Buffer Techniques For Stochastic Resource Constrained Project Scheduling With Stochastic Task Insertions Problems

Project managers are faced with the challenging task of managing an environment filled with uncertainties that may lead to multiple disruptions during project execution. In particular, they are frequently confronted with planning for routine and non-routine unplanned work: known, identified, tasks that may or may not occur depending upon various, often unpredictable, factors. This problem is known as the stochastic task insertion problem, where tasks of deterministic duration occur stochastically. Traditionally, project managers may include an extra margin within deterministic task times or an extra time buffer may be allotted at the end of the project schedule to protect the final project completion milestone. Little scientific guidance is available to better integrate buffers strategically into the project schedule. Motivated by the Critical Chain and Buffer Management approach of Goldratt, this research identifies, defines, and demonstrates new buffer sizing techniques to improve project duration and stability metrics associated with the stochastic resource constrained project scheduling problem with stochastic task insertions. Specifically, this research defines and compares partial buffer sizing strategies for projects with varying levels of resource and network complexity factors as well as the level and location of the stochastically occurring tasks. Several project metrics may be impacted by the stochastic occurrence or non-occurrence of a task such as the project makespan and the project stability. New duration and stability metrics are developed in this research and are used to evaluate the effectiveness of the proposed buffer sizing techniques. These robustness measures are computed through the comparison of the characteristics of the initial schedule (termed the infeasible base schedule), a modified base schedule (or as-run schedule) and an optimized version of the base schedule (or perfect knowledge schedule). Seven new buffer sizing techniques are introduced in this research. Three are based on a fixed percentage of task duration and the remaining four provide variable buffer sizes based upon the location of the stochastic task in the schedule and knowledge of the task stochasticity characteristic. Experimental analysis shows that partial buffering produces improvements in the project stability and duration metrics when compared to other baseline scheduling approaches. Three of the new partial buffering techniques produced improvements in project metrics. One of these partial buffers was based on a fixed percentage of task duration and the other two used a variable buffer size based on knowledge of the location of the task in the project network. This research provides project schedulers with new partial buffering techniques and recommendations for the type of partial buffering technique that should be utilized when project duration and stability performance improvements are desired. When a project scheduler can identify potential unplanned work and where it might occur, the use of these partial buffer techniques will yield a better estimated makespan. Furthermore, it will result in less disruption to the planned schedule and minimize the amount of time that specific tasks will have to move to accommodate the unplanned tasks

What do others think? The why, when and how of using surveys in CBT

Surveys are a powerful technique in cognitive behavioural therapy (CBT). A form of behavioural experiment, surveys can be used to test beliefs, normalise symptoms and experiences, and generate compassionate perspectives. In this article, we discuss why and when to use surveys in CBT interventions for a range of psychological disorders. We also present a step-by-step guide to collaboratively designing surveys with patients, selecting the appropriate recipients, sending out surveys, discussing responses and using key learning as a part of therapy. In doing so, we hope to demonstrate that surveys are a flexible, impactful, time-efficient, individualised technique which can be readily and effectively integrated into CBT interventions

Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder

Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT. Method: The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling. Results: Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals. Conclusions: The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism

Intensive Cognitive Therapy for PTSD: A Feasibility Study

Background: Cognitive Behaviour Therapy (CBT) of anxiety disorders is usually delivered in weekly or biweekly sessions. There is evidence that intensive CBT can be effective in phobias and obsessive compulsive disorder. Studies of intensive CBT for posttraumatic stress disorder (PTSD) are lacking. Method: A feasibility study tested the acceptability and efficacy of an intensive version of Cognitive Therapy for PTSD (CT-PTSD) in 14 patients drawn from consecutive referrals. Patients received up to 18 hours of therapy over a period of 5 to 7 working days, followed by 1 session a week later and up to 3 follow-up sessions. Results: Intensive CT-PTSD was well tolerated and 85.7 % of patients no longer had PTSD at the end of treatment. Patients treated with intensive CT-PTSD achieved similar overall outcomes as a comparable group of patients treated with weekly CT-PTSD in an earlier study, but the intensive treatment improved PTSD symptoms over a shorter period of time and led to greater reductions in depression. Conclusions: The results suggest that intensive CT-PTSD is a feasible and promising alternative to weekly treatment that warrants further evaluation in randomized trials

Early screening for post-stroke depression, and the effect on functional outcomes, quality of life and mortality: a protocol for a systematic review and meta-analysis

INTRODUCTION: Post-stroke depression (PSD) is a severe complication of cerebrovascular stroke affecting about one-third of stroke survivors. Moreover, PSD is associated with functional recovery and quality of life (QOL) in stroke survivors. Screening for PSD is recommended. There are, however, differences in the literature on the impact of early screening on functional outcomes. In this systematic review, we synthesise the currently available literature regarding the associations between timing and setting of PSD screening and mortality, QOL and functional outcomes in stroke survivors. METHODS AND ANALYSIS: We will systematically search electronic databases including PubMed, Embase, APA PsycINFO, Web of Science, Scopus and CINAHL from inception to August 2021. Four reviewers will screen the title and abstract and full-text level records identified in the search in a blinded fashion to determine the study eligibility. Any selection disagreements between the reviewers will be resolved by the study investigator. Data extraction of eligible studies will be conducted by two reviewers using a predefined template. We will complete the quality assessment of included articles independently by two reviewers using the Newcastle Ottawa Scale. Eventual discrepancies will be resolved by the principal investigator. ETHICS AND DISSEMINATION: Due to the nature of the study design, ethical approval is not required. The systematic review and meta-analysis findings will be published and disseminated in a peer-reviewed journal. Our results will also be disseminated through posters and presentations at appropriate scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42021235993

Interventions to promote access to eye care for non-Indigenous, non-dominant ethnic groups in high-income countries: a scoping review protocol.

INTRODUCTION: For many people, settling in a new country is associated with a new identity as an 'ethnic minority', one that can remain through future generations. People who are culturally distinct from the dominant population group may experience a variety of barriers to accessing healthcare, including linguistic and cultural barriers in communication, navigation of an unfamiliar health system and unconscious or overt discrimination. Here, we outline the protocol of a scoping review to identify, describe and summarise interventions aimed at improving access to eye care for non-Indigenous, non-dominant ethnic groups residing in high-income countries. METHODS AND ANALYSIS: We will search MEDLINE, Embase and Global Health from their inception to July 2019. We will include studies of any design that describe an intervention to promote access to eye care for non-Indigenous, non-dominant ethnic groups. Two authors will independently review titles, abstracts and full-text articles for inclusion. Reference lists from all included articles will also be searched. In cases of disagreement between initial reviewers, a third author will help resolve the conflict. For each included article, we will extract data about the target population, details of the intervention delivered and the effectiveness of or feedback from the intervention. Overall findings will be summarised with descriptive statistics and thematic analysis. ETHICS AND DISSEMINATION: This review will summarise existing literature and as such ethics approval is not required. We will publish the review in an open-access, peer-reviewed journal, and draft appropriate summaries for dissemination to the wider community. This wider community could include clinicians, policymakers, health service managers and organisations that work with non-dominant ethnic groups. Our findings will also feed into the ongoing Lancet Global Health Commission on Global Eye Health

Evaluation of a Brief Marriage Intervention for Internal Behavioral Health Consultants in Military Primary Care

Military couples face significant challenges to their relationships including demanding schedules, multiple deployments, and frequent moves. Despite the high costs of chronic marital distress, very few military (or civilian) couples seek marriage therapy. The military services and the VA system have implemented collaborative care models in primary care where internal behavioral health consultants are integrated into primary care. Integrated primary care can reduce the stigma of behavioral health services and may increase the odds that couples would seek help earlier. There are no established couple interventions designed for use in primary care. The purpose of this presentation is to describe a program of research focused on adapting and validating The Marriage Checkup (MC) for use in an integrated primary care clinic.https://corescholar.libraries.wright.edu/urop_celebration/1019/thumbnail.jp

Intravital FRAP imaging using an E-cadherin-GFP mouse reveals disease- and drug-dependent dynamic regulation of cell-cell junctions in live tissue

E-cadherin-mediated cell-cell junctions play a prominent role in maintaining the epithelial architecture. The disruption or deregulation of these adhesions in cancer can lead to the collapse of tumor epithelia that precedes invasion and subsequent metastasis. Here we generated an E-cadherin-GFP mouse that enables intravital photobleaching and quantification of E-cadherin mobility in live tissue without affecting normal biology. We demonstrate the broad applications of this mouse by examining E-cadherin regulation in multiple tissues, including mammary, brain, liver, and kidney tissue, while specifically monitoring E-cadherin mobility during disease progression in the pancreas. We assess E-cadherin stability in native pancreatic tissue upon genetic manipulation involving Kras and p53 or in response to anti-invasive drug treatment and gain insights into the dynamic remodeling of E-cadherin during in situ cancer progression. FRAP in the E-cadherin-GFP mouse, therefore, promises to be a valuable tool to fundamentally expand our understanding of E-cadherin-mediated events in native microenvironments

Interventions to promote access to eyecare for non-dominant ethnic groups in high-income countries: a scoping review

Purpose People who are distinct from the dominant ethnic group within a country can experience a variety of barriers to accessing eyecare services. We conducted a scoping review to map published interventions aimed at improving access to eyecare for non-Indigenous, non-dominant ethnic groups residing in high-income countries. Methods We searched MEDLINE, Embase and Global Health for studies that described an intervention to promote access to eyecare for the target population. Two authors independently screened titles and abstracts followed by review of the full text of potentially relevant sources. For included studies, data extraction was carried out independently by two authors. Findings were summarised using a combination of descriptive statistics and thematic analysis. Results We screened 5220 titles/abstracts, of which 82 reports describing 67 studies met the inclusion criteria. Most studies were conducted in the USA (90%), attempted to improve access for Black (48%) or Latinx (28%) communities at-risk for diabetic retinopathy (42%) and glaucoma (18%). Only 30% included the target population in the design of the intervention; those that did tended to be larger, collaborative initiatives, which addressed both patient and provider components of access. Forty-eight studies (72%) evaluated whether an intervention changed an outcome measure. Among these, attendance at a follow-up eye examination after screening was the most common (n=20/48, 42%), and directly supporting patients to overcome barriers to attendance was reported as the most effective approach. Building relationships between patients and providers, running coordinated, longitudinal initiatives and supporting reduction of root causes for inequity (education and economic) were key themes highlighted for success. Conclusion Although research evaluating interventions for non-dominant, non-Indigenous ethnic groups exist, key gaps remain. In particular, the paucity of relevant studies outside the USA needs to be addressed, and target communities need to be involved in the design and implementation of interventions more frequently

The Huqoq Excavation Project : 2014-2017 interim report

Excavations at Huqoq in Israel’s eastern Lower Galilee are bringing to light a Late Roman synagogue, a medieval public building, and the remains of ancient and modern (pre-1948) villages. In this interim report, we describe the major discoveries of the 2014–2017 seasons, including the extraordinary figural mosaics decorating the synagogue floor. Our discoveries provide evidence of a Galilean Jewish community that flourished through the 5th and 6th centuries c.e.—a picture contrasting with recent claims of a decline in Jewish settlement under Byzantine Christian rule. The possibility that the medieval public building might also be a synagogue has important implications for understanding Galilean Jewish settlement in the Middle Ages, about which almost nothing is known. The excavations also shed light on the last phase of the settlement’s long history: the development of the modern village of Yakuk in the 19th through 20th centuries.peer-reviewe