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Sample records for measuring therapeutic alliance

  1. Therapeutic alliance.

    PubMed

    Fox, Valerie

    2002-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  3. Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research

    PubMed Central

    Ardito, Rita B.; Rabellino, Daniela

    2011-01-01

    This paper proposes a historical excursus of studies that have investigated the therapeutic alliance and the relationship between this dimension and outcome in psychotherapy. A summary of how the concept of alliance has evolved over time and the more popular alliance measures used in literature to assess the level of alliance are presented. The proposal of a therapeutic alliance characterized by a variable pattern over the course of treatment is also examined. The emerging picture suggests that the quality of the client–therapist alliance is a reliable predictor of positive clinical outcome independent of the variety of psychotherapy approaches and outcome measures. In our opinion, with regard to the relationship between the therapeutic alliance and outcome of psychotherapy, future research should pay special attention to the comparison between patients’ and therapists’ assessments of the therapeutic alliance. This topic, along with a detailed examination of the relationship between the psychological disorder being treated and the therapeutic alliance, will be the subject of future research projects. PMID:22028698

  4. Measuring therapeutic alliance between oncologists and patients with advanced cancer: The Human Connection Scale

    PubMed Central

    Mack, Jennifer W; Block, Susan D.; Nilsson, Matthew; Wright, Alexi; Trice, Elizabeth; Friedlander, Robert; Paulk, Elizabeth; Prigerson, Holly G

    2009-01-01

    Objectives Patients consider having a human connection with a physician to be an important aspect of end-of-life (EOL) care. We sought to develop and validate a measure of therapeutic alliance between advanced cancer patients and their physicians, and to evaluate the effects of therapeutic alliance on EOL experiences and care. Methods We developed The Human Connection (THC) scale to measure the extent to which patients felt a sense of mutual understanding, caring, and trust with their physicians. The scale was administered to 217 advanced cancer patients along with measures of attributes hypothesized to be related to therapeutic alliance, including emotional acceptance of terminal illness. EOL outcomes in 90 patients who died during the study were also examined. Results The 16-item THC questionnaire was internally consistent (Cronbach’s α =.90) and valid, based on its expected positive association with emotional acceptance of the terminal illness (r=.31, P<.0001). THC scores were inversely related to symptom burden (r=−.19, P=.006), functional status (Karnofsky score, r=.22, P=.001), and mental illness (THC score 50.69 for patients with any DSM diagnosis versus 55.22 for those without, P=.03). THC scores were not significantly associated with EOL discussions (P=.68). Among patients who had died, EOL ICU care was inversely associated with therapeutic alliance (THC score 46.5 for those with ICU care versus 55.5 for those without, P=.002), such that patients with higher THC scores were less likely to spend time in the ICU during the last week of life. Conclusion The THC scale is a valid and reliable measure of therapeutic alliance between advanced cancer patients and their physicians. In addition, we found no evidence to suggest that EOL discussions harm patients’ therapeutic alliance. A strong therapeutic alliance is associated with emotional acceptance of a terminal illness and with decreased ICU care at the end of life among patients with advanced cancer

  5. Therapeutic alliance in videoconferencing psychotherapy: a review.

    PubMed

    Simpson, Susan G; Reid, Corinne L

    2014-12-01

    Psychotherapy services are limited in remote and rural areas in Australia and across the globe. Videoconferencing has become well established as a feasible and acceptable mode of psychological treatment delivery. Therapeutic alliance (TA) is an essential factor underlying successful therapy across therapeutic models. In order to determine the state of knowledge regarding TA in psychotherapy via videoconferencing, a literature review was conducted on research studies that formally measured TA as primary, secondary or tertiary outcome measures over the past 23 years. The databases searched were Medline, PsycArticles, PsycINFO, PsycEXTRA and EMBASE. Searching identified 9915 articles that measured satisfaction, acceptability or therapeutic rapport, of which 23 met criteria for the review. Three studies were carried out in Australia, 11 in USA, 4 in Canada, 3 in Scotland and 2 in England. Studies overwhelmingly supported the notion that TA can be developed in psychotherapy by videoconference, with clients rating bond and presence at least equally as strongly as in-person settings across a range of diagnostic groups. Therapists also rated high levels of TA, but often not quite as high as that of their clients early in treatment. The evidence was examined in the context of important aspects of TA, including bond, presence, therapist attitudes and abilities, and client attitudes and beliefs. Barriers and facilitators of alliance were identified. Future studies should include observational measures of bond and presence to supplement self-report.

  6. Clinicians’ Attitudes Toward Therapeutic Alliance in ETherapy

    PubMed Central

    Madalina, Sucala; Julie B., Schnur; Emily H., Brackman; Michael J., Constantino; Guy H., Montgomery

    2013-01-01

    Although therapeutic alliance is a crucial factor in face-to-face therapies, no data exist on clinicians’ attitudes towards alliance in E-therapy. The study explored clinicians’ perceived importance of alliance in E-therapy, clinicians’ confidence in their skills to develop alliance in E-therapy, and whether attitudes towards alliance in E-therapy are associated with intended E-therapy practice. Clinicians (n=106) responded to an online survey. The majority of clinicians considered alliance to be extremely important in both face-to-face therapy and E-therapy. However, clinicians’ ratings of the importance of alliance in face-to-face therapies were significantly higher than their ratings of the importance of alliance in E-therapy. Clinicians reported less confidence in their skills to develop alliance in E-therapy than in face-to-face therapy. Intended E-therapy practice correlated with confidence in one’s ability to develop alliance in E-therapy and with previous E-therapy practice. PMID:24837821

  7. Annotation: The Therapeutic Alliance--A Significant but Neglected Variable in Child Mental Health Treatment Studies

    ERIC Educational Resources Information Center

    Green, Jonathan

    2006-01-01

    Background: There has been relatively little research into therapeutic alliance in child and adolescent mental health and virtually no incorporation of alliance measures as a variable in treatment trials in Child and Adolescent Mental Health Services (CAMHS). Method: A selective literature review on studies in therapeutic alliance in adulthood and…

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

    PubMed

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

    2016-07-01

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

  9. Predictive Validity of Therapeutic Alliance in Group Marital Therapy.

    ERIC Educational Resources Information Center

    Bourgeois, Lise; And Others

    1990-01-01

    Investigated relation between marital distress, therapeutic alliance formation, and treatment outcome in group marital skills training program in which 63 couples met for 9 weeks. Results indicated that levels of marital distress neither impaired nor facilitated alliance formation. Strength of alliance appeared to be more powerful predictor of…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  11. Emotional experience and alliance contribute to therapeutic change in psychodynamic therapy.

    PubMed

    Fisher, Hadar; Atzil-Slonim, Dana; Bar-Kalifa, Eran; Rafaeli, Eshkol; Peri, Tuvia

    2016-03-01

    Accumulating evidence suggests that the therapeutic alliance and clients' contact with emotions during therapy sessions can be effective in reducing their suffering outside of sessions. However, the complex associations among these determinants are not yet clear. Using data collected in therapy on a session-by-session basis, this study explored (a) the temporal associations between emotional experience and the therapeutic alliance; (b) the temporal associations between emotional experience and clients' level of functioning; and (c) the direct and indirect associations among emotional experience, the therapeutic alliance, and functioning. Clients (N = 101) undergoing psychodynamic therapy completed a functioning and distress measure prior to each session, and reported on their emotional experience and perceived alliance strength following each session. Longitudinal multilevel models indicated that higher therapeutic alliance scores at the end of 1 session predicted a greater emotional experience in the next session but that emotional experience did not predict subsequent levels of alliance. The results provided evidence of reciprocal prediction in which a previous emotional experience predicted a subsequent change in functioning and vice versa. Finally, the alliance predicted emotional experience, which, in turn, predicted functioning; hence, alliance strength indirectly predicted clients' level of functioning. Findings indicate that emotional experience and the therapeutic alliance are important determinants of the therapeutic process, which contribute to predict clients' improvement in functioning within psychodynamic treatment.

  12. Therapeutic alliance in early schizophrenia spectrum disorders: a cross-sectional study

    PubMed Central

    2013-01-01

    Background The therapeutic alliance is related to better course and outcome of treatment in schizophrenia. This study explores predictors and characteristics of the therapeutic alliance in recent-onset schizophrenia spectrum disorders including the agreement between patient and therapist alliance ratings. Methods Forty-two patients were assessed with demographic, neurocognitive, and clinical measures including the Positive and Negative Syndrome Scale (PANSS). The therapeutic alliance was measured with the Working Alliance Inventory - Short Form (WAI-S). Results Patient WAI-S total scores were predicted by age and PANSS excitative symptoms. Therapist WAI-S total scores were predicted by PANSS insight. Patient and therapist WAI-S total scores were moderately associated. Neurocognition was not associated with working alliance. Conclusion Working alliance is associated with specific demographic and symptom characteristics in patients with recent-onset schizophrenia spectrum disorders. There is moderate agreement between patients and therapists on the total quality of their working alliance. Findings highlight aspects that may increase therapists’ specificity in the use of alliance-enhancing strategies. PMID:23656747

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

    ERIC Educational Resources Information Center

    Simpson, Arlene J.; Bedi, Robinder P.

    2012-01-01

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

  14. Toward a conceptual alliance about therapeutic alliance: a voyage through the Inferno.

    PubMed

    Szajnberg, N M

    1996-01-01

    I suggest that there is not a conceptual consensus in psychoanalysis regarding the therapeutic alliance. Some argue that the unobjectionable part of the transference should be facilitated; some argue that there is no unobjectionable part of the transference, that all parts should be subjected to analysis. There are those who argue that the therapeutic alliance exists in early treatment; others who argue that it exists later. I suggest using a classical text, Dante's Inferno, as a paradigm for a journey of self-discovery. By reviewing the moments of hesitation that Dante experiences with Virgil and how these are overcome, we cast light on our current problem on the nature of the therapeutic alliance and how to facilitate it. The components of the unobjectionable are related to Winnicott's idea of the maturational processes and Hartmann's (1958) ideas of the primary and secondary autonomous function. Based on their considerations, we make recommendations for use of the therapeutic alliance.

  15. Metacognition as a predictor of therapeutic alliance over 26 weeks of psychotherapy in schizophrenia.

    PubMed

    Davis, Louanne W; Eicher, Amanda C; Lysaker, Paul H

    2011-06-01

    Research to identify client factors that impact treatment outcome has found that deficits in metacognitive abilities and weaker therapeutic alliance are both associated with poorer treatment outcomes for schizophrenia. However, it is unknown if metacognition and therapeutic alliance are related in any way, in particular, if metacognitive abilities predict therapeutic alliance. This study explored whether differing capacities for mastery, a domain of metacognition that involves the ability to use knowledge about mental states to respond to psychological challenges, predicted client perceptions of therapeutic alliance assessed by the Working Alliance Inventory - Short Form (WAI-S). Participants were 63 adults with schizophrenia or schizoaffective disorder enrolled in a 6-month program of cognitive behavioral or supportive therapy, placed into a high, intermediate or minimal mastery group as measured by the Metacognitive Assessment Scale (MAS). Repeated measures ANOVA found group effects for the total WAI-S score, with the high and intermediate mastery groups having better alliance scores than the minimal mastery group. The group effects approached significance when neurocognition was controlled for. Results suggest that greater capacity for mastery predict stronger therapeutic alliance, but do not predict its development over time.

  16. Does the cognitive dispute of psychotic symptoms do harm to the therapeutic alliance?

    PubMed

    Wittorf, Andreas; Jakobi, Ute E; Bannert, Kerstin K; Bechdolf, Andreas; Müller, Bernhard W; Sartory, Gudrun; Wagner, Michael; Wiedemann, Georg; Wölwer, Wolfgang; Herrlich, Jutta; Buchkremer, Gerhard; Klingberg, Stefan

    2010-07-01

    We examined whether the cognitive dispute of psychotic symptoms has a negative impact on the course of the therapeutic alliance. Sixty-seven patients with persistent psychotic symptoms received either cognitive behavioral therapy (CBT) or supportive therapy. Questionnaire-based alliance ratings were repeatedly obtained throughout the course of therapy. Patient and therapist alliance ratings were examined separately. Data analyses comprised repeated measurement analyses of variance and cluster analytic procedures. Neither patient nor therapist alliance ratings showed a differential course throughout the treatments. This was despite the implementation of disputing strategies in later stages of CBT. Irrespective of the treatment condition a cluster with a positive alliance rating and a cluster with a poorer rating were found for therapist and patient ratings, respectively. Baseline symptoms and insight differentiated between the types of clusters. In conclusion, CBT-specific interventions that challenge psychotic symptoms do not necessarily negatively influence the course of the alliance.

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

    PubMed

    Bender, Donna S

    2005-03-01

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

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

    PubMed Central

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

    2013-01-01

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

  19. Culturally Adapted Skill Use as a Therapeutic Alliance Catalyst

    ERIC Educational Resources Information Center

    Lewicki, Todd

    2015-01-01

    Purpose: In this article, I explore how the therapeutic alliance, along with culturally competent and adapted skill use can be positively correlated with treatment outcome when using the ecological validity model as the frame. The ecological validity model refers to the degree to which there is consistency between the environment as experienced by…

  20. The Resolution of Ruptures in the Therapeutic Alliance.

    ERIC Educational Resources Information Center

    Safran, Jeremy D.; Muran, J. Christopher

    1996-01-01

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

  1. The relationships between therapeutic alliance and internalizing and externalizing symptoms in Trauma-Focused Cognitive Behavioral Therapy.

    PubMed

    Zorzella, Karina P M; Muller, Robert T; Cribbie, Robert A

    2015-12-01

    Therapeutic alliance has been considered an important factor in child psychotherapy and is consistently associated with positive outcomes. Nevertheless, research on alliance in the context of child trauma therapy is very scarce. This study examined the relationships between child therapeutic alliance and psychopathology in an empirically supported child trauma therapy model designed to address issues related to trauma with children and their caregivers. Specifically, we examined the extent to which the child's psychopathology would predict the establishment of a positive alliance early in treatment, as well as the association between alliance and outcome. Participants were 95 children between the ages of 7 and 12 and their caregivers, who went through a community-based Trauma-Focused Cognitive Behavioral Therapy program in Canada. Caregivers filled out the CBCL prior to assessment and following treatment. Children and therapists completed an alliance measure (TASC) at three time points throughout treatment. Symptomatology and child gender emerged as important factors predicting alliance at the beginning of treatment. Girls and internalizing children developed stronger alliances early in treatment. In addition, a strong early alliance emerged as a significant predictor of improvement in internalizing symptoms at the end of treatment. Our findings indicate that symptomatology and gender influence the development of a strong alliance in trauma therapy. We suggest that clinicians should adjust therapeutic style to better engage boys and highly externalizing children in the early stages of therapy.

  2. The relationships between therapeutic alliance and internalizing and externalizing symptoms in Trauma-Focused Cognitive Behavioral Therapy.

    PubMed

    Zorzella, Karina P M; Muller, Robert T; Cribbie, Robert A

    2015-12-01

    Therapeutic alliance has been considered an important factor in child psychotherapy and is consistently associated with positive outcomes. Nevertheless, research on alliance in the context of child trauma therapy is very scarce. This study examined the relationships between child therapeutic alliance and psychopathology in an empirically supported child trauma therapy model designed to address issues related to trauma with children and their caregivers. Specifically, we examined the extent to which the child's psychopathology would predict the establishment of a positive alliance early in treatment, as well as the association between alliance and outcome. Participants were 95 children between the ages of 7 and 12 and their caregivers, who went through a community-based Trauma-Focused Cognitive Behavioral Therapy program in Canada. Caregivers filled out the CBCL prior to assessment and following treatment. Children and therapists completed an alliance measure (TASC) at three time points throughout treatment. Symptomatology and child gender emerged as important factors predicting alliance at the beginning of treatment. Girls and internalizing children developed stronger alliances early in treatment. In addition, a strong early alliance emerged as a significant predictor of improvement in internalizing symptoms at the end of treatment. Our findings indicate that symptomatology and gender influence the development of a strong alliance in trauma therapy. We suggest that clinicians should adjust therapeutic style to better engage boys and highly externalizing children in the early stages of therapy. PMID:26338348

  3. Therapeutic alliance: a concept for the childbearing season.

    PubMed

    Doherty, Mary Ellen

    2009-01-01

    This analysis was conducted to describe the concept of therapeutic alliance and its appropriateness for health-care provider-client interactions during the childbearing season. The concept has been defined in other disciplines. A universal definition suggested a merging of efforts directed toward health. A simple and concise definition evolved, which is applicable to the childbearing season as well as to health-care encounters across the life span. This definition states: Therapeutic alliance is a process within a health-care provider-client interaction that is initiated by an identified need for positive client health-care behaviors, whereby both parties work together toward this goal with consideration of the client's current health status and developmental stage within the life span.

  4. Therapeutic Alliance: A Concept for the Childbearing Season

    PubMed Central

    Doherty, Mary Ellen

    2009-01-01

    This analysis was conducted to describe the concept of therapeutic alliance and its appropriateness for health-care provider-client interactions during the childbearing season. The concept has been defined in other disciplines. A universal definition suggested a merging of efforts directed toward health. A simple and concise definition evolved, which is applicable to the childbearing season as well as to health-care encounters across the life span. This definition states: Therapeutic alliance is a process within a health-care provider-client interaction that is initiated by an identified need for positive client health-care behaviors, whereby both parties work together toward this goal with consideration of the client's current health status and developmental stage within the life span. PMID:20514120

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  6. Quality of Object Relations and Security of Attachment as Predictors of Early Therapeutic Alliance

    ERIC Educational Resources Information Center

    Goldman, Gregory A.; Anderson, Timothy

    2007-01-01

    Security of attachment and quality of object relations were measured as predictors of initial impressions of the therapeutic alliance as well as dropout. Fifty-five individual psychotherapy clients were administered the Revised Adult Attachment Scale and the Bell Object Relations and Reality Testing Inventory prior to their initial therapy…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    PubMed

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

    2012-06-01

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

  9. Three Perspectives on Clients' Experiences of the Therapeutic Alliance: A Discovery-Oriented Investigation

    ERIC Educational Resources Information Center

    Beck, Michael; Friedlander, Myrna L.; Escudero, Valentin

    2006-01-01

    To deepen our understanding of the therapeutic alliance in conjoint treatment, we interviewed clients in four families about their individual, private experience of the alliance after an early session. These qualitative data were triangulated with family members' scores on Pinsof's Family Therapy Alliance Scale-Revised and observational ratings of…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Schiff, Miriam; Levit, Shabtay

    2010-01-01

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

  13. The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders

    PubMed Central

    Cronin, Elisabeth; Brand, Bethany L.; Mattanah, Jonathan F.

    2014-01-01

    Background Research has shown that the therapeutic alliance plays an important role in enhancing treatment outcome among individuals with a variety of disorders, including posttraumatic stress disorder (PTSD). However, the therapeutic alliance and treatment outcome has not yet been studied in dissociative disorders (DD). Objectives The current study sought to investigate the impact of alliance on treatment outcome for DD patients. Methods Data from a naturalistic, longitudinal international treatment study of DD patients and their therapists were analyzed to determine if the alliance, as reported by patients and therapists, was associated with treatment outcome. Results Patients with higher self-rated alliance had fewer symptoms of dissociation, PTSD, and general distress, as well as higher levels of therapist-rated adaptive functioning. Over time, self-rated alliance scores predicted better outcomes, after controlling for patient adaptive capacities including symptom management at the time when the alliance ratings were made. Patient-rated alliance was more strongly associated with outcome than therapist-rated alliance. Conclusion Therapists who work with DD patients should understand the importance of the alliance on treatment outcome. These findings are consistent with previous literature demonstrating the importance of developing and maintaining a strong therapeutic alliance, although the effect sizes of individuals with DD were stronger than what has been found in many other patient groups. A greater understanding of the impact of the alliance in traumatized individuals may contribute to better outcomes for these individuals. PMID:24616755

  14. [Risk announcement in paediatric cancerology: strengthen the therapeutic alliance].

    PubMed

    Doz, F; Davous, D; Seigneur, E; Heard, M

    2008-03-01

    Although announcement of the risks related to treatment has become a general rule in the healthcare relationship, doctors, nurses and parents of severely ill children tend to feel uncomfortable in relation to this mandatory information. The work conducted by the AP-HP Espace éthique working party in collaboration with parents, healthcare personnel and a philosopher demonstrates the need to announce these risks, even beyond the legal framework, while bearing in mind the difficulties and hazards inherent to changes in legislation and by observing the philosophical values that subtend this legislation. Faced with the broad range of diverse and complex risks, the working party proposes a classification of risks and hierarchisation of the difficulties encountered by the doctor during this announcement, which is difficult to make, and difficult to hear, as intimately related to the child's quality of life. The very concept of the probability of a risk raises concepts that are difficult to accept: chance, randomness, and uncertainty. Informing the patient involves hearing as much as talking, listening as much as explaining and requires availability, time, space and an ability to listen to the patient. This article proposes several good practice guidelines designed to consolidate the therapeutic alliance by sharing the uncertainty of the risk and allowing the various partners to remain actors. Nonconfiscation of knowledge by doctors does not lead to a loss or transfer of their responsibility, but allows decisions to be taken in the context of the alliance, while taking the risks into account.

  15. The Role of Therapeutic Alliance in Therapy Outcomes for Youth in Residential Care

    ERIC Educational Resources Information Center

    Handwerk, Michael L.; Huefner, Jonathan C.; Ringle, Jay L.; Howard, Brigid K.; Soper, Stephen H.; Almquist, Julie K.; Chmelka, M. Beth

    2008-01-01

    This study examined the impact of therapeutic alliance (TA) on therapy outcomes for youth with behavioral and emotional problems residing in residential care. Study participants were 71 youth in an out-of-home family-style residential treatment facility who were referred to an onsite psychotherapy clinic. A therapeutic alliance scale was completed…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  17. Examining Change in Therapeutic Alliance to Predict Youth Mental Health Outcomes

    PubMed Central

    Duppong Hurley, Kristin; Van Ryzin, Mark J.; Lambert, Matthew; Stevens, Amy L.

    2014-01-01

    Objective To examine the link between therapeutic alliance and youth outcomes. Method The study was conducted at a group-home with 112 youth with a disruptive-behavior diagnosis. Therapeutic alliance was collected routinely via youth and staff report. Outcome data were collected using youth and staff reports of externalizing behavior as well as behavioral incidents occurring during care. Outcome data were collected following intake into services and at 6 and 12 months of care. Data were analyzed to examine (1) if youth behavior problems at intake were predictive of therapeutic alliance and (2) if changes in alliance were predictive of subsequent youth outcomes. These were conducted with a 6-month service-delivery model and replicated with a 12-month model. Results There was some support for the first hypothesis, that initial levels of youth externalizing behavior would be related to alliance ratings; however, most of the effects were marginally significant. The second hypothesis, that changes in therapeutic alliance would be related to subsequent youth outcomes, was supported for the 6-month model, but not the 12-month model. Conclusions Changes in therapeutic alliance may be predictive of youth outcomes during care. Additional research into examining therapeutic alliance trajectories is warranted to improve mental health services for youth. PMID:25960629

  18. Heart rate variability and the anxious client: cardiac autonomic and behavioral associations with therapeutic alliance.

    PubMed

    Stratford, Trisha; Meara, Alan; Psychotherapy, M Gestalt; Lal, Sara

    2014-08-01

    This exploratory study was designed to investigate the link between a client's heart rate variability (HRV) and the forming of a therapeutic alliance (TA) during psychotherapy. Change in HRV is associated with many psychological and physiological situations, including cardiac mortality. Cardiac effects were evaluated during therapy in 30 symptomatically anxious clients using HRV during six weekly 1-hour therapy sessions (S1-S6). Therapeutic index (TI), a measure of TA, was evaluated using skin conductance resonance between client and therapist. The Working Alliance Inventory provides a subjective measure of TA. State and trait anxiety and mood states were also assessed. Most HRV parameters were highest during S4. The sympathovagal balance was highest in S1 but stabilized after S2. In S4, TI was linked to high HRV parameters. Overall higher anxiety levels seem to be associated to lower HRV parameters. Conversely, in S4, high HRV parameters were linked to higher mood scores. This study found that a subjective measure of TA contradicted the physiological outcome. Results suggest that physiological data collected during therapy are a more accurate barometer of TA forming. These research findings suggest a need for further research identifying physiological markers in clients with a variety of mental health disorders over long-term therapy. PMID:25010104

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

    PubMed

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

    2014-06-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  2. A Measure of the Parent-Team Alliance in Youth Residential Psychiatry: The Revised Short Working Alliance Inventory

    ERIC Educational Resources Information Center

    Lamers, Audri; Delsing, Marc J. M. H.; van Widenfelt, Brigit M.; Vermeiren, Robert R. J. M.

    2015-01-01

    Background: The therapeutic alliance between multidisciplinary teams and parents within youth (semi) residential psychiatry is essential for the treatment process and forms a promising process variable for Routine Outcome Monitoring (ROM). No short evaluative instrument, however, is currently available to assess parent-team alliance. Objective: In…

  3. Negotiating therapeutic alliances with a family at impasse.

    PubMed

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

    2014-03-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed

    Sheehan, Alyson H; Friedlander, Myrna L

    2015-10-01

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

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

    PubMed

    Sheehan, Alyson H; Friedlander, Myrna L

    2015-10-01

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

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

    PubMed

    Auchincloss, Elizabeth L

    2016-03-01

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

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

    PubMed

    Auchincloss, Elizabeth L

    2016-03-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  13. Enhancing Behavioral Couple Therapy: Addressing the Therapeutic Alliance, Hope, and Diversity

    ERIC Educational Resources Information Center

    Kelly, Shalonda; Iwamasa, Gayle Y.

    2005-01-01

    The strengths and weaknesses of behavioral couple therapy (BCT) are well documented and disseminated, and this couple therapy approach continues to evolve. Newer behaviorally based approaches share an openness to integration and can enhance the ability of BCT to address three key process-related variables: the therapeutic alliance, hope, and…

  14. Relationships among client-therapist personality congruence, working alliance, and therapeutic outcome.

    PubMed

    Taber, Brian J; Leibert, Todd W; Agaskar, Vaibhavee R

    2011-12-01

    Despite the importance of the working alliance in therapeutic outcome, little is known about the factors associated with its formation. We advance that personality similarity between client and therapist is one such factor pertinent to the working alliance. In this study, personality similarity in 32 client-therapist dyads was examined for its relations to the bond, task, and goal elements of the working alliance (Bordin, 1979, Psychotherapy: Theory, Research, and Practice, 16, 252-260) and therapeutic outcome. Personality similarity was conceptualized using Holland's (1997, Making vocational choices [3rd ed.]) congruence construct. Therapists completed the Self-Directed Search pretreatment and clients completed the Working Alliance Inventory-Short Revised and Self-Directed Search after the third session. Results indicated that (a) client-therapist personality congruence was associated with the bond, (b) bond was associated with task and goal, and (c) task and goal were associated with therapeutic outcome. Congruence was not associated with task, goal, or therapeutic outcome. Holland's theory provides a framework for adapting to clients of varying personality types. By understanding how client-therapist personalities relate to each other in therapy, client-therapist bonds may be more efficiently realized.

  15. Therapeutic alliance building during the child psychiatric intake: does VTC make a difference?

    PubMed

    Penska, Keith; Michael, Robin; Messer, Stephen C; Smith, Ryan; Black, Nancy B; Cozza, Stephen

    2012-05-01

    This study examined potential changes in perceptions of therapeutic ("working") alliance during a child's initial diagnostic interview from the parent's perspective. The major study objective was to determine whether parental perceptions of alliance vary by group (video teleconferencing [VTC], face-to-face [FTF]) over time (Pre, Post intake). It was predicted that parental alliance would be more favorable after an FTF encounter relative to a VTC intervention. Participants were recruited and enrolled in two study cohorts between August 2000 and October 2005. Parents completed the Parental Perceptions of Alliance Questionnaire (PPAQ) immediately before (pre-PPAQ) and after (post-PPAQ) their interview. Analysis of variance (ANOVA) tests showed that the mean PPAQ scores of FTF groups being higher than that of VTC groups (controlling for time) was statistically significant, F (1,144) = 4.14, p = 0.04. However, upon further analysis, the interaction effect was not significant, F (1,144) = 1.20, p = 0.28. Findings from the current exploratory study suggest that, at least following an intake child psychiatric examination, parents' perceptions of therapeutic alliance are stronger than they were before intake for those conducted in an FTF format as well as through VTC.

  16. "Straight up": enhancing rapport and therapeutic alliance with previously-detained youth in the delivery of mental health services.

    PubMed

    Brown, James R; Holloway, Evan D; Akakpo, Tohoro F; Aalsma, Matthew C

    2014-02-01

    A strong therapeutic alliance has been shown to improve mental health treatment outcomes in adults, but this topic has not been fully explored with youth. Adolescents, particularly justice-involved youth, stand to benefit greatly from an improved treatment experience. One quality which can improve treatment is mental health providers' interpersonal skills when attempting to build a therapeutic rapport with adolescent clients. Semi-structured interviews were conducted with 19 youth who screened positive for mental health concerns while in juvenile detention. Four themes were identified as important to improving the therapeutic alliance: Empathy, client-directed care, sequencing, and positive rapport. Suggestions for strengthening a therapeutic alliance are provided.

  17. Case formulation and the therapeutic alliance in contemporary problem-solving therapy (PST).

    PubMed

    Nezu, Christine Maguth; Nezu, Arthur M; Colosimo, Meghan M

    2015-05-01

    In addition to providing psychoeducation and sharing clinical explanations and treatment goals, case formulation serves as a potential mechanism by which therapists may facilitate an alliance with their patients. This article illustrates how a case formulation shared with a patient early in the process of contemporary problem-solving therapy (PST) may yield both a road map to treatment and a means to build and adapt a therapeutic alliance based on patient attributes. We provide a description of a clinical case in which PST was carried out with a woman who, in the midst of alcohol recovery, experienced symptoms of anxiety, depression, and binge eating.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Smerud, Phyllis E.; Rosenfarb, Irwin S.

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  1. The therapeutic alliance in schema-focused therapy and transference-focused psychotherapy for borderline personality disorder.

    PubMed

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

    2007-02-01

    This study investigated the quality and development of the therapeutic alliance as a mediator of change in schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder. Seventy-eight patients were randomly allocated to 3 years of biweekly SFT or TFP. Scores of both therapists and patients for the therapeutic alliance were higher in SFT than in TFP. Negative ratings of therapists and patients at early treatment were predictive of dropout, whereas increasingly positive ratings of patients in the 1st half of treatment predicted subsequent clinical improvement. Dissimilarity between therapist and patients in pathological personality characteristics had a direct effect on growth of the therapeutic alliance but showed no relationship with clinical improvement. The authors conclude that the therapeutic alliance and specific techniques interact with and influence one another and may serve to facilitate change processes underlying clinical improvement in patients with borderline personality disorder.

  2. Avoiding emotional bonds: an examination of the dimensions of therapeutic alliance among cannabis users.

    PubMed

    Healey, Alison; Kay-Lambkin, Frances; Bowman, Jenny; Childs, Steven

    2013-01-01

    There is a growing need to provide treatment for cannabis users, yet engaging and maintaining this population in treatment is particularly difficult. Although past research has focused on the importance of therapeutic alliance on drug treatment outcomes, this is the first study to examine the dimensions of therapeutic alliance for cannabis users compared with users of alcohol or other drugs in a naturalistic setting. The acceptability of Internet-delivered interventions for drug and alcohol treatments is also investigated. Participants (n = 77) included clients who were receiving outpatient drug and alcohol treatment at a publicly funded health service, including a Specialist Cannabis Clinic. The results indicated that one particular domain of alliance, Bond, was consistently lower, from both client and clinician perspectives, for current cannabis users relative to those not currently using cannabis. Client perceptions of Bond decreased as the severity of cannabis use increased (r = -0.373, p = 0.02). Cannabis Clinic clients did not report a significantly lower Bond with their clinicians, suggesting that specialized cannabis services may be better placed to provide appropriate treatment for this population than embedding cannabis treatment within traditional drug and alcohol treatment teams. In addition, Internet/computer-based treatments may be one potential way to engage, transition, or retain cannabis users in treatment.

  3. Personality assessment in today's health care environment: therapeutic alliance and patient satisfaction.

    PubMed

    Quirk, Michael P; Erdberg, Philip; Crosier, Marlan; Steinfeld, Bradley

    2007-10-01

    This article addresses the role of personality assessment-specifically the Rorschach (Exner, 2002)-]in the context of the health care industry's increased focus on patient satisfaction. When providing psychotherapy, a challenge to providing patient-centered care turns on understanding and acting on the key aspects of the patient's personality that are crucial to forming an effective alliance. This article includes a description and examples of how personality assessment can enhance therapists' understanding of the ideational, affective, and self-control aspects of complicated patients' problem-solving styles. This enhanced understanding in turn can lead to improved therapeutic alliance between therapists and patients and to increased patient satisfaction with their care. How to provide feedback to the therapist also is addressed.

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

    PubMed

    Manning, Walter H

    2010-11-01

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

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

    PubMed

    Dillon, Frank R

    2013-08-01

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

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

    NASA Technical Reports Server (NTRS)

    Iatrou, Kostas; Skourias, Nikolaos

    2005-01-01

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

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

    PubMed Central

    Koole, Sander L.; Tschacher, Wolfgang

    2016-01-01

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

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

    PubMed

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

    2016-07-30

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

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

    ERIC Educational Resources Information Center

    Amat, Mohamad Isa

    2013-01-01

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

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

    PubMed Central

    Asnaani, Anu; Hofmann, Stefan G.

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

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

  15. The impact of computer use on therapeutic alliance and continuance in care during the mental health intake.

    PubMed

    Rosen, Daniel C; Nakash, Ora; Alegría, Margarita

    2016-03-01

    Advances in information technology within clinical practice have rapidly expanded over recent years. Despite the documented benefits of using electronic health records, which often necessitate computer use during the clinical encounter, little is known about the impact of computer use during the mental health visit and its effect on the quality of the therapeutic alliance. We investigated the association between computer use and quality of the working alliance and continuance in care in 104 naturalistic mental health intake sessions. Data were collected from 8 safety-net outpatient clinics in the Northeast offering mental health services to a diverse client population. All intakes were video recorded. Use of computer during the intake session was ascertained directly from the recording of the session (n = 22; 22.15% of intakes). Working alliance was assessed from the session videotapes by independent reliable coders, using the Working Alliance Inventory, Observer Form-bond scale. Therapist computer use was significantly associated with the quality of the observer-rated therapeutic alliance (Coefficient = -6.29, SE = 2.2, p < .01; Cohen's effect size of d = -0.76), and client's continuance in care (Odds ratio = .11, CI = 0.03-0.38; p < .001). The quality of the observer-rated working alliance and client's continuance in care were significantly lower in intakes in which the therapist used a computer during the session. Findings indicate a cautionary call in advancing computer use within the mental health intake, and demonstrate the need for future research to identify the specific behaviors that promote or hinder a strong working alliance within the context of psychotherapy in the technological era. PMID:26214322

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

    PubMed Central

    Pas, Elise T.; Bradshaw, Catherine P.

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Abidin, Richard R.; Brunner, John F.

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

    Murphy, Nancy

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Vasquez, Melba J. T.

    2007-01-01

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

  1. The advising alliance for international and domestic graduate students: Measurement invariance and implications for academic stress.

    PubMed

    Rice, Kenneth G; Suh, Hanna; Yang, Xiaohui; Choe, Elise; Davis, Don E

    2016-04-01

    We expanded the focus of a prior study of international graduate student advising relationships (Rice et al., 2009) to examine advising experiences of both international and domestic students. International (n = 434) and domestic (n = 387) students completed the Advisory Working Alliance Inventory (AWAI-S; Schlosser & Gelso, 2001) and measures of advising experiences, perceived academic stress, and desire to change advisor. Measurement invariance analyses suggested that a 23-item AWAI-S showed support for scalar invariance. A bifactor structure showed superior fit to the 3-factor model or a second-order factor model for the AWAI-S. International and domestic graduate students did not differ in ratings of general alliance, academic stress, or desire to change advisors. General alliance was strongly related to less academic stress and less desire to change advisors. International students who felt disrespected by their advisors were more likely to be academically stressed than domestic students. Structured mentoring experiences were associated with lower stress and less desire to change, and this effect was similar in both international and domestic students. Overall, results suggested that the current level of measurement, and possibly theory development, regarding the advisory alliance is good at identifying generic satisfaction but weaker at differentiating components of the alliance.

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

    ERIC Educational Resources Information Center

    Richards, Penelope; Simpson, Susan

    2015-01-01

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

  3. To enforce or engage: the relationship between coercion, treatment motivation and therapeutic alliance within community-based drug and alcohol clients.

    PubMed

    Wolfe, Samantha; Kay-Lambkin, Frances; Bowman, Jenny; Childs, Steven

    2013-05-01

    Three fundamental clinical issues are consistently associated with treatment engagement and outcomes in substance using populations; coercion, motivation and therapeutic alliance. It is accepted that these factors play an integral role in the success of substance use treatment and particularly that higher motivation and therapeutic alliance are advantageous to treatment outcomes. The impact of coercion on engagement and treatment outcome, on the other hand, is less clear, and the relationship between these three issues has not been adequately explored. The current study aimed to address this gap, by examining the presenting characteristics of clients attending a community drug and alcohol counselling service in relation to coercion, motivation, therapeutic alliance and substance use, as well as the effect that these variables had on treatment outcomes 15 weeks later. A total of 77 clients recruited from the Central Coast Drug and Alcohol Service participated in the study, completing a phone assessment upon treatment entry and 15 weeks post-baseline. Results indicated that facets of motivation and therapeutic alliance played a significant role in client's substance use upon presentation for treatment, although coercion did not. Coercion was not associated with substance use outcomes at 15 week follow up. However, due to a relatively small sample completing post-baseline assessments (n=33), further research is needed to examine the predictive effects of these variables in community drug and alcohol clients.

  4. To enforce or engage: the relationship between coercion, treatment motivation and therapeutic alliance within community-based drug and alcohol clients.

    PubMed

    Wolfe, Samantha; Kay-Lambkin, Frances; Bowman, Jenny; Childs, Steven

    2013-05-01

    Three fundamental clinical issues are consistently associated with treatment engagement and outcomes in substance using populations; coercion, motivation and therapeutic alliance. It is accepted that these factors play an integral role in the success of substance use treatment and particularly that higher motivation and therapeutic alliance are advantageous to treatment outcomes. The impact of coercion on engagement and treatment outcome, on the other hand, is less clear, and the relationship between these three issues has not been adequately explored. The current study aimed to address this gap, by examining the presenting characteristics of clients attending a community drug and alcohol counselling service in relation to coercion, motivation, therapeutic alliance and substance use, as well as the effect that these variables had on treatment outcomes 15 weeks later. A total of 77 clients recruited from the Central Coast Drug and Alcohol Service participated in the study, completing a phone assessment upon treatment entry and 15 weeks post-baseline. Results indicated that facets of motivation and therapeutic alliance played a significant role in client's substance use upon presentation for treatment, although coercion did not. Coercion was not associated with substance use outcomes at 15 week follow up. However, due to a relatively small sample completing post-baseline assessments (n=33), further research is needed to examine the predictive effects of these variables in community drug and alcohol clients. PMID:23454883

  5. The Integrative Psychotherapy Alliance: Family, Couple and Individual Therapy Scales.

    ERIC Educational Resources Information Center

    Pinsof, William M.; Catherall, Donald R.

    1986-01-01

    Presents an integrative definition of the therapeutic alliance that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this concept for therapy reserach are examined. Three new systematically oriented scales to measure the alliance are presented along with some preliminary data…

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

    NASA Technical Reports Server (NTRS)

    Reehorst, Andrew L.

    2001-01-01

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

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

    PubMed

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

    2011-02-01

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

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

    SciTech Connect

    Minnett, P.J.

    1993-08-01

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

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

    PubMed

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

    2015-12-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  12. How Central Is the Alliance in Psychotherapy? A Multilevel Longitudinal Meta-Analysis

    ERIC Educational Resources Information Center

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

    2012-01-01

    Prior meta-analyses have found a moderate but robust relationship between alliance and outcome across a broad spectrum of treatments, presenting concerns, contexts, and measurements. However, there continues to be a lively debate about the therapeutic role of the alliance, particularly in treatments that are tested using randomized clinical trial…

  13. The Working Alliance in Online Therapy with Young People: Preliminary Findings

    ERIC Educational Resources Information Center

    Hanley, Terry

    2009-01-01

    This paper examines the quality of the working alliance in online counseling relationships with young people. A mixed method approach has been adopted which combines the completion of a self-report quantitative measure (the "Therapeutic Alliance Quality Scale") and qualitative interviews with service users of a UK-based service (Kooth.com).…

  14. Angioma Alliance

    MedlinePlus

    ... of Excellence at University of Chicago. LEARN MORE Free Genetic Testing through Angioma Alliance Angioma Alliance is now able to offer free genetic testing to our members who have multiple cavernous angiomas. ...

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

    PubMed Central

    Schnur, Julie B.; Montgomery, Guy H.

    2010-01-01

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

  16. [The therapeutic alliance as a main factor of building cooperation during the treatment of patients with opiate addiction].

    PubMed

    Agibalova, T V; Tuchin, P V; Shustov, D I; Buzik, O Zh

    2014-01-01

    Objective. To assess an alliance-centred method of short-term psychotherapy (AP) in the formation of compliance in patients with opiate addiction. Material and methods. Authors studied 100 male inpatients with ICD-10 diagnosis Opioid Dependence (F11.2). Patients were stratified into main (with use of AP) and control groups. The tasks of short-term psychotherapy were to determine mutual goals for the patient and the physician and the interaction between them. Results and Conclusion. Based on some special quantitative psychological tests and correlation analysis, it was identified that AP stimulated compliance behaviour in patients with opioid dependence more effectively than traditional recommendations.

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  18. Alliance-focused training.

    PubMed

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

    2015-06-01

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

  19. Alliance-focused training.

    PubMed

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

    2015-06-01

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

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

    PubMed Central

    Brocato, Jo

    2013-01-01

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

  1. Predicting Spouses Perceptions of Their Parenting Alliance

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  2. The Therapy Process Observational Coding System-Alliance Scale: Measure Characteristics and Prediction of Outcome in Usual Clinical Practice

    ERIC Educational Resources Information Center

    McLeod, Bryce D.; Weisz, John R.

    2005-01-01

    The authors describe psychometric characteristics of the new Therapy Process Observational Coding System-Alliance scale (TPOCS-A; B. D. McLeod, 2001) and illustrate its use in the study of treatment as usual. The TPOCS-A uses session observation to assess child-therapist and parent-therapist alliance. Both child and parent forms showed acceptable…

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  7. Group Climate, Cohesion, Alliance, and Empathy in Group Psychotherapy: Multilevel Structural Equation Models

    ERIC Educational Resources Information Center

    Johnson, Jennifer E.; Burlingame, Gary M.; Olsen, Joseph A.; Davies, D. Robert; Gleave, Robert L.

    2005-01-01

    This study examined the definitional and statistical overlap among 4 key group therapeutic relationship constructs--group climate, cohesion, alliance, and empathy--across member-member, member-group, and member-leader relationships. Three multilevel structural equation models were tested using self-report measures completed by 662 participants…

  8. Analysis of the Development of the Working Alliance Using Hierarchical Linear Modeling.

    ERIC Educational Resources Information Center

    Kivlighan, Dennis M.; Shaughnessy, Peter

    1995-01-01

    Describes method of analysis of the relation between working alliance and therapeutic outcome using hierarchical linear modeling. Results revealed a significant association between linear growth function of therapist ratings of working alliance and therapeutic outcome. Discusses need to conceptualize working alliance as a temporally variant, as…

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

    SciTech Connect

    Not Available

    2014-09-01

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

  10. Therapeutic magnetic microcarriers characterization by measuring magnetophoretic attributes

    NASA Astrophysics Data System (ADS)

    Vidal Ibacache, Guillermo

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

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

    PubMed

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

    2015-01-01

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

  12. Building Alliances Series: Education

    ERIC Educational Resources Information Center

    Brady, Cecilia

    2009-01-01

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

  13. Workforce Development Alliances

    ERIC Educational Resources Information Center

    Thornton, Robert H.; Shattuck, James M.

    2006-01-01

    Housatonic Community College (HCC) in Bridgeport, Connecticut, is of the opinion that an answer to the theme of Re-creating America's Community Colleges lies in forming better alliances with all possible partners. HCC has found in leveraging funds to foster Bridgeport's Manufacturers Education and Training Alliance (METAL) that the college could…

  14. Alliance through Change

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  15. Alliances in "The Hunger Games"

    ERIC Educational Resources Information Center

    Painter, Judith

    2012-01-01

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

  16. National Blood Clot Alliance

    MedlinePlus

    ... Mon-Fri, 8:30am - 5:00pm EDT National Blood Clot Alliance 8321 Old Courthouse Road Suite ... not rely on the information provided as a substitute for actual professional medical advice, care, or treatment. ...

  17. Mars Museum Visualization Alliance

    NASA Astrophysics Data System (ADS)

    Sohus, A. M.; Viotti, M. A.; de Jong, E. M.

    2004-11-01

    The Mars Museum Visualization Alliance is a collaborative effort funded by the Mars Public Engagement Office and supported by JPL's Informal Education staff and the Solar System Visualization Project to share the adventure of exploration and make Mars a real place. The effort started in 2002 with a small working group of museum professionals to learn how best to serve museum audiences through informal science educators. By the time the Mars Exploration Rovers landed on Mars in January 2004, over 100 organizations were partners in the Alliance, which has become a focused community of Mars educators. The Alliance provides guaranteed access to images, information, news, and resources for use by the informal science educators with their students, educators, and public audiences. Thousands of people have shared the adventure of exploring Mars and now see it as a real place through the efforts of the Mars Museum Visualization Alliance partners. The Alliance has been lauded for "providing just the right inside track for museums to do what they do best," be that webcasts, live presentations with the latest images and information, high-definition productions, planetarium shows, or hands-on educational activities. The Alliance is extending its mission component with Cassini, Genesis, Deep Impact, and Stardust. The Mars Exploration and Cassini Programs, as well as the Genesis, Deep Impact, and Stardust Projects, are managed for NASA by the Jet Propulsion Laboratory, California Institute of Technology, Pasadena, California.

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

    ERIC Educational Resources Information Center

    Rogers, Daniel T.

    2015-01-01

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

  19. Global Equity Gauge Alliance.

    PubMed

    Ntuli, Antoinette

    2007-01-01

    The lack of attention to equity in health, health care and determinants of health is a burden to the attainment of good health in many countries. With this underlying problem as a basis, a series of meetings took place between 1999 and 2000, culminating in the creation the Global Equity Gauge Alliance (GEGA). G EGA is an international network of groups in developing countries, mainly Asia, Africa and Latin America, which develop projects designed to confront and mitigate inequities in health, know as Equity Gauges. Equity Gauges aim to contribute towards the sustained decline in inequities in both the broad sociopolitical determinants of health, as well as inequities in the health system. Their approach is based on three broad spheres of action, known as "pillars": 1) measurement and monitoring, 2) advocacy, and 3) community empowerment. Through a series of examples from local or national level gauges, this paper showcases their work promoting the interaction between research and evidence-based policy formulation and implementation, and the interaction between the community and policy makers. PMID:17665716

  20. Women in the Farmers' Alliance.

    ERIC Educational Resources Information Center

    Wagner, MaryJo

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

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

    ERIC Educational Resources Information Center

    Gnilka, Philip B.

    2010-01-01

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

  2. Evaluation of Various Therapeutic Measures in Striae Rubra

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-05-01

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

  4. Measurement of anticomplementary activity in therapeutic intravenous immunoglobulin preparations.

    PubMed

    Ramasamy, I; Tran, E; Farrugia, A

    1997-03-01

    Anticomplementary activity (ACA) of aggregates in intravenous immunoglobulin preparations (IVIG) was investigated using the modified Kabat and Meyer classical complement consumption method recommended by the European Pharmacopoeia and a C1q-coated microtitre enzyme-linked immunosorbent assay (ELISA). The physical characteristics of aggregates were found to affect complement binding. Aggregates formed by heating IVIG preparations at acid pH bound complement poorly, while aggregates formed by heating IVIG at neutral pH showed high ACA. This suggests that analysis of complement binding capacity provides a level of aggregate characterization of aggregates which is additional to quantitation by High-performance liquid chromatography ((HPLC). The correlation (r = 0.98) between the two tests was good when aggregates formed at neutral pH were compared, but decreased (r = 0.57) when aggregates formed at acid pH were included. A comparison of the results showed that there were no significant differences in the classification of aggregates with acceptable/unacceptable (i.e. pass/fail outcome) values of ACA. Between assay variation (CV = 7.6%) was lower in the ELISA test compared with the complement consumption assay (where percentage binding varied from 78.9% to 100%). Both assays are justified for the evaluation of ACA in therapeutic IVIG. The ELISA had the advantage in being more precise, less dependent on reagent source and requiring less technical expertise.

  5. Alliance building and narcissistic personality disorder.

    PubMed

    Ronningstam, Elsa

    2012-08-01

    Building a therapeutic alliance with a patient with pathological narcissism or narcissistic personality disorder is a challenging process. A combined alliance building and diagnostic strategy is outlined that promotes patients' motivation and active engagement in identifying their own problems. The main focus is on identifying grandiosity, self-regulatory patterns, and behavioral fluctuations in their social and interpersonal contexts while engaging the patient in meaningful clarifications and collaborative inquiry. A definition of grandiosity as a diagnostic characterological trait is suggested, one that captures self-criticism, inferiority, and fragility in addition to superiority, assertiveness, perfectionism, high ideals, and self-enhancing and self-serving interpersonal behavior. These reformulations serve to expand the spectrum of grandiosity-promoting strivings and activities, capture their fluctuations, and help clinicians attend to narcissistic individuals' internal experiences and motivation as well as to their external presentation and interpersonal self-enhancing, self-serving, controlling, and aggressive behavior. A case example illustrates this process. PMID:22729478

  6. System for Observing Family Therapy Alliances: A Tool for Research and Practice

    ERIC Educational Resources Information Center

    Friedlander, Myrna L.; Escudero, Valentin; Horvath, Adam O.; Heatherington, Laurie; Cabero, Andres; Martens, Matthew P.

    2006-01-01

    To advance research and inform practice, the authors developed an observational rating system of client behavior reflecting strong and weak therapeutic alliances in couple and family therapy. The System for Observing Family Therapy Alliances (SOFTA), in both English and Spanish, has 2 dimensions that are common across therapy modalities…

  7. Adolescent and Parent Alliance and Treatment Outcome in Multidimensional Family Therapy

    ERIC Educational Resources Information Center

    Shelef, Karni; Diamond, Gary M.; Diamond, Guy S.; Liddle, Howard A.

    2005-01-01

    In this study, the authors examined the relation between adolescent and parent therapeutic alliances and treatment outcome among 65 substance-abusing adolescents receiving multidimensional family therapy. Observer ratings of parent alliance predicted premature termination from treatment. Observer ratings, but not self-report, of adolescent…

  8. The Validity of the Personal Orientation Inventory for Measuring the Effects of Training for Therapeutic Practice

    ERIC Educational Resources Information Center

    Fischer, Joel; Knapp, Robert R.

    1977-01-01

    The effects of training counselors for the core therapeutic conditions of empathy, warmth, and genuineness were studied in terms of increased levels of actualizing as measured by the Personal Orientation Inventory. Results support the discriminant validity of the inventory. (JKS)

  9. NASA Museum Alliance

    NASA Astrophysics Data System (ADS)

    Sohus, Anita

    2006-12-01

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

  10. Program, Counselor, and Patient Variability in the Alliance: A Multilevel Study of the Alliance in Relation to Substance Use Outcomes

    PubMed Central

    Crits-Christoph, Paul; Hamilton, Jessica L.; Ring-Kurtz, Sarah; Gallop, Robert; McClure, Bridget; Kulaga, Agatha; Rotrosen, John

    2011-01-01

    We explored patient, therapist, and program variability in the alliance in relation to drug and alcohol use during treatment, and whether alliance mediates the relation of program characteristics to drug/alcohol use. Data (N=1613 patients) were drawn from a randomized clinical trial investigating the efficacy of an intervention that provided alliance and outcome feedback to 112 counselors across 20 community-based outpatient substance abuse treatment clinics in the northeast United States. Program characteristics were measured using the Organization Readiness for Change scale. Using multilevel modeling, we found that alliance was related to both drug and alcohol use during the past week at the patient and program levels of analysis, but not the counselor level. Several program characteristics were related to average drug and alcohol use. The alliance was not a mediator of these relationships. Program variability in the alliance is important to the alliance-outcome relationship in the treatment of substance abuse. Better outcomes can be achieved by improving both organizational functioning and the patient-counselor alliance. PMID:21349680

  11. Grand alliance HDTV

    NASA Astrophysics Data System (ADS)

    Petajan, Eric D.

    1995-12-01

    Terrestrial broadcast television in the United States has remained essentially unchanged in the last fifty years except for the addition of color and stereo sound. Today, personal computers are addressing the need for random access of high resolution images and CD quality audio. Furthermore, advances in digital video compression and digital communication technology have cleared the way toward offering high resolution video and audio services to consumers using traditional analog communications channels. In 1987, the U.S. Federal Communications Commission (FCC) chartered an advisory committee to recommend an advanced television system for the United States. From 1990 to 1992, the Advanced Television Test Center tested four all-digital systems, one analog High Definition Television (HDTV) system, and one enhancement NTSC system using broadcast and cable television environment simulators. The formation of the HDTV Grand Alliance in May of 1993 resulted from the withdrawal of the only analog HDTV system from the competition and a stalemate between the other four all- digital systems. The HDTV Grand Alliance system is composed of the best components from previously competing digital systems demonstrated to the FCC. Moving Pictures Experts Group (MPEG-2) syntax is used with novel encoding techniques to deliver a set of video scanning formats for a variety of applications. This paper describes the important features and concepts embodied in the HDTV Grand Alliance system.

  12. Robustness of airline alliance route networks

    NASA Astrophysics Data System (ADS)

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

    2015-05-01

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

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

    PubMed

    Naidu, Thirusha; Behari, Sheethal

    2010-06-01

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

  14. [Alliance against MDRO: safeguarding antibiotics].

    PubMed

    Carlet, J; Rambaud, C; Pulcini, C

    2012-09-01

    Resistance to antibiotics has increased recently to a dramatic extend, and the pipeline of new antibiotics is almost dry for the 5 next years. Failures happen already for trivial community acquired infections, like pyelonephritis, or peritonitis, and this is likely to increase. Difficult surgical procedures, transplants, and other immunosuppressive therapies will become far more risky. Resistance is mainly due to an excessive usage of antibiotics, in all sectors, including the animal one. Action is urgently needed. Therefore, an alliance against MDRO has been recently created, which includes health care professionals, consumers, health managers, and politicians. The document highlights the different proposed measures, and represents a strong consensus between the different professionals, including general practitioners, and veterinarians.

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

    ERIC Educational Resources Information Center

    Lester, Mindy Chaky

    2012-01-01

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

  16. Building Alliances Series: Workforce Development

    ERIC Educational Resources Information Center

    Brady, Cecilia

    2009-01-01

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

  17. Alliance for Computational Science Collaboration

    SciTech Connect

    Scheick, S. H.

    2003-04-26

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

  18. Therapist-reported alliance: is it really a predictor of outcome?

    PubMed Central

    Zilcha-Mano, Sigal; Solomonov, Nili; Chui, Harold; McCarthy, Kevin S.; Barrett, Marna S.; Barber, Jacques P.

    2015-01-01

    Most of the literature on the alliance-outcome association is based exclusively on differences between patient reports on alliance. Much less is known about the unique contribution of the therapist’s report to this association across treatment, that is, the association between therapist-reported alliance and outcome over the course of treatment, after controlling for the patient’s contribution. The present study is the first to examine the unique contribution of the therapist-reported alliance to outcome, accounting for reverse causation (symptomatic levels predicting alliance), at several time points in the course of treatment. Of 156 patients randomized to dynamic supportive-expressive psychotherapy, antidepressant medication with clinical management, and placebo with clinical management, 149 were included in the present study. Alliance was assessed from the perspective of both the patient and the therapist. Outcome measures included the patients’ self-reported and diagnostician-rated depressive symptoms. Overall, the findings demonstrate that the therapists’ contribution to the alliance-outcome association was explained mainly by prior symptomatic levels. However, when a time lag of several sessions was introduced between alliance and symptoms, a positive association emerged between alliance at one time point and symptomatic distress assessed several sessions later in the treatment, controlling for previous symptomatic level. The findings were similar whether or not we controlled for the patient’s perspective on the alliance. Taken together, the findings attest to the importance of improving therapists’ ability to detect deterioration in the alliance. PMID:26323043

  19. Strategic alliances and market risk.

    PubMed

    Havenaar, Matthias; Hiscocks, Peter

    2012-08-01

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

  20. The Research Data Alliance

    NASA Astrophysics Data System (ADS)

    Fontaine, K. S.

    2015-12-01

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

  1. The Alliance Negotiation Scale: A psychometric investigation.

    PubMed

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

    2016-08-01

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

  2. "What should we talk about?" The association between the information exchanged during the mental health intake and the quality of the working alliance.

    PubMed

    Nakash, Ora; Nagar, Maayan; Kanat-Maymon, Yaniv

    2015-07-01

    We investigated the association between the content of the information exchanged between clients and therapists during mental health intake and the quality of the therapeutic alliance. Thirty-eight therapists and 107 clients from four mental health clinics in Israel participated in the study. The content of information discussed was coded directly from the recorded intakes by blinded raters. Clients and therapists completed the Working Alliance Inventory immediately following the intake. Therapists spent the majority of intake time in collecting information about their clients' diagnostic symptoms and personal history and sociocultural background. Due to the high negative correlation between these factors, r(107) = -.68, p < .001, we created a measure of delta score with higher scores reflecting more discussion of personal history and sociocultural background and less discussion of diagnostic symptoms. We computed three-level hierarchical linear model analysis, with intakes nested within therapists and therapists nested within sites, to examine the association between the delta score and the working alliance, while controlling for intake duration. Results showed significant association between the delta score and clients' rating of the working alliance (γ200 = 0.014, p = .02), indicating that discussing more personal history and sociocultural background and less diagnostic symptoms was associated with better clients' rating of the working alliance. Therapists' rating of the working alliance was not significantly associated with the content of the information exchanged. The restricted intake time allocated to therapists dictates use of strategies to deal with time trade-offs to complete a thorough diagnostic assessment while allowing clients to tell their personal story.

  3. A calculating alliance.

    PubMed

    Alanis, M; Sippel, S

    1999-01-01

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

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

    PubMed

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

    2016-02-21

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

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

    PubMed

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

    2016-02-21

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

  6. Global Alliance for Tuberculosis Drug Development

    MedlinePlus

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  8. Your alliances are too stable.

    PubMed

    Ernst, David; Bamford, James

    2005-06-01

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

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

    PubMed Central

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

    2016-01-01

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

  10. The global alliance for transplantation.

    PubMed

    Groth, C G; Chapman, J R

    2006-03-01

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

  11. An Offender Version of the Working Alliance Inventory-Short Revised

    ERIC Educational Resources Information Center

    Tatman, Anthony W.; Love, Keisha M.

    2010-01-01

    The series of Working Alliance Inventories remains the most extensively researched and utilized instruments to measure the working alliance. However, these instruments have not been normed and validated among individuals on probation or parole. Therefore, this study provides psychometric properties for a modified, offender version of the Working…

  12. [Assessment of blood pressure measurement for the diagnosis and therapeutic monitoring of hypertension (author's transl)].

    PubMed

    Krönig, B

    1978-03-31

    Blood pressure readings are the central parameter in the diagnosis and therapeutic monitoring of arterial hypertension. Frequent measurements are therefore necessary because the blood pressures of healthy people, and in particular of patients with hypertension, are subject to considerable variability. Emotional factors, physical strain and diurnal differences have a modifying effect. Attempts to standardize a single measurement such as has been tried in the determination of the basic blood pressure or the diastolic levels have proved of little relevance for information on the daily blood pressure profile. The frequent determination of a random blood pressure after 2 to 3 minutes rest is a logical alternative. Regular monitoring is almost ideally obtained, especially under antihypertensive drug therapy, by the patient measuring his own blood pressure.

  13. Working Alliances in College Classrooms

    ERIC Educational Resources Information Center

    Meyers, Steven A.

    2008-01-01

    I explain how professors can establish working alliances with students to cultivate a climate conducive to learning. This process involves (a) attending to the emotional bonds that exist in the college classroom, (b) developing shared educational goals and tasks to promote a common sense of purpose, and (c) addressing classroom conflict to repair…

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

    PubMed Central

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

    2016-01-01

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

  15. Measuring the quality of therapeutic apheresis care in the pediatric intensive care unit.

    PubMed

    Sussmane, Jeffrey B; Torbati, Dan; Gitlow, Howard S

    2012-01-01

    Our goal was to measure the quality of care provided in the Pediatric Intensive Care Unit (PICU) during Therapeutic Apheresis (TA). We described the care as a step by step process. We designed a flow chart to carefully document each step of the process. We then defined each step with a unique clinical indictor (CI) that represented the exact task we felt provided quality care. These CIs were studied and modified for 1 year. We measured our performance in this process by the number of times we accomplished the CI vs. the total number of CIs that were to be performed. The degree of compliance, with these clinical indicators, was analyzed and used as a metric for quality by calculating how close the process is running exactly as planned or "in control." The Apheresis Process was in control (compliance) for 47% of the indicators, as measured in the aggregate for the first observational year. We then applied the theory of Total Quality Management (TQM) through our Design, Measure, Analyze, Improve, and Control (DMAIC) model. We were able to improve the process and bring it into control by increasing the compliance to > 99.74%, in the aggregate, for the third and fourth quarter of the second year. We have implemented TQM to increase compliance, thus control, of a highly complex and multidisciplinary Pediatric Intensive Care therapy. We have shown a reproducible and scalable measure of quality for a complex clinical process in the PICU, without additional capital expenditure. PMID:22095668

  16. Measured microdosimetric spectra and therapeutic potential of boron neutron capture enhancement of 252Cf brachytherapy.

    PubMed

    Burmeister, J; Kota, C; Maughan, R L

    2005-09-01

    Californium-252 is a neutron-emitting radioisotope used as a brachytherapy source for radioresistant tumors. Presented here are microdosimetric spectra measured as a function of simulated site diameter and distance from applicator tube 252Cf sources. These spectra were measured using miniature tissue-equivalent proportional counters (TEPCs). An investigation of the clinical potential of boron neutron capture (BNC) enhancement of 252Cf brachytherapy is also provided. The absorbed dose from the BNC reaction was measured using a boron-loaded miniature TEPC. Measured neutron, photon and BNC absorbed dose components are provided as a function of distance from the source. In general, the absorbed dose results show good agreement with results from other measurement techniques. A concomitant boost to 252Cf brachytherapy may be provided through the use of the BNC reaction. The potential magnitude of this BNC enhancement increases with increasing distance from the source and is capable of providing a therapeutic gain greater than 30% at a distance of 5 cm from the source, assuming currently achievable boron concentrations.

  17. Measuring the quality of therapeutic apheresis care in the pediatric intensive care unit.

    PubMed

    Sussmane, Jeffrey B; Torbati, Dan; Gitlow, Howard S

    2012-01-01

    Our goal was to measure the quality of care provided in the Pediatric Intensive Care Unit (PICU) during Therapeutic Apheresis (TA). We described the care as a step by step process. We designed a flow chart to carefully document each step of the process. We then defined each step with a unique clinical indictor (CI) that represented the exact task we felt provided quality care. These CIs were studied and modified for 1 year. We measured our performance in this process by the number of times we accomplished the CI vs. the total number of CIs that were to be performed. The degree of compliance, with these clinical indicators, was analyzed and used as a metric for quality by calculating how close the process is running exactly as planned or "in control." The Apheresis Process was in control (compliance) for 47% of the indicators, as measured in the aggregate for the first observational year. We then applied the theory of Total Quality Management (TQM) through our Design, Measure, Analyze, Improve, and Control (DMAIC) model. We were able to improve the process and bring it into control by increasing the compliance to > 99.74%, in the aggregate, for the third and fourth quarter of the second year. We have implemented TQM to increase compliance, thus control, of a highly complex and multidisciplinary Pediatric Intensive Care therapy. We have shown a reproducible and scalable measure of quality for a complex clinical process in the PICU, without additional capital expenditure.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

    Hearld, Larry R; Alexander, Jeffrey A

    2014-03-01

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

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

    PubMed

    Hearld, Larry R; Alexander, Jeffrey A

    2014-03-01

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

  1. [Severe complications in hemorrhagic stomach ulcer in the elderly and the therapeutic measures].

    PubMed

    Ueda, Kazuki; Enomoto, Shotaro; Maekita, Takao; Ichinose, Masao

    2010-11-01

    In recent years, the prevalence of peptic ulcer has been increasing among the elderly. The characteristics of gastric ulcers in elderly patients include an increased rate of complications such as bleeding and perforation and a tendency to increase in severity. In conjunction with increases in the elderly population, current challenges include therapeutic measures against bleeding ulcers. In hemorrhagic stomach ulcers, some cases present with critical complications such as shock, and a prompt response is thus required. After the stabilization of circulatory and respiratory conditions is attained, endoscopic hemostatic procedures should be extended. When performing endoscopy for an elderly patient, existing functional impairments may lead to unforeseeable events, and it is therefore necessary to pay close attention to ensure the safety of such patients.

  2. [Therapeutic touch and anorexia nervosa].

    PubMed

    Satori, Nadine

    2016-01-01

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

  3. Therapeutic friendliness and the development of therapeutic leverage by mental health nurses in community rehabilitation settings.

    PubMed

    Gardner, Andrew

    2010-01-01

    In a world dominated by technology and driven by fiscal policy emphasis, the therapeutic relationship as a healing modality is still a central theme to mental health nurses (MHN) in their everyday work. This research, as part of a PhD program, used a constructivist grounded theory approach to explore the process of therapeutic relationships and professional boundaries. The current paper outlines how therapeutic friendliness provides a connection for the therapeutic relationship to develop but in doing so requires a balancing of the therapeutic relationship and constant maintenance of the professional boundary. The authors also discuss how community mental health nurses (CMHN) invest in the therapeutic relationship in order to develop a therapeutic alliance and how the alliance between the CMHN and the client facilitates the use of therapeutic leverage applied by the CMHN as part of the therapeutic process. PMID:20509798

  4. A model of strategic marketing alliances for hospices: vertical, internal, osmotic alliances and the complete model.

    PubMed

    Starnes, B J; Self, D R

    1999-01-01

    This article develops two previous research efforts. William J. Winston (1994, 1995) has proposed a set of strategies by which health care organizations can benefit from forging strategic alliances. Raadt and Self (1997) have proposed a classification model of alliances including horizontal, vertical, internal, and osmotic. In the second of two articles, this paper presents a model of vertical, internal, and osmotic alliances. Advantages and disadvantages of each are discussed. Finally, the complete alliance system model is presented. PMID:10623195

  5. Terra Nova breaks new ground for alliances

    SciTech Connect

    Ghiselin, D.

    1996-08-01

    This paper reviews the development of alliances to help develop the Terra Nova oil and gas field in the offshore Atlantic areas of Canada. Largely attributed to BP, the strategic alliance concept got its start in the North Sea and on the North Slope of Alaska. BP saw it as the best way to take advantage of economy-of-scale, mitigate risk, and achieve outsourcing goals while retaining their core competencies. This paper reviews the methods of developing the alliances, the developing of a development plan for the Terra Nova field, and how the alliance plans to maximize the profittability of the operation for all involved.

  6. The Alliance in Couple Therapy: Partner Influence, Early Change, and Alliance Patterns in a Naturalistic Sample

    ERIC Educational Resources Information Center

    Anker, Morten G.; Owen, Jesse; Duncan, Barry L.; Sparks, Jacqueline A.

    2010-01-01

    Objective: The purpose of this study was to explore the relationship between the alliance and outcome in couple therapy and examine whether the alliance predicted outcomes over and above early change. The authors also investigated partner influence and gender and sought to identify couple alliance patterns that predicted couple outcomes. Method:…

  7. A Step toward Disentangling the Alliance/Improvement Cycle in Family Therapy

    ERIC Educational Resources Information Center

    Friedlander, Myrna L.; Lambert, Jessica E.; de la Pena, Cristina Muniz

    2008-01-01

    The authors focused on 2 unique aspects of the alliance in conjoint therapy: feeling safe in the therapeutic context with other family members and the family's shared sense of purpose about treatment (i.e., productive within-family collaboration). Low-income, multiproblem families were seen in a community clinic by therapists with varying…

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

    ERIC Educational Resources Information Center

    Kivlighan, Dennis M., Jr.

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  10. Leading the Dental Quality Movement: A Dental Quality Alliance Perspective.

    PubMed

    Ojha, Diptee; Aravamudhan, Krishna

    2016-04-01

    Changing regulatory priorities set forth by the Affordable Care Act and recent activities of the Centers for Medicare and Medicaid Services clearly prioritize the need to improve the quality of health care in both the public and private sectors. As the largest multistakeholder organization focused on oral health care quality measurement and improvement, the Dental Quality Alliance is leading the way in establishing standardized and valid quality measures applicable in both private and public sectors. PMID:27265980

  11. Distance Education Alliance Tackles FCS Teacher Shortage

    ERIC Educational Resources Information Center

    McGinnis, Gay Nell

    2004-01-01

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

  12. Iowa Distance Education Alliance. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Sorensen, Chris; Sweeney, Jan

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

  13. 3rd year final contractor report for: U.S. Department of Energy Stewardship Science Academic Alliances Program Project Title: Detailed Measurements of Rayleigh-Taylor Mixing at Large and Small Atwood Numbers

    SciTech Connect

    Malcolm J. Andrews

    2006-04-14

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

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

    ERIC Educational Resources Information Center

    Manso, Ana; Rauktis, Mary Elizabeth

    2011-01-01

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

  15. Therapeutic Drug Monitoring

    MedlinePlus

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

  16. Therapeutic trials in lupus nephritis. Problems related to renal histology, monitoring of therapy and measures of outcome.

    PubMed

    Balow, J E

    1981-01-01

    Approaches to treatment of lupus nephritis have been complicated by controversies in the definitions of the types of renal histology, the relevance of immunological and renal monitoring techniques as therapeutic guidelines, and lack of definitive clinical trials. It is suggested that demonstration of the efficacy of various therapeutic agents in clinical trials may be identified earlier by renal histological changes and/or assessment of drug toxicity compared to the time required for differences based on renal functional changes to emerge as ultimate measures of outcome.

  17. Successful alliances driven by processes, not discounts

    SciTech Connect

    Brett, J.F.; Craig, V.B.; Pile, K.E.; Wadsworth, D.B.; Brett, K.V.; Aslakson, J.

    1996-09-23

    When alliances are executed properly and partners have a full understanding of true integration, drilling ventures can improve their potential to reduce costs and accelerate production by 12--30%. Many companies enter alliances without a full grasp of the economic potential such a relationship might offer. Many alliances rely too heavily on relationship issues and commercial terms instead of focusing on integrating their technical processes successfully. Process-driven alliance (PDA) is the term adopted by a new Gas Research Institute report prepared by OGCI Management Inc. to represent a fundamentally different way to plan, execute, and evaluate drilling projects. This paper discusses the findings of the GRI study, describing the stability of PDAs, value chain, successful PDAs, changed commercial terms, and characteristics of failure.

  18. Specialty products: the next challenge for alliances.

    PubMed

    Loesch, J

    1991-11-01

    As group purchasing matures, alliances and GPOs will need to expand their contract portfolio to include specialty products. As groups and manufacturers negotiate successful specialty products agreements and hospitals actively support those contracts, the industry as a whole stands to benefit. If alliance and manufacturers do not attempt to negotiate specialty products agreements that bring value to both parties, hospitals will miss out on savings, and suppliers will lose market share opportunities.

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

    PubMed

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

    2003-09-01

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

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

    ERIC Educational Resources Information Center

    Washington, Cheryl A.

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  2. Humor: A Therapeutic Intervention for Child Counseling

    ERIC Educational Resources Information Center

    Berg, Rachelle G.; Parr, Gerald; Bradley, Loretta J.; Berry, Jeremy J.

    2009-01-01

    Counselors utilize many strategies, techniques, and tools when building a therapeutic alliance or addressing children's issues. Due to the serious nature of discussing problems or perhaps because of the fear of seeming insensitive, counselors often overlook humor as a means to enhance therapy. Whether deliberate or spontaneous, humor can add…

  3. Uncertainty assessment in measurement of myotube thickness in cells culture treated with and without therapeutic ultrasound

    NASA Astrophysics Data System (ADS)

    Abrunhosa, V. M.; Costa, M. L.; Mermelstein, C.; Alvarenga, A. V.; Costa-Félix, R. P. B.

    2015-01-01

    Effectiveness of an ultrasound treatment shall be assessed by experiments. A reliable cell culture protocol is available and spatial discrepancies could arise. To assure if the spatial difference are relevant or not, and how they should be dealt with, an uncertainty model for the treatment result is a metrological reliable solution. The present work reports a metrological approach to assess myotube thickness and to validate a primary cell culture of muscle after a therapeutic ultrasound treatment, comparing it with a control group. The results reinforced the importance of such approach and show an efficacy of treatment on myotube differentiation.

  4. Alliances and reproductive success in Camargue stallions.

    PubMed

    Feh

    1999-03-01

    A study of a herd of Camargue horses Equus caballus, showed that while the majority of high-ranking stallions held single-male harems, some sons of low-ranking mares, being low ranking themselves, formed alliances that could last a lifetime. The two stallions were each other's closest associate and preferential grooming partner. Alliances were based on coalitions in which either both partners confronted an intruder synchronously or the dominant of the pair tended the female(s) while the subordinate simultaneously displayed towards the rival. Alliance partners were of similar age but were not more closely related to each other than to other stallions in the herd. Long-term paternity data revealed that subordinates sired close to a quarter of the foals born into the alliance group, and significantly more foals than low-ranking stallions in the herd adopting a 'sneak'-mating strategy. The dominant appeared to benefit from the presence of his subordinate partner. Fights occurred all year round, and the subordinate stallion of each alliance pair fought outside competitors more than twice as often as the dominant. Forming short-term alliances before defending mares on their own may enhance long-term reproductive success for both partners. Other benefits to both partners include higher survivorship of their foals and increased access to proven reproductive mares. These results suggest that the relationship between alliance partners is based on mutualism, but several conditions for reciprocity seem to be fulfilled: the benefit to the dominant (assistance in fights), and the benefit to the subordinate (access to reproduction), are both costly to the other partner and delayed in time. Copyright 1999 The Association for the Study of Animal Behaviour.

  5. Japanese contributions to International Planetary Data Alliance

    NASA Astrophysics Data System (ADS)

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

    2012-07-01

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

  6. [From teaching and care to creativity, a therapeutic stay project].

    PubMed

    Cherai, M'hand

    2011-01-01

    A group of young patients led by teachers and caregivers decided to organise a therapeutic stay. The objective of the stay was to visit historical sites to act out scenes from a fictional play written in a workshop. This stay enabled patients to develop their autonomy and strengthened the therapeutic alliance.

  7. The working alliance in a randomized controlled trial comparing online with face-to-face cognitive-behavioral therapy for depression

    PubMed Central

    2011-01-01

    Background Although numerous efficacy studies in recent years have found internet-based interventions for depression to be effective, there has been scant consideration of therapeutic process factors in the online setting. In face-to face therapy, the quality of the working alliance explains variance in treatment outcome. However, little is yet known about the impact of the working alliance in internet-based interventions, particularly as compared with face-to-face therapy. Methods This study explored the working alliance between client and therapist in the middle and at the end of a cognitive-behavioral intervention for depression. The participants were randomized to an internet-based treatment group (n = 25) or face-to-face group (n = 28). Both groups received the same cognitive behavioral therapy over an 8-week timeframe. Participants completed the Beck Depression Inventory (BDI) post-treatment and the Working Alliance Inventory at mid- and post- treatment. Therapists completed the therapist version of the Working Alliance Inventory at post-treatment. Results With the exception of therapists' ratings of the tasks subscale, which were significantly higher in the online group, the two groups' ratings of the working alliance did not differ significantly. Further, significant correlations were found between clients' ratings of the working alliance and therapy outcome at post-treatment in the online group and at both mid- and post-treatment in the face-to-face group. Correlation analysis revealed that the working alliance ratings did not significantly predict the BDI residual gain score in either group. Conclusions Contrary to what might have been expected, the working alliance in the online group was comparable to that in the face-to-face group. However, the results showed no significant relations between the BDI residual gain score and the working alliance ratings in either group. Trial registration ACTRN12611000563965 PMID:22145768

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  11. Financial analysis for the infusion alliance.

    PubMed

    Perucca, Roxanne

    2010-01-01

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

  12. Contractor Alliances and the New World of Work.

    ERIC Educational Resources Information Center

    Owen, C.; Bound, H.

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

  13. 2013 NCI Alliance for Nanotechnology in Cancer Annual Bulletin

    Cancer.gov

    The NCI Alliance for Nanotechnology in Cancer Bulletin is a resource that serves to connect Alliance participants, partners, and affiliates by highlighting the innovative work of the Alliance members in their efforts to harness the power of nanotechnology to radically change the way we diagnose, treat, and prevent cancer.

  14. An Overview of Strategic Alliances between Universities and Corporations

    ERIC Educational Resources Information Center

    Elmuti, Dean; Abebe, Michael; Nicolosi, Marco

    2005-01-01

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

  15. Challenges of Capacity Building in Multisector Community Health Alliances

    ERIC Educational Resources Information Center

    Alexander, Jeffrey A.; Christianson, Jon B.; Hearld, Larry R.; Hurley, Robert; Scanlon, Dennis P.

    2010-01-01

    Capacity building is often described as fundamental to the success of health alliances, yet there are few evaluations that provide alliances with clear guidance on the challenges related to capacity building. This article attempts to identify potential challenges of capacity building in multistakeholder health alliances. The study uses a multiple…

  16. Global University Alliances and the Creation of Collaborative Advantage

    ERIC Educational Resources Information Center

    Gunn, Andrew; Mintrom, Michael

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  18. Translating outcomes measurement in experimental therapeutics of systemic rheumatic disease to patient care.

    PubMed

    Liang, Matthew H

    2006-02-01

    This article discusses the clinimetrics of disease activity and organ damage, and response criteria using systemic lupus erythematosus as a paradigm. Similar considerations apply to the other systemic rheumatic illnesses. Clinically relevant and psychometrically tested measures of disease states aid the conduct of clinical studies and trials that are more rigorous, efficient, and relevant to patients' concerns. These same measures used in clinical trials will likely improve clinical outcomes if they are used in the monitoring and titration of therapy in patients who have these disorders. For this use to really occur, clinical trials will have to demonstrate treatments that alter these therapies in a meaningful way and the measures or modifications of them will need to meet the desiderata of techniques that can be used in practice.

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

    NASA Astrophysics Data System (ADS)

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

    2016-10-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-07-01

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

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

    SciTech Connect

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

    1997-11-15

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

  2. Earth System Science Education Alliance

    NASA Astrophysics Data System (ADS)

    Myers, R.; Schwerin, T.

    2007-12-01

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

  3. Earth System Science Education Alliance

    NASA Astrophysics Data System (ADS)

    Myers, R.; Schwerin, T.

    2006-12-01

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

  4. Facilitating Economic Development through Strategic Alliances.

    ERIC Educational Resources Information Center

    Noftsinger, John B., Jr.

    2002-01-01

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

  5. Developing Strategic Alliances in Management Learning

    ERIC Educational Resources Information Center

    Thorne, E. Ann; Wright, Gill

    2005-01-01

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

  6. Academic Alliances: School/College Faculty Collaboratives.

    ERIC Educational Resources Information Center

    Slaughter, Debra

    1985-01-01

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

  7. The Carnegie Mellon/Sirsi Corporation Alliance.

    ERIC Educational Resources Information Center

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

    1999-01-01

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

  8. Report on the Black Hills Alliance.

    ERIC Educational Resources Information Center

    Ryan, Joe

    1979-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Sathiyan, S.; Ravikumar, M.

    2007-01-01

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

  10. Ureteroscopic treatment of ureteral stones: only an auxiliary measure of extracorporeal shockwave lithotripsy or a primary therapeutic option?

    PubMed

    Osti, A H; Hofmockel, G; Frohmüller, H

    1997-01-01

    Both extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy are well-established methods in stone treatment; however, the therapeutic procedure in ureteral calculi, especially in the distal third of the ureter, is still controversially discussed. The aim of the present study was to examine the role of ureteroscopy as an auxiliary measure after ESWL and its importance as an alternative therapeutic option in the treatment of distal ureteral stones. Between 1991 and 1994, 115 ureteroscopic procedures in 104 patients with ureteral stones or stone fragments were carried out at our institution. During the same period of time, 1,595 patients with ureteral calculi (in the proximal two thirds of the ureter: n = 956; in the distal third of the ureter: n = 639) were treated with a Dornier HM-3 lithotriptor. In 77 of those 104 patients treated by ureteroscopy, this procedure was indicated as an auxiliary measure after failure of ESWL including 34 out of the 639 patients (5.3%) with stones in the distal part of the ureter. The overall direct success rate during the ureteroscopic stone treatment (including 11 cases with a second procedure) in the proximal, middle and distal third of the ureter was 74, 81 and 92%, respectively. The success rate of primary ureteroscopic removal of distal-third ureteral stones alone was 100% in 27 of these 104 patients. After 3 months the overall stone-free rate of all patients treated with ureteroscopy was 94%. Ureteroscopy appears to be a safe and effective treatment modality, if used as an auxiliary measure after failure of ESWL as well as a primary treatment modality in the case of stones in the distal third of the ureter. On the other hand, ESWL alone is a noninvasive and also successful procedure in treating stones situated in the distal part of the ureter.

  11. Therapeutic Nanodevices

    NASA Astrophysics Data System (ADS)

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

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

  12. Therapeutic Nanodevices

    NASA Astrophysics Data System (ADS)

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

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

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

    NASA Technical Reports Server (NTRS)

    Iatrou, Kostas; Alamdari, Fariba

    2003-01-01

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

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

    PubMed

    Wilkens, Volker; Sonntag, Sven; Georg, Olga

    2016-03-01

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

  15. The effect of qigong on therapeutic balancing measured by Electroacupuncture According to Voll (EAV): a preliminary study.

    PubMed

    Sancier, K M

    1994-01-01

    Electroacupuncture According to Voll (EAV) was used to monitor the effects of qigong practice on therapeutic balancing of subjects. In EAV the electrical conductance of the skin above individual acupuncture points is measured using low voltage and current. Diagnosis depends on measuring the relative electrical conductance and its time dependence. An important diagnostic criterion of degeneration of an organ is an indicator drop which occurs during the measurement when the conductance decreases from an apparent maximum value and then levels off. Two series of EAV measurements were made before and after healthy subjects practiced qigong. Measurements were made at 24 acupuncture points at the ends of the meridians of the fingers and toes of a subject and were made by the same operator and equipment. The subjects were asked to perform a qigong exercise of their choosing. In the first series, four subjects were examined by EAV before and after qigong exercise. Qigong exercise decreased the average EAV measured values of the four subjects in the range of -19 to -31%. Qigong eliminated indicator drops for three subjects and reduced the indicator drop by 80% for the fourth subject. In the second series, each of seven subjects was examined by EAV three times in a blind protocol so that the operator did not know whether a subject had practiced qigong before the second or third examination. Qigong exercise changed the average EAV measured values in the range of -17 to -35% for four subjects and 4 to 15% for three subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Random coincidences during in-beam PET measurements at microbunched therapeutic ion beams

    NASA Astrophysics Data System (ADS)

    Parodi, K.; Crespo, P.; Eickhoff, H.; Haberer, T.; Pawelke, J.; Schardt, D.; Enghardt, W.

    2005-06-01

    At the experimental carbon ion tumour therapy facility at GSI Darmstadt, in-beam positron emission tomography (PET) is used to monitor the dose delivery precision. A dual head positron camera has been assembled from commercial detector components in order to measure the β+-activity, induced by the irradiation, simultaneously to the dose application. Despite the positive clinical impact, the image quality is limited by the low counting statistics, orders of magnitude below that in standard PET applications to nuclear medicine. This paper investigates the origin for the noisy acquisition during particle extraction from the synchrotron of GSI. The results demonstrate the failure of standard random correction techniques due to a γ-ray background correlated in time with the carbon ion beam microstructure. This prevents the use of data acquired during beam extraction for imaging. The loss of counting statistics is expected to rise further at the future hospital-based facility at Heidelberg, due to a more efficient utilisation of the accelerator resulting in shorter beam pauses and a reduced treatment time. In this respect, this paper provides the basis for a new data acquisition concept tailored to the unconventional application of in-beam PET imaging to therapy monitoring at radiofrequency pulsed radiation sources.

  17. Marriage and the Parenting Alliance: Longitudinal Prediction of Change in Parenting Perceptions and Behaviors.

    ERIC Educational Resources Information Center

    Floyd, Frank J.; Gilliom, Laura A.; Costigan, Catherine L.

    1998-01-01

    Couples with school-age children with mental retardation completed self-report and observational measures of marriage, the parenting alliance, and parenting attitudes and behaviors at two periods. Findings indicated significant effects of marital quality on changes in self-reports of perceived parenting competence, and in observed negative…

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

    PubMed

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

    2010-02-23

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

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

    PubMed

    Differding, Edmond

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Schafer, Rachel; Gmitro, Arthur F.

    2015-03-01

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

  1. Strategic defense and the Western alliance

    SciTech Connect

    Lakoff, S.; Willoughby, R. )

    1987-01-01

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

  2. Creating a NASA-Wide Museum Alliance

    NASA Technical Reports Server (NTRS)

    Sohus, Anita M.

    2006-01-01

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

  3. Science alliance: A scientist/teacher partnership

    SciTech Connect

    Eckstrand, A.

    1994-12-31

    Science Alliance, sponsored by the National Institutes of Health, involves fifty NIH scientists, teachers in six elementary schools, and two school districts. The goals are to: (1) support teachers and schools as they develop science programs; (2) provide role models for students; (3) illustrate what scientists do; and (4) encourage a multidisciplinary approach to learning. Activities include classroom visits, workshops on hands-on science for teachers and scientists, a scientist training program, an electronic bulletin board, a workbook of activities that scientists have developed for classroom visits, and a newsletter. Aided by an annual evaluation, we have identified several elements critical to the success of Science Alliance. Teachers and scientists need a good personal relationship; good communications are fundamental. The responsibilities of participants must be clear, and both scientists and teachers need support and encouragement from their supervisors.

  4. International Planetary Data Alliance (IPDA) Information Model

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  5. Humanism and multiculturalism: an evolutionary alliance.

    PubMed

    Comas-Diaz, Lillian

    2012-12-01

    Humanism and multiculturalism are partners in an evolutionary alliance. Humanistic and multicultural psychotherapies have historically influenced each other. Humanism represents the third force in psychotherapy, while multiculturalism embodies the fourth developmental stage. Multiculturalism embraces humanistic values grounded in collective and social justice contexts. Examples of multicultural humanistic constructs include contextualism, holism, and liberation. Certainly, the multicultural-humanistic connection is a necessary shift in the evolution of psychotherapy. Humanism and multiculturalism participate in the development of an inclusive and evolutionary psychotherapy. PMID:23205825

  6. The NPARC Alliance Verification and Validation Archive

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  7. Humanism and multiculturalism: an evolutionary alliance.

    PubMed

    Comas-Diaz, Lillian

    2012-12-01

    Humanism and multiculturalism are partners in an evolutionary alliance. Humanistic and multicultural psychotherapies have historically influenced each other. Humanism represents the third force in psychotherapy, while multiculturalism embodies the fourth developmental stage. Multiculturalism embraces humanistic values grounded in collective and social justice contexts. Examples of multicultural humanistic constructs include contextualism, holism, and liberation. Certainly, the multicultural-humanistic connection is a necessary shift in the evolution of psychotherapy. Humanism and multiculturalism participate in the development of an inclusive and evolutionary psychotherapy.

  8. Psychological and behavioral disease during developmental age: the importance of the alliance with parents

    PubMed Central

    Gatta, Michela; Ramaglioni, Elisabetta; Lai, Jessica; Svanellini, Lorenza; Toldo, Irene; Del Col, Lara; Salviato, Cinzia; Spoto, Andrea; Antonio, Battistella Pier

    2009-01-01

    The aim of the study is to analyze the clinician’s alliance with parents during the diagnostic process in relation to therapeutic compliance and clinical evolution of individuals aged 0–11 years. The sample was formed by 84 individuals aged 0 to 11 years (18 < 6 years, 66 aged 6 to 11 years; 62 males and 22 females) who came to the Neuropsychiatric Unit for Children and Adolescents for a consultation regarding psychorelational and behavioral problems. Neuropsychiatric consultation took place in five diagnostic interviews with child and parents, separately. The last session was devoted to communication of psychiatric diagnosis (according to ICD 10) and therapeutic suggestions, if any. The clinician’s relationship with parents and patients’ participation were evaluated in terms of collaboration and quality of interaction, on the basis of pre-established criteria. Data about patients’ therapeutic compliance and clinical outcome were collected during a follow-up visit eight months after the last session. Results suggest that the better the alliance between parents and clinician, the higher the therapeutic compliance and the likelihood of a positive outcome for patients. Our data suggest that good communication with parents benefits child patients, both in terms of response to the parents’ need to report their children’s worrying behavior and as a response to the discomfort expressed by children when they come in for consultation. PMID:19898668

  9. The clinical partnership as strategic alliance.

    PubMed

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

    2004-01-01

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

  10. The way to win in cross-border alliances.

    PubMed

    Bleeke, J; Ernst, D

    1991-01-01

    Global competition has paved the way to new corporate combinations--and opened up new pitfalls along the way. In "The Way to Win in Cross-Border Alliances," Joel Bleeke and David Ernst offer the unconventional lessons of their study of 49 cross-border alliances. For example, alliances between a weak and a strong company usually don't work; but fifty-fifty ownership of joint ventures actually improves decision making. PMID:10114925

  11. MRI measurement of angiogenesis and the therapeutic effect of acute marrow stromal cell administration on traumatic brain injury.

    PubMed

    Li, Lian; Chopp, Michael; Ding, Guang Liang; Qu, Chang Sheng; Li, Qing Jiang; Lu, Mei; Wang, Shiyang; Nejad-Davarani, Siamak P; Mahmood, Asim; Jiang, Quan

    2012-11-01

    Using magnetic resonance imaging (MRI), the present study was undertaken to investigate the therapeutic effect of acute administration of human bone marrow stromal cells (hMSCs) on traumatic brain injury (TBI) and to measure the temporal profile of angiogenesis after the injury with or without cell intervention. Male Wistar rats (300 to 350 g, n=18) subjected to controlled cortical impact TBI were intravenously injected with 1 mL of saline (n=9) or hMSCs in suspension (n=9, 3 × 10(6) hMSCs) 6 hours after TBI. In-vivo MRI acquisitions of T2-weighted imaging, cerebral blood flow (CBF), three-dimensional (3D) gradient echo imaging, and blood-to-brain transfer constant (Ki) of contrast agent were performed on all animals 2 days after injury and weekly for 6 weeks. Sensorimotor function and spatial learning were evaluated. Volumetric changes in the trauma-induced brain lesion and the lateral ventricles were tracked and quantified using T2 maps, and hemodynamic alteration and blood-brain barrier permeability were monitored by CBF and Ki, respectively. Our data show that transplantation of hMSCs 6 hours after TBI leads to reduced cerebral atrophy, early and enhanced cerebral tissue perfusion and improved functional outcome compared with controls. The hMSC treatment increases angiogenesis in the injured brain, which may promote neurologic recovery after TBI.

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

    PubMed Central

    Campbell, Richard; Balbach, Edith D.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    1992-01-01

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

  14. Person-centered Therapeutics

    PubMed Central

    Cloninger, C. Robert; Cloninger, Kevin M.

    2015-01-01

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

  15. North Carolina science and mathematics alliance

    SciTech Connect

    DuBay, D.T.

    1994-12-31

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

  16. Strategic Alliances in Education: The Knowledge Engineering Web

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  17. Service company alliance reduces tight sands frac costs

    SciTech Connect

    Hunter, J.L. ); Stuchly, S.G. )

    1994-08-15

    Smaller, multiple-stage fracture treatments, worked out by an alliance between a producing and a service company, were a significant element in reducing costs for fracturing Carthage Cotton Valley infill wells in Panola County, Texas. Pennzoil's infill drilling program takes advantage of the Texas Railroad Commission's (RRC) ruling that allows optional 80-acre well spacing in this tight gas-sand reservoir. Pennzoil spudded 29 wells between September 1992 and December 1993 and expects to spud 20 more in 1994. The Pennzoil-Halliburton alliance began in September 1992 for the purpose of drilling and completing Cotton Valley infill wells through 1993. The two companies share the cost of new technology development, with Pennzoil providing the rig times to test Halliburton technology. To date, the alliance has experimented with an elastic strain relaxation, a six-arm extensometer, and a water-recovery surfactant. Some of the features of the alliance are: Halliburton guarantees the availability of crews and equipment to meet Pennzoil's drilling and completion schedule; Halliburton technical advisor studies existing wells to find candidates for workover or refracture; the technical advisor analyzes, plants, and evaluates the ongoing program; and the alliance is not rigidly structured, and other service companies perform part of the work. Both parties have benefited financially from the alliance and well performance has met or exceeded expectations. The alliance has enabled Pennzoil to stay on a rigid and aggressive drilling schedule and through efforts of the alliance, fracture orientation has been confirmed.

  18. The Global Research Alliance on agricultural greenhouse gases

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  19. The School and Business Alliance Blooms in Yonkers.

    ERIC Educational Resources Information Center

    Enterprise and Education, 1987

    1987-01-01

    Participants in the New York State School and Business Alliance program, which is designed to strengthen the partnership among public schools, the private sector, communities, and government are working to improve secondary education as well as the quality of the youth labor force. The Alliance Development Committee (ADC) of Yonkers, New York…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    SciTech Connect

    Cernea, M.M.

    1997-03-01

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

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

    ERIC Educational Resources Information Center

    Bedi, Robinder P.

    2006-01-01

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

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

    ERIC Educational Resources Information Center

    Dealtry, Richard

    2008-01-01

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

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

    SciTech Connect

    1995-09-01

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

  5. Global alliances effect in coalition forming

    NASA Astrophysics Data System (ADS)

    Vinogradova, Galina; Galam, Serge

    2014-11-01

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

  6. The Slaying of a Beautiful Hypothesis: The Efficacy of Counseling and the Therapeutic Process

    ERIC Educational Resources Information Center

    Hauser, Mike; Hays, Danica G.

    2010-01-01

    Although the efficacy of counseling has been empirically linked to the therapeutic process, the emphasis in much of the literature remains on technique use. This article discusses 3 components of therapeutic efficacy (i.e., common factors, working alliance, and counselor attributes) and provides implications for counselors and counselor training.…

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

    PubMed

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

    2014-11-01

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

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

    PubMed

    Telio, Summer; Ajjawi, Rola; Regehr, Glenn

    2015-05-01

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

  9. A model measuring therapeutic inertia and the associated factors among diabetes patients: A nationwide population-based study in Taiwan.

    PubMed

    Huang, Li-Ying; Shau, Wen-Yi; Yeh, Hseng-Long; Chen, Tsung-Tai; Hsieh, Jun Yi; Su, Syi; Lai, Mei-Shu

    2015-01-01

    This article presents an analysis conducted on the patterns related to therapeutic inertia with the aim of uncovering how variables at the patient level and the healthcare provider level influence the intensification of therapy when it is clinically indicated. A cohort study was conducted on 899,135 HbA1c results from 168,876 adult diabetes patients with poorly controlled HbA1c levels. HbA1c results were used to identify variations in the prescription of hypoglycemic drugs. Logistic regression and hierarchical linear models (HLMs) were used to determine how differences among healthcare providers and patient characteristics influence therapeutic inertia. We estimated that 38.5% of the patients in this study were subject to therapeutic inertia. The odds ratio of cardiologists choosing to intensify therapy was 0.708 times that of endocrinologists. Furthermore, patients in medical centers were shown to be 1.077 times more likely to be prescribed intensified treatment than patients in primary clinics. The HLMs presented results similar to those of the logistic model. Overall, we determined that 88.92% of the variation in the application of intensified treatment was at the within-physician level. Reducing therapeutic inertia will likely require educational initiatives aimed at ensuring adherence to clinical practice guidelines in the care of diabetes patients.

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

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

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

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

    PubMed

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

    2015-01-01

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

  12. In Congress: Alliance for planet Earth

    NASA Astrophysics Data System (ADS)

    Senator Barbara A. Mikulski of Baltimore, Md., is the new chairman of the Senate Sub-committee on HUD-Independent Agencies of the Committee on Appropriations. That sub-committee oversees funding for the National Aeronautics and Space Administration, National Science Foundation, Environmental Protection Agency, Department of Housing and Urban Development, and Veterans Administration.Senator Mikulski has proposed an Alliance for Planet Earth for groups affected by the money her subcommittee budgets. She suggests that the groups work together to maximize their collective funding and urges individuals to write their Senators, particularly if those Senators are members of the Appropriations Committee, suggesting that they support both the science programs and the housing and urban programs that her subcommittee funds.

  13. Strategic hospital alliances: impact on financial performance.

    PubMed

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

    1997-01-01

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

  14. 77 FR 73637 - Alliance Pipeline L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-11

    ... Energy Regulatory Commission Alliance Pipeline L.P.; Notice of Application Take notice that on November 26, 2012, Alliance Pipeline L.P. (Alliance), 800, 605-5 Ave. SW., Calgary, Alberta, Canada T2P 3H5... directed to Brian Troicuk, Manager, Regulatory Affairs, Alliance Pipeline Ltd. on behalf of...

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

    ERIC Educational Resources Information Center

    Preston-Ortiz, Dina

    2010-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Zhang-sheng, Jiang

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

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

    SciTech Connect

    1998-04-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Jackson, Matthew O; Nei, Stephen

    2015-12-15

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

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

    PubMed Central

    Jackson, Matthew O.; Nei, Stephen

    2015-01-01

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

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

    PubMed

    Galdiolo, Sarah; Roskam, Isabelle

    2016-01-01

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

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

    PubMed

    Galdiolo, Sarah; Roskam, Isabelle

    2016-01-01

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

  3. The development of family alliance from pregnancy to toddlerhood and child outcomes at 5 years.

    PubMed

    Favez, Nicolas; Lopes, Francesco; Bernard, Mathieu; Frascarolo, France; Lavanchy Scaiola, Chloe; Corboz-Warnery, Antoinette; Fivaz-Depeursinge, Elisabeth

    2012-12-01

    This article presents a longitudinal study of the development of "family alliance" from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self-reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: "high stable" (n = 19), "high to low" (n = 10), and "low stable" (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family-level and individual-level variables for understanding individual differences in the social and cognitive development of children. PMID:23230984

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

    Cancer.gov

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

  5. Establishing the heparin therapeutic range using aPTT and anti-Xa measurements for monitoring unfractionated heparin therapy

    PubMed Central

    Byun, Jung-Hyun; Jang, In-Seok; Kim, Jong Woo

    2016-01-01

    Background Unfractionated heparin (UFH) has unstable pharmacokinetics and requires close monitoring. The activated partial thromboplastin time (aPTT) test has been used to monitor UFH therapy for decades in Korea, but its results can be affected by numerous variables. We established an aPTT heparin therapeutic range (HTR) corresponding to therapeutic anti-Xa levels for continuous intravenous UFH administration, and used appropriate monitoring to determine if an adequate dose of UFH was applied. Methods A total of 134 ex vivo samples were obtained from 71 patients with a variety of thromboembolisms. All patients received intravenous UFH therapy and were enrolled from June to September 2015 at Gyeongsang National University Hospital. All laboratory protocols were in accordance with the Clinical and Laboratory Standards Institute guidelines and the College of American Pathologist requirements for aPTT HTR. Results An aPTT range of 87.1 sec to 128.7 sec corresponded to anti-Xa levels of 0.3 IU/mL to 0.7 IU/mL for HTR under our laboratory conditions. Based on their anti-Xa levels, blood specimen distribution were as follows: less than 0.3 IU/mL, 65.7%; 0.3–0.7 IU/mL (therapeutic range), 33.6%; and more than 0.7 IU/mL, 0.7%. No evidence of recurring thromboembolism was observed. Conclusion Using the conventional aPTT target range may lead to inappropriate dosing of UFH. Transitioning from the aPTT test to the anti-Xa assay is required to avoid the laborious validation of the aPTT HTR test, even though the anti-Xa assay is more expensive. PMID:27722127

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

    PubMed

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

    2012-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Willis, Mike

    2003-01-01

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

  10. Heat pump associations, alliances, and allies

    SciTech Connect

    Not Available

    1992-09-01

    Associations, Alliances, and Allies, a seminar and workshop sponsored by the Electric Power Research Institute, was held in Memphis, Tennessee, April 10--11, 1991. The focus of the meeting was relationships forged between electric utilities and trade allies that sell residential heat pumps. one hundred and seven representatives of electric utilities, dealer/contractors, manufacturers, and consultants attended. Electric utility trade ally programs run the gamut from coop advertising to heat pump association to elaborate technician training programs. All utility participants recognize the important programs, since it is the trade ally who sells, installs, and services heat pumps, while it is the electric utility who gets blamed if the heat pumps fail to operate properly or are inefficient. Heat pumps are efficient and effective, but their efficiency and effectiveness depends critically upon the quality of installation and maintenance. A utility can thus help to ensure satisfied customers and can also help to achieve its own load shape objectives by working closely with its trade allies, the dealers, contractors, manufacturers, and distributors. Attendees spent the morning sessions of the two day meeting in plenary sessions, hearing about utility and dealer heat pump programs and issues. Afternoon roundtable discussions provided structured forums to discuss: Advertising; Heat pump association startup and operation; Rebates and incentives; Technician training school and centers; Installation inspection and dealer qualification; and Heat pump association training. These proceedings report on the papers presented in the morning plenary sessions and summarize the main points discussed in the afternoon workshops.

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

    SciTech Connect

    Olson, Hilary

    2013-09-01

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

  12. Strategic Classification and Examination of the Development of Current Airline Alliance Activities

    NASA Technical Reports Server (NTRS)

    Wang, Zhi H.; Evans, Michael

    2002-01-01

    Previous research argues that despite the fact that strategic alliances have become an important feature of the world airline industry, little rigorous analysis has been done on the effects of these alliances. This is partially because there is a lack of precise definitions to specify different types of airline alliances in the literature. This research identifies several categories of airline alliances through a strategic classification of the current alliance activities involving the major airlines for the period 1989 to 1999. The classification enables this research to examine how strategic alliance activities are evolving, particularly to compare how airlines in North America, the European Union and the Asia Pacific region have committed to different alliances. Findings show that there is a significant difference between the number and scope of alliances adopted in the three aviation markets. These findings facilitate research to further analyse the impact of market liberalization on various formations of strategic airline alliances.

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

    NASA Astrophysics Data System (ADS)

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

    2006-12-01

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

  14. Strategic alliances for the future of the gas industry

    SciTech Connect

    Catell, R.B.

    1993-12-31

    The natural gas industry is in a position to benefit significantly from the inherent environmental advantages of natural gas and access to a large reserves base. Concurrently, the domestic natural gas industry will be undergoing extensive regulatory and structural changes in the coming years as a result of the implementation of FERC Order 636. The competition between fuels is intensifying, and the number of new market players and consumer demands are rising. As all sectors of the industry are facing new risk resulting from changes in access to storage, balancing, excess capacity, capacity release programs, and from the entry of gas marketers and aggregators, companies must increasingly rely on strategic alliances to remain competitive and stable. Strategic alliances are cooperative relationships between gas companies, pipelines, end-users, producers, marketers, as well as government bodies and labor unions. The principal goals of strategic alliances are to reduce risks, leverage resources and competitiveness, achieve long-term objectives, and build flexibility. Brooklyn Union has been involved in strategic alliances in the areas of (1) exploration, production, and supply; (2) transportation and storage; (3) marketing and market development; (4) regulatory and legislative activities; and (5) environmental activities. These alliances have allowed Brooklyn Union to diversify its gas supply, cooperatively support new pipelines, introduce new products and services, retain customers, generate new business, and assist in the enactment of reasonable Federal and State regulations and energy policies. Brooklyn Union recognizes that in the future the natural gas industry must continue to form strategic alliances to better serve the customer. Through strategic alliances the industry can increase the value and importance of natural gas as America`s premier energy source.

  15. The International Planetary Data Alliance (IPDA)

    NASA Astrophysics Data System (ADS)

    Stein, Thomas; Gopala Krishna, Barla; Crichton, Daniel J.

    2016-07-01

    The International Planetary Data Alliance (IPDA) is a close association of partners with the aim of improving the quality of planetary science data and services to the end users of space based instrumentation. The specific mission of the IPDA is to facilitate global access to, and exchange of, high quality scientific data products managed across international boundaries. Ensuring proper capture, accessibility and availability of the data is the task of the individual member space agencies. The IPDA is focused on developing an international standard that allows discovery, query, access, and usage of such data across international planetary data archive systems. While trends in other areas of space science are concentrating on the sharing of science data from diverse standards and collection methods, the IPDA concentrates on promoting governing data standards that drive common methods for collecting and describing planetary science data across the international community. This approach better supports the long term goal of easing data sharing across system and agency boundaries. An initial starting point for developing such a standard will be internationalization of NASA's Planetary Data System's (PDS) PDS4 standard. The IPDA was formed in 2006 with the purpose of adopting standards and developing collaborations across agencies to ensure data is captured in common formats. It has grown to a dozen member agencies represented by a number of different groups through the IPDA Steering Committee. Member agencies include: Armenian Astronomical Society, China National Space Agency (CNSA), European Space Agency (ESA), German Aerospace Center (DLR), Indian Space Research Organization (ISRO), Italian Space Agency (ASI), Japanese Aerospace Exploration Agency (JAXA), National Air and Space Administration (NASA), National Centre for Space Studies (CNES), Space Research Institute (IKI), UAE Space Agency, and UK Space Agency. The IPDA Steering Committee oversees the execution of

  16. Final report : PATTON Alliance gazetteer evaluation project.

    SciTech Connect

    Bleakly, Denise Rae

    2007-08-01

    In 2005 the National Ground Intelligence Center (NGIC) proposed that the PATTON Alliance provide assistance in evaluating and obtaining the Integrated Gazetteer Database (IGDB), developed for the Naval Space Warfare Command Research group (SPAWAR) under Advance Research and Development Activity (ARDA) funds by MITRE Inc., fielded to the text-based search tool GeoLocator, currently in use by NGIC. We met with the developers of GeoLocator and identified their requirements for a better gazetteer. We then validated those requirements by reviewing the technical literature, meeting with other members of the intelligence community (IC), and talking with both the United States Geologic Survey (USGS) and the National Geospatial Intelligence Agency (NGA), the authoritative sources for official geographic name information. We thus identified 12 high-level requirements from users and the broader intelligence community. The IGDB satisfies many of these requirements. We identified gaps and proposed ways of closing these gaps. Three important needs have not been addressed but are critical future needs for the broader intelligence community. These needs include standardization of gazetteer data, a web feature service for gazetteer information that is maintained by NGA and USGS but accessible to users, and a common forum that brings together IC stakeholders and federal agency representatives to provide input to these activities over the next several years. Establishing a robust gazetteer web feature service that is available to all IC users may go a long way toward resolving the gazetteer needs within the IC. Without a common forum to provide input and feedback, community adoption may take significantly longer than anticipated with resulting risks to the war fighter.

  17. MACROMOLECULAR THERAPEUTICS

    PubMed Central

    Yang, Jiyuan; Kopeček, Jindřich

    2014-01-01

    This review covers water-soluble polymer-drug conjugates and macromolecules that possess biological activity without attached low molecular weight drugs. The main design principles of traditional and backbone degradable polymer-drug conjugates as well as the development of a new paradigm in nanomedicines – (low molecular weight) drug-free macromolecular therapeutics are discussed. To address the biological features of cancer, macromolecular therapeutics directed to stem/progenitor cells and the tumor microenvironment are deliberated. Finally, the future perspectives of the field are briefly debated. PMID:24747162

  18. Highlights of recent developments and trends in cancer nanotechnology research--view from NCI Alliance for Nanotechnology in Cancer.

    PubMed

    Hull, L C; Farrell, D; Grodzinski, P

    2014-01-01

    Although the incidence of cancer and cancer related deaths in the United States has decreased over the past two decades due to improvements in early detection and treatment, cancer still is responsible for a quarter of the deaths in this country. There is much room for improvement on the standard treatments currently available and the National Cancer Institute (NCI) has recognized the potential for nanotechnology and nanomaterials in this area. The NCI Alliance for Nanotechnology in Cancer was formed in 2004 to support multidisciplinary researchers in the application of nanotechnology to cancer diagnosis and treatment. The researchers in the Alliance have been productive in generating innovative solutions to some of the central issues of cancer treatment including how to detect tumors earlier, how to target cancer cells specifically, and how to improve the therapeutic index of existing chemotherapies and radiotherapy treatments. Highly creative ideas are being pursued where novelty in nanomaterial development enables new modalities of detection or therapy. This review highlights some of the innovative materials approaches being pursued by researchers funded by the NCI Alliance. Their discoveries to improve the functionality of nanoparticles for medical applications includes the generation of new platforms, improvements in the manufacturing of nanoparticles and determining the underlying reasons for the movement of nanoparticles in the blood. PMID:23948249

  19. Highlights of recent developments and trends in cancer nanotechnology research--view from NCI Alliance for Nanotechnology in Cancer.

    PubMed

    Hull, L C; Farrell, D; Grodzinski, P

    2014-01-01

    Although the incidence of cancer and cancer related deaths in the United States has decreased over the past two decades due to improvements in early detection and treatment, cancer still is responsible for a quarter of the deaths in this country. There is much room for improvement on the standard treatments currently available and the National Cancer Institute (NCI) has recognized the potential for nanotechnology and nanomaterials in this area. The NCI Alliance for Nanotechnology in Cancer was formed in 2004 to support multidisciplinary researchers in the application of nanotechnology to cancer diagnosis and treatment. The researchers in the Alliance have been productive in generating innovative solutions to some of the central issues of cancer treatment including how to detect tumors earlier, how to target cancer cells specifically, and how to improve the therapeutic index of existing chemotherapies and radiotherapy treatments. Highly creative ideas are being pursued where novelty in nanomaterial development enables new modalities of detection or therapy. This review highlights some of the innovative materials approaches being pursued by researchers funded by the NCI Alliance. Their discoveries to improve the functionality of nanoparticles for medical applications includes the generation of new platforms, improvements in the manufacturing of nanoparticles and determining the underlying reasons for the movement of nanoparticles in the blood.

  20. Measurement and simulation of ionic current as a means of quantifying effects of therapeutic millimeter wave radiation

    NASA Astrophysics Data System (ADS)

    Slovinsky, William Stanley

    A "millimeter wave" (MMW) is an electromagnetic oscillation with a wavelength between 1 and 10 mm, and a corresponding frequency of 30 to 300 GHz. In the spectrum of electromagnetic radiation, this band falls above the frequencies of radio waves and microwaves, and below that of infrared radiation. Since the 1950s, frequencies in this regime have been used for short range communications and beginning in the 1970s, a form of therapy known as "millimeter wave therapy" (MWT) , or microwave resonance therapy, in some publications. This form of therapy has been widely used in the republics of the former Soviet Union (FSU). As of 1995, it is estimated that more than one thousand medical centers in the FSU have performed MWT and more than three million patients have received this method of treatment. Despite the abundant use of this form of medicine, very little is known about the mechanisms by which it works. Early accounts of use are limited to Soviet government documents, largely unavailable to the scientific public, and limited translations and oral accounts from FSU scientists and literature reviews . This anecdotal body of evidence lacks the scrutiny of peer-reviewed journal publications. In order to gain more widespread acceptance in Western medicine, the pathway through which this regime of the electromagnetic radiation spectrum affects the human body must be rigorously mapped and quantified. Despite the anecdotal nature of a large portion of the existing research on biological MMW effects, a common link is the idea of an interaction occurring at the skin level, which is transduced into a signal used at a remote location in the body. This study explores a possible mechanism for the generation of this signal. The effects of therapeutic frequency MMW on the ionic currents through two different types of ion transport channels were studied, and the results are discussed with emphasis on how they relate to possible changes in nerve signals used by the body for

  1. Application of multi-factorial design of experiments to successfully optimize immunoassays for robust measurements of therapeutic proteins.

    PubMed

    Ray, Chad A; Patel, Vimal; Shih, Judy; Macaraeg, Chris; Wu, Yuling; Thway, Theingi; Ma, Mark; Lee, Jean W; Desilva, Binodh

    2009-02-20

    Developing a process that generates robust immunoassays that can be used to support studies with tight timelines is a common challenge for bioanalytical laboratories. Design of experiments (DOEs) is a tool that has been used by many industries for the purpose of optimizing processes. The approach is capable of identifying critical factors and their interactions with a minimal number of experiments. The challenge for implementing this tool in the bioanalytical laboratory is to develop a user-friendly approach that scientists can understand and apply. We have successfully addressed these challenges by eliminating the screening design, introducing automation, and applying a simple mathematical approach for the output parameter. A modified central composite design (CCD) was applied to three ligand binding assays. The intra-plate factors selected were coating, detection antibody concentration, and streptavidin-HRP concentrations. The inter-plate factors included incubation times for each step. The objective was to maximize the logS/B (S/B) of the low standard to the blank. The maximum desirable conditions were determined using JMP 7.0. To verify the validity of the predictions, the logS/B prediction was compared against the observed logS/B during pre-study validation experiments. The three assays were optimized using the multi-factorial DOE. The total error for all three methods was less than 20% which indicated method robustness. DOE identified interactions in one of the methods. The model predictions for logS/B were within 25% of the observed pre-study validation values for all methods tested. The comparison between the CCD and hybrid screening design yielded comparable parameter estimates. The user-friendly design enables effective application of multi-factorial DOE to optimize ligand binding assays for therapeutic proteins. The approach allows for identification of interactions between factors, consistency in optimal parameter determination, and reduced method

  2. MRI enables measurement of therapeutic nanoparticle uptake in rat N1-S1 liver tumors after nanoablation

    PubMed Central

    McDevitt, Joseph L.; Mouli, Samdeep; Tyler, Patrick D.; Li, Weiguo; Nicolai, Jodi; Procissi, Daniele; Ragin, Ann B.; Wang, Y. Andrew; Lewandowski, Robert J.; Salem, Riad; Larson, Andrew C.; Omary, Reed A.

    2014-01-01

    Purpose Superparamagnetic iron oxide nanoparticles (SPIOs) functionalized with doxorubicin (DOX) can serve dual diagnostic and therapeutic purposes. Nanoablation is an approach to increase intratumoral nanoparticle uptake that combines IV nanoparticle delivery with reversible electroporation. However, a method to quantify drug delivery during this therapy is needed. This study tested the hypothesis that MRI can quantify intratumoral SPIO uptake after nanoablation. Methods DOX-SPIOs were synthesized. N1-S1 hepatomas were successfully induced in 17 Sprague-Dawley rats distributed into three dosage groups. Baseline tumor R2* values (the reciprocal of T2*) were determined using 7T MRI. Following IV injection of SPIOs, reversible electroporation (1300 V/cm, 8 pulses, 100 µs pulse duration) was applied. Animals were imaged to determine post-procedural tumor R2* and change in R2* (ΔR2*) was calculated. Inductively-coupled plasma mass spectrometry was used to determine post-procedure intratumoral iron concentration, which served as a proxy for SPIO uptake. Mean tumor iron concentration and ΔR2* for each subject were assessed for correlation with linear regression, and mean iron concentration for each dosage group was compared with analysis of variance. Results ΔR2* significantly correlated with tumor SPIO uptake after nanoablation (r=0.50, p=0.039). On average, each 0.1 ms−1 increase in R2* corresponded to a 0.1394 mM increase in iron concentration. There was no significant difference in mean SPIO uptake among dosage groups (p=0.57). Conclusion Intratumoral SPIO uptake after nanoablation can be successfully quantified non-invasively with 7T MRI. Imaging can thus be used as a method to estimate localized drug delivery after nanoablation. PMID:24854392

  3. A Socio-technical Approach for Transient SME Alliances

    NASA Astrophysics Data System (ADS)

    Rezgui, Yacine

    The paper discusses technical requirements to promote the adoption of alliance modes of operation by SMEs in the construction sector. These requirements have provided a basis for specifying a set of functionality to support the collaboration and cooperation needs of SMEs. While service-oriented architectures and semantic web services provide the middleware technology to implement the identified functionality, a number of key technical limitations have been identified, including lack of support for the dynamic and non-functional characteristics of SME alliances distributed business processes, lack of execution monitoring functionality to manage running business processes, and lack of support for semantic reasoning to enable SME business process service composition. The paper examines these issues and provides key directions for supporting SME alliances effectively.

  4. 76 FR 28226 - Southwest Health Alliances, Inc., Doing Business as BSA Provider Network; Analysis of Agreement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-16

    ... Southwest Health Alliances, Inc., Doing Business as BSA Provider Network; Analysis of Agreement Containing... agreement containing a proposed Consent Order with Southwest Health Alliances, Inc., dba BSA Provider Network (``BSA Provider Network'' or ``Respondent''). The agreement settles charges that BSA...

  5. Using the Diagnostic Assessment of the Severely Handicapped-II (DASH-II) to Measure the Therapeutic Effects of Risperidone

    ERIC Educational Resources Information Center

    Valdovinos, M. G.; Zarcone, J. R.; Hellings, J. A.; Kim, G.; Schroeder, S. R.

    2004-01-01

    Within the scope of a double-blind, placebo-controlled, crossover medication study, the Diagnostic Assessment of the Severely Handicapped-II (DASH-II) was evaluated as a measurement for determining the effectiveness of the medication risperidone in treating the problem behaviour of 21 people with intellectual disabilities (ID). Participants…

  6. Annual report 1994 - Science and Engineering Alliance, Inc.

    SciTech Connect

    1998-04-01

    The Science and Engineering Alliance (SEA) was formed in 1990. The goal of the SEA is to foster and encourage collaborative research among the Alliance members. Collaborative research enhances the production of well-qualified scientists and engineers graduating from the SEA member institutions. These students will become contributing participants in the United States technical workforce now and into the next century. The SEA consist of four historically black colleges and universities (HBCUs) and a national laboratory. The SEA is a non-profit consortium. The SEA collaborates on research projects with government agencies, national laboratories, private foundations, industry, and other universities in a broad range of scientific and technical areas.

  7. Research on suppliers selection for e-commerce alliance

    NASA Astrophysics Data System (ADS)

    Ju, Chunhua; Sun, Bin; Liu, Dongsheng

    2009-07-01

    First, the characteristics of suppliers in the e-Commerce alliances of certain industries will be analyzed in this paper and the initial model to select suppliers is built. Then, the history performances of providers in the initial model and the ability to cooperate with others are recorded and analyzed. Based on the analysis above and considering the restriction of supply, the number of re-sellers and the price of products, an improved model to select suppliers in the e-Commerce alliance of certain industries called "the mix-integers model" is built. Finally, a mathematical example is used to describe how the mix-integers model to work.

  8. Cystic fibrosis and the role of gastrointestinal outcome measures in the new era of therapeutic CFTR modulation.

    PubMed

    Bodewes, Frank A J A; Verkade, Henkjan J; Taminiau, Jan A J M; Borowitz, Drucy; Wilschanski, Michael

    2015-03-01

    With the development of new drugs that directly affect CFTR protein function, clinical trials are being designed or initiated for a growing number of patients with cystic fibrosis. The currently available and accepted clinical endpoints, FEV1 and BMI, have limitations. The aim of this report is to draw attention to the need and the ample possibilities for the development and validation of relevant gastrointestinal clinical endpoints for scientific evaluation of CFTR modulation treatment, particularly in young children and infants. The gastrointestinal tract offers very good opportunities to measure CFTR protein function and systematically evaluate CF related clinical outcomes based on the principal clinical gastrointestinal manifestations of CF: intestinal pH, intestinal transit time, intestinal bile salt malabsorption, intestinal inflammation, exocrine pancreatic function and intestinal fat malabsorption. We present a descriptive analysis of a variety of gastrointestinal outcome measures for clinical relevance, reliability, validity, responsiveness to interventions, feasibility in particular in young children and the availability of reference values.

  9. Strategic Alliances between Chinese and Foreign Universities: Was a Staggered Form of Entry Used?

    ERIC Educational Resources Information Center

    Willis, Mike

    2001-01-01

    Explored whether foreign universities moved through levels of alliance with China as a form of staggered market entry. Found almost no movement between levels of alliance, and that high levels of commitment were required at all levels to make an alliance successful. This indicates that foreign universities should be careful to establish alliances…

  10. Patient's and Therapist's Views of Early Alliance Building in Dynamic Psychotherapy: Patterns and Relation to Outcome

    ERIC Educational Resources Information Center

    Kramer, Ueli; de Roten, Yves; Beretta, Veronique; Michel, Luc; Despland, Jean-Nicolas

    2008-01-01

    Patients and therapists have somewhat divergent perspectives of alliance. Usually in psychotherapy research, the focus is on the patient's view of alliance, predicting parts of outcome. This study questions this hypothesis by applying the shape-of-change procedure to patient's and therapist's view of alliance-building processes in dynamic…

  11. An Exploration of the Working Alliance in Mental Health Case Management

    ERIC Educational Resources Information Center

    Kondrat, David C.; Early, Theresa J.

    2010-01-01

    The working alliance between clients and helpers has been identified as a common factor of treatment effectiveness, yet very little research has explored variables associated with working alliance between mental health case managers and their consumers. This study explored the potential covariates of working alliance within community mental health…

  12. Inspiring Minds through a Professional Alliance of Community Teachers (IMPACT): Evaluation Results of the Cohort 1 Math and Science Apprentice Teachers. CRESST Report 826

    ERIC Educational Resources Information Center

    Wang, Jia; Schweig, Jon; Griffin, Noelle; Baldanza, Michelle; Rivera, Nichole M.; Hsu, Vivian

    2013-01-01

    This evaluation reports findings from a study of a UCLA teacher education program called IMPACT, Inspiring Minds through a Professional Alliance of Community Teachers. To measure program quality and goal attainment, the evaluation team used a comprehensive, multiple measures approach which included instructional artifacts, classroom logs, measures…

  13. Therapeutic perspectives

    PubMed Central

    Fiore, Carmelo E.; Pennisi, Pietra; Tinè, Marianna

    2008-01-01

    Osteoporosis and atherosclerosis are linked by biological association. This encourages the search for therapeutic strategies having both cardiovascular and skeletal beneficial effects. Among drugs that may concordantly enhance bone density and reduce the progression of atherosclerosis we can include bisphosphonates (BP), statins, β -blockers, and possibly anti-RANKL antibodies. Available data come from experimental animals and human studies. All these treatments however lack controlled clinical studies designed to demonstrate dual-action effects. PMID:22460845

  14. Therapeutic insemination.

    PubMed

    Alexander, N J; Ackerman, S

    1987-12-01

    Except in special circumstances, therapeutic insemination with a husband's sample has a low success rate. Couples in whom oligozoospermia has been identified as the principal cause of infertility do not benefit from therapeutic insemination by husband. Because of this low success rate, intrauterine insemination to provide sperm in closer proximity to the egg has become popular, but intrauterine insemination also has a low success rate. We suggest that intrauterine insemination should be approached aggressively in cases of male factor infertility. The recipient should be stimulated to enhance egg production and closely monitored for ovulation. A semen specimen of not less than 1 X 10(6) motile sperm with antibiotics added should be placed in the uterus the day after ovulation. If no pregnancies occur within four cycles, alternate approaches should be considered. Therapeutic insemination by donor involves careful donor selection to avoid inheritance of malformations and familial diseases. Because of the possibilities of sexually transmitted diseases, careful and repeated screening should be conducted. A complete sexual history should be obtained, and donors should be excluded if they have had any homosexual contact since 1978, if they have been an intravenous drug user, if they come from a geographic area where the sex ratio of AIDS is close to 1:1, or if they have recently had multiple sexual partners. A permanent record preserving the confidentiality but allowing the tracing of genetic anomalies, even if not present at birth, should be kept. PMID:3328130

  15. Application of activity pencil beam algorithm using measured distribution data of positron emitter nuclei for therapeutic SOBP proton beam

    SciTech Connect

    Miyatake, Aya; Nishio, Teiji

    2013-09-15

    Purpose: Recently, much research on imaging the clinical proton-irradiated volume using positron emitter nuclei based on target nuclear fragment reaction has been carried out. The purpose of this study is to develop an activity pencil beam (APB) algorithm for a simulation system for proton-activated positron-emitting imaging in clinical proton therapy using spread-out Bragg peak (SOBP) beams.Methods: The target nuclei of activity distribution calculations are {sup 12}C nuclei, {sup 16}O nuclei, and {sup 40}Ca nuclei, which are the main elements in a human body. Depth activity distributions with SOBP beam irradiations were obtained from the material information of ridge filter (RF) and depth activity distributions of compounds of the three target nuclei measured by BOLPs-RGp (beam ON-LINE PET system mounted on a rotating gantry port) with mono-energetic Bragg peak (MONO) beam irradiations. The calculated data of depth activity distributions with SOBP beam irradiations were sorted in terms of kind of nucleus, energy of proton beam, SOBP width, and thickness of fine degrader (FD), which were verified. The calculated depth activity distributions with SOBP beam irradiations were compared with the measured ones. APB kernels were made from the calculated depth activity distributions with SOBP beam irradiations to construct a simulation system using the APB algorithm for SOBP beams.Results: The depth activity distributions were prepared using the material information of RF and the measured depth activity distributions with MONO beam irradiations for clinical therapy using SOBP beams. With the SOBP width widening, the distal fall-offs of depth activity distributions and the difference from the depth dose distributions were large. The shapes of the calculated depth activity distributions nearly agreed with those of the measured ones upon comparison between the two. The APB kernels of SOBP beams were prepared by making use of the data on depth activity distributions with SOBP

  16. The therapeutic effect of theophylline in mild obstructive sleep Apnea/Hypopnea syndrome: results of repeated measurements with portable recording devices at home.

    PubMed

    Hein, H; Behnke, G; Jörres, R A; Magnussen, H

    2000-09-18

    Theophylline has been recommended in the literature as a therapeutic option in mild OSAHS. In mild obstructive sleep apnea/hypopnea syndrome (OSAHS), night-to-night variability of parameters of sleep-disordered breathing has been determined rarely, we therefore compared the results of serial measurements of sleep apnea/hypopnea parameters under the effects of placebo and theophylline. To this end, we measured the individual variability of the apnea-hypopnea index (AHI) for seven consecutive nights using a portable sleep apnea recording device, in 14 subjects (2 women, 12 men, mean age +/- [standard deviation] 50 +/- 8 years), treated with placebo or theophylline in a double blind, randomized crossover fashion, whose polysomnographically measured AHI was 13 +/- 5 /hour. Under theophylline treatment in comparison with placebo we observed a small but significant decrease in mean (of seven days) AHI at home (9.2 +/- 7.7 to 6.7 +/- 6.1 /hour), which was independent of body position. The night-to-night variability of AHI at home was high (9. 2 +/- 8.9 /hour; range: 0-31.4 /hour) and proved to be independent of body position and alcohol consumption. - In mild OSAHS, repeated measurements of sleep related breathing events should be performed. Theophylline showed a small but clinically insignificant potencial to reduce AHI.

  17. Corporate Developments and Strategic Alliances in E-Learning.

    ERIC Educational Resources Information Center

    Clarke, Thomas; Hermens, Antoine

    2001-01-01

    Describes the emergence of corporate universities and strategic alliances among universities, electronic learning companies, and technology companies that are providing online delivery of interactive education and training. Outlines characteristics of comprehensive electronic learning and cautions against the use of new technologies to deliver…

  18. National Alliance for Public Charter Schools 2015 Annual Report

    ERIC Educational Resources Information Center

    National Alliance for Public Charter Schools, 2016

    2016-01-01

    This 2015 annual report shares many of the accomplishments achieved by the National Alliance for Public Charter Schools in 2015 including the celebration of their 10th anniversary. Among other achievements, the report highlights: (1) At the end of 2015 Congress and the President agreed to an $80 million increase in support for the federal Charter…

  19. Striving for Empathy: Affinities, Alliances and Peer Sexuality Educators

    ERIC Educational Resources Information Center

    Fields, Jessica; Copp, Martha

    2015-01-01

    Peer sexuality educators' accounts of their work reveal two approaches to empathy with their students: affinity and alliance. "Affinity-based empathy" rests on the idea that the more commonalities sexuality educators and students share (or perceive they share), the more they will be able to empathise with one another, while…

  20. Alliance Building in the Information and Online Database Industry.

    ERIC Educational Resources Information Center

    Alexander, Johanna Olson

    2001-01-01

    Presents an analysis of information industry alliance formation using environmental scanning methods. Highlights include why libraries and academic institutions should be interested; a literature review; historical context; industry and market structures; commercial and academic models; trends; and implications for information providers,…

  1. Science alliance: A vital ORNL-UT partnership

    SciTech Connect

    Richmond, C.R.; Riedinger, L.; Garritano, T.

    1991-01-01

    Partnerships between Department of Energy national laboratories and universities have long been keys to advancing scientific research and education in the United States. Perhaps the most enduring and closely knit of these relationships is the one between Oak Ridge National Laboratory and the University of Tennessee at Knoxville. Since its birth in the 1940's, ORNL has had a very special relationship with UT, and today the two institutions have closer ties than virtually any other university and national laboratory. Seven years ago, ORNL and UT began a new era of cooperation by creating the Science Alliance, a Center of Excellence at UT sponsored by the Tennessee Higher Education Commission. As the oldest and largest of these centers, the Science Alliance is the primary vehicle through which Tennessee promotes research and educational collaboration between UT and ORNL. By letting the two institutions pool their intellectual and financial resources, the alliance creates a more fertile scientific environment than either could achieve on its own. Part of the UT College of Liberal Arts, the Science Alliance is composed of four divisions (Biological Sciences, Chemical Sciences, Physical Sciences, and Mathematics and Computer Science) that team 100 of the university's top faculty with their outstanding colleagues from ORNL.

  2. Eagle and the Condor: Indigenous Alliances for Youth Leadership Development

    ERIC Educational Resources Information Center

    Wihak, Christine; Hately, Lynne; Allicock, Sydney; Lickers, Michael

    2007-01-01

    This narrative describes the growth of an alliance between two indigenous organizations in North and South America, illustrating how a shared indigenous vision of cultural survival and connection to the land led to the creation of an ongoing collaboration for indigenous youth leadership development, which has extended to encompass collaboration…

  3. Supporting Early Childhood Environmental Education through the Natural Start Alliance

    ERIC Educational Resources Information Center

    Merrick, Christy; Braus, Judy

    2013-01-01

    The Natural Start Alliance is a new initiative of the North American Association for Environmental Education. Natural Start was created to support and expand early childhood environmental education (ECEE) by creating a network of organizations, educators, parents, and others who care about using environmental education to support young children's…

  4. Cooperation and Alliances: Higher Education and the Use of Television.

    ERIC Educational Resources Information Center

    Dotolo, Lawrence G.

    2002-01-01

    Describes the Virginia Tidewater Consortium for Higher Education, a consortium of 15 colleges and universities located in the Hampton Roads area of Virginia, which has operated its own cable television channel for the past 21 years. The channel serves the educational needs of the community and allows strategic alliances with other agencies. (EV)

  5. Academic Alliances: A New Approach to School/College Collaboration.

    ERIC Educational Resources Information Center

    Gaudiani, Claire L.; Burnett, David G.

    1986-01-01

    Academic alliances between secondary school teachers and postsecondary faculty are discussed. Teachers and faculty who teach the same subject in the same geographical area voluntarily meet regularly to examine the quality of teaching and learning in their discipline at the local level. School and college faculty together develop some common ground…

  6. Enacting Feminist Alliance Principles in a Doctoral Writing Support Group

    ERIC Educational Resources Information Center

    Swadener, Beth Blue; Peters, Lacey; Eversman, Kimberly A.

    2015-01-01

    This study utilizes a multivocal narrative approach to analyze the dynamics, accomplishments, and challenges of an interdisciplinary doctoral support group consisting primarily of female members. The authors raise issues of power, alliance, troubling expert-novice models of mentoring, and the role of social justice pedagogy in the group.

  7. Alliances in the Dutch BeweegKuur Lifestyle Intervention

    ERIC Educational Resources Information Center

    den Hartog, Franciska; Wagemakers, Annemarie; Vaandrager, Lenneke; van Dijk, Marieke; Koelen, Maria A.

    2014-01-01

    Objective: BeweegKuur (Exercise Therapy) is a Dutch lifestyle programme in which participants are referred by a general practitioner (GP) to a lifestyle advisor. To support participants, regional and local alliances are established. The present study explored the successes and challenges associated with collaboration processes in local BeweegKuur…

  8. Combining regional expertise to form a bereavement support alliance.

    PubMed

    Friedrichs, Judy B; Kobler, Kathie; Roose, Rosmarie E; Meyer, Charlotte; Schmitz, Nancy; Kavanaugh, Karen

    2014-01-01

    Providing compassionate bereavement care for families experiencing perinatal loss is a standard of care in most healthcare organizations. In this article, we describe the development of The Alliance of Perinatal Bereavement Support Facilitators, begun over 25 years ago in Chicago by staff who identified the need to reach out to colleagues at other area institutions for advice and support in this work. This collaboration created a regional support network that has resulted in a long-lasting, active, sustainable organization of excellence focused on enhancing practice, education, and perinatal bereavement care. Alliance activities center around four main areas: education, networking/support, policy, and recognizing outstanding service to families. By continuing to draw upon the collective talent, wisdom, and expertise of its members, The Alliance still serves grieving families and provides mentoring for future interdisciplinary team members engaged in this work. The path taken to build this organization can be used by professionals in other specialties who are looking to create their own alliance infrastructure based on mutual benefit and interest.

  9. 78 FR 9003 - Airworthiness Directives; Engine Alliance Turbofan Engines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-07

    ... ``significant rule'' under the DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), (3) Will... Federal Aviation Administration 14 CFR Part 39 RIN 2120-AA64 Airworthiness Directives; Engine Alliance Turbofan Engines AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed...

  10. Alliance between tobacco and alcohol industries to shape public policy

    PubMed Central

    Jiang, Nan

    2013-01-01

    Aims The tobacco and alcohol industries share common policy goals when facing regulation, opposing policies such as tax increases and advertising restrictions. The collaboration between these two industries in the tobacco policy arena is unknown. This study explored if tobacco and alcohol companies built alliances to influence tobacco legislation, and if so, how those alliances worked. Methods Analysis of previously secret tobacco industry documents. Findings In the early 1980s, tobacco companies started efforts to build coalitions with alcohol and other industries to oppose cigarette excise taxes, clean indoor air policies, and tobacco advertising and promotion constraints. Alcohol companies were often identified as a key partner and source of financial support for the coalitions. These coalitions had variable success interfering with tobacco control policymaking. Conclusions The combined resources of tobacco and alcohol companies may have affected tobacco control legislation. These alliances helped to create the perception that there is a broader base of opposition to tobacco control. Advocates should be aware of the covert alliances between tobacco, alcohol, and other industries and expose them to correct this misperception. PMID:23587076

  11. The STARS Alliance: Viable Strategies for Broadening Participation in Computing

    ERIC Educational Resources Information Center

    Dahlberg, Teresa; Barnes, Tiffany; Buch, Kim; Rorrer, Audrey

    2011-01-01

    The Students and Technology in Academia, Research, and Service (STARS) Alliance is a nationally-connected system of regional partnerships among higher education, K-12 schools, industry and the community with a mission to broaden the participation of women, under-represented minorities and persons with disabilities in computing (BPC). Each regional…

  12. Creative Alliances with the Business Community: Pima Community College.

    ERIC Educational Resources Information Center

    Hines, Thomas E.

    Pima Community College (PCC) in Tucson is involved in a number of creative alliances with the Arizona business community, including the Arizona Consortium for Education and Training and the Arizona State Environmental Technical Training Center (ASETT). Through the Consortium, PCC, in conjunction with Arizona four-year colleges, provides specific…

  13. Franklin University of Ohio and the Community College Alliance (CCA).

    ERIC Educational Resources Information Center

    Illinois State Board of Education, Springfield.

    This document summarizes a request by Franklin University of Columbus, Ohio to receive approval from the Illinois Board of Higher Education to operate and grant degrees statewide in Illinois. The vehicle through which it proposed to offer instruction was the Community College Alliance (CCA), a creation of the university designed to offer…

  14. Combining regional expertise to form a bereavement support alliance.

    PubMed

    Friedrichs, Judy B; Kobler, Kathie; Roose, Rosmarie E; Meyer, Charlotte; Schmitz, Nancy; Kavanaugh, Karen

    2014-01-01

    Providing compassionate bereavement care for families experiencing perinatal loss is a standard of care in most healthcare organizations. In this article, we describe the development of The Alliance of Perinatal Bereavement Support Facilitators, begun over 25 years ago in Chicago by staff who identified the need to reach out to colleagues at other area institutions for advice and support in this work. This collaboration created a regional support network that has resulted in a long-lasting, active, sustainable organization of excellence focused on enhancing practice, education, and perinatal bereavement care. Alliance activities center around four main areas: education, networking/support, policy, and recognizing outstanding service to families. By continuing to draw upon the collective talent, wisdom, and expertise of its members, The Alliance still serves grieving families and provides mentoring for future interdisciplinary team members engaged in this work. The path taken to build this organization can be used by professionals in other specialties who are looking to create their own alliance infrastructure based on mutual benefit and interest. PMID:24759313

  15. Applying Lessons from Industry to Intra-Campus Alliances.

    ERIC Educational Resources Information Center

    Turner, Walter L.

    To break out of the mold of the modern college compartmentalized setting, alliances can and must be formed between different disciplines on campus. Knowledge the students gain from the differing perspectives will enhance their ability to communicate; oral and written communication; and effective listening have been identified as factors that help…

  16. Alliance Affiliate Activities: Non-Governmental Organizations in Environmental Education.

    ERIC Educational Resources Information Center

    Disinger, John F., Comp.

    Short descriptions of organizational structure and goals and descriptions of environmental education interests, activities, and priorities are presented for 32 nongovernmental organizations affiliated with the Alliance for Environmental Education. The organizations included are listed in the table of contents. The groups included represent a…

  17. Building Alliances: Photojournalism Educators and Members of NPPA.

    ERIC Educational Resources Information Center

    Kenney, Keith

    Alliances between members of the visual communication division of the Association for Journalism and Mass Communication (AEJMC) and the National Press Photographers Association (NPPA) can be strengthened without sacrificing the basic liberal arts principles promoted by R. O. Blanchard and W. G. Christ in their book "Media Education and the Liberal…

  18. Alliance for Workforce Skills. Final Report. Summative Evaluation Report.

    ERIC Educational Resources Information Center

    Capital Community-Technical Coll., Hartford, CT.

    The Alliance for Workforce Skills (AWS), a public/private partnership, provided adult basic skills training to employed and unemployed men and women in the Greater Hartford area. Many goals were not met, due in large part to the massive downturn in the Hartford economy. Only one of the four sponsoring corporations was still an active AWS partner…

  19. The MATRIX: Multicultural Alliance for Technology, Research, and Information Exchange

    ERIC Educational Resources Information Center

    Turner, Raymond E.

    2006-01-01

    Community colleges, although being a potential source of future scientists and engineers, there are certain faults in the reform approach of these colleges that need to be addressed. The Multicultural Alliance for Technology, Research, and Information Exchange (MATRIX) model is presented to energize community colleges to create a science research…

  20. Social Scientists Can Benefit from Alliance for Excellence Report.

    ERIC Educational Resources Information Center

    Senese, Donald J.

    1987-01-01

    Contends that the "Alliance for Excellence: Librarians Respond to a Nation at Risk" report contains information which can be useful for improving social studies instruction. Denotes special attention to the need for quality elementary and secondary school library services and suggests social studies teachers can recommend current materials to the…

  1. Measurement of extracellular vesicles as biomarkers of consequences or cause complications of pathological states, and prognosis of both evolution and therapeutic safety/efficacy.

    PubMed

    Amiral, Jean; Seghatchian, Jerard

    2016-08-01

    Utility of EVs, as biomarkers of cause or consequence of various pathological complications, and prognosis of blood components' therapy in terms of safety/efficacy and their potential associated hazards, primed by EVs involvements in pro-inflammatory, immunomodulatory and activations of both pro/anti-coagulatory and others associated pathways, as well as various cellular cross talks, are highlighted as the fundamental. Today EVs are becoming the "buzz" words of the current diagnosis, development and research [DDR] strategies, with the aim of ensuring safer therapeutic approaches in the current clinical practices, also incorporating their potential in long term cost effectiveness in health care systems. The main focus of this manuscript is to review the current opinions in some fundamental areas of EVs involvements in health and diseases. Firstly, our goal is highlighting what are EVs/MVs/MPs and how are they generated in physiology, pathology or blood products; classification and significance of EVs generated in vivo; followed by consequences and physiological/pathological induced effects of EVs generation in vivo. Secondly, specific cell origin EVs and association with malignancy; focus on EVs carrying TF and annexin V as a protective protein for harmful effects of EVs, and associations with LA; and incidence of anti-annexin V antibodies are also discussed. Thirdly, utility of EVs is presented: as diagnostic tools of disease markers; prognosis and follow-up of clinical states; evaluation of therapy efficacy; quality and risk assessment of blood products; followed by the laboratory tools for exploring, characterizing and measuring EVs, and/or their associated activity, using our own experiences of capture based assays. Finally, in perspective, the upcoming low volume sampling, fast, reliable and reproducibility and friendly use laboratory tools and the standardization of measurement methods are highlighted with the beneficial effects that we are witnessing in both

  2. Full validation of therapeutic antibody sequences by middle-up mass measurements and middle-down protein sequencing.

    PubMed

    Resemann, Anja; Jabs, Wolfgang; Wiechmann, Anja; Wagner, Elsa; Colas, Olivier; Evers, Waltraud; Belau, Eckhard; Vorwerg, Lars; Evans, Catherine; Beck, Alain; Suckau, Detlev

    2016-01-01

    The regulatory bodies request full sequence data assessment both for innovator and biosimilar monoclonal antibodies (mAbs). Full sequence coverage is typically used to verify the integrity of the analytical data obtained following the combination of multiple LC-MS/MS datasets from orthogonal protease digests (so called "bottom-up" approaches). Top-down or middle-down mass spectrometric approaches have the potential to minimize artifacts, reduce overall analysis time and provide orthogonality to this traditional approach. In this work we report a new combined approach involving middle-up LC-QTOF and middle-down LC-MALDI in-source decay (ISD) mass spectrometry. This was applied to cetuximab, panitumumab and natalizumab, selected as representative US Food and Drug Administration- and European Medicines Agency-approved mAbs. The goal was to unambiguously confirm their reference sequences and examine the general applicability of this approach. Furthermore, a new measure for assessing the integrity and validity of results from middle-down approaches is introduced - the "Sequence Validation Percentage." Full sequence data assessment of the 3 antibodies was achieved enabling all 3 sequences to be fully validated by a combination of middle-up molecular weight determination and middle-down protein sequencing. Three errors in the reference amino acid sequence of natalizumab, causing a cumulative mass shift of only -2 Da in the natalizumab Fd domain, were corrected as a result of this work.

  3. Dynamics of Alliance Formation and the Egalitarian Revolution

    PubMed Central

    Gavrilets, Sergey; Duenez-Guzman, Edgar A.; Vose, Michael D.

    2008-01-01

    Background Arguably the most influential force in human history is the formation of social coalitions and alliances (i.e., long-lasting coalitions) and their impact on individual power. Understanding the dynamics of alliance formation and its consequences for biological, social, and cultural evolution is a formidable theoretical challenge. In most great ape species, coalitions occur at individual and group levels and among both kin and non-kin. Nonetheless, ape societies remain essentially hierarchical, and coalitions rarely weaken social inequality. In contrast, human hunter-gatherers show a remarkable tendency to egalitarianism, and human coalitions and alliances occur not only among individuals and groups, but also among groups of groups. These observations suggest that the evolutionary dynamics of human coalitions can only be understood in the context of social networks and cognitive evolution. Methodology/Principal Findings Here, we develop a stochastic model describing the emergence of networks of allies resulting from within-group competition for status or mates between individuals utilizing dyadic information. The model shows that alliances often emerge in a phase transition-like fashion if the group size, awareness, aggressiveness, and persuasiveness of individuals are large and the decay rate of individual affinities is small. With cultural inheritance of social networks, a single leveling alliance including all group members can emerge in several generations. Conclusions/Significance We propose a simple and flexible theoretical approach for studying the dynamics of alliance emergence applicable where game-theoretic methods are not practical. Our approach is both scalable and expandable. It is scalable in that it can be generalized to larger groups, or groups of groups. It is expandable in that it allows for inclusion of additional factors such as behavioral, genetic, social, and cultural features. Our results suggest that a rapid transition from a

  4. Nonlinear analysis of the cooperation of strategic alliances through stochastic catastrophe theory

    NASA Astrophysics Data System (ADS)

    Xu, Yan; Hu, Bin; Wu, Jiang; Zhang, Jianhua

    2014-04-01

    The excitation intervention of strategic alliance may change with the changes in the parameters of circumstance (e.g., external alliance tasks). As a result, the stable cooperation between members may suffer a complete unplanned betrayal at last. However, current perspectives on strategic alliances cannot adequately explain this transition mechanism. This study is a first attempt to analyze this nonlinear phenomenon through stochastic catastrophe theory (SCT). A stochastic dynamics model is constructed based on the cooperation of strategic alliance from the perspective of evolutionary game theory. SCT explains the discontinuous changes caused by the changes in environmental parameters. Theoretically, we identify conditions where catastrophe can occur in the cooperation of alliance members.

  5. Quality of working alliance in psychotherapy: therapist variables and patient/therapist similarity as predictors.

    PubMed

    Hersoug, A G; Høglend, P; Monsen, J T; Havik, O E

    2001-01-01

    Therapist characteristics were explored as possible predictors of working alliance, rated early and later in therapy both by therapists (n=59) and patients (n=270) in an ongoing multisite project on process and outcome of psychotherapy. Patients and therapists had divergent perspectives on the working alliance. Therapists' experience, training, skill, and progress as therapists did not have any significant impact on alliance as rated by patients. Training and skill were positively related to alliance as rated by therapists. Interpersonal relationships on the cold-warm dimension had a moderate impact for both patients' and therapists' alliance ratings. Some implications for therapist training are discussed. PMID:11696646

  6. Early change in defence mechanisms and coping in short-term dynamic psychotherapy: relations with symptoms and alliance.

    PubMed

    Kramer, Ueli; De Roten, Yves; Michel, Luc; Despland, Jean-Nicholas

    2009-01-01

    Several patient-related variables have already been investigated as predictors of change in psychodynamic psychotherapy. Defensive functioning is one of them. However, few studies have investigated adaptational processes, encompassing defence mechanisms and coping, from an integrative or comparative viewpoint. This study includes 32 patients, mainly diagnosed with adjustment disorder and undergoing time-limited psychodynamic psychotherapy lasting up to 40 sessions, and will focus on early change in defence and coping. Observer-rater methodology was applied to the transcripts of two sessions of the first part of the psychotherapeutic process. It is assumed that the contextual-relational variable of therapeutic alliance intervenes as moderator on change in adaptational processes. Results corroborated the hypothesis, but only for coping, whereas for defences, overall functioning remained stable over the first 20 sessions of psychotherapy. These results are discussed within the framework of disentangling processes underlying adaptation, i.e., related to issues on trait and state aspects, as well as the role of the therapeutic alliance.

  7. How Do Airlines Perceive That Strategic Alliances Affect Their Individual Branding?

    NASA Technical Reports Server (NTRS)

    Kalligiannis, Konstantinos; Iatrou, Kostas; Mason, Keith

    2006-01-01

    Much research has been carried out to evaluate the impact of strategic alliance membership on the performance of airlines. However it would be of interest to identify how airlines perceive this impact in terms of branding by each of the three global alliance groupings. It is the purpose of this paper to gather the opinion of airlines, belonging to the three strategic alliance groups, on the impact that the strategic alliance brands have had on their individual brands and how do they perceive that this impact will change in the future. To achieve this, a comprehensive survey of the alliance management and marketing departments of airlines participating in the three global strategic alliances was required. The results from this survey give an indication whether the strategic airline alliances, which are often referred to as marketing agreements, enhance, damage or have no impact on the individual airline brands.

  8. Schools without Fear. Proceedings of the Annual International Alliance for Invitational Education Conference (14th). International Alliance for Invitational Education.

    ERIC Educational Resources Information Center

    Francis, Adrianna Hayes, Ed.

    Papers presented at the fourteenth Annual Conference of the Alliance for Invitational Education are (1) "Caring, Sharing, Daring: Three Tests to Help Develop More Inviting Policies, Programmes, and Procedures" (M. Ayers); (2) "Project: Gentlemen on the Move - Combating the Poor Academic and Social Performance of African American Male Youth" (D. F.…

  9. Studying Psychotherapy Using the One-with-Many Design: The Therapeutic Alliance as an Exemplar

    ERIC Educational Resources Information Center

    Marcus, David K.; Kashy, Deborah A.; Baldwin, Scott A.

    2009-01-01

    Most psychotherapy research uses a one-with-many design, in which each therapist (the one) treats multiple clients (the many), which raises the challenge of nonindependent data. We present a statistical model for analyzing data from studies that use a one-with-many design. This model addresses the problems associated with nonindependence and can…

  10. Innovative and Brain-Friendly Strategies for Building a Therapeutic Alliance with Adolescents

    ERIC Educational Resources Information Center

    Roaten, Gail K.

    2011-01-01

    Brain growth and change are key factors in adolescent development and influence cognitions, emotions, and behavior. Much of the research on the adolescent brain is fairly recent, and mental health practitioners working with adolescents must have knowledge about these changes to more effectively engage their young clients in therapy. The…

  11. Differentiating Life Goals and Therapeutic Goals: Expanding Our Understanding of the Working Alliance

    ERIC Educational Resources Information Center

    Mackrill, Thomas

    2011-01-01

    Reviews have shown that goal consensus and collaboration between client and therapist are significant for treatment outcome. This study introduces a differentiation between goals and tasks in the client's everyday life and goals and tasks in psychotherapy sessions while focusing on the links between the two. Five typical types of problematic goal…

  12. Calcific aortic valve disease: A consensus summary from the Alliance of Investigators on Calcific Aortic Valve Disease

    PubMed Central

    Yutzey, Katherine E.; Demer, Linda L.; Body, Simon C.; Huggins, Gordon S.; Towler, Dwight A.; Giachelli, Cecilia M.; Hofmann-Bowman, Marion A.; Mortlock, Douglas P.; Rogers, Melissa B.; Sadeghi, Mehran M.; Aikawa, Elena

    2014-01-01

    Calcific Aortic Valve Disease (CAVD) is increasingly prevalent worldwide with significant morbidity and mortality. Therapeutic options beyond surgical valve replacement are currently limited. In 2011, the National Heart Lung and Blood Institute assembled a working group on aortic stenosis. This group identified CAVD as an actively regulated disease process in need of further study. As a result, the Alliance of Investigators on CAVD was formed to coordinate and promote CAVD research, with the goals of identifying individuals at risk, developing new therapeutic approaches, and improving diagnostic methods. The group is composed of cardiologists, geneticists, imaging specialists, and basic science researchers. This report reviews the current status of CAVD research and treatment strategies with identification of areas in need of additional investigation for optimal management of this patient population. PMID:25189570

  13. The effect of songwriting on knowledge of coping skills and working alliance in psychiatric patients: a randomized clinical effectiveness study.

    PubMed

    Silverman, Michael J

    2011-01-01

    The purpose of this study was to determine the effects of a songwriting intervention on psychiatric patients' knowledge of coping skills and working alliance. Participants were randomly assigned to scripted and manualized experimental (n=48) or control (n=41) conditions. The experimental condition was a group psychoeducational music therapy songwriting session concerning coping skills while the control condition was a group psychoeducational session concerning coping skills. Both conditions were single-session therapy with patients on an acute adult psychiatric unit. Results indicated no significant between group differences in measures of knowledge of coping skills, consumer working alliance, or perception of enjoyment (p>.05), although the experimental condition tended to have slightly higher mean scores than the control group for these measures. There was a significant between group difference in measures of therapist working alliance (p<.001), with the therapist scoring the experimental group higher than the control group. Although the music therapy group had a higher mean rate of previous psychiatric hospitalizations, their perception of enjoyment scores were still higher than those of the control condition, a finding incongruent in the literature. Furthermore, despite the increased number of previous hospitalizations, the music therapy condition had higher attendance rates than the control condition, thus possibly providing incentives for funding. It seems that group songwriting about coping skills can be as effective a psychosocial intervention as traditional talk-based psychoeducation to teach psychiatric inpatients how to proactively manage their illness. Additionally, music therapy can be as effective as talk-based psychoeducation in establishing working alliance. Implications for clinical practice, limitations, and suggestions for future research are provided.

  14. A study of the strategic alliance for EMS industry: the application of a hybrid DEA and GM (1, 1) approach.

    PubMed

    Wang, Chia Nan; Nguyen, Nhu Ty; Tran, Thanh Tuyen; Huong, Bui Bich

    2015-01-01

    Choosing a partner is a critical factor for success in international strategic alliances, although criteria for partner selection vary between developed and transitional markets. This study aims to develop effective methods to assist enterprise to measure the firms' operation efficiency, find out the candidate priority under several different inputs and outputs, and forecast the values of those variables in the future. The methodologies are constructed by the concepts of Data Envelopment Analysis (DEA) and grey model (GM). Realistic data in four consecutive years (2009-2012) a total of 20 companies of the Electronic Manufacturing Service (EMS) industry that went public are completely collected. This paper tries to help target company-DMU1-to find the right alliance partners. By our proposed approach, the results show the priority in the recent years. The research study is hopefully of interest to managers who are in manufacturing industry in general and EMS enterprises in particular. PMID:25821859

  15. A study of the strategic alliance for EMS industry: the application of a hybrid DEA and GM (1, 1) approach.

    PubMed

    Wang, Chia Nan; Nguyen, Nhu Ty; Tran, Thanh Tuyen; Huong, Bui Bich

    2015-01-01

    Choosing a partner is a critical factor for success in international strategic alliances, although criteria for partner selection vary between developed and transitional markets. This study aims to develop effective methods to assist enterprise to measure the firms' operation efficiency, find out the candidate priority under several different inputs and outputs, and forecast the values of those variables in the future. The methodologies are constructed by the concepts of Data Envelopment Analysis (DEA) and grey model (GM). Realistic data in four consecutive years (2009-2012) a total of 20 companies of the Electronic Manufacturing Service (EMS) industry that went public are completely collected. This paper tries to help target company-DMU1-to find the right alliance partners. By our proposed approach, the results show the priority in the recent years. The research study is hopefully of interest to managers who are in manufacturing industry in general and EMS enterprises in particular.

  16. The Medical Research Council prion disease rating scale: a new outcome measure for prion disease therapeutic trials developed and validated using systematic observational studies.

    PubMed

    Thompson, Andrew G B; Lowe, Jessica; Fox, Zoe; Lukic, Ana; Porter, Marie-Claire; Ford, Liz; Gorham, Michele; Gopalakrishnan, Gosala S; Rudge, Peter; Walker, A Sarah; Collinge, John; Mead, Simon

    2013-04-01

    Progress in therapeutics for rare disorders like prion disease is impeded by the lack of validated outcome measures and a paucity of natural history data derived from prospective observational studies. The first analysis of the U.K. National Prion Monitoring Cohort involved 1337 scheduled clinical assessments and 479 telephone assessments in 437 participants over 373 patient-years of follow-up. Scale development has included semi-quantitative and qualitative carer interviews, item response modelling (Rasch analysis), inter-rater reliability testing, construct analysis and correlation with several existing scales. The proposed 20-point Medical Research Council prion disease rating scale assesses domains of cognitive function, speech, mobility, personal care/feeding and continence, according to their relative importance documented by carer interviews. It is quick and simple to administer, and has been validated for use by doctors and nurses and for use over the telephone, allowing for frequent assessments that capture the rapid change typical of these diseases. The Medical Research Council Scale correlates highly with widely used cognitive and single item scales, but has substantial advantages over these including minimal floor effects. Three clear patterns of decline were observed using the scale: fast linear decline, slow linear decline (usually inherited prion disease) and in some patients, decline followed by a prolonged preterminal plateau at very low functional levels. Rates of decline and progress through milestones measured using the scale vary between sporadic, acquired and inherited prion diseases following clinical expectations. We have developed and validated a new functionally-oriented outcome measure and propose that future clinical trials in prion disease should collect data compatible with this scale, to allow for combined and comparative analyses. Such approaches may be advantageous in orphan conditions, where single studies of feasible duration will

  17. The Medical Research Council prion disease rating scale: a new outcome measure for prion disease therapeutic trials developed and validated using systematic observational studies.

    PubMed

    Thompson, Andrew G B; Lowe, Jessica; Fox, Zoe; Lukic, Ana; Porter, Marie-Claire; Ford, Liz; Gorham, Michele; Gopalakrishnan, Gosala S; Rudge, Peter; Walker, A Sarah; Collinge, John; Mead, Simon

    2013-04-01

    Progress in therapeutics for rare disorders like prion disease is impeded by the lack of validated outcome measures and a paucity of natural history data derived from prospective observational studies. The first analysis of the U.K. National Prion Monitoring Cohort involved 1337 scheduled clinical assessments and 479 telephone assessments in 437 participants over 373 patient-years of follow-up. Scale development has included semi-quantitative and qualitative carer interviews, item response modelling (Rasch analysis), inter-rater reliability testing, construct analysis and correlation with several existing scales. The proposed 20-point Medical Research Council prion disease rating scale assesses domains of cognitive function, speech, mobility, personal care/feeding and continence, according to their relative importance documented by carer interviews. It is quick and simple to administer, and has been validated for use by doctors and nurses and for use over the telephone, allowing for frequent assessments that capture the rapid change typical of these diseases. The Medical Research Council Scale correlates highly with widely used cognitive and single item scales, but has substantial advantages over these including minimal floor effects. Three clear patterns of decline were observed using the scale: fast linear decline, slow linear decline (usually inherited prion disease) and in some patients, decline followed by a prolonged preterminal plateau at very low functional levels. Rates of decline and progress through milestones measured using the scale vary between sporadic, acquired and inherited prion diseases following clinical expectations. We have developed and validated a new functionally-oriented outcome measure and propose that future clinical trials in prion disease should collect data compatible with this scale, to allow for combined and comparative analyses. Such approaches may be advantageous in orphan conditions, where single studies of feasible duration will

  18. The world alliance against antibiotic resistance: consensus for a declaration.

    PubMed

    Carlet, Jean

    2015-06-15

    Antibiotic resistance is increasing worldwide and has become a very important threat to public health. The overconsumption of antibiotics is the most important cause of this problem. We created a World Alliance Against Antibiotic Resistance (WAAAR), which now includes 720 people from 55 different countries and is supported by 145 medical societies or various groups. In June 2014, WAAAR launched a declaration against antibiotic resistance. This article describes the process and the content of this declaration.

  19. The Aeronautics Education, Research, and Industry Alliance (AERIAL) 2002 Report

    NASA Technical Reports Server (NTRS)

    Bowen, Brent D.; Fink, Mary M.; Nickerson, Jocelyn S.

    2002-01-01

    This report presents and overview of the Aeronautics Education, Research, and Industry Alliance (AERIAL). It covers the University of Nebraska's areas of research, and its outreach to students at Native American schools as part of AERIAL. The report contains three papers: "Airborne Remote Sensing (ARS) for Agricultural Research and Commercialization Application" (White Paper), "Validated Numerical Models for the Convective Extinction of Fuel Droplets (CEFD)", and "The Small Aircraft Transportation System (SATS): Research Collaborations with the NASA Langley Research Center".

  20. American lifelines alliance efforts to improve electric power transmission reliability

    USGS Publications Warehouse

    Nishenko, S.P.; Savage, W.U.; Honegger, D.G.; McLane, T.R.; ,

    2002-01-01

    A study was performed on American Lifelines Alliance (ALA) efforts to improve electric power transmission reliability. ALA is a public-private partnership project, with the goal of reducing risks to lifelines from natural hazards and human threat events. The mechanism used by ALA for developing national guidelines for lifeline systems is dependent upon using existing Standards Developing Organizations (SDO) accredited by the American National Standards Institute (ANSI) as means to achieve national consensus.

  1. A grand alliance takes shape behind 'Facts for Life'.

    PubMed

    Allan, D

    1989-12-01

    Convinced that if parents could be reached with today's health knowledge and supported in putting it into use, child survival and development would experience a great forward surge, WHO, Unicef and Unesco have compiled a ten chapter summary of the essential information parents need. This booklet is Facts for Life, but more than a publication, it is a movement and the handbook of a grand alliance of communicators. PMID:2599518

  2. Dmt and opioid peptides: a potent alliance.

    PubMed

    Bryant, Sharon D; Jinsmaa, Yunden; Salvadori, Severo; Okada, Yoshio; Lazarus, Lawrence H

    2003-01-01

    The introduction of the Dmt (2',6'-dimethyl-L-tyrosine)-Tic pharmacophore into the design of opioid ligands produced an extraordinary family of potent delta-opioid receptor antagonists and heralded a new phase in opioid research. First reviewed extensively in 1998, the incorporation of Dmt into a diverse group of opioid molecules stimulated the opioid field leading to the development of unique analogues with remarkable properties. This overview will document the crucial role played by this residue in the proliferation of opioid peptides with high receptor affinity (K(i) equal to or less than 1 nM) and potent bioactivity. The discussion will include the metamorphosis between delta-opioid receptor antagonists to delta-agonists based solely on subtle structural changes at the C-terminal region of the Dmt-Tic pharmacophore as well as their behavior in vivo. Dmt may be considered promiscuous due to the acquisition of potent mu-agonism by dermorphin and endomorphin derivatives as well as by a unique class of opioidmimetics containing two Dmt residues separated by alkyl or pyrazinone linkers. Structural studies on the Dmt-Tic compounds were enhanced tremendously by x-ray diffraction data for three potent and biologically diverse Dmt-Tic opioidmimetics that led to the development of pharmacophores for both delta-opioid receptor agonists and antagonists. Molecular modeling studies of other unique Dmt opioid analogues illuminated structural differences between delta- and mu-receptor ligand interactions. The future of these compounds as therapeutic applications for various medical syndromes including the control of cancer-associated pain is only a matter of time and perseverance.

  3. Seapower in the nuclear age: NATO as a maritime alliance

    SciTech Connect

    Sokolsky, J.J.

    1986-01-01

    This study examines the North Atlantic Treaty Organization, (NATO), from the perspective of its collective maritime forces; how those forces were organized, what task they were given, and how they related to the broader strategic and political doctrines of the Alliance. Drawing upon much heretofore classified material, the study begins with a history and analysis of the cold water at sea. It then examines the impact of the growth in Soviet maritime capabilities and the adoption by NATO of a strategy of flexible response upon the allied posture at sea. A single chapter is devoted to the reinforcement sealift problem. The concluding chapter discusses NATO and the war at sea in the early 1980s. The study comes to the following basic conclusions: (1) the collective maritime forces of the Alliance, both nuclear and conventional, have had as their tasks the traditional task all maritime forces have had in the past - to exploit the strategic value of the seas for the purposes of conveyance and projection and to deny these usages to the enemy; (2) NATO's maritime posture has been consistent with the overall strategies of the Alliance (3) the strategy of flexible response only increased NATO's need to exploit that strategic value of the seas, but did so at a time when the Soviets were becoming increasingly able to deny NATO effective use of the sea to support its position on the European continent.

  4. Partnering with Sandia National Laboratories through alliances or consortia

    SciTech Connect

    Winchell, B.M.

    1994-12-01

    To better facilitate working with industry, groups of industrial participants, and partners in alliances or consortia, Sandia National Laboratories presents information helpful to those outside groups as to the forms of arrangements that may be used to better facilitate partnering relationships between Sandia National Laboratories and consortia or alliances of outside parties. It is expected that these alliances and consortia will include both large and small for-profit industrial concerns, as well as not-for-profit entities such as universities, institutes, other research facilities, and other nonprofit institutions or consortia containing institutions. The intent of this report is to provide such outside groups with information that will facilitate rapid interactions with Sandia National Laboratories through some of these forms of business which will be discussed in this report. These are not the only approaches to facilitating business interactions with Sandia National Laboratories and it is not intended that this report be legal advice or required approaches to doing business with Sandia National Laboratories. The intent of this report is merely to suggest ways in which Sandia National Laboratories can work with outside parties in the most expeditious manner.

  5. Partnering with Sandia National Laboratories through alliances or consortia

    SciTech Connect

    Winchell, B.M.

    1994-04-01

    To better facilitate working with industry, groups of industrial participants, and partners in alliances or consortia, Sandia National laboratories presents information helpful to those outside groups as to the forms of arrangements that may be used to better facilitate partnering relationships between Sandia National Laboratories and consortia or alliances of outside parties. It is expected that these alliances and consortia will include both large and small for-profit industrial concerns, as well as not-for-profit entities such as universities, institutes, other research facilities, and other nonprofit institutions or consortia containing institutions. The intent of this report is to provide such outside groups with information that will facilitate rapid interactions with Sandia National Laboratories through some of these forms of business which will be discussed in this report. These are not the only approaches to facilitating business interactions with Sandia National Laboratories and it is not intended that this report be legal advice or required approaches to doing business with Sandia National Laboratories. The intent of this report is merely to suggest ways in which Sandia National Laboratories can work with outside parties in the most expeditious manner.

  6. ALLIANCE: An architecture for fault tolerant multi-robot cooperation

    SciTech Connect

    Parker, L.E.

    1995-02-01

    ALLIANCE is a software architecture that facilitates the fault tolerant cooperative control of teams of heterogeneous mobile robots performing missions composed of loosely coupled, largely independent subtasks. ALLIANCE allows teams of robots, each of which possesses a variety of high-level functions that it can perform during a mission, to individually select appropriate actions throughout the mission based on the requirements of the mission, the activities of other robots, the current environmental conditions, and the robot`s own internal states. ALLIANCE is a fully distributed, behavior-based architecture that incorporates the use of mathematically modeled motivations (such as impatience and acquiescence) within each robot to achieve adaptive action selection. Since cooperative robotic teams usually work in dynamic and unpredictable environments, this software architecture allows the robot team members to respond robustly, reliably, flexibly, and coherently to unexpected environmental changes and modifications in the robot team that may occur due to mechanical failure, the learning of new skills, or the addition or removal of robots from the team by human intervention. The feasibility of this architecture is demonstrated in an implementation on a team of mobile robots performing a laboratory version of hazardous waste cleanup.

  7. Comparison of PHITS, GEANT4, and HIBRAC simulations of depth-dependent yields of β(+)-emitting nuclei during therapeutic particle irradiation to measured data.

    PubMed

    Rohling, Heide; Sihver, Lembit; Priegnitz, Marlen; Enghardt, Wolfgang; Fiedler, Fine

    2013-09-21

    For quality assurance in particle therapy, a non-invasive, in vivo range verification is highly desired. Particle therapy positron-emission-tomography (PT-PET) is the only clinically proven method up to now for this purpose. It makes use of the β(+)-activity produced during the irradiation by the nuclear fragmentation processes between the therapeutic beam and the irradiated tissue. Since a direct comparison of β(+)-activity and dose is not feasible, a simulation of the expected β(+)-activity distribution is required. For this reason it is essential to have a quantitatively reliable code for the simulation of the yields of the β(+)-emitting nuclei at every position of the beam path. In this paper results of the three-dimensional Monte-Carlo simulation codes PHITS, GEANT4, and the one-dimensional deterministic simulation code HIBRAC are compared to measurements of the yields of the most abundant β(+)-emitting nuclei for carbon, lithium, helium, and proton beams. In general, PHITS underestimates the yields of positron-emitters. With GEANT4 the overall most accurate results are obtained. HIBRAC and GEANT4 provide comparable results for carbon and proton beams. HIBRAC is considered as a good candidate for the implementation to clinical routine PT-PET.

  8. Mechanoregulatory tumor-stroma crosstalk in pancreatic cancer: Measurements of the effects of extracellular matrix mechanics on tumor growth behavior, and vice-versa, to inform therapeutics

    NASA Astrophysics Data System (ADS)

    Celli, Jonathan; Jones, Dustin; El-Hamidi, Hamid; Cramer, Gwendolyn; Hanna, William; Caide, Andrew; Jafari, Seyedehrojin

    The rheological properties of the extracellular matrix (ECM) have been shown to play key roles in regulating tumor growth behavior through mechanotranduction pathways. The role of the mechanical microenvironment may be particularly important tumors of the pancreas, noted for an abundance of rigid fibrotic stroma, implicated in therapeutic resistance. At the same time, cancer cells and their stromal partners (e.g. tumor associated fibroblasts) continually alter the mechanical microenvironment in response to extracellular physical and biochemical cues as part of a two-way mechanoregulatory dialog. Here, we describe experimental studies using 3D pancreatic cell cultures with customized mechanical properties, combined with optical microrheology to provide insight into tumor-driven matrix remodeling. Quantitative microscopy provides measurements of phenotypic changes accompanying systematic variation of ECM composition in collagen and laminin-rich basement membrane admixtures, while analysis of the trajectories of passive tracer particles embedded in ECM report dynamic changes in heterogeneity, microstructure and local shear modulus accompanying both ECM stiffening (fibrosis) processes, and ECM degradation near invading cells. We gratefully acknowledge funding from the National Cancer Institute, R00CA155045 (PI: Celli).

  9. The relevance of the alliance for CME competencies for planning, organizing, and sustaining an interorganizational educational collaborative.

    PubMed

    Balmer, Jann T; Bellande, Bruce J; Addleton, Robert L; Havens, Carol S

    2011-01-01

    The heightened demand for accountability, access, and quality performance from health care professionals has resulted in linkages between continuing education (CE), performance improvement (PI), and outcomes. CE health professionals must also expand their skills and abilities to design, implement, and measure CE activities consistent with these new expectations. In addition to administrative and meeting-planning activities, new competencies associated with educational consultation and performance coaching are needed. This article utilizes the Alliance competencies as the framework for discussion of the competencies of CE professionals and applies it to the unique setting of a collaborative. The CS2day initiative serves as an example of the application of these competencies in this environment. The framework of the Alliance competencies can serve as a guide and a tool for self-assessment, work design, and professional development at individual, organization, and systems levels. Continual reassessment of the Alliance competencies for CE in the health professions will be critical to the continued effectiveness of CE that is linked to performance improvement and outcomes for the CE professional and the health care professionals we serve. A collaborative can provide one option for meeting these new expectations for professional development for CE professionals and the creation of effective educational initiatives.

  10. Establishing strategic alliance among hospitals through SAIS: a case study in Taiwan.

    PubMed

    Hung, Won-Fu; Hwang, Hsin-Ginn; Liao, Chechen

    2005-01-01

    Due to a reformed healthcare insurance system and a gradually decreasing public affairs' budget by the government year by year, Central Taiwan Office (CTO), the Department of Health (DOH) in Taiwan, initiated a strategic alliance project of the hospitals subordinated to the DOH in November, 2001. This project was a five-year plan with an attempt to expand and develop three more strategic alliances covering the northern, southern and eastern regions of Taiwan respectively. Through a cooperative system, such an alliance allows the following: resource sharing, technique collaboration, marketing affiliations and so on. In order to decrease operation management costs and improve the quality of service at hospitals, the strategic alliance practice is supported by IS. We call this alignment the IS-enabled strategic alliance. All the IS-enabled functions are supported by the Strategic Alliance Information System (SAIS). In this article, the SAIS developed by the CTO of the DOH is introduced. PMID:18048210

  11. An International Framework for Data Sharing: Moving Forward with the Global Alliance for Genomics and Health.

    PubMed

    Rahimzadeh, Vasiliki; Dyke, Stephanie O M; Knoppers, Bartha M

    2016-06-01

    The Global Alliance for Genomics and Health is marshaling expertise in biomedical research and data sharing policy to propel bench-to-bedside translation of genomics in parallel with many of the BioSHaRE-EU initiatives described at length in this Issue. Worldwide representation of institutions, funders, researchers, and patient advocacy groups at the Global Alliance is testament to a shared ideal that sees maximizing the public good as a chief priority of genomic innovation in health. The Global Alliance has made a critical stride in this regard with the development of its Framework for Responsible Sharing of Genomic and Health-related Data.(1) This article first discusses the human rights pillars that underlie the Framework and mission of the Global Alliance. Second, it outlines the Global Alliance's use of data governance policies through a number of demonstration projects. Finally, the authors describe how the Global Alliance envisions international data sharing moving forward in the postgenomic era. PMID:27082668

  12. Working Alliance in Patients with Severe Mental Illness Who Need a Crisis Intervention Plan.

    PubMed

    Ruchlewska, Asia; Kamperman, Astrid M; van der Gaag, Mark; Wierdsma, André I; Mulder, Niels C L

    2016-01-01

    Working alliance has been characterized as an important predictor of positive treatment outcomes. We examined whether illness insight, psychosocial functioning, social support and locus of control were associated with working alliance as perceived by both patient and clinician. We assessed 195 outpatients with psychotic or bipolar disorders. Our findings indicated that patients rated the alliance more positively when they experienced a greater need for treatment, fewer behavioral and social problems, and more psychiatric symptoms. Clinicians rated the alliance more positively in patients who reported fewer social problems and better illness insight. Patients' demographic characteristics, including being female and married, were also positively related to the clinician-rated alliance. Our results suggest that patients and clinicians have divergent perceptions of the alliance. Clinicians may need help developing awareness of the goals and tasks of patients with certain characteristics, i.e., singles, men, those with poor illness insight and those who report poor social functioning.

  13. The Effect of R&D Alliances on the Speed of Innovation: Evidence from Chinese SMEs

    NASA Astrophysics Data System (ADS)

    Zhang, Minghong; Yin, Xinke

    The aim of this paper is to analyze the R&D alliances' effect on technological innovation. There are many factors that have effect on technological innovation, but few empirical literatures have studied R&D alliances. After reviewing related literature, we propose some hypotheses and test them with a sample of 504 small and medium enterprises that have carried out R&D activities and joined in R&D alliances. The results indicate that, for small and medium enterprises, participating in R&D alliances is good for technological innovation. Moreover, capital investment and human resource has positive impacts on innovation, but which industry that enterprises belong to has no effect.

  14. West European public and the Atlantic Alliance

    SciTech Connect

    Ziegler, A.H. Jr.

    1987-01-01

    Using original and previously published survey data, this study explores West European public attitudes about Atlantic cooperation in general and NATO in particular. Alternative viewpoints are categorized into a typology that is used to describe the conceptual nature of European beliefs and to measure the level of public support for the different viewpoints. Long-term trends in these attitudes and causal determinants are also examined. A distinguishing feature of this study is that it is truly comparative. The analysis relies on identical survey items administered in four European countries: Great Britain, France, West German, and Italy. The longitudinal data examined indicate that some fundamental changes have occurred in European security beliefs. Anti-Americanism has increased dramatically at the same time that attitudes toward the Soviet Union have become more favorable, and the fear of nuclear weapons and nuclear war has increased substantially. Explanations for these shifts in opinion are not found in sociological factors, such as changes in generational experiences, educational levels, or social classes; but instead, European attitudes appear to reflect broad changes in international politics, such as the Vietnam War, nuclear parity, and detente. Favorable opinion for NATO tends to be high, yet specific defense-related measures receive much less support.

  15. Therapeutic showering in labor.

    PubMed

    Stark, Mary Ann

    2013-08-01

    While showering is thought to be an effective coping strategy during labor, research on this comfort measure is lacking. The purpose of this study was to measure effectiveness of therapeutic showering on pain, coping, tension, anxiety, relaxation, and fatigue in labor. A quasi-experimental pretest-posttest single group design was conducted in a community hospital. Participants were women who had singleton, uncomplicated pregnancies and were in active labor at term (N = 24). After completing pretest measures, participants took a 30 min shower where they were encouraged to be seated but could choose positions of comfort. There were significant reductions in tension and anxiety and increased relaxation and coping. Showering may be a safe and effective comfort measure for healthy, laboring women who are experiencing tension or anxiety, or having difficulty relaxing or coping with labor. Further research is needed to test the maternal and neonatal outcomes of this nonpharmacologic comfort measure.

  16. The Therapeutic School.

    ERIC Educational Resources Information Center

    Rice, John Steadman

    2002-01-01

    Contributes to the recent research on specific institutional carriers of the therapeutic culture, such as the state, the corporation, and the self- help movement, defining therapeutic discourse and discussing the therapeutic ethic, the therapeutic school, schools of education and their critics, and disappointing results of therapeutic schooling.…

  17. One size does not fit all: Examining heterogeneity and identifying moderators of the alliance-outcome association.

    PubMed

    Zilcha-Mano, Sigal; Errázuriz, Paula

    2015-10-01

    Although the alliance-outcome association is one of the most consistent findings in psychotherapy research, it is also highly heterogeneous. Little is known about the factors explaining this variability, and consequently there is a lack of adequate knowledge about how to utilize this association to improve treatment. The present study had the following objectives: (a) to examine the associations between within- and between-individual variability in alliance and outcome, controlling for previous symptomatic levels; (b) to examine the duration of the alliance-outcome association; and (c) to examine potential moderators of the alliance-outcome association. A total of 547 patients treated in a primary care psychotherapy setting in Chile were randomly assigned to 5 feedback conditions. The alliance-outcome association was analyzed using multilevel models, disentangling changes in alliance within-individuals from alliance between-individuals. Patient and therapist characteristics were examined as potential moderators. Findings suggest that patients who reported a better early alliance also reported a better outcome. Furthermore, patients reporting time-specific improvement in alliance also reported a greater reduction in symptoms. The unique effect of alliance on outcome at one point in time is maintained for a period of 2 weeks. Patients with more severe symptoms and longer treatments benefited more from a good alliance. Therapists identifying themselves as more integrative in their treatment orientation were able to better utilize good alliances for treatment success. Finally, the size of the alliance-outcome association can be manipulated by feedback to therapists.

  18. Alliance for Earth Sciences, Engineering and Development in Africa

    NASA Astrophysics Data System (ADS)

    Barron, E. J.; Adewumi, M.

    2004-12-01

    Penn State University, with a significant number of African University partners (University of Ibadan, University of Lagos, University of Cape Town, University of Witwatersrand, and Agustino Neto University) as well as HBCUs (Howard University and the Mississippi Consortium for International Development - a consortium of four HBCUs in Mississippi), has established the Alliance for Earth Sciences, Engineering and Development in Africa (AESEDA). AESEDA is designed to enable the integration of science, engineering, and social sciences in order to develop human resources, promote economic vitality and enable environmental stewardship in Africa. The Alliance has a coherent and significant multidisciplinary focus, namely African georesources. Education is a central focus, with research collaboration as one element of the vehicle for education. AESEDA is focused on building an environment of intellectual discourse and pooled intellectual capital and developing innovative and enabling educational programs and enhancing existing ones. AESEDA also has unique capabilities to create role models for under-represented groups to significantly enable the utilization of human potential. The efforts of the Alliance center around specific activities in support of its objectives: (1) Focused research collaboration among partner institutions, (2) Development of an international community of scholars, and (3) Joint development of courses and programs and instructional innovation. Penn State has a unique ability to contribute to the success of this program. The College of Earth and Mineral Sciences contains strong programs in the areas of focus. More than 25 faculty in the College have active research and educational efforts in Africa. Hence, the Alliance has natural and vigorous support within the College. The College is also providing strong institutional support for AESEDA, by establishing a Director and support staff and creating permanent funds for a unique set of new faculty hires

  19. PROCEEDINGS OF THE 2002 NATIONAL OILHEAT RESEARCH ALLIANCE TECHNOLOGY SYMPOSIUM.

    SciTech Connect

    MCDONALD,R.J.

    2002-08-20

    This is the PROCEEDINGS OF THE 2002 NATIONAL OILHEAT RESEARCH ALLIANCE TECHNOLOGY SYMPOSIUM, which was Held at Oilheat Visions Conference, Rhode Island Convention Center, Providence, Rhode Island, August 20-21, 2002. The specific objectives of this conference are to: (1) identify and evaluate the current state-of-the-art and recommend new initiatives for higher efficiency, a cleaner environment, and to satisfy consumer needs cost-effectively, reliably, and safely; and (2) foster cooperative interactions among federal and industrial representatives for the common goal of sustained economic growth and energy security via energy conservation.

  20. LED Surgical Task Lighting Scoping Study: A Hospital Energy Alliance Project

    SciTech Connect

    Tuenge, Jason R.

    2011-01-17

    Tungsten-halogen (halogen) lamps have traditionally been used to light surgical tasks in hospitals, even though they are in many respects ill-suited to the application due to the large percentage of radiant energy outside the visible spectrum and issues with color rendering/quality. Light-emitting diode (LED) technology offers potential for adjustable color and improved color rendition/quality, while simultaneously reducing side-effects from non-visible radiant energy. It also has the potential for significant energy savings, although this is a fairly narrow application in the larger commercial building energy use sector. Based on analysis of available products and Hospital Energy Alliance member interest, it is recommended that a product specification and field measurement procedure be developed for implementation in demonstration projects.

  1. The NCI Alliance for Nanotechnology in Cancer: achievement and path forward.

    PubMed

    Ptak, Krzysztof; Farrell, Dorothy; Panaro, Nicholas J; Grodzinski, Piotr; Barker, Anna D

    2010-01-01

    Nanotechnology is a 'disruptive technology', which can lead to a generation of new diagnostic and therapeutic products, resulting in dramatically improved cancer outcomes. The National Cancer Institute (NCI) of National Institutes of Health explores innovative approaches to multidisciplinary research allowing for a convergence of molecular biology, oncology, physics, chemistry, and engineering and leading to the development of clinically worthy technological approaches. These initiatives include programmatic efforts to enable nanotechnology as a driver of advances in clinical oncology and cancer research, known collectively as the NCI Alliance for Nanotechnology in Cancer (ANC). Over the last 5 years, ANC has demonstrated that multidisciplinary approach catalyzes scientific developments and advances clinical translation in cancer nanotechnology. The research conducted by ANC members has improved diagnostic assays and imaging agents, leading to the development of point-of-care diagnostics, identification and validation of numerous biomarkers for novel diagnostic assays, and the development of multifunctional agents for imaging and therapy. Numerous nanotechnology-based technologies developed by ANC researchers are entering clinical trials. NCI has re-issued ANC program for next 5 years signaling that it continues to have high expectations for cancer nanotechnology's impact on clinical practice. The goals of the next phase will be to broaden access to cancer nanotechnology research through greater clinical translation and outreach to the patient and clinical communities and to support development of entirely new models of cancer care. PMID:20552623

  2. 77 FR 7572 - Alliance Pipeline L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... Energy Regulatory Commission Alliance Pipeline L.P.; Notice of Application Take notice that on January 25, 2012, Alliance Pipeline L.P. filed with the Federal Energy Regulatory Commission an application under... interstate natural gas pipeline lateral designed to connect new natural gas production near Tioga,...

  3. Alliances and Arguments: A Case Study of a Child with Persisting Speech Difficulties in Peer Play

    ERIC Educational Resources Information Center

    Tempest, Alison; Wells, Bill

    2012-01-01

    The ability to argue and to create alliances with peers are important social competencies for all children, including those who have speech, language and communication needs. In this study, we investigated the management of arguments and alliances by a group of 5-year-old male friends, one of whom has a persisting speech difficulty (PSD). Twelve…

  4. The Contribution of the Counselor-Client Working Alliance to Career Exploration

    ERIC Educational Resources Information Center

    Elad-Strenger, Julia; Littman-Ovadia, Hadassah

    2012-01-01

    This longitudinal study examines the effects of Israeli counselors' and clients' ratings of their working alliance on clients' career exploration (CE), using a sample of 94 three-session career counseling processes. Results reveal that both clients' and counselors' working alliance ratings increased over time; yet, clients' ratings remained…

  5. The Education Alliance: Business and Community for Public Schools. Annual Report, 1997.

    ERIC Educational Resources Information Center

    Education Alliance, Charleston, WV.

    Formerly the West Virginia Education Fund, the Education Alliance is a nonprofit organization that serves as a catalyst for business and community involvement in West Virginia public schools. This annual report describes the following Education Alliance activities during 1997: (1) Mini-Grants for Classroom Projects (grants to 195 teachers of up to…

  6. The Working Alliance Efficacy among Rehabilitation Service Providers by Education, Experience, and Disability Category

    ERIC Educational Resources Information Center

    O'Sullivan, Deirdre

    2012-01-01

    The Working Alliance, consisting of building bonds, establishing goals, and developing tasks, has been deemed the cornerstone of helping professions, and has been found to significantly and reliably predict client outcomes. The importance of client characteristics and perceptions of working alliance has been established in the literature. Less is…

  7. Management of Cultural Differences under Various Forms of China-UK Higher Education Strategic Alliances

    ERIC Educational Resources Information Center

    Li, Xiaoqing; Roberts, Joanne; Yan, Yanni; Tan, Hui

    2016-01-01

    International strategic alliances are notorious for their high failure rate. Increased inter-partner conflict resulting from ineffective cross-cultural management is perceived to be one of the key reasons for unsatisfactory alliance performance. Driven by globalization, universities are extending into foreign markets through the establishment of…

  8. The Identification of Funding Options, Problems and Issues Associated with Sino-Foreign University Alliances

    ERIC Educational Resources Information Center

    Willis, Mike

    2003-01-01

    Many Chinese universities (there are over 1,080) have various forms of alliances with foreign universities to undertake the development and delivery of courses in China, participate in exchange activities, collaborate in research projects and engage in consulting programs. It is now quite common for these alliances to offer complete undergraduate…

  9. 77 FR 75200 - AllianceBernstein Active ETFs, Inc., et al.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-19

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION AllianceBernstein Active ETFs, Inc., et al.; Notice of Application December 13, 2012. AGENCY...Bernstein Active ETFs, Inc. (``Corporation''), AllianceBernstein L.P. (``Adviser''), and ALPS...

  10. Alliances That Work. A Report from a Conference (Louisville, Kentucky, May 23, 2000).

    ERIC Educational Resources Information Center

    Regional Technology Strategies, Inc., Carrboro, NC.

    This monograph summarizes presentations and discussions that took place at a symposium organized in conjunction with the spring meeting of the Trans-Atlantic Technology and Training Alliance (TA3). TA3 is an international alliance dedicated to sharing practices that prepare workers for technical careers, providing opportunities for faculty…

  11. The Impact of Belonging to a High School Gay/Straight Alliance.

    ERIC Educational Resources Information Center

    Lee, Camille

    This qualitative investigation studies the impact of belonging to a high school Gay/Straight Alliance (GSA or Alliance) on the lives of seven students in a Salt Lake City (Utah) high school. Individual and focus group interviews were conducted over a 2-year period. The researcher/author used voices of gay, lesbian, bi-sexual, and straight students…

  12. 76 FR 56749 - Northern Laramie Range Alliance; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Energy Regulatory Commission Northern Laramie Range Alliance; Notice of Petition for Declaratory Order Take notice that on July 12, 2011, Northern Laramie Range Alliance filed a Petition for Declaratory...Support@ferc.gov , or call (866) 208-3676 (toll free). For TTY, call (202) 502-8659. Comment Date: 5...

  13. The Power of Partnerships: Lessons Learned from Research Alliances in the Northwest

    ERIC Educational Resources Information Center

    Akey, Terri; Hodara, Michelle; Morse, Les; Rosselli, Hilda; Finkelstein, Neal

    2014-01-01

    The purpose of this panel is to discuss how researchers and policymakers work together in two Regional Education Laboratory (REL) research alliances to develop research agendas aimed at changing policy and practice and to provide practical lessons for researchers about the challenges and solutions to working in a research alliance context. The…

  14. Professional Development and the Teaching Schools Experiment in England: Leadership Challenges in an Alliance's First Year

    ERIC Educational Resources Information Center

    Dowling, Simon

    2016-01-01

    This article reports findings from the first year of a longitudinal, mixed-methods case study of a large teaching school alliance in England. This national initiative is intended to drive improvement at system level by grouping schools around formally designated teaching schools. These "alliances" work collaboratively to share learning,…

  15. Chinese Cultural Values and Their Applicability of Successful Sino-Foreign Educational Alliances

    ERIC Educational Resources Information Center

    Willis, Mike

    2006-01-01

    Alliances between Chinese and foreign usually western universities continue to attract considerable attention and one of the issues which remains of particular interest is the cross cultural dimension of such alliances and, in particular, the importance of understanding various strands and aspects of Chinese culture when negotiating and managing a…

  16. How To Make International Strategic Alliances Work: One More Business Lesson from the Japanese.

    ERIC Educational Resources Information Center

    Raffield, Barney T., III

    International strategic alliances are established by two or more companies as synergistic relationships to achieve a common goal where both parties benefit. The evolving global market has focused renewed interest on these alliances as an important tool in penetrating new markets. No country has achieved as much success as Japan in forging such…

  17. How a Fully Automated eHealth Program Simulates Three Therapeutic Processes: A Case Study

    PubMed Central

    Johansen, Ayna; Brendryen, Håvar

    2016-01-01

    Background eHealth programs may be better understood by breaking down the components of one particular program and discussing its potential for interactivity and tailoring in regard to concepts from face-to-face counseling. In the search for the efficacious elements within eHealth programs, it is important to understand how a program using lapse management may simultaneously support working alliance, internalization of motivation, and behavior maintenance. These processes have been applied to fully automated eHealth programs individually. However, given their significance in face-to-face counseling, it may be important to simulate the processes simultaneously in interactive, tailored programs. Objective We propose a theoretical model for how fully automated behavior change eHealth programs may be more effective by simulating a therapist’s support of a working alliance, internalization of motivation, and managing lapses. Methods We show how the model is derived from theory and its application to Endre, a fully automated smoking cessation program that engages the user in several “counseling sessions” about quitting. A descriptive case study based on tools from the intervention mapping protocol shows how each therapeutic process is simulated. Results The program supports the user’s working alliance through alliance factors, the nonembodied relational agent Endre and computerized motivational interviewing. Computerized motivational interviewing also supports internalized motivation to quit, whereas a lapse management component responds to lapses. The description operationalizes working alliance, internalization of motivation, and managing lapses, in terms of eHealth support of smoking cessation. Conclusions A program may simulate working alliance, internalization of motivation, and lapse management through interactivity and individual tailoring, potentially making fully automated eHealth behavior change programs more effective. PMID:27354373

  18. Reentrant phase transitions and defensive alliances in social dilemmas with informed strategies

    NASA Astrophysics Data System (ADS)

    Szolnoki, Attila; Perc, Matjaž

    2015-05-01

    Knowing the strategy of an opponent in a competitive environment conveys obvious evolutionary advantages. But this information is costly, and the benefit of being informed may not necessarily offset the additional cost. Here we introduce social dilemmas with informed strategies, and we show that this gives rise to two cyclically dominant triplets that form defensive alliances. The stability of these two alliances is determined by the rotation velocity of the strategies within each triplet. A weaker strategy in a faster rotating triplet can thus overcome an individually stronger competitor. Fascinating spatial patterns favor the dominance of a single defensive alliance, but enable also the stable coexistence of both defensive alliances in very narrow regions of the parameter space. A continuous reentrant phase transition reveals before unseen complexity behind the stability of strategic alliances in evolutionary social dilemmas.

  19. Selecting Cooperative Enterprise in Dynamic Enterprise Alliance Based on Fuzzy Comprehensive Evaluation

    NASA Astrophysics Data System (ADS)

    Li, Yan; Zhang, Guoxing; Liu, Jun

    Dynamic enterprise alliance is a complex organization system. It has the virtual enterprise establishment, virtual operation and virtual management functions. The suitable cooperative partner is the necessary condition to ensure the efficient functioning of the dynamic enterprises alliance. It is the key technology of selecting the suitable partner reasonably and forming the dynamic enterprises alliance to realize the network manufacturing. In this paper, one reasonable model of fuzzy comprehensive evaluation on the cooperative partner of the dynamic enterprises alliance is established, using the fuzzy multi-grade comprehensive evaluation method based on the theories of fuzzy logic. It can offer a scientific method to select the optimum cooperative partner for the dynamic enterprises alliance, and improve the comparison level for alternatives.

  20. The effect of working alliance on adherence and outcome in cognitive remediation therapy.

    PubMed

    Huddy, Vyv; Reeder, Clare; Kontis, Dimitris; Wykes, Til; Stahl, Daniel

    2012-07-01

    Cognitive remediation therapy (CRT) for schizophrenia has been effective in improving cognitive and global functioning outcomes. It is now important to determine what factors maximize benefit. The quality of relationship--or working alliance--between clients and therapists may be one such factor that improves outcome. To investigate this, 49 individuals with schizophrenia were recruited into a naturalistic study of the impact of CRT on work and structured activity outcomes. Participant's cognitive skills, severity of symptoms, and social skills were assessed at baseline. Both client and therapist working alliance ratings were gathered early in therapy. After controlling for depression, clients who rated the alliance more favorably stayed in therapy longer and were more likely to improve on their main target complaint but notably not on working memory performance or self-esteem. Therapist's ratings of the alliance were not associated with memory outcome. These findings indicate that working alliance is important for client satisfaction with therapy.

  1. National Alliance for Radiation Readiness: Leveraging Partnerships to Increase Preparedness.

    PubMed

    Blumenstock, James S; Allen, Meredith

    2016-02-01

    The National Alliance for Radiation Readiness (NARR) is an alliance of 16 national member organizations that have banded together to serve as the collective "voice of health" in radiological preparedness through: • participation in national dialogues on radiological emergency issues; • provision of thoughtful feedback on documents, policies, and guidelines; and • convening of partners to raise awareness of and resolve radiological emergency issues. NARR benefits from the intersection and interaction of public health, radiation control, healthcare, and emergency management professionals--all with an interest in bolstering the nation's preparedness for a radiological or nuclear incident. NARR is able to provide a unique perspective on radiological and nuclear preparedness by creating multi-disciplinary workgroups to develop guidance, recommendations, and provide subject matter feedback. NARR aims to build response and recovery capacity and capabilities by supporting the sharing of resources and tools, including technical methods and information through the development of an online clearinghouse. NARR also aims to identify and disseminate best practices, as well as define and educate on the roles and responsibilities of local, state, and federal government and the numerous agencies involved with the response to a radiological emergency. PMID:26717184

  2. Pricing Mechanism Design for Centralized Pollutant Treatment with SME Alliances.

    PubMed

    Li, Yuyu; Huang, Bo; Tao, Fengming

    2016-06-22

    In this paper, we assume that a professional pollutant treatment enterprise treats all of the pollutants emitted by multiple small and medium-sized enterprises (SMEs). In order to determine the treatment price, SMEs can bargain with the pollutant treatment enterprise individually, or through forming alliances. We propose a bargaining game model of centralized pollutant treatment to study how the pollutant treatment price is determined through negotiation. Then, we consider that there is a moral hazard from SMEs in centralized pollutant treatment; in other words, they may break their agreement concerning their quantities of production and pollutant emissions with the pollutant treatment enterprise. We study how the pollutant treatment enterprise can prevent this by pricing mechanism design. It is found that the pollutant treatment enterprise can prevent SMEs' moral hazard through tiered pricing. If the marginal treatment cost of the pollutant treatment enterprise is a constant, SMEs could bargain with the pollutant treatment enterprise individually, otherwise, they should form a grand alliance to bargain with it as a whole.

  3. Northeast Waste Management Alliance (NEWMA). Annual report FY 1993

    SciTech Connect

    Goland, A.N.; Kaplan, E.

    1993-11-01

    Funding was provided to Brookhaven National Laboratory in the fourth quarter of FY93 to establish a regional alliance as defined by Dr. Clyde Frank during his visit to BNL on March 7, 1993. In collaboration with the Long Island Research Institute (LIRI), BNL developed a business plan for the Northeast Waste Management Alliance (NEWMA). Concurrently, informal discussions were initiated with representatives of the waste management industry, and meetings were held with local and state regulatory and governmental personnel to obtain their enthusiasm and involvement. A subcontract to LIRI was written to enable it to formalize interactions with companies offering new waste management technologies selected for their dual value to the DOE and local governments in the Northeast. LIRI was founded to develop and coordinate economic growth via introduction of new technologies. As a not-for-profit institution it is in an ideal position to manage the development of NEWMA through ready access to venture capital and strong interactions with the business community, universities, and BNL. Another subcontract was written with a professor at SUNY/Stony Brook to perform an evaluation of new pyrolitic processes, some of which may be appropriate for development by NEWMA. Independent endorsement of the business plan recently by another organization, GETF, with broad knowledge of DOE/EM-50 objectives, provides a further incentive for moving rapidly to implement the NEWMA strategy. This report describes progress made during the last quarter of FY93.

  4. Pricing Mechanism Design for Centralized Pollutant Treatment with SME Alliances

    PubMed Central

    Li, Yuyu; Huang, Bo; Tao, Fengming

    2016-01-01

    In this paper, we assume that a professional pollutant treatment enterprise treats all of the pollutants emitted by multiple small and medium-sized enterprises (SMEs). In order to determine the treatment price, SMEs can bargain with the pollutant treatment enterprise individually, or through forming alliances. We propose a bargaining game model of centralized pollutant treatment to study how the pollutant treatment price is determined through negotiation. Then, we consider that there is a moral hazard from SMEs in centralized pollutant treatment; in other words, they may break their agreement concerning their quantities of production and pollutant emissions with the pollutant treatment enterprise. We study how the pollutant treatment enterprise can prevent this by pricing mechanism design. It is found that the pollutant treatment enterprise can prevent SMEs’ moral hazard through tiered pricing. If the marginal treatment cost of the pollutant treatment enterprise is a constant, SMEs could bargain with the pollutant treatment enterprise individually, otherwise, they should form a grand alliance to bargain with it as a whole. PMID:27338440

  5. National Alliance for Radiation Readiness: Leveraging Partnerships to Increase Preparedness.

    PubMed

    Blumenstock, James S; Allen, Meredith

    2016-02-01

    The National Alliance for Radiation Readiness (NARR) is an alliance of 16 national member organizations that have banded together to serve as the collective "voice of health" in radiological preparedness through: • participation in national dialogues on radiological emergency issues; • provision of thoughtful feedback on documents, policies, and guidelines; and • convening of partners to raise awareness of and resolve radiological emergency issues. NARR benefits from the intersection and interaction of public health, radiation control, healthcare, and emergency management professionals--all with an interest in bolstering the nation's preparedness for a radiological or nuclear incident. NARR is able to provide a unique perspective on radiological and nuclear preparedness by creating multi-disciplinary workgroups to develop guidance, recommendations, and provide subject matter feedback. NARR aims to build response and recovery capacity and capabilities by supporting the sharing of resources and tools, including technical methods and information through the development of an online clearinghouse. NARR also aims to identify and disseminate best practices, as well as define and educate on the roles and responsibilities of local, state, and federal government and the numerous agencies involved with the response to a radiological emergency.

  6. Pricing Mechanism Design for Centralized Pollutant Treatment with SME Alliances.

    PubMed

    Li, Yuyu; Huang, Bo; Tao, Fengming

    2016-01-01

    In this paper, we assume that a professional pollutant treatment enterprise treats all of the pollutants emitted by multiple small and medium-sized enterprises (SMEs). In order to determine the treatment price, SMEs can bargain with the pollutant treatment enterprise individually, or through forming alliances. We propose a bargaining game model of centralized pollutant treatment to study how the pollutant treatment price is determined through negotiation. Then, we consider that there is a moral hazard from SMEs in centralized pollutant treatment; in other words, they may break their agreement concerning their quantities of production and pollutant emissions with the pollutant treatment enterprise. We study how the pollutant treatment enterprise can prevent this by pricing mechanism design. It is found that the pollutant treatment enterprise can prevent SMEs' moral hazard through tiered pricing. If the marginal treatment cost of the pollutant treatment enterprise is a constant, SMEs could bargain with the pollutant treatment enterprise individually, otherwise, they should form a grand alliance to bargain with it as a whole. PMID:27338440

  7. School Climate, Individual Support, or Both? Gay-Straight Alliances and the Mental Health of Sexual Minority Youth

    ERIC Educational Resources Information Center

    Walls, N. Eugene; Wisneski, Hope; Kane, Sarah

    2013-01-01

    Using a sample of 284 sexual minority youth and young adults, this paper examines the relationships between mental health variables, the absence or presence of a gay-straight alliance, and membership status in a gay-straight alliance. The results suggest that the presence of a gay-straight alliance in a school or college, rather than actual…

  8. Adolescent and parent alliances with therapists in Brief Strategic Family Therapy with drug-using Hispanic adolescents.

    PubMed

    Robbins, Michael S; Mayorga, Carla C; Mitrani, Victoria B; Szapocznik, José; Turner, Charles W; Alexander, James F

    2008-07-01

    This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent, adolescent) and family level (within-family differences) for families that either dropped out or completed family therapy. Participants were 31 Hispanic adolescents and their family members who received brief strategic family therapy for the treatment of adolescent drug use. Videotapes of first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that Completer cases had significantly higher levels of alliance across all family members than Dropout cases, and Dropout cases had significantly higher unbalanced alliances than Completer cases. Clinical implications are discussed. PMID:18717922

  9. Dynamic Relationships of Therapist Alliance and Group Cohesion in Transdiagnostic Group CBT for Anxiety Disorders

    PubMed Central

    Norton, Peter J.; Kazantzis, Nikolaos

    2015-01-01

    Objective Little is known about the temporal variability of the alliance-symptom change and cohesion-symptom change relationships over the course of group therapy. These questions were examined in a sample of 373 clients receiving a transdiagnostic cognitive behavior therapy (tCBT), which culled the principle research-supported mechanisms of change for anxiety disorders. Method We examined relationships between the client versions of the Working Alliance Inventory and Group Cohesion Scale in predicting subsequent symptom change, as assessed by the state scale of the State-Trait Anxiety Inventory. Results Alliance and cohesion were significant predictors of next session anxiety scores. The alliance was consistently associated with anxiety symptoms (rs = −.152 to −.198, ps < .05), but cohesion only showed significant relationships with anxiety symptoms at sessions 8 and 10 (Session 8, r = −.233, p = .020, and 10, r = −.236, p = .027). Alliance-anxiety relations remained constant, whereas cohesion-anxiety relations substantially increased from earlier to later sessions. Discussion Differences that were obtained in the relation of alliance and cohesion with anxiety symptoms suggests that these processes have different roles within group tCBT. If replicated, the present findings would suggest that the dynamic relationships between alliance and cohesion and symptoms within group CBT for anxiety disorders have been an important omission in process-outcome studies. PMID:26689305

  10. The Aeronautics Education, Research, and Industry Alliance (AERIAL) 2002 Report

    NASA Technical Reports Server (NTRS)

    Bowen, Brent D.; Box, Richard C.; Fink, Mary; Gogos, George; Lehrer, Henry R.; Narayanan, Ram M.; Nickerson, Jocelyn S.; Tarry, Scott E.; Vlasek, Karisa D.; O'Neil, Patrick D.

    2002-01-01

    The NASA Nebraska Space Grant Consortium (NSGC) & EPSCoR programs at the University of Nebraska at Omaha are involved in a variety of innovative research activities. Such research is supported through the Aeronautics Education, Research, and Industry Alliance (AERIAL) and collaborative seed funds. AERIAL is a comprehensive, multi-faceted, five year NASA EPSCoR initiative that contributes substantially to the strategic research and technology priorities of NASA while intensifying Nebraska s rapidly growing aeronautics research and development endeavors. AERIAL includes three major collaborative research teams (CRTs) whose nexus is a common focus in aeronautics research. Each CRT - Small Aircraft Transportation System (SATS), Airborne Remote Sensing for Agricultural Research and Commercialization Applications (ARS), and Numerical Simulation of the Combustion of Fuel Droplets: Finite Rate Kinetics and Flame Zone Grid Adaptation (CEFD) -has a distinct research agenda. This program provides the template for funding of new and innovative research that emphasizes aerospace technology.

  11. Cripping safe sex : Life Goes On's queer/disabled alliances.

    PubMed

    Elman, Julie Passanante

    2012-09-01

    Life Goes On (1989-1993) was the first television series in U.S. history not only to introduce a recurring teenaged HIV-positive character but also to feature an actor with Down syndrome in a leading role. Drawing new connections among disability studies, queer theory, and bioethics, I argue that Life responded to American disability rights activism and the AIDS epidemic of the early 1990s by depicting sex education as disability activism. By portraying fulfilling sexual relationships for its disabled protagonists, Life challenged heteronormative and ableist underpinnings of marriage, sexuality, reproduction, and sex education and imagined transgressive queer/disabled alliances that often surpassed those of activists of its cultural moment. By representing homophobia, AIDS-phobia, and ableism as intertwined oppressions, the series conjured an expansive vision of sexual justice and pleasure, one that included and united teenagers, intellectually disabled people, and seropositive people-populations whose sexualities have generally been regarded as pathological or nonexistent. PMID:23180332

  12. NASA's Contributions to the Gulf of Mexico Alliance

    NASA Technical Reports Server (NTRS)

    Glorioso, Mark

    2008-01-01

    This viewgraph document reviews the contribution that NASA has made and the plans for future missions that will assist the mission of the Gulf of Mexico Alliance (GOMA). Specific reference to the work of the Stennis Space Center is reviewed. Some of the projects are: Coastal Online Assessment and Synthesis Tool (COAST), Regional Sediment Management, Coral Reef Early Warning System, Harmful Algal Bloom, Hypoxia, Land-Use and Land-Cover (LULC) Change from 1974-2008 around Mobile Bay, AL, Satellite Estimation of Suspended Particulate Loads in and around Mobile Bay, AL, Estimating Relative Nutrient Contributions of Agriculture and Forests Using MODIS Time Series, Coastal Marsh Monitoring for Persistent Saltwater Intrusion, Standardized Remote Sensing PRoduct for Water Clarity estimation within Gulf of Mexico Coastal Waters.

  13. Solid State Energy Conversion Alliance 2nd Annual Workshop Proceedings

    SciTech Connect

    National Energy Technology Laboratory

    2001-03-30

    The National Energy Technology Laboratory (NETL) and the Pacific Northwest National Laboratory (PNNL) are pleased to provide the proceedings of the second annual Solid State Energy Conversion Alliance (SECA) Workshop held on March 29-30, 2001 in Arlington. The package includes the presentations made during the workshop, a list of participants, and the results of the breakout sessions. Those sessions covered stack materials and processes, power electronics, balance of plant and thermal integration, fuel processing technologies, and stack and system performance modeling. The breakout sessions have been reported as accurately as possible; however, due to the recording and transcription process errors may have occurred. If you note any significant omissions or wish to provide additional information, we welcome your comments and hope that all stakeholder groups will use the enclosed information in their planning endeavors.

  14. Cripping safe sex : Life Goes On's queer/disabled alliances.

    PubMed

    Elman, Julie Passanante

    2012-09-01

    Life Goes On (1989-1993) was the first television series in U.S. history not only to introduce a recurring teenaged HIV-positive character but also to feature an actor with Down syndrome in a leading role. Drawing new connections among disability studies, queer theory, and bioethics, I argue that Life responded to American disability rights activism and the AIDS epidemic of the early 1990s by depicting sex education as disability activism. By portraying fulfilling sexual relationships for its disabled protagonists, Life challenged heteronormative and ableist underpinnings of marriage, sexuality, reproduction, and sex education and imagined transgressive queer/disabled alliances that often surpassed those of activists of its cultural moment. By representing homophobia, AIDS-phobia, and ableism as intertwined oppressions, the series conjured an expansive vision of sexual justice and pleasure, one that included and united teenagers, intellectually disabled people, and seropositive people-populations whose sexualities have generally been regarded as pathological or nonexistent.

  15. Science and Engineering Alliance, Inc., Annual Report 1993

    SciTech Connect

    1994-01-01

    Science and Engineering Alliance (SEA) is a not-for-profit corporation formed by four Historically Black Colleges and Universities (HBCUs) and a leading national laboratory. The four HBCU Institutions are: Alabama A and M University, Jackson State University, Prairie View A and M University, and Southern University and A and M College. The national laboratory is Lawrence Livermore National Laboratory. This was a year of continued focusing for SEA. Guided by the belief that involving faculty and students in high-quality research, coupled with implementing action plans to enhance the research infrastructure of the universities will lead to the production of well-qualified African-American scientists and engineers, SEA research agenda became one of the primary focus. The Research Design Teams represents SEA's vanguard activity, and their work this past year reflected the commitment to producing technical talent of the highest quality.

  16. Constituents of political cognition: Race, party politics, and the alliance detection system.

    PubMed

    Pietraszewski, David; Curry, Oliver Scott; Petersen, Michael Bang; Cosmides, Leda; Tooby, John

    2015-07-01

    Research suggests that the mind contains a set of adaptations for detecting alliances: an alliance detection system, which monitors for, encodes, and stores alliance information and then modifies the activation of stored alliance categories according to how likely they will predict behavior within a particular social interaction. Previous studies have established the activation of this system when exposed to explicit competition or cooperation between individuals. In the current studies we examine if shared political opinions produce these same effects. In particular, (1) if participants will spontaneously categorize individuals according to the parties they support, even when explicit cooperation and antagonism are absent, and (2) if party support is sufficiently powerful to decrease participants' categorization by an orthogonal but typically-diagnostic alliance cue (in this case the target's race). Evidence was found for both: Participants spontaneously and implicitly kept track of who supported which party, and when party cross-cut race-such that the race of targets was not predictive of party support-categorization by race was dramatically reduced. To verify that these results reflected the operation of a cognitive system for modifying the activation of alliance categories, and not just socially-relevant categories in general, an identical set of studies was also conducted with in which party was either crossed with sex or age (neither of which is predicted to be primarily an alliance category). As predicted, categorization by party occurred to the same degree, and there was no reduction in either categorization by sex or by age. All effects were replicated across two sets of between-subjects conditions. These studies provide the first direct empirical evidence that party politics engages the mind's systems for detecting alliances and establish two important social categorization phenomena: (1) that categorization by age is, like sex, not affected by alliance

  17. Cystic Fibrosis Therapeutics

    PubMed Central

    Ramsey, Bonnie W.

    2013-01-01

    A great deal of excitement and hope has followed the successful trials and US Food and Drug Administration approval of the drug ivacaftor (Kalydeco), the first therapy available that targets the underlying defect that causes cystic fibrosis (CF). Although this drug has currently demonstrated a clinical benefit for a small minority of the CF population, the developmental pathway established by ivacaftor paves the way for other CF transmembrane conductance regulator (CFTR) modulators that may benefit many more patients. In addition to investigating CFTR modulators, researchers are actively developing numerous other innovative CF therapies. In this review, we use the catalog of treatments currently under evaluation with the support of the Cystic Fibrosis Foundation, known as the Cystic Fibrosis Foundation Therapeutics Pipeline, as a platform to discuss the variety of candidate treatments for CF lung disease that promise to improve CF care. Many of these approaches target the individual components of the relentless cycle of airway obstruction, inflammation, and infection characteristic of lung disease in CF, whereas others are aimed directly at the gene defect, or the resulting dysfunctional protein, that instigates this cycle. We discuss how new findings from the laboratory have informed not only the development of novel therapeutics, but also the rationales for their use and the outcomes used to measure their effects. By reviewing the breadth of candidate treatments currently in development, as well as the recent progress in CF therapies reflected by the evolution of the therapeutics pipeline over the past few years, we hope to build upon the optimism and anticipation generated by the recent success of Kalydeco. PMID:23276843

  18. The early formation of the working alliance from the client's perspective: A qualitative study.

    PubMed

    MacFarlane, Peter; Anderson, Timothy; McClintock, Andrew S

    2015-09-01

    This research used qualitative methods and archival data to examine clients' perceptions of the early formation of the working alliance. Following their first and second sessions of individual psychotherapy, 54 clients responded to structured written assignments that were rooted in Bordin's (1979) model of the alliance. Analysis yielded 884 recording units, which were organized into 4 main clusters: (a) clients' initial misgivings about psychotherapy; (b) organization and meaning-making; (c) psychotherapist supportive activities; and (d) client appreciation of techniques. Clients' perceived contributions to alliance development and their experiences of the initial interactions with their psychotherapists are explored in the context of existing theory and research.

  19. The working alliance in pediatric chronic disease management: a pilot study of instrument reliability and feasibility.

    PubMed

    Ely, Beth; Alexander, Leslie B; Reed, Monica

    2005-06-01

    Findings are presented from a pilot study to determine the reliability, relevance, and feasibility of child and adult versions of the Working Alliance Inventory, adapted from psychotherapy research for use in the management of chronic childhood hematologic disorders. Thirty-four children, 13 adolescents, 43 parent/guardians, and 4 health-care providers participated. The adapted scales, called the Working Alliance Inventories for Chronic Care, had strong internal consistencies for all versions; retest reliabilities were generally acceptable. The instruments were feasible to use and understandable for children 9 years and older, parent/guardians, and health-care professionals. Recommendations for additional research, using this promising group of alliance instruments, are provided.

  20. Congruence of group therapist and group member alliance judgments in emotionally focused group therapy for binge eating disorder.

    PubMed

    Compare, Angelo; Tasca, Giorgio A; Lo Coco, Gianluca; Kivlighan, Dennis M

    2016-06-01

    We used West and Kenny's (2011) Truth-and-Bias (T&B) model to examine how accurately group therapists' judge their group members' alliances, and the effects of therapist-patient congruence in alliance ratings on patient outcomes. Were considered: (a) directional bias - therapists' tendency to over- or underrate their clients' alliances, (b) truth strength - clients' alliance ratings, and (c) bias strength - therapists' tendency to conflate their alliance ratings for a specific group member with the average alliance ratings for the other members of the group. There were 118 obese adult patients with binge-eating disorder that were treated by 8 therapists with Emotionally Focused Group Therapy. Outcomes were operationalized as pre- to postchanges in: health-related quality of life, binge eating, and psychological distress. Patients' and therapists' working alliance were assessed after the 2nd, 10th, and last (20th) group therapy sessions. (a) There was no significant congruence between group therapists' and members' ratings of alliance; (b) therapists' ratings of an individual group member's alliance were significantly related to therapists' ratings of the other group members' alliance in early sessions but unrelated in later sessions; and (c) the relationship between therapists' alliance ratings and bias strength was weaker when patient binge eating outcomes improved. Group therapists adopted a "better safe than sorry" strategy by underestimating the strength of their group members' alliances. Therapists had a tendency to judge each group member's individual alliance based on the aggregated alliance of the other group members. Improvement in patient binge eating outcomes was related to therapists overcoming this tendency. (PsycINFO Database Record PMID:26914591

  1. American Therapeutic Recreation Association

    MedlinePlus

    ... Remember Me I forgot my password American Therapeutic Recreation Association Empowering Recreational Therapists Call for 2017 Webinars – ... http://ow.ly/qzAj304HTCi Join thousands of Therapeutic Recreation specialists today Join Now Renew your membership today ...

  2. Therapeutic drug levels

    MedlinePlus

    ... medlineplus.gov/ency/article/003430.htm Therapeutic drug levels To use the sharing features on this page, please enable JavaScript. Therapeutic drug levels are lab tests to look for the presence ...

  3. A Study of the Strategic Alliance for EMS Industry: The Application of a Hybrid DEA and GM (1, 1) Approach

    PubMed Central

    Wang, Chia Nan; Tran, Thanh Tuyen; Huong, Bui Bich

    2015-01-01

    Choosing a partner is a critical factor for success in international strategic alliances, although criteria for partner selection vary between developed and transitional markets. This study aims to develop effective methods to assist enterprise to measure the firms' operation efficiency, find out the candidate priority under several different inputs and outputs, and forecast the values of those variables in the future. The methodologies are constructed by the concepts of Data Envelopment Analysis (DEA) and grey model (GM). Realistic data in four consecutive years (2009–2012) a total of 20 companies of the Electronic Manufacturing Service (EMS) industry that went public are completely collected. This paper tries to help target company—DMU1—to find the right alliance partners. By our proposed approach, the results show the priority in the recent years. The research study is hopefully of interest to managers who are in manufacturing industry in general and EMS enterprises in particular. PMID:25821859

  4. Abstracts of Research Papers 1981. Presented at the Research Consortium Meetings at the Annual Meeting of the American Alliance for Health, Physical Education, Recreation and Dance (Boston, MA, April 13-17, 1981).

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD).

    This volume contains abstracts of 157 original research papers scheduled for presentation at the Boston, Massachusetts Convention of the American Alliance for Health, Physical Education, Recreation and Dance. The papers are grouped by the topic of each session, which included: tests and measurements; motor development; exercise physiology;…

  5. National Alliance for Clean Energy Incubators New Mexico Clean Energy Incubator

    SciTech Connect

    Roberts, Suzanne S.

    2004-12-15

    The National Alliance for Clean Energy Incubators was established by the National Renewable Energy Laboratory (NREL) to develop an emerging network of business incubators for entrepreneurs specializing in clean energy enterprises. The Alliance provides a broad range of business services to entrepreneurs in specific geographic locales across the U.S. and in diverse clean energy technology areas such as fuel cells, alternative fuels, power generation, and renewables, to name a few. Technology Ventures Corporation (TVC) participates in the Alliance from its corporate offices in Albuquerque, NM, and from its sites in Northern and Southern New Mexico, California, and Nevada. TVC reports on the results of its attempts to accelerate the growth and success of clean energy and energy efficiency companies through its array of business support services. During the period from September 2002 through September 2004, TVC describes contributions to the Alliance including the development of 28 clients and facilitating capital raises exceeding $35M.

  6. Attachment style and its relationship to working alliance in the supervision of British clinical psychology trainees.

    PubMed

    Dickson, Joanne M; Moberly, Nicholas J; Marshall, Yehuda; Reilly, James

    2011-01-01

    Although the supervisory relationship is thought to be critical in training clinical psychologists, little is known about factors affecting the supervisory alliance. We conducted an Internet survey of British clinical doctoral trainees (N = 259) in which participants rated their supervisory working alliance, parental style during childhood, pathological adult attachment behaviours and attachment style for themselves and their supervisors. Trainees' ratings of the working alliance were associated with perceptions of supervisors' attachment style, but not with perceptions of trainees' own attachment styles. Path analysis supported a causal chain linking parental indifference, compulsive self-reliance, insecure supervisor attachment style and lower ratings of the working alliance. Our results broadly replicate data from a US sample and suggest that attachment theory is helpful in understanding clinical supervisory processes.

  7. Strategic alliance: adapting to the business environment in long-term care.

    PubMed

    Mara, Cynthia Massie; Ziegenfuss, James T

    2002-01-01

    This article is addressed to long-term-care administrators and planners as well as purchasers of long-term care. Believing the current and future business environment will force continued adaptation in long-term-care organizations, the authors utilize nine categories to map pressures for change: cultural, technological, educational, political, legal, natural resource, demographic, sociologic, and economic. Long-term-care organizations, especially those that are not-for-profit, are becoming members of alliances as one way of addressing these pressures. This article describes and presents a case example of a composite alliance to demonstrate the advantages of membership in a strategic alliance. We also present examples of ways in which alliance members use strategic partnerships to improve their ability to manage these forces. PMID:12847938

  8. Active Learning Classrooms and Educational Alliances: Changing Relationships to Improve Learning

    ERIC Educational Resources Information Center

    Baepler, Paul; Walker, J. D.

    2014-01-01

    This chapter explores the "educational alliance" among students and between students and instructors. We contend that this is a framework that can help us understand how active learning classrooms facilitate positive educational outcomes.

  9. Awards Breakfast for Inventions and Contributions Board (ICB), Glenn Alliance for Technology Exchang

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Awards Breakfast for Inventions and Contributions Board (ICB), Glenn Alliance for Technology Exchange (GATE), Technology Transfer and Partnership Office (TTP), and Research & Development (R&D) 100 Award Winners

  10. Mechanics, Problems and Contributions of Tertiary Strategic Alliance: The Case of 22 Australian Universities.

    ERIC Educational Resources Information Center

    Saffu, Kojo; Mamman, Aminu

    1999-01-01

    A study of international strategic alliances involving 22 Australian universities indicates that a majority of universities have frameworks for internationalization initiatives, with top institutional management instrumental in initiating joint ventures with overseas institutions despite limited resources. Australian universities believe they…

  11. The role of perceived partner alliance on the efficacy of CBT-I: Preliminary findings from the Partner Alliance in Insomnia Research Study (PAIRS)

    PubMed Central

    Ellis, Jason G.; Deary, Vincent; Troxel, Wendy

    2015-01-01

    Despite Cognitive Behavioural Therapy for Insomnia (CBT-I) being effective, barriers to adherence have been documented. Perceived partner alliance has been shown to influence adherence and treatment outcome across a range of other health conditions. The present study examined patients’ perceptions regarding the role of their partner in CBT-I and the impact of perceived partner alliance on treatment outcome. Twenty-one patients were interviewed, following CBT-I, to examine the areas where partners were thought to influence the process of CBT-I. The majority of statements made during interviews explicitly mentioned a partner’s influence (65%). Additionally, the production of more positive partner statements was associated with better treatment outcome (using the Insomnia Severity Index). The integration of perceived partner alliance, into CBT-I, is discussed. PMID:24527869

  12. The role of perceived partner alliance on the efficacy of CBT-I: preliminary findings from the Partner Alliance in Insomnia Research Study (PAIRS).

    PubMed

    Ellis, Jason G; Deary, Vincent; Troxel, Wendy M

    2015-01-01

    Despite cognitive behavioral therapy for insomnia (CBT-I) being effective, barriers to adherence have been documented. Perceived partner alliance has been shown to influence adherence and treatment outcome across a range of other health conditions. The present study examined patients' perceptions regarding the role of their partner in CBT-I and the impact of perceived partner alliance on treatment outcome. Twenty-one patients were interviewed, following CBT-I, to examine the areas where partners were thought to influence the process of CBT-I. The majority of statements made during interviews explicitly mentioned a partner's influence (65%). Additionally, the production of more positive partner statements was associated with better treatment outcome (using the Insomnia Severity Index). The integration of perceived partner alliance into CBT-I is discussed.

  13. The Climate Change Education Partnership Alliance: Building a Network for Effective Collaboration and Impact (Invited)

    NASA Astrophysics Data System (ADS)

    Scowcroft, G.

    2013-12-01

    The mission of the Climate Change Education Partnership Alliance (The Alliance), funded by the National Science Foundation (NSF), is to advance exemplary climate change education through research and innovative partnerships. Through six unique regional projects, The Alliance is reaching wide and diverse audiences across the U.S., while linking groups and institutions that might not otherwise be connected by a common focus on climate change education. The goals for The Alliance include building collaborations between projects and institutions, sharing effective practices, and leveraging resources to create a community in which the whole is greater than the sum of its parts. To foster these goals, NSF has funded a central hub, the Alliance Office. Currently, the Alliance Office is building the infrastructure necessary to support activities and communication between the projects. Successful networks need objectives for their interactions and a common vision held by the partners. In the first national meeting of The Alliance members, held in June 2013, the foundation was laid to begin this work. The Alliance now has a common mission and vision to guide the next four years of activities. An initial 'mapping' of the network has identified the scope and diversity of the network, how members are connected, current boundaries of the network, network strengths and weaknesses, and network needs. This information will serve as a baseline as the network develops. The Alliance has also identified the need for key 'working groups' which provide an opportunity for members to work across the projects on common goals. As The Alliance evolves, building blocks identified by the field of network science will be used to forge a strong and successful collaborative enterprise. Infrastructure is being established to support widespread engagement; social ties are being fostered through face-to-face meetings and monthly teleconferences; time is provided to build and share knowledge; the

  14. Therapeutic Efficacy of E-64-d, a Selective Calpain Inhibitor, in Experimental Acute Spinal Cord Injury.

    PubMed

    Zhang, Zifeng; Huang, Zheng; Dai, Hao; Wei, Licheng; Sun, Songtao; Gao, Feng

    2015-01-01

    This study aims to investigate the therapeutic effect of calpain inhibitor E-64-d on SCI and to find a new approach to treat SCI. When an SCI rat model was established, it was immediately administered with E-64-d. RT-PCR and Western blotting were used to determine the protein and mRNA levels of calpain 1 and 68-kD NFP. TUNEL staining and NeuN labeling were performed to analyze neuronal apoptosis in the lesion. Immunohistochemistry assay was carried out to observe the expressions of calpain 1 and GFAP. Cyclooxygenase-2 activity was measured to show the immune response status. Locomotor function was evaluated by inclined plane test and Basso, Beattie, and Bresnahan locomotor rating scale. The results showed that calpain 1 was activated after SCI occurred. Treatment with E-64-d decreased expressions of calpain 1 and GFAP, alleviated neuronal apoptosis, inhibited cyclooxygenase-2 activity, and resulted in the promoted locomotor function. Furthermore, combination of E-64-d and MP had better efficacy than did E-64-d or MP alone. E-64-d is expected to be applied to treat SCI, and its alliance with MP may provide a valid strategy for SCI therapy. PMID:26240815

  15. Conduct of therapeutic trials.

    PubMed

    Vaïsse

    1996-06-01

    Ambulatory blood pressure monitoring (ABPM) is now very useful for assessing the blood pressure response to antihypertensive drugs. It gives accurate information on blood pressure profiles and provides more detailed information on first-dose effects, dose-response relationships, and the direction of action of antihypertensive treatment. However, ABPM studies will also allow new questions to be addressed. The reliability of ABPM measurements must receive more attention: validation of the different ABP monitors, evaluation of missed data, standardization of activities during the monitoring period. Concerning these technical problems, it seems reasonable to propose a control of quality of ABPM data in therapeutic trials. As a result of previous studies, it might be argued that ABPM should not obly be used to evaluate the effects of treatment, but also to improve the selection of patients for clinical trials who are hypertensive both in the clinic and during ABPM. Despite a generally good agreement between sthe effects of medication on clinic and ABP when analysed on a group basis, several studies have reported weak, insignificant correlations on an individual basis, indicating discrepancies between clinic and ambulatory pressures. Clinic pressures tend to overestimate the degree of blood pressure control during daily activities. Treatment produces a significant reduction in ABP in the 'true hypertensives', whereas in the other 'white-coat hypertensives' it has no effect. There is also a question of the duration of action of treatment: whether medication should be equally effective throughout the day and night or should be focused on moments when the pressure is highest. The value of blood pressure variability in therapeutic trials is not yet well known, and needs further evaluation. The definition of hypertension and normotension have traditionally been difficult and arbitrary when based on clinic blood pressure measurements, the difficulty is not removed when trying

  16. Rethinking schools of public health: a strategic alliance model.

    PubMed

    Moloughney, Brent W; Skinner, Harvey A

    2006-01-01

    Canada is in the midst of rejuvenation of public health organizations, mandates and infrastructure. Major planning exercises are underway regarding public health human resources, where academic institutions have a key role to play. To what extent could schools of public health be part of the solution? Many universities across Canada are considering or in the process of implementing MPH programs (some 17 programs planned and/or underway) and possible schools of public health. However, concerns are raised about critical mass, quality and standards. We encourage innovation and debate about ways to enhance collaborative and structural arrangements for education programs. A school of public health model might emerge from this, but so too might other models. Also, novel types of organizational structure need consideration. One example is a "strategic alliance" model that is broad-based, integrative and adaptive--building on the interdisciplinary focus needed for addressing public health concerns in the 21st century. From our perspective, the central question is: what (new) types of organizational structures and, equally important, collaborative networks will enable Canada to strengthen its public health workforce so that it may better address local and global challenges to public health? PMID:16827419

  17. Earth Science Big Data Activities at Research Data Alliance

    NASA Astrophysics Data System (ADS)

    Kuo, Kwo-Sen; Baumann, Peter; Evans, Ben; Riedel, Morris

    2016-04-01

    In this presentation we introduce Earth science related activities of the Big Data Interest Group (BDIG) in Research Data Alliance (RDA). "RDA is an international organization focused on the development of infrastructure and community activities that reduce barriers to data sharing and exchange, and the acceleration of data driven innovation worldwide." The participation of researchers in RDA is voluntary. As the name implies, an Interest Group is a collection of participants sharing the same interest. The BDIG seeks to address community needs on all things having to do with Big Data. The ultimate goal of RDA Big Data Interest Group is to produce a set of recommendation documents to advise diverse research communities with respect to: • How to select an appropriate Big Data solution for a particular science application to realize optimal value? and • What are the best practices in dealing with various data and computing issues associated with such a solution? The primary means to reaching such recommendations is through the establishment and work of Working Groups, each of which focuses on a specific issue. Although BDIG is not specific to Earth science, its recent activities revolve mostly around it. We introduce some of these activities that are designed to advance our knowledge and to characterize Big Data in Earth science.

  18. Annual report 1992 - Science and Engineering Alliance, Inc.

    SciTech Connect

    1998-04-01

    Twenty years of attention has resulted in little change in the minorities in science pipeline problem. What happened? The answers to this question are many. They are synergistically linked around some complex issues. The Science and Engineering Alliance (SEA) institutions have long focused on the need for more minorities in science and engineering. In fact, the creation of SEA is a demonstration of how the member institutions continue exploring new and innovative ways of addressing the pipeline problem. Combining their resources and appointing a fulltime director to oversee this longterm effort shows commitment. This annual report reviews SEA activities that occurred in 1992 to address the minorities in science problem. The commitment to this challenging problem is evident in the many programs and creative efforts described in this report. Because SEA believes commitment begins with accountability, this report contains facts and figures that demonstrate actual accomplishments by SEA during fiscal year 1992 (the year ending September 30, 1992). Where warranted, the report highlights events from the last quarter of the calendar year.

  19. Annual report 1993 - Science and Engineering Alliance, Inc.

    SciTech Connect

    1998-04-01

    By combining their resources and with support from the US Department of Energy (DOE), Science and Engineering Alliance (SEA) has worked for the past three years to increase the participation of African-Americans in science, engineering, and related fields. At the core of the SEA is a combined population of over 33,000 African-American students, and a combined Historically Black Colleges and Universities research faculty and staff of nearly 400 individuals that specialize in several major areas of science and engineering. SEA views its approach as a constructive, long-term solution to increasing the nation`s technical manpower talent pool. For the faculty and students, SEA develops new collaborative research opportunities, creates new summer research internships and coop programs, strengthens existing programs, provides students participation in technical conferences, workshops, and seminars, and grants scholarships and incentive awards to future scientists and engineers. SEA relies on the collective talents of its members to build partnerships with the Federal government and private industry that help create opportunities for African-American science and engineering students, and promote activities that advance this mission. As the number of science and engineering students graduating from SEA institutions continues to rise, SEA is pleased to report that the program is making a difference.

  20. Annual report 1991 - Science and Engineering Alliance, Inc.

    SciTech Connect

    1992-02-21

    Nineteen ninety-one was a busy and productive year for the Science and Engineering Alliance (SEA). This report covers the major programs and activities of the SEA during the fiscal year 1991 (the year ending September 30, 1991), which was the first year of operation. Where warranted, the report highlights some of the events from the last quarter of the calendar year. The SEA is a non-profit consortium of four Historically Black Colleges and Universities. The SEA members are Alabama A&M University (Normal, Alabama); Jackson State University (Jackson, Mississippi); Prairie View A&M University (Prairie View, Texas); and Southern University and A&M College (Baton Rouge, Louisiana). The SEA`s mission is to help increase the number of well-qualified minority scientists for the next century and beyond, and to provide input into the research and development needs of the nation. The SEA collaborates on research projects with government agencies, national laboratories, private foundations, industry and other universities in a broad range of technical areas.

  1. Santa Fe Alliance for Science: The First Eight Years

    NASA Astrophysics Data System (ADS)

    Eisenstein, Robert A.

    2013-04-01

    The Santa Fe Alliance for Science (SFAFS) was founded in May, 2005. SFAFS exists to provide assistance in K-14 math and science education in the greater Santa Fe area. It does this via extensive programs (1) in math and science tutoring at Santa Fe High School, Santa Fe Community College and to a lesser degree at other schools, (2) science fair advising and judging, (3) its ``Santa Fe Science Cafe for Young Thinkers'' series, (4) a program of professional enrichment for K-12 math and science teachers, and (5) a fledging math intervention program in middle school math. Well over 150 STEM professionals, working mostly as volunteers, have contributed since our beginning. Participation by students, parents and teachers has increased dramatically over the years, leading to much more positive views of math and science, especially among elementary school students and teachers. Support from the community and from local school districts has been very strong. I will present a brief status report on SFAFS activities, discuss some of the lessons learned along the way and describe briefly some ideas for the future. More information can be found at the SFAFS website, www.sfafs.org.

  2. Youth Empowerment and High School Gay-Straight Alliances

    PubMed Central

    Muraco, Anna; Subramaniam, Aarti; Laub, Carolyn

    2010-01-01

    In the field of positive youth development programs, “empowerment” is used interchangeably with youth activism, leadership, civic participation and self-efficacy. However, few studies have captured what empowerment means to young people in diverse contexts. This article explores how youth define and experience empowerment in youth-led organizations characterized by social justice goals: high school Gay-Straight Alliances (GSAs). Through focus group interviews, fifteen youth leaders of GSAs from different regions of California explain what they think empowerment means and how they became empowered through their involvement with the GSA. Youth describe three inter-related dimensions of empowerment: personal empowerment, relational empowerment, and strategic empowerment through having and using knowledge. When these three dimensions are experienced in combination, GSA leaders have the potential for individual and collective empowerment as agents of social change at school. By understanding these youth's perspectives on the meanings of empowerment, this article clarifies the conceptual arena for future studies of socially marginalized youth and of positive youth development. PMID:19636734

  3. Building an alliance for a green revolution in Africa.

    PubMed

    Toenniessen, Gary; Adesina, Akinwumi; DeVries, Joseph

    2008-01-01

    Most of Africa's people live in rural areas and depend on agriculture for their livelihoods. These predominantly small-scale farmers face many challenges, including food insecurity, rising poverty, and natural resource degradation. To increase the productivity, profitability, and sustainability of their farms, they need greater access to affordable yield-enhancing inputs, including well-adapted seeds and new methods for integrated soil fertility management, as well as to output markets where they can convert surplus production into cash. To address these needs, the Rockefeller Foundation and the Bill and Melinda Gates Foundation established the Alliance for a Green Revolution in Africa (AGRA). AGRA is now African led and is working within the context of the comprehensive agricultural development program established by Africa's leaders. From offices in Nairobi, Kenya, and Accra, Ghana, AGRA will support work across all key aspects of the African agricultural value chain to help millions of small-scale farmers and their families lift themselves out of poverty and hunger.

  4. Youth empowerment and high school Gay-Straight Alliances.

    PubMed

    Russell, Stephen T; Muraco, Anna; Subramaniam, Aarti; Laub, Carolyn

    2009-08-01

    In the field of positive youth development programs, "empowerment" is used interchangeably with youth activism, leadership, civic participation and self-efficacy. However, few studies have captured what empowerment means to young people in diverse contexts. This article explores how youth define and experience empowerment in youth-led organizations characterized by social justice goals: high school Gay-Straight Alliances (GSAs). Through focus group interviews, fifteen youth leaders of GSAs from different regions of California explain what they think empowerment means and how they became empowered through their involvement with the GSA. Youth describe three inter-related dimensions of empowerment: personal empowerment, relational empowerment, and strategic empowerment through having and using knowledge. When these three dimensions are experienced in combination, GSA leaders have the potential for individual and collective empowerment as agents of social change at school. By understanding these youth's perspectives on the meanings of empowerment, this article clarifies the conceptual arena for future studies of socially marginalized youth and of positive youth development.

  5. Overview of Therapeutic Drug Monitoring

    PubMed Central

    Lee, Min-Ho

    2009-01-01

    Therapeutic drug monitoring (TDM) is the clinical practice of measuring specific drugs at designated intervals to maintain a constant concentration in a patient's bloodstream, thereby optimizing individual dosage regimens. It is unnecessary to employ TDM for the majority of medications, and it is used mainly for monitoring drugs with narrow therapeutic ranges, drugs with marked pharmacokinetic variability, medications for which target concentrations are difficult to monitor, and drugs known to cause therapeutic and adverse effects. The process of TDM is predicated on the assumption that there is a definable relationship between dose and plasma or blood drug concentration, and between concentration and therapeutic effects. TDM begins when the drug is first prescribed, and involves determining an initial dosage regimen appropriate for the clinical condition and such patient characteristics as age, weight, organ function, and concomitant drug therapy. When interpreting concentration measurements, factors that need to be considered include the sampling time in relation to drug dose, dosage history, patient response, and the desired medicinal targets. The goal of TDM is to use appropriate concentrations of difficult-to-manage medications to optimize clinical outcomes in patients in various clinical situations. PMID:19270474

  6. Impact of HMO market structure on physician-hospital strategic alliances.

    PubMed Central

    Burns, L R; Bazzoli, G J; Dynan, L; Wholey, D R

    2000-01-01

    OBJECTIVE: To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. STUDY DESIGN: Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four models present in the hospital. Because managed care and physician-hospital integration are endogenous (e.g., some hospitals also sponsor HMOs), we used an instrumental variables approach to model the determinants of HMO penetration and HMO numbers. These instruments were then used with other predictors of alliance formation: physician supply characteristics, the extent of hospital competition, hospital-level descriptors, population size and demographic characteristics, and indicators for each year. All equations were estimated at the MSA level using mixed linear models and first-difference models. PRINCIPAL FINDINGS: Contrary to conventional wisdom, alliance formation is shaped by the number of HMOs in the market rather than by HMO penetration. This confirms a growing perception that hospital-sponsored alliances with physicians are contracting vehicles for managed care: the greater the number of HMOs to contract with, the greater the development of alliances

  7. The GAVI Alliance and the 'Gates approach' to health system strengthening.

    PubMed

    Storeng, Katerini T

    2014-01-01

    Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS). This article critically analyses this development through an ethnographic case study of the GAVI Alliance, which funds vaccines in poor countries. Despite GAVI's self-proclaimed 'single-minded' focus on vaccines, HSS support is fronted as a key principle of GAVI's mission. Yet, its meaning remains unclear and contested understandings of the health systems agenda abound, reflecting competing public health ideologies and professional pressures within the global health field. Contrary to broader conceptualisations of HSS that emphasise social and political dimensions, GAVI's HSS support has become emblematic of the so-called 'Gates approach' to global health, focused on targeted technical solutions with clear, measurable outcomes. In spite of adopting rhetoric supportive of 'holistic' health systems, GHIs like GAVI have come to capture the global debate about HSS in favour of their disease-specific approach and ethos.

  8. The GAVI Alliance and the 'Gates approach' to health system strengthening.

    PubMed

    Storeng, Katerini T

    2014-01-01

    Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS). This article critically analyses this development through an ethnographic case study of the GAVI Alliance, which funds vaccines in poor countries. Despite GAVI's self-proclaimed 'single-minded' focus on vaccines, HSS support is fronted as a key principle of GAVI's mission. Yet, its meaning remains unclear and contested understandings of the health systems agenda abound, reflecting competing public health ideologies and professional pressures within the global health field. Contrary to broader conceptualisations of HSS that emphasise social and political dimensions, GAVI's HSS support has become emblematic of the so-called 'Gates approach' to global health, focused on targeted technical solutions with clear, measurable outcomes. In spite of adopting rhetoric supportive of 'holistic' health systems, GHIs like GAVI have come to capture the global debate about HSS in favour of their disease-specific approach and ethos. PMID:25156323

  9. The GAVI Alliance and the ‘Gates approach’ to health system strengthening

    PubMed Central

    Storeng, Katerini T.

    2014-01-01

    Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS). This article critically analyses this development through an ethnographic case study of the GAVI Alliance, which funds vaccines in poor countries. Despite GAVI's self-proclaimed ‘single-minded’ focus on vaccines, HSS support is fronted as a key principle of GAVI's mission. Yet, its meaning remains unclear and contested understandings of the health systems agenda abound, reflecting competing public health ideologies and professional pressures within the global health field. Contrary to broader conceptualisations of HSS that emphasise social and political dimensions, GAVI's HSS support has become emblematic of the so-called ‘Gates approach’ to global health, focused on targeted technical solutions with clear, measurable outcomes. In spite of adopting rhetoric supportive of ‘holistic’ health systems, GHIs like GAVI have come to capture the global debate about HSS in favour of their disease-specific approach and ethos. PMID:25156323

  10. [The Alliance for the Prevention of Colorectal Cancer in Spain. A civil commitment to society].

    PubMed

    Morillas, Juan Diego; Castells, Antoni; Oriol, Isabel; Pastor, Ana; Pérez-Segura, Pedro; Echevarría, José Manuel; Caballero, Begoña; González-Navarro, Andrés; Bandrés, Fernando; Brullet, Enric; Iniesta, Antonio; Carballo, Fernando; Bouzas, Rosa; Ariza, Aurelio; Ibisate, Alfredo; García-Alfonso, Pilar; Escudero, Beatriz; Camacho, Silvia; Fernández-Marcos, Ana; González, Teresa; Quintero, Enrique; Lanas, Angel; Marzo, Mercè; Mascort, Juanjo; Andréu, Monserrat; Cerezo, Laura; Vázquez-Sequeiros, Enrique; Borrás, Josep María; Salas, Dolores; Ascunce, Nieves; Portillo, Isabel; Herráiz, Mayte; Valle, María Luisa; Sotoca, Amalia; Nieto, Santiago; Hué, Carlos; Paz-Ares, Luis

    2012-03-01

    Colorectal cancer (CRC) is the most common malignant tumor in Spain, when men and women are considered together, and the second leading cause of cancer death. Every week in Spain over 500 cases of CRC are diagnosed, and nearly 260 people die from the disease. Epidemiologic estimations for the coming years show a significant increase in the number of annual cases. CRC is a perfectly preventable tumor and can be cured in 90% of cases if detected in the early stages. Population-based screening programs have been shown to reduce the incidence of CRC and mortality from the disease. Unless early detection programs are established in Spain, it is estimated that in the coming years, 1 out of 20 men and 1 out of 30 women will develop CRC before the age of 75. The Alliance for the Prevention of Colorectal Cancer in Spain is an independent and non-profit organization created in 2008 that integrates patients' associations, altruistic non-governmental organizations and scientific societies. Its main objective is to raise awareness and disseminate information on the social and healthcare importance of CRC in Spain and to promote screening measures, early detection and prevention programs. Health professionals, scientific societies, healthcare institutions and civil society should be sensitized to this highly important health problem that requires the participation of all sectors of society. The early detection of CRC is an issue that affects the whole of society and therefore it is imperative for all sectors to work together.

  11. Electric energy costs and firm productivity in the countries of the Pacific Alliance

    NASA Astrophysics Data System (ADS)

    Camacho, Anamaria

    This paper explores the relation between energy as an input of production and firm-level productivity for Chile, Colombia, Mexico and Peru, all country members of the Pacific Alliance economic bloc. The empirical literature, has explored the impact of infrastructure on productivity; however there is limited analysis on the impact of particular infrastructure variables, such as energy, on productivity at the firm level in Latin America. Therefore, this study conducts a quantitative assessment of the responsiveness of productivity to energy cost and quality for Chile, Colombia, Mexico and Peru. For this, the empirical strategy is to estimate a Cobb-Douglas production function using the World Bank's Enterprise Survey to obtain comparable measures of output and inputs of production. This approach provides estimates of input factor elasticities for all of the factors of production including energy. The results indicate that electric energy costs explain cross-country differences in firm level productivity. For the particular case of Colombia, the country exhibits the lowest capital and labor productivity of the PA, and firm output is highly responsive to changes in energy use. As a result, the evidence suggests that policies reducing electric energy costs are an efficient alternative to increase firm performance, particularly in the case of Colombia.

  12. BATTELLE ENERGY ALLIANCE, LLC (BEA) 2014 Annual Report for Idaho National Laboratory (INL)

    SciTech Connect

    Juan Alvarez; Todd Allen

    2014-10-01

    This Fiscal Year (FY) 2014 annual report provides the Department of Energy (DOE) with BEA’s self-assessment of performance managing and operating the INL for the period ending September 30, 2014. After considering all of the information related to INL performance during the rating period against the Goals, Objectives and Notable Outcomes in the FY 2014 Performance Evaluation and Measurement Plan (PEMP), BEA believes it earned an overall grade closest to an A. The paragraphs below highlight how INL excelled in delivering innovative and impactful research across the three mission areas; how INL has successfully positioned itself for future growth and sustainment; and how, through strong leadership, INL has set and implemented a strategic direction to ensure we meet and exceed the expectations of DOE and other customers. Attachments 1 through 5 provide additional detail on FY 2014 mission accomplishments, outline corporate contributions for success, highlight national and international awards and recognitions at the organization and individual levels, and describe the performance issues and challenges faced in FY 2014. • Attachment 1, “Self-Assessed PEMP Ratings” • Attachment 2, “INL Mission Accomplishments” • Attachment 3, “Battelle Energy Alliance, LLC Contributions to INL Success” • Attachment 4, “FY 2014 Awards, Recognition, Professional Roles and Certifications” • Attachment 5, “Performance Issues and Challenges.”

  13. Relational mindfulness, spirituality, and the therapeutic bond.

    PubMed

    Falb, Melissa D; Pargament, Kenneth I

    2012-12-01

    Mindfulness training, which emphasizes deliberate non-judgmental attention to present moment experiences, has become increasingly mainstream over the past several decades. With accumulating evidence for the physical and mental health benefits of mindfulness, it has been integrated into medical and psychological treatments and is increasingly accepted in the fields of psychology and psychiatry. However, several elements of mindfulness practice which potentially contribute to its benefits have been largely neglected. These include the connections between mindfulness, interpersonal relationships, spirituality, and the psychotherapeutic alliance. The emerging concept of "relational mindfulness" focuses attention on the oft-neglected interpersonal aspects of mindfulness practices. Relational mindfulness is potentially relevant to the psychotherapeutic process, due to its cultivation of the types of qualities that enhance the therapeutic relationship, including warmth, empathy, curiosity, acceptance, self-attunement, and emotional intelligence. In addition, mindfulness practices, especially relational ones, can contribute to the development of spiritual qualities, such as transcendence, boundlessness, ultimacy, and interconnectedness. Several recent studies suggest that meditation/mindfulness interventions may be explained and or enhanced by an emphasis on spiritual components. In this paper, we suggest that focusing on the oft-neglected relational and spiritual aspects of mindfulness practice has the potential to deepen its benefits, especially within the context of the psychotherapeutic relationship.

  14. Relational mindfulness, spirituality, and the therapeutic bond.

    PubMed

    Falb, Melissa D; Pargament, Kenneth I

    2012-12-01

    Mindfulness training, which emphasizes deliberate non-judgmental attention to present moment experiences, has become increasingly mainstream over the past several decades. With accumulating evidence for the physical and mental health benefits of mindfulness, it has been integrated into medical and psychological treatments and is increasingly accepted in the fields of psychology and psychiatry. However, several elements of mindfulness practice which potentially contribute to its benefits have been largely neglected. These include the connections between mindfulness, interpersonal relationships, spirituality, and the psychotherapeutic alliance. The emerging concept of "relational mindfulness" focuses attention on the oft-neglected interpersonal aspects of mindfulness practices. Relational mindfulness is potentially relevant to the psychotherapeutic process, due to its cultivation of the types of qualities that enhance the therapeutic relationship, including warmth, empathy, curiosity, acceptance, self-attunement, and emotional intelligence. In addition, mindfulness practices, especially relational ones, can contribute to the development of spiritual qualities, such as transcendence, boundlessness, ultimacy, and interconnectedness. Several recent studies suggest that meditation/mindfulness interventions may be explained and or enhanced by an emphasis on spiritual components. In this paper, we suggest that focusing on the oft-neglected relational and spiritual aspects of mindfulness practice has the potential to deepen its benefits, especially within the context of the psychotherapeutic relationship. PMID:23174445

  15. Calibration of the Al2O3:C optically stimulated luminescence (OSL) signal for linear energy transfer (LET) measurements in therapeutic proton beams.

    PubMed

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

    2014-08-01

    Optically stimulated luminescence (OSL) detectors (OSLDs) have shown potential for measurements of linear energy transfer (LET) in proton therapy beams. However, the technique lacks the efficiency needed for clinical implementation, and a faster, simpler approach to LET measurements is desirable. The goal of this work was to demonstrate and evaluate the potential of calibrating Al2O3:C OSLDs for LET measurements using new methods. We exposed batches of OSLDs to unmodulated proton beams of varying LET and calibrated three parameters of the resulting OSL signals as functions of fluence-averaged LET (ϕ-LET) and dose-averaged LET (D-LET). These three parameters included the OSL curve shape evaluated under continuous wave stimulation (CW-OSL), the OSL curve shape evaluated under pulsed stimulation (P-OSL), and the intensity ratio of the two main emission bands in the Al2O3:C OSL emission spectrum (ultraviolet [UV]/blue ratio). To test the calibration, we then irradiated new batches of OSLDs in modulated proton beams of varying LET, and used the OSL signal parameters to calculate ϕ-LET and D-LET under these new test conditions. Using the P-OSL curve shape, D-LET was measured within 5.7% of the expected value. We conclude that from a single 10 s readout (following initial calibration), both the absorbed dose and LET in proton therapy beams can be measured using OSLDs. This has potential future applications in the quality assurance of proton therapy treatment plans, particularly for those that may account for LET or relative biological effectiveness in their optimization. The methods demonstrated in this work may also be applicable to other particle therapy beams, including carbon ion beams. PMID:25029434

  16. Calibration of the Al2O3:C optically stimulated luminescence (OSL) signal for linear energy transfer (LET) measurements in therapeutic proton beams

    NASA Astrophysics Data System (ADS)

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

    2014-08-01

    Optically stimulated luminescence (OSL) detectors (OSLDs) have shown potential for measurements of linear energy transfer (LET) in proton therapy beams. However, the technique lacks the efficiency needed for clinical implementation, and a faster, simpler approach to LET measurements is desirable. The goal of this work was to demonstrate and evaluate the potential of calibrating Al2O3:C OSLDs for LET measurements using new methods. We exposed batches of OSLDs to unmodulated proton beams of varying LET and calibrated three parameters of the resulting OSL signals as functions of fluence-averaged LET (ϕ-LET) and dose-averaged LET (D-LET). These three parameters included the OSL curve shape evaluated under continuous wave stimulation (CW-OSL), the OSL curve shape evaluated under pulsed stimulation (P-OSL), and the intensity ratio of the two main emission bands in the Al2O3:C OSL emission spectrum (ultraviolet [UV]/blue ratio). To test the calibration, we then irradiated new batches of OSLDs in modulated proton beams of varying LET, and used the OSL signal parameters to calculate ϕ-LET and D-LET under these new test conditions. Using the P-OSL curve shape, D-LET was measured within 5.7% of the expected value. We conclude that from a single 10 s readout (following initial calibration), both the absorbed dose and LET in proton therapy beams can be measured using OSLDs. This has potential future applications in the quality assurance of proton therapy treatment plans, particularly for those that may account for LET or relative biological effectiveness in their optimization. The methods demonstrated in this work may also be applicable to other particle therapy beams, including carbon ion beams.

  17. [Comparison of calculated LDL cholesterol (LDL-C) versus measured LDL cholesterol (LDL-M) and potential impact in terms of therapeutic management].

    PubMed

    Reignier, Arnaud; Sacchetto, Emilie; Hardouin, Jean-Benoît; Orsonneau, Jean-Luc; Le Carrer, Didier; Delaroche, Odile; Bigot-Corbel, Edith

    2014-01-01

    LDL-cholesterol value is one of the criteria used by the Haute autorité de santé (HAS) in the management of patients in primary and secondary prevention with the aim to reduce cardiovascular mortality. In this respect, the recommendations have been established based on target to achieve LDL-cholesterol. Currently in France, the determination of LDL-cholesterol is mainly carried out by the Friedewald formula whose limits are well known. However, reliable methods for the determination of LDL-cholesterol exist. We compared the results of calculated and measured LDL-cholesterol obtained from 444 patients presenting normal triglyceridemia values in terms of ranking relative to the thresholds of the HAS. The correlation between the two methods is quite good, but a significant difference (p <0.0001) was observed between the calculated and measured values of LDL-cholesterol. On the other hand in 17% of cases the classification of subjects will be different, with a majority so overestimation of calculated LDL-cholesterol with respect to measured LDL-cholesterol. This overestimation is not proportional, in fact most values measured LDL-cholesterol, the higher the calculate-measured difference is important. The rating difference is particularly important when subjects have between 1 and 3 factors of cardiovascular risk where the target LDL-cholesterol to achieve is between 1.3 and 1.9 g/L. The management of patients with lipid lowering may potentially be dependent on the method used for the determination of LDL-cholesterol.

  18. Therapeutic Recreation Practicum Manual.

    ERIC Educational Resources Information Center

    Schneegas, Kay

    This manual provides information on the practicum program offered by Moraine Valley Community College (MVCC) for students in its therapeutic recreation program. Sections I and II outline the rationale and goals for providing practical, on-the-job work experiences for therapeutic recreation students. Section III specifies MVCC's responsibilities…

  19. Cannabis: its therapeutic use.

    PubMed

    Wall, J; Davis, S; Ridgway, S

    This article provides an overview of the issues surrounding the use of cannabis for therapeutic purposes. Examples of some of the ethical issues related to professional practice are discussed. The authors do not advocate legalising cannabis for all, but the therapeutic advantages and disadvantages of using cannabis are highlighted.

  20. Muddy Waters: Earth System Science Education Alliance Wetlands Degradation Module

    NASA Astrophysics Data System (ADS)

    Hall, C.; Jordan, S.; Kaufman, C.

    2008-12-01

    The College of Charleston, Charleston, SC recently obtained funding from the South Carolina Space Grant Consortium to develop a geoscience-based education module for integration into the Earth System Science Education Alliance (ESSEA). The Muddy Waters Education Module will prepare students in science, technology, engineering and math (STEM), in addition to pre-service educators, in using remotely sensed data and geographic information systems (GIS) to delineate, understand and monitor our changing wetland and delta environments. The curriculum will provide opportunities for students to participate in inquiry-based, data-driven experiences founded in sound educational pedagogy. The ESSEA curriculum exists within a national network of universities, colleges, and science education organizations dedicated to improving Earth science education, thereby increasing exposure to a significant environmental issue - wetland and delta degradation - and providing a means of sustainability for the future. This session will provide information on the new module highlighting the crisis of wetland and delta degradation occurring on a global scale, specifically focusing on the Ganges Delta, the Yellow River Delta, the Everglades and all of the associated and surrounding wetlands. In addition, we will discuss the Merritt Island National Refuge and the wetlands surrounding Cape Canaveral, as a pristine environment that has been protected due to its proximity to the space shuttle launches. This Muddy Waters Education Module will raise awareness of processes that are currently underway with global climatic change and anthropogenic effects and the interconnectedness of the various spheres (atmosphere, lithosphere, hydrosphere, and biosphere) in wetland environments. The Muddy Waters Curriculum will be designed to meet National Education Standards in science, geography, math, etc. The module will engage students in authentic research and will engage and inspire students in environmental

  1. Ocean Literacy Alliance-Hawaii (OLA-HI) Resource Guide

    NASA Astrophysics Data System (ADS)

    Bruno, B. C.; Rivera, M.; Hicks Johnson, T.; Baumgartner, E.; Davidson, K.

    2008-05-01

    The Ocean Literacy Alliance-Hawaii (OLA-HI) was founded in 2007 to establish a framework for collaboration in ocean science education in Hawaii. OLA-HI is supported by the federal Interagency Working Group-Ocean Education (IWG-OE) and funded through NSF and NOAA. Hawaii support is provided through the organizations listed above in the authors' block. Our inaugural workshop was attended by 55 key stakeholders, including scientists, educators, legislators, and representatives of federal, state, and private organizations and projects in Hawaii. Participants reviewed ongoing efforts, strengthened existing collaborations, and developed strategies to build new partnerships. Evaluations showed high satisfaction with the workshop, with 100% of respondents ranking the overall quality as `good' or `excellent'. Expected outcomes include a calendar of events, a website (www.soest.hawaii.edu/OLAHawaii), a list serve, and a resource guide for ocean science education in Hawaii. These products are all designed to facilitate online and offline networking and collaboration among Hawaii's ocean science educators. The OLA-HI resource guide covers a gamut of marine resources and opportunities, including K-12 curriculum, community outreach programs, museum exhibits and lecture series, internships and scholarships, undergraduate and graduate degree programs, and teacher professional development workshops. This guide is designed to share existing activities and products, minimize duplication of efforts, and help provide gap analysis to steer the direction of future ocean science projects and programs in Hawaii. We ultimately plan on using the resource guide to develop pathways to guide Hawaii's students toward ocean-related careers. We are especially interested in developing pathways for under-represented students in the sciences, particularly Native Hawaiians and Pacific Islanders, and will focus on this topic at a future OLA-HI workshop.

  2. Cytokines and therapeutic oligonucleotides.

    PubMed

    Hartmann, G; Bidlingmaier, M; Eigler, A; Hacker, U; Endres, S

    1997-12-01

    Therapeutic oligonucleotides - short strands of synthetic nucleic acids - encompass antisense and aptamer oligonucleotides. Antisense oligonucleotides are designed to bind to target RNA by complementary base pairing and to inhibit translation of the target protein. Antisense oligonucleotides enable specific inhibition of cytokine synthesis. In contrast, aptamer oligonucleotides are able to bind directly to specific proteins. This binding depends on the sequence of the oligonucleotide. Aptamer oligonucleotides with CpG motifs can exert strong immunostimulatory effects. Both kinds of therapeutic oligonucleotides - antisense and aptamer oligonucleotides - provide promising tools to modulate immunological functions. Recently, therapeutic oligonucleotides have moved towards clinical application. An antisense oligonucleotide directed against the proinflammatory intercellular adhesion molecule 1 (ICAM-1) is currently being tested in clinical trials for therapy of inflammatory disease. Immunostimulatory aptamer oligonucleotides are in preclinical development for immunotherapy. In the present review we summarize the application of therapeutic oligonucleotides to modulate immunological functions. We include technological aspects as well as current therapeutic concepts and clinical studies.

  3. Impact of Exchanges and Client–Therapist Alliance in Online-Text Psychotherapy

    PubMed Central

    Stiles, William B.; Bailer, A. John; Hughes, Michael R.

    2013-01-01

    Abstract The impact of exchanges and client–therapist alliance of online therapy text exchanges were compared to previously published results in face-to-face therapy, and the moderating effects of four participant factors found significant in previously published face-to-face studies were investigated using statistical mixed-effect modeling analytic techniques. Therapists (N=30) and clients (N=30) engaged in online therapy were recruited from private practitioner sites, e-clinics, online counseling centers, and mental-health-related discussion boards. In a naturalistic design, they each visited an online site weekly and completed the standard impact and alliance questionnaires for at least 6 weeks. Results indicated that the impact of exchanges and client–therapist alliance in text therapy was similar to, but in some respects more positive than, previous evaluations of face-to-face therapy. The significance of participant factors previously found to influence impact and alliance in face-to-face therapy (client symptom severity, social support, therapist theoretical orientation, and therapist experience) was not replicated, except that therapists with the more symptomatic clients rated their text exchanges as less smooth and comfortable. Although its small size and naturalistic design impose limitations on sensitivity and generalizability, this study provides some insights into treatment impact and the alliance in online therapy. PMID:23530546

  4. Structured supervision of graduate clinicians in psychodynamic psychotherapy: alliance and technique.

    PubMed

    Hilsenroth, Mark J; Kivlighan, Dennis M; Slavin-Mulford, Jenelle

    2015-04-01

    This is the first study to examine longitudinal differences in alliance and technique across multiple cases, controlling for client distress and therapist effects, during structured supervision in psychodynamic psychotherapy. Patient and therapist ratings of alliance as well as independent clinical ratings of psychodynamic interventions were assessed during the 3rd and 9th sessions in the psychotherapy of 58 outpatients, conducted by 24 graduate clinicians. Findings demonstrated that patient-rated alliance was higher across cases at both the 3rd and 9th sessions. These differences in alliance were paralleled by trainees' using significantly more psychodynamic techniques across cases during the 3rd session. All of these differences were in evidence, controlling for patient level of pathology. It is also important to note that there were no significant differences during the course of training for cognitive-behavioral techniques. This is consistent with the specific supervision provided to the graduate clinicians in this training practicum. Practical implications for the use of structured clinical training and issues pertinent to supervision in graduate education are reviewed. Finally, the relationship that structured training may have to graduate clinicians' ability to form a positive alliance with their patients is also discussed.

  5. Male reproductive success increases with alliance size in Indo-Pacific bottlenose dolphins (Tursiops aduncus).

    PubMed

    Wiszniewski, Joanna; Corrigan, Shannon; Beheregaray, Luciano B; Möller, Luciana M

    2012-03-01

    1. Determining the extent of variation in male mating strategies and reproductive success is necessary to understand the fitness benefits of social and cooperative behaviour. 2. This study assesses the reproductive success of male Indo-Pacific bottlenose dolphins in a small embayment population where different behavioural strategies of males have previously been identified. Parentage for 44 sampled calves was examined using 23 microsatellite loci and one mitochondrial DNA marker. Our candidate parent pool of 70 males and 64 females contained individuals sampled from both the embayment and adjacent coastal populations. 3. A moderate level of polygyny was detected in our sample. We assigned paternity of 23 calves to 12 males at the strict 95% confidence level and an additional nine calves to two males at the 80% confidence level. The majority (92%) of successful males were identified as residents to the embayment, and 46% of offspring were located within the same social group or community as their father. 4. Our results suggest that the size of alliances was the best predictor of reproductive success for males in this population, while the strength of association among allied males, alliance stability and male ranging patterns had little influence. In line with predictions for male alliances formed between unrelated individuals, we found that reproductive skew within alliances was not large. 5. Together, our genetic and behavioural analyses demonstrate that alliance formation between male dolphins is a successful strategy to enhance reproductive output.

  6. Reporting therapeutic discourse in a therapeutic community.

    PubMed

    Chapman, G E

    1988-03-01

    Research in nurses' communications has concentrated on nurse to patient interactions. Those few studies which focus on nurse to nurse communications seem to be generated by a pragmatic and normative concern with effective information sharing. In this paper, which describes one aspect of a larger case study of a hospital-based therapeutic community, the description and analysis of nurses' reports flows not from a normative model of professional practice, but rather an exploration of how professional practice is articulated as discourse in nurses' written accounts. Foucault's ideas about therapeutic discourse inform the theoretical framework of the research. Ethnomethodological concerns with the importance of documentary analysis provide the methodological rationale for examining nurses' 24-hour report documents, as official discourse, reflecting therapeutic practice in this setting. A content analysis of nurses' reports, collected over a period of 4 months, demonstrated the importance of domesticity and ordinary everyday activities in nurses' accounts of hospital life. Disruption to the 'life as usual' domesticity in the community seemed to be associated with admission to and discharge from the hospital when interpersonal and interactional changes between patients occur. It is suggested that nurses in general hospital wards and more orthodox psychiatric settings might usefully consider the impact of admissions and discharges on the group of patients they manage, and make this a discursive focus of their work. PMID:3372900

  7. Confirmatory Trials in the Evaluation of Anticancer Medicinal Products in Man—PFS2: A Measure of Therapeutic Action-At-A-Distance

    PubMed Central

    Oronsky, Bryan; Carter, Corey A.; Reid, Tony R.; Scicinski, Jan; Oronsky, Arnold; Lybeck, Michelle; Caroen, Scott; Stirn, Meaghan; Oronsky, Neil; Langecker, Peter

    2015-01-01

    Overall survival (OS) has emerged as the definitive regulatory “be-all, end-all” for the demonstration of benefit in cancer clinical trials. The reason and the rationale for why this is so are easily appreciated: literally a “test of time,” OS is a seemingly unambiguous, agenda-free end point, independent of bias-prone variables such as the frequency and methods of assessment, clinical evaluation, and the definition of progression. However, by general consensus, OS is an imperfect end point for several reasons: First, it may often be impractical because of the length, cost, and the size of clinical trials. Second, OS captures the impact of subsequent therapies, both beneficial (i.e., active) and detrimental, on survival but it does not take into account the contribution of subsequent therapies by treatment arm; the postprogression period is treated as an unknown black box (no information about the potential influence of next-line therapies on the outcome) under the implicit assumption that the clinical trial treatment is the only clinical variable that matters: what OS explicitly measures is the destination, that is, the elapsed time between the date of randomization (or intention to treat) and the date of death, not the journey, that is, what transpires in-between. In long-term maintenance strategies, patients receive treatment in temporally separated but mutually interdependent and causally linked sequences that exert a “field of influence” akin to action-at-a-distance forces like gravity, electricity, and magnetism on both the tumor and each other. Hence, in this setting, a new end point, PFS2, is required to measure this field of influence. This article reviews the definition and use in clinical trials of PFS2 and makes the case for its potential applicability as a preferred end point to measure the mutual influence of individual regimens in long-term maintenance strategies with resensitizing agents in particular. PMID:26476079

  8. Confirmatory Trials in the Evaluation of Anticancer Medicinal Products in Man--PFS2: A Measure of Therapeutic Action-At-A-Distance.

    PubMed

    Oronsky, Bryan; Carter, Corey A; Reid, Tony R; Scicinski, Jan; Oronsky, Arnold; Lybeck, Michelle; Caroen, Scott; Stirn, Meaghan; Oronsky, Neil; Langecker, Peter

    2015-09-01

    Overall survival (OS) has emerged as the definitive regulatory "be-all, end-all" for the demonstration of benefit in cancer clinical trials. The reason and the rationale for why this is so are easily appreciated: literally a "test of time," OS is a seemingly unambiguous, agenda-free end point, independent of bias-prone variables such as the frequency and methods of assessment, clinical evaluation, and the definition of progression. However, by general consensus, OS is an imperfect end point for several reasons: First, it may often be impractical because of the length, cost, and the size of clinical trials. Second, OS captures the impact of subsequent therapies, both beneficial (i.e., active) and detrimental, on survival but it does not take into account the contribution of subsequent therapies by treatment arm; the postprogression period is treated as an unknown black box (no information about the potential influence of next-line therapies on the outcome) under the implicit assumption that the clinical trial treatment is the only clinical variable that matters: what OS explicitly measures is the destination, that is, the elapsed time between the date of randomization (or intention to treat) and the date of death, not the journey, that is, what transpires in-between. In long-term maintenance strategies, patients receive treatment in temporally separated but mutually interdependent and causally linked sequences that exert a "field of influence" akin to action-at-a-distance forces like gravity, electricity, and magnetism on both the tumor and each other. Hence, in this setting, a new end point, PFS2, is required to measure this field of influence. This article reviews the definition and use in clinical trials of PFS2 and makes the case for its potential applicability as a preferred end point to measure the mutual influence of individual regimens in long-term maintenance strategies with resensitizing agents in particular. PMID:26476079

  9. Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

    PubMed Central

    2014-01-01

    Background The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. Discussion The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. Summary In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor. PMID:25023339

  10. Development and Operation of Dual-Mode Analyzers for Wireless Power Consortium/Power Matters Alliance Wireless Power Systems.

    PubMed

    Um, Keehong

    2016-05-01

    We have designed a protocol analyzer to be used in wireless power systems and analyzed the operation of wireless chargers defined by standards of Qi of Wireless Power Consortium (WPC) and Power Matters Alliance (PMA) protocols. The integrated circuit (IC, or microchip) developed so far for wireless power transmission is not easily adopted by chargers for specific purposes. A device for measuring the performance of test equipment currently available is required to transform and expand the types of protocol. Since a protocol analyzer with these functions is required, we have developed a device that can analyze the two protocols of WPC and PMA at the same time. As a result of our research, we present a dual-mode system that can analyze the protocols of both WPC and PMA.

  11. Tropospheric Airborne Meteorological Data Reporting (TAMDAR) Icing Sensor Performance During the 2003 Alliance Icing Research Study (AIRS II)

    NASA Technical Reports Server (NTRS)

    Murray, John J.; Schaffner, Philip R.; Minnis, Patrick; Nguyen, Louis; Delnore, Victor E.; Daniels, Taumi S.; Grainger, C. A.; Delene, D.; Wolff, C. A.

    2004-01-01

    The Tropospheric Airborne Meteorological Data Reporting (TAMDAR) sensor was deployed onboard the University of North Dakota Citation II aircraft in the Alliance Icing Research Study (AIRS II) from Nov 19 through December 14, 2003. TAMDAR is designed to measure and report winds, temperature, humidity, turbulence and icing from regional commercial aircraft (Daniels et. al., 2004). TAMDAR icing sensor performance is compared to a) in situ validation data from the Citation II sensor suite, b) Current Icing Potential products developed by the National Center for Atmospheric Research (NCAR) and available operationally on the NOAA Aviation Weather Center s Aviation Digital Data Server (ADDS) and c) NASA Advanced Satellite Aviation-weather Products (ASAP) cloud microphysical products.

  12. Development and Operation of Dual-Mode Analyzers for Wireless Power Consortium/Power Matters Alliance Wireless Power Systems.

    PubMed

    Um, Keehong

    2016-05-01

    We have designed a protocol analyzer to be used in wireless power systems and analyzed the operation of wireless chargers defined by standards of Qi of Wireless Power Consortium (WPC) and Power Matters Alliance (PMA) protocols. The integrated circuit (IC, or microchip) developed so far for wireless power transmission is not easily adopted by chargers for specific purposes. A device for measuring the performance of test equipment currently available is required to transform and expand the types of protocol. Since a protocol analyzer with these functions is required, we have developed a device that can analyze the two protocols of WPC and PMA at the same time. As a result of our research, we present a dual-mode system that can analyze the protocols of both WPC and PMA. PMID:27483911

  13. Longitudinal measures of cognition in the Ts65Dn mouse: Refining windows and defining modalities for therapeutic intervention in Down syndrome.

    PubMed

    Olmos-Serrano, J Luis; Tyler, William A; Cabral, Howard J; Haydar, Tarik F

    2016-05-01

    Mouse models have provided insights into adult changes in learning and memory in Down syndrome, but an in-depth assessment of how these abnormalities develop over time has never been conducted. To address this shortcoming, we conducted a longitudinal behavioral study from birth until late adulthood in the Ts65Dn mouse model to measure the emergence and continuity of learning and memory deficits in individuals with a broad array of tests. Our results demonstrate for the first time that the pace at which neonatal and perinatal milestones are acquired is correlated with later cognitive performance as an adult. In addition, we find that life-long behavioral indexing stratifies mice within each genotype. Our expanded assessment reveals that diminished cognitive flexibility, as measured by reversal learning, is the most robust learning and memory impairment in both young and old Ts65Dn mice. Moreover, we find that reversal learning degrades with age and is therefore a useful biomarker for studying age-related decline in cognitive ability. Altogether, our results indicate that preclinical studies aiming to restore cognitive function in Ts65Dn should target both neonatal milestones and reversal learning in adulthood. Here we provide the quantitative framework for this type of approach.

  14. Evaluation of an academic service partnership using a strategic alliance framework.

    PubMed

    Murray, Teri A; James, Dorothy C

    2012-01-01

    Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one's own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care. The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model. PMID:22177471

  15. Evaluation of an academic service partnership using a strategic alliance framework.

    PubMed

    Murray, Teri A; James, Dorothy C

    2012-01-01

    Strategic alliances involve the sharing of resources to achieve mutually relevant benefits and they are flexible ways to access resources outside of one's own institution. The recent landmark report from the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health, called for academic and health care organizations to strategically align around the future registered nurse workforce to improve the quality and safety of patient care. The dedicated education unit (DEU) is one practical way for 2 entities to align so that students can learn to administer safe, quality care. Because DEUs have great potential, it is critical to evaluate the alignment between the academic and service partner for appropriate fit, mutual benefit, and long-term success. In this article, we analyze the effectiveness of the Saint Louis University School of Nursing (SLUSON) and Mercy Hospital, St. Louis (MHSL) DEU project, an alliance between a medical center and school of nursing, using the Single Alliance Key Success Model.

  16. Proceedings: EPRI's Agricultural and Food Technology Alliances: Memphis, Tennessee, May 12-14, 1998

    SciTech Connect

    1998-05-01

    This document is a compilation of field trip overviews, presentations and committee reports from the EPRI Agricultural Technology Alliance (ATA) and Food Technology Alliance (FTA) Joint Meeting held in Memphis, Tennessee, May 12-14, 1998. Presentation titles include: Agricultural Research Programs in Tennessee; Tennessee's Food and Agricultural Research Programs; The TVA -- Formation and Evolution, Deregulation/Restructuring the Electric Utility Industry -- Status and Update; Water and Wastewater Program Interactions with the Food and Agricultural Technology Alliances; Aquaculture -- Its Importance to Food and Agriculture; The Poultry Industry -- The Original Agriculture and Food Integrator; Update on Electronic Pasteurization; and California's Electric Industry Restructuring New Options for Agricultural Customers. The document also includes steering committee actions of both the ATA and the FTA, a registration list, steering committee operating procedures and member services for the ATA and the FTA, project summaries, and minutes from the ozone workshop that took place prior to the meeting.

  17. Biomimetic Particles as Therapeutics

    PubMed Central

    Green, Jordan J.

    2015-01-01

    In recent years, there have been major advances in the development of novel nanoparticle and microparticle-based therapeutics. An emerging paradigm is the incorporation of biomimetic features into these synthetic therapeutic constructs to enable them to better interface with biological systems. Through the control of size, shape, and material consistency, particle cores have been generated that better mimic natural cells and viruses. In addition, there have been significant advances in biomimetic surface functionalization of particles through the integration of bio-inspired artificial cell membranes and naturally derived cell membranes. Biomimetic technologies enable therapeutic particles to have increased potency to benefit human health. PMID:26277289

  18. Level 2 Therapeutic Model site.

    PubMed

    Spears, Brad; Sanchez, David; Bishop, Jane; Rogers, Sharon; DeJong, Judith A

    2006-01-01

    L2, one of the original sites first funded under the Therapeutic Residential Model Initiative in 2001-2002, is operated as a peripheral dormitory. This dormitory cares for 185 boys and girls in grades 1-12 who attend local public schools. L2 presented an outstanding proposal which identified gaps in services and presented a reasonable budget to address those gaps by adding additional mental health services and increasing the number of residential and recreation staff. With only minor modifications to this budget, the site efficiently and effectively implemented the strategies it had proposed and utilized evaluation feedback to fine-tune systems and maximize positive outcomes. The Therapeutic Residential Model funds enabled the site to move from a functional dormitory to a therapeutic residential situation where the needs of students are assessed and addressed. Outcome indicators in spring 2002, 2003, 2004, and 2005 showed impacts in a number of areas when compared with the baseline year of 2000-2001: Retention of students steadily increased going from 40.7% in 2000-2001 to 68.4% in 2004-2005; 75 students graduated from high school during the four Therapeutic Residential Model years, compared with 41 in the preceding four years; Academic Proficiency and ACT scores improved significantly; Thirty-day cigarette use dropped from 62% in spring 2001 to 38% in spring 2005 among 7th and 8th graders, from 58% to 33% among 9th and 10th graders, and from 72% to 29% among 11th and 12th graders; Alienation indices showed an increase in feelings of inclusion and a decrease in lack of meaning. This site is an outstanding example of what can be done with a well-designed and responsibly implemented Therapeutic Model Program, and the measurable impacts which can result from such strategic use of resources. PMID:17602401

  19. Adolescent and Parent Alliances with Therapists in Brief Strategic Family Therapy[TM] with Drug-Using Hispanic Adolescents

    ERIC Educational Resources Information Center

    Robbins, Michael S.; Mayorga, Carla C.; Mitrani, Victoria B.; Szapocznik, Jose; Turner, Charles W.; Alexander, James F.

    2008-01-01

    This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent, adolescent) and family level (within-family differences) for families that either dropped out or completed family therapy. Participants were 31 Hispanic adolescents and their family members who received brief…

  20. The Relation of Secondary Traumatization to Therapists' Perceptions of the Working Alliance with Clients Who Commit Sexual Abuse

    ERIC Educational Resources Information Center

    Carmel, Melissa J. Sheehy; Friedlander, Myrna L.

    2009-01-01

    The authors assessed burnout, compassion fatigue, secondary trauma symptoms, and compassion satisfaction in relation to experienced therapists' perceptions of the working alliance. Participants, 106 specialists in the treatment of clients who commit sexual abuse, completed the Working Alliance Inventory-Short Form (T. J. Tracey & A. M. Kokotovic,…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    Objective: The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also…

  2. Predictors of Working Alliance Efficacy among State VR Counselors as a Function of Ex-Offender Status

    ERIC Educational Resources Information Center

    Bates, Julie K.

    2012-01-01

    The purpose of this study was to determine if statistically significant relationships existed between burnout, stigma, flourishing, caseload size, experience, and working alliance self-efficacy and to assess the predictive power of these variables on levels of working alliance self-efficacy with clients with disabilities alone and clients with…

  3. Protecting Sacred Sites on Public Land: Religion and Alliances in the Mato Tipila-Devils Tower Litigation

    ERIC Educational Resources Information Center

    Freedman, Eric

    2007-01-01

    This article traces the Devils Tower litigation in the context of the "Bear Lodge" alliance's theoretical underpinnings, particularly the interrelationship among culture, geographic place, and religion, as well as the institutional mechanisms that regulate litigation alliances in the U.S. judicial system. It discusses principal factors in…

  4. 76 FR 54758 - Alliance Pipeline L.P.; Notice of Intent To Prepare an Environmental Assessment for the Planned...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Project involving construction and operation of facilities by Alliance Pipeline L.P. (Alliance) in... mainline in Renville County; One pig \\1\\ launcher at the proposed compressor station site and one pig receiver at the pressure regulating station site; and \\1\\ A ``pig'' is a tool that is inserted into...

  5. Teaming Up: Higher Education-Business Partnerships and Alliances in North America. Understanding the Differences Series. Working Paper No. 7.

    ERIC Educational Resources Information Center

    de la Garza, Guillermo Fernandez; Landrum, Bertha A.; Samuels, Barbara

    This report presents the responses of three experts from Canada, Mexico, and the United States to 18 questions concerning issues in business-higher education alliances in the context of the North American Free Trade Agreement (NAFTA). They address such issues as the need for alliances; the characteristics of successful (and unsuccessful)…

  6. How To Form and Operate a Local Alliance. A Handbook for Local Action To Improve Science and Technology Education.

    ERIC Educational Resources Information Center

    Livermore, Arthur H.; And Others

    The growth of local alliances (partnerships of business, industry, labor, professional associations, educators, and other concerned groups) is evidence of a widespread public concern for improving the quality of science and technology education. This document defines the concept of local alliances and discusses aspects of the founding and…

  7. [Online Counselling: The prospect of a therapeutic connection].

    PubMed

    Giotakos, O; Papadomarkaki, E

    2016-01-01

    Over the last few years, Internet has become an integral part of daily life. An abundant source of information and a principal gateway of communication between individuals, Internet has been continuously gaining considerable ground as a tool of awareness and intervention in the area of public health. With regard to the field of mental health, Internet exhibits a credible potential in facilitating dialogue not only between experts and their beneficiaries but also between stakeholders. Moreover and with regard to various aspects of public concern, it can serve as a circulation portal of educational material between students and teachers. The advent of remote support services dates back in the decade of 1970-1980. In the present time, they consist of informative guides and self-help groups or online counselling. The latter is defined as the process in which both parties, namely the therapist and the client, are involved in an oral or written conciliation through means of an internet connection, videoconferencing, live chat or e-mail exchange. The benefits of this practice - accessibility, relocation, convenience, anonymity, facilitation of face-to-face psychotherapy and low cost - could make online counseling, in specific cases, the treatment of choice. While the usage of the World Wide Web seems promising for the rectification of mental health disorders, there is some debate among experts regarding the ethical aspect of practicing psychotherapy in an interactive digital environment. Issues such as technical expertise and the tackling of related problems, difficulties in the diagnostic process, interchange of verbal and nonverbal cues, crisis management, safeguarding the therapeutic alliance, protection of personal data, age restriction, keeping boundaries in relation to the setting, the time and the dynamics of the therapeutic relationship and, finally, training and supervisory process of online therapist, are some subjects of disagreement. Relevant research reveals

  8. [Online Counselling: The prospect of a therapeutic connection].

    PubMed

    Giotakos, O; Papadomarkaki, E

    2016-01-01

    Over the last few years, Internet has become an integral part of daily life. An abundant source of information and a principal gateway of communication between individuals, Internet has been continuously gaining considerable ground as a tool of awareness and intervention in the area of public health. With regard to the field of mental health, Internet exhibits a credible potential in facilitating dialogue not only between experts and their beneficiaries but also between stakeholders. Moreover and with regard to various aspects of public concern, it can serve as a circulation portal of educational material between students and teachers. The advent of remote support services dates back in the decade of 1970-1980. In the present time, they consist of informative guides and self-help groups or online counselling. The latter is defined as the process in which both parties, namely the therapist and the client, are involved in an oral or written conciliation through means of an internet connection, videoconferencing, live chat or e-mail exchange. The benefits of this practice - accessibility, relocation, convenience, anonymity, facilitation of face-to-face psychotherapy and low cost - could make online counseling, in specific cases, the treatment of choice. While the usage of the World Wide Web seems promising for the rectification of mental health disorders, there is some debate among experts regarding the ethical aspect of practicing psychotherapy in an interactive digital environment. Issues such as technical expertise and the tackling of related problems, difficulties in the diagnostic process, interchange of verbal and nonverbal cues, crisis management, safeguarding the therapeutic alliance, protection of personal data, age restriction, keeping boundaries in relation to the setting, the time and the dynamics of the therapeutic relationship and, finally, training and supervisory process of online therapist, are some subjects of disagreement. Relevant research reveals

  9. Overview of the Earth System Science Education Alliance Online Courses

    NASA Astrophysics Data System (ADS)

    Botti, J. A.

    2001-12-01

    Science education reform has skyrocketed over the last decade in large part thanks to technology-and one technology in particular, the Internet. The World Wide Web has opened up dynamic new online communities of learners. It has allowed educators from around the world to share thoughts about Earth system science and reexamine the way science is taught. A positive offshoot of this reform effort is the Earth System Science Education Alliance (ESSEA). This partnership among universities, colleges, and science education organizations is led by the Institute for Global Environmental Strategies and the Center for Educational TechnologiesTM at Wheeling Jesuit University. ESSEA's mission is to improve Earth system science education. ESSEA has developed three Earth system science courses for K-12 teachers. These online courses guide teachers into collaborative, student-centered science education experiences. Not only do these courses support teachers' professional development, they also help teachers implement Earth systems science content and age-appropriate pedagogical methods into their classrooms. The ESSEA courses are open to elementary, middle school, and high school teachers. Each course lasts one semester. The courses begin with three weeks of introductory content. Then teachers develop content and pedagogical and technological knowledge in four three-week learning cycles. The elementary school course focuses on basic Earth system interactions between land, life, air, and water. In week A of each learning cycle, teachers do earth system activities with their students. In week B teachers investigate aspects of the Earth system -- for instance, the reason rocks change to soil, the relationship between rock weathering and soil nutrients, and the consequent development of biomes. In week C teachers develop classroom activities and share them online with other course participants. The middle school course stresses the effects of real-world events -- volcanic eruptions

  10. Overview of the Earth System Science Education Alliance Online Courses

    NASA Astrophysics Data System (ADS)

    Botti, J.; Myers, R.

    2002-12-01

    Science education reform has skyrocketed over the last decade in large part thanks to technology-and one technology in particular, the Internet. The World Wide Web has opened up dynamic new online communities of learners. It has allowed educators from around the world to share thoughts about Earth system science and reexamine the way science is taught. A positive offshoot of this reform effort is the Earth System Science Education Alliance (ESSEA). This partnership among universities, colleges, and science education organizations is led by the Institute for Global Environmental Strategies and the Center for Educational Technologiestm at Wheeling Jesuit University. ESSEA's mission is to improve Earth system science education. ESSEA has developed three Earth system science courses for K-12 teachers. These online courses guide teachers into collaborative, student-centered science education experiences. Not only do these courses support teachers' professional development, they also help teachers implement Earth systems science content and age-appropriate pedagogical methods into their classrooms. The ESSEA courses are open to elementary, middle school, and high school teachers. Each course lasts one semester. The courses begin with three weeks of introductory content. Then teachers develop content and pedagogical and technological knowledge in four three-week learning cycles. The elementary school course focuses on basic Earth system interactions between land, life, air, and water. In week A of each learning cycle, teachers do earth system activities with their students. In week B teachers investigate aspects of the Earth system-for instance, the reason rocks change to soil, the relationship between rock weathering and soil nutrients, and the consequent development of biomes. In week C teachers develop classroom activities and share them online with other course participants. The middle school course stresses the effects of real-world events-volcanic eruptions

  11. Core Standards and Implementation of the International Planetary Data Alliance

    NASA Astrophysics Data System (ADS)

    Crichton, Daniel

    Solar System exploration in the 21st Century is ushering in a new paradigm with complex missions that are hosting instruments developed and managed by the international scientific community. Over the past decade, the European and United States space agencies have collaborated extensively to share common data standards for planetary science archiving, while, just recently, countries including Japan, India and China are now planning and executing robotic exploration missions of the solar system. The collective results yield an unprecedented volume of data across a large number of missions as compared with the last forty years of exploration. At the same time, resources from any one agency are scarce, requiring agencies to leverage existing standards and tools, where possible, and coordinate release and sharing of scientific data results to the worldwide scientific community. In 2006, the International Planetary Data Alliance (IPDA) was founded which includes representatives on a Steering Committee from major space agencies around the world that are involved in planetary science exploration missions. The purpose of the IPDA is two pronged. First, it is to develop a set of data standards for archiving and sharing scientific data products across international agencies and missions. Second, to develop a set of technical information system standards allowing interoperability between agency data systems. These standards are critical to building compatible archives that will allow for science data from international missions to be both captured and shared in a consistent manner. The Planetary Data System (PDS) has a long history of providing data standards to missions for the explicit purpose of archiving and preserving data. These standards have been adopted by the European Space Agency in developing their Planetary Science Archive. In addition, at the time of the IPDA founding, the PDS Standards are considered the "de facto" standards for capturing and archiving planetary

  12. Earth System Science Education Alliance (ESSEA) IPY Modules

    NASA Astrophysics Data System (ADS)

    Blaney, L. S.; Myers, R. J.; Schwerin, T.

    2008-12-01

    The Earth System Science Education Alliance (ESSEA) is a National Science Foundation-supported program implemented by the Institute for Global Environmental Strategies (IGES) to improve the quality of geoscience instruction for pre-service, middle, and high school teachers. ESSEA increases teachers' access to quality materials, standards-based instructional methods and content knowledge. With additional support from NASA, the ESSEA program is being enhanced to reflect emphasis on the International Polar Year. From 1999-2005 the ESSEA program was based on a trio of online courses (for elementary, middle, and high school teachers), the courses have been used by 40 faculty at 20 institutions educating over 1,700 teachers in Earth system science. Program evaluation of original course participants indicated that the courses had significant impact on teachers Earth system content knowledge and beliefs about teaching and learning. Seventeen of the original participating institutions have continued to use the courses and many have developed new programs that incorporate the courses in Earth science education opportunities for teachers. Today the ESSEA program lists nearly 40 colleges and universities as participants. With NASA support, the K-4 course and modules have been revised to include topics and resources focusing on the International Polar Year. Additional modules examining the changes in black carbon, ice sheets and permafrost have been added for middle and high school levels. The new modules incorporate geoscience data and analysis tools into classroom instruction. By exploring IPY related topics and data, participating teachers and their students will develop new understandings about the interactions and dependencies of the Earth spheres and our polar regions. Changes in climate, air, water, and land quality and animal and plant populations make the news everyday. The ESSEA IPY modules will help teachers inform rather than frighten their students as they learn

  13. Alliance for Sustainable Colorado Renovation Raises Its Energy Performance to New Heights, Commercial Building Energy Efficiency (Fact Sheet); Energy Efficiency & Renewable Energy (EERE)

    SciTech Connect

    2015-03-01

    The Alliance for Sustainable Colorado (The Alliance) is a nonprofit organization aiming to transform sustainability from vision to reality. Part of its mission is to change the operating paradigms of commercial building design to make them more sustainable. Toward that end The Alliance uses its headquarters, The Alliance Center at 1536 Wynkoop Street in Denver, as a living laboratory, conductingpilot studies of innovative commercial-building-design solutions for using and generating energy.

  14. The content of our cooperation, not the color of our skin: an alliance detection system regulates categorization by coalition and race, but not sex.

    PubMed

    Pietraszewski, David; Cosmides, Leda; Tooby, John

    2014-01-01

    Humans in all societies form and participate in cooperative alliances. To successfully navigate an alliance-laced world, the human mind needs to detect new coalitions and alliances as they emerge, and predict which of many potential alliance categories are currently organizing an interaction. We propose that evolution has equipped the mind with cognitive machinery that is specialized for performing these functions: an alliance detection system. In this view, racial categories do not exist because skin color is perceptually salient; they are constructed and regulated by the alliance system in environments where race predicts social alliances and divisions. Early tests using adversarial alliances showed that the mind spontaneously detects which individuals are cooperating against a common enemy, implicitly assigning people to rival alliance categories based on patterns of cooperation and competition. But is social antagonism necessary to trigger the categorization of people by alliance--that is, do we cognitively link A and B into an alliance category only because they are jointly in conflict with C and D? We report new studies demonstrating that peaceful cooperation can trigger the detection of new coalitional alliances and make race fade in relevance. Alliances did not need to be marked by team colors or other perceptually salient cues. When race did not predict the ongoing alliance structure, behavioral cues about cooperative activities up-regulated categorization by coalition and down-regulated categorization by race, sometimes eliminating it. Alliance cues that sensitively regulated categorization by coalition and race had no effect on categorization by sex, eliminating many alternative explanations for the results. The results support the hypothesis that categorizing people by their race is a reversible product of a cognitive system specialized for detecting alliance categories and regulating their use. Common enemies are not necessary to erase important social

  15. Engineering antibody therapeutics.

    PubMed

    Chiu, Mark L; Gilliland, Gary L

    2016-06-01

    The successful introduction of antibody-based protein therapeutics into the arsenal of treatments for patients has within a few decades fostered intense innovation in the production and engineering of antibodies. Reviewed here are the methods currently used to produce antibodies along with how our knowledge of the structural and functional characterization of immunoglobulins has resulted in the engineering of antibodies to produce protein therapeutics with unique properties, both biological and biophysical, that are leading to novel therapeutic approaches. Antibody engineering includes the introduction of the antibody combining site (variable regions) into a host of architectures including bi and multi-specific formats that further impact the therapeutic properties leading to further advantages and successes in patient treatment. PMID:27525816

  16. Leadership, Organizational Climate, and Working Alliance in a Children's Mental Health Service System

    PubMed Central

    Green, Amy E.; Albanese, Brian J.; Cafri, Guy; Aarons, Gregory A.

    2014-01-01

    The goal of this study was to examine the relationships of transformational leadership and organizational climate with working alliance, in a children's mental health service system. Using multilevel structural equation modeling, the effect of leadership on working alliance was mediated by organizational climate. These results suggest that supervisors may be able to impact quality of care through improving workplace climate. Organizational factors should be considered in efforts to improve public sector services. Understanding these issues is important for program leaders, mental health service providers, and consumers because they can affect both the way services are delivered and ultimately, clinical outcomes. PMID:24323137

  17. The Need for a National Alliance for Broadening Participation of Native Americans in the Geosciences.

    NASA Astrophysics Data System (ADS)

    Dalbotten, D. M.

    2008-12-01

    The continuing underrepresentation of Native Americans in the Geosciences can only mean that Native voices go unheard in setting research agendas and priorities. This is particularly significant where issues such as global climate change impact the land and livelihood of Native American communities. This talk will outline the need for a national alliance for broadening participation of Native Americans in the Geosciences. Our focus will be on defining goals for this alliance, i.e., new research in Geoscience education, defining best practices, inclusion of Native voices in Geoscience research, the potential for new collaborations, and promotion of opportunities for Native students and communities.

  18. Quantitative naturalistic methods for detecting change points in psychotherapy research: an illustration with alliance ruptures.

    PubMed

    Eubanks-Carter, Catherine; Gorman, Bernard S; Muran, J Christopher

    2012-01-01

    Analysis of change points in psychotherapy process could increase our understanding of mechanisms of change. In particular, naturalistic change point detection methods that identify turning points or breakpoints in time series data could enhance our ability to identify and study alliance ruptures and resolutions. This paper presents four categories of statistical methods for detecting change points in psychotherapy process: criterion-based methods, control chart methods, partitioning methods, and regression methods. Each method's utility for identifying shifts in the alliance is illustrated using a case example from the Beth Israel Psychotherapy Research program. Advantages and disadvantages of the various methods are discussed.

  19. New Kid on the Block Turns Ten! The Brief, Remarkable History of the National Physicians Alliance

    PubMed Central

    Silver-Isenstadt, Jean

    2015-01-01

    Founded in 2005 by General Surgeon Lydia J Vaias, MD, MPH, the National Physicians Alliance is a 501c3 public charity with a mission to create research and education programs that promote health and foster active engagement of physicians with their communities to achieve high-quality, affordable health care for all. The National Physicians Alliance offers a professional home to physicians across medical specialties who share a commitment to professional integrity and health justice. As the organization celebrates its tenth birthday, the history and scope of this mission-aligned group are described. PMID:26176575

  20. Health care alliances and alternative dispute resolution: managing trust and conflict.

    PubMed

    Rotarius, T; Liberman, A

    2000-03-01

    The U.S. health care industry has entered an unprecedented era of alliance activity. These alliances involve medical groups and hospitals, as well as many of the newer health care entities such as managed care organizations and integrated delivery systems. The increase in organizational collaboration has resulted in an increase in organizational conflict. Alternative dispute resolution (ADR) techniques can serve as a valuable tool for mitigating this type of conflict. The role of ADR is to refocus partners' attentions away from an adversarial posture and toward a complementary existence. This will permit the partners to realize the intended outcomes of the collaboration. PMID:10915338

  1. New Kid on the Block Turns Ten! The Brief, Remarkable History of the National Physicians Alliance.

    PubMed

    Silver-Isenstadt, Jean

    2015-01-01

    Founded in 2005 by General Surgeon Lydia J Vaias, MD, MPH, the National Physicians Alliance is a 501c3 public charity with a mission to create research and education programs that promote health and foster active engagement of physicians with their communities to achieve high-quality, affordable health care for all. The National Physicians Alliance offers a professional home to physicians across medical specialties who share a commitment to professional integrity and health justice. As the organization celebrates its tenth birthday, the history and scope of this mission-aligned group is described. PMID:26176575

  2. Leadership, organizational climate, and working alliance in a children's mental health service system.

    PubMed

    Green, Amy E; Albanese, Brian J; Cafri, Guy; Aarons, Gregory A

    2014-10-01

    The goal of this study was to examine the relationships of transformational leadership and organizational climate with working alliance, in a children's mental health service system. Using multilevel structural equation modeling, the effect of leadership on working alliance was mediated by organizational climate. These results suggest that supervisors may be able to impact quality of care through improving workplace climate. Organizational factors should be considered in efforts to improve public sector services. Understanding these issues is important for program leaders, mental health service providers, and consumers because they can affect both the way services are delivered and ultimately, clinical outcomes.

  3. A systematic review of the effects of different types of therapeutic exercise on physiologic and functional measurements in patients with HIV/AIDS.

    PubMed

    Gomes-Neto, Mansueto; Conceição, Cristiano Sena; Oliveira Carvalho, Vitor; Brites, Carlos

    2013-01-01

    Several studies have reported the benefits of exercise training for adults with HIV, although there is no consensus regarding the most efficient modalities. The aim of this study was to determine the effects of different types of exercise on physiologic and functional measurements in patients with HIV using a systematic strategy for searching randomized controlled trials. The sources used in this review were the Cochrane Library, EMBASE, MEDLINE, and PEDro from 1950 to August 2012. We selected randomized controlled trials examining the effects of exercise on body composition, muscle strength, aerobic capacity, and/or quality of life in adults with HIV. Two independent reviewers screened the abstracts using the Cochrane Collaboration's protocol. The PEDro score was used to evaluate methodological quality. In total, 29 studies fulfilled the inclusion criteria. Individual studies suggested that exercise training contributed to improvement of physiologic and functional parameters, but that the gains were specific to the type of exercise performed. Resistance exercise training improved outcomes related to body composition and muscle strength, with little impact on quality of life. Aerobic exercise training improved body composition and aerobic capacity. Concurrent training produced significant gains in all outcomes evaluated, although moderate intensity and a long duration were necessary. We concluded that exercise training was shown to be a safe and beneficial intervention in the treatment of patients with HIV.

  4. The Oral HIV/AIDS Research Alliance Program: lessons learned and future directions.

    PubMed

    Shiboski, C H; Webster-Cyriaque, J Y; Ghannoum, M; Dittmer, D P; Greenspan, J S

    2016-04-01

    The Oral HIV/AIDS Research Alliance (OHARA) was established in 2006 to provide the capacity to investigate the oral complications associated with HIV/AIDS within the ACTG infrastructure. Its goals were to explore the effects of potent antiretroviral therapy (ART) on the development of opportunistic infections, and variation and resistance of opportunistic pathogens in the context of immune suppression and long-term ART. The objectives of this talk, presented as part of a plenary session at the 7th World Workshop on Oral Health and Disease in AIDS, were to (i) provide an overview of OHARA's most recent research agenda, and how it evolved since OHARA's inception; (ii) describe OHARA's main accomplishments, including examples of research protocols completed and their key findings; and (iii) describe spin-off projects derived from OHARA, lessons learned, and future directions. OHARA has met its central goal and made key contributions to the field in several ways: (i) by developing/updating diagnostic criteria for oral disease endpoints commonly measured in OHARA protocols and in HIV/AIDS research in general and has creating standardized training modules, both for measuring these oral disease endpoints across clinical specialties, and for collecting oral fluid specimens; (ii) by implementing a total of nine protocols, six of which are completed. Three protocols involved domestic research sites, while three involved international research sites (in Africa, India, and South America); (iii) and by developing and validating a number of laboratory assays used in its protocols and in the field of oral HIV/AIDS research. PMID:27109281

  5. The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints.

    PubMed

    Shiboski, C H; Patton, L L; Webster-Cyriaque, J Y; Greenspan, D; Traboulsi, R S; Ghannoum, M; Jurevic, R; Phelan, J A; Reznik, D; Greenspan, J S

    2009-07-01

    The Oral HIV/AIDS Research Alliance (OHARA) is part of the AIDS Clinical Trials Group (ACTG), the largest HIV clinical trials organization in the world. Its main objective is to investigate oral complications associated with HIV/AIDS as the epidemic is evolving, in particular, the effects of antiretrovirals on oral mucosal lesion development and associated fungal and viral pathogens. The OHARA infrastructure comprises: the Epidemiologic Research Unit (at the University of California San Francisco), the Medical Mycology Unit (at Case Western Reserve University) and the Virology/Specimen Banking Unit (at the University of North Carolina). The team includes dentists, physicians, virologists, mycologists, immunologists, epidemiologists and statisticians. Observational studies and clinical trials are being implemented at ACTG-affiliated sites in the US and resource-poor countries. Many studies have shared end-points, which include oral diseases known to be associated with HIV/AIDS measured by trained and calibrated ACTG study nurses. In preparation for future protocols, we have updated existing diagnostic criteria of the oral manifestations of HIV published in 1992 and 1993. The proposed case definitions are designed to be used in large-scale epidemiologic studies and clinical trials, in both US and resource-poor settings, where diagnoses may be made by non-dental healthcare providers. The objective of this article is to present updated case definitions for HIV-related oral diseases that will be used to measure standardized clinical end-points in OHARA studies, and that can be used by any investigator outside of OHARA/ACTG conducting clinical research that pertains to these end-points. PMID:19594839

  6. Therapist effects and the outcome—alliance correlation in cognitive behavioral therapy for panic disorder with agoraphobia

    PubMed Central

    Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2014-01-01

    Although the alliance–outcome correlation is well established, no published studies to date have separated between therapists’ and patients’ contributions while controlling for early symptom change. In this study, we examined therapist effects in two trials of CBT for panic disorder with agoraphobia (PDA) and the impact of therapists’ and patients’ contribution to the alliance on outcome and attrition in one trial. Alliance ratings were obtained from patients and therapists early and late in treatment (n = 133). Data were analyzed using multi-level modeling controlling for early symptom change. No therapist effects were found. The patients’ contribution to the alliance predicted outcome (in both panic severity and anxiety sensitivity) and attrition. The therapists’ contribution to the alliance predicted attrition but not outcome. Results suggest that the patient's contribution to the alliance plays an important role in CBT for PDA and that including common factors into research on CBT may help elucidate treatment processes. PMID:24275067

  7. Are therapeutic communities therapeutic for women?

    PubMed Central

    Eliason, Michele J

    2006-01-01

    This paper addresses the growing phenomena of therapeutic community (TC) treatment approaches for women in correctional settings. Although rapidly increasing in number across the country, there is very little empirical research to support the effectiveness of TC treatment for women. Therefore, the literature on the efficacy and effectiveness of TC treatment for women is reviewed in relation to the literature on women's treatment issues. The literature review highlights the gaps where TC treatment ignores or exacerbates issues that are common to addicted women, or uses methods that may be contradictory to women's recovery. PMID:16722560

  8. Best practices in cancer nanotechnology: perspective from NCI nanotechnology alliance.

    PubMed

    Zamboni, William C; Torchilin, Vladimir; Patri, Anil K; Hrkach, Jeff; Stern, Stephen; Lee, Robert; Nel, Andre; Panaro, Nicholas J; Grodzinski, Piotr

    2012-06-15

    Historically, treatment of patients with cancer using chemotherapeutic agents has been associated with debilitating and systemic toxicities, poor bioavailability, and unfavorable pharmacokinetics. Nanotechnology-based drug delivery systems, on the other hand, can specifically target cancer cells while avoiding their healthy neighbors, avoid rapid clearance from the body, and be administered without toxic solvents. They hold immense potential in addressing all of these issues, which has hampered further development of chemotherapeutics. Furthermore, such drug delivery systems will lead to cancer therapeutic modalities that are not only less toxic to the patient but also significantly more efficacious. In addition to established therapeutic modes of action, nanomaterials are opening up entirely new modalities of cancer therapy, such as photodynamic and hyperthermia treatments. Furthermore, nanoparticle carriers are also capable of addressing several drug delivery problems that could not be effectively solved in the past and include overcoming formulation issues, multidrug-resistance phenomenon, and penetrating cellular barriers that may limit device accessibility to intended targets, such as the blood-brain barrier. The challenges in optimizing design of nanoparticles tailored to specific tumor indications still remain; however, it is clear that nanoscale devices carry a significant promise toward new ways of diagnosing and treating cancer. This review focuses on future prospects of using nanotechnology in cancer applications and discusses practices and methodologies used in the development and translation of nanotechnology-based therapeutics. PMID:22669131

  9. "Am I going crazy, doc?": a self psychology approach to therapeutic assessment.

    PubMed

    Peters, Eric J; Handler, Leonard; White, Kathryn G; Winkel, Justin D

    2008-09-01

    In this case study, we explore the effectiveness of Therapeutic Assessment with a severely disturbed 25-year-old man, referred by his therapist, following Finn's (2007; Finn & Tonsager, 1992, 1997) model. This patient-therapist pair had been working together for approximately 2 months, but the therapy had ceased to progress. The therapist requested a clearer picture of his patient's affective functioning, interpersonal functioning, and self-functioning that might facilitate more effective treatment. Through a collaborative assessment process informed by the principles of Kohutian self psychology, the evaluator and patient slowly formed a working alliance that proved useful for the eventual communication to the patient of his psychologically tenuous reality. This case illustrates the utility of a collaborative, multimethod Therapeutic Assessment with a severely ill patient and the use of Therapeutic Assessment by a less experienced clinician.

  10. "Am I going crazy, doc?": a self psychology approach to therapeutic assessment.

    PubMed

    Peters, Eric J; Handler, Leonard; White, Kathryn G; Winkel, Justin D

    2008-09-01

    In this case study, we explore the effectiveness of Therapeutic Assessment with a severely disturbed 25-year-old man, referred by his therapist, following Finn's (2007; Finn & Tonsager, 1992, 1997) model. This patient-therapist pair had been working together for approximately 2 months, but the therapy had ceased to progress. The therapist requested a clearer picture of his patient's affective functioning, interpersonal functioning, and self-functioning that might facilitate more effective treatment. Through a collaborative assessment process informed by the principles of Kohutian self psychology, the evaluator and patient slowly formed a working alliance that proved useful for the eventual communication to the patient of his psychologically tenuous reality. This case illustrates the utility of a collaborative, multimethod Therapeutic Assessment with a severely ill patient and the use of Therapeutic Assessment by a less experienced clinician. PMID:18704801

  11. The Content of Our Cooperation, Not the Color of Our Skin: An Alliance Detection System Regulates Categorization by Coalition and Race, but Not Sex

    PubMed Central

    Pietraszewski, David; Cosmides, Leda; Tooby, John

    2014-01-01

    Humans in all societies form and participate in cooperative alliances. To successfully navigate an alliance-laced world, the human mind needs to detect new coalitions and alliances as they emerge, and predict which of many potential alliance categories are currently organizing an interaction. We propose that evolution has equipped the mind with cognitive machinery that is specialized for performing these functions: an alliance detection system. In this view, racial categories do not exist because skin color is perceptually salient; they are constructed and regulated by the alliance system in environments where race predicts social alliances and divisions. Early tests using adversarial alliances showed that the mind spontaneously detects which individuals are cooperating against a common enemy, implicitly assigning people to rival alliance categories based on patterns of cooperation and competition. But is social antagonism necessary to trigger the categorization of people by alliance—that is, do we cognitively link A and B into an alliance category only because they are jointly in conflict with C and D? We report new studies demonstrating that peaceful cooperation can trigger the detection of new coalitional alliances and make race fade in relevance. Alliances did not need to be marked by team colors or other perceptually salient cues. When race did not predict the ongoing alliance structure, behavioral cues about cooperative activities up-regulated categorization by coalition and down-regulated categorization by race, sometimes eliminating it. Alliance cues that sensitively regulated categorization by coalition and race had no effect on categorization by sex, eliminating many alternative explanations for the results. The results support the hypothesis that categorizing people by their race is a reversible product of a cognitive system specialized for detecting alliance categories and regulating their use. Common enemies are not necessary to erase important

  12. Offsetting Risks: High School Gay-Straight Alliances and Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth

    ERIC Educational Resources Information Center

    Heck, Nicholas C.; Flentje, Annesa; Cochran, Bryan N.

    2011-01-01

    Lesbian, gay, bisexual, and transgender (LGBT) youth are at risk for engaging in negative health behaviors and for experiencing at-school victimization. Specific benefits of attending a high school with a gay-straight alliance (GSA), including lower levels of suicidality, have been published; however, it is unclear whether GSAs are related to…

  13. The Leadership Alliance: Twenty Years of Developing a Diverse Research Workforce

    ERIC Educational Resources Information Center

    Ghee, Medeva; Collins, Deborah; Wilson, Valerie; Pearson, Willie, Jr.

    2014-01-01

    The Leadership Alliance is a national academic consortium currently comprising 32 academic institutions including Ivy League and major-research and minority-serving institutions, including Historically Black Colleges and Universities (HBCUs). For 2 decades these institutions have worked collaboratively to train, mentor, and support…

  14. School Reform and Decentralization in the United States: The National Alliance Experience.

    ERIC Educational Resources Information Center

    Marsh, David D.

    In the past 2 decades, the United States has had a more troubled experience in establishing common standards and decentralized authority than comparable school systems in other cultures. This paper describes how the National Center for Education and Economy (NCEE) has been working through the National Alliance (NA) for Restructuring Education to…

  15. Shaping Democratic Identities and Building Citizenship Skills through Student Activism: Mexico's First Gay-Straight Alliance

    ERIC Educational Resources Information Center

    MacGillivray, Ian K.

    2005-01-01

    In democratic societies schools play a large role in helping students learn the values and skills necessary for adult participation in a free and open society. This article is a case study of a group of students who started a Gay-Straight Alliance (GSA) at a private American school in Mexico City. The students' struggle to form and keep their GSA,…

  16. Preparing Youth for College and Career: A Process Evaluation of Urban Alliance

    ERIC Educational Resources Information Center

    Theodos, Brett; Pergamit, Michael R.; Edelstein, Sara; George, Taz; Freiman, Lesley

    2014-01-01

    This report presents baseline and process study findings of an evaluation of the Urban Alliance high school internship program, which provides training, mentoring, and work experience to high school seniors from distressed communities in Washington, DC, Baltimore, Northern Virginia, and Chicago. The report, which focuses on the program's…

  17. Gay-Straight Alliances in High Schools: Social Predictors of Early Adoption

    ERIC Educational Resources Information Center

    Fetner, Tina; Kush, Kristin

    2008-01-01

    This article examines the patterns of emergence of gay-straight alliances (GSAs) in public high schools in the United States. These extracurricular student groups offer safe spaces, social support, and opportunities for activism to lesbian, gay, bisexual, transgender, queer, and straight students. Combining data on various characteristics of…

  18. Interlibrary Loan on OCLC by Colorado Alliance of Research Libraries Member Libraries.

    ERIC Educational Resources Information Center

    Larsgaard, Mary L.

    An investigation of the interlibrary loan (ILL) borrowing patterns of six academic libraries and one large urban library--all members of the Colorado Alliance of Research Libraries (CARL)--analyzed data on transactions carried out through the OCLC ILL system during the 3 month period of March through May of 1988. The data and analyses focused on…

  19. 76 FR 35000 - Award of an Urgent Single-Source Grant to Heartland Alliance, Chicago, IL

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... HUMAN SERVICES Office of Refugee Resettlement Award of an Urgent Single-Source Grant to Heartland Alliance, Chicago, IL AGENCY: Office of Refugee Resettlement, ACF, HHS. ACTION: Notice. CFDA Number: 93.676... Immigration and Nationality Act (INA) (8 U.S.C. 1522(c)(1)(A), as amended, and the Refugee...

  20. Aboriginal Education with Anti-Racist Education: Building Alliances across Cultural and Racial Identity Politics

    ERIC Educational Resources Information Center

    St. Denis, Verna

    2007-01-01

    A critical race analysis could provide both Aboriginal students and their university student advisors with knowledge to understand and potentially challenge the effects and processes of racialization that have historically, legally, and politically divided Aboriginal communities and families. Coalition and alliances can be made within and across…