determine the demographic and clinical predictors of violent behaviour in patients with schizophrenia. We recruited 133 schizophrenic patients without concomitant substance abuse or axis II disorder. Diagnoses were based on the SCID-I and SCID-II. Violent behaviours were assessed using the Overt Aggression Scale. Insight and cognitive insight were assessed with the Scale to Assess Unawareness of Mental Disorder and the Beck Cognitive Insight Scale, respectively. We compared 47 patients with violent schizophrenia with 86 nonviolent patients. Non-violent patients had more severe depression, lower scores on positive symptoms, better clinical insight, more self-reflectivity and higher R-C index scores than did violent patients. In addition, history of violence, lower self-reflectiveness, worse clinical insight and delusion severity were significant predictors of violence in schizophrenia. The present study suggests that the inclusion of insight and cognitive insight may increase the prediction of violence in this population. In addition, clinicians should consider using non-pharmacological techniques that are based on cognitive behaviour therapy and enhance insight, particularly cognitive insight, among patients with schizophrenia who exhibit violent behaviour.

  15. A Cross-sectional, Comparative Study of Insight in Schizophrenia and Bipolar Patients in Remission.

    PubMed

    Ramachandran, Arul Saravanan; Ramanathan, Rajkumar; Praharaj, Samir Kumar; Kanradi, Haridas; Sharma, Podila Satya Venkata Narasimha

    2016-01-01

    To study insight correlates in schizophrenia and bipolar mood disorder in remission among out-patients attending the Psychiatry Department of a Tertiary Care Hospital. In a cross-sectional, naturalistic study, adult patients with schizophrenia and bipolar mood disorder in remission (n = 80; schizophrenia-40, mania-20, bipolar depression-20) were compared on insight measures and clinical correlates. Scale to Assess the Unawareness of Mental Disorders (SUMD) was used as the main tool to assess current and past measures of insight. Hogan's Drug Attitude Inventory was used to assess the drug attitude and compliance. Positive and Negative Symptom Scale for Schizophrenia, Young's Mania Rating Scale, and HAMD were used to rate psychopathology. Clinical Global Improvement was used as a screening tool for remission. For comparison of the three clinical groups, analysis of variance and Chi-square test were used. In the post-hoc analysis, the Ryan-Einot-Gabriel-Welsch test was used to find the group difference. About 40% in the schizophrenia group were unaware of their mental illness as against none in the bipolar group. The awareness of mental disorder for the current period, the awareness of the achieved effects of medications, and the awareness of social consequence was better in the bipolar group. The drug attitude (compliant positive attitude) increased as the SUMD item scale decreased or in other words, as the insight improved. Insight, both current and retrospect, showed significant differences between the schizophrenia and bipolar patients. Insight is significantly correlated with the observed compliance and drug attitude of the patient groups.

  16. Local people's knowledge with regard to land use activities in southwest Madagascar - Conceptual insights for sustainable land management.

    PubMed

    Fritz-Vietta, Nadine V M; Tahirindraza, H Stone; Stoll-Kleemann, Susanne

    2017-09-01

    Environmental conditions in the Mahafaly Plateau region in southwest Madagascar are harsh, with a long dry season and a short rainy season. The local people's land use capabilities and skills are adapted to these conditions. Nevertheless, they are currently confronted by drastic climatic changes, including longer dry seasons, which have resulted in food and water scarcities. It is therefore essential to ensure sustainable land management in the region. At present, the main land use activities are agriculture, livestock farming, natural resource collection including timber and non-timber forest products, and the practice of local customs. Land use activities have always resulted in land conversion, yet over time this ecological transformation also leads to the accumulation of knowledge. The aim of the present article is therefore twofold. First, it aims to examine local people's knowledge with regard to land use activities and the transmission of this knowledge from one generation to the next; second, it considers the extent to which local people's knowledge may contribute to the development of sustainable land management. Our research is based on more than 80 qualitative interviews with local inhabitants of the Mahafaly Plateau region. Our analysis of local people's knowledge identifies four categories: ecological knowledge, knowledge related to natural resource usage, knowledge of names, and the interconnection between knowledge and belief. Furthermore, these knowledge categories provide conceptual insights for sustainable land management. Along with the long-term persistence of natural resources and their functions and the satisfaction of basic needs through resource usage, both the recognition of mental images as a regulating mechanism and the maintenance of the relation between the natural and the supernatural world have a role to play in sustainable land management in the study area. Local knowledge transmission processes serve to foster ongoing learning and

  17. Mental capacity, diagnosis and insight in psychiatric in-patients: a cross-sectional study.

    PubMed

    Owen, G S; David, A S; Richardson, G; Szmukler, G; Hayward, P; Hotopf, M

    2009-08-01

    Mental capacity is now a core part of UK mental health law and clinicians will increasingly be expected to assess it. Because it is a legal concept there is a need to clarify associations with variables that clinicians are more familiar with, especially insight. In this cross-sectional study we recruited consecutive psychiatric admissions to the Maudsley Hospital, London. We carried out structured assessments of decision making using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), resulting in a clinical judgement about capacity status. We analysed associations with a range of sociodemographic and clinical variables, including insight score on the Expanded Schedule for the Assessment of Insight (SAI-E). The same variables were compared in an analysis stratified according to diagnostic group: psychotic disorders/bipolar affective disorder (BPAD)/non-psychotic disorders. Psychotic disorders and manic episodes of BPAD are most strongly associated with incapacity. In such patients, insight is the best discriminator of capacity status. In patients with non-psychotic disorders, insight is less strongly associated with capacity; in this group depressed mood discriminates capacity status whereas it does not in psychotic disorders. Cognitive performance does not discriminate capacity status in patients with psychotic disorders. Mental capacity has complex relationships with psychopathological variables, and these relationships are different according to diagnostic group. Insight is the best discriminator of capacity status in psychotic disorders and BPAD but not in non-psychotic disorders.

  18. Experiential Learning in Hospitality Management Education

    ERIC Educational Resources Information Center

    Brennen, Paul George

    2017-01-01

    The research study recognized that, although the knowledge obtained from academic textbooks and traditional classes are important to post-secondary hospitality management curriculum as they provide numerous insights and perspectives of different methods to manage a particular avenue within the hospitality industry; it is not the only aspect of the…

  19. Recent Insights and Advances in the Management of Merkel Cell Carcinoma.

    PubMed

    Banks, Patricia D; Sandhu, Shahneen; Gyorki, David E; Johnston, Meredith L; Rischin, Danny

    2016-07-01

    Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine malignancy with a propensity for recurrence and a poor prognosis. Incidence of MCC is on the rise and is known to increase with advanced age, immunosuppression, and UV exposure. Merkel cell polyomavirus is implicated in the pathogenesis of virus-positive MCC and accounts for 80% of MCCs in the northern hemisphere and 25% in southern latitudes. In contrast, tumorigenesis of virus-negative MCC is linked to UV-induced DNA damage. Interplay between ubiquitous Merkel cell polyomavirus skin infections that commonly occur in healthy skin and other established risk factors, such as immunosuppression and UV exposure, remains poorly understood. Surgery and radiotherapy achieves excellent locoregional control; however, invariably, a significant proportion of patients develop disseminated disease that is incurable. Chemotherapy offers a high response rate for metastatic disease, but responses are short-lived and the impact on survival is not established. Recent advances in our understanding of the genetic landscape and immunobiology of MCC has led to investigation of novel treatments, including immune checkpoint inhibitors, which are likely to rapidly transform the way we manage these patients. We review epidemiologic, clinical, and histopathologic features of MCC; describe recent insights in MCC biology; and discuss novel therapeutic approaches. Copyright © 2016 by American Society of Clinical Oncology.

  20. Insights into the Management of Emerging Infections: Regulating Variant Creutzfeldt-Jakob Disease Transfusion Risk in the UK and the US

    PubMed Central

    Ponte, Maya L

    2006-01-01

    of blood products for possible vCJD contamination in the UK, contributed to a greater sense of urgency and a speedier implementation of regulations in that country. Third, while the results of scientific studies played a prominent role in the construction of regulations in both nations, this role was shaped by existing social and professional networks. In the UK, early focus on a European study implicating B-lymphocytes as the carrier of prion infectivity in blood led to the introduction of a policy that requires universal leukoreduction of blood components. In the US, early focus on an American study highlighting the ability of plasma to serve as a reservoir of prion infectivity led the FDA and its advisory panel to eschew similar measures. Conclusions The results of this study yield three important theoretical insights that pertain to the global management of emerging infectious diseases. First, because the perception and management of disease may be shaped by previous experience with disease, especially catastrophic experience, there is always the possibility for over-management of some possible routes of transmission and relative neglect of others. Second, local specificities within a given nation may influence the temporality of decision making, which in turn may influence the choice of disease management policies. Third, a preference for science-based risk management among nations will not necessarily lead to homogeneous policies. This is because the exposure to and interpretation of scientific results depends on the existing social and professional networks within a given nation. Together, these theoretical insights provide a framework for analyzing and anticipating potential conflicts in the international management of emerging infectious diseases. In addition, this study illustrates the utility of qualitative methods in investigating research questions that are difficult to assess through quantitative means. PMID:17076547

  1. Insights into the management of emerging infections: regulating variant Creutzfeldt-Jakob disease transfusion risk in the UK and the US.

    PubMed

    Ponte, Maya L

    2006-10-01

    vCJD contamination in the UK, contributed to a greater sense of urgency and a speedier implementation of regulations in that country. Third, while the results of scientific studies played a prominent role in the construction of regulations in both nations, this role was shaped by existing social and professional networks. In the UK, early focus on a European study implicating B-lymphocytes as the carrier of prion infectivity in blood led to the introduction of a policy that requires universal leukoreduction of blood components. In the US, early focus on an American study highlighting the ability of plasma to serve as a reservoir of prion infectivity led the FDA and its advisory panel to eschew similar measures. The results of this study yield three important theoretical insights that pertain to the global management of emerging infectious diseases. First, because the perception and management of disease may be shaped by previous experience with disease, especially catastrophic experience, there is always the possibility for over-management of some possible routes of transmission and relative neglect of others. Second, local specificities within a given nation may influence the temporality of decision making, which in turn may influence the choice of disease management policies. Third, a preference for science-based risk management among nations will not necessarily lead to homogeneous policies. This is because the exposure to and interpretation of scientific results depends on the existing social and professional networks within a given nation. Together, these theoretical insights provide a framework for analyzing and anticipating potential conflicts in the international management of emerging infectious diseases. In addition, this study illustrates the utility of qualitative methods in investigating research questions that are difficult to assess through quantitative means.

  2. Outcome of first-episode schizophrenia in India: longitudinal study of effect of insight and psychopathology.

    PubMed

    Saravanan, Balasubramanian; Jacob, K S; Johnson, Shanthi; Prince, Martin; Bhugra, Dinesh; David, Anthony S

    2010-06-01

    Transcultural studies have found lack of insight to be an almost invariable feature of acute and chronic schizophrenia, but its influence on prognosis is unclear. To investigate the relationship between insight, psychopathology and outcome of first-episode schizophrenia in Vellore, India. Patients with a DSM-IV diagnosis of schizophrenia (n = 131) were assessed prospectively at baseline and at 6-month and 12-month follow-up. Demographic and clinical measures included insight, psychopathology, duration of untreated psychosis (DUP) and social functioning. Linear and logistic regression was used to measure predictors of outcome. Follow-up data were available for 115 patients at 1 year. All achieved remission, half of them with and half without residual symptoms. Changes in psychopathology and insight during the first 6 months and DUP strongly predicted outcome (relapse or functional impairment), controlling for baseline measures. Outcome of schizophrenia in this setting is driven by early symptomatic improvement and is relatively favourable, in line with other studies from low- and middle-income countries. Early improvement in insight might be a useful clinical guide to future outcome. Reduction of DUP should be a target for intervention.

  3. Everyday Functioning in Huntington's Disease: A Laboratory-Based Study of Financial Management Capacity.

    PubMed

    Sheppard, David P; Pirogovsky-Turk, Eva; Woods, Steven Paul; Holden, Heather M; Nicoll, Diane R; Filoteo, J Vincent; Corey-Bloom, Jody; Gilbert, Paul E

    2017-01-01

    One important limitation of prior studies examining functional decline in Huntington's disease (HD) has been the reliance on self-reported measures of ability. Since report-based methods can be biased by lack of insight, depression, and cognitive impairment, contrasting self-reported ability with measures that assess capacity may lead to a more comprehensive estimation of real-world functioning. The present study examined self-reported ability to perform instrumental activities of daily living (iADLs) and performance-based financial management capacity in 20 patients diagnosed with mild-moderate Huntington's disease (HD) and 20 demographically similar healthy adults. HD patients reported significantly greater declines in their ability to manage finances. On the capacity measure of financial management, HD patients performed significantly below healthy adults. Additionally, in the HD group there were no significant correlations between self-reported ability and capacity measures of financial management. HD patients endorsed declines in global iADL ability and exhibited deficits in functional capacity when performing a financial management task. Capacity measures may aid in assessing the extent to which HD patients accurately estimate real-world iADL performance, and the present findings suggest that such measures of capacity may be related to the cognitive, but not motor or affective, symptoms of HD.

  4. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Bruce Banerdt, InSight principal investigator, NASA JPL, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  5. InSight Cruise Stage and Lander in Assembly

    NASA Image and Video Library

    2015-05-27

    Spacecraft specialists in a clean room at Lockheed Martin Space Systems, Denver, are working on NASA's InSight spacecraft in this January 2015 scene from the mission's assembly and testing phase. At center is the cruise stage, which will serve multiple functions during the flight from Earth to Mars. In the background is the InSight lander. InSight, for Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport, will investigate the deep interior of Mars to gain information about how rocky planets, including Earth, formed and evolved. The mission is scheduled for launch from California in March 2016 and landing on Mars in September 2016. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19403

  6. Heat Shield Construction for NASA InSight Mission

    NASA Image and Video Library

    2015-05-27

    In this February 2015 scene from a clean room at Lockheed Martin Space Systems, Denver, specialists are building the heat shield to protect NASA's InSight spacecraft when it is speeding through the Martian atmosphere. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19404

  7. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study

    PubMed Central

    2014-01-01

    Background Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This “parenting” intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT’s central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent–child responsibility for feeding, reducing subsequent risk for overeating and overweight. Methods/Design 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the “parenting” or “safety” groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3–4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic

  8. Creativity Development in Adolescence: Insight from Behavior, Brain, and Training Studies

    ERIC Educational Resources Information Center

    Kleibeuker, Sietske W.; De Dreu, Carsten K. W.; Crone, Eveline A.

    2016-01-01

    Creativity is a multifaceted construct that recruits different cognitive processes. Here, we summarize studies that show that creativity develops considerably during adolescence with different developmental trajectories for insight, verbal divergent thinking, and visuospatial divergent thinking. Next, these developmental time courses are mapped to…

  9. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Social media guest listen as Bruce Banerdt, InSight principal investigator, NASA JPL, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  10. Insight in psychosis: Standards, science, ethics and value judgment.

    PubMed

    Jacob, K S

    2017-06-01

    The clinical assessment of insight solely employs biomedical perspectives and criteria to the complete exclusion of context and culture and to the disregard of values and value judgments. The aim of this discussion article is to examine recent research from India on insight and explanatory models in psychosis and re-examine the framework of assessment, diagnosis and management of insight and explanatory models. Recent research from India on insight in psychosis and explanatory models is reviewed. Recent research, which has used longitudinal data and adjusted for pretreatment variables, suggests that insight and explanatory models of illness at baseline do not predict course, outcome and treatment response in schizophrenia, which seem to be dependent on the severity and quality of the psychosis. It supports the view that people with psychosis simultaneously hold multiple and contradictory explanatory models of illness, which change over time and with the trajectory of the illness. It suggests that insight, like all explanatory models, is a narrative of the person's reality and a coping strategy to handle with the varied impact of the illness. This article argues that the assessment of insight necessarily involves value entailments, commitments and consequences. It supports a need for a broad-based approach to assess awareness, attribution and action related to mental illness and to acknowledge the role of values and value judgment in the evaluation of insight in psychosis.

  11. Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level.

    PubMed

    Mehdizadeh, Mahsa; Rezaei, Omid

    2016-01-01

    According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight.

  12. Third-person Diagnostic Interview on the Cognitive Insight Level of Psychotic Patients with an Insight at the Denial Level

    PubMed Central

    Mehdizadeh, Mahsa; Rezaei, Omid

    2016-01-01

    Objectives: According to the previous findings, the third-person technique improved the clinical insight of psychotic patients, therefore the present study aims to examine the effect of a third-person interview compared to a first-person interview on the level of cognitive insight of psychotic patients with an insight at the denial level. Materials and Methods: In this study, using interviews and questionnaires, a total number of 44 patients of Razi Psychiatric Educational and Treatment Center with an insight at the denial level being assessed using diagnostic interviews were divided randomly into two groups. Then, the two groups of patients' cognitive insights were evaluated using Beck Cognitive Insight Scale. Results: The findings indicated that in psychotic patients with an insight at the denial level, the third-person technique of interview compared to the first-person had little effect on the improvement of overall cognitive insight and its components, including self-reflection and self-assurance; however, this effect was not strong enough to make a significant difference between the two groups of patients. Conclusion: According to the study findings, we can conclude that the third-person interview compared to the first-person interview has no effect on the improvement of the cognitive insight of psychotic patients with an insight at the denial level. This finding is consistent with the previous studies indicating that although the theory of mind has some correlations with the clinical insight of patients, it has no effect on their cognitive insight. PMID:27335517

  13. InSight Launch

    NASA Image and Video Library

    2018-05-05

    The NASA InSight spacecraft launches onboard a United Launch Alliance Atlas-V rocket, Saturday, May 5, 2018, from Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  14. InSight Prelaunch

    NASA Image and Video Library

    2018-05-03

    The United Launch Alliance (ULA) Atlas-V rocket is seen with NASA's InSight spacecraft onboard, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  15. Initial insights on the performances and management of dairy cattle herds combining two breeds with contrasting features.

    PubMed

    Magne, M A; Thénard, V; Mihout, S

    2016-05-01

    Finding ways of increasing animal production with low external inputs and without compromising reproductive performances is a key issue of livestock systems sustainability. One way is to take advantage of the diversity and interactions among components within livestock systems. Among studies that investigate the influence of differences in animals' individual abilities in a herd, few focus on combinations of cow breeds with contrasting features in dairy cattle herds. This study aimed to analyse the performances and management of such multi-breed dairy cattle herds. These herds were composed of two types of dairy breeds: 'specialist' (Holstein) and 'generalist' (e.g. Montbeliarde, Simmental, etc.). Based on recorded milk data in southern French region, we performed (i) to compare the performances of dairy herds according to breed-type composition: multi-breed, single specialist breed or single generalist breed and (ii) to test the difference of milk performances of specialist and generalist breed cows (n = 10 682) per multi-breed dairy herd within a sample of 22 farms. The sampled farmers were also interviewed to characterise herd management through multivariate analysis. Multi-breed dairy herds had a better trade-off among milk yield, milk fat and protein contents, herd reproduction and concentrate-conversion efficiency than single-breed herds. Conversely, they did not offer advantages in terms of milk prices and udder health. Compared to specialist dairy herds, they produce less milk with the same concentrate-conversion efficiency but have better reproductive performances. Compared to generalist dairy herds, they produce more milk with better concentrate-conversion efficiency but have worse reproductive performances. Within herds, specialist and generalist breed cows significantly differed in milk performances, showing their complementarity. The former produced more milk for a longer lactation length while the latter produced milk with higher protein and fat

  16. "What Is a Sociologist Doing in a School of Management?" Reflections on the Use of Sociological Concepts in Management Education

    ERIC Educational Resources Information Center

    Duarte, Fernanda

    2009-01-01

    Written from an auto-biographic perspective, this paper is based on reflections and insights arising from a journey of adaptation by a "sociologist-teaching-in-a-school-of-management". These reflections unveil the relevance to management studies of four interrelated conceptual tools: critical thinking, reflection, reflexivity and the sociological…

  17. Assessing surface water flood risk and management strategies under future climate change: Insights from an Agent-Based Model.

    PubMed

    Jenkins, K; Surminski, S; Hall, J; Crick, F

    2017-10-01

    Climate change and increasing urbanization are projected to result in an increase in surface water flooding and consequential damages in the future. In this paper, we present insights from a novel Agent Based Model (ABM), applied to a London case study of surface water flood risk, designed to assess the interplay between different adaptation options; how risk reduction could be achieved by homeowners and government; and the role of flood insurance and the new flood insurance pool, Flood Re, in the context of climate change. The analysis highlights that while combined investment in property-level flood protection and sustainable urban drainage systems reduce surface water flood risk, the benefits can be outweighed by continued development in high risk areas and the effects of climate change. In our simulations, Flood Re is beneficial in its function to provide affordable insurance, even under climate change. However, the scheme does face increasing financial pressure due to rising surface water flood damages. If the intended transition to risk-based pricing is to take place then a determined and coordinated strategy will be needed to manage flood risk, which utilises insurance incentives, limits new development, and supports resilience measures. Our modelling approach and findings are highly relevant for the ongoing regulatory and political approval process for Flood Re as well as for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and internationally. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Parents' experiences of managing their child's postoperative pain at home: an exploratory qualitative study.

    PubMed

    Longard, Julie; Twycross, Alison; Williams, Anna M; Hong, Paul; Chorney, Jill

    2016-09-01

    To understand parents' experiences of managing their child's postoperative pain at home. Recent changes in children's health care services often shift the responsibility of managing children's postoperative pain to parents. Although pain management is important for good postoperative outcomes, it can be a challenging task for families, and children's pain is often under-managed. This qualitative study used semi-structured interviews to explore parents' experiences of managing their child's postoperative pain at home. Participants were parents of 10 typically developing 5- and 6-year olds, who underwent (adeno)tonsillectomy, and experienced no complications leading to hospitalisation in the postoperative period. One-on-one interviews were conducted with parents within three months of their child's surgery. Interviews were transcribed verbatim and content analysis was used to identify themes in parents' experiences. All children experienced some postoperative pain. Parents' experiences of managing their child's pain were impacted by balancing the pros and cons of administering analgesic medications, managing the emotional and psychological effects of their child's pain, as well as parents' information needs. Most parents' information needs were met yet they still struggled to manage their child's pain. These findings provide insight into some of the barriers that make this process challenging for many families, and what health care centres can do to help support parents manage their child's postoperative pain at home. The results of this study may aid in the design of interventions that will support parents when managing their child's postoperative pain at home and thus improve children's experiences. © 2016 John Wiley & Sons Ltd.

  19. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study.

    PubMed

    Johnson, Shanthi; Sathyaseelan, Manoranjitham; Charles, Helen; Jeyaseelan, Visalakshi; Jacob, Kuruthukulangara Sebastian

    2012-09-27

    The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Patients diagnosed to have DSM IV schizophrenia (n = 131) were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE) were employed to assess predictors of outcome. We could follow up 95 (72.5%) patients. Sixty-five of these patients (68.4%) achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context, acceptable cultural explanations and the prevalent social stigma

  20. InSight Lift & Mate

    NASA Image and Video Library

    2018-04-23

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, technicians and engineers position NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  1. InSight Lift & Mate

    NASA Image and Video Library

    2018-04-23

    Encapsulated in its payload fairing NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander is prepared for transport to Space Launch Complex 3 at Vandenberg Air Force Base in California. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  2. InSight Battery Installation

    NASA Image and Video Library

    2018-04-20

    In the gantry at Space Launch Complex 3 at Vandenberg Air Force Base in California, a technician prepares batteries for installation in NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  3. InSight Battery Installation

    NASA Image and Video Library

    2018-04-20

    In the gantry at Space Launch Complex 3 at Vandenberg Air Force Base in California, technicians and engineers prepare batteries for installation in NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  4. Self-management by family caregivers to manage changes in the behavior and mood of their relative with dementia: an online focus group study.

    PubMed

    Huis In Het Veld, Judith; Verkaik, Renate; van Meijel, Berno; Verkade, Paul-Jeroen; Werkman, Wendy; Hertogh, Cees; Francke, Anneke

    2016-05-03

    Self-management is important for family caregivers of people with dementia, especially when they face changes in their relative's behavior and mood, such as depression, apathy, anxiety, agitation and aggression. The aim of this study is to give insight into why these changes in behavior and mood are stressful for family caregivers, what self-management strategies family caregivers use when managing these changes and the stress they experience. A qualitative study was conducted using four online focus groups with 32 family caregivers of people with dementia living in the Netherlands. Transcripts of the focus group discussions were analyzed using principles of thematic analysis. Managing changes in the behavior and mood of their relative with dementia is stressful for family caregivers because of constantly having to switch, continuously having to keep the person with dementia occupied and distracted, the fact that others see a different side to the relative, and the fact that caregivers know what to do, but are often not able to put this into practice. Caregivers use calming down and stimulation as self-management strategies for influencing the changes in the behavior and mood of their relative. Furthermore, caregivers describe three self-management strategies that let them manage their own stress and keep up the care for their loved ones: looking for distractions, getting rest, and discussing their feelings and experiences. Behavior and mood changes of a person with dementia are stressful for family caregivers. They use several self-management strategies to positively affect the mood and behavior changes, and also to manage their own stress.

  5. [Evaluation by case managers dementia : An explorative practice based study on types and content].

    PubMed

    Ketelaar, Nicole A B M; Jukema, Jan S; van Bemmel, Marlies; Adriaansen, Marian J M; Smits, Carolien H M

    2017-06-01

    This practice based explorative study aims to provide insight into the ways in which case managers shape and fill up the evaluation phase of their support of the informal care network of persons with dementia. A combination of quantitative and qualitative research methods were used. A group of 57 case managers of persons with dementia in three different organisational networks took part in this study. Results from the quantitative and qualitative data are organized into four themes: (1) attitude towards evaluation, (2) forms of evaluation, (3) implementation of evaluation and (4) content of evaluation. There are different ways in shaping evaluation and the content of it. The importance of interim and final evaluation is recognized, but is difficult to realize in a methodical way. Barriers experienced by the case managers include various factors associated both with clients as professionals. Case managers evaluate continuously and in an informal way to assess whether the extent of their assistance is meeting the needs of the client and informal network. Case managers do not use systematic evaluation to measure the quality of care they offer to persons with dementia and their caregivers. The findings demand a discussion on the level of clients, as well as on the professional and societal level about the way case managers should evaluate their support.

  6. [Insight, neurocognition and psychopathology in schizophrenia].

    PubMed

    Gil, D; Bengochea, R; Arrieta, M; Alvarez, A; Sánchez, R; Diego, M

    2006-01-01

    In recent years, research has been aimed at finding variables mediating between neurocognition and psychosocial functioning in schizophrenia, proposing insight as one of these variables. Some authors have found associations between insight and functional outcome, and between insight and symptomatology, although these associations remain unclear. These different findings could be explained by the insight definition used. The current study evaluates insight unidimensionally and multidimensionally and studies its relationship with cognitive and psychopathological variables. The sample consisted of 94 subjects admitted to an outpatient Psychosocial Rehabilitation Program, all diagnosed of schizophrenia according to ICD-10 diagnostic criteria. A brief version of the Neuropsychology Battery Test Barcelona and the Wisconsin Card Sorting Test were used to evaluate cognitive variables. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychopathology. Insight was assessed with the PANSS item ((lack of judgment and insight)), and with a semi-structured interview. Two insight factors were found, one including more specific knowledge about the disease and its consequences (cognitive factor), that is related to executive functions, and another referring to unspecific knowledge about suffering from an illness and the need for treatment (psychotic factor). Each factor was statistically related to positive symptoms and superior cognitive functions. These findings support a relationship between insight and low cognitive performance.

  7. The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation

    PubMed Central

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia J; Huerta, Timothy R

    2015-01-01

    Objective To improve understanding of facilitators of EHR system implementation, paying particular attention to opportunities to maximize physician adoption and effective deployment. Data Sources/Study Setting Primary data collected from 47 physician and 35 administrative key informants from six U.S. health care organizations identified because of purported success with EHR implementation. Study Design We conducted interviews and focus groups in an extensive qualitative study. Data Collection/Extraction Methods Verbatim transcripts were analyzed both deductively and inductively using the constant comparative method. Principal Findings Conceptualizing EHR adoption as loss through the lens of Kübler-Ross's five stages of grief model may help individuals and organizations more effectively orient to the challenge of change. Coupled with Kotter's eight-step change management framework, we offer a structure to facilitate organizations' movement through the EHR implementation journey. Combining insights from these frameworks, we identify 10 EHR strategies that can help address EHR implementation barriers. Conclusions Loss is one part of change often overlooked. Addressing it directly and compassionately can potentially facilitate the EHR implementation journey. We offer a summarized list of deployment strategies that are sensitive to these issues to support physician transition to new technologies that will bring value to clinical practice. PMID:25219627

  8. InSight Liftoff

    NASA Image and Video Library

    2018-05-05

    A United Launch Alliance Atlas V rocket lifts off from Space Launch Complex 3 at Vandenberg Air Force Base, California, carrying NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. Liftoff was at 4:05 a.m. PDT (7:05 a.m. EDT). The spacecraft will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created.

  9. InSight Prelaunch

    NASA Image and Video Library

    2018-05-04

    A heavy fog rolls in as the United Launch Alliance (ULA) Atlas-V rocket with NASA's InSight spacecraft onboard awaits launch, Friday, May 4, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  10. NCCN Guidelines Insights: Colon Cancer, Version 2.2018.

    PubMed

    Benson, Al B; Venook, Alan P; Al-Hawary, Mahmoud M; Cederquist, Lynette; Chen, Yi-Jen; Ciombor, Kristen K; Cohen, Stacey; Cooper, Harry S; Deming, Dustin; Engstrom, Paul F; Garrido-Laguna, Ignacio; Grem, Jean L; Grothey, Axel; Hochster, Howard S; Hoffe, Sarah; Hunt, Steven; Kamel, Ahmed; Kirilcuk, Natalie; Krishnamurthi, Smitha; Messersmith, Wells A; Meyerhardt, Jeffrey; Miller, Eric D; Mulcahy, Mary F; Murphy, James D; Nurkin, Steven; Saltz, Leonard; Sharma, Sunil; Shibata, David; Skibber, John M; Sofocleous, Constantinos T; Stoffel, Elena M; Stotsky-Himelfarb, Eden; Willett, Christopher G; Wuthrick, Evan; Gregory, Kristina M; Freedman-Cass, Deborah A

    2018-04-01

    The NCCN Guidelines for Colon Cancer provide recommendations regarding diagnosis, pathologic staging, surgical management, perioperative treatment, surveillance, management of recurrent and metastatic disease, and survivorship. These NCCN Guidelines Insights summarize the NCCN Colon Cancer Panel discussions for the 2018 update of the guidelines regarding risk stratification and adjuvant treatment for patients with stage III colon cancer, and treatment of BRAF V600E mutation-positive metastatic colorectal cancer with regimens containing vemurafenib. Copyright © 2018 by the National Comprehensive Cancer Network.

  11. Insight and satisfaction with life among adolescents with mental disorders: assessing associations with self-stigma and parental insight.

    PubMed

    Gaziel, M; Hasson-Ohayon, I; Morag-Yaffe, M; Schapir, L; Zalsman, G; Shoval, G

    2015-02-01

    The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders. Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students' Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents. Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect. The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. InSight Lift & Mate

    NASA Image and Video Library

    2018-04-23

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, a crane is used to lift NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander for mating atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  13. InSight Prelaunch Overview

    NASA Image and Video Library

    2018-05-03

    Members of the media and social media participants attended the NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, prelaunch briefing at Vandenberg Air Force Base in California. The presentation focused on InSight Mars lander. InSight is scheduled for liftoff May 5, 2018, atop a United Launch Alliance (ULA) Atlas V rocket from Space Launch Complex 3 at Vandenberg. The spacecraft will be the first mission to look deep beneath the Martian surface studying the planet's interior by measuring its heat output and listen for marsquakes.

  14. An Integrated Approach Is Needed for Ecosystem Based Fisheries Management: Insights from Ecosystem-Level Management Strategy Evaluation

    PubMed Central

    Fulton, Elizabeth A.; Smith, Anthony D. M.; Smith, David C.; Johnson, Penelope

    2014-01-01

    An ecosystem approach is widely seen as a desirable goal for fisheries management but there is little consensus on what strategies or measures are needed to achieve it. Management strategy evaluation (MSE) is a tool that has been widely used to develop and test single species fisheries management strategies and is now being extended to support ecosystem based fisheries management (EBFM). We describe the application of MSE to investigate alternative strategies for achieving EBFM goals for a complex multispecies fishery in southeastern Australia. The study was undertaken as part of a stakeholder driven process to review and improve the ecological, economic and social performance of the fishery. An integrated management strategy, involving combinations of measures including quotas, gear controls and spatial management, performed best against a wide range of objectives and this strategy was subsequently adopted in the fishery, leading to marked improvements in performance. Although particular to one fishery, the conclusion that an integrated package of measures outperforms single focus measures we argue is likely to apply widely in fisheries that aim to achieve EBFM goals. PMID:24454722

  15. The predictive effect of insight on adverse clinical outcomes in bipolar I disorder: a two-year prospective study.

    PubMed

    Yen, Cheng-Fang; Chen, Cheng-Sheng; Yen, Ju-Yu; Ko, Chih-Hung

    2008-05-01

    Research has revealed that a lack of insight is associated with poorer clinical outcomes in schizophrenia; however, the predictive value of insight on adverse clinical outcomes among bipolar patients is quite understudied. The aim of this prospective study was to examine the impact of insight on adverse clinical outcomes among the patients with bipolar I disorder over a 2-year period. Sixty-five remitted bipolar I disorder patients received follow-up assessments at 3, 6, 9, 12, 18, and 24 months to detect the adverse clinical outcomes defined by the incidence of bipolar-related psychiatric hospitalization, emergency room visits, violent or suicidal behavior. The Schedule of Assessment of Insight was used to provide a baseline insight score. Cox regression analysis was used to examine the predictive value of insight on the adverse clinical outcomes. Impaired insight into treatment and a greater number of previous hospitalizations significantly increased the risk of adverse clinical outcomes with bipolar disorder in the 2-year period. However, insight into recognition of the illness and re-labeling of psychotic phenomena did not have any significant effect on adverse clinical outcomes. Bipolar patients' insight into treatment is an independent predictor of adverse clinical outcomes. Improving insight into treatment might be a promising target for a better outcome.

  16. Testing for Instrument Deployment by InSight Robotic Arm

    NASA Image and Video Library

    2015-03-04

    In the weeks after NASA's InSight mission reaches Mars in September 2016, the lander's arm will lift two key science instruments off the deck and place them onto the ground. This image shows testing of InSight's robotic arm inside a clean room at NASA's Jet Propulsion Laboratory, Pasadena, California, about two years before it will perform these tasks on Mars. InSight -- an acronym for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport -- will launch in March 2016. It will study the interior of Mars to improve understanding of the processes that formed and shaped rocky planets, including Earth. One key instrument that the arm will deploy is the Seismic Experiment for Interior Structure, or SEIS. It is from France's national space agency (CNES), with components from Germany, Switzerland, the United Kingdom and the United States. In this scene, the arm has just deployed a test model of a protective covering for SEIS, the instrument's wind and thermal shield. The shield's purpose is to lessen disturbances that weather would cause to readings from the sensitive seismometer. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19144

  17. Cognitive insight: A systematic review.

    PubMed

    Van Camp, L S C; Sabbe, B G C; Oldenburg, J F E

    2017-07-01

    Cognitive insight is the ability to re-evaluate thoughts and beliefs in order to make thoughtful conclusions. It differs from clinical insight, as it focuses on more general metacognitive processes. Therefore, it could be relevant to diverse disorders and non-clinical subjects. There is a growing body of research on cognitive insight in individuals with and without psychosis. This review has summarised the current state of the art regarding this topic. We conclude that while cognitive insight in its current form seems valid for use in individuals with psychosis, it is less so for individuals without psychosis. Additionally, higher cognitive insight not always leads to better psychological functioning. For instance, higher levels of self-reflection are often associated with depressive mood. We therefore recommend the sub-components of cognitive insight to be studied separately. Also, it is unclear what position cognitive insight takes within the spectrum of metacognitive processes and how it relates to other self-related concepts that have been defined previously in literature. Combining future and past research on cognitive insight and its analogue concepts will help in the formation of a uniform definition that fits all subjects discussed here. Copyright © 2017. Published by Elsevier Ltd.

  18. InSight Prelaunch

    NASA Image and Video Library

    2018-05-04

    NASA social media attendees pose for a group photograph in front of the United Launch Alliance (ULA) Atlas-V rocket with NASA's InSight spacecraft onboard, Friday, May 4, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  19. InSight Prelaunch

    NASA Image and Video Library

    2018-05-04

    The United Launch Alliance (ULA) Atlas-V rocket with the NASA InSight spacecraft onboard is seen shortly after the mobile service tower was rolled back, Friday, May 4, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  20. InSight Prelaunch

    NASA Image and Video Library

    2018-05-04

    The mobile service tower at SLC-3 is rolled back to reveal the United Launch Alliance (ULA) Atlas-V rocket with the NASA InSight spacecraft onboard, Friday, May 4, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  1. InSight Prelaunch

    NASA Image and Video Library

    2018-05-05

    The United Launch Alliance (ULA) Atlas-V rocket with the NASA InSight spacecraft onboard is seen shortly after the mobile service tower was rolled back, Friday, May 4, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  2. InSight Liftoff

    NASA Image and Video Library

    2018-05-05

    A United Launch Alliance Atlas V rocket lifts off from Space Launch Complex 3 at Vandenberg Air Force Base, California, carrying NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. Liftoff was at 4:05 a.m. PDT (7:05 a.m. EDT). The spacecraft will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created.

  3. Insight in schizophrenia: from conceptualization to neuroscience.

    PubMed

    Ouzir, Mounir; Azorin, Jean Michel; Adida, Marc; Boussaoud, Driss; Battas, Omar

    2012-04-01

    Lack of insight into illness is a prevalent and distinguishing feature of schizophrenia, which has a complex history and has been given a variety of definitions. Currently, insight is measured and treated as a multidimensional phenomenon, because it is believed to result from psychological, neuropsychological and organic factors. Thus, schizophrenia patients may display dramatic disorders including demoralization, depression and a higher risk of suicide, all of which are directly or indirectly related to a lack of insight into their illness, and make the treatment difficult. To improve the treatment of people with schizophrenia, it is thus crucial to advance research on insight into their illness. Insight is studied in a variety of ways. Studies may focus on the relationship between insight and psychopathology, may view behavioral outcomes or look discretely at the cognitive dysfunction versus anatomy level of insight. All have merit but they are dispersed across a wide body of literature and rarely are the findings integrated and synthesized in a meaningful way. The aim of this study was to synthesize findings across the large body of literature dealing with insight, to highlight its multidimensional nature, measurement, neuropsychology and social impact in schizophrenia. The extensive literature on the cognitive consequences of lack of insight and the contribution of neuroimaging techniques to elucidating neurological etiology of insight deficits, is also reviewed. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.

  4. Wildland fire management futures: insights from a foresight panel

    Treesearch

    Robert L. Olson; David N. Bengston; Leif A. DeVaney; Trevor A.C. Thompson

    2015-01-01

    Wildland fire management faces unprecedented challenges in the 21st century: the increasingly apparent effects of climate change, more people and structures in the wildland-urban interface, growing costs associated with wildfire management, and the rise of high-impact fires, to name a few. Given these significant and growing challenges, conventional fire management...

  5. A prospective study of the trajectories of clinical insight, affective symptoms, and cognitive ability in bipolar disorder

    PubMed Central

    Depp, Colin A.; Harmell, Alexandrea L.; Savla, Gauri N.; Mausbach, Brent T.; Jeste, Dilip V.; Palmer, Barton W.

    2014-01-01

    Background Clinical insight in bipolar disorder is associated with treatment adherence and psychosocial outcome. The short-term dynamics of clinical insight in relationship to symptoms and cognitive abilities are unknown. Methods In a prospective observational study, a total of 106 outpatients with bipolar disorder I or II were assessed at baseline, 6 weeks, 12 weeks, and 26 weeks. Participants were administered a comprehensive neuropsychological battery, clinical ratings of manic and depressive symptom severity, and self-reported clinical insight. Lagged correlations and linear mixed-effects models were used to determine the temporal associations between symptoms and insight, as well as the moderating influence of global cognitive abilities. Results At baseline, insight was modestly correlated with severity of manic symptoms, but not with depressive symptoms or cognitive abilities. Insight and depressive symptoms fluctuated to approximately the same extent over time. Both lagged correlations and mixed effects models with lagged effects indicated that the severity of manic symptoms predicted worse insight at later assessments, whereas the converse was not significant. There were no direct or moderating influences of global cognitive abilities. Limitations Our sample size was modest, and included relatively psychiatrically stable outpatients, followed for a six month period. Our results may not generalize to acutely symptomatic patients followed over a longer period. Conclusions Clinical insight varies substantially over time within patients with bipolar disorder. Impaired insight in bipolar disorder is more likely to follow than to precede manic symptoms. PMID:24200153

  6. Parachute Testing for NASA InSight Mission

    NASA Image and Video Library

    2015-05-27

    This parachute testing for NASA's InSight mission to Mars was conducted inside the world's largest wind tunnel, at NASA Ames Research Center, Moffett Field, California, in February 2015. The wind tunnel is 80 feet (24 meters) tall and 120 feet (37 meters) wide. It is part of the National Full-Scale Aerodynamics Complex, operated by the Arnold Engineering Development Center of the U.S. Air Force. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19405

  7. A pilot study of cognitive insight and structural covariance in first-episode psychosis.

    PubMed

    Kuang, Corin; Buchy, Lisa; Barbato, Mariapaola; Makowski, Carolina; MacMaster, Frank P; Bray, Signe; Deighton, Stephanie; Addington, Jean

    2017-01-01

    Cognitive insight is described as a balance between one's self-reflectiveness (recognition and correction of dysfunctional reasoning), and self-certainty (overconfidence). Neuroimaging studies have linked the ventrolateral prefrontal cortex (VLPFC) to cognitive insight in people with psychosis. However, the relationship between cognitive insight and structural connectivity between the VLPFC and other brain areas is unknown. Here, we investigated the modulation of cognitive insight on structural covariance networks involving the VLPFC in a first-episode psychosis sample. Fifteen patients with a first-episode psychosis provided magnetic resonance (MR) scans and completed the Beck Cognitive Insight Scale (BCIS). MR scans were also available for 15 historical controls. Seed-based analysis of structural covariance was conducted using the Mapping Anatomical Correlations Across the Cerebral Cortex (MACACC) methodology, whereby Pearson correlation coefficients were extracted between seed regions in left and right VLPFC and cortical thickness across the brain. Structural covariance maps between groups were compared at each vertex. In first-episode subjects, we evaluated the modulation of BCIS scores on cortical covariance between VLPFC and every other vertex. Findings showed no significant group difference between first-episode psychosis subjects and controls in thickness covariance seeded from left or right VLPFC. However, in first-episode psychosis subjects, a positive association with self-certainty was found in networks seeded from both left and right VLPFC with thickness in medial frontal cortex and right pars triangularis. No significant associations were found for self-reflectiveness. These results suggest that self-certainty, but not self-reflectiveness, positively modulated cortical covariance in a frontal network in patients with a first-episode psychosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Self-esteem and insight as predictors of symptom change in schizophrenia: a longitudinal study.

    PubMed

    Erickson, Molly A; Lysaker, Paul H

    2012-07-01

    Though it is known that symptom profiles in schizophrenia change throughout the course of the illness, it is not yet clear which psychological antecedents predict these changes. The purpose of the present study was to explore "level of insight into mental illness" and "self-esteem" as predictors of positive symptom change in schizophrenia patients. Fifty-seven schizophrenia patients completed assessments of self-esteem, insight into mental illness, positive symptoms and paranoia once every four weeks for a total of eight individual testing sessions. Hierarchical linear regression analysis revealed that changes in self-esteem predicted future changes in paranoia as well as positive symptoms more broadly; decreases in self-esteem at any given time point were associated with an increase in persecutory beliefs and other positive symptoms at the following assessment. On the other hand, decreases in insight were not significantly associated with paranoia or positive symptoms, either as a stable trait of the mental illness or as a predictor of change over time. Taken together, these results suggest that change in self-esteem, but not insight, has a significant and unique association with positive symptoms of schizophrenia, and may be a valuable target for future treatment.

  9. What is case management in palliative care? An expert panel study

    PubMed Central

    2012-01-01

    Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent. PMID:22709349

  10. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    Encapsulated in its payload fairing NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander arrives at Space Launch Complex 3 at Vandenberg Air Force Base in California. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  11. Course of insight in manic episode.

    PubMed

    Kumar, A; Kumar, S; Khan, N M; Mishra, S

    2013-01-01

    Insight is an important factor associated with non compliance and poor outcome. Poor level of insight has been described as a characteristic in patients with acute bipolar disorder with more unawareness in social consequences with increasing severity in manic episode. Main aim of study was to see the baseline and longitudinal relationship between dimensions of insight with improvement in psychopathology. Forty four patients diagnosed with mania, were selected from an inpatient setting at Institute of Mental Health and Hospital, Agra with mean age of 31.07(±9.00) years. They were assessed at base line and were followed up weekly or psychopathology and insight. The Young's mania rating scale for psychopathology and insight was assessed on three dimensions of SUMD. Twenty five patients eventually completed the study. There was a positive correlation with global insight and with psychopathology consistent in longitudinal follow-up (P<0.05), but not correlating for awareness for achieved effect of medication and social consequences. Linear regression showed a positive relationship at the first and second week of assessment of SUMD and YMRS scores (P=0.001; 0.019). Improvement in insight is graded in a manic episode as compared to psychopathology. There is slower improvement in awareness of social consequences of mental disorder. It means that improvement in psychopathology may not necessarily indicate remission and need further supervision to improve insight and hence monitoring.

  12. Wildlife disease ecology from the individual to the population: Insights from a long-term study of a naturally infected European badger population.

    PubMed

    McDonald, Jenni L; Robertson, Andrew; Silk, Matthew J

    2018-01-01

    Long-term individual-based datasets on host-pathogen systems are a rare and valuable resource for understanding the infectious disease dynamics in wildlife. A study of European badgers (Meles meles) naturally infected with bovine tuberculosis (bTB) at Woodchester Park in Gloucestershire (UK) has produced a unique dataset, facilitating investigation of a diverse range of epidemiological and ecological questions with implications for disease management. Since the 1970s, this badger population has been monitored with a systematic mark-recapture regime yielding a dataset of >15,000 captures of >3,000 individuals, providing detailed individual life-history, morphometric, genetic, reproductive and disease data. The annual prevalence of bTB in the Woodchester Park badger population exhibits no straightforward relationship with population density, and both the incidence and prevalence of Mycobacterium bovis show marked variation in space. The study has revealed phenotypic traits that are critical for understanding the social structure of badger populations along with mechanisms vital for understanding disease spread at different spatial resolutions. Woodchester-based studies have provided key insights into how host ecology can influence infection at different spatial and temporal scales. Specifically, it has revealed heterogeneity in epidemiological parameters; intrinsic and extrinsic factors affecting population dynamics; provided insights into senescence and individual life histories; and revealed consistent individual variation in foraging patterns, refuge use and social interactions. An improved understanding of ecological and epidemiological processes is imperative for effective disease management. Woodchester Park research has provided information of direct relevance to bTB management, and a better appreciation of the role of individual heterogeneity in disease transmission can contribute further in this regard. The Woodchester Park study system now offers a rare

  13. A General Procedure to Assess the Internal Structure of a Noncognitive Measure--The Student360 Insight Program (S360) Time Management Scale. Research Report. ETS RR-11-42

    ERIC Educational Resources Information Center

    Ling, Guangming; Rijmen, Frank

    2011-01-01

    The factorial structure of the Time Management (TM) scale of the Student 360: Insight Program (S360) was evaluated based on a national sample. A general procedure with a variety of methods was introduced and implemented, including the computation of descriptive statistics, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).…

  14. Incorporating evolutionary insights to improve ecotoxicology for freshwater species

    USGS Publications Warehouse

    Brady, Steven P.; Richardson, Jonathan L.; Kunz, Bethany K.

    2017-01-01

    Ecotoxicological studies have provided extensive insights into the lethal and sublethal effects of environmental contaminants. These insights are critical for environmental regulatory frameworks, which rely on knowledge of toxicity for developing policies to manage contaminants. While varied approaches have been applied to ecotoxicological questions, perspectives related to the evolutionary history of focal species or populations have received little consideration. Here, we evaluate chloride toxicity from the perspectives of both macroevolution and contemporary evolution. First, by mapping chloride toxicity values derived from the literature onto a phylogeny of macroinvertebrates, fish, and amphibians, we tested whether macroevolutionary relationships across species and taxa are predictive of chloride tolerance. Next, we conducted chloride exposure tests for two amphibian species to assess whether potential contemporary evolutionary change associated with environmental chloride contamination influences chloride tolerance across local populations. We show that explicitly evaluating both macroevolution and contemporary evolution can provide important and even qualitatively different insights from those obtained via traditional ecotoxicological studies. While macroevolutionary perspectives can help forecast toxicological end points for species with untested sensitivities, contemporary evolutionary perspectives demonstrate the need to consider the environmental context of exposed populations when measuring toxicity. Accounting for divergence among populations of interest can provide more accurate and relevant information related to the sensitivity of populations that may be evolving in response to selection from contaminant exposure. Our data show that approaches accounting for and specifically examining variation among natural populations should become standard practice in ecotoxicology.

  15. Artist Concept of InSight Lander on Mars

    NASA Image and Video Library

    2014-03-26

    This artist's concept depicts the stationary NASA Mars lander known by the acronym InSight at work studying the interior of Mars. The InSight mission (for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport) is scheduled to launch in March 2016 and land on Mars six months later. It will investigate processes that formed and shaped Mars and will help scientists better understand the evolution of our inner solar system's rocky planets, including Earth. InSight will deploy two instruments to the ground using a robotic arm: a seismometer (contributed by the French space agency Centre National d'Etudes Spatiales, or CNES) to measure the microscopic ground motions from distant marsquakes, providing detailed information about the interior structure of Mars; and a heat-flow probe (contributed by the German Aerospace Center, or DLR) designed to hammer itself 3 to 5 meters (about 16 feet) deep and monitor heat coming from the planet's interior. The mission will also track the lander's radio to measure wobbles in the planet's rotation that relate to the size of its core and will include a camera and a suite of environmental sensors to monitor the weather and variations in the magnetic field. Lockheed Martin Space Systems, Denver, is building the spacecraft. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA17358

  16. The Neural Basis of Insight Problem Solving: An Event-Related Potential Study

    ERIC Educational Resources Information Center

    Qiu, Jiang; Li, Hong; Yang, Dong; Luo, Yuejia; Li, Ying; Wu, Zhenzhen; Zhang, Qinglin

    2008-01-01

    The electrophysiological correlates of successful insight problem solving (Chinese logogriphs) were studied in 18 healthy subjects using high-density event-related potentials (ERPs). A new experimental paradigm (learning-testing model) was adopted in order to make subjects find a solution on their own initiative rather than receive an answer…

  17. Stoking the Dialogue on the Domains of Transformative Learning Theory: Insights From Research With Faith-Based Organizations in Kenya

    ERIC Educational Resources Information Center

    Moyer, Joanne M.; Sinclair, A. John

    2016-01-01

    Transformative learning theory is applied in a variety of fields, including archaeology, religious studies, health care, the physical sciences, environmental studies, and natural resource management. Given the breadth of the theory's application, it needs to be adaptable to broad contexts. This article shares insights gained from applying the…

  18. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    The United Launch Alliance (ULA) Atlas-V rocket is seen with NASA's InSight spacecraft onboard, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  19. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    NASA Chief Scientist Jim Green discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  20. Management Development Study.

    ERIC Educational Resources Information Center

    Department of Transportation, Washington, DC.

    This document reports on a management development study within the Department of Transportation (DOT). The aim of the study was to develop a systematic approach to management development for military and civilian personnel. A variety of methods was used to gather data including having DOT staff members gather the information to be passed on to the…

  1. Managing Complex Dynamical Systems

    ERIC Educational Resources Information Center

    Cox, John C.; Webster, Robert L.; Curry, Jeanie A.; Hammond, Kevin L.

    2011-01-01

    Management commonly engages in a variety of research designed to provide insight into the motivation and relationships of individuals, departments, organizations, etc. This paper demonstrates how the application of concepts associated with the analysis of complex systems applied to such data sets can yield enhanced insights for managerial action.

  2. Orbital debris hazard insights from spacecraft anomalies studies

    NASA Astrophysics Data System (ADS)

    McKnight, Darren S.

    2016-09-01

    Since the dawning of the space age space operators have been tallying spacecraft anomalies and failures then using these insights to improve the space systems and operations. As space systems improved and their lifetimes increased, the anomaly and failure modes have multiplied. Primary triggers for space anomalies and failures include design issues, space environmental effects, and satellite operations. Attempts to correlate anomalies to the orbital debris environment have started as early as the mid-1990's. Early attempts showed tens of anomalies correlated well to altitudes where the cataloged debris population was the highest. However, due to the complexity of tracing debris impacts to mission anomalies, these analyses were found to be insufficient to prove causation. After the fragmentation of the Chinese Feng-Yun satellite in 2007, it was hypothesized that the nontrackable fragments causing anomalies in LEO would have increased significantly from this event. As a result, debris-induced anomalies should have gone up measurably in the vicinity of this breakup. Again, the analysis provided some subtle evidence of debris-induced anomalies but it was not convincing. The continued difficulty in linking debris flux to satellite anomalies and failures prompted the creation of a series of spacecraft anomalies and failure workshops to investigate the identified shortfalls. These gatherings have produced insights into why this process is not straightforward. Summaries of these studies and workshops are presented and observations made about how to create solutions for anomaly attribution, especially as it relates to debris-induced spacecraft anomalies and failures.

  3. Clinical correlates of loss of insight in bipolar depression.

    PubMed

    Silva, Rafael de Assis da; Mograbi, Daniel C; Camelo, Evelyn V M; Santana, Cristina M T; Landeira-Fernandez, Jesus; Cheniaux, Elie

    2017-01-01

    Affective state may influence insight, especially regarding mania. Nevertheless, studies have so far suggested that depression seems not to significantly impair insight. To the best of our knowledge, this study pioneers the evaluation of how insight variations in bipolar depression correlate with clinical variables. A group of 165 bipolar patients, 52 of whom had depressive episodes according to DSM-5 criteria, were followed during a year. All patients underwent clinical assessment, and insight was evaluated through the Insight Scale for Affective Disorders (ISAD). Repeated-measures ANOVA was calculated comparing scores on the four ISAD factors (insight into symptoms, the condition itself, self-esteem and social relationships) in order to investigate differences in insight according to different objects. Correlational analysis explored which clinical symptoms were linked to reduced insight. Worse total insight correlated with suicide attempt/ideation and fewer subsyndromal manic symptoms such as mood elevation, increased energy and sexual interest. Worse self-esteem insight was associated with not only suicide ideation/attempt but also with activity reduction and psychomotor retardation. Worse symptom insight also correlated with psychomotor retardation. Better insight into having an affective disorder was associated with more intense hypochondria symptoms. Finally, worse insight into having an illness was associated with psychotic episodes. Our study found that symptoms other than psychosis - suicide ideation, psychomotor retardation and reduction of activity and work - correlate with insight impairment in bipolar depression.

  4. Symptom burden and self-management in persons with chronic obstructive pulmonary disease.

    PubMed

    Bringsvor, Heidi B; Skaug, Knut; Langeland, Eva; Oftedal, Bjørg Frøysland; Assmus, Jörg; Gundersen, Doris; Osborne, Richard H; Bentsen, Signe Berit

    2018-01-01

    Self-management is crucial for effective COPD management. This study aimed at identifying associations between self-management and sociodemographic characteristics, clinical characteristics, and symptom burden in people with COPD. In this cross-sectional study with 225 participants diagnosed with COPD grades II-IV, multiple linear regression analysis was conducted, using sociodemographic and clinical characteristics and symptom burden (COPD Assessment Test) as the independent variables and the eight self-management domains of the Health Education Impact Questionnaire (heiQ) as the outcome variables. Higher symptom burden was significantly associated with worse scores in all self-management domains ( p <0.003), except for self-monitoring and insight ( p =0.012). Higher disease severity ( p =0.004) and numbers of comorbidities ( p <0.001) were associated with more emotional distress, and women scored higher than men on positive and active engagement in life ( p =0.001). Higher score in pack-years smoking was associated with lower score in health-directed activities ( p =0.006) and self-monitoring and insight ( p <0.001), and participation in organized physical training was associated with higher score in health-directed activities ( p <0.001). The final models explained 3.7%-31.7% of variance (adjusted R 2 ) across the eight heiQ scales. A notable finding of this study was that higher symptom burden was associated with worse scores in all self-management domains, except for self-monitoring and insight. In addition, sex, disease severity, comorbidity, pack-years smoking, and participation in organized physical training were associated with one or two self-management domains. The study contributes to improved understanding of self-management in COPD. However, the explained variance levels indicate that more research needs to be done to uncover what else explains self-management domains in COPD.

  5. “I see it now”: Using photo elicitation to understand chronic illness self-management

    PubMed Central

    Fritz, Heather; Lysack, Cathy

    2018-01-01

    Background How people integrate self-management into daily life remains underexamined, and such processes are difficult to elicit through traditional approaches used to understand human occupation. Purpose This paper will provide a brief overview of one visual research method, photo elicitation, that holds promise for studying self-management of health behaviours and will present findings from an analysis of how the use of photo elicitation interviews contributed additional insights into self-management beyond those generated from the data collected through the other methods used in the study. Method A qualitative, multiple-methods, multiple-case study was conducted with a purposive sample of 10 low-income women ages 40 to 64 with type 2 diabetes. Findings The photo elicitation interviews contributed insights beyond those generated from other study methods about how individuals viewed their self-management behaviours and how occupations changed across time. Implications Photo elicitation is a valuable research method for better understanding clients' chronic illness self-management practices. PMID:29898501

  6. Bureau of Land Management density management study.

    Treesearch

    John Cissel; Paul Anderson; Shanti Berryman; Sam Chan; Deanna Olson; Klaus Puettman

    2004-01-01

    The Bureau of Land Management (BLM), Pacific Northwest Research Station (PNW), U.S. Geological Survey (USGS), and Oregon State University (OSU) established the Density Management Study (DMS) in 1994 to develop and test options for young stand management to meet Northwest Forest Plan objectives in western Oregon. The DMS demonstrates and evaluates alternative approaches...

  7. New insights into insight: Neurophysiological correlates of the difference between the intrinsic "aha" and the extrinsic "oh yes" moment.

    PubMed

    Rothmaler, Katrin; Nigbur, Roland; Ivanova, Galina

    2017-01-27

    Insight refers to a situation in which a problem solver immediately changes his understanding of a problem situation. This representational change can either be triggered by external stimuli, like a hint or the solution itself, or by internal solution attempts. In the present paper, the differences and similarities between these two phenomena, namely "extrinsic" and "intrinsic" insight, are examined. To this end, electroencephalogram (EEG) is recorded while subjects either recognize or generate solutions to German verbal compound remote associate problems (CRA). Based on previous studies, we compare the alpha power prior to insightful solution recognition with the alpha power prior to insightful solution generation. Results show that intrinsic insights are preceded by an increase in alpha power at right parietal electrodes, while extrinsic insights are preceded by a respective decrease. These results can be interpreted in two ways. In consistency with other studies, the increase in alpha power before intrinsic insights can be interpreted as an increased internal focus of attention. Accordingly, the decrease in alpha power before extrinsic insights may be associated with a more externally oriented focus of attention. Alternatively, the increase in alpha power prior to intrinsic insights can be interpreted as an active inhibition of solution-related information, while the alpha power decrease prior to extrinsic insights may reflect its activation. Regardless of the interpretation, the results provide strong evidence that extrinsic and intrinsic insight differ on the behavioral as well as the neurophysiological level. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander is positioned atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  9. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    Encapsulated in its payload fairing, NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander is transported to Space Launch Complex 3 at Vandenberg Air Force Base in California. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  10. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, technicians and engineers position NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  11. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    Encapsulated in its payload fairing NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander is transported to Space Launch Complex 3 at Vandenberg Air Force Base in California. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  12. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander has been mated atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  13. Management of Leigh syndrome: Current status and new insights.

    PubMed

    Chen, L; Cui, Y; Jiang, D; Ma, C Y; Tse, H-F; Hwu, W-L; Lian, Q

    2018-06-01

    Leigh syndrome (LS) is an inherited mitochondrial encephalopathy associated with gene mutations of oxidative phosphorylation pathway that result in early disability and death in affected young children. Currently, LS is incurable and unresponsive to many treatments, although some case reports indicate that supplements can improve the condition. Many novel therapies are being continuously tested in pre-clinical studies. In this review, we summarize the genetic basis of LS, current treatment, pre-clinical studies in animal models and the management of other mitochondrial diseases. Future therapeutical strategies and challenges are also discussed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. A management study template for learning about postwildfire management.

    Treesearch

    B.T. Bormann; J.A. Laurence; K. Shimamoto; J. Thrailkill; J. Lehmkuhl; G. Reeves; A. Markus; D.W. Peterson; E. Forsman

    2008-01-01

    The concept of management studies--implemented by managers as normal business to meet priority learning needs--is applied to a priority regional question: how to manage after a large wildfire to better meet preexisting or new societal needs. Because of a lack of knowledge and studies, deciding how to manage after wildfire is fraught with uncertainty. We have developed...

  15. Insight into dementia care management using social-behavioral theory and mixed methods.

    PubMed

    Connor, Karen; McNeese-Smith, Donna; van Servellen, Gwen; Chang, Betty; Lee, Martin; Cheng, Eric; Hajar, Abdulrahman; Vickrey, Barbara G

    2009-01-01

    For health organizations (private and public) to advance their care-management programs, to use resources effectively and efficiently, and to improve patient outcomes, it is germane to isolate and quantify care-management activities and to identify overarching domains. The aims of this study were to identify and report on an application of mixed methods of qualitative statistical techniques, based on a theoretical framework, and to construct variables for factor analysis and exploratory factor analytic steps for identifying domains of dementia care management. Care-management activity data were extracted from the care plans of 181 pairs of individuals (with dementia and their informal caregivers) who had participated in the intervention arm of a randomized controlled trial of a dementia care-management program. Activities were organized into types, using card-sorting methods, influenced by published theoretical constructs on self-efficacy and general strain theory. These activity types were mapped in the initial data set to construct variables for exploratory factor analysis. Principal components extraction with varimax and promax rotations was used to estimate the number of factors. Cronbach's alpha was calculated for the items in each factor to assess internal consistency reliability. The two-phase card-sorting technique yielded 45 activity types out of 450 unique activities. Exploratory factor analysis produced four care-management domains (factors): behavior management, clinical strategies and caregiver support, community agency, and safety. Internal consistency reliability (Cronbach's alpha) of items for each factor ranged from.63 for the factor "safety" to.89 for the factor "behavior management" (Factor 1). Applying a systematic method to a large set of care-management activities can identify a parsimonious number of higher order categories of variables and factors to guide the understanding of dementia care-management processes. Further application of this

  16. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Tim Dunn, launch director, NASA’s Launch Services Program, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  17. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    A video showing NASA's InSight spacecraft separating from the Atlas V rocket is seen during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  18. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Andy Klesh, MarCO chief engineer, NASA JPL, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  19. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Tilman Spohn, HP3 investigation lead, Institute of Planetary Research (DLR), discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  20. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Stephanie Smith, Digital & Social Media Supervisor, Jet Propulsion Laboratory moderates a prelaunch media briefing for the NASA InSight mission, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  1. Quality pain management outcomes: the power of place.

    PubMed

    Wild, L R; Mitchell, P H

    2000-01-01

    This study explores how an organization, as the context of care, influences nursing practice and a nursing-sensitive, quality health outcome-pain management. The results provide important insights into organizational patterns associated with favorable pain management-related outcomes as well as the congruence between and among subunits within the organization. Outcomes were most favorable on units where nurses had attitudes supportive of aggressive pain management and higher levels of coordination and discretion.

  2. Sustainability, Complexity and Learning: Insights from Complex Systems Approaches

    ERIC Educational Resources Information Center

    Espinosa, A.; Porter, T.

    2011-01-01

    Purpose: The purpose of this research is to explore core contributions from two different approaches to complexity management in organisations aiming to improve their sustainability,: the Viable Systems Model (VSM), and the Complex Adaptive Systems (CAS). It is proposed to perform this by summarising the main insights each approach offers to…

  3. InSight Prelaunch

    NASA Image and Video Library

    2018-05-04

    American professional basketball player Chris Bosh poses for a photograph in front of the United Launch Alliance (ULA) Atlas-V rocket with NASA's InSight spacecraft onboard, Friday, May 4, 2018, at Vandenberg Air Force Base in California. Bosh joined other social media guests on a behind the scenes tour ahead of the planned launch. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  4. Liftoff of InSight

    NASA Image and Video Library

    2018-05-05

    A United Launch Alliance Atlas V rocket lifts off at 4:05 a.m. PDT (7:05 a.m. EDT) from Space Launch Complex 3 at Vandenberg Air Force Base in California carrying NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created.

  5. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    At Space l Launch Complex 3 at Vandenberg Air Force Base in California, a crane is used to lift NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander for mating atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  6. InSight Rollout to Pad

    NASA Image and Video Library

    2018-04-23

    At Space Launch Complex 3 at Vandenberg Air Force Base in California, a crane is used to lift NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander for mating atop a United Launch Alliance Atlas V rocket. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  7. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    1st Lieutenant Kristina Williams, weather officer, 30th Space Wing, Vandenberg Air Force Base, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  8. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Philippe Lognonné, SEIS investigation lead, Institut de Physique du Globe de Paris (IPGP) discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  9. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Col. Michael Hough, Commander 30th Space Wing, Vandenberg Air Force Base, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  10. Insight into the prevalence and distribution of microbial contamination to evaluate water management in the fresh produce processing industry.

    PubMed

    Holvoet, Kevin; Jacxsens, Liesbeth; Sampers, Imca; Uyttendaele, Mieke

    2012-04-01

    This study provided insight into the degree of microbial contamination in the processing chain of prepacked (bagged) lettuce in two Belgian fresh-cut produce processing companies. The pathogens Salmonella and Listeria monocytogenes were not detected. Total psychrotrophic aerobic bacterial counts (TPACs) in water samples, fresh produce, and environmental samples suggested that the TPAC is not a good indicator of overall quality and best manufacturing practices during production and processing. Because of the high TPACs in the harvested lettuce crops, the process water becomes quickly contaminated, and subsequent TPACs do not change much throughout the production process of a batch. The hygiene indicator Escherichia coli was used to assess the water management practices in these two companies in relation to food safety. Practices such as insufficient cleaning and disinfection of washing baths, irregular refilling of the produce wash baths with water of good microbial quality, and the use of high product/water ratios resulted in a rapid increase in E. coli in the processing water, with potential transfer to the end product (fresh-cut lettuce). The washing step in the production of fresh-cut lettuce was identified as a potential pathway for dispersion of microorganisms and introduction of E. coli to the end product via cross-contamination. An intervention step to reduce microbial contamination is needed, particularly when no sanitizers are used as is the case in some European Union countries. Thus, from a food safety point of view proper water management (and its validation) is a critical point in the fresh-cut produce processing industry.

  11. Is Insight Always the Same? A Protocol Analysis of Insight in Compound Remote Associate Problems

    ERIC Educational Resources Information Center

    Cranford, Edward A.; Moss, Jarrod

    2012-01-01

    Compound Remote Associate (CRA) problems have been used to investigate insight problem solving using both behavioral and neuroimaging techniques. However, it is unclear to what extent CRA problems exhibit characteristics of insight such as impasses and restructuring. CRA problem-solving characteristics were examined in a study in which…

  12. Artist Concept of InSight Lander on Mars

    NASA Image and Video Library

    2015-08-18

    This artist's concept from August 2015 depicts NASA's InSight Mars lander fully deployed for studying the deep interior of Mars. This illustration updates the correct placement and look of Insight's main instruments. For an earlier artist rendition, see PIA17358. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, will investigate processes that formed and shaped Mars. Its findings will improve understanding about the evolution of our inner solar system's rocky planets, including Earth. The lander will be the first mission to permanently deploy instruments directly onto Martian ground using a robotic arm. The two instruments to be placed into a work area in front of the lander are a seismometer (contributed by the French space agency Centre National d'Études Spatiales, or CNES) to measure the microscopic ground motions from distant marsquakes providing information about the interior structure of Mars, and a heat-flow probe (contributed by the German Aerospace Center, or DLR) designed to hammer itself 3 to 5 meters (about 16 feet) deep and monitor heat coming from the planet's interior. The mission will also track the lander's radio to measure wobbles in the planet's rotation that relate to the size of its core and a suite of environmental sensors to monitor the weather and variations in the magnetic field. Two cameras will aid in instrument deployment and monitoring the local environment. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using Seismic Investigations Geodesy and Heat Transport (InSight) mission. The decision follows unsuccessful attempts to repair a leak in a section of the prime instrument in the science payload. http://photojournal.jpl.nasa.gov/catalog/PIA19811

  13. Insight and psychopathology in never-treated schizophrenia.

    PubMed

    Tirupati, Srinivasan; Padmavati, Raman; Thara, Rangaswamy; McCreadie, Robin G

    2007-01-01

    Insight is a feature of schizophrenia related to psychopathology, which could be modified by treatment. The real relationship will be more evident in the never-treated state. This study compared insight and its relationship to psychopathology in 143 never-treated patients with chronic schizophrenia with 183 treated patients. The treated patients had not received any structured intervention for improvement of insight. The item on insight and judgment from the Positive and Negative Syndrome Scale for schizophrenia was used as a measure of insight. Never-treated patients were more ill and poorer in insight than the TT group. Sex, age, duration of illness, negative symptoms related to insight only in the TT group. Positive symptoms score correlated with insight in both the groups, but negative symptoms correlated with insight only among the treated patients. Delusions, uncooperativeness, and poor attention predicted 27% of variation in the level of insight in the never-treated, whereas age; duration of illness; and symptoms of emotional withdrawal, difficulty in abstract thinking, and uncooperativeness predicted 30.3% of variation in insight of the TT group. The observed differences between the never-treated and treated subjects were due to influence of treatment on the association between insight and psychopathology. A subgroup of patients with a treatment-resistant trait of negative symptoms associated with poor insight was hypothesized.

  14. Does the organisational model of dementia case management make a difference in satisfaction with case management and caregiver burden? An evaluation study.

    PubMed

    Peeters, José M; Pot, Anne Margriet; de Lange, Jacomine; Spreeuwenberg, Peter M; Francke, Anneke L

    2016-03-09

    In the Netherlands, various organisational models of dementia case management exist. In this study the following four models are distinguished, based on differences in the availability of the service and in the case management function: Model 1: the case management service is available from first dementia symptoms + is always a separate specialist function; Model 2: the case management service is only available after a formal dementia diagnosis + is always a separate specialist function; Model 3: the case management service is available from first dementia symptoms + is often a combined function; Model 4: the case management service is only available after a formal dementia diagnosis + is often a combined function. The objectives of this study are to give insight into whether satisfaction with dementia case management and the development of caregiver burden depend on the organisational model. A survey was carried out in regional dementia care networks in the Netherlands among 554 informal carers for people with dementia at the start of case management (response of 85 %), and one year later. Descriptive statistics and multilevel models were used to analyse the data. The satisfaction with the case manager was high in general (an average of 8.0 within a possible range of 1 to 10), although the caregiver burden did not decrease in the first year after starting with case management. No differences were found between the four organisational models regarding the development of caregiver burden. However, statistically significant differences (p < 0.05) were found regarding satisfaction: informal carers in the organisational model where case management is only available after formal diagnosis of dementia and is often a combined function had on average the lowest satisfaction scores. Nevertheless, the satisfaction of informal carers within all organisational models was high (ranging from 7.51 to 8.40 within a range of 1 to 10). Organisational features of case management seem

  15. Management of ErbB2-positive Breast Cancer: Insights from Preclinical and Clinical Studies with Lapatinib

    PubMed Central

    Vogel, Charles; Chan, Arlene; Gril, Brunilde; Kim, Sung-Bae; Kurebayashi, Junichi; Liu, Li; Lu, Yen-Shen; Moon, Hanlim

    2010-01-01

    The management of human epidermal growth factor receptor 2-positive (ErbB2+) breast cancer is challenging; patients with ErbB2+ breast tumors have more aggressive disease and a poor prognosis. The increasing incidence of breast cancer in Asia and the limitations of existing treatments pose additional challenges. In this review, we summarize the preclinical and clinical evidence that indicates how lapatinib, a novel inhibitor that targets the human epidermal growth factor receptor (ErbB1) and ErbB2 may help clinicians address four particularly challenging issues in the management of ErbB2+ breast cancer. These issues are: (i) trastuzumab therapy failure, (ii) development of central nervous system metastases, (iii) minimizing toxicity and (iv) selecting the most appropriate partners (chemotherapy and non-chemotherapy) for combination therapy with lapatinib. Lapatinib, in combination with chemotherapeutic agents, such as capecitabine, provides clinical benefits to patients with ErbB2+ breast cancer, including patients who develop progressive disease on trastuzumab. Lapatinib, in combination with non-chemotherapeutic agents, such as letrozole, may also provide a chemotherapy-free treatment option for postmenopausal patients with estrogen receptor-positive/ErbB2+ metastatic breast cancer. Encouraging results have also emerged regarding the synergistic effects of lapatinib in combination with other agents for the treatment of ErbB2+ breast cancer. Promising findings have also been reported for the use of lapatinib to prevent and treat central nervous system metastases. Collectively, these results indicate that the judicious use of lapatinib, an effective oral therapy with a manageable toxicity profile, can enhance the management of patients with ErbB2+ breast cancer. PMID:20542996

  16. Management of ErbB2-positive breast cancer: insights from preclinical and clinical studies with lapatinib.

    PubMed

    Vogel, Charles; Chan, Arlene; Gril, Brunilde; Kim, Sung-Bae; Kurebayashi, Junichi; Liu, Li; Lu, Yen-Shen; Moon, Hanlim

    2010-11-01

    The management of human epidermal growth factor receptor 2-positive (ErbB2+) breast cancer is challenging; patients with ErbB2+ breast tumors have more aggressive disease and a poor prognosis. The increasing incidence of breast cancer in Asia and the limitations of existing treatments pose additional challenges. In this review, we summarize the preclinical and clinical evidence that indicates how lapatinib, a novel inhibitor that targets the human epidermal growth factor receptor (ErbB1) and ErbB2 may help clinicians address four particularly challenging issues in the management of ErbB2+ breast cancer. These issues are: (i) trastuzumab therapy failure, (ii) development of central nervous system metastases, (iii) minimizing toxicity and (iv) selecting the most appropriate partners (chemotherapy and non-chemotherapy) for combination therapy with lapatinib. Lapatinib, in combination with chemotherapeutic agents, such as capecitabine, provides clinical benefits to patients with ErbB2+ breast cancer, including patients who develop progressive disease on trastuzumab. Lapatinib, in combination with non-chemotherapeutic agents, such as letrozole, may also provide a chemotherapy-free treatment option for postmenopausal patients with estrogen receptor-positive/ErbB2+ metastatic breast cancer. Encouraging results have also emerged regarding the synergistic effects of lapatinib in combination with other agents for the treatment of ErbB2+ breast cancer. Promising findings have also been reported for the use of lapatinib to prevent and treat central nervous system metastases. Collectively, these results indicate that the judicious use of lapatinib, an effective oral therapy with a manageable toxicity profile, can enhance the management of patients with ErbB2+ breast cancer.

  17. Forest fire management to avoid unintended consequences: a case study of Portugal using system dynamics.

    PubMed

    Collins, Ross D; de Neufville, Richard; Claro, João; Oliveira, Tiago; Pacheco, Abílio P

    2013-11-30

    Forest fires are a serious management challenge in many regions, complicating the appropriate allocation to suppression and prevention efforts. Using a System Dynamics (SD) model, this paper explores how interactions between physical and political systems in forest fire management impact the effectiveness of different allocations. A core issue is that apparently sound management can have unintended consequences. An instinctive management response to periods of worsening fire severity is to increase fire suppression capacity, an approach with immediate appeal as it directly treats the symptom of devastating fires and appeases the public. However, the SD analysis indicates that a policy emphasizing suppression can degrade the long-run effectiveness of forest fire management. By crowding out efforts to preventative fuel removal, it exacerbates fuel loads and leads to greater fires, which further balloon suppression budgets. The business management literature refers to this problem as the firefighting trap, wherein focus on fixing problems diverts attention from preventing them, and thus leads to inferior outcomes. The paper illustrates these phenomena through a case study of Portugal, showing that a balanced approach to suppression and prevention efforts can mitigate the self-reinforcing consequences of this trap, and better manage long-term fire damages. These insights can help policymakers and fire managers better appreciate the interconnected systems in which their authorities reside and the dynamics that may undermine seemingly rational management decisions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Culturally Relevant Management Education: Insights from Experience in Nunavut

    ERIC Educational Resources Information Center

    Wihak, Christine

    2005-01-01

    The author's experience with a Nunavut business management education program illustrates how to develop culturally relevant organizational behavior curriculum. The process initially involved interviews with Inuit Elders about culturally appropriate responses to scenarios of cultural conflicts in the workplace identified by Inuit managers. The…

  19. Cachexia in chronic obstructive pulmonary disease: new insights and therapeutic perspective

    PubMed Central

    Sanders, Karin J. C.; Kneppers, Anita E. M.; van de Bool, Coby; Langen, Ramon C. J.

    2015-01-01

    Abstract Cachexia and muscle wasting are well recognized as common and partly reversible features of chronic obstructive pulmonary disease (COPD), adversely affecting disease progression and prognosis. This argues for integration of weight and muscle maintenance in patient care. In this review, recent insights are presented in the diagnosis of muscle wasting in COPD, the pathophysiology of muscle wasting, and putative mechanisms involved in a disturbed energy balance as cachexia driver. We discuss the therapeutic implications of these new insights for optimizing and personalizing management of COPD‐induced cachexia. PMID:27066314

  20. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    1st Lieutenant Kristina Williams, weather officer, 30th Space Wing, Vandenberg Air Force Base, right, discusses NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  1. Portfolio Management Decision Support Tools Analysis Relating to Management Value Metrics

    DTIC Science & Technology

    2007-03-01

    creative activities that have been labeled “management dark matter ” (Housel and Kanevsky, 2007). Further, this new source of data can be used, not...organization. “The idea of management dark matter is introduced in this literature as the use of manager’s creative insights when they attempt to...we account for the dark matter or intuitive (i.e., non-algorithmically definable) heuristics that allow a manager to make creative management

  2. InSight Rollout for Launch

    NASA Image and Video Library

    2018-05-04

    At Vandenberg Air Force Base in California, the gantry rolls back at Space Launch Complex 3 in preparation for the liftoff of NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. The United Launch Alliance Atlas V rocket now is poised to boost the spacecraft with liftoff scheduled for 4:05 a.m. PDT (7:05 a.m. EDT). InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. InSight will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created.

  3. An insight of traditional plasmid curing in Vibrio species

    PubMed Central

    Letchumanan, Vengadesh; Chan, Kok-Gan; Lee, Learn-Han

    2015-01-01

    As the causative agent of foodborne related illness, Vibrio species causes a huge impact on the public health and management. Vibrio species is often associated with seafood as the latter plays a role as a vehicle to transmit bacterial infections. Hence, antibiotics are used not to promote growth but rather to prevent and treat bacterial infections. The extensive use of antibiotics in the aquaculture industry and environment has led to the emerging of antibiotic resistant strains. This phenomenon has triggered an alarming public health concern due to the increase number of pathogenic Vibrio strains that are resistant to clinically used antibiotics and is found in the environment. Antibiotic resistance and the genes location in the strains can be detected through plasmid curing assay. The results derived from plasmid curing assay is fast, cost effective, sufficient in providing insights, and influence the antibiotic management policies in the aquaculture industry. This presentation aims in discussing and providing insights on various curing agents in Vibrio species. To our best of knowledge, this is a first review written discussing on plasmid curing in Vibrio species. PMID:26347714

  4. Insights into the management of chronic myeloid leukemia in resource-poor settings: a Mexican perspective.

    PubMed

    Gomez-de-León, Andrés; Gómez-Almaguer, David; Ruiz-Delgado, Guillermo J; Ruiz-Arguelles, Guillermo J

    2017-09-01

    The arrival of targeted therapy for chronic myeloid leukemia (CML) was revolutionary. However, due to the high cost of tyrosine kinase inhibitors, access to this highly effective therapy with strict monitoring strategies is limited in low to middle-income countries. In this context, following standard recommendations proposed by experts in developed countries is difficult. Areas covered: This review aims to provide an insight into the management of patients with CML living in a resource-limited setting. It addresses several issues: diagnosis, initial treatment, disease monitoring, and additional treatment alternatives including allogeneic hematopoietic stem cell transplantation. Expert commentary: Imatinib is probably the most cost-effective TKI for initial treatment in developing and underdeveloped countries. Generic imatinib preparations should be evaluated before considering their widespread use. Adherence to treatment should be emphasized. Adequate monitoring can be performed through several methods successfully and is important for predicting outcomes, particularly early in the first year, and if treatment suspension is being considered. Access to further therapeutic alternatives should define our actions after failure or intolerance to imatinib, preferring additional TKIs if possible. Allogeneic transplantation in chronic phase is a viable option in this context.

  5. Clinicians' Views on Management and Terminology for Papillary Thyroid Microcarcinoma: A Qualitative Study.

    PubMed

    Nickel, Brooke; Brito, Juan P; Barratt, Alexandra; Jordan, Susan; Moynihan, Ray; McCaffery, Kirsten

    2017-05-01

    There is growing acceptance that the increase in thyroid cancer incidence is in part a result of overdiagnosis of small low-risk papillary microcarcinomas (PMCs) with indolent clinical course. Although surgery is the cornerstone treatment for patients with PMCs, recent management guidelines are shifting toward inclusion of more conservative treatments such as active surveillance. There is little evidence on clinicians' experience in managing PMC patients and their attitudes toward treatment options, including their willingness to accept a nonsurgical option. The aim of this study was to understand how clinicians perceive a diagnosis of PMC, potential changes to terminology, and the treatment options available to patients. This was a qualitative study using semi-structured interviews conducted between November 2015 and May 2016 with 22 clinicians (seven endocrinologists and 15 thyroid surgeons). Transcribed audio-recordings were thematically coded, and a framework method was used to analyze the data. Across a sample of clinicians who manage thyroid cancer patients, awareness of overdiagnosis and overtreatment of PMC was common. However, there was little acceptance of active surveillance to manage these patients. Clinicians did not feel comfortable recommending this management approach, as they were worried about the risk of metastases, did not feel that evidence to support this approach was strong enough, and also believed that patients currently have a high preference for surgery. The majority of clinicians did not believe that changing the terminology of this diagnosis was a viable strategy to reduce patients' anxiety and their perceived preference for more aggressive treatments. However, most clinicians felt that thyroid nodules <1 cm should not be biopsied, which could help minimize the risk of overdiagnosis of PMC. This study, based on a non-representative sample of 22 clinicians, which remains an important limitation, provides revealing insight into

  6. Applying business intelligence innovations to emergency management.

    PubMed

    Schlegelmilch, Jeffrey; Albanese, Joseph

    2014-01-01

    The use of business intelligence (BI) is common among corporations in the private sector to improve business decision making and create insights for competitive advantage. Increasingly, emergency management agencies are using tools and processes similar to BI systems. With a more thorough understanding of the principles of BI and its supporting technologies, and a careful comparison to the business model of emergency management, this paper seeks to provide insights into how lessons from the private sector can contribute to the development of effective and efficient emergency management BI utilisation.

  7. Impact of interpersonal factors on insight in schizophrenia.

    PubMed

    Hélène, Tastet; Hélène, Verdoux; Jean, Bouisson; Jean-Marc, Destaillats; Antoinette, Prouteau

    2014-11-01

    Whereas clinical insight in schizophrenia has been consistently associated with personal factors (i.e. sociodemographic characteristics, symptoms or cognition), little is known about its relationships with interpersonal factors (i.e. close environment and personal characteristics involved in social interactions). Most of the few studies available have focused on one particular interpersonal factor, such as social cognition, contact frequencies or therapeutic alliance. To date, no study has explored the specificity of associations between clinical insight and different levels of interpersonal factors, neither if these associations are independent of personal factors. Associations between insight and interpersonal factors were explored through multiple regression in a sample of 80 outpatients with schizophrenia spectrum disorders. Lower insight was associated with lower interpersonal functioning, independently from personal factors such as age, gender, age at first hospitalization, executive functioning and symptoms. Our findings replicate previous studies with regard to the associations between clinician-rated insight and social cognition or social contact frequencies. They also provide new information about specific associations between clinician-rated insight and perceived social support as well as between patient-rated insight and therapeutic alliance. Finally, models of insight based on personal factors were significantly improved by the inclusion of interpersonal factors. These results strongly support the crucial role of interpersonal factors in insight, both from the clinician's and the patient's point of view. These exploratory data require further replication. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Genetic correlates of insight in schizophrenia.

    PubMed

    Xavier, Rose Mary; Vorderstrasse, Allison; Keefe, Richard S E; Dungan, Jennifer R

    2018-05-01

    Insight in schizophrenia is clinically important as it is associated with several adverse outcomes. Genetic contributions to insight are unknown. We examined genetic contributions to insight by investigating if polygenic risk scores (PRS) and candidate regions were associated with insight. Schizophrenia case-only analysis of the Clinical Antipsychotics Trials of Intervention Effectiveness trial. Schizophrenia PRS was constructed using Psychiatric Genomics Consortium (PGC) leave-one out GWAS as discovery data set. For candidate regions, we selected 105 schizophrenia-associated autosomal loci and 11 schizophrenia-related oligodendrocyte genes. We used regressions to examine PRS associations and set-based testing for candidate analysis. We examined data from 730 subjects. Best-fit PRS at p-threshold of 1e-07 was associated with total insight (R 2 =0.005, P=0.05, empirical P=0.054) and treatment insight (R 2 =0.005, P=0.048, empirical P=0.048). For models that controlled for neurocognition, PRS significantly predicted treatment insight but at higher p-thresholds (0.1 to 0.5) but did not survive correction. Patients with highest polygenic burden had 5.9 times increased risk for poor insight compared to patients with lowest burden. PRS explained 3.2% (P=0.002, empirical P=0.011) of variance in poor insight. Set-based analyses identified two variants associated with poor insight- rs320703, an intergenic variant (within-set P=6e-04, FDR P=0.046) and rs1479165 in SOX2-OT (within-set P=9e-04, FDR P=0.046). To the best of our knowledge, this is the first study examining genetic basis of insight. We provide evidence for genetic contributions to impaired insight. Relevance of findings and necessity for replication are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Insights from human genetic studies of lung and organ fibrosis.

    PubMed

    Garcia, Christine Kim

    2018-01-02

    Genetic investigations of fibrotic diseases, including those of late onset, often yield unanticipated insights into disease pathogenesis. This Review focuses on pathways underlying lung fibrosis that are generalizable to other organs. Herein, we discuss genetic variants subdivided into those that shorten telomeres, activate the DNA damage response, change resident protein expression or function, or affect organelle activity. Genetic studies provide a window into the downstream cascade of maladaptive responses and pathways that lead to tissue fibrosis. In addition, these studies reveal interactions between genetic variants, environmental factors, and age that influence the phenotypic spectrum of disease. The discovery of forces counterbalancing inherited risk alleles identifies potential therapeutic targets, thus providing hope for future prevention or reversal of fibrosis.

  10. Insight in schizophrenia: involvement of self-reflection networks?

    PubMed

    van der Meer, Lisette; de Vos, Annerieke E; Stiekema, Annemarie P M; Pijnenborg, Gerdina H M; van Tol, Marie-José; Nolen, Willem A; David, Anthony S; Aleman, André

    2013-11-01

    Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one's traits and characteristics. The current study aims to investigate the neural correlates of self-reflective processing and its relationship with insight in schizophrenia. Forty-seven schizophrenia patients and 21 healthy controls performed a self-reflection task in a functional magnetic resonance imaging (fMRI) scanner. The tasks comprised a self-reflection, close other-reflection, and a semantic (baseline) condition. Insight scores were obtained with the Schedule of Assessment of Insight Expanded. In addition, cognitive insight scores were obtained (Beck Cognitive Insight Scale [BCIS]). Schizophrenia patients demonstrated less activation in the posterior cingulate cortex in the self- and other-reflection conditions and less activation in the precuneus in the other-reflection condition compared with healthy controls. Better insight was associated with greater response in the inferior frontal gyrus, anterior insula, and inferior parietal lobule during self-reflection. In addition, better cognitive insight was associated with higher activation in ventromedial prefrontal cortex during self-reflection. In the current study, evidence for a relationship between self-reflection and insight in patients with schizophrenia was found in brain areas related to self-reflection, self/other distinction and source attribution. The findings support the rationale for a treatment that is currently under evaluation, which attempts to increase insight by enhancing self-reflection.

  11. High-level managers' considerations for RFID adoption in hospitals: an empirical study in Taiwan.

    PubMed

    Lai, Hui-Min; Lin, I-Chun; Tseng, Ling-Tzu

    2014-02-01

    Prior researches have indicated that an appropriate adoption of information technology (IT) can help hospitals significantly improve services and operations. Radio Frequency Identification (RFID) is believed to be the next generation innovation technology for automatic data collection and asset/people tracking. Based on the Technology-Organization-Environment (TOE) framework, this study investigated high-level managers' considerations for RFID adoption in hospitals. This research reviewed literature related IT adoption in business and followed the results of a preliminary survey with 37 practical experts in hospitals to theorize a model for the RFID adoption in hospitals. Through a field survey of 102 hospitals and hypotheses testing, this research identified key factors influencing RFID adoption. Follow-up in-depth interviews with three high-level managers of IS department from three case hospitals respectively also presented an insight into the decision of RFID's adoption. Based on the research findings, cost, ubiquity, compatibility, security and privacy risk, top management support, hospital scale, financial readiness and government policy were concluded to be the key factors influencing RFID adoption in hospitals. For practitioners, this study provided a comprehensive overview of government policies able to promote the technology, while helping the RFID solution providers understand how to reduce the IT barriers in order to enhance hospitals' willingness to adopt RFID.

  12. How Do Teachers Become Knowledgeable and Confident in Classroom Management? Insights from a Pilot Study. Teaching in Focus, No. 19

    ERIC Educational Resources Information Center

    OECD Publishing, 2017

    2017-01-01

    The Innovative Teaching for Effective Learning (ITEL) Teacher Knowledge Survey is the first international study to explore the nature, function and development of teachers' pedagogical knowledge, i.e. what teachers know about teaching and learning. In-service and pre-service teachers exhibited higher knowledge on the classroom management portion…

  13. Factors affecting fire suppression costs as identified by incident management teams

    Treesearch

    Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

    2006-01-01

    This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

  14. Neurobiological Basis of Insight in Schizophrenia: A Systematic Review.

    PubMed

    Xavier, Rose Mary; Vorderstrasse, Allison

    2016-01-01

    Insight in schizophrenia is defined as awareness into illness, symptoms, and need for treatment and has long been associated with cognition, other psychopathological symptoms, and several adverse clinical and functional outcomes. However, the biological basis of insight is not clearly understood. The aim of this systematic review was to critically evaluate and summarize advances in the study of the biological basis of insight in schizophrenia and to identify gaps in this knowledge. A literature search of PubMed, CINAHL, PsycINFO, and EMBASE databases was conducted using search terms to identify articles relevant to the biology of insight in schizophrenia published in the last 6 years. Articles that focused on etiology of insight in schizophrenia and those that examined the neurobiology of insight in schizophrenia or psychoses were chosen for analysis. Articles on insight in conditions other than schizophrenia or psychoses and which did not investigate the neurobiological underpinnings of insight were excluded from the review. Twenty-six articles met the inclusion criteria for this review. Of the 26 articles, 3 focused on cellular abnormalities and 23 were neuroimaging studies. Preliminary data identify the prefrontal cortex, cingulate cortex, and regions of the temporal and parietal lobe (precuneus, inferior parietal lobule) and hippocampus as the neural correlates of insight. A growing body of literature attests to the neurobiological basis of insight in schizophrenia. Current evidence supports the neurobiological basis of insight in schizophrenia and identifies specific neural correlates for insight types and its dimensions. Further studies that examine the precise biological mechanisms of insight are needed to apply this knowledge to effective clinical intervention development.

  15. [Relationship between insight, violence and diagnoses in psychotic patients].

    PubMed

    Lera Calatayud, Guillem; Herrero Sebastián, Neus; Aguilar García-Iturrospe, Eduardo; González Piqueras, José Carlos; Sanjuán Arias, Julio; Leal Cercós, Carmen

    2012-01-01

    Lack of insight is a common clinical problem in psichiatric patients, but few times has been properly studied until recently. Patients with good insight tend to show a better treatment adherence with a better prognosis and swow less hostility. This study aims to investigate whether there is a relationship between the hostility degree and insight or not and to anlalyze if there are insight quantitative differences between the patients regarding their diagnoses. 168 psychotic patients were studied (including 86 patients with schizophrenia and 43 with bipolar disorder). PANNS P7 (hostility) item and G14 (poor impulse control) were analized in order to assess patients' violence and G12 in order to assess insight. All these data was correlated. It was also analyzed the PANSS results of schizophrenic vs bipolar patients regarding insight and hostility separately looking for a more homogenic pull of patients. Patients with greater hostility showed a worse impulse control and poorer insight than the rest. Schizophrenic patients showed a greater hostility and lower insight than bipolar patients. Lack of insight may lead to a greater hostility and worse impulse control. Therapeutic interventions adressed to improve insight could indirectly lower hostility and gain a better impulse control for psychotic patients. Copyright © 2010 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  16. New insights in morphological analysis for managing activated sludge systems.

    PubMed

    Oliveira, Pedro; Alliet, Marion; Coufort-Saudejaud, Carole; Frances, Christine

    2018-06-01

    In activated sludge (AS) process, the impact of the operational parameters on process efficiency is assumed to be correlated with the sludge properties. This study provides a better insight into these interactions by subjecting a laboratory-scale AS system to a sequence of operating condition modifications enabling typical situations of a wastewater treatment plant to be represented. Process performance was assessed and AS floc morphology (size, circularity, convexity, solidity and aspect ratio) was quantified by measuring 100,000 flocs per sample with an automated image analysis technique. Introducing 3D distributions, which combine morphological properties, allowed the identification of a filamentous bulking characterized by a floc population shift towards larger sizes and lower solidity and circularity values. Moreover, a washout phenomenon was characterized by smaller AS flocs and an increase in their solidity. Recycle ratio increase and COD:N ratio decrease both promoted a slight reduction of floc sizes and a constant evolution of circularity and convexity values. The analysis of the volume-based 3D distributions turned out to be a smart tool to combine size and shape data, allowing a deeper understanding of the dynamics of floc structure under process disturbances.

  17. The Association of Insight and Change in Insight with Clinical Symptoms in Depressed Inpatients.

    PubMed

    He, Hongbo; Chang, Qing; Ma, Yarong

    2018-04-25

    Lack of insight has been extensively studied and was found to be adversely correlated with impaired treatment compliance and worse long term clinical outcomes among patients with schizophrenia, while not much is known about this phenonmenon in patients with severe depression. To explore the correlates of insight and its relation to symptom changes among the most seriously ill patients with affective disorders, those who require hospitalization. Patients hospitalized in a large psychiatric hospital in south China with either major depressive disorder (MDD)(N=55) or bipolar depression (BD) (N=85) based on ICD-10 diagnostic criteria were assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ) one week after admission and at the time of discharge. Clinical symptoms were measured at the same time with the Hamilton Rating Scale for Depression (HAMD-17) and the Depression subscale of the Symptom Check list-90 (SCL-90). Length of stay (LOS), duration of illness, duration of untreated mood disorder, number of previous episodes of depression and previous admissions for depression were documented during interviews with patients and their families and from a review of medical records. Bivariate correlations and multiple regression analysis were used to examine the relationship of sociodemographic characteristics, clinical symptomatology and clinical history, to insight at the time of admission. The relationships between change in clinical symptoms and change in insight from admission to discharge were also examined. Stepwise multiple regression models suggested that any previous admissions for depression and higher anxiety factor scores on the HAMD-17 are significant independent predictors of insight accounting for 22.9% of the variance. Multiple regression analysis residual change scores (change scores adjusted for baseline values) on the ITAQ showed that improved insight over average stays of 51 days were inversely related to the residual psychomotor

  18. The Association of Insight and Change in Insight with Clinical Symptoms in Depressed Inpatients

    PubMed Central

    HE, Hongbo; CHANG, Qing; MA, Yarong

    2018-01-01

    Background Lack of insight has been extensively studied and was found to be adversely correlated with impaired treatment compliance and worse long term clinical outcomes among patients with schizophrenia, while not much is known about this phenonmenon in patients with severe depression. Aim To explore the correlates of insight and its relation to symptom changes among the most seriously ill patients with affective disorders, those who require hospitalization. Methods Patients hospitalized in a large psychiatric hospital in south China with either major depressive disorder (MDD)(N=55) or bipolar depression (BD) (N=85) based on ICD-10 diagnostic criteria were assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ) one week after admission and at the time of discharge. Clinical symptoms were measured at the same time with the Hamilton Rating Scale for Depression (HAMD-17) and the Depression subscale of the Symptom Check list-90 (SCL-90). Length of stay (LOS), duration of illness, duration of untreated mood disorder, number of previous episodes of depression and previous admissions for depression were documented during interviews with patients and their families and from a review of medical records. Bivariate correlations and multiple regression analysis were used to examine the relationship of sociodemographic characteristics, clinical symptomatology and clinical history, to insight at the time of admission. The relationships between change in clinical symptoms and change in insight from admission to discharge were also examined. Results Stepwise multiple regression models suggested that any previous admissions for depression and higher anxiety factor scores on the HAMD-17 are significant independent predictors of insight accounting for 22.9% of the variance. Multiple regression analysis residual change scores (change scores adjusted for baseline values) on the ITAQ showed that improved insight over average stays of 51 days were inversely related to the

  19. Contemporary Management and Control of Uncomplicated Hypertension in Canada: Insight From the Primary Care Audit of Global Risk Management (PARADIGM) Study.

    PubMed

    Gupta, Milan; Szmitko, Paul; Singh, Narendra; Tsigoulis, Michelle; Kajil, Mahesh; Stone, James

    2015-05-01

    Although clinical practice guidelines for the management of hypertension exist in Canada, the rate of contemporary blood pressure (BP) control remains unclear. In the Primary Care Audit of Global Risk Management (PARADIGM) study, 3015 healthy, middle-aged Canadians, free of cardiovascular disease (CVD) or diabetes were evaluated. In this analysis, we characterized the CVD risk factors, treatment patterns, and BP control rates in subjects with uncomplicated hypertension. A total of 917 subjects (30.4%) had a diagnosis of hypertension. The median age was 59 ± 8 years. The mean treated systolic/diastolic BP were 134 ± 14 mm Hg/82 ± 9 mm Hg, respectively. CVD risk factors included past/current smoking (35.9%), abdominal obesity (62.5%), and dyslipidemia (59.4%). Using the Framingham Risk Score, 20.4%, 41.0%, and 38.5% of the subjects were at low, intermediate, and high risk, respectively. Of the 88% with treated hypertension, 46.9%, 38.7%, and 14.3% received 1, 2, or ≥3 drugs, respectively. The rate of BP control was 57.4% (systolic BP < 140 and diastolic BP < 90 mm Hg). The rate of BP control was lower in patients prescribed diuretic monotherapy (53.2%) vs those who received angiotensin converting enzyme inhibitor/angiotensin receptor blocker monotherapy (66.5%; P < 0.01). Importantly, BP control deteriorated with increasing Framingham Risk Score, and was lower in patients with metabolic syndrome vs those without (P < 0.00001 for both). PARADIGM demonstrated that CVD risk factors are prevalent in Canadians with uncomplicated hypertension. BP control was modest (57.4%) and was lowest in patients prescribed diuretic monotherapy and in those at highest CVD risk. Despite the success of national hypertension strategies, enhanced efforts are warranted to improve BP control in Canada. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  20. Beyond disease susceptibility-Leveraging genome-wide association studies for new insights into complex disease biology.

    PubMed

    Lee, J C

    2017-12-01

    Genetic studies in complex diseases have been highly successful, but have also been largely one-dimensional: predominantly focusing on the genetic contribution to disease susceptibility. While this is undoubtedly important-indeed it is a pre-requisite for understanding the mechanisms underlying disease development-there are many other important aspects of disease biology that have received comparatively little attention. In this review, I will discuss how existing genetic data can be leveraged to provide new insights into other aspects of disease biology, why such insights could change the way we think about complex disease, and how this could provide opportunities for better therapies and/or facilitate personalised medicine. To do this, I will use the example of Crohn's disease-a chronic form of inflammatory bowel disease that has been one of the main success stories in complex disease genetics. Indeed, thanks to genetic studies, we now have a much more detailed understanding of the processes involved in Crohn's disease development, but still know relatively little about what determines the subsequent disease course (prognosis) and why this differs so considerably between individuals. I will discuss how we came to realise that genetic variation plays an important role in determining disease prognosis and how this has changed the way we think about Crohn's disease genetics. This will illustrate how phenotypic data can be used to leverage new insights from genetic data and will provide a broadly applicable framework that could yield new insights into the biology of multiple diseases. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Distinct pattern of cerebral blood flow alterations specific to schizophrenics experiencing auditory verbal hallucinations with and without insight: a pilot study.

    PubMed

    Jing, Rixing; Huang, Jiangjie; Jiang, Deguo; Lin, Xiaodong; Ma, Xiaolei; Tian, Hongjun; Li, Jie; Zhuo, Chuanjun

    2018-01-23

    Schizophrenia is associated with widespread and complex cerebral blood flow (CBF) disturbance. Auditory verbal hallucinations (AVH) and insight are the core symptoms of schizophrenia. However, to the best of our knowledge, very few studies have assessed the CBF characteristics of the AVH suffered by schizophrenic patients with and without insight. Based on our previous findings, Using a 3D pseudo-continuous ASL (pcASL) technique, we investigated the differences in AVH-related CBF alterations in schizophrenia patients with and without insight. We used statistical parametric mapping (SPM8) and statistical non-parametric mapping (SnPM13) to perform the fMRI analysis. We found that AVH-schizophrenia patients without insight showed an increased CBF in the left temporal pole and a decreased CBF in the right middle frontal gyrus when compared to AVH-schizophrenia patients with insight. Our novel findings suggest that AVH-schizophrenia patients without insight possess a more complex CBF disturbance. Simultaneously, our findings also incline to support the idea that the CBF aberrant in some specific brain regions may be the common neural basis of insight and AVH. Our findings support the mostly current hypotheses regarding AVH to some extent. Although our findings come from a small sample, it provide the evidence that indicate us to conduct a larger study to thoroughly explore the mechanisms of schizophrenia, especially the core symptoms of AVHs and insight.

  2. Toward an expert project management system

    NASA Technical Reports Server (NTRS)

    Silverman, Barry G.; Murray, Arthur; Diakite, Coty; Feggos, Kostas

    1987-01-01

    The purpose of the research effort is to prescribe a generic reusable shell that any project office can install and customize for the purposes of advising, guiding, and supporting project managers in that office. The prescribed shell is intended to provide both: a component that generates prescriptive guidance for project planning and monitoring activities, and an analogy (intuition) component that generates descriptive insights of previous experience of successful project managers. The latter component is especially significant in that it has the potential to: retrieve insights, not just data, and provide a vehicle for expert PMs to easily transcribe their current experiences in the course of each new project managed.

  3. Behavior Management in Preschool Classrooms: Insights Revealed through Systematic Observation and Interview

    ERIC Educational Resources Information Center

    Ritz, Mariah; Noltemeyer, Amity; Davis, Darrel; Green, Jennifer

    2014-01-01

    This mixed methods study examined behavior management strategies used by preschool teachers to address student noncompliance in the classroom. Specifically, the study aimed to (1) examine the methods that preschool teachers are currently using to respond to noncompliant behavior in their classrooms, (2) measure the frequency with which each…

  4. Insight in Schizophrenia: Involvement of Self-Reflection Networks?

    PubMed Central

    de Vos, Annerieke E.

    2013-01-01

    Background: Impaired insight is a common feature in psychosis and an important predictor of variables such as functional outcome, prognosis, and treatment adherence. A cognitive process that may underlie insight in psychosis is self-reflection, or the conscious evaluation of one’s traits and characteristics. The current study aims to investigate the neural correlates of self-reflective processing and its relationship with insight in schizophrenia. Methods: Forty-seven schizophrenia patients and 21 healthy controls performed a self-reflection task in a functional magnetic resonance imaging (fMRI) scanner. The tasks comprised a self-reflection, close other-reflection, and a semantic (baseline) condition. Insight scores were obtained with the Schedule of Assessment of Insight Expanded. In addition, cognitive insight scores were obtained (Beck Cognitive Insight Scale [BCIS]). Results: Schizophrenia patients demonstrated less activation in the posterior cingulate cortex in the self- and other-reflection conditions and less activation in the precuneus in the other-reflection condition compared with healthy controls. Better insight was associated with greater response in the inferior frontal gyrus, anterior insula, and inferior parietal lobule during self-reflection. In addition, better cognitive insight was associated with higher activation in ventromedial prefrontal cortex during self-reflection. Conclusion: In the current study, evidence for a relationship between self-reflection and insight in patients with schizophrenia was found in brain areas related to self-reflection, self/other distinction and source attribution. The findings support the rationale for a treatment that is currently under evaluation, which attempts to increase insight by enhancing self-reflection. PMID:23104865

  5. Teaching Goal-Setting for Weight-Gain Prevention in a College Population: Insights from the CHOICES Study.

    PubMed

    Gardner, Jolynn; Kjolhaug, Jerri; Linde, Jennifer A; Sevcik, Sarah; Lytle, Leslie A

    2013-01-01

    This article describes the effectiveness of goal setting instruction in the CHOICES (Choosing Healthy Options in College Environments and Settings) study, an intervention evaluating the effectiveness of weight gain prevention strategies for 2-year college students. Four hundred and forty-one participants from three community colleges were recruited. Participants randomized into the intervention (n=224) enrolled in a course that taught strategies to help maintain or achieve a healthy weight. Participants were instructed in SMART (Specific, Measurable, Attainable, Realistic, Time-based) and behavioral goal-setting practices. Throughout the course, participants set goals related to improving their sleep, stress-management, exercise, and nutrition." Intervention participants set four hundred eighteen goals. Each goal was carefully evaluated. The efforts to teach behavioral goal-setting strategies were largely successful; however efforts to convey the intricacies of SMART goal-setting were not as successful. Implications for effective teaching of skills in setting SMART behavioral goals were realized in this study. The insights gained from the goal-setting activities of this study could be used to guide educators who utilize goals to achieve health behavior change. Based on the results of this study, it is recommended that very clear and directed instruction be provided in addition to multiple opportunities for goal-setting practice. Implications for future interventions involving education about goal-setting activities are discussed.

  6. Cognitive deficits and reduced insight in primary progressive aphasia.

    PubMed

    Banks, Sarah Jane; Weintraub, Sandra

    2008-01-01

    Primary progressive aphasia (PPA) is a form of dementia caused by frontotemporal lobar degeneration. Unlike aphasia due to stroke, in which the association between particular aphasia profiles and insight has been well characterized, this relationship has not been investigated in PPA. Reduced insight is seen in other neurological conditions, but tends to involve right hemisphere damage, whereas PPA is predominantly a left hemisphere disorder. The aim of the current study was to examine whether fluent aphasia with less meaningful speech output, associated with diminished insight in stroke, is also characteristic of PPA patients with reduced insight. Fourteen PPA patients were studied. Results indicated that reduced information content in speech and poor performance on a nonlanguage test, the Pyramids and Palm Trees test, predicted reduced insight. This study has implications for the anatomical network involved in insight and clinical implications in terms of selecting interventions appropriate for individual patients with PPA.

  7. The politics of insight

    PubMed Central

    Salvi, Carola; Cristofori, Irene; Grafman, Jordan; Beeman, Mark

    2016-01-01

    Previous studies showed that liberals and conservatives differ in cognitive style. Liberals are more flexible, and tolerant of complexity and novelty, whereas conservatives are more rigid, are more resistant to change, and prefer clear answers. We administered a set of compound remote associate problems, a task extensively used to differentiate problem-solving styles (via insight or analysis). Using this task, several researches have proven that self-reports, which differentiate between insight and analytic problem-solving, are reliable and are associated with two different neural circuits. In our research we found that participants self-identifying with distinct political orientations demonstrated differences in problem-solving strategy. Liberals solved significantly more problems via insight instead of in a step-by-step analytic fashion. Our findings extend previous observations that self-identified political orientations reflect differences in cognitive styles. More specifically, we show that type of political orientation is associated with problem-solving strategy. The data converge with previous neurobehavioural and cognitive studies indicating a link between cognitive style and the psychological mechanisms that mediate political beliefs. PMID:26810954

  8. The politics of insight.

    PubMed

    Salvi, Carola; Cristofori, Irene; Grafman, Jordan; Beeman, Mark

    2016-01-01

    Previous studies showed that liberals and conservatives differ in cognitive style. Liberals are more flexible, and tolerant of complexity and novelty, whereas conservatives are more rigid, are more resistant to change, and prefer clear answers. We administered a set of compound remote associate problems, a task extensively used to differentiate problem-solving styles (via insight or analysis). Using this task, several researches have proven that self-reports, which differentiate between insight and analytic problem-solving, are reliable and are associated with two different neural circuits. In our research we found that participants self-identifying with distinct political orientations demonstrated differences in problem-solving strategy. Liberals solved significantly more problems via insight instead of in a step-by-step analytic fashion. Our findings extend previous observations that self-identified political orientations reflect differences in cognitive styles. More specifically, we show that type of political orientation is associated with problem-solving strategy. The data converge with previous neurobehavioural and cognitive studies indicating a link between cognitive style and the psychological mechanisms that mediate political beliefs.

  9. An Inquiry into Conflict Management Strategies: Study of Higher Education Institutions in Khyber Pakhtunkhwa, Pakistan

    ERIC Educational Resources Information Center

    Din, Siraj ud; Khan, Bakhtiar; Bibi, Zainab

    2012-01-01

    The purpose of this paper is to gain an insight into the conflict management strategies (CMS) of faculty in the higher education institutions (HEIs) of Khyber Pakhtunkhwa, Pakistan. To achieve the above mentioned purpose, survey method was used with the help of questionnaire. In this research, impact of CMS was assessed on the negative…

  10. The SEIS Experiment for the Insight Mission: Development and management plan

    NASA Astrophysics Data System (ADS)

    Laudet, P.

    2015-10-01

    SEIS is a Mars seismometer, provided by CNES to JPL to be the threshold instrument of the next Mars mission, InSight, to be launched by NASA in March 2016. Discovery missions leads to a very strict frame of development, where schedule is driving development and qualification plans. We will explain how this constraint has been taken into account during development phases, until delivery of flight model, with a context of international cooperation without exchange of founds between partners.

  11. Ethics in Publishing: Complexity Science and Human Factors Offer Insights to Develop a Just Culture.

    PubMed

    Saurin, Tarcisio Abreu

    2016-12-01

    While ethics in publishing has been increasingly debated, there seems to be a lack of a theoretical framework for making sense of existing rules of behavior as well as for designing, managing and enforcing such rules. This letter argues that systems-oriented disciplines, such as complexity science and human factors, offer insights into new ways of dealing with ethics in publishing. Some examples of insights are presented. Also, a call is made for empirical studies that unveil the context and details of both retracted papers and the process of writing and publishing academic papers. This is expected to shed light on the complexity of the publication system as well as to support the development of a just culture, in which all participants are accountable.

  12. A multi-dimensional approach to insight and its evolution in first-episode psychosis: a 1-year outcome naturalistic study.

    PubMed

    Capdevielle, Delphine; Norton, Joanna; Jaussent, Isabelle; Prud'homme, Cindy; Raffard, Stéphane; Gelly, Françoise; Boulenger, Jean-Philippe; Ritchie, Karen

    2013-12-30

    The aim of the study was to describe the evolution of the different dimensions of insight at 1 year and its associations with psychopathology and symptomatic remission. Participants included 55 patients hospitalized for a first psychosis episode and followed up at 6 and 12 months after discharge. Measures included the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale (PANSS). Six dimensions of insight were evaluated, for current episode at hospital discharge and at 6 and 12 month FUs and past episode (at 6 and 12 month follow-ups). Our results show that concerning the current episode, only awareness of the social consequences and of the positive symptoms significantly improved during follow-up. Insight into the past episode improved for awareness of having a mental disorder, the social consequences and the positive symptoms of mental illness. Cross-sectional associations between insight and PANSS show weak to moderate, albeit significant, associations. Most of the dimensions of insight are positively and significantly associated with remission. Our findings suggest that the main underlying dimensions of insight evolve differently over time, which could suggest different inherent processes. This could be useful for developing psychotherapeutic programmes acting upon the different aspects of insight. © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. InSight Prelaunch Briefing

    NASA Image and Video Library

    2018-05-03

    Col. Michael Hough, Commander 30th Space Wing, Vandenberg Air Force Base, left, and 1st Lieutenant Kristina Williams, weather officer, 30th Space Wing, Vandenberg Air Force Base, discuss NASA's InSight mission during a prelaunch media briefing, Thursday, May 3, 2018, at Vandenberg Air Force Base in California. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is a Mars lander designed to study the "inner space" of Mars: its crust, mantle, and core. Photo Credit: (NASA/Bill Ingalls)

  14. Effective strategies for comprehensive corridor management

    DOT National Transportation Integrated Search

    2004-10-01

    Despite the increasing importance of comprehensive corridor management at the state and local government level, questions remain regarding effective methods for developing and implementing corridor management plans. Further insight is also needed int...

  15. Exploratory study of the association between insight and Theory of Mind (ToM) in stable schizophrenia patients.

    PubMed

    Pousa, Esther; Duñó, Rosó; Blas Navarro, J; Ruiz, Ada I; Obiols, Jordi E; David, Anthony S

    2008-05-01

    Poor insight and impairment in Theory of Mind (ToM) reasoning are common in schizophrenia, predicting poorer clinical and functional outcomes. The present study aimed to explore the relationship between these phenomena. 61 individuals with a DSM-IV diagnosis of schizophrenia during a stable phase were included. ToM was assessed using a picture sequencing task developed by Langdon and Coltheart (1999), and insight with the Scale to Assess Unawareness of Mental Disorder (SUMD; Amador et al., 1993). Multivariate linear regression analysis was carried out to estimate the predictive value of insight on ToM, taking into account several possible confounders and interaction variables. No direct significant associations were found between any of the insight dimensions and ToM using bivariate analysis. However, a significant linear regression model which explained 48% of the variance in ToM was revealed in the multivariate analysis. This included the 5 insight dimensions and 3 interaction variables. Misattribution of symptoms--in aware patients with age at onset >20 years--and unawareness of need for medication--in patients with GAF >60--were significantly predictive of better ToM. Insight and ToM are two complex and distinct phenomena in schizophrenia. Relationships between them are mediated by psychosocial, clinical, and neurocognitive variables. Intact ToM may be a prerequisite for aware patients to attribute their symptoms to causes other than mental illness, which could in turn be associated with denial of need for medication.

  16. Phosphorus dynamics in lake sediments: Insights from field study and reactive-transport modeling

    NASA Astrophysics Data System (ADS)

    Dittrich, Maria; Markovic, Stefan; Cadena, Sandra; Doan, Phuong T. K.; Watson, Sue; Mugalingam, Shan

    2016-04-01

    Phosphorus is an indispensable nutrient for organisms in aquatic systems and its availability often controls primary productivity. At the sediment-water interface, intensive microbiological, geochemical and physical processes determine the fraction of organic matter, nutrients and pollutants released into the overlying water. Therefore, detailed understanding of the processes occurring in the top centimeters of the sediment is essential for the assessment of water quality and the management of surface waters. In cases where measurements are impossible or expensive, diagenetic modelling is required to investigate the interplay among the processes, verify concepts and predict potential system behavior. The main aims of this study are to identify and predict the dynamics of phosphorus (P) in sediments and gain insight into the mechanism of P release from sediments under varying environmental conditions. We measured redox, O2 and pH profiles with micro-sensors at the sediment-water interface; analyzed phosphate and metals (Fe, Mn, Al, Ca) content in pore waters collected using in situ samplers, so called "peepers"; determined P binding forms using sequential extraction and analyzed metals associated with each fraction. Following the sediment analysis, P binding forms were divided in five groups: inert, carbonate-bound, organic, redox-sensitive, and labile P. Using the flux of organic and inorganic matter as dynamic boundary conditions, the diagenetic model simulates P internal loading and predicts P retention. This presentation will discuss the results of two years studies on P dynamics at the sediment-water interface in three different lakes ranging from heavy-polluted Hamilton Harbor and Bay of Quinte to pristine Georgian Bay in Ontario, Canada.

  17. Legacy phosphorus accumulation and management in the global context: insights from long-term analysis of major river basins

    NASA Astrophysics Data System (ADS)

    Powers, S. M.; Burt, T. P.; Chan, N. I.; Elser, J. J.; Haygarth, P. M.; Howden, N. J. K.; Jarvie, H. P.; Peterson, H. M.; Shen, J.; Worrall, F.; Sharpley, A. N.

    2014-12-01

    Phosphorus (P) is closely linked to major societal concerns including food security and water quality, and human activities strongly control the modern global P cycle. Current knowledge of the P cycle includes many insights about relatively short-term processes, but a long-term and landscape-level view may be needed to understand P status and optimize P management towards P sustainability. We reconstructed long-term (>40 years) P mass balances and rates of P accumulation in three major river basins where excess P pollution is demanding improvements in P management at local, national, and international levels. We focus on: Maumee River Basin, a major source of agricultural P to Lake Erie, the southernmost and shallowest of the Laurentian Great Lakes; Thames River Basin, where fluxes of effluent P from the London, England metropolitan area have declined following improvements in wastewater treatment; Yangtze (Changjiang) River Basin, the largest in China, which is undergoing rapid economic development. The Maumee and Thames are intensively monitored, and show long-term declines in basin P inputs that represent a step towards P sustainability. However, river P outputs have been slower to decline, consistent with the hypothesis that legacy P is mobilizing from soils or from within the river network. Published data on the Yangtze indicate the P flux from land to water has clearly increased with industrialization and population growth. Historical trajectories of P accumulation and depletion in major river basins are providing new understanding about the long-term impacts of P management, including watershed P legacies and response times, that may inform future policy towards local, national, and global P sustainability.

  18. Gene regulation in amphioxus: An insight from transgenic studies in amphioxus and vertebrates.

    PubMed

    Kozmikova, Iryna; Kozmik, Zbynek

    2015-12-01

    Cephalochordates, commonly known as amphioxus or lancelets, are the most basal subphylum of chordates. Cephalochordates are thus key to understanding the origin of vertebrates and molecular mechanisms underlying vertebrate evolution. The evolution of developmental control mechanisms during invertebrate-to-vertebrate transition involved not only gene duplication events, but also specific changes in spatial and temporal expression of many genes. To get insight into the spatiotemporal regulation of gene expression during invertebrate-to-vertebrate transition, functional studies of amphioxus gene regulatory elements are highly warranted. Here, we review transgenic studies performed in amphioxus and vertebrates using promoters and enhancers derived from the genome of Branchiostoma floridae. We describe the current methods of transgenesis in amphioxus, provide evidence of Tol2 transposon-generated transgenic embryos of Branchiostoma lanceolatum and discuss possible future directions. We envision that comparative transgenic analysis of gene regulatory sequences in the context of amphioxus and vertebrate embryos will likely provide an important mechanistic insight into the evolution of vertebrate body plan. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Cognitive Deficits and Reduced Insight in Primary Progressive Aphasia

    PubMed Central

    Banks, Sarah Jane; Weintraub, Sandra

    2009-01-01

    Primary progressive aphasia (PPA) is a form of dementia caused by frontotemporal lobar degeneration. Unlike aphasia due to stroke, in which the association between particular aphasia profiles and insight has been well characterized, this relationship has not been investigated in PPA. Reduced insight is seen in other neurological conditions, but tends to involve right hemisphere damage, whereas PPA is predominantly a left hemisphere disorder. The aim of the current study was to examine whether fluent aphasia with less meaningful speech output, associated with diminished insight in stroke, is also characteristic of PPA patients with reduced insight. Fourteen PPA patients were studied. Results indicated that reduced information content in speech and poor performance on a nonlanguage test, the Pyramids and Palm Trees test, predicted reduced insight. This study has implications for the anatomical network involved in insight and clinical implications in terms of selecting interventions appropriate for individual patients with PPA. PMID:18836134

  20. A systematic review of the literature about competence and poor insight.

    PubMed

    Ruissen, A M; Widdershoven, G A M; Meynen, G; Abma, T A; van Balkom, A J L M

    2012-02-01

      Formally, incompetence implies that a patient cannot meet the legal requirements for informed consent. Our aim was to review the scientific literature on the relationship between competence and insight in patients with psychiatric disorders, how competence and insight are connected in these patients and whether there are differences in competence and insight among patients with different disorders.   A search in PubMed/Medline was performed. Articles were assessed on relevance criteria by two independent reviewers. Study design, population, variables, and outcomes were extracted.   Seven articles were included on studies of psychiatric inpatients and outpatients and of psychotic and non-psychotic patients. All studies used the MacArthur Competence Assessment Tool (MacCAT). All studies but one found a strong correlation between poor insight and incompetence. Psychotic patients with poor insight are very likely to be incompetent, and psychotic patients with adequate insight are generally competent. One well-executed study showed that in non-psychotic disorders, however, another relationship emerges; competence and insight do not completely overlap in these patients.   Most incompetent psychotic patients have poor insight, but non-psychotic patients with adequate insight were incompetent in a substantial number of cases. In sum: non-psychotic patients with adequate insight can be incompetent. © 2011 John Wiley & Sons A/S.

  1. A review of EEG, ERP, and neuroimaging studies of creativity and insight.

    PubMed

    Dietrich, Arne; Kanso, Riam

    2010-09-01

    Creativity is a cornerstone of what makes us human, yet the neural mechanisms underlying creative thinking are poorly understood. A recent surge of interest into the neural underpinnings of creative behavior has produced a banquet of data that is tantalizing but, considered as a whole, deeply self-contradictory. We review the emerging literature and take stock of several long-standing theories and widely held beliefs about creativity. A total of 72 experiments, reported in 63 articles, make up the core of the review. They broadly fall into 3 categories: divergent thinking, artistic creativity, and insight. Electroencephalographic studies of divergent thinking yield highly variegated results. Neuroimaging studies of this paradigm also indicate no reliable changes above and beyond diffuse prefrontal activation. These findings call into question the usefulness of the divergent thinking construct in the search for the neural basis of creativity. A similarly inconclusive picture emerges for studies of artistic performance, except that this paradigm also often yields activation of motor and temporoparietal regions. Neuroelectric and imaging studies of insight are more consistent, reflecting changes in anterior cingulate cortex and prefrontal areas. Taken together, creative thinking does not appear to critically depend on any single mental process or brain region, and it is not especially associated with right brains, defocused attention, low arousal, or alpha synchronization, as sometimes hypothesized. To make creativity tractable in the brain, it must be further subdivided into different types that can be meaningfully associated with specific neurocognitive processes.

  2. Social support systems as determinants of self-management and quality of life of people with diabetes across Europe: study protocol for an observational study.

    PubMed

    Koetsenruijter, Jan; van Lieshout, Jan; Vassilev, Ivaylo; Portillo, Mari Carmen; Serrano, Manuel; Knutsen, Ingrid; Roukova, Poli; Lionis, Christos; Todorova, Elka; Foss, Christina; Rogers, Anne; Wensing, Michel

    2014-03-04

    Long-term conditions pose major challenges for healthcare systems. Optimizing self-management of people with long-term conditions is an important strategy to improve quality of life, health outcomes, patient experiences in healthcare, and the sustainability of healthcare systems. Much research on self-management focuses on individual competencies, while the social systems of support that facilitate self-management are underexplored. The presented study aims to explore the role of social systems of support for self-management and quality of life, focusing on the social networks of people with diabetes and community organisations that serve them. The protocol concerns a cross-sectional study in 18 geographic areas in six European countries, involving a total of 1800 individuals with diabetes and 900 representatives of community organisations. In each country, we include a deprived rural area, a deprived urban area, and an affluent urban area. Individuals are recruited through healthcare practices in the targeted areas. A patient questionnaire comprises measures for quality of life, self-management behaviours, social network and social support, as well as individual characteristics. A community organisations' survey maps out interconnections between community and voluntary organisations that support patients with chronic illness and documents the scope of work of the different types of organisations. We first explore the structure of social networks of individuals and of community organisations. Then linkages between these social networks, self-management and quality of life will be examined, taking deprivation and other factors into account. This study will provide insight into determinants of self-management and quality of life in individuals with diabetes, focusing on the role of social networks and community organisations.

  3. Ecosystem Services Insights into Water Resources Management in China: A Case of Xi'an City.

    PubMed

    Liu, Jingya; Li, Jing; Gao, Ziyi; Yang, Min; Qin, Keyu; Yang, Xiaonan

    2016-11-24

    Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi'an City in China to test reasonable and effective methods to address water resource shortages. The study generated a framework combining ecosystem services and water resource management. Seven ecosystem indicators were classified as supply services, regulating services, or cultural services. Index values for each indicator were calculated, and based on questionnaire results, each index's weight was calculated. Using the Likert method, we calculated ecosystem service supplies in every region of the city. We found that the ecosystem's service capability is closely related to water resources, providing a method for managing water resources. Using Xi'an City as an example, we apply the ecosystem services concept to water resources management, providing a method for decision makers.

  4. [Lack of insight in schizophrenia: a review].

    PubMed

    Raffard, S; Bayard, S; Capdevielle, D; Garcia, F; Boulenger, J-P; Gely-Nargeot, M-C

    2008-10-01

    Relative to other psychiatric disorders, patients with schizophrenia are often unaware of the consequences of their disease and their need for treatment. These deficits in awareness referred in general in the English literature as "poor insight", have been the focus of many clinical studies over recent years. This phenomenon, which is considered as fundamental in clinical evaluations of schizophrenia, should be understood as a multidimensional process rather than a dichotomic phenomenon, as is presently the case. The links between insight deficits and responses to vocational rehabilitation efforts represent a major interest in research, including those related to medication compliance and clinical outcome. To conduct such studies, various evaluation tools have been developed, enabling the assessment of insight, of its time-course and of its components in psychosis and schizophrenia spectrum disorders. The Scale to Assess Unawareness of illness in Mental Disorders (SUMD) developed by Amador and Strauss appears to be the most frequently used scale for the evaluation of awareness of the disorder in schizophrenia. Although the model proposed by Amador and Strauss is considered as the privileged model in the multidimensional approach of insight, it corresponds only to a phenomenological analysis of this concept. In the second part of this article, we thus review the current models attempting to explain the lack of insight in schizophrenia. Four current explanatory models of lack of insight will be described as follows: resulting either from adaptation or defence mechanisms to environmental stressors, resulting from cognitive bias of data processing, resulting from neuropsychological functional deficits and resulting from metacognitive deficits. Several hypotheses concerning these deficits arise from clinical studies. Although coping, and defence mechanisms to the consequences and stigmatization of the disease were hardly studied, the fact that poor insight does not

  5. InSight Prelaunch Overview

    NASA Image and Video Library

    2018-05-03

    During a prelaunch briefing at Vandenberg Air Force Base in California, Stephanie Smith, NASA Communications, speaks to members of the media. The presentation focused on NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander. InSight is scheduled for liftoff May 5, 2018, atop a United Launch Alliance (ULA) Atlas V rocket from Space Launch Complex 3 at Vandenberg. The spacecraft will be the first mission to look deep beneath the Martian surface studying the planet's interior by measuring its heat output and listen for marsquakes.

  6. Obsessive-compulsive skin disorders: a novel classification based on degree of insight.

    PubMed

    Zhu, Tian Hao; Nakamura, Mio; Farahnik, Benjamin; Abrouk, Michael; Reichenberg, Jason; Bhutani, Tina; Koo, John

    2017-06-01

    Individuals with obsessive-compulsive features frequently visit dermatologists for complaints of the skin, hair or nails, and often progress towards a chronic relapsing course due to the challenge associated with accurate diagnosis and management of their psychiatric symptoms. The current DSM-5 formally recognizes body dysmorphic disorder, trichotillomania, neurotic excoriation and body focused repetitive behavior disorder as psychodermatological disorders belonging to the category of Obsessive-Compulsive and Related Disorders. However there is evidence that other relevant skin diseases such as delusions of parasitosis, dermatitis artefacta, contamination dermatitis, AIDS phobia, trichotemnomania and even lichen simplex chronicus possess prominent obsessive-compulsive characteristics that do not necessarily fit the full diagnostic criteria of the DSM-5. Therefore, to increase dermatologists' awareness of this unique group of skin disorders with OCD features, we propose a novel classification system called Obsessive-Compulsive Insight Continuum. Under this new classification system, obsessive-compulsive skin manifestations are categorized along a continuum based on degree of insight, from minimal insight with delusional obsessions to good insight with minimal obsessions. Understanding the level of insight is thus an important first step for clinicians who routinely interact with these patients.

  7. Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management

    NASA Astrophysics Data System (ADS)

    Dreiss, Lindsay M.; Hessenauer, Jan-Michael; Nathan, Lucas R.; O'Connor, Kelly M.; Liberati, Marjorie R.; Kloster, Danielle P.; Barclay, Janet R.; Vokoun, Jason C.; Morzillo, Anita T.

    2017-02-01

    Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

  8. Adaptive Management as an Effective Strategy: Interdisciplinary Perceptions for Natural Resources Management.

    PubMed

    Dreiss, Lindsay M; Hessenauer, Jan-Michael; Nathan, Lucas R; O'Connor, Kelly M; Liberati, Marjorie R; Kloster, Danielle P; Barclay, Janet R; Vokoun, Jason C; Morzillo, Anita T

    2017-02-01

    Adaptive management is a well-established approach to managing natural resources, but there is little evidence demonstrating effectiveness of adaptive management over traditional management techniques. Peer-reviewed literature attempts to draw conclusions about adaptive management effectiveness using social perceptions, but those studies are largely restricted to employees of US federal organizations. To gain a more comprehensive insight into perceived adaptive management effectiveness, this study aimed to broaden the suite of disciplines, professional affiliations, and geographic backgrounds represented by both practitioners and scholars. A questionnaire contained a series of questions concerning factors that lead to or inhibit effective management, followed by another set of questions focused on adaptive management. Using a continuum representing strategies of both adaptive management and traditional management, respondents selected those strategies that they perceived as being effective. Overall, characteristics (i.e., strategies, stakeholders, and barriers) identified by respondents as contributing to effective management closely aligned with adaptive management. Responses were correlated to the type of adaptive management experience rather than an individual's discipline, occupational, or regional affiliation. In particular, perceptions of characteristics contributing to adaptive management effectiveness varied between respondents who identified as adaptive management scholars (i.e., no implementation experience) and adaptive management practitioners. Together, these results supported two concepts that make adaptive management effective: practitioners emphasized adaptive management's value as a long-term approach and scholars noted the importance of stakeholder involvement. Even so, more communication between practitioners and scholars regarding adaptive management effectiveness could promote interdisciplinary learning and problem solving for improved

  9. Inside 'bed management': ethnographic insights from the vantage point of UK hospital nurses.

    PubMed

    Allen, Davina

    2015-03-01

    In the face of unprecedented financial and demographic challenges, optimising acute bed utilisation by the proactive management of patient flows is a pressing policy concern in high-income countries. Despite the growing literature on this topic, bed management has received scant sociological attention. Drawing on practice-based approaches, this article deploys ethnographic data to examine bed management from the perspective of UK hospital nurses. While the nursing contribution to bed management is recognised formally in their widespread employment in patient access and discharge liaison roles, nurses at all levels in the study site were enrolled in this organisational priority. Rather than the rational, centrally controlled processes promulgated by policymakers, bed management emerges as a predominantly distributed activity, described here as match-making. An example of micro-level rationing, for the most part, match-making was not informed by explicit criteria nor did it hinge on clearly identifiable decisions to grant or deny access. Rather it was embedded in the everyday practices and situated rationalities through which nurses accomplished the accommodations necessary to balance demand with resources. © 2014 Foundation for the Sociology of Health & Illness.

  10. Ecosystem Services Insights into Water Resources Management in China: A Case of Xi’an City

    PubMed Central

    Liu, Jingya; Li, Jing; Gao, Ziyi; Yang, Min; Qin, Keyu; Yang, Xiaonan

    2016-01-01

    Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi’an City in China to test reasonable and effective methods to address water resource shortages. The study generated a framework combining ecosystem services and water resource management. Seven ecosystem indicators were classified as supply services, regulating services, or cultural services. Index values for each indicator were calculated, and based on questionnaire results, each index’s weight was calculated. Using the Likert method, we calculated ecosystem service supplies in every region of the city. We found that the ecosystem’s service capability is closely related to water resources, providing a method for managing water resources. Using Xi’an City as an example, we apply the ecosystem services concept to water resources management, providing a method for decision makers. PMID:27886137

  11. Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part I: Innovation Management at Lego Group

    NASA Astrophysics Data System (ADS)

    Rusu, G.; Avasilcăi, S.

    2015-11-01

    competitive strategies, new technologies developed for sustainable development and innovation, emphasizing also the concerns of the LEGO Group for a long-term orientation strategy which implies developing innovative products, made by ecological materials, reducing the negative impact on the environment. In addition, the company aims to foster innovation maintaining a clear vision, multiple contacts with the internal and external environment, and the flat structures which enable the communication between innovative management teams and top management team. Consequently, the study provides the insights regarding the innovation management of the LEGO Group, emphasizing the role of engaging customers and other external stakeholders in the co-creation of value.

  12. Encouraging School Transportation Effective Energy Management (ESTEEM). Fuel Economy Management Handbook for Directors of Pupil Transportation; School District Administrators; Transportation Department Management.

    ERIC Educational Resources Information Center

    BRI Systems, Inc., Phoenix, AZ.

    This handbook offers a practical approach for pupil transportation energy management by suggesting ideas to save fuel in the purchasing, planning, routing, scheduling, driving, and maintenance areas of the pupil transportation operation. The handbook is divided into seven parts. Part 1 and 2 provide insight into energy management in pupil…

  13. Mental health claims management and return to work: qualitative insights from Melbourne, Australia.

    PubMed

    Brijnath, Bianca; Mazza, Danielle; Singh, Nabita; Kosny, Agnieszka; Ruseckaite, Rasa; Collie, Alex

    2014-12-01

    Mental health conditions (MHC) are an increasing reason for claiming injury compensation in Australia; however little is known about how these claims are managed by different gatekeepers to injury entitlements. This study, drawing on the views of four stakeholders-general practitioners (GPs), injured persons, employers and compensation agents, aims to describe current management of MHC claims and to identify the current barriers to return to work (RTW) for injured persons with a MHC claim and/or mental illness. Ninety-three in-depth interviews were undertaken with GPs, compensation agents, employers and injured persons. Data were collected in Melbourne, Australia. Thematic techniques were used to analyse data. MHC claims were complex to manage because of initial assessment and diagnostic difficulties related to the invisibility of the injury, conflicting medical opinions and the stigma associated with making a MHC claim. Mental illness also developed as a secondary issue in the recovery process. These factors made MHC difficult to manage and impeded timely RTW. It is necessary to undertake further research (e.g. guideline development) to improve current practice in order to enable those with MHC claims to make a timely RTW. Further education and training interventions (e.g. on diagnosis and management of MHC) are also needed to enable GPs, employers and compensation agents to better assess and manage MHC claims.

  14. The Association of DRD2 with Insight Problem Solving.

    PubMed

    Zhang, Shun; Zhang, Jinghuan

    2016-01-01

    Although the insight phenomenon has attracted great attention from psychologists, it is still largely unknown whether its variation in well-functioning human adults has a genetic basis. Several lines of evidence suggest that genes involved in dopamine (DA) transmission might be potential candidates. The present study explored for the first time the association of dopamine D2 receptor gene ( DRD2 ) with insight problem solving. Fifteen single-nucleotide polymorphisms (SNPs) covering DRD2 were genotyped in 425 unrelated healthy Chinese undergraduates, and were further tested for association with insight problem solving. Both single SNP and haplotype analysis revealed several associations of DRD2 SNPs and haplotypes with insight problem solving. In conclusion, the present study provides the first evidence for the involvement of DRD2 in insight problem solving, future studies are necessary to validate these findings.

  15. The Association of DRD2 with Insight Problem Solving

    PubMed Central

    Zhang, Shun; Zhang, Jinghuan

    2016-01-01

    Although the insight phenomenon has attracted great attention from psychologists, it is still largely unknown whether its variation in well-functioning human adults has a genetic basis. Several lines of evidence suggest that genes involved in dopamine (DA) transmission might be potential candidates. The present study explored for the first time the association of dopamine D2 receptor gene (DRD2) with insight problem solving. Fifteen single-nucleotide polymorphisms (SNPs) covering DRD2 were genotyped in 425 unrelated healthy Chinese undergraduates, and were further tested for association with insight problem solving. Both single SNP and haplotype analysis revealed several associations of DRD2 SNPs and haplotypes with insight problem solving. In conclusion, the present study provides the first evidence for the involvement of DRD2 in insight problem solving, future studies are necessary to validate these findings. PMID:27933030

  16. Insight Is Not in the Problem: Investigating Insight in Problem Solving across Task Types.

    PubMed

    Webb, Margaret E; Little, Daniel R; Cropper, Simon J

    2016-01-01

    The feeling of insight in problem solving is typically associated with the sudden realization of a solution that appears obviously correct (Kounios et al., 2006). Salvi et al. (2016) found that a solution accompanied with sudden insight is more likely to be correct than a problem solved through conscious and incremental steps. However, Metcalfe (1986) indicated that participants would often present an inelegant but plausible (wrong) answer as correct with a high feeling of warmth (a subjective measure of closeness to solution). This discrepancy may be due to the use of different tasks or due to different methods in the measurement of insight (i.e., using a binary vs. continuous scale). In three experiments, we investigated both findings, using many different problem tasks (e.g., Compound Remote Associates, so-called classic insight problems, and non-insight problems). Participants rated insight-related affect (feelings of Aha-experience, confidence, surprise, impasse, and pleasure) on continuous scales. As expected we found that, for problems designed to elicit insight, correct solutions elicited higher proportions of reported insight in the solution compared to non-insight solutions; further, correct solutions elicited stronger feelings of insight compared to incorrect solutions.

  17. Insight Is Not in the Problem: Investigating Insight in Problem Solving across Task Types

    PubMed Central

    Webb, Margaret E.; Little, Daniel R.; Cropper, Simon J.

    2016-01-01

    The feeling of insight in problem solving is typically associated with the sudden realization of a solution that appears obviously correct (Kounios et al., 2006). Salvi et al. (2016) found that a solution accompanied with sudden insight is more likely to be correct than a problem solved through conscious and incremental steps. However, Metcalfe (1986) indicated that participants would often present an inelegant but plausible (wrong) answer as correct with a high feeling of warmth (a subjective measure of closeness to solution). This discrepancy may be due to the use of different tasks or due to different methods in the measurement of insight (i.e., using a binary vs. continuous scale). In three experiments, we investigated both findings, using many different problem tasks (e.g., Compound Remote Associates, so-called classic insight problems, and non-insight problems). Participants rated insight-related affect (feelings of Aha-experience, confidence, surprise, impasse, and pleasure) on continuous scales. As expected we found that, for problems designed to elicit insight, correct solutions elicited higher proportions of reported insight in the solution compared to non-insight solutions; further, correct solutions elicited stronger feelings of insight compared to incorrect solutions. PMID:27725805

  18. Are performance indicators used for hospital quality management: a qualitative interview study amongst health professionals and quality managers in The Netherlands.

    PubMed

    Botje, Daan; Ten Asbroek, Guus; Plochg, Thomas; Anema, Helen; Kringos, Dionne S; Fischer, Claudia; Wagner, Cordula; Klazinga, Niek S

    2016-10-13

    Hospitals are under increasing pressure to share indicator-based performance information. These indicators can also serve as a means to promote quality improvement and boost hospital performance. Our aim was to explore hospitals' use of performance indicators for internal quality management activities. We conducted a qualitative interview study among 72 health professionals and quality managers in 14 acute care hospitals in The Netherlands. Concentrating on orthopaedic and oncology departments, our goal was to gain insight into data collection and use of performance indicators for two conditions: knee and hip replacement surgery and breast cancer surgery. The semi-structured interviews were recorded and summarised. Based on the data, themes were synthesised and the analyses were executed systematically by two analysts independently. The findings were validated through comparison. The hospitals we investigated collect data for performance indicators in different ways. Similarly, these hospitals have different ways of using such data to support their quality management, while some do not seem to use the data for this purpose at all. Factors like 'linking pin champions', pro-active quality managers and engaged medical specialists seem to make a difference. In addition, a comprehensive hospital data infrastructure with electronic patient records and robust data collection software appears to be a prerequisite to produce reliable external performance indicators for internal quality improvement. Hospitals often fail to use performance indicators as a means to support internal quality management. Such data, then, are not used to its full potential. Hospitals are recommended to focus their human resource policy on 'linking pin champions', the engagement of professionals and a pro-active quality manager, and to invest in a comprehensive data infrastructure. Furthermore, the differences in data collection processes between Dutch hospitals make it difficult to draw

  19. Managing Your Medicines

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Managing Your Medicines Updated:Mar 8,2018 If you have heart ... Weight • Tools & Resources Heart Insight Supplement: Know Your Medicines Keeping track of your medicines can be overwhelming. ...

  20. The “Insight Paradox” in Schizophrenia: Magnitude, Moderators and Mediators of the Association Between Insight and Depression

    PubMed Central

    Belvederi Murri, Martino; Amore, Mario; Calcagno, Pietro; Respino, Matteo; Marozzi, Valentina; Masotti, Mattia; Bugliani, Michele; Innamorati, Marco; Pompili, Maurizio; Galderisi, Silvana; Maj, Mario

    2016-01-01

    The so-called “insight paradox” posits that among patients with schizophrenia higher levels of insight are associated with increased levels of depression. Although different studies examined this issue, only few took in account potential confounders or factors that could influence this association. In a sample of clinically stable patients with schizophrenia, insight and depression were evaluated using the Scale to assess Unawareness of Mental Disorder and the Calgary Depression Scale for Schizophrenia. Other rating scales were used to assess the severity of psychotic symptoms, extrapyramidal symptoms, hopelessness, internalized stigma, self-esteem, and service engagement. Regression models were used to estimate the magnitude of the association between insight and depression while accounting for the role of confounders. Putative psychological and sociodemographic factors that could act as mediators and moderators were examined using the PROCESS macro. By accounting for the role of confounding factors, the strength of the association between insight into symptoms and depression increased from 13% to 25% explained covariance. Patients with lower socioeconomic status (F = 8.5, P = .04), more severe illness (F = 4.8, P = .03) and lower levels of service engagement (F = 4.7, P = .03) displayed the strongest association between insight and depression. Lastly, hopelessness, internalized stigma and perceived discrimination acted as significant mediators. The relationship between insight and depression should be considered a well established phenomenon among patients with schizophrenia: it seems stronger than previously reported especially among patients with lower socioeconomic status, severe illness and poor engagement with services. These findings may have relevant implications for the promotion of insight among patients with schizophrenia. PMID:27069064

  1. Insight and white matter fractional anisotropy in first-episode schizophrenia.

    PubMed

    Asmal, Laila; du Plessis, Stefan; Vink, Matthijs; Fouche, Jean-Paul; Chiliza, Bonginkosi; Emsley, Robin

    2017-05-01

    Impaired insight is a hallmark feature of schizophrenia. Structural studies implicate predominantly prefrontal, cingulate, cuneus/precuneus, and inferior temporal brain regions. The cortical midline structures (CMS) are also implicated in functional studies primarily through self-reflective processing tasks. However, few studies have explored the relationship between white matter tracts and insight in schizophrenia, and none in first-episode schizophrenia (FES). Here, we examined for fractional anisotropy (FA) differences in 89 minimally treated FES patients and 98 matched controls, and identified those FA differences associated with impaired clinical insight in patients. We found widespread FA reduction in FES patients compared to controls. Poorer insight in patients was predicted by lower FA values in a number of white matter tracts with a predilection for tracts associated with cortical midline structures (fronto-occipital, cingulate, cingulate hippocampus, uncinate, anterior corona radiata), and more severe depressive symptoms. The association between FA abnormalities and insight was most robust for the awareness of symptoms and illness awareness domains. Our study implicates a network of tracts involved in impaired insight in schizophrenia with a predilection for the CMS. This study is a first step in delineating the white matter tracts involved in insight impairment in schizophrenia prior to chronicity. Copyright © 2016. Published by Elsevier B.V.

  2. Retaining nurses in metropolitan areas: insights from senior nurse and human resource managers.

    PubMed

    Drennan, Vari M; Halter, Mary; Gale, Julia; Harris, Ruth

    2016-11-01

    To investigate the views of senior nurse and human resource managers of strategies to retain hospital nurses in a metropolitan area. Against a global shortage, retaining nurses is a management imperative for the quality of hospital services. Semi-structured interviews, thematically analysed. Metropolitan areas have many health organisations in geographical proximity, offering nurses choices in employer and employment. Senior nurse and human resource managers recognised the complexity of factors influencing nurse turnover, including those that 'pulled' nurses out of their jobs to other posts and factors that 'pushed' nurses to leave. Four themes emerged in retaining nurses: strategy and leadership, including analysis of workforce and leavers' data, remuneration, the type of nursing work and career development and the immediate work environment. In contexts where multiple organisations compete for nurses, addressing retention through strategic leadership is likely to be important in paying due attention and apportioning resources to effective strategies. Aside from good human resource management practices for all, strategies tailored to different segments of the nursing workforce are likely to be important. This metropolitan study suggests attention should be paid to strategies that address remuneration, progressing nursing careers and the immediate work environment. © 2016 The Authors Journal of Nursing Management Published by John Wiley & Sons Ltd.

  3. Longevity and growth of Acacia tortilis; insights from 14C content and anatomy of wood

    PubMed Central

    Andersen, Gidske L; Krzywinski, Knut

    2007-01-01

    Background Acacia tortilis is a keystone species across arid ecosystems in Africa and the Middle East. Yet, its life-history, longevity and growth are poorly known, and consequently ongoing changes in tree populations cannot be managed in an appropriate manner. In other arid areas parenchymatic bands marking growth zones in the wood have made dendrochronological studies possible. The possibilities for using pre- and post-bomb 14C content in wood samples along with the presence of narrow marginal parenchymatic bands in the wood is therefore tested to gain further insight into the age, growth and growth conditions of A. tortilis in the hyper-arid Eastern Desert of Egypt. Results Based on age scenarios and the Gompertz growth equation, the age of trees studied seems to be from 200 up to 650 years. Annual radial growth estimated from calibrated dates based on the post-bomb 14C content of samples is up to 2.4 mm, but varies both spatially and temporally. Parenchymatic bands are not formed regularly. The correlation in band pattern among trees is poor, both among and within sites. Conclusion The post-bomb 14C content of A. tortilis wood gives valuable information on tree growth and is required to assess the age scenario approach applied here. This approach indicates high longevities and slow growth of trees. Special management measures should therefore be taken at sites where the trend in tree population size is negative. The possibilities for dendrochronological studies based on A. tortilis from the Eastern Desert are poor. However, marginal parenchymatic bands can give insight into fine scale variation in growth conditions and the past management of trees. PMID:17573964

  4. The "Insight Paradox" in Schizophrenia: Magnitude, Moderators and Mediators of the Association Between Insight and Depression.

    PubMed

    Belvederi Murri, Martino; Amore, Mario; Calcagno, Pietro; Respino, Matteo; Marozzi, Valentina; Masotti, Mattia; Bugliani, Michele; Innamorati, Marco; Pompili, Maurizio; Galderisi, Silvana; Maj, Mario

    2016-09-01

    The so-called "insight paradox" posits that among patients with schizophrenia higher levels of insight are associated with increased levels of depression. Although different studies examined this issue, only few took in account potential confounders or factors that could influence this association. In a sample of clinically stable patients with schizophrenia, insight and depression were evaluated using the Scale to assess Unawareness of Mental Disorder and the Calgary Depression Scale for Schizophrenia. Other rating scales were used to assess the severity of psychotic symptoms, extrapyramidal symptoms, hopelessness, internalized stigma, self-esteem, and service engagement. Regression models were used to estimate the magnitude of the association between insight and depression while accounting for the role of confounders. Putative psychological and sociodemographic factors that could act as mediators and moderators were examined using the PROCESS macro. By accounting for the role of confounding factors, the strength of the association between insight into symptoms and depression increased from 13% to 25% explained covariance. Patients with lower socioeconomic status (F = 8.5, P = .04), more severe illness (F = 4.8, P = .03) and lower levels of service engagement (F = 4.7, P = .03) displayed the strongest association between insight and depression. Lastly, hopelessness, internalized stigma and perceived discrimination acted as significant mediators. The relationship between insight and depression should be considered a well established phenomenon among patients with schizophrenia: it seems stronger than previously reported especially among patients with lower socioeconomic status, severe illness and poor engagement with services. These findings may have relevant implications for the promotion of insight among patients with schizophrenia. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved

  5. New Insights into the Management of Hypertension and Cardiovascular Risk with Angiotensin Receptor Blockers: Observational Studies Help Us?

    PubMed Central

    Goudev, Assen

    2014-01-01

    Post-marketing observational studies are valuable for establishing the real-world effectiveness of treatment regimens in routine clinical practice as they typically monitor a diverse population of patients over many months. This article reviews recent observational studies of angiotensin receptor blockers (ARBs) for the management of hypertension: the 6-month eprosartan POWER study (n~29,400), the 3-month valsartan translational research programme (n~19,500), the 9-month irbesartan Treat to Target study (n=14,200), the 6-month irbesartan DO-IT survey (n~3300) and the 12-week candesartan CHILI survey programme (n=4600). Reduction in blood pressure with ARBs reported across these studies appears to be comparable for the different agents, although direct comparisons between studies cannot be made owing to different treatment durations and baseline patient demographics. Of these studies, the eprosartan POWER study, 2 of the 7 studies in the valsartan translational research programme, and the candesartan CHILI Triple T study measured total cardiovascular risk, as recommended in the 2013 European Society of Cardiology-European Society of Hypertension guidelines. The POWER study confirmed the value of the Systemic Coronary Risk Evaluation (SCORE) to accurately assess total cardiovascular risk. With the advent of new healthcare practices, such as the use of electronic health records (EHRs), observational studies in larger patient populations will become possible. In the future, algorithms embedded in EHR systems could evolve as decision support tools to inform on patient care. PMID:24847388

  6. AIPRC--BIA Management Study: Personnel Management

    ERIC Educational Resources Information Center

    American Indian Journal, 1976

    1976-01-01

    Continuing the American Indian Policy Review Commission's (AIPRC) Bureau of Indian Affairs (BIA) Management Study, this article reviews the divisions of responsibility, Indian preference, recruitment and hiring problems, training, labor relations, and internal communication. (NQ)

  7. InSight Final Flight Installation of Heatshield

    NASA Image and Video Library

    2018-04-12

    In the Astrotech facility at Vandenberg Air Force Base in California, technicians and engineers place the heatshield on NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander prior to encapsulation in its payload fairing. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  8. Insights from human studies into the host defense against candidiasis.

    PubMed

    Filler, Scott G

    2012-04-01

    Candida spp. are the most common cause of mucosal and disseminated fungal infections in humans. Studies using mutant strains of mice have provided initial information about the roles of dectin-1, CARD9, and Th17 cytokines in the host defense against candidiasis. Recent technological advances have resulted in the identification of mutations in specific genes that predispose humans to develop candidal infection. The analysis of individuals with these mutations demonstrates that dectin-1 is critical for the host defense against vulvovaginal candidiasis and candidal colonization of the gastrointestinal tract. They also indicate that CARD9 is important for preventing both mucosal and disseminated candidiasis, whereas the Th17 response is necessary for the defense against mucocutaneous candidiasis. This article reviews the recent studies of genetic defects in humans that result in an increased susceptibility to candidiasis and discusses how these studies provide new insight into the host defense against different types of candidal infections. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. A qualitative study of patients' experiences of participating in SPACE for COPD: a Self-management Programme of Activity, Coping and Education.

    PubMed

    Apps, Lindsay D; Harrison, Samantha L; Mitchell, Katy E; Williams, Johanna E A; Hudson, Nicky; Singh, Sally J

    2017-10-01

    The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.

  10. Obesity and cancer: mechanistic insights from transdisciplinary studies

    PubMed Central

    Allott, Emma H.; Hursting, Stephen D.

    2015-01-01

    Obesity is associated with a range of health outcomes that are of clinical and public health significance, including cancer. Herein, we summarize epidemiologic and preclinical evidence for an association between obesity and increased risk of breast and prostate cancer incidence and mortality. Moreover, we describe data from observational studies of weight change in humans and from calorie restriction studies in mouse models which support a potential role for weight loss in counteracting tumor-promoting properties of obesity in breast and prostate cancers. Given that weight loss is challenging to achieve and maintain, we also consider evidence linking treatments for obesity-associated co-morbidities, including metformin, statins and non-steroidal anti-inflammatory drugs, with reduced breast and prostate cancer incidence and mortality. Finally, we highlight several challenges that should be considered when conducting epidemiologic and preclinical research in the area of obesity and cancer, including the measurement of obesity in population-based studies, the timing of obesity and weight change in relation to tumor latency and cancer diagnosis, and the heterogeneous nature of obesity and its associated co-morbidities. Given that obesity is a complex trait, comprised of behavioral, epidemiologic and molecular/metabolic factors, we argue that a transdisciplinary approach is the key to understanding the mechanisms linking obesity and cancer. As such, this review highlights the critical need to integrate evidence from both epidemiologic and preclinical studies to gain insight into both biologic and non-biologic mechanisms contributing to the obesity-cancer link. PMID:26373570

  11. An old disease with new insights: Update on diagnosis and treatment of gout

    PubMed Central

    Bitik, Berivan; Öztürk, M. Akif

    2014-01-01

    Gout is an acute and chronic inflammatory disorder associated with high morbidity and impaired quality of life. There has been a substantial increase in the prevalence and incidence of gout in recent years. Novel diagnostic and therapeutic options have provided new insights into the pathogenesis and management of hyperuricemia and gout in the last decade. This clinical review aims to summarize the diagnostic process and management of acute and chronic gout. PMID:27708879

  12. Metacognitive Reflection and Insight Therapy for Early Psychosis: A preliminary study of a novel integrative psychotherapy.

    PubMed

    Vohs, Jenifer L; Leonhardt, Bethany L; James, Alison V; Francis, Michael M; Breier, Alan; Mehdiyoun, Nikki; Visco, Andrew C; Lysaker, Paul H

    2018-05-01

    Poor insight impedes treatment in early phase psychosis (EPP). This manuscript outlines preliminary findings of an investigation of the novel metacognitively oriented integrative psychotherapy, Metacognitive Reflection and Insight Therapy, for individuals with early phase psychosis (MERIT-EP). Twenty adults with EPP and poor insight were randomized to either six months of MERIT-EP or treatment as usual (TAU). Therapists were trained and therapy was successfully delivered under routine, outpatient conditions. Insight, assessed before and after treatment, revealed significant improvement for the MERIT-EP, but not TAU, group. These results suggest MERIT-EP is feasible to deliver, accepted by patients, and leads to clinically significant improvements in insight. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Managing bundled payments.

    PubMed

    Draper, Andrew

    2011-04-01

    Results of Medicare's ACE demonstration project and Geisinger Health System's ProvenCare initiative provide insight into the challenges hospitals will face as bundled payment proliferates. An early analysis of these results suggests that hospitals would benefit from bringing full automation using clinical IT tools to bear in their efforts to meet these challenges. Other important factors contributing to success include board and physician leadership, organizational structure, pricing methodology for bidding, evidence-based medical practice guidelines, supply cost management, process efficiency management, proactive and aggressive case management, business development and marketing strategy, and the financial management system.

  14. An Analytics-Based Approach to Managing Cognitive Load by Using Log Data of Learning Management Systems and Footprints of Social Media

    ERIC Educational Resources Information Center

    Yen, Cheng-Huang; Chen, I-Chuan; Lai, Su-Chun; Chuang, Yea-Ru

    2015-01-01

    Traces of learning behaviors generally provide insights into learners and the learning processes that they employ. In this article, a learning-analytics-based approach is proposed for managing cognitive load by adjusting the instructional strategies used in online courses. The technology-based learning environment examined in this study involved a…

  15. INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

    PubMed

    Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

    2016-03-01

    Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia.

  16. Survey of Spanish general practitioners' attitudes toward management of sore throat: an internet-based questionnaire study.

    PubMed

    Llor, Carl; Vilaseca, Isabel; Lehrer-Coriat, Eduardo; Boleda, Xavier; Cañada, José L; Moragas, Ana; Cots, Josep M

    2017-02-14

    The management of sore throat varies widely in Europe. The objective of this study was to gain insight into clinicians' perceptions on the current management of sore throat in Spain. Cross-sectional, internet-based questionnaire study answered from July to September 2013. General practitioners (GPs) affiliated with the two largest scientific societies of primary care were invited to participate in the study. Questions were asked about physician knowledge, the use of current national guidelines for sore throat management, and management in two clinical scenarios, depicting a young adult with sore throat and: 1. cough, coriza with or without fever, and 2. fever without cough and coriza. The questionnaire was completed by 1476 GPs (5%) and 12.7% declared using rapid antigen detection tests. Antibiotics were considered by 18.8% of the GPs in the first scenario and by 32% in the second scenario (p < 0.001). The antibiotics most commonly mentioned by GPs were amoxicillin and amoxicillin + clavulanate (52.7 and 31.2%, respectively) whereas penicillin V was only prescribed in 11.9% of the cases. The drugs most commonly considered in both scenarios were analgesics and anti-inflammatory drugs. Antitussives, decongestants and expectorants were more commonly prescribed in cases of suspected viral infection (p < 0.001). GPs have misconceptions as to the indications for using rapid antigen detection tests and prescribing drugs in the management of sore throat. These results suggest that guidelines are seldom followed since one in five GPs declared giving antibiotics for patients with a suspected viral infection and the use of second-choice antibiotics seems considerable.

  17. An analysis of opinions from veterinarians in South Africa regarding business management skills.

    PubMed

    Krecek, R C; Tobin, P

    2004-03-01

    The changing role of veterinarians in the global market is a current topic of debate and discussion. Few countries including South Africa have formally examined the changing dynamics of this profession. Therefore, the present study addressed 2 objectives. The 1st was to examine basic information about veterinarians in South Africa including their age, gender and distribution across provinces, the percentage whose practice was urban, rural or periurban, the numbers working with specific animal species, and the extent of business management and skills previously gained. The 2nd objective was to obtain opinions and insights from veterinarians in South Africa about the challenges and opportunities facing their business practices to better understand what they considered important dynamics to their businesses today. Several areas of business on which they were questioned and which were included in this study were: marketing, vision, human resources, leadership, financial management, ethics, competition, day-to-day operations, interpersonal skills and information management. This is the 1st known survey to employ a questionnaire to gain insights and opinions from veterinarians about business management skills.

  18. Applying change management metaphors to a national e-Health strategy.

    PubMed

    Saunders, Chad; Scott, Richard E

    2014-01-01

    Recent attempts at a collective understanding of how to develop an e-Health strategy have addressed the individual organisation, collection of organisations, and national levels. At the national level the World Health Organisation's National eHealth Strategy Toolkit serves as an exemplar that consolidates knowledge in this area, guides practical implementations, and identifies areas for future research. A key implication of this toolkit is the considerable number of organisational changes required to successfully apply their ideas in practice. This study looks critically at the confluence of change management and e-Health strategy using metaphors that underpin established models of change management. Several of Morgan's organisational metaphors are presented (highlighting varied beliefs and assumptions regarding how change is enacted, who is responsible for the change, and guiding principles for that change), and used to provide a framework. Attention is then directed to several prominent models of change management that exemplify one or more of these metaphors, and these theoretical insights are applied to evaluate the World Health Organisation's National eHealth Strategy Toolkit. The paper presents areas for consideration when using the WHO/ITU toolkit, and suggestions on how to improve its use in practice. The goal is to seek insight regarding the optimal sequence of steps needed to ensure successful implementation and integration of e-health into health systems using change management models. No single model, toolkit, or guideline will offer all the needed answers, but clarity around the underlying metaphors informing the change management models being used provides valuable insight so potentially challenging areas can be avoided or mitigated.

  19. Characteristics of Kodak Insight, an F-speed intraoral film.

    PubMed

    Ludlow, J B; Platin, E; Mol, A

    2001-01-01

    This study reports film speed, contrast, exposure latitude, resolution, and response to processing solution depletion of Kodak Insight intraoral film. Densitometric curves were generated by using International Standards Organization protocol. Additional curves were generated for Ultra-speed, Ektaspeed Plus, and Insight films developed in progressively depleted processing solutions. Eight observers viewed images of a resolution test tool for maximum resolution assessment. Images of an aluminum step-wedge were reviewed to determine useful exposure latitude. Insight's sensitivity in fresh automatic processor solutions places it in the F-speed group. An average gradient of 1.8 was found with all film types. Insight provided 93% of the useful exposure latitude of Ektaspeed Plus film. Insight maintained contrast in progressively depleted processing solutions. Like Ektaspeed Plus, Insight was able to resolve at least 20 line-pairs per millimeter. Under International Standards Organization conditions, Insight required only 77% of the exposure of Ektaspeed Plus film. Insight film provided stable contrast in depleted processing solutions.

  20. Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients' needs.

    PubMed

    Azevedo, Rita; Bernardes, Miguel; Fonseca, João; Lima, Aurea

    2015-10-01

    Patient-centered smartphone applications have potential to support rheumatoid arthritis (RA) self-management but remain almost unexplored in literature. Therefore, this study evaluated the usefulness of a smartphone application to support RA self-management, the willingness of RA patients to use and pay for it and the features the application should have. In this cross-sectional study, a questionnaire was developed to collect information on population, device ownership, usefulness and willingness to use and pay for a RA self-management application and application features. Descriptive statistics, Chi-square, Fisher's exact test, t test or Mann-Whitney's test and multivariate analysis were used. One hundred RA patients answered the questionnaire. Patients' mean age was 57 ± 11.9 years, most were females (91 %), with multiple drug regimens and a 40 % treatment non-compliance rate. Most patients believed that could have a more active role in self-management (94 %) and reported it would be useful to develop a RA self-management application (86 %). Patients willing to use an application (83 %) were younger, with a possible more active role in self-management, with access to a smartphone, and using short message service, electronic mail and Internet. Multivariate analysis confirmed these results, except the associations regarding access to a smartphone and use of electronic mail and Internet. Fifty-eight patients (82 %) were willing to pay for a RA self-management application and the most requested feature for it was information in a simple format. This study suggested the usefulness and patients' willingness to use and pay for a RA self-management application and provided insight on patients' needs.

  1. [Insight in schizophrenia: relationship to family history, and positive and negative symptoms].

    PubMed

    Danki, Demet; Dilbaz, Nesrin; Okay, Ihsan Tuncer; Telci, Sükran

    2007-01-01

    To determine the level of insight among patients with schizophrenia and to compare sociodemographic and clinical features. The study included 66 patients with schizophrenia based on DSM-IV criteria. A semi-structured sociodemographic instrument, the Positive and Negative Syndrome Scale (PANSS), and the Schedule for Assessing the Three Components of Insight (SATCI) were used for the study. Family history was significantly related to low-level insight in schizophrenic patients. Positive symptom scores in patients with a family history of schizophrenia were significantly higher than in patients without such a family history. Positive and general psychopathological symptoms were inversely related to level of insight in patients with schizophrenia. There was no significant relationship between the negative symptoms scores and level of insight. Family history of schizophrenia in schizophrenic patients was significantly related to low-level insight. Insight in the schizophrenic patients was affected by biological, psychological, and psychosociological factors. Family history of schizophrenia was one of these factors, which may affect the level of insight in numerous ways. Studies of patient family position and its relationship to insight have generally explored the effects of family situation on schizophrenia and insight, but not family history and its relationship to insight. In this study positive symptom severity was higher in patients with a family history of schizophrenia than in those without such a history. There was a positive relationship between low-level insight and both high positive and general psychopathology symptom levels in patients with schizophrenia.

  2. Insight and illness perception in Mexican patients with psychosis.

    PubMed

    Gómez-de-Regil, Lizzette

    2015-03-01

    Insight and illness perception are two concepts of interest in the study of factors related to clinical outcome in patients with psychosis. Insight implies a risk of emotional distress for the patient. Illness perceptions, regardless of their accuracy, might be favorable or not to illness. Literature provides evidence of significant correlates of these factors with clinical outcome, but they are rarely included in a single study. 1) assessing insight and illness perception in a sample of Mexican patients who have experienced psychosis and, 2) analyzing how insight and illness perception relate to each other and how they relate to clinical status (i.e., positive, negative, and general psychopathology, depression, and anxiety). Sixty-one participants (55.7% females) were recruited from a public psychiatric hospital; insight and illness perceptions were assessed with the SUMD and the Brief-IPQ, respectively. Clinical status was assessed with the PANSS, CDS and BAI scales. Participants showed good insight, favorable illness perceptions for the cognitive and comprehension dimensions, but unfavorable for the emotional dimension. Clinical status of sample was characterized by mild symptoms. Poor insight related to positive symptoms and general psychopathology. Cognitive and emotional perceptions of illness were significantly associated to most clinical status parameters, whereas comprehension showed no significant results. The study not only replicates the significant association on insight and illness perception with clinical outcome, but shows how their patterns of interactions are different, reinforcing the idea that they are two distinct factors worthy of being habitually acknowledged in research and clinical practice.

  3. Insights Gained From the Study of Pediatric Systemic Lupus Erythematosus.

    PubMed

    Lo, Mindy S

    2018-01-01

    The pathophysiology of systemic lupus erythematosus (SLE) has been intensely studied but remains incompletely defined. Currently, multiple mechanisms are known to contribute to the development of SLE. These include inadequate clearance of apoptotic debris, aberrant presentation of self nucleic antigens, loss of tolerance, and inappropriate activation of T and B cells. Genetic, hormonal, and environmental influences are also known to play a role. The study of lupus in children, in whom there is presumed to be greater genetic influence, has led to new understandings that are applicable to SLE pathophysiology as a whole. In particular, characterization of inherited disorders associated with excessive type I interferon production has elucidated specific mechanisms by which interferon is induced in SLE. In this review, we discuss several monogenic forms of lupus presenting in childhood and also review recent insights gained from cytokine and autoantibody profiling of pediatric SLE.

  4. Applying the best available science to fire management: Individual and organizational influences to success

    Treesearch

    Vita Wright

    2012-01-01

    Fifty years of scientific literature on human behavior, communication and organizations offers numerous insights into the communication and use of science in the context of public land management. Using diverse but complementary social science theories and methods, I studied individual and organizational influences on the use of science by federal fire managers and...

  5. Examination of clinical and cognitive insight in acute schizophrenia patients.

    PubMed

    Greenberger, Cheryl; Serper, Mark R

    2010-07-01

    Lack of insight or awareness of illness is a hallmark feature of schizophrenic illness and has become an increasingly important area of investigation. Although clinical insight focuses on awareness of illness factors, the concept of cognitive insight focuses on the cognitive processes involved in correcting erroneous judgments and certainty about mistaken judgments. The present study was aimed at further investigating the clinical utility and the statistical coherence of the Beck Cognitive Insight Scale (BCIS) (Beck et al., 2004) in acute schizoaffective and schizophrenia (SZ) patients. The present study examined the internal consistency of the scale, as well as its discriminative and predictive validity relative to a well-established traditional measure of clinical insight in a sample of 50 DSM-IV diagnosed SZ patients, presenting for acute inpatient treatment. The BCIS was found to be an internally consistent and a coherent measure of cognitive insight. The BCIS was unassociated with clinical insight, indicating the 2 constructs share little empirical overlap. Cognitive insight was found to be inversely associated with patients' severity of autistic preoccupation symptoms such that those individuals with more cognitive insight, exhibited fewer autistic/cognitive symptoms. Patients' clinical insight, however, was found to be inversely associated specifically with patients' severity of depression. Additionally, clinical insight was also found to be more impaired in patients residing in nursing home environments relative to their counterparts living in less restrictive settings when outside the hospital. Results are discussed in terms of the relationship between clinical and cognitive insight constructs to SZ symptom domains.

  6. The Ecosystem-Economy Relationship: Insights from Six Forested LTER Sites

    Treesearch

    Paul N. Courant; Ernie Niemi; Ed. Whitelaw

    1997-01-01

    The debate over forest-management policy in the U.S. often is cast as a choice between jobs and [pick the environmental attribute of your choice]. The purpose of this paper is neither to rehash nor to characterize these conflicts, but to discuss insights into them that have emerged from an examination of the forest-economy relationship in different regions of the U.S....

  7. Geomorphic and hydrologic study of peak-flow management on the Cedar River, Washington

    USGS Publications Warehouse

    Magirl, Christopher S.; Gendaszek, Andrew S.; Czuba, Christiana R.; Konrad, Christopher P.; Marineau, Mathieu D.

    2012-01-01

    Assessing the linkages between high-flow events, geomorphic response, and effects on stream ecology is critical to river management. High flows on the gravel-bedded Cedar River in Washington are important to the geomorphic function of the river; however, high flows can deleteriously affect salmon embryos incubating in streambed gravels. A geomorphic analysis of the Cedar River showed evidence of historical changes in river form over time and quantified the effects of anthropogenic alterations to the river corridor. Field measurements with accelerometer scour monitors buried in the streambed provided insight into the depth and timing of streambed scour during high-flow events. Combined with a two-dimensional hydrodynamic model, the recorded accelerometer disturbances allowed the prediction of streambed disturbance at the burial depth of Chinook and sockeye salmon egg pockets for different peak discharges. Insight gained from these analyses led to the development of suggested monitoring metrics for an ongoing geomorphic monitoring program on the Cedar River.

  8. Contemporary HIV/AIDS research: Insights from knowledge management theory.

    PubMed

    Callaghan, Chris William

    2017-12-01

    Knowledge management as a field is concerned with the management of knowledge, including the management of knowledge in research processes. Knowledge management theory has the potential to support research into problems such as HIV, antibiotic resistance and others, particularly in terms of aspects of scientific research related to the contribution of social science. To date, however, these challenges remain with us, and theoretical contributions that can complement natural science efforts to eradicate these problems are needed. This paper seeks to offer a theoretical contribution grounded in Kuhn's paradigm theory of innovation, and in the argument by Lakatos that scientific research can be fundamentally non-innovative, which suggests that social science aspects of knowledge creation may hold the key to more effective biomedical innovation. Given the consequences of ongoing and emerging global crises, and the failure of knowledge systems of scientific research to solve such problems outright, this paper provides a review of theory and literature arguing for a new paradigm in scientific research, based on the development of global systems to maximise research collaborations. A global systems approach effectively includes social science theory development as an important complement to the natural sciences research process. Arguably, information technology and social media technology have developed to the point at which solutions to knowledge aggregation challenges can enable solutions to knowledge problems on a scale hitherto unimaginable. Expert and non-expert crowdsourced inputs can enable problem-solving through exponentially increasing problem-solving inputs, using the 'crowd,' thereby increasing collaborations dramatically. It is argued that these developments herald a new era of participatory research, or a democratisation of research, which offers new hope for solving global social problems. This paper seeks to contribute to this end, and to the recognition

  9. Contemporary HIV/AIDS research: Insights from knowledge management theory

    PubMed Central

    Callaghan, Chris William

    2017-01-01

    Abstract Knowledge management as a field is concerned with the management of knowledge, including the management of knowledge in research processes. Knowledge management theory has the potential to support research into problems such as HIV, antibiotic resistance and others, particularly in terms of aspects of scientific research related to the contribution of social science. To date, however, these challenges remain with us, and theoretical contributions that can complement natural science efforts to eradicate these problems are needed. This paper seeks to offer a theoretical contribution grounded in Kuhn’s paradigm theory of innovation, and in the argument by Lakatos that scientific research can be fundamentally non-innovative, which suggests that social science aspects of knowledge creation may hold the key to more effective biomedical innovation. Given the consequences of ongoing and emerging global crises, and the failure of knowledge systems of scientific research to solve such problems outright, this paper provides a review of theory and literature arguing for a new paradigm in scientific research, based on the development of global systems to maximise research collaborations. A global systems approach effectively includes social science theory development as an important complement to the natural sciences research process. Arguably, information technology and social media technology have developed to the point at which solutions to knowledge aggregation challenges can enable solutions to knowledge problems on a scale hitherto unimaginable. Expert and non-expert crowdsourced inputs can enable problem-solving through exponentially increasing problem-solving inputs, using the ‘crowd,’ thereby increasing collaborations dramatically. It is argued that these developments herald a new era of participatory research, or a democratisation of research, which offers new hope for solving global social problems. This paper seeks to contribute to this end, and to

  10. Elderly self-management: a qualitative study

    PubMed Central

    Ravanipour, Maryam; Salehi, Shayesteh; Taleghani, Fariba; Abedi, Heidar Ali

    2010-01-01

    BACKGROUND: The population of elderly in Iran and in the world is increasing. It is predicted that the population of elderly reaches to 10 millions in Iran by the year 2019. Elders more than other age groups are at risk of chronic diseases and health problems; and elderly affects their self-management and makes them feel disabled. Since the knowledge of self-management for Iranian elderly is not well developed, this paper aimed to determine the concept of self-management for Iranian elders. METHODS: This was a qualitative study with grounded theory approach on Iranian elderly self-management. Data were collected through deep interviews with 26 participants in a period of one year and were analyzed using a Strauss Corbin analysis method. RESULTS: Self-management in the context of power means using different managing methods in dealing with daily life needs, especially in interactions with others in a way that accelerates affairs with efficiency and satisfaction. The main categories emerged from this qualitative study included: managing plans, managing life goals and policies, persuading the desired goals, managing self-care, directing others, coordinating and consulting with others. CONCLUSIONS: The findings of this study provided a deep understanding of elderly perceptions of self-management in their lives. These findings can be a baseline for future researches on developing effective health interventions such as developing a nursing model for increasing the elderly self-management abilities in Iran. Such a model can provide a strong basis for nursing care. PMID:21589781

  11. The impact of insight on social functioning in patients with schizophrenia.

    PubMed

    Erol, Almila; Delibas, Hakan; Bora, Ozlem; Mete, Levent

    2015-06-01

    It is still unclear whether insight has a direct association with social functioning in schizophrenia, independent of its association with symptoms. This study aimed to investigate the relationship of insight and its dimensions with social functioning in schizophrenia. A total of 170 outpatients with schizophrenia were included in this study. All patients were evaluated with the Scale to Assess Unawareness of Mental Disorder (SUMD), Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance Scale (PSP). Patients with impaired insight and patients with unimpaired insight were compared for PSP score through independent samples t test. Pearson's correlation analysis was used to determine the correlations between study variables. Multiple stepwise linear regression analysis was used in order to determine the variables that predict social performance. The PSP score of patients with impaired insight was significantly lower than that of patients with unimpaired insight. There were significant correlations between insight dimensions and PSP score. PANSS negative scale score, awareness of achieved effects of medication and awareness of anhedonia/asociality were significant predictors of social performance. Insight has a significant impact on social functioning in schizophrenia, and some, but not all, insight dimensions have direct impact on social performance, independent of their association with symptoms. © The Author(s) 2014.

  12. Impaired insight into illness and cognitive insight in schizophrenia spectrum disorders: Resting state functional connectivity

    PubMed Central

    Gerretsen, Philip; Menon, Mahesh; Mamo, David C.; Fervaha, Gagan; Remington, Gary; Pollock, Bruce G.; Graff-Guerrero, Ariel

    2015-01-01

    Background Impaired insight into illness (clinical insight) in schizophrenia has negative effects on treatment adherence and clinical outcomes. Schizophrenia is described as a disorder of disrupted brain connectivity. In line with this concept, resting state networks (RSNs) appear differentially affected in persons with schizophrenia. Therefore, impaired clinical, or the related construct of cognitive insight (which posits that impaired clinical insight is a function of metacognitive deficits), may reflect alterations in RSN functional connectivity (fc). Based on our previous research, which showed that impaired insight into illness was associated with increased left hemisphere volume relative to right, we hypothesized that impaired clinical insight would be associated with increased connectivity in the DMN with specific left hemisphere brain regions. Methods Resting state MRI scans were acquired for participants with schizophrenia or schizoaffective disorder (n = 20). Seed-to-voxel and ROI-to-ROI fc analyses were performed using the CONN-fMRI fc toolbox v13 for established RSNs. Clinical and cognitive insight were measured with the Schedule for the Assessment of Insight—Expanded Version and Beck Cognitive Insight Scale, respectively, and included as the regressors in fc analyses. Results As hypothesized, impaired clinical insight was associated with increased connectivity in the default mode network (DMN) with the left angular gyrus, and also in the self-referential network (SRN) with the left insula. Cognitive insight was associated with increased connectivity in the dorsal attention network (DAN) with the right inferior frontal cortex (IFC) and left anterior cingulate cortex (ACC). Conclusion Increased connectivity in DMN and SRN with the left angular gyrus and insula, respectively, may represent neural correlates of impaired clinical insight in schizophrenia spectrum disorders, and is consistent with the literature attributing impaired insight to left

  13. Unanticipated Insights into Biomedicine from the Study of Acupuncture.

    PubMed

    MacPherson, Hugh; Hammerschlag, Richard; Coeytaux, Remy R; Davis, Robert T; Harris, Richard E; Kong, Jiang-Ti; Langevin, Helene M; Lao, Lixing; Milley, Ryan J; Napadow, Vitaly; Schnyer, Rosa N; Stener-Victorin, Elisabet; Witt, Claudia M; Wayne, Peter M

    2016-02-01

    Research into acupuncture has had ripple effects beyond the field of acupuncture. This paper identifies five exemplars to illustrate that there is tangible evidence of the way insights gleaned from acupuncture research have informed biomedical research, practice, or policy. The first exemplar documents how early research into acupuncture analgesia has expanded into neuroimaging research, broadening physiologic understanding and treatment of chronic pain. The second describes how the acupuncture needle has become a tool to enhance biomedical knowledge of connective tissue. The third exemplar, which illustrates use of a modified acupuncture needle as a sham device, focuses on emergent understanding of placebo effects and, in turn, on insights into therapeutic encounters in treatments unrelated to acupuncture. The fourth exemplar documents that two medical devices now in widespread use were inspired by acupuncture: transcutaneous electrical nerve stimulators for pain control and antinausea wrist bands. The final exemplar describes how pragmatic clinical trial designs applied in acupuncture research have informed current general interest in comparative effectiveness research. In conclusion, these exemplars of unanticipated outcomes of acupuncture research comprise an additional rationale for continued support of basic and clinical research evaluating acupuncture and other under-researched therapies.

  14. Correlation Between Insight Level and Suicidal Behavior/Ideation in Bipolar Depression.

    PubMed

    de Assis da Silva, Rafael; Mograbi, Daniel C; Bifano, Jaqueline; Santana, Cristina M T; Cheniaux, Elie

    2017-03-01

    Suicide is a relatively common outcome along the course of bipolar disorder. Studies have shown a positive correlation between ideation or attempts of suicide and higher insight in schizophrenic patients. Nevertheless there are still few studies that evaluate the relationship between suicide and insight in mood disorders. Evaluate the relationship between insight and suicidal ideation or behavior in bipolar depression. A group of 165 bipolar patients were followed up along 1 year. Each patient's mood was assessed in every consultation according to DSM-IV-TR criteria. Suicidal ideation and behavior were prospectively assessed through item 3 of HAM-D whenever a major depressive episode was diagnosed. Insight was evaluated through the Insight Scale for Affective Disorders. A history of suicidal attempts was associated with worse insight in 60 patients with one episode of bipolar depression. The difference remained even when the supposed effect of depression over insight was controlled. No correlation between current suicidal ideation and insight level was found though. Our results suggest that a history of suicide attempts may correlate with higher impairment of insight in bipolar depression. No relationship was found between current suicidal ideation and insight.

  15. Supporting self-management by Community Matrons through a group intervention; an action research study.

    PubMed

    Barkham, Abigail M; Ersser, Steven J

    2017-07-01

    The aim of this study was to examine the feasibility and impact of a group intervention by Community Matrons to support those living with multiple long-terms conditions. Little evidence exists as to how the role of the Community Matron (CM) should be delivered to effectively enhance disease self-management and levels of self-efficacy for the service users. This qualitative participatory action research study explored the use of group work as a method of intervention by CMs. A purposive sample of 29 participants was recruited. Each patient group had 8-10 participants, led by a CM working in both the researcher and practitioner role, operating over 12-month period. Data were collected by participant observation, researcher reflexive account and interviews. Grounded theory method was used to systematically analyse the data. Three main data categories emerged: (i) comparison by patients that leads to re-motivation of the self; (ii) learning, leading to enhanced self-management techniques, through storytelling and understanding of each other's experiences; and (iii) ownership that resulted in the self-awareness, cognisance and insight into the role of the support group they were based in and how it benefited them. The core category of 'Taking back the self - understanding the whole,' conveyed the impact that this care delivery method had upon readjusting the balance of power between health professional and service users and its consequence in refreshing and improving their self-management and the patients' self-efficacy. It was concluded that CM intervention using a model of group learning can lead to more effective and efficient support, through improving self-efficacy and patients' related self-management ability. © 2017 John Wiley & Sons Ltd.

  16. Proofs that Develop Insight

    ERIC Educational Resources Information Center

    Weber, Keith

    2010-01-01

    Many mathematics educators have noted that mathematicians do not only read proofs to gain conviction but also to obtain insight. The goal of this article is to discuss what this insight is from mathematicians' perspective. Based on interviews with nine research-active mathematicians, two sources of insight are discussed. The first is reading a…

  17. Teaching self-management support in Dutch Bachelor of Nursing education: A mixed methods study of the curriculum.

    PubMed

    van Hooft, Susanne M; Becqué, Yvonne N; Dwarswaard, Jolanda; van Staa, AnneLoes; Bal, Roland

    2018-06-08

    Nurses are expected to support people to self-manage. Student nurses therefore need to master competencies that include the assessment of peoples' needs and preferences, and shared decision-making, whilst respecting and enhancing peoples' autonomy. Adapting nurse education programmes to meet this goal requires insight into the practice of teaching self-management support. In order to reveal this practice, one can distinguish between the intended, the taught, and the received curriculum. This study aimed to explore how Dutch Bachelor of Nursing students are educated to support peoples' self-management in clinical practice. Mixed methods. Focus group meetings with 30 lecturers, and qualitative semi-structured interviews with four coordinators and four (associate) professors of four Dutch schools for Bachelor of Nursing. Syllabuses were screened for learning objectives related to self-management. A survey measuring self-efficacy and behaviour regarding self-management support was distributed among 444 final-year students of these schools, resulting in 238 valid responses (response rate 53.6%). Much attention is paid in the curriculum to assessment of people's preferences and healthcare education but less attention is given to teaching the arrangement of follow-up care. The study further reveals that students have problems transferring theory into practice, and that they experience conflicting values between their nurse education and internships. Currently, students are taught to provide people with self-management support by learning about theoretical models, developing communication skills, and reflecting on their internships. This approach seems inadequate to prepare students for this task in daily practice. A shared view on self-management support based on authentic situations, having role models at university and on internships and empowering students may enable them to better support people to self-manage. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Insight in schizophrenia and risk of suicide: a systematic update.

    PubMed

    López-Moríñigo, Javier D; Ramos-Ríos, Ramón; David, Anthony S; Dutta, Rina

    2012-05-01

    Suicide has been shown to represent the major single cause of premature death among patients with schizophrenia spectrum disorders. Insight has been proposed to increase such risk. However, this subject has not been sufficiently investigated, and inconclusive results have been reported. The objective of this study is to systematically examine the role of insight in the risk of suicide attempts and completed suicide among patients with schizophrenia and related disorders. Articles assessing insight and suicidality in patients with schizophrenia spectrum disorders published between 1977 and 2010 were reviewed. A MEDLINE search strategy was used to identify studies using keywords. Application of meta-analytic techniques to selected studies was not possible because of important methodological differences between them. Fifteen studies met predetermined selection criteria. Ten failed to demonstrate a positive association between insight and risk for suicide. There is little evidence to support the suggestion that insight may represent a risk factor for suicide in patients with schizophrenia. If there is an association between such risk and insight, it appears to be mediated by other variables such as depression and, above all, hopelessness. Further studies with larger samples and longer follow-up periods in naturalistic conditions, in which insight should be evaluated from a multidimensional approach, are required to analyze this issue in depth, given the crucial implications that it may have on the development of a model for suicide prevention in schizophrenia. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Children's, parents' and health professionals' views on the management of childhood asthma: a qualitative study.

    PubMed

    Searle, Aidan; Jago, Russell; Henderson, John; Turner, Katrina M

    2017-09-11

    The management of childhood asthma is often sub-optimal. Parents and other caregivers are primarily responsible for disease management and this responsibility includes communication with health professionals. The aim of this multi-perspective qualitative study was to explore the views of children, parents and health professionals to gain insight into the approach to clinical care in the management of childhood asthma. Interviews were held with nine parent-child (6-8 years) dyads, and 13 health professionals working in primary and secondary care. Interviews were transcribed verbatim and analysed thematically. Three key themes emerged that were common to all data sets; (1) Child and parent awareness of symptoms; (2) Management and child wellbeing; and (3) Professional communication education and consultation with families. Although some children demonstrate good awareness of symptoms and appropriate use of medication, some parents expressed difficulty in identifying triggers and symptoms of asthma. Furthermore, parents lacked awareness regarding appropriate use of medication for preventing and managing symptoms of asthma. Health professionals believed that communication and education was lacking. Data from all participants suggested that consultations could be enhanced with greater emphasis on children's and parents' perceptions of asthma in the development of asthma management plans. GUIDING FAMILIES THROUGH DISEASE MANAGEMENT: Both parents' and children's perceptions and understanding of childhood asthma should be considered when developing asthma management plans. The management of asthma is challenging and can result in poor disease outcomes if care is not taken. An individual's perception of their (or their child's) asthma can also affect the efficacy of treatment. Aidan Searle at the Bristol Biomedical Research Centre, UK, and co-workers, interviewed nine parent-child groups and thirteen health professionals to determine their perceptions of childhood asthma

  20. Obesity and cancer: mechanistic insights from transdisciplinary studies.

    PubMed

    Allott, Emma H; Hursting, Stephen D

    2015-12-01

    Obesity is associated with a range of health outcomes that are of clinical and public health significance, including cancer. Herein, we summarize epidemiologic and preclinical evidence for an association between obesity and increased risk of breast and prostate cancer incidence and mortality. Moreover, we describe data from observational studies of weight change in humans and from calorie-restriction studies in mouse models that support a potential role for weight loss in counteracting tumor-promoting properties of obesity in breast and prostate cancers. Given that weight loss is challenging to achieve and maintain, we also consider evidence linking treatments for obesity-associated co-morbidities, including metformin, statins and non-steroidal anti-inflammatory drugs, with reduced breast and prostate cancer incidence and mortality. Finally, we highlight several challenges that should be considered when conducting epidemiologic and preclinical research in the area of obesity and cancer, including the measurement of obesity in population-based studies, the timing of obesity and weight change in relation to tumor latency and cancer diagnosis, and the heterogeneous nature of obesity and its associated co-morbidities. Given that obesity is a complex trait, comprised of behavioral, epidemiologic and molecular/metabolic factors, we argue that a transdisciplinary approach is the key to understanding the mechanisms linking obesity and cancer. As such, this review highlights the critical need to integrate evidence from both epidemiologic and preclinical studies to gain insight into both biologic and non-biologic mechanisms contributing to the obesity-cancer link. © 2015 Society for Endocrinology.

  1. How does vineyard management intensity affect ecosystem services and disservices - insights from a meta-analysis

    NASA Astrophysics Data System (ADS)

    Winter, Silvia; Zaller, Johann G.; Kratschmer, Sophie; Pachinger, Bärbel; Strauss, Peter; Bauer, Thomas; Paredes, Daniel; Gómez, José A.; Guzmán, Gema; Landa, Blanca; Nicolai, Annegret; Burel, Francoise; Cluzeau, Daniel; Popescu, Daniela; Bunea, Claudiu-Ioan; Potthoff, Martin; Guernion, Muriel; Batáry, Péter

    2016-04-01

    Viticultural agro-ecosystems provide a range of different ecosystem services which are affected by management decisions of winegrowers. At the global scale, vineyards are often high intensity agricultural systems with bare soil or inter-row vegetation consisting of only a few plant species. These systems primarily aim at optimizing wine production by reducing competition for water and nutrients between grapevines and weeds and by preventing the outbreak of pests and diseases. At the same time, this kind of management is often associated with ecosystem disservices such as high rates of soil erosion, degradation of soil structure and fertility, contamination of groundwater and decline of biodiversity. Recently, several initiatives across the world tried to overcome detrimental effects of that management style by creating biodiversity friendly vineyards. The consequences of establishing divers cover crop mixes or tolerating spontaneous vegetation in vineyards for ecosystem services (including yield) overstretching local case studies has not been investigated yet. This meta-analysis will provide an overview of all published studies comparing the effects of different vineyard management practices on a range of different ecosystem services like biodiversity, pest control, pollination, soil conservation and carbon sequestration. The aggregated effect size will point out which management measures can provide the best overall net sum of ecosystem services. This meta-analysis is part of the transdisciplinary BiodivERsA project VineDivers and will ultimately lead into management and policy recommendations for various stakeholder groups engaged in viticulture.

  2. New insights into managing the risk of hypoglycaemia associated with intermittent high-intensity exercise in individuals with type 1 diabetes mellitus: implications for existing guidelines.

    PubMed

    Guelfi, Kym J; Jones, Timothy W; Fournier, Paul A

    2007-01-01

    -to-recovery ratios observed in team and field sports have been conducted. The findings of these studies do not support the existing recommendations for managing blood glucose levels during IHE. Hence, the purpose of this article is to discuss the results of these recent studies, which provide new insight into the management of blood glucose levels during and after IHE and have implications for current guidelines aimed at minimising the risk of hypoglycaemia. These findings, along with future investigations, should provide valuable information for health professionals and individuals with type 1 diabetes on the management of blood glucose levels during and after exercise to allow for safe participation in intermittent activities along with their peers.

  3. PV Calibration Insights | NREL

    Science.gov Websites

    PV Calibration Insights PV Calibration Insights The Photovoltaic (PV) Calibration Insights blog will provide updates on the testing done by the NREL PV Device Performance group. This NREL research group measures the performance of any and all technologies and sizes of PV devices from around the world

  4. Perspectives on mealtime management in residential aged care: insights from a cross-disciplinary investigation.

    PubMed

    Bennett, Michelle K; Ward, Elizabeth; Scarinci, Nerina; Waite, Monique

    2014-01-01

    Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: ( 1 ) mealtimes are highly valued; ( 2 ) service providers face common barriers to mealtime management; ( 3 ) communication among service providers is challenging; and ( 4 ) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care.

  5. Fundamentals of Managing Reference Collections

    ERIC Educational Resources Information Center

    Singer, Carol A.

    2012-01-01

    Whether a library's reference collection is large or small, it needs constant attention. Singer's book offers information and insight on best practices for reference collection management, no matter the size, and shows why managing without a plan is a recipe for clutter and confusion. In this very practical guide, reference librarians will learn:…

  6. Field scale lysimeters to assess nutrient management impacts on runoff

    USDA-ARS?s Scientific Manuscript database

    Most empirical studies on the impact of field management on runoff water quality rely on edge-of-field monitoring, which is generally unreplicated and prone to high variances, or small plots, which constrain the use of conventional farm equipment and can hinder insight into landscape processes drivi...

  7. Internet of things and Big Data as potential solutions to the problems in waste electrical and electronic equipment management: An exploratory study.

    PubMed

    Gu, Fu; Ma, Buqing; Guo, Jianfeng; Summers, Peter A; Hall, Philip

    2017-10-01

    Management of Waste Electrical and Electronic Equipment (WEEE) is a vital part in solid waste management, there are still some difficult issues require attentionss. This paper investigates the potential of applying Internet of Things (IoT) and Big Data as the solutions to the WEEE management problems. The massive data generated during the production, consumption and disposal of Electrical and Electronic Equipment (EEE) fits the characteristics of Big Data. Through using the state-of-the-art communication technologies, the IoT derives the WEEE "Big Data" from the life cycle of EEE, and the Big Data technologies process the WEEE "Big Data" for supporting decision making in WEEE management. The framework of implementing the IoT and the Big Data technologies is proposed, with its multiple layers are illustrated. Case studies with the potential application scenarios of the framework are presented and discussed. As an unprecedented exploration, the combined application of the IoT and the Big Data technologies in WEEE management brings a series of opportunities as well as new challenges. This study provides insights and visions for stakeholders in solving the WEEE management problems under the context of IoT and Big Data. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Insights into interventions in managing COPD patients: lessons from the TORCH and UPLIFT® studies

    PubMed Central

    Miravitlles, Marc; Anzueto, Antonio

    2009-01-01

    Influencing the progression of COPD has long been an elusive goal of drug therapy. Directly or indirectly, this has again been investigated in two of the largest, long-term drug trials in COPD: Towards a Revolution in COPD Health (TORCH) and Understanding Potential Long-Term Impacts on Function with Tiotropium (UPLIFT®). Neither trial achieved statistical significance in their respective primary outcomes; however, both make considerable contributions to understanding of how the progression of COPD may be influenced. The objective of this article is to review the data from these different trials with a view to what can be learnt about the management of COPD. The long-term improvements in lung function, health-related quality of life, and possibly survival from the use of long-acting bronchodilators in these trials suggest an influence on progression of the disease. With the more optimistic view of benefits from drug treatment of COPD that these trials provide, a review of prescribing practices is warranted. PMID:19516917

  9. Adaptive social impact management for conservation and environmental management.

    PubMed

    Kaplan-Hallam, Maery; Bennett, Nathan J

    2018-04-01

    Concerns about the social consequences of conservation have spurred increased attention the monitoring and evaluation of the social impacts of conservation projects. This has resulted in a growing body of research that demonstrates how conservation can produce both positive and negative social, economic, cultural, health, and governance consequences for local communities. Yet, the results of social monitoring efforts are seldom applied to adaptively manage conservation projects. Greater attention is needed to incorporating the results of social impact assessments in long-term conservation management to minimize negative social consequences and maximize social benefits. We bring together insights from social impact assessment, adaptive management, social learning, knowledge coproduction, cross-scale governance, and environmental planning to propose a definition and framework for adaptive social impact management (ASIM). We define ASIM as the cyclical process of monitoring and adaptively managing social impacts over the life-span of an initiative through the 4 stages of profiling, learning, planning, and implementing. We outline 14 steps associated with the 4 stages of the ASIM cycle and provide guidance and potential methods for social-indicator development, predictive assessments of social impacts, monitoring and evaluation, communication of results, and identification and prioritization of management responses. Successful ASIM will be aided by engaging with best practices - including local engagement and collaboration in the process, transparent communication of results to stakeholders, collective deliberation on and choice of interventions, documentation of shared learning at the site level, and the scaling up of insights to inform higher-level conservation policies-to increase accountability, trust, and perceived legitimacy among stakeholders. The ASIM process is broadly applicable to conservation, environmental management, and development initiatives at various

  10. Knowledge Management Analysis: A Case Study

    ERIC Educational Resources Information Center

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  11. Insight in pediatric obsessive-compulsive disorder: associations with clinical presentation.

    PubMed

    Storch, Eric A; Milsom, Vanessa A; Merlo, Lisa J; Larson, Michael; Geffken, Gary R; Jacob, Marni L; Murphy, Tanya K; Goodman, Wayne K

    2008-08-15

    Insight has emerged as a significant treatment outcome predictor in adult obsessive-compulsive disorder (OCD), with some suggesting that OCD with poor insight represents a distinct clinical subtype. Despite its clinical relevance, limited data exist on insight in pediatric OCD patients. The present study investigated the relation between poor insight and clinical characteristics among children and adolescents with OCD (N=78, ages 6-20 years). Forty-five percent of the sample (n=35) was considered to have low levels of insight into their symptoms, as determined by clinician rating on item 11 of the Children's Yale-Brown Obsessive-Compulsive Scale. Pearson product-moment correlations showed a significant, inverse relation between insight and OCD severity. Relative to the high insight group, parents of patients with low insight reported higher levels of OCD-related impairment and family accommodation. These findings suggest that OCD with poor insight may represent a distinct clinical feature that may require more intensive and multimodal treatment approaches.

  12. Agency capacity for recreation science and management: the case of the U.S. Forest Service.

    Treesearch

    Lee K. Cerveny; Clare M. Ryan

    2008-01-01

    This report examines the capacity of natural resource agencies to generate scientific knowledge and information for use by resource managers in planning and decisionmaking. This exploratory study focused on recreation in the U.S. Department of Agriculture, Forest Service. A semistructured, open-ended interview guide elicited insights from 58 managers and 28 researchers...

  13. Applying the best available science to fire management: Individual and organizational influences to success (Abstract)

    Treesearch

    Vita Wright

    2012-01-01

    Fifty years of scientific literature on human behavior, communication and organizations offers numerous insights into the communication and use of science in the context of public land management. Using diverse but complementary social science theories and methods, I studied individual and organizational influences on the use of science by federal fire managers and...

  14. InSight Probes the 'Inner Space' of Mars

    NASA Image and Video Library

    2018-01-25

    An artist's impression of the InSight lander on Mars. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is designed to give the Red Planet its first thorough check up since it formed 4.5 billion years ago. It is scheduled to launch from Vandenberg Air Force Base on the California coast between May 5 through June 8, 2018, and land on Mars six months later. InSight will look for tectonic activity and meteorite impacts, study how much heat is still flowing through the planet, and track Mars' wobble as it orbits the sun. While InSight is a Mars mission, it's more than a Mars mission. InSight will help answer key questions about the formation of the rocky planets of the solar system. https://photojournal.jpl.nasa.gov/catalog/PIA22226

  15. The effects of aging on insight into illness in schizophrenia: a review†

    PubMed Central

    Gerretsen, Philip; Plitman, Eric; Rajji, Tarek K.; Graff-Guerrero, Ariel

    2015-01-01

    Objectives Impaired insight into illness is a prevalent feature of schizophrenia, which negatively influences treatment adherence and clinical outcomes. Little is known about the effects of aging on insight impairment. We aimed to review the available research literature on the effects of aging on insight into illness in schizophrenia, in relation to positive, negative, and cognitive symptoms. Ultimately, we propose a trajectory of insight in schizophrenia across the lifespan. Method A systematic Medline® literature search was conducted, searching for English language studies describing the relationship of insight into illness in schizophrenia with aging. Results We identified 62 studies. Insight impairment is associated with illness severity, premorbid intellectual function (i.e. IQ), executive function, and memory. Insight impairment improves modestly during midlife, worsening again in late life. It tends to fluctuate with each episode of psychosis, likely in relation to worsening positive symptoms that improve with antipsychotic treatment. The relationship between insight impairment and cognitive dysfunction appears to attenuate with age, while the relationship with lower premorbid intellectual function is preserved. The association between impaired insight and negative symptoms is unclear. Conclusions The available literature suggests that the course of insight impairment follows a U-shaped curve, where insight impairment is severe during the first episode of psychosis, modestly improves over midlife, and declines again in late life. Future studies are required to investigate the trajectory of insight into illness and its core domains across the lifespan from prodromal phase to late life. PMID:25055980

  16. Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study

    PubMed Central

    Walvoort, Serge JW; van der Heijden, Paul T; Kessels, Roy PC; Egger, Jos IM

    2016-01-01

    Aim Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8) was investigated in patients with Korsakoff’s syndrome (KS) and in alcohol use disorder (AUD) patients with mild neurocognitive deficits. Methods First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX) were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. Results Internal consistency of the Q8 was acceptable (ie, Cronbach’s α =0.73). The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. Conclusion The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction. PMID:27445476

  17. Epidemiological characteristics, management and early outcomes of acute coronary syndromes in Greece: The PHAETHON study.

    PubMed

    Andrikopoulos, G; Terentes-Printzios, D; Tzeis, S; Vlachopoulos, C; Varounis, C; Nikas, N; Lekakis, J; Stakos, D; Lymperi, S; Symeonidis, D; Chrissos, D; Kyrpizidis, C; Alexopoulos, D; Zombolos, S; Foussas, S; Κranidis, Α; Oikonomou, Κ; Vasilikos, V; Andronikos, P; Dermitzakis, Α; Richter, D; Fragakis, N; Styliadis, I; Mavridis, S; Stefanadis, C; Vardas, P

    In view of recent therapeutic breakthroughs in acute coronary syndromes (ACS) and essential demographic and socioeconomic changes in Greece, we conducted the prospective, multi-center, nationwide PHAETHON study (An Epidemiological Cohort Study of Acute Coronary Syndromes in the Greek Population) that aimed to recruit a representative cohort of ACS patients and examine current management practices and patient prognosis. The PHAETHON study was conducted from May 2012 to February 2014. We enrolled 800 consecutive ACS patients from 37 hospitals with a proportional representation of all types of hospitals and geographical areas. Patients were followed for a median period of 189 days. Outcome was assessed with a composite endpoint of death, myocardial infarction, stroke, urgent revascularization and urgent hospitalization for cardiovascular causes. The mean age of patients was 62.7 years (78% males). The majority of patients (n=411, 51%) presented with ST-elevation myocardial infarction (STEMI), whereas 389 patients presented with NSTEMI (n=303, 38%) or UA (n=86, 11%). Overall, 58.8% of the patients had hypertension, 26.5% were diabetic, 52.5% had dyslipidemia, 71.1% had a smoking history (current or past), 25.8% had a family history of coronary artery disease (CAD) and 24.1% had a prior history of CAD. In STEMI patients, 44.5% of patients were treated with thrombolysis, 38.9% underwent a coronary angiogram (34.1% were treated with primary percutaneous coronary intervention) and 16.5% did not receive urgent treatment. The pain-to-door time was 169 minutes. During hospitalization, 301 (38%) patients presented one or more complications, and 13 died (1.6%). During follow-up, 99 (12.6%) patients experienced the composite endpoint, and 21 died (2.7%). The PHAETHON study provided valuable insights into the epidemiology, management and outcome of ACS patients in Greece. Management of ACS resembles the management observed in other European countries. However, several issues

  18. Landing Area Narrowed for 2016 InSight Mission to Mars

    NASA Image and Video Library

    2013-09-04

    The process of selecting a site for NASA's next landing on Mars, planned for September 2016, has narrowed to four semifinalist sites located close together in the Elysium Planitia region of Mars. The mission known by the acronym InSight will study the Red Planet's interior, rather than surface features, to advance understanding of the processes that formed and shaped the rocky planets of the inner solar system, including Earth. The location of the cluster of semifinalist landing sites for InSight is indicated on this near-global topographic map of Mars, which also indicates landing sites of current and past NASA missions to the surface of Mars. The mission's full name is Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport. The location of Elysium Planitia close to the Martian equator meets an engineering requirement for the stationary InSight lander to receive adequate solar irradiation year-round on its photovoltaic array. The location also meets an engineering constraint for low elevation, optimizing the amount of atmosphere the spacecraft can use for deceleration during its descent to the surface. The number of candidate landing sites for InSight was trimmed from 22 down to four in August 2013. This down-selection facilitates focusing the efforts to further evaluate the four sites. Cameras on NASA's Mars Reconnaissance Orbiter will be used to gather more information about them before the final selection. The topographic map uses data from the Mars Orbiter Laser Altimeter on NASA's Mars Global Surveyor spacecraft. The color coding on this map indicates elevation relative to a reference datum, since Mars has no "sea level." The lowest elevations are presented as dark blue; the highest as white. The difference between green and orange in the color coding is about 2.5 miles (4 kilometers) vertically. Note: After thorough examination, NASA managers have decided to suspend the planned March 2016 launch of the Interior Exploration using

  19. Neural pathway in the right hemisphere underlies verbal insight problem solving.

    PubMed

    Zhao, Q; Zhou, Z; Xu, H; Fan, W; Han, L

    2014-01-03

    Verbal insight problem solving means to break mental sets, to select the novel semantic information and to form novel, task-related associations. Although previous studies have identified the brain regions associated with these key processes, the interaction among these regions during insight is still unclear. In the present study, we explored the functional connectivity between the key regions during solving Chinese 'chengyu' riddles by using event-related functional magnetic resonance imaging. Results showed that both insight and noninsight solutions activated the bilateral inferior frontal gyri, middle temporal gyri and hippocampi, and these regions constituted a frontal to temporal to hippocampal neural pathway. Compared with noninsight solution, insight solution had a stronger functional connectivity between the inferior frontal gyrus and middle temporal gyrus in the right hemisphere. Our study reveals the neural pathway of information processing during verbal insight problem solving, and supports the right-hemisphere advantage theory of insight. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

  20. Self-Reflection, Insight, and Individual Differences in Various Language Tasks

    ERIC Educational Resources Information Center

    Xu, Xu

    2011-01-01

    This study explored the relationships of self-reflection and insight with individuals' performances on various language tasks. The Self-Reflection and Insight Scale (SRIS; Grant, Franklin, & Langford, 2002) assessed individual differences in three factors: engagement in reflection, need for reflection, and insight. A high need for reflection was…

  1. Insight and Treatment Outcomes in Schizophrenia: Post-hoc Analysis of a Long-term, Double-blind Study Comparing Lurasidone and Quetiapine XR.

    PubMed

    Harvey, Philip D; Siu, Cynthia O; Loebel, Antony D

    2017-12-01

    Objective: The objective of this post-hoc analysis was to evaluate the effect of lurasidone and quetiapine extended-release (XR) on insight and judgment and assess the longitudinal relationships between improvement in insight and cognitive performance, functional capacity, quality of well-being, and depressive symptoms in patients with schizophrenia. Design: Clinically unstable patients with schizophrenia (N=488) were randomized to once-daily, fixed-dose treatment with lurasidone 80mg, lurasidone 160mg, quetiapine XR 600mg, or placebo, followed by a long-term, double-blind, flexible-dose continuation study involving these agents. Results: Significantly greater improvement in insight and judgment (assessed by the Positive and Negative Syndrome Scale G12 item) for the lurasidone and quetiapine XR groups, compared to the placebo group, was observed at Week 6. Over a subsequent six-month continuation period, the flexible dose lurasidone group showed significantly greater improvement in insight from acute phase baseline compared to the flexible-dose quetiapine XR group (QXR-QXR) (p=0.032). Improvement in insight was significantly correlated with improvement in cognition ( p =0.014), functional capacity (p=0.006, UPSA-B), quality of well-being ( p =0.033, QWB), and depressive symptoms ( p =0.05, Montgomery-Åsberg Depression Rating Scale [MADRS] score) across treatment groups and study periods. Conclusion: In this post-hoc analysis, flexibly dosed lurasidone 40 to 160mg/d was found to be associated with significantly greater improvement in insight compared to flexibly dosed quetiapine XR 200 to 800mg/d over long-term treatment in patients with schizophrenia. Across treatment groups, improvement in insight and judgment was significantly associated with improvement in cognition, functional capacity, quality of well-being, and depressive symptoms over time.

  2. Association between prefrontal N-acetylaspartate and insight in psychotic disorders.

    PubMed

    Larabi, Daouia I; Liemburg, Edith J; Pijnenborg, Gerdina H M; Sibeijn-Kuiper, Anita; de Vos, Annerieke E; Bais, Leonie; Knegtering, Henderikus; Ćurčić-Blake, Branislava; Aleman, André

    2017-01-01

    Insight is impaired in most patients with psychosis and has been associated with poorer prognosis. The exact neural basis of impaired insight is still unknown, but it may involve disrupted prefrontal neural connectivity. Numerous studies have indeed found white matter (WM) abnormalities in psychosis. The association between prefrontal WM abnormalities and insight has not been studied yet by means of proton magnetic resonance spectroscopy ( 1 H-MRS). 1 H-MRS can be used to measure N-acetylaspartate (NAA), which is considered to be a marker of neuronal integrity. We measured insight with the Birchwood Insight Scale (BIS) as well as item G12 of the Positive and Negative Syndrome Scale (PANSS) in 88 patients with psychosis. Prefrontal WM concentrations of NAA and ratios of NAA to creatine (Cr) were assessed with 1 H-MRS. Nonparametric partial correlational analyses were conducted between NAA concentrations and insight controlling for illness duration, standardized antipsychotic dose, symptom scores, voxel grey matter content and voxel cerebrospinal fluid content. We found a significant correlation between reduced NAA/Cr ratios and poorer insight as measured with the BIS, which remained significant after additional correction for full width at half maximum, signal/noise and age. This is the first study reporting a relationship between lower prefrontal concentrations of a marker of neuronal integrity and impaired insight, providing further evidence that prefrontal pathology may play an important role in impaired insight in psychosis. This may be explained by the involvement of the prefrontal cortex in several executive and metacognitive functions, such as cognitive flexibility and perspective taking. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Microgravity Fluid Management Symposium

    NASA Technical Reports Server (NTRS)

    1987-01-01

    The NASA Microgravity Fluid Management Symposium, held at the NASA Lewis Research Center, September 9 to 10, 1986, focused on future research in the microgravity fluid management field. The symposium allowed researchers and managers to review space applications that require fluid management technology, to present the current status of technology development, and to identify the technology developments required for future missions. The 19 papers covered three major categories: (1) fluid storage, acquisition, and transfer; (2) fluid management applications, i.e., space power and thermal management systems, and environmental control and life support systems; (3) project activities and insights including two descriptions of previous flight experiments and a summary of typical activities required during development of a shuttle flight experiment.

  4. Dreaming and insight

    PubMed Central

    Edwards, Christopher L.; Ruby, Perrine M.; Malinowski, Josie E.; Bennett, Paul D.; Blagrove, Mark T.

    2013-01-01

    This paper addresses claims that dreams can be a source of personal insight. Whereas there has been anecdotal backing for such claims, there is now tangential support from findings of the facilitative effect of sleep on cognitive insight, and of REM sleep in particular on emotional memory consolidation. Furthermore, the presence in dreams of metaphorical representations of waking life indicates the possibility of novel insight as an emergent feature of such metaphorical mappings. In order to assess whether personal insight can occur as a result of the consideration of dream content, 11 dream group discussion sessions were conducted which followed the Ullman Dream Appreciation technique, one session for each of 11 participants (10 females, 1 male; mean age = 19.2 years). Self-ratings of deepened self-perception and personal gains from participation in the group sessions showed that the Ullman technique is an effective procedure for establishing connections between dream content and recent waking life experiences, although wake life sources were found for only 14% of dream report text. The mean Exploration-Insight score on the Gains from Dream Interpretation questionnaire was very high and comparable to outcomes from the well-established Hill (1996) therapist-led dream interpretation method. This score was associated between-subjects with pre-group positive Attitude Toward Dreams (ATD). The need to distinguish “aha” experiences as a result of discovering a waking life source for part of a dream, from “aha” experiences of personal insight as a result of considering dream content, is discussed. Difficulties are described in designing a control condition to which the dream report condition can be compared. PMID:24550849

  5. Informing policy to protect coastal coral reefs: insight from a global review of reducing agricultural pollution to coastal ecosystems.

    PubMed

    Kroon, Frederieke J; Schaffelke, Britta; Bartley, Rebecca

    2014-08-15

    The continuing degradation of coral reefs has serious consequences for the provision of ecosystem goods and services to local and regional communities. While climate change is considered the most serious risk to coral reefs, agricultural pollution threatens approximately 25% of the total global reef area with further increases in sediment and nutrient fluxes projected over the next 50 years. Here, we aim to inform coral reef management using insights learned from management examples that were successful in reducing agricultural pollution to coastal ecosystems. We identify multiple examples reporting reduced fluxes of sediment and nutrients at end-of-river, and associated declines in nutrient concentrations and algal biomass in receiving coastal waters. Based on the insights obtained, we recommend that future protection of coral reef ecosystems demands policy focused on desired ecosystem outcomes, targeted regulatory approaches, up-scaling of watershed management, and long-term maintenance of scientifically robust monitoring programs linked with adaptive management. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  6. Understanding the potential role of mobile phone-based monitoring on asthma self-management: qualitative study.

    PubMed

    Pinnock, H; Slack, R; Pagliari, C; Price, D; Sheikh, A

    2007-05-01

    National and international healthcare policy increasingly seeks technological solutions to the challenge of providing care for people with long-term conditions. Novel technologies, however, have the potential to change the dynamics of disease monitoring and self-management. We aimed to explore the opinions and concerns of people with asthma and primary care clinicians on the potential role of mobile phone monitoring technology (transmitting symptoms and peak flows, with immediate feedback of control and reminder of appropriate actions) in supporting asthma self-management. This qualitative study recruited 48 participants (34 adults and teenagers with asthma, 14 asthma nurses and doctors) from primary care in Lothian (Central Scotland) and Kent (South East England). Thirty-nine participated in six focus groups, which included a demonstration of the technology; nine gave in-depth interviews before and after a 4-week trial of the technology. Participants considered that mobile phone-based monitoring systems can facilitate guided self-management although, paradoxically, may engender dependence on professional/technological support. In the early phases, as patients are learning to accept, understand and control their asthma, this support was seen as providing much-needed confidence. During the maintenance phase, when self-management predominates, patient and professionals were concerned that increased dependence may be unhelpful, although they appreciated that maintaining an on-going record could facilitate consultations. Mobile phone-based monitoring systems have the potential to support guided self-management by aiding transition from clinician-supported early phases to effective self-management during the maintenance phase. Continuing development, adoption and formal evaluation of these systems should take account of the insights provided by our data.

  7. Insights into the Intrinsic and Extrinsic Challenges for Implementing Technology Education: Case Studies of Queensland Teachers

    ERIC Educational Resources Information Center

    Finger, Glenn; Houguet, Belinda

    2009-01-01

    This study, embedded within the "Researching School Change in Technology Education" (RSCTE) project in Queensland, Australia, aimed to gain insights into the intrinsic and extrinsic challenges experienced by teachers during the implementation of technology education within primary school settings. The official publication and launch of…

  8. Neural Activity When People Solve Verbal Problems with Insight

    PubMed Central

    Bowden, Edward M; Haberman, Jason; Frymiare, Jennifer L; Arambel-Liu, Stella; Greenblatt, Richard; Reber, Paul J

    2004-01-01

    People sometimes solve problems with a unique process called insight, accompanied by an “Aha!” experience. It has long been unclear whether different cognitive and neural processes lead to insight versus noninsight solutions, or if solutions differ only in subsequent subjective feeling. Recent behavioral studies indicate distinct patterns of performance and suggest differential hemispheric involvement for insight and noninsight solutions. Subjects solved verbal problems, and after each correct solution indicated whether they solved with or without insight. We observed two objective neural correlates of insight. Functional magnetic resonance imaging (Experiment 1) revealed increased activity in the right hemisphere anterior superior temporal gyrus for insight relative to noninsight solutions. The same region was active during initial solving efforts. Scalp electroencephalogram recordings (Experiment 2) revealed a sudden burst of high-frequency (gamma-band) neural activity in the same area beginning 0.3 s prior to insight solutions. This right anterior temporal area is associated with making connections across distantly related information during comprehension. Although all problem solving relies on a largely shared cortical network, the sudden flash of insight occurs when solvers engage distinct neural and cognitive processes that allow them to see connections that previously eluded them. PMID:15094802

  9. Effects of antipsychotic drugs on insight in schizophrenia.

    PubMed

    Bianchini, Oriana; Porcelli, Stefano; Nespeca, Claudia; Cannavò, Dario; Trappoli, Angela; Aguglia, Eugenio; De Ronchi, Diana; Serretti, Alessandro

    2014-08-15

    Lack of insight is predominant in schizophrenia though the causes are still unclear. The present study was carried on to investigate the effect of three Second Generation Antipsychotics (SGAs) and Haloperidol on insight and the associations among different clusters of symptoms and insight. Fifty-five patients have been recruited at the moment of pharmacological switch needed for psychotic exacerbation, from other antipsychotic drugs to Olanzapine, Aripiprazole, Ziprasidone and Haloperidol. Patients have been followed for 6 months and evaluated at baseline, after 3 months and after 6 months. Regarding the insight improvement, all SGAs resulted more effective than Haloperidol, while no difference was detected among different SGAs. Concerning psychopathology, all SGAs showed a better efficacy than Haloperidol, positive symptoms apart. All SGAs showed a similar efficacy on all domains, except for negative symptoms which resulted less responsive to ziprasidone and haloperidol. An association between improvement of insight and psychopathology was detected. Furthermore, insight appears to be related to psychopathology severity, particularly to negative symptoms. However, the observed different effectiveness of Ziprasidone on negative symptoms and insight suggests that these psychopathological features may be not strictly related and, thus, they may be sustained by different psychopathological processes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Forest management for mitigation and adaptation: insights from long-term silvicultural experiments

    Treesearch

    Anthony W. D' Amato; John B. Bradford; Shawn Fraver; Brian J. Palik

    2011-01-01

    Developing management strategies for addressing global climate change has become an increasingly important issue influencing forest management around the globe. Currently, management approaches are being proposed that intend to (1) mitigate climate change by enhancing forest carbon stores and (2) foster adaptation by maintaining compositionally and structurally complex...

  11. Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: insights from the EYESHOT study.

    PubMed

    De Luca, Leonardo; Leonardi, Sergio; Smecca, Ignazio Maria; Formigli, Dario; Lucci, Donata; Gonzini, Lucio; Tuccillo, Bernardino; Olivari, Zoran; Gulizia, Michele Massimo; Bovenzi, Francesco Maria; De Servi, Stefano

    2015-07-01

    Patients with acute coronary syndromes (ACSs) who are managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients with ACS enrolled in the prospective, multicentre, nationwide EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) registry. Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P < 0.0001 and 50 vs. 33, P < 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did. Unique identifier: NCT02015624, http://www.clinicaltrials.gov. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please

  12. Endometriosis: translation of molecular insights to management.

    PubMed

    Langan, K L; Farrell, M E; Keyser, E A; Salyer, B A; Burney, R O

    2014-09-01

    Endometriosis is a debilitating gynecologic disorder causing pelvic pain and infertility and characterized by the implantation of endometrial tissue to extrauterine locations. Though aspects of the condition remain enigmatic, the molecular pathophysiology of endometriosis appears to be clarifying. Estrogen dependence of the disease is a sentinel endocrine feature and reduction of estrogen bioavailability is the therapeutic principle upon which traditional treatment and prevention approaches have been based. Endometriosis is a chronic inflammatory condition associated with lesional neoangiogenesis and attenuated progesterone action at the level of the endometrium. The elucidation of the molecular pathways mediating these observations has revealed new targets for directed medical and surgical treatment. This paper will review current approaches to the management of endometriosis in the context of the molecular pathophysiology.

  13. Management of acute respiratory failure in interstitial lung diseases: overview and clinical insights.

    PubMed

    Faverio, Paola; De Giacomi, Federica; Sardella, Luca; Fiorentino, Giuseppe; Carone, Mauro; Salerno, Francesco; Ora, Jousel; Rogliani, Paola; Pellegrino, Giulia; Sferrazza Papa, Giuseppe Francesco; Bini, Francesco; Bodini, Bruno Dino; Messinesi, Grazia; Pesci, Alberto; Esquinas, Antonio

    2018-05-15

    Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017). In managing ARF, it is important to establish an adequate diagnostic and therapeutic management depending on whether the patient has an underlying known chronic ILD or ARF is presenting in an unknown or de novo ILD. In the first case both primary causes, such as acute exacerbations of the disease, and secondary causes, including concomitant pulmonary infections, fluid overload and pulmonary embolism need to be investigated. In the second case, a diagnostic work-up that includes investigations in regards to ILD etiology, such as autoimmune screening and bronchoalveolar lavage, should be performed, and possible concomitant causes of ARF have to be ruled out. Oxygen supplementation and ventilatory support need to be titrated according to the severity of ARF and patients' therapeutic options. High-Flow Nasal oxygen might potentially be an alternative to conventional oxygen therapy in patients requiring both high flows and high oxygen concentrations to correct hypoxemia and control dyspnea, however the evidence is still scarce. Neither Non-Invasive Ventilation (NIV) nor Invasive Mechanical Ventilation (IMV) seem to change the poor outcomes associated to advanced stages of ILDs. However, in selected patients, such as those with less severe ARF, a NIV trial might help in the early recognition of NIV-responder patients, who may present a better short-term prognosis. More invasive

  14. Key Intersections between HRD and Management

    ERIC Educational Resources Information Center

    Egan, Toby M.

    2011-01-01

    This article is in part inspired by an HRD director's insight that his HRD staff should view themselves as HRD Family Doctors, suggesting that a doctor-patient relationship was similar in many respects to the HRD-manager consulting relationship. Although that is possible in some organizations, the author's interviews with corporate managers and…

  15. Relationship between insight and theory of mind in schizophrenia: A meta-analysis.

    PubMed

    Bora, Emre

    2017-12-01

    Poor insight in schizophrenia has been associated with executive dysfunction and deficits in general cognitive ability. The overall outcome of available neurocognitive studies suggests that there is a significant but modest relationship between cognitive deficits and poor insight in schizophrenia. However, social cognitive abilities, particularly, theory of mind (ToM), might also play a role in poor insight in schizophrenia. A novel meta-analysis of the relationship between ToM and insight in schizophrenia was conducted. Current meta-analysis included 16 studies including 1085 patients with schizophrenia-spectrum disorders. There was a significant association between ToM and clinical insight (r=0.28, CI=0.20-0.36). By contrast, there was no significant relationship between ToM and cognitive insight. Current findings suggest that there is a small but significant relationship between ToM and clinical insight in schizophrenia. ToM impairment is one of the factors contributing to poor insight in schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Neurological soft signs in obsessive compulsive disorder with good and poor insight.

    PubMed

    Karadag, Filiz; Tumkaya, Selim; Kırtaş, Duygu; Efe, Muharrem; Alacam, Hüseyin; Oguzhanoglu, Nalan K

    2011-06-01

    Obsessive compulsive disorder (OCD) is a clinically heterogeneous disorder; OCD with poor insight has been suggested to be a specific clinical subtype. Neurological soft signs (NSSs) may be helpful to identify the specific subtypes of OCD patients. In the present study, we aimed to compare OCD patients with poor insight with OCD patients having good insight, and healthy individuals. Sixty-four OCD patients (38 with good insight and 26 with poor insight), and 32 healthy subjects were enrolled in the present study. The Overvalued Ideas Scale (OVIS) was used to determine OCD patients with poor insight. NSSs were assessed by using the Neurological Evaluation Scale (NES). Two OCD groups had significantly higher total NES scores compared to controls (p=.000). Compared to healthy controls, OCD patients with poor insight performed significantly worse on all NES subscales, and they had significantly more NSSs on motor coordination, and sensory integration subscales compared to the OCD with good insight group. Our results suggested that OCD patients with poor insight exhibit more extensive neurodevelopmental impairments compared to OCD patients with good insight. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Novel insights into mitotic chromosome condensation

    PubMed Central

    Piskadlo, Ewa; Oliveira, Raquel A.

    2016-01-01

    The fidelity of mitosis is essential for life, and successful completion of this process relies on drastic changes in chromosome organization at the onset of nuclear division. The mechanisms that govern chromosome compaction at every cell division cycle are still far from full comprehension, yet recent studies provide novel insights into this problem, challenging classical views on mitotic chromosome assembly. Here, we briefly introduce various models for chromosome assembly and known factors involved in the condensation process (e.g. condensin complexes and topoisomerase II). We will then focus on a few selected studies that have recently brought novel insights into the mysterious way chromosomes are condensed during nuclear division. PMID:27508072

  18. Senescence in the wild: Insights from a long-term study on Seychelles warblers.

    PubMed

    Hammers, Martijn; Kingma, Sjouke A; Bebbington, Kat; van de Crommenacker, Janske; Spurgin, Lewis G; Richardson, David S; Burke, Terry; Dugdale, Hannah L; Komdeur, Jan

    2015-11-01

    Senescence--the progressive age-dependent decline in performance--occurs in most organisms. There is considerable variation in the onset and rate of senescence between and within species. Yet the causes of this variation are still poorly understood, despite being central to understanding the evolution of senescence. Long-term longitudinal studies on wild animals are extremely well-suited to studying the impact of environmental and individual characteristics (and the interaction between the two) on senescence, and can help us to understand the mechanisms that shape the evolution of senescence. In this review, we summarize and discuss the insights gained from our comprehensive long-term individual-based study of the Seychelles warbler (Acrocephalus sechellensis). This species provides an excellent model system in which to investigate the evolution of senescence in the wild. We found that Seychelles warblers show senescent declines in survival and reproduction, and discuss how individual characteristics (body condition, body size) and environmental effects (low- versus high-quality environments) may affect the onset and rate of senescence. Further, we highlight the evidence for trade-offs between early-life investment and senescence. We describe how key cellular and physiological processes (oxidative stress and telomere shortening) underpinning senescence are affected by individual and environmental characteristics in the Seychelles warbler (e.g. food availability, reproductive investment, disease) and we discuss how such physiological variation may mediate the relationship between environmental characteristics and senescence. Based on our work using Seychelles warblers as a model system, we show how insights from long-term studies of wild animals may help unravel the causes of the remarkable variation in senescence observed in natural systems, and highlight areas for promising future research.

  19. Comparison of standardized patients with high-fidelity simulators for managing stress and improving performance in clinical deterioration: A mixed methods study.

    PubMed

    Ignacio, Jeanette; Dolmans, Diana; Scherpbier, Albert; Rethans, Jan-Joost; Chan, Sally; Liaw, Sok Ying

    2015-12-01

    The use of standardized patients in deteriorating patient simulations adds realism that can be valuable for preparing nurse trainees for stress and enhancing their performance during actual patient deterioration. Emotional engagement resulting from increased fidelity can provide additional stress for student nurses with limited exposure to real patients. To determine the presence of increased stress with the standardized patient modality, this study compared the use of standardized patients (SP) with the use of high-fidelity simulators (HFS) during deteriorating patient simulations. Performance in managing deteriorating patients was also compared. It also explored student nurses' insights on the use of standardized patients and patient simulators in deteriorating patient simulations as preparation for clinical placement. Fifty-seven student nurses participated in a randomized controlled design study with pre- and post-tests to evaluate stress and performance in deteriorating patient simulations. Performance was assessed using the Rescuing A Patient in Deteriorating Situations (RAPIDS) rating tool. Stress was measured using salivary alpha-amylase levels. Fourteen participants who joined the randomized controlled component then participated in focus group discussions that elicited their insights on SP use in patient deterioration simulations. Analysis of covariance (ANCOVA) results showed no significant difference (p=0.744) between the performance scores of the SP and HFS groups in managing deteriorating patients. Amylase levels were also not significantly different (p=0.317) between the two groups. Stress in simulation, awareness of patient interactions, and realism were the main themes that resulted from the thematic analysis. Performance and stress in deteriorating patient simulations with standardized patients did not vary from similar simulations using high-fidelity patient simulators. Data from focus group interviews, however, suggested that the use of

  20. PORTALS: design of an innovative approach to anticoagulation management through eHealth.

    PubMed

    Talboom-Kamp, E P W A; Verdijk, N A; Talboom, I J S H; Harmans, L M; Numans, M E; Chavannes, N H

    2017-03-16

    For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes. Our study, called PORTALS, aims at identifying the optimal implementation strategy of training to improve self-management and explore factors that enhance good self-management skills. In addition, the relationship between the implementation strategy of training, clinical outcomes, and individual characteristics will be investigated. Of the 247 recruited participants, 110 chose to continue with regular care. 137 patients have been randomly divided in subgroups and compared using a parallel cohort design: one group will be trained and educated by e-learning, and the other group will receive face-to-face group training. More insight in factors that enhance good self-management will help to improve clinical outcomes and patient satisfaction on anticoagulation therapy. Our study will provide practical insights and knowledge of eHealth in daily practice and of the importance of education on the adoption of self-management. We expect the self-management program including training to help patients to better manage their own INR values and medication use, thereby increasing health status and diminishing thromboembolic events and hospitalisation. The Netherlands National Trial Register, number NTR3947 .

  1. Effects on cognitive and clinical insight with the use of Guided Self-Determination in outpatients with schizophrenia: A randomized open trial.

    PubMed

    Jørgensen, R; Licht, R W; Lysaker, P H; Munk-Jørgensen, P; Buck, K D; Jensen, S O W; Hansson, L; Zoffmann, V

    2015-07-01

    Poor insight has a negative impact on the outcome in schizophrenia; consequently, poor insight is a logical target for treatment. However, neither medication nor psychosocial interventions have been demonstrated to improve poor insight. A method originally designed for diabetes patients to improve their illness management, Guided Self-Determination (GSD), has been adapted for use in patients with schizophrenia (GSD-SZ). The purpose of this study was to investigate the effect on insight of GSD-SZ as a supplement to treatment as usual (TAU) as compared to TAU alone in outpatients diagnosed with schizophrenia. The design was an open randomized trial. The primary hypothesis was cognitive insight would improve in those patients who received GSD-SZ+TAU as assessed by the BCIS. We additionally explored whether the intervention led to changes in clinical insight, self-perceived recovery, self-esteem, social functioning and symptom severity. Assessments were conducted at baseline, and at 3-, 6- and 12-month follow-up. Analysis was based on the principles of intention to treat and potential confounders were taken into account through applying a multivariate approach. A total of 101 participants were randomized to GSD-SZ+TAU (n=50) or to TAU alone (n=51). No statistically significant differences were found on the cognitive insight. However, at 12-month follow-up, clinical insight (measured by G12 from the Positive and Negative Syndrome Scale), symptom severity, and social functioning had statistically significantly improved in the intervention group as compared to the control group. "Improving insight in patients diagnosed with schizophrenia", NCT01282307, http://clinicaltrials.gov/. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Fostering sustainable operations in a natural resource management agency: insights from the field

    Treesearch

    Patricia L. Winter; Shawn M. Burn

    2010-01-01

    Sustainable operations (SO; operating in an environmentally, economically, and socially sustainable manner) is consistent with the environmental stewardship mission of natural resource management organizations. This study sought to examine SO practices in the daily work lives of US Forest Service employees, including those primarily stationed in the office and in the...

  3. Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices.

    PubMed

    Neufeld, E J; Solimeno, L; Quon, D; Walsh, C; Seremetis, S; Cooper, D; Iyer, N N; Hoxer, C S; Giangrande, P

    2017-11-01

    While there is substantial literature addressing the principles of general management of haemophilia, literature on perioperative management of haemostasis is scarce. The aim of this study was to better understand perioperative management among congenital haemophilia B patients (without inhibitors) and to gain insights into real-world surgical practices. A systematic literature review, with an emphasis on haemophilia B, was conducted using EMBASE ® , Medline ® and the Cochrane Library. Studies from 1974 to June 2015 were accessed, and 132 studies were eligible for the full-study review. An international expert panel with five haematologists and one surgeon reviewed the resulting literature and provided further insights. The literature review revealed that documented experience in the perioperative management of bleeding risk in haemophilia B patients is relatively scarce. Therefore, the review was amended to provide a comprehensive overview of the perioperative management for haemophilia A and B patients; the expert panel applied a particular focus to haemophilia B. Several gaps were identified in the literature including the lack of consensus on defining surgery in terms of bleeding risk, optimal factor levels during surgery and lack of robust evidence on surgical outcomes. The ensuing discussions with the expert panel provided validation of some of the results from the systematic literature review and proposed future directions for perioperative management. Suggestions included collaboration with haemophilia treatment centres (HTCs) to collect real-world data on perioperative management, establishing the need for optimal factor level monitoring practice, and the appropriate adoption of extended half-life products in clinical settings. © 2017 John Wiley & Sons Ltd.

  4. Patients' Attitudes and Approaches to the Self-Management of Hypertension: Perspectives from an Australian Qualitative Study in Community Pharmacy.

    PubMed

    Bajorek, Beata; Lemay, Kate; Magin, Parker; Roberts, Christopher; Krass, Ines; Armour, Carol

    2017-06-01

    In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as 'normal'. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. This study highlights patients' inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients' self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.

  5. Disability and Study: Layers of Management

    ERIC Educational Resources Information Center

    Werth, Shalene; Hammer, Sara; d'Abadie, Danielle

    2014-01-01

    The findings of this paper are based on a 3-year study of students registered with disability services at an Australian, regional university between 2008 and 2010. The concept of self-management, in its various dimensions, was a key theme emerging from the study. We argue that participants in our study employ "layers of self-management"…

  6. Managing Communications with Experts in Geographically Distributed Collaborative Networks

    DTIC Science & Technology

    2009-03-01

    agent architectures, and management of sensor-unmanned vehicle decision maker self organizing environments . Although CENETIX has its beginnings...understanding how everything in a complex system is interconnected. Additionally, environmental factors that impact the management of communications with...unrestricted warfare environment . In “Unconventional Insights for Managing Stakeholder Trust”, Pirson, et al. (2008) emphasizes the challenges of managing

  7. Insights and participatory actions driven by a socio-hydrogeological approach for groundwater management: the Grombalia Basin case study (Tunisia)

    NASA Astrophysics Data System (ADS)

    Tringali, C.; Re, V.; Siciliano, G.; Chkir, N.; Tuci, C.; Zouari, K.

    2017-08-01

    Sustainable groundwater management strategies in water-scarce countries need to guide future decision-making processes pragmatically, by simultaneously considering local needs, environmental problems and economic development. The socio-hydrogeological approach named `Bir Al-Nas' has been tested in the Grombalia region (Cap Bon Peninsula, Tunisia), to evaluate the effectiveness of complementing hydrogeochemical and hydrogeological investigations with the social dimension of the issue at stake (which, in this case, is the identification of groundwater pollution sources). Within this approach, the social appraisal, performed through social network analysis and public engagement of water end-users, allowed hydrogeologists to get acquainted with the institutional dimension of local groundwater management, identifying issues, potential gaps (such as weak knowledge transfer among concerned stakeholders), and the key actors likely to support the implementation of the new science-based management practices resulting from the ongoing hydrogeological investigation. Results, hence, go beyond the specific relevance for the Grombaila basin, showing the effectiveness of the proposed approach and the importance of including social assessment in any given hydrogeological research aimed at supporting local development through groundwater protection measures.

  8. Recent Neurobiological Insights into the Concept of Insight in Psychosis

    PubMed Central

    Mythri, Starlin Vijay; Sanjay, Y

    2016-01-01

    The concept of insight in psychosis has been an interesting area in clinical psychiatry for well over a century with a surge in research interest over the past 25 years. Moreover, the past 5 years have been particularly fruitful in deciphering its neurobiological underpinnings. This article presents the development of the concept of insight in psychosis and reviews the current neurobiological research findings in this area. PMID:27335512

  9. Functional magnetic resonance imaging study of external source memory and its relation to cognitive insight in non-clinical subjects.

    PubMed

    Buchy, Lisa; Hawco, Colin; Bodnar, Michael; Izadi, Sarah; Dell'Elce, Jennifer; Messina, Katrina; Lepage, Martin

    2014-09-01

    Previous research has linked cognitive insight (a measure of self-reflectiveness and self-certainty) in psychosis with neurocognitive and neuroanatomical disturbances in the fronto-hippocampal neural network. The authors' goal was to use functional magnetic resonance imaging (fMRI) to investigate the neural correlates of cognitive insight during an external source memory paradigm in non-clinical subjects. At encoding, 24 non-clinical subjects travelled through a virtual city where they came across 20 separate people, each paired with a unique object in a distinct location. fMRI data were then acquired while participants viewed images of the city, and completed source recognition memory judgments of where and with whom objects were seen, which is known to involve prefrontal cortex. Cognitive insight was assessed with the Beck Cognitive Insight Scale. External source memory was associated with neural activity in a widespread network consisting of frontal cortex, including ventrolateral prefrontal cortex (VLPFC), temporal and occipital cortices. Activation in VLPFC correlated with higher self-reflectiveness and activation in midbrain correlated with lower self-certainty during source memory attributions. Neither self-reflectiveness nor self-certainty significantly correlated with source memory accuracy. By means of virtual reality and in the context of an external source memory paradigm, the study identified a preliminary functional neural basis for cognitive insight in the VLPFC in healthy people that accords with our fronto-hippocampal theoretical model as well as recent neuroimaging data in people with psychosis. The results may facilitate the understanding of the role of neural mechanisms in psychotic disorders associated with cognitive insight distortions. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  10. Insight in bipolar mania: evaluation of its heterogeneity and correlation with clinical symptoms.

    PubMed

    Silva, Rafael de Assis da; Mograbi, Daniel C; Bifano, Jaqueline; Santana, Cristina M T; Cheniaux, Elie

    2016-07-15

    Studies on insight in bipolar mania are not numerous and usually consider insight as a unitary construct. Evaluate how different facets of insight are affected in bipolar mania and investigate correlations between insight for each specific object in bipolar disorder and manic symptomatology. A group of 165 bipolar patients were followed during a year, with 51 patients having manic episodes according to DSM-IV-TR criteria. Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. The study found that insight regarding symptoms is worse than insight of having bipolar disorder, social relationships and self esteem. Moreover, poor global insight (total ISAD) correlates with more severe changes in mood, speech and thought structure, with worse insight about symptoms correlating with the same alterations and also with more severe symptoms of agitation/energy. Although a large sample of bipolar patients was followed up, the final sample composed of patients with at least one manic episode was relatively smaller. Moreover, the fact that the study was performed in a university hospital may have led to selection biases. Results suggest that patients with BD are reasonably capable of identifying that their condition implies consequences but have more impaired awareness of their energy and activity levels. A lower level of insight specifically about symptoms correlates with more severe symptoms of agitation/energy, which suggests a psychomotor nucleus able to impair insight in mania. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Managing Conflict: 50 Strategies for School Leaders

    ERIC Educational Resources Information Center

    Edmonson, Stacey; Combs, Julie; Harris, Sandra

    2008-01-01

    This book offers 50 easy-to-read strategies for managing conflicts in your school involving students, parents, and teachers. Individually, these strategies provide specific insights into conflict resolution, reduction, and management. As a whole, the 50 strategies provide a comprehensive method to lead constructive change in your school. With…

  12. Insight, Neurocognition, and Schizophrenia: Predictive Value of the Wisconsin Card Sorting Test

    PubMed Central

    Yanos, Philip T.

    2013-01-01

    Lack of insight in schizophrenia is a key feature of the illness and is associated with both positive and negative clinical outcomes. Previous research supports that neurocognitive dysfunction is related to lack of insight, but studies have not examined how neurocognition relates to change in insight over time. Therefore, the current study sought to understand how performance on the Wisconsin Card Sorting Test (WCST) differed between participants with varying degrees of change in insight over a 6-month period. Fifty-two patients with schizophrenia or schizoaffective disorder were administered the WCST and Positive and Negative Syndrome Scale (PANSS) at baseline, and the PANSS was again administered at a 6-month follow-up assessment. Results indicated that while neurocognition was related to insight at baseline, it was not related to subsequent change in insight. The implications of findings for conceptualization and assessment of insight are discussed. PMID:24303216

  13. InSight Spacecraft Arrival

    NASA Image and Video Library

    2018-02-28

    At Vandenberg Air Force Base in California, NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft arrives at the Astrotech processing facility. InSight was developed and built by Lockheed-Martin Space Systems in Denver, Colorado, and is scheduled for liftoff is May 5, 2018. InSight is the first mission to land on Mars and explore the Red Planet's deep interior. It will investigate processes that shaped the rocky planets of the inner solar system including Earth.

  14. [Insight into illness: an overview of the concept focusing on schizophrenia].

    PubMed

    Bottlender, Ronald; Hloucal, Teresa-Maria

    2010-03-01

    Insight into illness is key to successful treatment. Poor insight, especially in schizophrenia, is, however, quite a frequent phenomenon that is also associated with poor adherence to treatment and a variety of unfavorable outcome parameters. On that background, the concept of insight into illness has gained new reseach interest during the last 10 years. The present review aims to report new findings regarding conceptual changes of insight, findings on the etiology, contributing factors as well as the assessment and methods to develop insight. Based on a review of the literature, results from more recent studies on insight into illness will be presented. Insight into illness is a complex, multidimensional, strongly culturally embedded phenomenon that is influenced by a variety of factors. The etiology of insight still remains poorly understood but is likely to be multifactorial including psychological, neuropsychological and organic reasons. Further research is needed, in particularly regarding therapeutical techniques to improve insight into illness.

  15. Enhancing insight in scientific problem solving by highlighting the functional features of prototypes: an fMRI study.

    PubMed

    Hao, Xin; Cui, Shuai; Li, Wenfu; Yang, Wenjing; Qiu, Jiang; Zhang, Qinglin

    2013-10-09

    Insight can be the first step toward creating a groundbreaking product. As evident in anecdotes and major inventions in history, heuristic events (heuristic prototypes) prompted inventors to acquire insight when solving problems. Bionic imitation in scientific innovation is an example of this kind of problem solving. In particular, heuristic prototypes (e.g., the lotus effect; the very high water repellence exhibited by lotus leaves) help solve insight problems (e.g., non-stick surfaces). We speculated that the biological functional feature of prototypes is a critical factor in inducing insightful scientific problem solving. In this functional magnetic resonance imaging (fMRI) study, we selected scientific innovation problems and utilized "learning prototypes-solving problems" two-phase paradigm to test the supposition. We also explored its neural mechanisms. Functional MRI data showed that the activation of the middle temporal gyrus (MTG, BA 37) and the middle occipital gyrus (MOG, BA 19) were associated with the highlighted functional feature condition. fMRI data also indicated that the MTG (BA 37) could be responsible for the semantic processing of functional features and for the formation of novel associations based on related functions. In addition, the MOG (BA 19) could be involved in the visual imagery of formation and application of function association between the heuristic prototype and problem. Our findings suggest that both semantic processing and visual imagery could be crucial components underlying scientific problem solving. © 2013 Elsevier B.V. All rights reserved.

  16. Managers' views on and experiences with moral case deliberation in nursing teams.

    PubMed

    Weidema, Froukje C; Molewijk, A C Bert; Kamsteeg, Frans; Widdershoven, Guy A M

    2015-11-01

    Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences regarding facilitating MCD's implementation have not yet been studied. As part of an empirical qualitative study on implementing MCD in mental health care, a responsive evaluation design was used. Using former research findings (iterative procedures), a managers' focus group was organised. Managers appreciated MCD, fostering nurses' empowerment and critical reflection - according to managers, professional core competences. Managers found MCD a challenging intervention, resulting in dilemmas due to MCD's confidential and egalitarian nature. Managers value MCD's process-related outcomes, yet these are difficult to control/regulate. MCD urges managers to reflect on their role and (hierarchical) position both within MCD and in the nursing team. MCD is in line with transformative and participatory management, fostering dialogical interaction between management and nursing team. © 2015 John Wiley & Sons Ltd.

  17. Contemporary insights into the management of type A aortic dissection.

    PubMed

    Tolis, George; Sundt, Thoralf M

    2016-10-01

    Acute Type A Dissection remains a surgical emergency with a relatively high operative mortality despite advances in cardiac surgical techniques and medical management over the past thirty years. In this presentation we will discuss the issues surrounding diagnosis, triage, surgical treatment and perioperative medical management as well as long term surveillance of patients suffering from Acute Type A Dissection and present the literature that supports our management strategies. Expert commentary: The ultimate goal of surgical intervention for patients with Type A Acute Aortic Dissection is an alive patient. A more complicated operation which addresses the root and arch and potentially reduces late complications should be approached with caution since it may increase the operative mortality of the procedure itself. With the recent evolution in endovascular techniques, there is hope that later complications can be reduced without increasing the risk of the primary operation. It remains to be seen whether the improved distal aortic remodeling afforded by a combined open/endovascular approach to Acute Type A Dissection will lead to decreased need for aortic reinterventions and overall long term complications of a residual descending thoracic chronic dissection.

  18. Adolescent Girls' Assessment and Management of Sexual Risks: Insights from Focus Group Research

    ERIC Educational Resources Information Center

    Bay-Cheng, Laina Y.; Livingston, Jennifer A.; Fava, Nicole M.

    2011-01-01

    We conducted focus groups with girls ages 14 to 17 (N = 43) to study how the dominant discourse of sexual risk shapes young women's understanding of the sexual domain and their management of these presumably pervasive threats. Through inductive analysis, we developed a coding scheme focused on three themes: (a) "types of sexual risk,"…

  19. Managing the initiation and early implementation of health promotion interventions: a study of a parental support programme in primary care.

    PubMed

    Westerlund, Anna; Garvare, Rickard; Nyström, Monica E; Eurenius, Eva; Lindkvist, Marie; Ivarsson, Anneli

    2017-03-01

    Mental health problems are increasing among children and adolescents worldwide, and parental support programmes have been suggested as one preventive intervention. However, the actual impact and low rates of adoption and sustainability of prevention programmes have proven to be a concern, and thus, further studies on their implementation are needed. This study focused on the initial implementation of the International Child Development Programme (ICDP) in primary care. The aim was to investigate the involved actors' views on factors likely to affect implementation and the strategies used to manage them. A case study design with a mixed-methods approach combining quantitative and qualitative data from questionnaires and interviews was used. Eighty-two professionals at different positions in the involved organisations participated. Directed content analysis was used for analyses, focusing on perceived levels of importance and the manifestation of implementation factors. Interviews and questionnaires provided descriptions of factors influencing the initial ICDP implementation. Uncertainty on how to manage important factors and vague change strategies was reported. Discrepancies in the perceived levels of importance versus manifestation were found regarding several factors, including hands-on support, time and resources, communication and information, a comprehensive plan of action, follow-ups, and external and internal collaborations. Manifested factors were a need for change, motivation and the ICDP's compatibility with existing norms, values and practices. Implementing a parental support programme in a complex setting will benefit from being preceded by a thorough examination of the intervention and the target context and the development of clear implementation strategies based on the results of that examination. This study provides insights into how and by whom knowledge on implementation is applied during the launch of a health promotion programme, and these

  20. Laboratory Studies Offer New Insights for Mesospheric Nightglow

    NASA Astrophysics Data System (ADS)

    Kalogerakis, K. S.; Matsiev, D.

    2017-12-01

    The hydroxyl radical has a key role in the chemistry and energetics of the Earth's middle atmosphere. A detailed knowledge of the rate constants and relevant pathways for OH(high v) vibrational relaxation by atomic and molecular oxygen and their temperature dependence is absolutely critical for understanding mesospheric OH and extracting reliable chemical heating rates from atmospheric observations. We have developed laser-based experimental approaches to study the complex collisional energy transfer processes involving the OH radical and other relevant atmospheric species. Work in our laboratory indicated that the total removal rate constant for OH(v = 9) + O at room temperature is more than one order of magnitude larger than that for removal by O2. Thus, O atoms are expected to significantly influence the intensity and vibrational distribution extracted from the Meinel OH(v) emissions. Our recent laboratory measurements corroborated the aforementioned result for OH(v = 9) + O and provided important new insights on the multi-quantum energy transfer pathways involved. We will discuss relevant atmospheric implications, including warranted revisions of mesospheric nightglow models. Research supported by SRI International Internal R&D and NSF Aeronomy Grant AGS-1441896. Previously funded by NASA Geospace Science Grant NNX12AD09G.

  1. InSight Spacecraft Arrival

    NASA Image and Video Library

    2018-02-28

    After arrival at Vandenberg Air Force Base in California, ground crews prepare NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft for transportation to the Astrotech processing facility. InSight was developed and built by Lockheed-Martin Space Systems in Denver, Colorado, and is scheduled for liftoff is May 5, 2018. InSight is the first mission to explore the deep interior of Mars. It will investigate processes that shaped the rocky planets of the inner solar system including Earth.

  2. A comparison of insight in body dysmorphic disorder and obsessive-compulsive disorder.

    PubMed

    Phillips, Katharine A; Pinto, Anthony; Hart, Ashley S; Coles, Meredith E; Eisen, Jane L; Menard, William; Rasmussen, Steven A

    2012-10-01

    Insight/delusionality of beliefs is an important dimension of psychopathology across psychiatric disorders. This construct is of increasing interest in obsessive-compulsive and related disorders, including obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD). Even though OCD and BDD are considered closely related, no prior study has compared these disorders across a range of categories of global insight (excellent, good, fair, poor, absent/delusional), and only one study has compared these disorders on individual components of insight. Using the reliable and valid Brown Assessment of Beliefs Scale (BABS), this study examined insight/delusionality of OCD- or BDD-related beliefs in 211 individuals with primary OCD versus 68 individuals with primary BDD. In both disorders, levels of insight spanned the full range, from excellent to absent (i.e., delusional beliefs). However, the distribution of BABS scores across insight categories differed significantly by disorder, with the majority of OCD subjects showing excellent or good insight, and the majority of BDD subjects showing poor or absent insight. Compared to OCD subjects, BDD subjects had significantly poorer insight both overall (total BABS score) and on all individual BABS items. BABS score was significantly correlated with BDD and OCD severity, but in regressions it accounted for only 21% of the variance in OCD and 28% in BDD. In summary, both global insight and its individual components are poorer in BDD than in OCD, which has implications for research and clinical care, as well as understanding of the relationship between these disorders. Disorder severity is associated with but not equivalent to insight/delusionality. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Engaging Teens with Asthma in Designing a Patient-Centered Mobile App to Aid Disease Self-Management.

    PubMed

    Schneider, Tali; Panzera, Anthony D; Couluris, Marisa; Lindenberger, James; McDermott, Robert; Bryant, Carol A

    2015-08-10

    Despite the growing market of e-health disease self-management tools, few studies have reported the presence of teen patients in all phases of product design. While rates of American teens using mobile Internet grow, an opportunity to deliver disease self-management targeted for teen patients exists. Building on findings from previous investigations with teens with asthma, we explored teens' insights on the development of a patient-centered asthma management application (app). Two existing asthma apps were used by 16 teen asthmatics for 7-10 days. At the end of the trial period, in-depth interviews were conducted with each participant to gather insights about the user experience. Participants requested more asthma-related content that educates them about their condition. Suggested improvements to currently available apps included a longer list of selectable symptoms to track, medication tracking, and more compelling interface features. Participants showed interest in using apps for managing their asthma, yet recommended improvements on current design. Whereas national figures point to a more ubiquitous mobile device environment, implementation efforts must respond to participants' recommendations while minding lingering digital divides. Currently available apps lack appealing components that teens seek or desire. Subsequent development should include teens' participation in component design insights.

  4. Predictive value of self-stigma, insight, and perceived adverse effects of medication for the clinical outcomes in patients with depressive disorders.

    PubMed

    Yen, Cheng-Fang; Lee, Yu; Tang, Tze-Chun; Yen, Ju-Yu; Ko, Chih-Hung; Chen, Cheng-Chung

    2009-03-01

    The aims of this prospective study were to examine the predictive values of self-stigma, insight, and perceived adverse effects of medication for remission of depressive symptoms, suicidal risk, and medication adherence in patients with depressive disorders over a 1-year follow-up period. One hundred seventy-four participants who were in a state of obvious depression underwent an index interview to determine their degree of self-stigma, insight, and perceived adverse effects of medication. One year later, they were reassessed to determine the severity of their depressive symptoms, suicidal risk, and the level of the medication adherence, and their associations with the 3 possible predictors at the index interview were examined. The results of this study indicated that perceiving more severe adverse effects of medication at the index interview increased the risks of the nonremission of depressive symptoms, occurrence of suicidal ideation or attempt, and medication nonadherence in patients with depressive disorders in the 1-year period. However, the degrees of self-stigma and insight did not predict the severity of depressive symptoms, suicidal risk, or the level of the medication adherence. Based on the results of this study, we suggest that it is important for clinicians to prevent the occurrence of and to help patients manage the adverse effects of medication. We also suggest that further prospective studies are needed to examine the predictive values of self-stigma and insight for clinical outcomes and medication adherence.

  5. Posterior Beta and Anterior Gamma Oscillations Predict Cognitive Insight

    ERIC Educational Resources Information Center

    Sheth, Bhavin R.; Sandkuhler, Simone; Bhattacharya, Joydeep

    2009-01-01

    Pioneering neuroimaging studies on insight have revealed neural correlates of the emotional "Aha!" component of the insight process, but neural substrates of the cognitive component, such as problem restructuring (a key to transformative reasoning), remain a mystery. Here, multivariate electroencephalogram signals were recorded from human…

  6. Insight in stable schizophrenia: relations with psychopathology and cognition.

    PubMed

    Mingrone, Cinzia; Rocca, Paola; Castagna, Filomena; Montemagni, Cristiana; Sigaudo, Monica; Scalese, Mara; Rocca, Giuseppe; Bogetto, Filippo

    2013-07-01

    This study evaluated the relationship among insight, sociodemographic and clinical variables, symptoms and cognitive functions in a population of outpatients with stable schizophrenia, in order to identify possible contributing factors to awareness. Two-hundred and seventy-six consecutive outpatients with stable schizophrenia were enrolled in a cross-sectional study. All subjects were assessed by psychiatric scales and interview, and a wide neuropsychological battery. A factor analysis was performed to identify cognitive factors and multiple regression analyses were executed to test the contribution of variables considered to insight. Our results showed that positive and negative symptoms, executive functions, verbal memory-learning were contributors of awareness of mental illness; positive and negative symptoms explained variability in awareness of the need for treatment; positive symptoms and executive functions contributed to awareness of the social consequences of disorder. These results suggested that insight was partially influenced by positive and negative symptoms and by cognitive functions. A complex system of overlapping variables may underlie impaired insight, contributing to a different extent to specific dimensions of poor insight in patients with stable schizophrenia. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. InSight Spacecraft Arrival

    NASA Image and Video Library

    2018-02-28

    After a U.S. Air Force C-17 aircraft arrived at Vandenberg Air Force Base in California, ground crews offload NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft designed to land on Mars. InSight was developed and built by Lockheed-Martin Space Systems in Denver, Colorado, and is scheduled for liftoff is May 5, 2018. InSight is the first mission to explore the Red Planet's deep interior. It will investigate processes that shaped the rocky planets of the inner solar system including Earth.

  8. InSight Spacecraft Arrival

    NASA Image and Video Library

    2018-02-28

    A U.S. Air Force C-17 aircraft arrives at Vandenberg Air Force Base in California carrying NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft designed to land on Mars. InSight was developed and built by Lockheed-Martin Space Systems in Denver, Colorado, and is scheduled for liftoff is May 5, 2018. InSight is the first mission to explore the Red Planet's deep interior. It will investigate processes that shaped the rocky planets of the inner solar system including Earth.

  9. College Presidents Examine Midlevel Management in the Community College.

    ERIC Educational Resources Information Center

    Gillett-Karam, Rosemary; Cameron, Donald W.; Messina, Jr., Robert C.; Mittelstet, Stephen K.; Mulder, Anne E.; Sykes, Jr., Abel B.; Thornton, Jerry Sue

    1999-01-01

    Provides six community-college presidents' insights into the midlevel-management role at their institutions. States that although midlevel managers go by various titles at different colleges, they all agree on the importance and substance of these administrative roles. (VWC)

  10. Extreme between-study homogeneity in meta-analyses could offer useful insights.

    PubMed

    Ioannidis, John P A; Trikalinos, Thomas A; Zintzaras, Elias

    2006-10-01

    Meta-analyses are routinely evaluated for the presence of large between-study heterogeneity. We examined whether it is also important to probe whether there is extreme between-study homogeneity. We used heterogeneity tests with left-sided statistical significance for inference and developed a Monte Carlo simulation test for testing extreme homogeneity in risk ratios across studies, using the empiric distribution of the summary risk ratio and heterogeneity statistic. A left-sided P=0.01 threshold was set for claiming extreme homogeneity to minimize type I error. Among 11,803 meta-analyses with binary contrasts from the Cochrane Library, 143 (1.21%) had left-sided P-value <0.01 for the asymptotic Q statistic and 1,004 (8.50%) had left-sided P-value <0.10. The frequency of extreme between-study homogeneity did not depend on the number of studies in the meta-analyses. We identified examples where extreme between-study homogeneity (left-sided P-value <0.01) could result from various possibilities beyond chance. These included inappropriate statistical inference (asymptotic vs. Monte Carlo), use of a specific effect metric, correlated data or stratification using strong predictors of outcome, and biases and potential fraud. Extreme between-study homogeneity may provide useful insights about a meta-analysis and its constituent studies.

  11. Chromobacterium violaceum: important insights for virulence and biotechnological potential by exoproteomic studies.

    PubMed

    Ciprandi, Alessandra; da Silva, Wanderson Marques; Santos, Agenor Valadares; de Castro Pimenta, Adriano Monteiro; Carepo, Marta Sofia Peixe; Schneider, Maria Paula Cruz; Azevedo, Vasco; Silva, Artur

    2013-07-01

    Chromobacterium violaceum is a beta-proteobacterium with high biotechnological potential, found in tropical environments. This bacterium causes opportunistic infections in both humans and animals, that can spread throughout several tissues, quickly leading to the death of the host. Genomic studies identified potential mechanisms of pathogenicity but no further studies were done to confirm the expression of these systems. In this study 36 unique protein entries were identified in databank from a two-dimensional profile of C. violaceum secreted proteins. Chromobacterium violaceum exoproteomic preliminary studies confirmed the production of proteins identified as virulence factors (such as a collagenase, flagellum proteins, metallopeptidases, and toxins), allowing us to better understand its pathogenicity mechanisms. Biotechnologically interesting proteins (such as chitinase and chitosanase) were also identified among the secreted proteins, as well as proteins involved in the transport and capture of amino acids, carbohydrates, and oxidative stress protection. Overall, the secreted proteins identified provide us important insights on pathogenicity mechanisms, biotechnological potential, and environment adaptation of C. violaceum.

  12. Autonomous sensor manager agents (ASMA)

    NASA Astrophysics Data System (ADS)

    Osadciw, Lisa A.

    2004-04-01

    Autonomous sensor manager agents are presented as an algorithm to perform sensor management within a multisensor fusion network. The design of the hybrid ant system/particle swarm agents is described in detail with some insight into their performance. Although the algorithm is designed for the general sensor management problem, a simulation example involving 2 radar systems is presented. Algorithmic parameters are determined by the size of the region covered by the sensor network, the number of sensors, and the number of parameters to be selected. With straight forward modifications, this algorithm can be adapted for most sensor management problems.

  13. Negative workplace behaviours: an ethical dilemma for nurse managers.

    PubMed

    Lindy, Cheryl; Schaefer, Florence

    2010-04-01

    To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.

  14. Insight into mental disorders and suicidal behavior: a qualitative and quantitative multimodal investigation.

    PubMed

    Vilaplana, Marlène; Richard-Devantoy, Stéphane; Turecki, Gustavo; Jaafari, Nematollah; Jollant, Fabrice

    2015-03-01

    To investigate the association between insight into mental disorders and suicidal behavior. English and French MEDLINE databases up to January 2014 were searched using suicide combined with awareness, consciousness, insight and anosognosia, unawareness, and awareness of illness. We also conducted a cross-sectional study comparing Mood Disorder Insight Scale (MDIS) and 24-item Hamilton Depression Rating Scale (HDRS-24), item 17, performance between 22 depressed (DSM-IV-TR criteria) suicide attempters and 22 patient controls. Study selection was based on the STROBE checklist. Selected studies were published in an English- or French-language peer-reviewed journal, included at least 1 measure of insight, and included patients with a history of suicidal behavior. Thirty-two studies were reviewed, of which 12 were longitudinal. A review of the literature and meta-analysis of studies were conducted to compare insight in patients with versus those without a history of suicidal behavior. Most studies (25) were conducted in psychotic disorders. A small majority showed a positive association between 1 measure of insight and higher risk of suicidal ideas or acts in both psychotic and mood disorders. Our study found that suicide attempters, mostly female attempters, tended to have better insight into depression than patient controls according to the HDRS-24 (P = .06, effect size = 1.43 [95% CI, 0.77 to 2.09]) but not MDIS. Finally, a meta-analysis of 7 studies confirmed significantly better insight scores in suicide attempters, with a small effect size (Hedges g = -0.16 [95% CI, -0.3 to -0.03]). Overall, a significant but weak association was found between insight and the risk of suicidal behavior. We also raised methodological and conceptual concerns and discussed new measures (eg, test based). © Copyright 2015 Physicians Postgraduate Press, Inc.

  15. Qualitative insights into practice time management: does 'patient-centred time' in practice management offer a portal to improved access?

    PubMed Central

    Buetow, S; Adair, V; Coster, G; Hight, M; Gribben, B; Mitchell, E

    2002-01-01

    BACKGROUND: Different sets of literature suggest how aspects of practice time management can limit access to general practitioner (GP) care. Researchers have not organised this knowledge into a unified framework that can enhance understanding of barriers to, and opportunities for, improved access. AIM: To suggest a framework conceptualising how differences in professional and cultural understanding of practice time management in Auckland, New Zealand, influence access to GP care for children with chronic asthma. DESIGN OF STUDY: A qualitative study involving selective sampling, semi-structured interviews on barriers to access, and a general inductive approach. SETTING: Twenty-nine key informants and ten mothers of children with chronic, moderate to severe asthma and poor access to GP care in Auckland. METHOD: Development of a framework from themes describing barriers associated with, and needs for, practice time management. The themes were independently identified by two authors from transcribed interviews and confirmed through informant checking. Themes from key informant and patient interviews were triangulated with each other and with published literature. RESULTS: The framework distinguishes 'practice-centred time' from 'patient-centred time.' A predominance of 'practice-centred time' and an unmet opportunity for 'patient-centred time' are suggested by the persistence of five barriers to accessing GP care: limited hours of opening; traditional appointment systems; practice intolerance of missed appointments; long waiting times in the practice; and inadequate consultation lengths. None of the barriers is specific to asthmatic children. CONCLUSION: A unified framework was suggested for understanding how the organisation of practice work time can influence access to GP care by groups including asthmatic children. PMID:12528583

  16. Managing U.S. climate risk through mitigation: Insights from the American Climate Prospectus

    NASA Astrophysics Data System (ADS)

    Kopp, R. E., III; Hsiang, S. M.; Houser, T.; Larsen, K.; Rasmussen, D. M., Jr.; Jina, A.; Rising, J.; Delgado, M.; Mohan, S.; Muir-Wood, R.; Wilson, P. S.

    2014-12-01

    The American Climate Prospectus (ACP), the technical analysis underlying the Risky Business project, quantitatively assessed the economic risks posed to the United States by six categories of climate change impacts: crop yield, energy demand, coastal storm damage, criminal activity, labor productivity, and mortality [1]. At a national level, measured by impact on gross domestic product, increased mortality and decreased labor productivity pose the large risks, followed by increased energy demand and coastal damages. Changes in crop yield and crime have smaller impacts. The ACP was not intended to conduct a benefit-cost analysis of climate change mitigation. It assessed the economic consequences of future impacts on an economy with a structure equivalent to that of the current economy, not accounting for socio-economic development and adaptation, and did not assess the cost of mitigation. One of its primary goals was to inform adaptation decisions that are conventionally considered 'endogenous' in economic analyses of climate change. Nonetheless, its results provide insight into the potential of mitigation to manage climate risk. Differences between RCP 8.5 (moderately-high business-as-usual emissions), RCP 4.5 (moderate mitigation) and RCP 2.6 (extremely strong mitigation) are not apparent until mid-century and become significant only late in the century. For all impacts except coastal damages, mitigation significantly reduces uncertainty in late-century impact estimates. Nationally, mitigation significantly and monotonically reduces median projected labor productivity losses and violent crime. Switching from RCP 8.5 to RCP 4.5 also significantly reduces median projections of mortality and energy demand, but the domestic value to the U.S. of further mitigation to RCP 2.6 is less clear. The marginal benefits decline in part because some regions of the country (especially the Northwest) may experience increased crop yields, reduced mortality, and reduced energy

  17. Management of atrial fibrillation in Greece: the MANAGE-AF study.

    PubMed

    Andrikopoulos, George; Pastromas, Sokratis; Mantas, Ioannis; Sakellariou, Dimitris; Kyrpizidis, Christos; Makridis, Pantelis; Goumas, Georgios; Stakos, Dimitris; Gotsis, Alexandros; Kartalis, Athanasios; Kazianis, Georgios; Babalis, Dimitrios; Toli, Konstantina; Tzeis, Stylianos; Papavasileiou, Maria; Kalogeropoulos, Petros; Vardas, Panos

    2014-01-01

    Although atrial fibrillation (AF) is a highly prevalent health problem with high morbidity and mortality, data regarding the clinical characteristics and management of AF in the Greek population are scarce. The "Current Clinical Practice in the MANAGEment of Atrial Fibrillation in Greece" study (MANAGEAF) aimed to assess the epidemiological features as well as the daily clinical practice in the management of Greek patients with AF. Taking into consideration the distribution of the Greek population, 603 consecutive patients over 18 years of age, with any type of AF, presenting at the emergency departments or outpatient clinics of 27 different centers, were included in our study. The mean age of the patients was 68.5 ± 12.1 years, with male patients representing 52.5% of the study population. The most common AF type in our cohort was non-paroxysmal AF (60%), including the patients with permanent (24.1%), persistent (17.4%), long-standing (4.8%) and first diagnosed AF (13.8%). Hypertension was the most common comorbidity (70.3%). A history of stroke or transient ischemic attack was detected in 9.2% of the patients, while 6.2% had a history of gastrointestinal bleeding. About half of the patients (49.3%) were treated with anticoagulant drugs, mainly vitamin K antagonists (46.9%), while 34.2% were on antiplatelet drugs, aspirin and/or clopidogrel. The mean INR level (1.7 ± 0.8) was sub-therapeutic, although the mean values for CHADS2 and CHA2DS2-VASc scores were 1.6 ± 1.2 and 3.0 ± 1.7, respectively. The MANAGE-AF baseline results indicate unsatisfactory levels of compliance with the current guidelines for the management of AF in Greece. Considering the undisputed effectiveness of anticoagulant treatment for preventing AF-related strokes, MANAGE-AF demonstrates the need for optimization of our therapeutic strategies for the management of cardioembolic stroke risk.

  18. Important, misunderstood, and challenging: a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD.

    PubMed

    Young, Hannah M L; Apps, Lindsay D; Harrison, Samantha L; Johnson-Warrington, Vicki L; Hudson, Nicky; Singh, Sally J

    2015-01-01

    In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses' and allied health professionals' (AHPs') understanding and provision of self-management in clinical practice. This study explores nurses' and AHPs' understanding and implementation of supported COPD self-management within routine clinical practice. Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach. A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients' perceived self-management abilities. Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding patients. The design of health care services also needs to consider the practical barriers to COPD self-management support for the implementation of such interventions to be successful.

  19. Energy Systems Integration Facility Insight Center | Energy Systems

    Science.gov Websites

    simulation data. Photo of researchers studying data on a 3-D power system profile depicting the interaction of renewable energy resources on the grid. Capabilities The Insight Center offers the following Integration Facility Insight Center Located adjacent to the Energy System Integration Facility's High

  20. Treatment adherence and insight in schizophrenia.

    PubMed

    Bitter, István; Fehér, László; Tényi, Tamás; Czobor, Pál

    2015-01-01

    Lack of adherence to treatment in patients with schizophrenia is a major risk factor for poor outcome, including relapse, rehospitalization, and suicide. Poor insight into illness may be a leading cause for partial- or nonadherence since a high proportion of patients with schizophrenia are partially or completely unaware of their mental disorder. The primary objective was to estimate the impact of lack of insight on adherence to medication based on a population of patients in Hungary who had the diagnosis of schizophrenia. The secondary objective was to investigate the association of the different aspects of insight (awareness of illness, the capacity to relabel psychotic experiences as abnormal, treatment acceptance) with (1) recent adherence behavior; (2) current mental state; (3) remission/non-remission status as measured by remission severity criteria; and (4) demographic and treatment history data. This was cross-sectional, noninterventional study, carried out under daily clinical practice conditions, with no influence exerted upon clinical practice in view of the observational nature of the study. Eligibility criteria included: a) patients' age (>18 years), b) diagnosis of schizophrenia (ICD-10), c) signed informed consent, d) no concomitant participation in another clinical trial. Study sites represented Mental Health Centers and outpatient clinics of hospital psychiatric units. Each investigator was asked to enroll patients consecutively. The final analysis sample comprised 262 patients, distributed across 13 sites. The following data were collected: general sociodemographic and clinical data (age, sex, level of education, socioeconomic situation, family support, psychiatric diagnosis, years of evolution, pharmacological and/or psychosocial treatments at the time of inclusion in the study, previous psychiatric admissions), with assessments of the Schedule of Assessing components of Insight (SAI), Compliance Rating Scale (CRS), Clinical Global Impression

  1. Policy on manager involvement in work re-integration: managers' experiences in a Canadian setting.

    PubMed

    Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans J N

    2014-01-01

    In Canada and other countries, sickness absence among workers is a significant concern. Local return-to-work policies developed by both management and workers' representatives are preferred to tackle the problem. This article examines how managers perceive this local bipartite agreed upon return-to-work policy, wherein a social constructivist view on the policy process is taken. In-depth interviews were held with 10 managers on their experiences with execution of this policy in a Canadian healthcare organization. Interviews were transcribed verbatim and qualitative analyses were completed to gain deep insight into the managers' perspectives. Results show that the managers viewed themselves as a linchpin between the workplace and the worker. They did not feel heard by the other stakeholders, wrestled with worker's limitations, struggled getting plans adjusted and became overextended to meet return-to-work objectives. The study shows that the managers felt unable to meet the responsibilities the policy demanded and got less involved in the return-to-work process than this policy intended. RTW policy needs to balance on the one hand, flexibility to safeguard active involvement of managers and, on the other hand, strictness regarding taking responsibility by stakeholders, particularly the health care and re-integration professionals.

  2. Psychiatrists' accounts of insight.

    PubMed

    Galasinski, Dariusz; Opalinski, Konrad

    2012-11-01

    Our main aim was to examine how insight into schizophrenia is discursively represented in psychiatrists' accounts, how these accounts relate to the current psychiatric literature on insight, and their potential clinical consequences. The article is anchored in the constructionist view of discourse and is based on nine semistructured interviews with specialist psychiatrists. We discuss three dimensions of insight into schizophrenia in the data we collected: a sense of illness, criticism, and readiness to receive treatment. We argue that they are embodiments of the dominant medical perspective in the relations between patients and physicians. Whereas in the former two it is possessing and accepting psychiatric knowledge which constitutes having insight, in the latter it is unquestioning acceptance and trust in whatever treatment the doctor deems fit to administer. We conclude with a discussion of medicalization of experience of mental illness, which appears to be the preferred mode of patient narrative for psychiatrists.

  3. Amniocentesis for PPROM management: a feasibility study.

    PubMed

    Lacerte, Maxime; Bujold, Emmanuel; Audibert, François; Mayrand, Marie-Hélène

    2008-08-01

    In Canada, most mothers whose amniotic membranes rupture before 34 weeks' gestation are hospitalized and delivered when signs of chorioamnionitis or fetal distress are observed or when a predetermined gestational age between 34 and 37 weeks is reached. This management approach can be questioned because in utero exposure to infection is a risk factor for cerebral palsy in neonates. Amniocentesis has the potential to detect markers of intra-amniotic infection. Our objective was to determine the acceptability of a randomized study comparing expectant management with amniocentesis-based management in women with premature rupture of the membranes. Between November 2005 and January 2007, we conducted a qualitative study involving 40 patients admitted to a tertiary care centre with premature rupture of the membranes between 28 and 34 weeks. The participants read an information booklet and answered a questionnaire. They were asked if they would agree to participate in a randomized study comparing expectant management with amniocentesis-based management. They graded the importance of a series of statements in their decision-making process. Seventy percent (28/40) of patients would have participated in the proposed study. Determining the presence of amniotic fluid infection or lung maturity was the main reason motivating their choice. The reasons for refusing to participate were related to complications of amniocentesis (fetal trauma, iatrogenic preterm labour, infection, or pain). The majority of patients with premature rupture of the membranes would participate in a study comparing expectant management to management based on amniocentesis results. This study helped us to better understand their motivations and fears.

  4. Business resilience: Reframing healthcare risk management.

    PubMed

    Simeone, Cynthia L

    2015-09-01

    The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.

  5. Insights from the past: incorporating long-term landscape evolution in studies of land degradation

    NASA Astrophysics Data System (ADS)

    Ferro-Vazquez, Cruz; Lang, Carol; Kabora, Tabitha; Thornton-Barnett, Senna; Richer, Suzi; Gallello, Gianni; Stump, Daryl

    2017-04-01

    Modern approaches for assessing land degradation encompass multidisciplinary studies that have allowed a more realistic understanding of the causes and consequences of land degradation. This incipient perspective includes an increasingly important role of the studies of the past, including human history, to understand modern ecosystems and landscapes. Indeed, the current promotion of indigenous resource-use strategies as models of sustainable development was initially prompted by historical studies. However, systematic studies on whether or not indigenous management practices led to land degradation, and therefore their benefits or constraints for sustained use of natural resources, are not truly known. We argue that a joint approach combining the characterization of current soil properties with the archaeological study of traditional agricultural systems can provide insights on their sustainability. Archaeological excavation enables discerning the order in which sediments are deposited and the sequence in which structures are built. This provides data on coincident cultural and ecological change, and a long-term perspective on how agro-ecological systems operated in pre-modern states and the ways in which they resemble or differ from modern contexts. Simultaneously, these changes would have left a physical, chemical and isotopic imprint in soils that can be detected and interpreted to contribute to the production of a "usable past" (Stump, 2013). The premise is: since ancient agricultural sites may provide information on agronomic conditions after centuries to millennia of use, they can help in understanding the ways in which agroecosystems have survived, failed or adapted in the past. This will contribute to a better holistic understanding of social-ecological systems evolution by including a temporal perspective, and to a more nuanced assessment of land degradation and sustainable use. To illustrate this we present the outcome of our research at two traditional

  6. Lean vs Agile in the Context of Complexity Management in Organizations

    ERIC Educational Resources Information Center

    Putnik, Goran D.; Putnik, Zlata

    2012-01-01

    Purpose: The objective of this paper is to provide a deeper insight into the relationship of the issue "lean vs agile" in order to inform managers towards more coherent decisions especially in a dynamic, unpredictable, uncertain, non-linear environment. Design/methodology/approach: The methodology is an exploratory study based on secondary data…

  7. How to Detect Insight Moments in Problem Solving Experiments.

    PubMed

    Laukkonen, Ruben E; Tangen, Jason M

    2018-01-01

    Arguably, it is not possible to study insight moments during problem solving without being able to accurately detect when they occur (Bowden and Jung-Beeman, 2007). Despite over a century of research on the insight moment, there is surprisingly little consensus on the best way to measure them in real-time experiments. There have also been no attempts to evaluate whether the different ways of measuring insight converge. Indeed, if it turns out that the popular measures of insight diverge , then this may indicate that researchers who have used one method may have been measuring a different phenomenon to those who have used another method. We compare the strengths and weaknesses of the two most commonly cited ways of measuring insight: The feelings-of-warmth measure adapted from Metcalfe and Wiebe (1987), and the self-report measure adapted from Bowden and Jung-Beeman (2007). We find little empirical agreement between the two measures, and conclude that the self-report measure of Aha! is superior both methodologically and theoretically, and provides a better representation of what is commonly regarded as insight. We go on to describe and recommend a novel visceral measure of insight using a dynamometer as described in Creswell et al. (2016).

  8. How to Detect Insight Moments in Problem Solving Experiments

    PubMed Central

    Laukkonen, Ruben E.; Tangen, Jason M.

    2018-01-01

    Arguably, it is not possible to study insight moments during problem solving without being able to accurately detect when they occur (Bowden and Jung-Beeman, 2007). Despite over a century of research on the insight moment, there is surprisingly little consensus on the best way to measure them in real-time experiments. There have also been no attempts to evaluate whether the different ways of measuring insight converge. Indeed, if it turns out that the popular measures of insight diverge, then this may indicate that researchers who have used one method may have been measuring a different phenomenon to those who have used another method. We compare the strengths and weaknesses of the two most commonly cited ways of measuring insight: The feelings-of-warmth measure adapted from Metcalfe and Wiebe (1987), and the self-report measure adapted from Bowden and Jung-Beeman (2007). We find little empirical agreement between the two measures, and conclude that the self-report measure of Aha! is superior both methodologically and theoretically, and provides a better representation of what is commonly regarded as insight. We go on to describe and recommend a novel visceral measure of insight using a dynamometer as described in Creswell et al. (2016). PMID:29593598

  9. Doctoral Women: Managing Emotions, Managing Doctoral Studies

    ERIC Educational Resources Information Center

    Aitchison, Claire; Mowbray, Susan

    2013-01-01

    This paper explores the experiences of women doctoral students and the role of emotion during doctoral candidature. The paper draws on the concept of emotional labour to examine the two sites of emotional investment students experienced and managed during their studies: writing and family relationships. Emotion is perceived by many dominant…

  10. On the temporality of creative insight: a psychological and phenomenological perspective

    PubMed Central

    Cosmelli, Diego; Preiss, David D.

    2014-01-01

    Research into creative insight has had a strong emphasis on the psychological processes underlying problem-solving situations as a standard model for the empirical study of this phenomenon. Although this model has produced significant advances in our scientific understanding of the nature of insight, we believe that a full comprehension of insight requires complementing cognitive and neuroscientific studies with a descriptive, first-person, phenomenological approach into how creative insight is experienced. Here we propose to take such first-person perspective while paying special attention to the temporal aspects of this experience. When this first-person perspective is taken into account, a dynamic past–future interplay can be identified at the core of the experience of creative insight, a structure that is compatible with both biological and biographical evidences. We believe this approach could complement and help bring together biological and psychological perspectives. Furthermore, we argue that because of its spontaneous but recurrent nature, creative insight could represent a relevant target for the phenomenological investigation of the flow of experience itself. PMID:25368595

  11. The Importance of Emotional Insight in Cognitive Behaviour Therapy for Anorexia Nervosa: An Adolescent Case Study

    ERIC Educational Resources Information Center

    Rupa, Megha; Girimaji, Satish; Muthuswamy, Selvi; Jacob, Preeti; Ravi, Malavika

    2013-01-01

    Anorexia nervosa is a rare but sever psychiatric disorder in adolescence, with chronicity and death being the most feared consequence. Emotional Insight into one's problem is considered a key determinant of success in therapy. The following case study of a 14-year-old client, describes the process of therapy as it unfolded across 45 sessions. An…

  12. Suicide, Satisfaction With Life, and Insight Capacity Among Adolescents With Mental Disorders.

    PubMed

    Schapir, Lior; Zalsman, Gil; Hasson-Ohayon, Ilanit; Gaziel, Meyrav; Morag-Yaffe, Mayad; Sever, Jonathan; Weizman, Abraham; Shoval, Gal

    2016-09-01

    Little is known about the role of insight and satisfaction with life in adolescent suicidal behavior. The objective of this study was to examine the relationship between suicide risk, insight, and satisfaction with life among adolescents with mental disorders. A total of 30 adolescents were evaluated using self-report measures of insight, satisfaction with life, and suicide risk. Regression analysis was used to assess the contribution of each factor to suicide risk. Positive correlations were found between suicide risk and insight dimensions. Satisfaction with life correlated negatively with suicide risk and insight dimensions. Insight explained 27.3% of suicide risk (p = .003). Both insight and satisfaction with life explained 39.0% of suicide risk (p = .031). Among adolescents with mental disorders, insight is a risk factor, whereas satisfaction with life is a protective factor for suicidality. Insight affects suicide risk of adolescents with mental disorders via reduction of satisfaction with life.

  13. Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention

    PubMed Central

    Burton, Cynthia Z.; Vella, Lea; Twamley, Elizabeth W.

    2013-01-01

    The impact of limited insight is a crucial consideration in the treatment of individuals with psychiatric illness. In the context of psychosis, both clinical and cognitive insight have been described. This study aimed to evaluate the relationships between clinical and cognitive insight and neuropsychological functioning, psychiatric symptom severity, and everyday functioning in patients with a primary psychotic disorder participating in a compensatory cognitive training (CT) intervention. Sixty-nine individuals diagnosed with a primary psychotic disorder were randomized to a 3-month CT intervention or to standard pharmacotherapy, and they completed a comprehensive neuropsychological, clinical, and functional battery at baseline, 3 months, and 6 months. The CT intervention focused on habit formation and compensatory strategy learning in four domains: prospective memory, attention and vigilance, learning and memory, and problem-solving/cognitive flexibility. At baseline, better clinical insight was significantly related to better executive functioning and less severe negative symptoms. There was no significant association between cognitive insight and cognitive functioning, symptom severity, or everyday functioning ability. The CT intervention did not have an effect on clinical or cognitive insight, but better cognitive insight prior to participation in CT significantly predicted decreased positive and depressive symptom severity posttreatment, and better clinical insight predicted improved self-reported quality of life. Although clinical insight is related to executive functioning, the correlates of cognitive insight remain elusive. Intact insight appears to be beneficial in ameliorating clinical symptomatology like positive symptoms and depression, rather than augmenting cognition. It may be valuable to develop brief interventions aimed at improving clinical and cognitive insight prior to other psychosocial rehabilitation in order to maximize the benefit of

  14. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

    PubMed

    Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

    2017-09-01

    There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  15. Modelling marine protected areas: insights and hurdles

    PubMed Central

    Fulton, Elizabeth A.; Bax, Nicholas J.; Bustamante, Rodrigo H.; Dambacher, Jeffrey M.; Dichmont, Catherine; Dunstan, Piers K.; Hayes, Keith R.; Hobday, Alistair J.; Pitcher, Roland; Plagányi, Éva E.; Punt, André E.; Savina-Rolland, Marie; Smith, Anthony D. M.; Smith, David C.

    2015-01-01

    Models provide useful insights into conservation and resource management issues and solutions. Their use to date has highlighted conditions under which no-take marine protected areas (MPAs) may help us to achieve the goals of ecosystem-based management by reducing pressures, and where they might fail to achieve desired goals. For example, static reserve designs are unlikely to achieve desired objectives when applied to mobile species or when compromised by climate-related ecosystem restructuring and range shifts. Modelling tools allow planners to explore a range of options, such as basing MPAs on the presence of dynamic oceanic features, and to evaluate the potential future impacts of alternative interventions compared with ‘no-action’ counterfactuals, under a range of environmental and development scenarios. The modelling environment allows the analyst to test if indicators and management strategies are robust to uncertainties in how the ecosystem (and the broader human–ecosystem combination) operates, including the direct and indirect ecological effects of protection. Moreover, modelling results can be presented at multiple spatial and temporal scales, and relative to ecological, economic and social objectives. This helps to reveal potential ‘surprises', such as regime shifts, trophic cascades and bottlenecks in human responses. Using illustrative examples, this paper briefly covers the history of the use of simulation models for evaluating MPA options, and discusses their utility and limitations for informing protected area management in the marine realm. PMID:26460131

  16. Nurse manager cognitive decision-making amidst stress and work complexity.

    PubMed

    Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

    2013-01-01

      The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

  17. From Walls to Windows: Using Barriers as Pathways to Insightful Solutions

    ERIC Educational Resources Information Center

    Walinga, Jennifer

    2010-01-01

    The purpose of this study was to explore and develop a conceptual model for how individuals unlock insight. The concept of insight--the "out of the box" or "aha!" solution to a problem--offers a framework for exploring and understanding how best to enhance problem solving skills due to the cognitive shift insight requires. Creative problem solving…

  18. The Arts Management Handbook: New Directions for Students and Practitioners

    ERIC Educational Resources Information Center

    Brindle, Meg, Ed.; DeVereaux, Constance, Ed.

    2011-01-01

    Whether the art form is theater, dance, music, festival, or the visual arts and galleries, the arts manager is the liaison between the artists and their audience. Bringing together the insights of educators and practitioners, this groundbreaker links the fields of management and organizational management with the ongoing evolution in arts…

  19. Insight and subjective measures of quality of life in chronic schizophrenia.

    PubMed

    Siu, Cynthia O; Harvey, Philip D; Agid, Ofer; Waye, Mary; Brambilla, Carla; Choi, Wing-Kit; Remington, Gary

    2015-09-01

    Lack of insight is a well-established phenomenon in schizophrenia, and has been associated with reduced rater-assessed functional performance but increased self-reported well-being in previous studies. The objective of this study was to examine factors that might influence insight (as assessed by the Insight and Treatment Attitudes Questionnaire [ITAQ] or PANSS item G12) and subjective quality-of-life (as assessed by Lehman QoL Interview [LQOLI]), using the large National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset. Uncooperativeness was assessed by PANSS item G8 ("Uncooperativeness"). In the analysis, we found significant moderating effects for insight on the relationships of subjective life satisfaction assessment to symptom severity (as assessed by CGI-S score), objective everyday functioning (as assessed by rater-administered Heinrichs-Carpenter Quality of Life scale), clinically rated uncooperativeness (as assessed by PANSS G8), and discontinuation of treatment for all causes (all P > 0.05 for statistical interaction between insight and subject QoL). Patients with chronic schizophrenia who reported being "pleased" or "delighted" on LQOLI were found to have significantly lower neurocognitive reasoning performance and poorer insight (ITAQ total score). Our findings underscore the importance of reducing cognitive and insight impairments for both treatment compliance and improved functional outcomes.

  20. Insight Into Illness and Cognition in Schizophrenia in Earlier and Later Life.

    PubMed

    Gerretsen, Philip; Voineskos, Aristotle N; Graff-Guerrero, Ariel; Menon, Mahesh; Pollock, Bruce G; Mamo, David C; Mulsant, Benoit H; Rajji, Tarek K

    2017-04-01

    Impaired insight into illness in schizophrenia is associated with illness severity and deficits in premorbid intellectual function, executive function, and memory. A previous study of patients aged 60 years and older found that illness severity and premorbid intellectual function accounted for variance in insight impairment. As such, we aimed to test whether similar relationships would be observed in earlier life. A retrospective analysis was performed on 1 large sample of participants (n = 171) with a DSM-IV-TR diagnosis of schizophrenia aged 19 to 79 years acquired from 2 studies: (1) a psychosocial intervention trial for older persons with schizophrenia (June 2008 to May 2014) and (2) a diffusion tensor imaging and genetics study of psychosis across the life span (February 2007 to December 2013). We assessed insight into illness using the Positive and Negative Syndrome Scale (PANSS) item G12 and explored its relationship to illness severity (PANSS total modified), premorbid intellectual function (Wechsler Test of Adult Reading [WTAR]), and cognition. Insight impairment was more severe in later life (≥ 60 years) than in earlier years (t = -3.75, P < .001). Across the whole sample, the variance of impaired insight was explained by PANSS total modified (Exp[B] = 1.070, P < .001) and WTAR scores (Exp[B] = 0.970, P = .028). Although age and cognition were correlated with impaired insight, they did not independently contribute to its variance. However, the relationships between impaired insight and illness severity and between impaired insight and cognition, particularly working memory, were stronger in later life than in earlier life. These results suggest an opportunity for intervention may exist with cognitive-enhancing neurostimulation or medications to improve insight into illness in schizophrenia across the life span. Original study registered on ClinicalTrials.gov (identifier: NCT00832845). © Copyright 2017 Physicians Postgraduate Press, Inc.

  1. Approaching the Distinction between Intuition and Insight.

    PubMed

    Zhang, Zhonglu; Lei, Yi; Li, Hong

    2016-01-01

    Intuition and insight share similar cognitive and neural basis. Though, there are still some essential differences between the two. Here in this short review, we discriminated between intuition, and insight in two aspects. First, intuition, and insight are toward different aspects of information processing. Whereas intuition involves judgment about "yes or no," insight is related to "what" is the solution. Second, tacit knowledge play different roles in between intuition and insight. On the one hand, tacit knowledge is conducive to intuitive judgment. On the other hand, tacit knowledge may first impede but later facilitate insight occurrence. Furthermore, we share theoretical, and methodological views on how to access the distinction between intuition and insight.

  2. Dimensions of insight in schizophrenia: Exploratory factor analysis of items from multiple self- and interviewer-rated measures of insight.

    PubMed

    Konsztowicz, Susanna; Schmitz, Norbert; Lepage, Martin

    2018-03-10

    Insight in schizophrenia is regarded as a multidimensional construct that comprises aspects such as awareness of the disorder and recognition of the need for treatment. The proposed number of underlying dimensions of insight is variable in the literature. In an effort to identify a range of existing dimensions of insight, we conducted a factor analysis on combined items from multiple measures of insight. We recruited 165 participants with enduring schizophrenia (treated for >3years). Exploratory factor analysis was conducted on itemized scores from two interviewer-rated measures of insight: the Schedule for the Assessment of Insight-Expanded and the abbreviated Scale to assess Unawareness of Mental Disorder; and two self-report measures: the Birchwood Insight Scale and the Beck Cognitive Insight Scale. A five-factor solution was selected as the best-fitting model, with the following dimensions of insight: 1) awareness of illness and the need for treatment; 2) awareness and attribution of symptoms and consequences; 3) self-certainty; 4) self-reflectiveness for objectivity and fallibility; and 5) self-reflectiveness for errors in reasoning and openness to feedback. Insight in schizophrenia is a multidimensional construct comprised of distinct clinical and cognitive domains of awareness. Multiple measures of insight, both clinician- and self-rated, are needed to capture all of the existing dimensions of insight. Future exploration of associations between the various dimensions and their potential determinants will facilitate the development of clinically useful models of insight and effective interventions to improve outcome. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Survey process quality: a question of healthcare manager approach.

    PubMed

    Nilsson, Petra; Blomqvist, Kerstin

    2017-08-14

    Purpose The purpose of this paper is to explore how healthcare first-line managers think about and act regarding workplace survey processes. Design/methodology/approach This interview study was performed at a hospital in south Sweden. First-line healthcare managers ( n=24) volunteered. The analysis was inspired by phenomenography, which aims to describe the ways in which different people experience a phenomenon. The phenomenon was a workplace health promotion (WHP) survey processes. Findings Four main WHP survey process approaches were identified among the managers: as a possibility, as a competition, as a work task among others and as an imposition. For each, three common subcategories emerged; how managers: stated challenges and support from hospital management; described their own work group and collaboration with other managers; and expressed themselves and their situation in their roles as first-line managers. Practical implications Insights into how hospital management can understand their first-line managers' motivation for survey processes and practical suggestions and how managers can work proactively at organizational, group and individual level are presented. Originality/value Usually these studies focus on those who should respond to a survey; not those who should run the survey process. Focusing on managers and not co-workers can lead to more committed and empowered managers and thereby success in survey processes.

  4. Dimensions of osteoarthritis self-management.

    PubMed

    Prior, Kirsty N; Bond, Malcolm J

    2004-06-01

    Our aims were to determine whether a taxonomy of self-management strategies for osteoarthritis could be identified, and whether the resultant dimensions of such a taxonomy demonstrate predictable relationships with health status indices. Participants (n = 117) from community-based self-help groups and a general rheumatology outpatient clinic completed a self-management inventory consisting of 11 items, answered for both the past 7 days and a day on which symptoms were worse than usual. Duration of symptoms, level of pain, perceived functional ability and self-rated health were recorded as indicators of health status. Three essentially identical factors were obtained for both past 7 days and worse day items. Resultant scales were labeled passive, complementary and active, respectively. Correlations with health status measures provided modest evidence for the construct validity of these self-management scales. Compared with a simple aggregate score based on the total number of strategies used, the scales provided a clearer understanding of the relationship between self-management and health. The study provided a useful extension to existing research, addressing a number of shortcomings identified by previous researchers. The identified self-management dimensions offered a greater insight into the self-management choices of patients. Suggestions for further improvements to the measurement of self-management are outlined.

  5. In Search of Insight.

    ERIC Educational Resources Information Center

    Kaplan, Craig A.; Simon, Herbert A.

    1990-01-01

    Attaining the insight needed to solve the Mutilated Checkerboard problem, which requires discovery of an effective problem representation (EPR), is described. Performance on insight problems can be predicted from the availability of generators and constraints in the search for an EPR. Data for 23 undergraduates were analyzed. (TJH)

  6. Contrasting fire responses to climate and management: insights from two Australian ecosystems.

    PubMed

    King, Karen J; Cary, Geoffrey J; Bradstock, Ross A; Marsden-Smedley, Jonathan B

    2013-04-01

    This study explores effects of climate change and fuel management on unplanned fire activity in ecosystems representing contrasting extremes of the moisture availability spectrum (mesic and arid). Simulation modelling examined unplanned fire activity (fire incidence and area burned, and the area burned by large fires) for alternate climate scenarios and prescribed burning levels in: (i) a cool, moist temperate forest and wet moorland ecosystem in south-west Tasmania (mesic); and (ii) a spinifex and mulga ecosystem in central Australia (arid). Contemporary fire activity in these case study systems is limited, respectively, by fuel availability and fuel amount. For future climates, unplanned fire incidence and area burned increased in the mesic landscape, but decreased in the arid landscape in accordance with predictions based on these limiting factors. Area burned by large fires (greater than the 95th percentile of historical, unplanned fire size) increased with future climates in the mesic landscape. Simulated prescribed burning was more effective in reducing unplanned fire activity in the mesic landscape. However, the inhibitory effects of prescribed burning are predicted to be outweighed by climate change in the mesic landscape, whereas in the arid landscape prescribed burning reinforced a predicted decline in fire under climate change. The potentially contrasting direction of future changes to fire will have fundamentally different consequences for biodiversity in these contrasting ecosystems, and these will need to be accommodated through contrasting, innovative management solutions. © 2012 Blackwell Publishing Ltd.

  7. Assessing cognitive insight in nonpsychiatric individuals and outpatients with schizophrenia in Taiwan: an investigation using the Beck Cognitive Insight Scale

    PubMed Central

    2011-01-01

    Background The Beck Cognitive Insight Scale (BCIS) was designed for the assessment of the cognitive processes involved in self-reflection and the ability to modify erroneous beliefs and misinterpretations. Studies investigating the factor structure of the BCIS have indicated a two-factor model in the psychotic population. The factor structure of the BCIS, however, has not received much consideration in the nonpsychiatric population. The present study examined the factor structure and validity of the BCIS and compared its scores between nonpsychiatric individuals and outpatients with psychosis. Method The Taiwanese version of the BCIS was administered to 507 nonpsychiatric individuals and 118 outpatients with schizophrenia. The psychometric properties of the BCIS were examined through the following analyses: exploratory and confirmatory factor analyses, reliability, correlation analyses, and discriminative validity. Results The BCIS showed adequate internal consistency and stability over time. Exploratory and confirmatory factor analyses on the 15-item measure indicated a two-factor solution that supported the two dimensions of the Taiwanese BCIS, which was also observed with the original BCIS. Following the construct validation, we obtained a composite index (self-reflectiveness minus self-certainty) of the Taiwanese BCIS that reflected cognitive insight. Consistent with previous studies, our results indicated that psychosis is associated with low self-reflectiveness and high self-certainty, which possibly reflect lower cognitive insight. Our results also showed that better cognitive insight is related to worse depression in patients with schizophrenia spectrum disorders, but not in nonpsychiatric individuals. The receiver operating characteristic (ROC) analyses revealed that the area under the curve (AUC) was 0.731. A composite index of 3 was a good limit, with a sensitivity of 87% and a specificity of 51%. Conclusion The BCIS proved to be useful for measuring

  8. Second Language Acquisition: Possible Insights from Studies on How Birds Acquire Song.

    ERIC Educational Resources Information Center

    Neapolitan, Denise M.; And Others

    1988-01-01

    Reviews research that demonstrates parallels between general linguistic and cognitive processes in human language acquisition and avian acquisition of song and discusses how such research may provide new insights into the processes of second-language acquisition. (Author/CB)

  9. Overlap and distinction between measures of insight and self-stigma.

    PubMed

    Hasson-Ohayon, Ilanit

    2018-05-24

    Multiple studies on insight into one's illness and self-stigma among patients with serious mental illness and their relatives have shown that these constructs are related to one another and that they affect outcome. However, a critical exploration of the items used to assess both constructs raises questions with regard to the possible overlapping and centrality of items. The current study used five different samples to explore the possible overlap and distinction between insight and self-stigma, and to identify central items, via network analyses and principal component factor analysis. Findings from the network analyses showed overlap between insight and self-stigma exist with a relatively clearer observational distinction between the constructs among the two parent samples in comparison to the patient samples. Principal component factor analysis constrained to two factors showed that a relatively high percentage of items were not loaded on either factor, and in a few datasets, several insight items were loaded on the self-stigma scale and vice versa. The author discusses implications for research and calls for rethinking the way insight is assessed. Clinical implications are also discussed in reference to central items of social isolation, future worries and stereotype endorsement among the different study groups. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Can Management Potential Be Revealed in Groups?

    ERIC Educational Resources Information Center

    Chartrand, P. J.; Jackson, D.

    1971-01-01

    Videotaping small group problem solving sessions and applying Bales Social Interaction scale can give valuable insight into areas where people (particularly managers) can profitably spend time developing themselves. (Author/EB)

  11. Risk management and precaution: insights on the cautious use of evidence.

    PubMed Central

    Hrudey, Steve E; Leiss, William

    2003-01-01

    Risk management, done well, should be inherently precautionary. Adopting an appropriate degree of precaution with respect to feared health and environmental hazards is fundamental to risk management. The real problem is in deciding how precautionary to be in the face of inevitable uncertainties, demanding that we understand the equally inevitable false positives and false negatives from screening evidence. We consider a framework for detection and judgment of evidence of well-characterized hazards, using the concepts of sensitivity, specificity, positive predictive value, and negative predictive value that are well established for medical diagnosis. Our confidence in predicting the likelihood of a true danger inevitably will be poor for rare hazards because of the predominance of false positives; failing to detect a true danger is less likely because false negatives must be rarer than the danger itself. Because most controversial environmental hazards arise infrequently, this truth poses a dilemma for risk management. PMID:14527835

  12. Parental insightfulness: retrospect and prospect.

    PubMed

    Koren-Karie, Nina; Oppenheim, David

    2018-06-01

    We open this introductory paper to the special issue with the theoretical and clinical roots of the insightfulness concept. Next, the Insightfulness Assessment (IA) is presented, followed by a review of key empirical findings supporting the IA. The central points in the papers in this special issue are reviewed next. These include the use of the IA with parents of children ranging in age from infancy to adolescence, its applicability outside the parent-child relationship (e.g. insightfulness toward a close friend), its use with high-risk mothers, and the usefulness of insightfulness both as a continuous and a categorical measure. The clinical applications of the IA are discussed, and we close with future directions for IA research.

  13. Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study.

    PubMed

    Nendaz, Mathieu R; Gut, Anne M; Louis-Simonet, Martine; Perrier, Arnaud; Vu, Nu V

    2011-04-01

    Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored. This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning. Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups. Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02). This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence.

  14. Training hospital managers for strategic planning and management: a prospective study.

    PubMed

    Terzic-Supic, Zorica; Bjegovic-Mikanovic, Vesna; Vukovic, Dejana; Santric-Milicevic, Milena; Marinkovic, Jelena; Vasic, Vladimir; Laaser, Ulrich

    2015-02-26

    Training is the systematic acquisition of skills, rules, concepts, or attitudes and is one of the most important components in any organization's strategy. There is increasing demand for formal and informal training programs especially for physicians in leadership positions. This study determined the learning outcomes after a specific training program for hospital management teams. The study was conducted during 2006 and 2007 at the Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade and included 107 participants involved in the management in 20 Serbian general hospitals. The management teams were multidisciplinary, consisting of five members on average: the director of the general hospital, the deputy directors, the head nurse, and the chiefs of support services. The managers attended a training program, which comprised four modules addressing specific topics. Three reviewers independently evaluated the level of management skills at the beginning and 12 months after the training program. Principal component analysis and subsequent stepwise multiple linear regression analysis were performed to determine predictors of learning outcomes. The quality of the SWOT (strengths, weaknesses, opportunities and threats) analyses performed by the trainees improved with differences between 0.35 and 0.49 on a Likert scale (p < 0.001). Principal component analysis explained 81% of the variance affecting their quality of strategic planning. Following the training program, the external environment, strategic positioning, and quality of care were predictors of learning outcomes. The four regression models used showed that the training program had positive effects (p < 0.001) on the ability to formulate a Strategic Plan comprising the hospital mission, vision, strategic objectives, and action plan. This study provided evidence that training for strategic planning and management enhanced the strategic decision-making of hospital

  15. The five minds of a manager.

    PubMed

    Gosling, Jonathan; Mintzberg, Henry

    2003-11-01

    Managers are told: Be global and be local. Collaborate and compete. Change, perpetually, and maintain order. Make the numbers while nurturing your people. To be effective, managers need to consider the juxtapositions in order to arrive at a deep integration of these seemingly contradictory concerns. That means they must focus not only on what they have to accomplish but also on how they have to think. When the authors, respectively the director of the Centre for Leadership Studies at the University of Exeter in the U.K. and the Cleghorn Professor of Management Studies at McGill University in Montreal, set out to develop a masters program for practicing managers, they saw that they could not rely on the usual MBA educational structure, which divides the management world into discrete business functions such as marketing and accounting. They needed an educational structure that would encourage synthesis rather than separation. Managing, they determined, involves five tasks, each with its own mind-set: managing the self (the reflective mind-set); managing organizations (the analytic mind-set); managing context (the worldly mind-set); managing relationships (the collaborative mind-set); and managing change (the action mind-set). The program is built on the exploration and integration of those five aspects of the managerial mind. The authors say it has proved powerful in the classroom and insightful in practice. Imagine the mind-sets as threads and the manager as weaver. Effective performance means weaving each mind-set over and under the others to create a fine, sturdy cloth.

  16. Asthma Management in Minority Children: Practical Insights for Clinicians, Researchers, and Public Health Planners.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    This monograph summarizes asthma management conclusions developed by five studies funded under a 5-year federal program titled "Interventions for the Control of Asthma among Black and Hispanic Children." The research goals were to develop model, replicable programs to reduce asthma morbidity; decrease inappropriate use of health care…

  17. Insights into rare diseases from social media surveys.

    PubMed

    Davies, William

    2016-11-09

    The internet, and social media platforms, are increasingly being used by substantial sectors of the worldwide population. By engaging effectively with online and social media, scientists and clinicians can obtain unprecedented access to relatively large cohorts of individuals with rare diseases, as well as their relatives, carers and professionals involved in their healthcare. Online surveys of these stakeholder groups may provide important new insights into rare conditions and their management relatively quickly and easily, with the possibility of rapid translation into healthcare interventions and policy. Here, I describe our recent positive experience with the online survey approach to a rare disease (X-linked ichthyosis), and review its advantages and limitations.

  18. Helicobacter pylori research: historical insights and future directions

    PubMed Central

    Fock, Kwong Ming; Graham, David Y.; Malfertheiner, Peter

    2014-01-01

    Helicobacter pylori leads to chronic gastritis, peptic ulcer disease and gastric cancer. With increasing issues of antibiotic resistance and changing epidemiology of this pathogen, new approaches are needed for effective management. In 1984, Dr Barry Marshall and Dr Robin Warren reported the association of Helicobacter pylori with peptic ulcers in The Lancet—a discovery that earned them the Nobel prize in Physiology or Medicine in 2005—but what progress have we made since then? Here, we have invited three international experts to give their insights into the advances in H. pylori research over the past 30 years and where research should be focused in the future. PMID:23752823

  19. Project nurse manager: an intrapreneurial role.

    PubMed

    Risner, P B; Anderson, M L

    1994-01-01

    Nurse intrapreneurs are the key to innovation and cost-effective health care in the 1990s. A project nurse manager, acting as a liaison between service departments, can provide the vision and insight for the successful outcome of such projects as product evaluation, unit renovation, and the development of a new facility. The role, benefits, and outcomes of one project nurse manager are described.

  20. Discourse coalitions in Swiss waste management: gridlock or winds of change?

    PubMed

    Duygan, Mert; Stauffacher, Michael; Meylan, Grégoire

    2018-02-01

    As a complex socio-technical system, waste management is crucially important for the sustainable management of material and energy flows. Transition to better performing waste management systems requires not only determining what needs to be changed but also finding out how this change can be realized. Without understanding the political context, insights from decision support tools such as life cycle assessment (LCA) are likely to be lost in translation to decision and policy making. This study strives to provide a first insight into the political context and address the opportunities and barriers pertinent to initiating a change in Swiss waste management. For this purpose, the discourses around a major policy process are analysed to uncover the policy beliefs and preferences of actors. Discourse coalitions are delineated by referring to the Advocacy Coalition Framework (Sabatier, 1998) and using the Discourse Network Analysis (Leifeld and Haunss, 2012) method. The results display an incoherent regime (Fuenfschilling and Truffer, 2014) with divergent belief clusters on core issues in waste management. Yet, some actors holding different beliefs appear to have overlapping interests on secondary issues such as the treatment of biogenic waste or plastics. Although the current political context hinders a system-wide disruptive change, transitions can be initiated at local or regional scale by utilizing the shared interest across different discourse coalitions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. [Relationship of insight with depression and suicidal ideation in psychotic disorders].

    PubMed

    Patelaros, E; Zournatzis, E; Kontstantakopoulos, G

    2015-01-01

    The associations of insight into psychosis (i.e., awareness of illness) with clinical variables have been examined by a great number of studies. Most of these studies revealed that the level of insight is negatively correlated with psychotic symptoms but positively correlated with depression and suicidal ideation. The aim of this study was to test these findings in a Greek sample of patients. Forty-three outpatients (30 men and 13 women) with schizophrenia or delusional disorder being followed up at the Mental Health Centre of Kavala took part in the study. Patients with bipolar or schizoaffective disorder were excluded. Patients' mean age was 40.7 years and the mean duration of illness was 18.67 years. All participants were under treatment and clinically stable at the time of the study. We used the Positive and Negative Syndrome Scale (PANSS) for the assessment of positive and negative symptoms, the Schedule for the Assessment of Insight-Expanded (SAI-E) to assess the insight into psychosis, and the Montgomery-Asberg Depression Rating Scale (MADRS) for the evaluation of depression recording separately the score for item 10 as an estimate of suicidal ideation. All the scales used have been adapted to Greek population. We used Spearman rho coefficient to assess the strength of correlations between the scales because the distributions of some scores were not normal. In order to assess the predictive value of insight for depression and suicidal ideation, we used hierarchical linear regression analysis. Correlation coefficients between SAI-E and the clinical scales of psychopathology, depression and suicide ideation was statistically significant at the p<0.01 level. The correlations between the clinical scales and the three subscales of SAI-E were also significant at the aforementioned p level. The regression analysis showed that our model of positive and negative psychopathology and insight explained 47.4% of the variance of depression and 32.2% of the variance of

  2. Lessons Learned from the First Decade of Adaptive Management in Comprehensive Everglades Restoration

    EPA Science Inventory

    Although few successful examples of large-scale adaptive management applications are available to ecosystem restoration scientists and managers, examining where and how the components of an adaptive management program have been successfully implemented yields insight into what ...

  3. Insight in Chinese schizophrenia patients: a 12-month follow-up.

    PubMed

    Wang, Y; Xiang, Y-T; Wang, C-Y; Chiu, H F K; Zhao, J-P; Chen, Q; Chan, S S M; Lee, E H M; Tang, W-K; Ungvari, G S

    2011-11-01

    This study aimed to assess insight in Chinese schizophrenia patients and to identify its relationship with socio-demographic and clinical factors, executive functions and quality of life (QOL). A cohort of 139 clinically stable schizophrenia patients was selected by consecutively screening patients diagnosed with schizophrenia who were attending the outpatient department of a university-affiliated psychiatric hospital in China. Participants' socio-demographic and clinical characteristics, including psychotic symptoms, depression and insight, as well as QOL and executive functions, were periodically assessed with standardized rating instruments. Patients received standard psychiatric care and were followed up for 1 year. Impaired insight was found to be common in stable Chinese schizophrenia patients (76.3%), with merely 5% showing improvement over the 1-year follow-up. Insight was inversely correlated with positive and negative symptoms at all but the 12-month assessment and with both the physical and mental components of QOL at baseline and the 12-month assessment. Insight was not associated with depressive symptoms or executive functions. Standard psychiatric care does not improve the level of insight in clinically stable Chinese schizophrenia outpatients, which warrants the introduction of specific therapeutic interventions that enhance insight. © 2011 Blackwell Publishing.

  4. Using data and quality monitoring to enhance maternity outcomes: a qualitative study of risk managers' perspectives.

    PubMed

    Simms, Rebecca A; Yelland, Andrew; Ping, Helen; Beringer, Antonia J; Draycott, Timothy J; Fox, Robert

    2014-06-01

    Risk management is a core part of healthcare practice, especially within maternity services, where litigation and societal costs are high. There has been little investigation into the experiences and opinions of those staff directly involved in risk management: lead obstetricians and specialist risk midwives, who are ideally placed to identify how current implementation of risk management strategies can be improved. A qualitative study of consultant-led maternity units in an English region. Semistructured interviews were conducted with the obstetric and midwifery risk management leads for each unit. We explored their approach to risk management, particularly their opinions regarding quality monitoring and related barriers/issues. Interviews were recorded, transcribed and thematically analysed. Twenty-seven staff from 12/15 maternity units participated. Key issues identified included: concern for the accuracy and validity of their local data, potential difficulties related to data collation, the negative impact of external interference by national regulatory bodies on local clinical priorities, the influence of the local culture of the maternity unit on levels of engagement in the risk management process, and scepticism about the value of benchmarking of maternity units without adjustment for population characteristics. Local maternity risk managers may provide valuable, clinically relevant insights into current issues in clinical data monitoring. Improvements should focus on the accuracy and ease of data collation with a need for an agreed maternity indicators set, populated from validated databases, and not reliant on data collection systems that distract clinicians from patient activity and quality improvement. It is clear that working relationships between risk managers, their own clinical teams and external national bodies require improvement and alignment. Further discussion regarding benchmarking between maternity units is required prior to implementation

  5. Top management and management science: An exploratory study in 15 Federal civilian agencies

    NASA Technical Reports Server (NTRS)

    White, M. J.

    1971-01-01

    A study of the relation between top managers in Federal agencies and the operations research and management science (OR/MS) group is reported. Sixteen managers were questioned about the following characteristics: closeness of top managers to OR/MS groups; top managers' attitudes toward the OR/MS activities; relation between closeness and these attitudes; and top managers' use of OR/MS groups. It is concluded that OR/MS is relevant to many top managers and that OR/MS has begun to play a role in decisions. Top management attitudes and actions are not related in obvious ways. The consequences to top management's use of and closeness to an OR/MS group need not be the success of the group as a professional, innovative, research-oriented unit.

  6. Space station human productivity study. Volume 5: Management plans

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The 67 Management Plans represent recommended study approaches for resolving 108 of the 305 Issues which were identified. Each study Management Plan is prepared in three formats: Management Plan Overview (lists the subsumed Issues, study background, and related overview information); Study Plan (details the study approach by tasks, lists special needs, and describes expected study products); Schedule-Task Flow (provides a time-lined schedule for the study tasks and resource requirements). The Management Relationships Matrix, included in this volume, shows the data input-output relationships among all recommended studies. A listing is also included which cross-references the unresolved requirements to Issues to management plans. A glossary of all abbreviations utilized is provided.

  7. Nurse managers' work life quality and their participation in knowledge management: a correlational study.

    PubMed

    Hashemi Dehaghi, Zahra; Sheikhtaheri, Abbas; Dehnavi, Fariba

    2015-01-01

    The association between quality of work life and participation in knowledge management is unknown. This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management. This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach's alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson's correlation coefficient and linear regression. Nurse managers' performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P < 0.001). The strongest correlations were found between implementation of knowledge management and participation of nurse managers in decision making (r = 0.82; P < 0.001). Improvement of nurse managers' work life quality, especially in decision-making, may increase their participation in implementing knowledge management.

  8. Insight and psychosis: comparing the perspectives of patient, entourage and clinician.

    PubMed

    Tranulis, Constantin; Corin, Ellen; Kirmayer, Laurence J

    2008-05-01

    The construct of insight in psychosis assumes congruence between patient and clinician views of the meaning of symptoms and experience. Current definitions and measures of insight do not give systematic attention to the impact of interpersonal, cultural and socio-economic contexts. We hypothesized that socio-cultural factors influence insight in patients with schizophrenia. We tested this hypothesis through comparison of insight in 18 triads, each composed of a patient, a family member and a clinician. The sample consisted of patients who were first diagnosed with psychosis in the last two years, and who were either immigrants from Africa or the Caribbean Islands, or Canadian born. Insight was assessed by analysis of narratives collected from patients, family members and clinicians for a research project on the negotiation of treatment. Each narrative was scored for insight along multiple dimensions with the Extracted Insight Scale (EIS), developed for this project. There was a significant correlation of insight on the EIS between patients and family members (r= 0.51, p= 0.03) but not between patient and clinician or family and clinician. The mean levels of insight across the three groups were comparable. Qualitative analysis of the illness narratives suggested that insight was based on the meanings constructed around psychotic experiences and that the process of interpreting and attributing psychotic experiences reflected each person's cultural background, life experiences, and other social determinants, especially stigma. Forms of insight can occur in the context of discordance or disagreement with the clinician's opinion. We present a testable model of the sociocultural determinants of insight that can guide future studies.

  9. NCCN Guidelines Insights: Non-Hodgkin's Lymphomas, Version 3.2016.

    PubMed

    Horwitz, Steven M; Zelenetz, Andrew D; Gordon, Leo I; Wierda, William G; Abramson, Jeremy S; Advani, Ranjana H; Andreadis, C Babis; Bartlett, Nancy; Byrd, John C; Fayad, Luis E; Fisher, Richard I; Glenn, Martha J; Habermann, Thomas M; Lee Harris, Nancy; Hernandez-Ilizaliturri, Francisco; Hoppe, Richard T; Kaminski, Mark S; Kelsey, Christopher R; Kim, Youn H; Krivacic, Susan; LaCasce, Ann S; Lunning, Matthew; Nademanee, Auayporn; Press, Oliver; Rabinovitch, Rachel; Reddy, Nishitha; Reid, Erin; Roberts, Kenneth; Saad, Ayman A; Sokol, Lubomir; Swinnen, Lode J; Vose, Julie M; Yahalom, Joachim; Zafar, Nadeem; Dwyer, Mary; Sundar, Hema; Porcu, Pierluigi

    2016-09-01

    Peripheral T-cell lymphomas (PTCLs) represent a relatively uncommon heterogeneous group of non-Hodgkin's lymphomas (NHLs) with an aggressive clinical course and poor prognosis. Anthracycline-based multiagent chemotherapy with or without radiation therapy followed by first-line consolidation with high-dose therapy followed by autologous stem cell rescue (HDT/ASCR) is the standard approach to most of the patients with newly diagnosed PTCL. Relapsed or refractory disease is managed with second-line systemic therapy followed by HDT/ASCR or allogeneic stem cell transplant, based on the patient's eligibility for transplant. In recent years, several newer agents have shown significant activity in patients with relapsed or refractory disease across all 4 subtypes of PTCL. These NCCN Guideline Insights highlight the important updates to the NCCN Guidelines for NHL, specific to the management of patients with relapsed or refractory PTCL. Copyright © 2016 by the National Comprehensive Cancer Network.

  10. Applying Fourth Generation Management to Access Services: Reinventing Customer Service and Process Management

    ERIC Educational Resources Information Center

    Hasty, Douglas F.

    2004-01-01

    Are librarians doing all they can to ensure that customer services are delivered with the customer in mind? Librarians are great at helping, but we sometimes need help with identifying customers, defining their needs, developing services, and reviewing the processes behind the services. Fourth Generation Management provides new insight for…

  11. Self-Managed Studying in College Courses.

    ERIC Educational Resources Information Center

    Edwards, K. Anthony

    In an introductory psychology course, students were taught some principles of "adjustment" using self-management techniques and were required to conduct a self-management project. The four student projects reported herein were specifically designed to improve study skills through use of Premack's principle and stimulus control. Course…

  12. Insight, symptoms and executive functions in schizophrenia.

    PubMed

    Simon, Andor E; Berger, Gregor E; Giacomini, Véronique; Ferrero, François; Mohr, Sylvia

    2006-09-01

    We investigated the relationship of insight with executive functions and symptoms in a group of stabilised inpatients with schizophrenia. Executive functions using an extensive battery constituted of several tests as well as psychopathology were assessed in 38 inpatients with a DSM-IV diagnosis of schizophrenia. Insight was assessed with the Scale to assess Unawareness of Mental Disorder (SUMD). A principal component analysis of the insight dimensions revealed a three-factor model which accounted for 98% of the variance. Of particular interest is the finding that a composite factor that accounted for 74% of the variance covered insight dimensions that represent a higher degree of insight (awareness of mental disorder, its social consequences, and attribution of symptoms). Only an association between letter fluency and this composite factor was found, which was weakly mediated by depressive symptoms. A stepwise multiple regression analysis revealed a relationship between antipsychotic dose and awareness of medication effect. No association of illness duration and insight was found. The findings of partial association between dimensions of insight and measures of executive function supports the growing evidence that insight is a multidimensional phenomenon. Accordingly, they emphasise that in the framework of therapeutic interventions, enhancement of higher levels of insight needs to take into account that patients suffering from schizophrenia have differential impairment in insight dimensions.

  13. Is it me? Verbal self-monitoring neural network and clinical insight in schizophrenia

    PubMed Central

    Sapara, Adegboyega; ffytche, Dominic H.; Cooke, Michael A.; Williams, Steven C.R.; Kumari, Veena

    2015-01-01

    Self-monitoring, defined as the ability to distinguish between self-generated stimuli from other-generated ones, is known to be impaired in schizophrenia. This impairment has been theorised as the basis for many of the core psychotic symptoms, in particular, poor clinical insight. This study aimed to investigate verbal self-monitoring related neural substrates of preserved and poor clinical insight in schizophrenia. It involved 40 stable schizophrenia outpatients, 20 with preserved and 20 with poor insight, and 20 healthy participants. All participants underwent functional magnetic resonance imaging with brain coverage covering key areas in the self-monitoring network during a verbal self-monitoring task. Healthy participants showed higher performance accuracy and greater thalamic activity than both preserved and poor insight patient groups. Preserved insight patients showed higher activity in the putamen extending into the caudate, insula and inferior frontal gyrus, compared to poor insight patients, and in the anterior cingulate and medial frontal gyrus, compared to healthy participants. Poor insight patients did not show greater activity in any brain area compared to preserved insight patients or healthy participants. Future studies may pursue therapeutic avenues, such as meta-cognitive therapies to promote self-monitoring or targeted stimulation of relevant brain areas, as means of enhancing insight in schizophrenia. PMID:26549744

  14. Depression in schizophrenia: the influence of the different dimensions of insight.

    PubMed

    Misdrahi, David; Denard, Sophie; Swendsen, Joel; Jaussent, Isabelle; Courtet, Philippe

    2014-04-30

    Improving insight in patients with schizophrenia appears necessary to enhance medication adherence and clinical outcome, but in some patients acquiring insight can paradoxically increase hopelessness, depression and suicidal behavior. The aim of this study is to explore the association of two dimensions of insight (cognitive and clinical) with depression, hopelessness and clinical variables in patients with psychosis. Using a cross-sectional design, 61 remitted outpatients meeting DSM-IV criteria for schizophrenia or schizoaffective disorders were included. Insight was assessed using the "Scale to Assess Unawareness of Mental Disorder" (SUMD), the PANSS-item G12 and the Beck Cognitive Insight Scale (BCIS). Overall, 41.2% of the sample had a history of suicide attempts. Patients in the high clinical insight group had significantly higher depression scores, higher hopelessness scores, greater histories of suicide attempts and were more likely to have received psychoeducation. Compared to patients with low cognitive insight, those with high overall cognitive insight were significantly more depressed and had more often received psychoeducation. Greater insight may have negative consequences in terms of depressive symptoms and therefore presents a challenge to clinicians in assessing the individual risks and benefits of strategies intended to enhance awareness of mental disorder. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Correlates of insight into different symptom dimensions in obsessive-compulsive disorder.

    PubMed

    Fontenelle, Jùlia M; Harrison, Ben J; Santana, Lívia; Conceição do Rosário, Maria; Versiani, Marcio; Fontenelle, Leonardo F

    2013-02-01

    In this study, we evaluated insight into different obsessive-compulsive disorder (OCD) symptom dimensions and their impact on clinical and sociodemographic features of patients with OCD. Sixty OCD patients were assessed with the Brown Assessment of Beliefs Scale (BABS), the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version, the Beck Depression Inventory, and the Sheehan Disability Scale. Two methods of using BABS were employed: 1) a traditional approach, which considers a composite of the insight into existing OCD symptoms, and 2) an alternative approach, which includes assessments of insight into each OCD symptom dimension separately. Composite BABS scores correlated with global severity of OCD and depressive symptoms, and degree of interference on social life/leisure activities and family life/home responsibilities. Dimension-specific correlations between severity of symptoms and insight ranged from very high (P = .87, for hoarding) to moderate (P = .61, for miscellaneous symptoms). Greater severity of depression and concomitant generalized anxiety disorder were independently associated with lower levels of insight into aggressive/checking symptoms. While earlier-onset OCD was associated with lower insight into sexual/religious and symmetry symptoms, later-onset OCD displayed lower insight into hoarding. Assessing insight into dimension-specific OCD symptoms may challenge the existence of clear-cut OCD with fair or poor insight.

  16. Insight in psychotic disorder: relation with psychopathology and frontal lobe function.

    PubMed

    Kumar, Atmesh; Sharma, Pranjal; Das, Shyamanta; Nath, Kamal; Talukdar, Uddip; Bhagabati, Dipesh

    2014-01-01

    Through conceptualising poor insight in psychotic disorders as a form of anosognosia, frontal lobe dysfunction is often ascribed a vital role in its pathogenesis. The objective of this study was to compare the relation of insight in patients with psychotic illness to that of psychopathology and frontal lobe function. Forty patients with psychotic disorder were selected from those attending the Department of Psychiatry in a tertiary care teaching hospital. The evaluation of insight was carried out using the Schedule for Assessment of Insight (SAI), that of frontal lobe function by the Frontal Assessment Battery (FAB) and psychopathology by the Brief Psychiatric Rating Scale (BPRS). The correlation coefficients were determined. A negative correlation between SAI and BPRS scores means that the BPRS score is opposite to SAI scores. When the SAI total score was compared with the FAB total score, the correlation coefficient demonstrated a positive correlation. Better insight predicted lesser psychopathology and also that poor insight would exist with greater psychopathology. Better insight predicted a higher functional status of frontal lobes and prefrontal cortex in particular. Insight deficits in schizophrenia and other psychotic illnesses are multidimensional. Integration of different aetiological factors like biological, psychopathological, environmental ones and others are necessary for a better understanding of insight in psychosis. Copyright © 2013 S. Karger AG, Basel.

  17. Using Facebook Page Insights Data to Determine Posting Best Practices in an Academic Health Sciences Library

    ERIC Educational Resources Information Center

    Houk, Kathryn M.; Thornhill, Kate

    2013-01-01

    Tufts University Hirsh Health Sciences Library created a Facebook page and a corresponding managing committee in March 2010. Facebook Page Insights data collected from the library's Facebook page were statistically analyzed to investigate patterns of user engagement. The committee hoped to improve posting practices and increase user engagement…

  18. Scoring the importance of tropical forest landscapes with local people: patterns and insights.

    PubMed

    Sheil, Douglas; Liswanti, Nining

    2006-07-01

    Good natural resource management is scarce in many remote tropical regions. Improved management requires better local consultation, but accessing and understanding the preferences and concerns of stakeholders can be difficult. Scoring, where items are numerically rated in relation to each other, is simple and seems applicable even in situations where capacity and funds are limited, but managers rarely use such methods. Here we investigate scoring with seven indigenous communities threatened by forest loss in Kalimantan, Indonesia. We aimed to clarify the forest's multifaceted importance, using replication, cross-check exercises, and interviews. Results are sometimes surprising, but generally explained by additional investigation that sometimes provides new insights. The consistency of scoring results increases in line with community literacy and wealth. Various benefits and pitfalls are identified and examined. Aside from revealing and clarifying local preferences, scoring has unexplored potential as a quantitative technique. Scoring is an underappreciated management tool with wide potential.

  19. Insightful practice: a reliable measure for medical revalidation

    PubMed Central

    Guthrie, Bruce; Sullivan, Frank M; Mercer, Stewart W; Russell, Andrew; Bruce, David A

    2012-01-01

    Background Medical revalidation decisions need to be reliable if they are to reassure on the quality and safety of professional practice. This study tested an innovative method in which general practitioners (GPs) were assessed on their reflection and response to a set of externally specified feedback. Setting and participants 60 GPs and 12 GP appraisers in the Tayside region of Scotland, UK. Methods A feedback dataset was specified as (1) GP-specific data collected by GPs themselves (patient and colleague opinion; open book self-evaluated knowledge test; complaints) and (2) Externally collected practice-level data provided to GPs (clinical quality and prescribing safety). GPs' perceptions of whether the feedback covered UK General Medical Council specified attributes of a ‘good doctor’ were examined using a mapping exercise. GPs' professionalism was examined in terms of appraiser assessment of GPs' level of insightful practice, defined as: engagement with, insight into and appropriate action on feedback data. The reliability of assessment of insightful practice and subsequent recommendations on GPs' revalidation by face-to-face and anonymous assessors were investigated using Generalisability G-theory. Main outcome measures Coverage of General Medical Council attributes by specified feedback and reliability of assessor recommendations on doctors' suitability for revalidation. Results Face-to-face assessment proved unreliable. Anonymous global assessment by three appraisers of insightful practice was highly reliable (G=0.85), as were revalidation decisions using four anonymous assessors (G=0.83). Conclusions Unlike face-to-face appraisal, anonymous assessment of insightful practice offers a valid and reliable method to decide GP revalidation. Further validity studies are needed. PMID:22653078

  20. Comparing Dutch case management care models for people with dementia and their caregivers: The design of the COMPAS study.

    PubMed

    MacNeil Vroomen, Janet; Van Mierlo, Lisa D; van de Ven, Peter M; Bosmans, Judith E; van den Dungen, Pim; Meiland, Franka J M; Dröes, Rose-Marie; Moll van Charante, Eric P; van der Horst, Henriëtte E; de Rooij, Sophia E; van Hout, Hein P J

    2012-05-28

    stakeholders based on the theoretical model of adaptive implementation are planned. This study provides relevant insights into care processes, description of two case management models along with clinical and economic data from persons with dementia and caregivers to clarify important differences in two case management care models compared to usual care.

  1. Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study

    PubMed Central

    2012-01-01

    -structured interviews with stakeholders based on the theoretical model of adaptive implementation are planned. Discussion This study provides relevant insights into care processes, description of two case management models along with clinical and economic data from persons with dementia and caregivers to clarify important differences in two case management care models compared to usual care. PMID:22640695

  2. InSight Spacecraft Lift to Spin Table & Pre-Spin Processing

    NASA Image and Video Library

    2018-03-28

    In the Astrotech facility at Vandenberg Air Force Base in California, technicians and engineers inspect NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, spacecraft after it was placed on a spin table during preflight processing. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  3. InSight Lift/Mate to PLA with SC to GTV

    NASA Image and Video Library

    2018-04-11

    In the Astrotech facility at Vandenberg Air Force Base in California, technicians and engineers monitor progress as NASA's Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, or InSight, Mars lander is prepared for encapsulation in its payload fairing. InSight will be the first mission to look deep beneath the Martian surface. It will study the planet's interior by measuring its heat output and listen for marsquakes. The spacecraft will use the seismic waves generated by marsquakes to develop a map of the planet’s deep interior. The resulting insight into Mars’ formation will provide a better understanding of how other rocky planets, including Earth, were created. InSight is scheduled for liftoff May 5, 2018.

  4. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol.

    PubMed

    Lemmens, Karin M M; Rutten-Van Mölken, Maureen P M H; Cramm, Jane M; Huijsman, Robbert; Bal, Roland A; Nieboer, Anna P

    2011-01-10

    Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost-effectiveness of a disease management

  5. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol

    PubMed Central

    2011-01-01

    Background Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. Methods To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. Discussion The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost

  6. Muslim Women in Graduate Studies: Some Insights into the Accessibility of Higher Education for Minority Women Students

    ERIC Educational Resources Information Center

    Oplatka, Izhar; Lapidot, Orit

    2012-01-01

    Based on semi-structured interviews with 11 Muslim women graduate students in Israel, the current study provides insight into the determinants enabling this group of women in the Arab sector to apply for a second degree and succeed. Among these determinants are the family, the high school, the individual's personal drive for learning, the…

  7. How rural land use management facilitates drought risk adaptation in a changing climate - A case study in arid northern China.

    PubMed

    Lei, Yongdeng; Zhang, Hailin; Chen, Fu; Zhang, Linbo

    2016-04-15

    Under a warming climate, frequent drought and water scarcity in northern China have severely disrupted agricultural production and posed a substantial threat to farmers' livelihoods. Based on first-hand data collected through in-depth interviews with local managers and farmer households, this study evaluated the effectiveness of rural land use management in mitigating drought risk, ensuring food security and improving farmers' livelihoods. Our findings indicate that a) reforestation on low-yield cropland not only can improve the eco-environment but can also prominently mitigate the production risk to local farmers; b) replacing the traditional border irrigation with sprinkler irrigation has substantially curbed agricultural water usage and increased the per unit of output; and c) in recent years, instead of planting water-intensive grain crops, local farmers cultivated more forage crops to raise animals, which greatly diversified their income sources and reduced the drought risk of agricultural production. By performing an empirical case study in drought-prone Inner Mongolia, this study provides decision-makers with insights into how to strategically adapt to drought risk and reduce rural poverty within the broader context of climate change. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Barriers to Managing Fertility: Findings From the Understanding Fertility Management in Contemporary Australia Facebook Discussion Group.

    PubMed

    Holton, Sara; Rowe, Heather; Kirkman, Maggie; Jordan, Lynne; McNamee, Kathleen; Bayly, Christine; McBain, John; Sinnott, Vikki; Fisher, Jane

    2016-02-15

    As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. To identify public opinion about sexual and reproductive health in Australia. To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health.

  9. The role of leadership perception as a mediator between managers' self-monitoring and subordinate attitudes.

    PubMed

    Özalp Türetgen, Ilknur; Unsal, Pinar; Dural, Uzay

    2017-01-01

    Although the role of social cognition in leadership perception has been emphasized frequently in recent years, research using this approach in an organizational context is rare. This study investigated subordinates' perceptions of their managers as leaders (that is, to what extent they perceive their manager as a leader) as a potential mediating factor explaining the relationship between managers' self-monitoring and their subordinates' attitudes toward their organizations. The study was carried out with middle-level managers (N = 64) and their subordinates (N = 210) from various business organizations in Turkey. Results indicate that subordinates' leadership perceptions of their managers mediate the relationship between managers' self-monitoring and their subordinates' affective and normative organizational commitment. These results provide insight into some of the antecedents and outcomes of leadership perception.

  10. Insight and gender in schizophrenia and other psychoses.

    PubMed

    Cobo, Jesus; Nieto, Lourdes; Ochoa, Susana; Pousa, Esther; Usall, Judith; Baños, Iris; González, Beatriz; Ruiz, Isabel; Ruiz, Ada I

    2016-09-30

    This study aimed to evaluate gender differences in the deficit of insight in psychosis and determine influences of clinical, functional, and sociodemographic variables. A multicenter sample of 401 adult patients with schizophrenia and other psychotic disorders who agreed to participate was evaluated in four centers of the metropolitan area of Barcelona (Catalonia). Psychopathological assessment was performed using the Positive and Negative Syndrome Scale Lindenmayers' Factors. Insight and its dimensions were assessed by means of the Scale of Unawareness of Mental Disorder. Significant differences were apparent neither between men and women in the three dimensions of insight, nor in the total awareness, nor in the total attribution subscales. However, statistically significant differences were found in awareness and attribution of particular symptoms. Women showed a worse awareness of thought disorder and alogia and a higher misattribution of apathy. Higher cognitive and positive symptoms, early stage of the illness, and having been married explained deficits of insight dimensions in women. In men, other variables such as lower functioning, higher age, other psychosis diagnosis, and, to a lower extent, higher scores in cognitive, positive, and excitative symptoms, explained deficits of insight dimensions. These data could help to design gender-specific preventive and therapeutic strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Understanding Insight in the Context of Q

    ERIC Educational Resources Information Center

    Coghlan, David

    2012-01-01

    In Revans' learning formula, L = P + Q, Q represents "questioning insight", by which Revans means that insight comes out of the process of questioning programmed knowledge (P) in the light of experience. We typically focus on the content of an insight rather than on the act of insight. Drawing primarily on the work of Bernard Lonergan this paper…

  12. Relationship of self-management to personality types and indices.

    PubMed

    Williams, R L; Verble, J S; Price, D E; Layne, B H

    1995-06-01

    This study addressed the relationship between self-management (as measured by the Lifestyle Approaches Inventory, Williams, Moore, Pettibone, & Thomas, 1992) and personality types and indexes (as measured by the Myers-Briggs Type Indicator, Myers & McCaulley, 1985) in a sample of 347 university students. Correlational analyses indicated that the self-management factor most consistently linked to the Myers-Briggs indices was Organization of Physical Space. The Myers-Briggs index most consistently correlated with the self-management factors was Judgment-Perception. Overall, male and female subjects showed similar patterns of relationships between the self-management and personality indices. When the self-management scores were compared for the various Myers-Briggs types, the analysis indicated that types having a J (planful and organized) or S (precise and practical) in the typology tended to score higher than those having a P (spontaneous and flexible) or N (imaginative and insightful).

  13. Insights from Earth Sciences into Human Evolution studies: The example of prehistoric landscape use in Africa and the Levant

    NASA Astrophysics Data System (ADS)

    Devès, Maud H.; Reynolds, Sally; King, Geoffrey C. P.; Kuebler, Simon; Sturdy, Derek; Godet, Nan

    2015-07-01

    Fossil remains are embedded in a continually evolving landscape. Earth scientists have the methods and approaches to study the processes that shape the landscape at various temporal and spatial scales. Some of these methods can generate insights that are of potential use for researchers in other fields, such as archaeology and palaeoanthropology. Here we present two case studies to illustrate how a broader landscape perspective can provide new insights into the land use by Pliocene hominins in southern Africa, and more recently, by Palaeolithic hominins in the southern Levant. Key landscape attributes can help explain why humans, hominins and the wider animal community exploit certain types of landscapes in predictable ways. Our first case study examines how active tectonics or volcanism appears to be important in creating fertile regions with reliable water sources and complex topography. While relatively easy for agile primates such as hominins to negotiate, zones of complex topography are harder for certain predators and prey animals to traverse. In the second case study, we consider that differences in soil edaphics can exert a major control on animals by supplying or failing to supply necessary trace elements, such as selenium, copper, phosphate and potassium (Henkin et al., 1995). We show that the pattern of trace element distribution can accurately map animal movements between areas of suitable grazing. This predictability could have enabled Levantine humans to ambush megafauna during these seasonal migrations. By studying the landscape attributes around fossil site locations, Earth scientists can offer new insights and perspectives into the past, particularly on the ways in which the inhabitants would have used their landscapes.

  14. Insight, self-stigma and psychosocial outcomes in Schizophrenia: a structural equation modelling approach.

    PubMed

    Lien, Y-J; Chang, H-A; Kao, Y-C; Tzeng, N-S; Lu, C-W; Loh, C-H

    2018-04-01

    Poor insight is prevalent in patients with schizophrenia and has been associated with acute illness severity, medication non-adherence and poor treatment outcomes. Paradoxically, high insight has been associated with various undesirable outcomes, including low self-esteem, depression and low subjective quality of life (QoL) in patients with schizophrenia. Despite the growing body of studies conducted in Western countries supporting the pernicious effects of improved insight in psychosis, which bases on the level of self-stigma, the effects are unclear in non-Western societies. The current study examined the role of self-stigma in the relationship between insight and psychosocial outcomes in a Chinese population. A total of 170 outpatients with schizophrenia spectrum disorders were recruited from two general university hospitals. Sociodemographic data and clinical variables were recorded and self-report scales were employed to measure self-stigma, depression, insight, self-esteem and subjective QoL. Structural equation modelling (SEM) was used to analyse the cross-sectional data. High levels of self-stigma were reported by 39% of the participants (n = 67). The influences of insight, self-stigma, self-esteem and depression on subjective QoL were confirmed by the SEM results. Our model with the closest fit to the data (χ 2 = 33.28; df = 20; p = 0.03; χ 2/df = 1.66; CFI = 0.98; TLI = 0.97; RMSEA = 0.06) demonstrated that self-stigma might fully mediate the association of insight with low self-esteem, depression and poor subjective QoL. High insight into illness contributed to self-stigma, which caused low self-esteem and depression and, consequently, low QoL. Notably, insight did not directly affect self-esteem, depression or QoL. Furthermore, the association of insight with poor psychosocial outcomes was not moderated by self-stigma. Our findings support the mediating model of insight relevant to the poor psychosocial outcomes of individuals diagnosed with

  15. Management of everyday work in Emergency Departments - an exploratory study with Swedish Managers.

    PubMed

    Andersson, Henrik; Wireklint Sundström, Birgitta; Nilsson, Kerstin; Jakobsson Ung, Eva

    2014-10-01

    Through their formal mandate, position and authority, managers are responsible for managing everyday work in Emergency Departments (EDs) as well as striving for excellence and dealing with the individual needs of practitioners and patients. The aim of the present study is to explore managers' experiences of managing everyday work in Swedish EDs. A qualitative and exploratory design has been used in this study. Seven managers were interviewed at two EDs. Data was analysed using qualitative content analysis with focus on latent content. Managers experience everyday work in the ED as lifesaving work. One of the characteristics of their approach to everyday work is their capability for rapidly identifying patients with life-threatening conditions and for treating them accordingly. The practitioners are on stand-by in order to deal with unexpected situations. This implies having to spend time waiting for the physicians' decisions. Management is characterised by a command and control approach. The managers experience difficulties in meeting the expectations of their staff. They strive to be proactive but instead they become reactive since the prevailing medical, bureaucratic and production-orientated systems constrain them. The managers demonstrate full compliance with the organisational systems. This threatens to reduce their freedom of action and influences the way they perform their managerial duties within and outside the EDs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. New developments concerning health care financial management.

    PubMed

    Drati, Nathan; Kleiner, Brian

    2005-01-01

    Managed care has become one of the leading developments in health care financial management, but ignorance and confusion surround its meaning and origins. Managed care seeks to reduced costs and increase profits while maintaining quality, yet the evidence that it is able to achieve these aims is mixed. The following analysis is a review of the events leading to the establishment of managed care and what it has become. Various terms and health care organizations involved in managed care are identified, with emphasis placed on the strengths and weaknesses of managed care programs. This analysis is performed to gain insight and better understanding of the direction health care financial management is headed in the 21st century.

  17. Independent evaluation: insights from public accounting.

    PubMed

    Brown, Abigail B; Klerman, Jacob Alex

    2012-06-01

    Maintaining the independence of contract government program evaluation presents significant contracting challenges. The ideal outcome for an agency is often both the impression of an independent evaluation and a glowing report. In this, independent evaluation is like financial statement audits: firm management wants both a public accounting firm to attest to the fairness of its financial accounts and to be allowed to account for transactions as it sees fit. In both cases, the evaluation or audit is being conducted on behalf of outsiders--the public or shareholders--but is overseen by a party with significant interests at stake in the outcome-the agency being evaluated or executive management of the firm. We review the contracting strategies developed to maintain independence in auditing. We examine evidence on the effectiveness of professionalism, reputation, liability and owner oversight in constraining behavior in auditing. We then establish parallels with contracting for evaluations and apply these insights to changes that might maintain and improve evaluator independence. By analogy with the Sarbanes Oxley Act of 2002 reforms in auditing, we recommend exploring using a reformulated Technical Working Group to encourage more prompt release of more evaluation results and to help insulate evaluators from inappropriate pressure to change their results or analysis approach.

  18. Hospital contract management: a descriptive profile.

    PubMed Central

    Alexander, J A; Lewis, B L

    1984-01-01

    Despite the dramatic growth in hospital contract management in the last decade, research only recently has begun to provide insights into the structure, operation, and effectiveness of these arrangements. Two descriptive questions regarding hospital contract management are addressed in an effort to increase correspondence between theoretical and evaluative research in this area: (1) how do contract-managed hospitals differ from traditionally managed hospitals? and (2) how do contract-managed hospitals differ from each other? Principal discriminating variables in the analyses are hospital size, control, urban-rural location, region, management organization control, and management organization size. Results of the analysis on a sample of 406 contract-managed hospitals and 401 unaffiliated hospitals reveal important differences between contract-managed and traditionally managed hospitals as well as among contract management organizations. These findings are discussed in terms of their implications for future research and performance evaluations on contract management arrangements. PMID:6490376

  19. Does Solving Insight-Based Problems Differ from Solving Learning-Based Problems? Some Evidence from an ERP Study

    ERIC Educational Resources Information Center

    Leikin, Roza; Waisman, Ilana; Leikin, Mark

    2016-01-01

    We asked: "What are the similarities and differences in mathematical processing associated with solving learning-based and insight-based problems?" To answer this question, the ERP research procedure was employed with 69 male adolescent subjects who solved specially designed insight-based and learning-based tests. Solutions of…

  20. Shipping InSight Mars Spacecraft to California for Launch

    NASA Image and Video Library

    2018-02-28

    Personnel supporting NASA's InSight mission to Mars load the crated InSight spacecraft into a C-17 cargo aircraft at Buckley Air Force Base, Denver, for shipment to Vandenberg Air Force Base, California. The spacecraft, built in Colorado by Lockheed Martin Space, was shipped February 28, 2018, in preparation for launch from Vandenberg in May 2018. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is the first mission dedicated to studying the deep interior of Mars. Its findings will advance understanding of the early history of all rocky planets, including Earth. https://photojournal.jpl.nasa.gov/catalog/PIA22220

  1. Shipping InSight Mars Spacecraft to California for Launch

    NASA Image and Video Library

    2018-02-28

    Personnel supporting NASA's InSight mission to Mars load the crated InSight spacecraft into a C-17 cargo aircraft at Buckley Air Force Base, Denver, for shipment to Vandenberg Air Force Base, California. The spacecraft, built in Colorado by Lockheed Martin Space, was shipped February 28, 2018, in preparation for launch from Vandenberg in May 2018. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is the first mission dedicated to studying the deep interior of Mars. Its findings will advance understanding of the early history of all rocky planets, including Earth. https://photojournal.jpl.nasa.gov/catalog/PIA22252

  2. Shipping InSight Mars Spacecraft to California for Launch

    NASA Image and Video Library

    2018-02-28

    Personnel supporting NASA's InSight mission to Mars load the crated InSight spacecraft into a C-17 cargo aircraft at Buckley Air Force Base, Denver, for shipment to Vandenberg Air Force Base, California. The spacecraft, built in Colorado by Lockheed Martin Space, was shipped February 28, 2018, in preparation for launch from Vandenberg in May 2018. InSight, short for Interior Exploration using Seismic Investigations, Geodesy and Heat Transport, is the first mission dedicated to studying the deep interior of Mars. Its findings will advance understanding of the early history of all rocky planets, including Earth. https://photojournal.jpl.nasa.gov/catalog/PIA22253

  3. Nutritional Management of Acute Diarrhea in Infants and Children.

    ERIC Educational Resources Information Center

    National Academy of Sciences-National Research Council, Washington, DC. Food and Nutrition Board.

    Written primarily for health professionals advising on programs and policy related to nutrition and diarrhea therapy, this report is aimed at management of diarrhea in less-developed countries, but its information and technical insights are relevant to an understanding of diarrhea and its management throughout the world. Technical in orientation…

  4. Is it me? Verbal self-monitoring neural network and clinical insight in schizophrenia.

    PubMed

    Sapara, Adegboyega; Ffytche, Dominic H; Cooke, Michael A; Williams, Steven C R; Kumari, Veena

    2015-12-30

    Self-monitoring, defined as the ability to distinguish between self-generated stimuli from other-generated ones, is known to be impaired in schizophrenia. This impairment has been theorised as the basis for many of the core psychotic symptoms, in particular, poor clinical insight. This study aimed to investigate verbal self-monitoring related neural substrates of preserved and poor clinical insight in schizophrenia. It involved 40 stable schizophrenia outpatients, 20 with preserved and 20 with poor insight, and 20 healthy participants. All participants underwent functional magnetic resonance imaging with brain coverage covering key areas in the self-monitoring network during a verbal self-monitoring task. Healthy participants showed higher performance accuracy and greater thalamic activity than both preserved and poor insight patient groups. Preserved insight patients showed higher activity in the putamen extending into the caudate, insula and inferior frontal gyrus, compared to poor insight patients, and in the anterior cingulate and medial frontal gyrus, compared to healthy participants. Poor insight patients did not show greater activity in any brain area compared to preserved insight patients or healthy participants. Future studies may pursue therapeutic avenues, such as meta-cognitive therapies to promote self-monitoring or targeted stimulation of relevant brain areas, as means of enhancing insight in schizophrenia. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  5. The effects of gender and self-insight on early semantic processing.

    PubMed

    Xu, Xu; Kang, Chunyan; Guo, Taomei

    2014-01-01

    This event-related potential (ERP) study explored individual differences associated with gender and level of self-insight in early semantic processing. Forty-eight Chinese native speakers completed a semantic judgment task with three different categories of words: abstract neutral words (e.g., logic, effect), concrete neutral words (e.g., teapot, table), and emotion words (e.g., despair, guilt). They then assessed their levels of self-insight. Results showed that women engaged in greater processing than did men. Gender differences also manifested in the relationship between level of self-insight and word processing. For women, level of self-insight was associated with level of semantic activation for emotion words and abstract neutral words, but not for concrete neutral words. For men, level of self-insight was related to processing speed, particularly in response to abstract and concrete neutral words. These findings provide electrophysiological evidence for the effects of gender and self-insight on semantic processing and highlight the need to take into consideration subject variables in related research.

  6. Reading skills, creativity, and insight: exploring the connections.

    PubMed

    Mourgues, Catalina V; Preiss, David D; Grigorenko, Elena L

    2014-08-04

    Studies of the relationship between creativity and specific reading disabilities have produced inconclusive results. We explored their relationship in a sample of 259 college students (age range: 17 to 38 years-old) from three Chilean universities. The students were tested on their verbal ability, creativity, and insight. A simple linear regression was performed on the complete sample, and on high- and low-achievement groups that were formed based on reading test scores. We observed a significant correlation in the total sample between outcomes on the verbal ability tasks, and on the creativity and insight tasks (range r =. 152 to r =. 356, ps <.001). Scores on the reading comprehension and phonological awareness tasks were the best predictors of performance on creativity and insight tasks (range β = .315 to β = .155, ps <.05). A comparison of the low- and high-scoring groups on verbal ability tasks yielded results to the same effect. These findings do not support the hypothesis that specific reading disability is associated with better performance on creative tasks. Instead, higher verbal ability was found to be associated with higher creativity and insight.

  7. Two-step adaptive management for choosing between two management actions

    USGS Publications Warehouse

    Moore, Alana L.; Walker, Leila; Runge, Michael C.; McDonald-Madden, Eve; McCarthy, Michael A

    2017-01-01

    Adaptive management is widely advocated to improve environmental management. Derivations of optimal strategies for adaptive management, however, tend to be case specific and time consuming. In contrast, managers might seek relatively simple guidance, such as insight into when a new potential management action should be considered, and how much effort should be expended on trialing such an action. We constructed a two-time-step scenario where a manager is choosing between two possible management actions. The manager has a total budget that can be split between a learning phase and an implementation phase. We use this scenario to investigate when and how much a manager should invest in learning about the management actions available. The optimal investment in learning can be understood intuitively by accounting for the expected value of sample information, the benefits that accrue during learning, the direct costs of learning, and the opportunity costs of learning. We find that the optimal proportion of the budget to spend on learning is characterized by several critical thresholds that mark a jump from spending a large proportion of the budget on learning to spending nothing. For example, as sampling variance increases, it is optimal to spend a larger proportion of the budget on learning, up to a point: if the sampling variance passes a critical threshold, it is no longer beneficial to invest in learning. Similar thresholds are observed as a function of the total budget and the difference in the expected performance of the two actions. We illustrate how this model can be applied using a case study of choosing between alternative rearing diets for hihi, an endangered New Zealand passerine. Although the model presented is a simplified scenario, we believe it is relevant to many management situations. Managers often have relatively short time horizons for management, and might be reluctant to consider further investment in learning and monitoring beyond collecting data

  8. Two-step adaptive management for choosing between two management actions.

    PubMed

    Moore, Alana L; Walker, Leila; Runge, Michael C; McDonald-Madden, Eve; McCarthy, Michael A

    2017-06-01

    Adaptive management is widely advocated to improve environmental management. Derivations of optimal strategies for adaptive management, however, tend to be case specific and time consuming. In contrast, managers might seek relatively simple guidance, such as insight into when a new potential management action should be considered, and how much effort should be expended on trialing such an action. We constructed a two-time-step scenario where a manager is choosing between two possible management actions. The manager has a total budget that can be split between a learning phase and an implementation phase. We use this scenario to investigate when and how much a manager should invest in learning about the management actions available. The optimal investment in learning can be understood intuitively by accounting for the expected value of sample information, the benefits that accrue during learning, the direct costs of learning, and the opportunity costs of learning. We find that the optimal proportion of the budget to spend on learning is characterized by several critical thresholds that mark a jump from spending a large proportion of the budget on learning to spending nothing. For example, as sampling variance increases, it is optimal to spend a larger proportion of the budget on learning, up to a point: if the sampling variance passes a critical threshold, it is no longer beneficial to invest in learning. Similar thresholds are observed as a function of the total budget and the difference in the expected performance of the two actions. We illustrate how this model can be applied using a case study of choosing between alternative rearing diets for hihi, an endangered New Zealand passerine. Although the model presented is a simplified scenario, we believe it is relevant to many management situations. Managers often have relatively short time horizons for management, and might be reluctant to consider further investment in learning and monitoring beyond collecting data

  9. Natural Resources Management: Course of Study.

    ERIC Educational Resources Information Center

    Ingvalson, Brian

    The document presents a course outline for the study of natural resources management by junior and senior year high school students. Basic information and practical experiences are offered to the student in the classroom and through several field trips in order to acquire more knowledge in various areas of natural resources and their management.…

  10. Market Orientation within University Schools of Business: Can a Dynamical Systems Viewpoint Applied to a Non-Temporal Data Set Yield Valuable Insights for University Managers?

    ERIC Educational Resources Information Center

    Cox, John C.; Webster, Robert L.; Hammond, Kevin L.

    2009-01-01

    This study investigates the use of using complexity theory--the study of nonlinear dynamical systems of which chaos and catastrophe theory are subsets--in the analysis of a non temporal data set to derive valuable insights into the functioning of university schools of business. The approach is unusual in that studies of nonlinearity in complex…

  11. Feeling the Insight: Uncovering Somatic Markers of the "aha" Experience.

    PubMed

    Shen, Wangbing; Tong, Yu; Yuan, Yuan; Zhan, Huijia; Liu, Chang; Luo, Jing; Cai, Houde

    2018-03-01

    Whether internal insight can be recognized by experiencing (somatic feeling) remains an unexplored problem. This study investigated the issue by examining potential somatic markers of the "aha" experience occurring at the moment of sudden insight. Participants were required to solve a set of compound remote associates (CRA) problems and were simultaneously monitored via electrodermal and cardiovascular recordings. The "aha"-related psychological components and somatic markers were determined by contrasting insightful solutions with non-insightful solutions. Results showed that the "aha" experience was an amalgam entailing positive affects and approached cognition accompanied by a greater mean skin conductance response (mSCR) amplitude and a marginally accelerated heart rate than the "no-aha" one. These results confirm and extend findings of the multidimensionality of the "aha" feeling and offer the first direct evidence of somatic markers, particularly an electrodermal signature of an "aha" feeling, which suggests a sudden insight could likely be experienced by individuals' external soma.

  12. Using a Learning Management System to Personalise Learning for Primary School Students

    ERIC Educational Resources Information Center

    Edmunds, Bronwyn; Hartnett, Maggie

    2014-01-01

    This paper reports on one aspect of a descriptive multiple-case study which set out to explore the role of a learning management system (LMS) in personalising learning for students from the perspective of three teachers in one primary school in New Zealand. The intention was to provide insight into the role the LMS could play in classrooms when…

  13. Knowledge and pharmacological management of Alzheimer's disease by managing community pharmacists: a nationwide study.

    PubMed

    Zerafa, Natalie; Scerri, Charles

    2016-12-01

    Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer's disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer's disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer's Disease Knowledge Scale and the Alzheimer's Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer's disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.

  14. Implementing a Nurse Manager Profile to Improve Unit Performance.

    PubMed

    Krugman, Mary E; Sanders, Carolyn L

    2016-06-01

    Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

  15. Entomopathogenic Fungi: New Insights into Host-Pathogen Interactions.

    PubMed

    Butt, T M; Coates, C J; Dubovskiy, I M; Ratcliffe, N A

    2016-01-01

    Although many insects successfully live in dangerous environments exposed to diverse communities of microbes, they are often exploited and killed by specialist pathogens. Studies of host-pathogen interactions (HPI) provide valuable insights into the dynamics of the highly aggressive coevolutionary arms race between entomopathogenic fungi (EPF) and their arthropod hosts. The host defenses are designed to exclude the pathogen or mitigate the damage inflicted while the pathogen responds with immune evasion and utilization of host resources. EPF neutralize their immediate surroundings on the insect integument and benefit from the physiochemical properties of the cuticle and its compounds that exclude competing microbes. EPF also exhibit adaptations aimed at minimizing trauma that can be deleterious to both host and pathogen (eg, melanization of hemolymph), form narrow penetration pegs that alleviate host dehydration and produce blastospores that lack immunogenic sugars/enzymes but facilitate rapid assimilation of hemolymph nutrients. In response, insects deploy an extensive armory of hemocytes and macromolecules, such as lectins and phenoloxidase, that repel, immobilize, and kill EPF. New evidence suggests that immune bioactives work synergistically (eg, lysozyme with antimicrobial peptides) to combat infections. Some proteins, including transferrin and apolipophorin III, also demonstrate multifunctional properties, participating in metabolism, homeostasis, and pathogen recognition. This review discusses the molecular intricacies of these HPI, highlighting the interplay between immunity, stress management, and metabolism. Increased knowledge in this area could enhance the efficacy of EPF, ensuring their future in integrated pest management programs. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Ancillary study management systems: a review of needs

    PubMed Central

    2013-01-01

    Background The valuable clinical data, specimens, and assay results collected during a primary clinical trial or observational study can enable researchers to answer additional, pressing questions with relatively small investments in new measurements. However, management of such follow-on, “ancillary” studies is complex. It requires coordinating across institutions, sites, repositories, and approval boards, as well as distributing, integrating, and analyzing diverse data types. General-purpose software systems that simplify the management of ancillary studies have not yet been explored in the research literature. Methods We have identified requirements for ancillary study management primarily as part of our ongoing work with a number of large research consortia. These organizations include the Center for HIV/AIDS Vaccine Immunology (CHAVI), the Immune Tolerance Network (ITN), the HIV Vaccine Trials Network (HVTN), the U.S. Military HIV Research Program (MHRP), and the Network for Pancreatic Organ Donors with Diabetes (nPOD). We also consulted with researchers at a range of other disease research organizations regarding their workflows and data management strategies. Lastly, to enhance breadth, we reviewed process documents for ancillary study management from other organizations. Results By exploring characteristics of ancillary studies, we identify differentiating requirements and scenarios for ancillary study management systems (ASMSs). Distinguishing characteristics of ancillary studies may include the collection of additional measurements (particularly new analyses of existing specimens); the initiation of studies by investigators unaffiliated with the original study; cross-protocol data pooling and analysis; pre-existing participant consent; and pre-existing data context and provenance. For an ASMS to address these characteristics, it would need to address both operational requirements (e.g., allocating existing specimens) and data management requirements

  17. Does self reflection and insight correlate with academic performance in medical students?

    PubMed Central

    2013-01-01

    Background Medical students in academic difficulty are often described as lacking insight. The Self Reflection and Insight Scale (SRIS) is a tool for measuring insight which has been validated in medical students. We investigated whether self reflection and insight scores correlate with academic performance in Year 4 medical students from a six year undergraduate medical degree, and whether self reflection and insight changes after one year of clinical training. Methods Self reflection and insight scores were measured in 162 students at the start of Year 4 at the University of Western Australia. Performance in end of year written and clinical exams was monitored and correlated with SRIS. Seventy of the students were surveyed again at the start of Year 5 to see if scores changed or were stable after one year of full time clinical training. Results We found no correlation between self reflection or insight and academic performance in written and clinical exams. There was a significant increase in recognition of the need for self reflection in Year 5 compared with Year 4. Conclusions While no correlation was found between this measure of self reflection and insight with academic performance, there was an increase in students’ recognition of the need for reflection after one year of clinical studies. This study is a valuable first step towards a potentially exciting research domain and warrants further longitudinal evaluation with larger cohorts of students using additional measures of achievement. PMID:23971859

  18. Does self reflection and insight correlate with academic performance in medical students?

    PubMed

    Carr, Sandra E; Johnson, Paula H

    2013-08-23

    Medical students in academic difficulty are often described as lacking insight. The Self Reflection and Insight Scale (SRIS) is a tool for measuring insight which has been validated in medical students. We investigated whether self reflection and insight scores correlate with academic performance in Year 4 medical students from a six year undergraduate medical degree, and whether self reflection and insight changes after one year of clinical training. Self reflection and insight scores were measured in 162 students at the start of Year 4 at the University of Western Australia. Performance in end of year written and clinical exams was monitored and correlated with SRIS. Seventy of the students were surveyed again at the start of Year 5 to see if scores changed or were stable after one year of full time clinical training. We found no correlation between self reflection or insight and academic performance in written and clinical exams. There was a significant increase in recognition of the need for self reflection in Year 5 compared with Year 4. While no correlation was found between this measure of self reflection and insight with academic performance, there was an increase in students' recognition of the need for reflection after one year of clinical studies. This study is a valuable first step towards a potentially exciting research domain and warrants further longitudinal evaluation with larger cohorts of students using additional measures of achievement.

  19. [Poor insight and psychosis].

    PubMed

    Giotakos, O

    2017-01-01

    A variety of phenomena might be considered as reflecting impaired insight in psychosis, like failure to recognize signs, symptoms or disease, failure to derive appropriate cognitive representations, despite recognition of the disease, and misattribution of the source or cause of the disease. The unawareness of tardive dyskinesia symptoms in schizophrenic patients points that self-awareness deficits in schizophrenia may be domain specific. Poor insight is an independent phenomenological and a prevalent feature in psychotic disorders in general, and in schizophrenia in particular, but we don't know yet if delusions in schizophrenia are the result of an entirely normal attempt to account for abnormal perceptual experiences or a product of abnormal experience but of normal reasoning. The theoretical approaches regarding impaired insight include the disturbed perceptual input, the impaired linkage between thought and emotion and the breakdown of the process of self-monitoring and error checking. The inability to distinguish between internally and externally generated mental events has been described by the metarepresentation theory. This theory includes the awareness of ones' goals, which leads to disorders of willed action, the awareness of intention, which leads to movement disorders, and the awareness of intentions of others, which leads to paranoid delusions. The theory of metarepresentation implies mainly output mechanisms, like the frontal cortex, while the input mechanism implies posterior brain systems, including the parietal lobe. There are many similarities between the disturbances of awareness seen in schizophrenia and those seen as a result of known neurological impairment. Neuropsychological models of impaired insight typically attribute the disturbance to any of a variety of core deficits in the processing of information. In this respect, lack of insight is on conceptual par with alogia, apraxia or aphasia in reflecting disturbed cognitive processing. In

  20. Unraveling interrelationships among psychopathology symptoms, cognitive domains and insight dimensions in chronic schizophrenia.

    PubMed

    Xavier, Rose Mary; Pan, Wei; Dungan, Jennifer R; Keefe, Richard S E; Vorderstrasse, Allison

    2018-03-01

    Insight in schizophrenia is long known to have a complex relationship with psychopathology symptoms and cognition. However, very few studies have examined models that explain these interrelationships. In a large sample derived from the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial (N=1391), we interrogated these interrelationships for potential causal pathways using structural equation modeling. Using the NIMH consensus model, latent variables were constructed for psychopathology symptom dimensions, including positive, negative, disorganized, excited and depressed from the Positive and Negative Syndrome Scale (PANSS) items. Neurocognitive variables were created from five predefined domains of working memory, verbal memory, reasoning, vigilance and processing speed. Illness insight and treatment insight were tested using latent variables constructed from the Illness and Treatment Attitude Questionnaire (ITAQ). Disorganized symptoms had the strongest effect on insight. Illness insight mediated the relationship of positive, depressed, and disorganized symptoms with treatment insight. Neurocognition mediated the relationship between disorganized and treatment insight and depressed symptoms and treatment insight. There was no effect of negative symptoms on either illness insight or treatment insight. Taken together, our results indicate overlapping and unique relational paths for illness and treatment insight dimensions, which could suggest differences in causal mechanisms and potential interventions to improve insight. Copyright © 2017 Elsevier B.V. All rights reserved.