An IPsec Compatible Implementation of DBRA and IP-ABR

Satellites are some of the most difficult links to exploit in a Quality of Service (QoS) sensitive network, largely due to their high latency, variable-bandwidth and low-bandwidth nature. Central management of shared links has been shown to provide efficiency gains and enhanced QoS by effectively allocating resources according to reservations and dynamic resource availability. In a modern network, segregated by secure gateways and tunnels such as provided by IPsec, central management appears impossible to implement due to the barriers created between a global Dynamic Bandwidth Resource Allocation (DBRA) system and the mediators controlling the individual flows. This thesis explores and evaluates various through-IPsec communications techniques aimed at providing a satellite-to-network control channel, while maintaining data security for all communications involved

Attitudes and preferences about the Stepped-Care Model of depression treatment in oncology: a pilot study

The current pilot study examines the feasibility of conducting a full-scale study that utilizes a survey-based cross-sectional methodological design. The purpose was to systematically explore the attitudes about the Stepped-Care (SC) Model of depression treatment, specific treatment preferences for depression, and client characteristics of a sample of women diagnosed with breast cancer. A total of 26 women were recruited from a breast cancer clinic located in the Northeastern United States. Preliminary results indicated that participants on average rated treatments within the SC Model as acceptable, tended to prefer step three (e.g. psychotherapy, medication, or a combined approach) or step two (e.g. self-help, or psychoeducation) of the SC Model, and tended to express strong to very strong preferences. Additionally, correlational analysis indicated moderate to strong significant relationships between the severity of depressive symptoms, quantified resilience, and emotional and cognitive perceptions of the illness. The current pilot study\u27s preliminary results are to be interpreted with caution and guide future directions in conducting a full-scale study with a larger and more representative sample

Interprofessional Education Initiatives at Salus University: A Unique Perspective in both Didactic and Clinical Education

Introduction and Sequence Dr. Aravamudhan: Introduction to the Session and Presenters. Dr. Di Stefano: Introduction to Salus and IPE. Dr. Casser: IPE task force and Jeff connection Dr. Vitek : Evidence based practice –Evolution and Implementation –Lessons learned. Dr. Aravamudhan: Specifics on the CPS Initiative and wrap up

Transkulturelle Kompetenzen in der Psychotherapie - Relevanz, Training und Messung

Durch Globalisierung, Flüchtlings- und Migrationsbewegungen verändert sich die Bevölkerungszusammensetzung stetig: Immerhin 21% der Bevölkerung in Deutschland haben einen Migrationshintergrund. Zudem weisen Studien drauf hin, dass der Bedarf an psychotherapeutischer Versorgung in dieser Bevölkerungsgruppe mindestens so hoch ist, wie bei Personen ohne Migrationshintergrund – z.B. aufgrund von Flucht- und Migrationserfahrungen oder Diskriminierung (Correa-Velez, Gifford, & Barnett, 2010; Fazel, Wheeler, & Danesh, 2005; Wells, Steel, Abo-Hilal, Hassan, & Lawsin, 2016). Damit kommt es auch in der psychosozialen Versorgung immer häufiger zu transkulturellen Begegnungen. Höhere Abbrecherquoten und geringere Therapieerfolge bei Patienten aus anderen Kulturen sprechen aber dafür, dass das hiesige Therapieangebot nicht ausreichend an dieses Klientel angepasst ist. Dafür spricht auch, dass transkulturelle Kompetenzen in der Psychotherapieausbildung kaum thematisiert und in der Regelversorgung nicht standardmäßig berücksichtigt werden. Die Notwendigkeit, transkulturelle Kompetenzen in der psychotherapeutischen Versorgung zu verbessern, ist also deutlich. Im Rahmen der vorliegenden Dissertation wurde zunächst untersucht, inwiefern Unterschiede zwischen Patientengruppen unterschiedlicher Kulturen bestehen. Anschließend wurden Möglichkeiten zur Förderung und Messung transkultureller Kompetenzen untersucht, um diesen Unterschieden Rechnung zu tragen. In Studie 1 wurden subjektive Krankheitskonzepte bezüglich psychischer Störungen zwischen iranischen und deutschen Patienten bzw. Personen der subklinisch belasteten Allgemeinbevölkerung miteinander verglichen. Es zeigte sich, dass iranische Patienten höhere Werte in emotionaler Repräsentation, Kohärenz und übernatürlicher Ursachenannahme berichteten. Da das subjektive Krankheitskonzept des Patienten Auswirkungen auf Therapieplanung und –prozess hat, liegt es nahe, dass kulturelle Unterschiede in der Therapie bei Patienten aus anderen Kulturen berücksichtigt werden müssen. Dazu bedarf es transkultureller Kompetenzen auf Seiten des Psychotherapeuten. Daher wurde in Studie 2 ein online Trainingsprogramm zur Förderung transkultureller Kompetenzen bei Psychotherapeuten entwickelt und eine geplante Evaluationsstudie (RCT) zur Überprüfung seiner Wirksamkeit vorgestellt. Das Programm wurde auf Grundlage des Konzepts zu transkulturellen Kompetenzen von Sue und Kollegen (1992) entwickelt. Es besteht aus sechs Modulen, welche Informationstexte sowie Übungen zur Selbstreflexion und Fallbeispiele umfassen. Inhaltlich behandeln sie Themen wie die Rolle der eigenen kulturellen Prägung, Vorurteile und Diskriminierung, Einfluss von Migrations- und Akkulturationsprozessen sowie kulturelle Aspekte bei Störungsmodell und Diagnostik. Im Training werden Wissen und Fertigkeiten im Umgang mit Patienten aus anderen Kulturen geschult sowie die Bedeutung der individuellen kulturellen Konzepte für die therapeutische Arbeit bewusst gemacht. Ziel des RCTs ist es, die allgemeine Wirksamkeit des Trainings zu überprüfen sowie die Relevanz der praktischen Übungsanteile für die Wirksamkeit des Programms zu untersuchen. Dazu wird ein Design gewählt, in dem drei Gruppen mit einander verglichen werden: eine Trainingsgruppe, eine Edukationsgruppe sowie eine Wartekontrollgruppe. Um die Wirksamkeit des Trainingsprogramms zu untersuchen wurde in Studie 3 das Inventar zur Erfassung transkultureller Kompetenzen bei Psychotherapeuten (TKKP) entwickelt und validiert. Wie das Training basiert es auf dem Konzept transkultureller Kompetenzen von Sue und Kollegen (1992) sowie auf den allgemeinen Wirkfaktoren für Psychotherapie (Grawe, Donati, Bernauer & Donati, 1994). Der Fragebogen besteht aus 16 Items, die sich auf die Skalen Fähigkeiten, Herausforderungen-Therapeut und Herausforderungen-Beziehung verteilen. Die Subskalen des TKKP weisen eine akzeptable Reliabilität auf, die Faktorenstruktur konnte in einer konfirmatorischen Faktorenanalyse mit gutem Model-Fit bestätigt werden. Korrelationen mit dem Big-Five-Inventory-10 (Rammstedt & John, 2007) sowie dem Multicultural Counseling Inventory (Sodowsky, Taffe, Gutkin & Wise, 1994) unterstützen die diskriminante und konvergente Validität des TKKP. Insgesamt konnte die vorliegende Dissertation zeigen, dass bestehende kulturelle Unterschiede in störungs- und therapierelevanten Konzepten zwischen Patienten unterschiedlicher Herkunft in der Psychotherapie bestehen und berücksichtigt werden müssen. Dies kann über das Training von transkulturellen Kompetenzen bei Psychotherapeuten geschehen. In Zukunft sollten Trainings wie das vorgestellte weiter entwickelt und flächendeckend angeboten werden. Besonders in der psychotherapeutischen Ausbildung ist eine standardmäßige Implementierung von Workshops zu transkulturellen Kompetenzen dringend notwendig

Design of vector autoregressive processes for invariant statistics

This paper discusses the Monte Carlo (MC) design of Gaussian Vector Au- toregressive processes (VAR) for the evalutation of invariant statistics. We focus on the case of cointegrated (CI) I(1) processes, linear and invertible trans- formations and CI rank likelihood ratio (LR) tests. It is found that all VAR of order 1 can be reduced to a system of independent or recursive subsystems, of computational dimension at most equal to 2. The results are applied to the indexing of the distribution of LR test statistics for CI rank under local alternatives. They are also extended to the case of VAR processes of higher order.Invariance, Vector autoregressive process, Monte Carlo, Likeli-hood ratio test, Cointegration.

Parental attributions regarding sleep problems of children with an autism spectrum disorder or Down syndrome, and clinical research portfolio

This study aimed to investigate any difference between the attributions parents made about their child’s sleep problem, in parents of children with an Autism Spectrum Disorder and parents of children with Down Syndrome. Seventy-six parents of children with an Autism Spectrum Disorder and fifty-two parents of children with Down Syndrome completed a series of questionnaires on-line, regarding their child’s sleep problem, their beliefs about their child’s sleep problem and the parent’s level of anxiety and depression. A significant difference was found between the groups on four of the causal items; other health problem, child’s emotional state, child’s personality and diet. Parents of children with Down Syndrome showed a higher level of agreement that their child’s sleep problem could be attributed to another health problem compared to parents of children with an Autism Spectrum Disorder. Parents of children with an Autism Spectrum Disorder showed a higher level of agreement that their child’s sleep problem could be attributed to their child’s personality, their child’s emotional state and their child’s diet compared to parents of children with DS. There was a high level of agreement across all parents that their child’s disability was a causal factor to their sleep problem and differences in attributions may reflect characteristics of the child’s diagnosis. The results are consistent with previous findings that parents view disability as an important causal factor to their child’s sleep problem and suggest a possible overlap in parent’s views of their child’s sleep problem and views of their disability

Interprofessional Poverty Simulation Affects Student Attitudes Toward Poverty and Interprofessional Relationships

Purpose: Poverty simulations in health professions education involving multiple disciplines have been studied, but the impact of poverty simulations on interprofessional attitudes has been surprisingly neglected. The purpose of this study was to determine the impact of the Cost of Poverty Experience simulation on attitudes toward interprofessional communication, learning, and collaboration, while still positively impacting attitudes toward poverty. Methods: Poverty simulations were held annually at a private midwestern university involving students from multiple disciplines inside and outside healthcare. Debriefing questions related to professional roles and teamwork were used to promote discussions between students from different professions about caring for clients experiencing poverty. Data from the 2017-19 events are detailed in this article. Over the three years, 325 students participated in the study. The University of West England Interprofessional Questionnaire and the Attitudes Toward Poverty Short Form were administered pre-and post-intervention. Results: The University of West England Interprofessional Questionnaire showed a significant (ppConclusions: The interprofessional poverty simulation experience positively impacted attitudes toward interprofessional communication and relationships while still significantly improving attitudes toward poverty. This finding adds to the literature by demonstrating that interprofessional poverty simulations can positively impact attitudes toward interprofessional communication and relationships when debriefing questions guide discussions about interprofessional roles and teams in caring for those living in poverty

Optimization of ship-pack in a two-echelon distribution system

Thesis (S.M.)--Massachusetts Institute of Technology, Computation for Design and Optimization Program, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 61-62).The traditional Economic Order Quantity (EOQ) model ignores the physical limitations of distribution practices. Very often distribution centers (DC) have to deliver merchandise in manufacturer-specified packages, which can impose restrictions on the application of the economic order quantity. These manufacturer-specified packages, or ship-packs, include cases (e.g., cartons containing 24 or 48 units), inners (packages of 6 or 8 units) and eaches (individual units). For each Stock Keeping Unit (SKU), a retailer decides which of these ship-pack options to use when replenishing its retail stores. Working with a major US retailer, we have developed a cost model to help determine the optimum warehouse ship-pack. Besides recommending the most economical ship-pack, the model is also capable of identifying candidates for warehouse dual-slotting, i.e., two picking modules for the same SKU that carry two different pack sizes. We find that SKUs whose sales volumes vary greatly over time will benefit more from dual-slotting. Finally, we extend our model to investigate the ideal case configuration for a particular SKU, that is, the ideal size for an inner package.by Naijun Wen.S.M

Consultation and illness behaviour in response to symptoms: a comparison of models from different disciplinary frameworks and suggestions for future research directions

We all get ill and social scientific interest in how we respond – the study of illness behaviour – continues unabated. Existing models are useful, but have been developed and applied within disciplinary silos, resulting in wasted intellectual and empirical effort and an absence of accumulation of knowledge across disciplines. We present a critical review and detailed comparison of three process models of response to symptoms: the Illness Action Model, the Common Sense Model of the Self-Regulation of Health and Illness and the Network Episode Model. We suggest an integrated framework in which symptoms, responses and actions are simultaneously interpreted and evaluated in the light of accumulated knowledge and through interactions. Evaluation may be subconscious and is influenced by the extent to which the symptoms impose themselves, expectations of outcomes, the resources available and understanding of symptoms' salience and possible outcomes. Actions taken are part of a process of problem solving through which both individuals and their immediate social network seek to (re)achieve ‘normality’. Response is also influenced by social structure (directly and indirectly), cultural expectations of health, the meaning of symptoms, and access to and understandings of the legitimate use of services. Changes in knowledge, in embodied state and in emotions can all be directly influential at any point. We do not underestimate the difficulty of operationalising an integrated framework at different levels of analysis. Attempts to do so will require us to move easily between disciplinary understandings to conduct prospective, longitudinal, research that uses novel methodologies to investigate response to symptoms in the context of affective as well as cognitive responses and interactions within social networks. While challenging such an approach would facilitate accumulation of knowledge across disciplines and enable movement beyond description to change in individual and organisational responses