DROPOUT, EARLY TERMINATION AND DETACHMENT FROM A PUBLIC PSYCHIATRIC CLINIC

Background: Dropout from an outpatient clinic is the loss of a patient to scheduled follow-up. Due to movement of mental health care to the community, adherence to ambulatory care is crucial to maintain stability among individuals with mental disorders. We hypothesized that patients drop out from ambulatory psychiatric care when regardless of the therapist\u27s evaluation, they feel that they have recovered, or because they are dissatisfied with treatment. The aim was to examine the phenomenon of premature termination of treatment in a public community-based ambulatory psychiatric clinic serving a catchment area with a population of 200,000. Subjects and methods: The study sample was drawn from patients who had at least one ambulatory therapy session during the previous five years, immediately or shortly following initial treatment and who were subsequently lost to follow-up. Participants completed a questionnaire that evaluated their satisfaction with treatment and described their reasons for early termination of treatment. Results: The sample included eighty-two patients. Eighty percent of the responders (N=65) terminated therapy on their own, and twenty percent (N=17) decided to end treatment together with their therapists. Discussion: Increased involvement of patients in treatment planning, duration and end of therapy, may improve attendance in ambulatory mental health care settings. Conclusions: Though dropouts generally reported satisfaction with the ambulatory service, some explained early termination of treatment as being due to dissatisfaction with the therapist, the type of treatment or because of therapist turnover. Others terminated treatment because they felt their problems were solved or their conditions had improved, though therapists had determined otherwise

NGBPA Next Generation BotNet Protocol Analysis

Abstract The command & control (c&c) protocols of botnets are moving away from plaintext IRC communicationt towards encrypted and obfuscated protocols. In gen-eral, these protocols are proprietary. Therefore, standard network monitoring tools are not able to extract the commands from the collected traffic. However, if we want to monitor these new botnets, we need to know how their protocol decryption works. In this paper we present a novel approach in malware analysis for locating the en-cryption and decryption functions in botnet programs. This information can be used to extract these functions for c&c protocols. We illustrate the applicability of our approach by a sample from the Kraken botnet. Using our approach, we were able to identify the encryption routine within minutes. We then extracted the c&c protocol encryption and decryption. Both are presented in this paper.

Gastroesophageal reflux disease in surgical versus clinical literature: clinicians do not read surgical journals

BACKGROUND: Several diseases may be treated either medically or surgically; however, clinical and surgical therapies are often not treated as different options for the same patient but rather as different medical philosophies. AIM: To assess whether the main surgical and medical journals make references to their counterparts, with gastroesophageal reflux as a model of clinical/surgical disease. METHOD: It was reviewed the leading medical journals in order to verify if surgeons and clinicians make references to their counterparts on their work using gastroesophageal reflux disease as a model of a clinical/surgical disease. It was reviewed the five top-ranked journals in the field of gastroenterology, general surgery and general medicine and a neutral journal. The issues of the year 2008 of the selected journals were searched for papers dealing with gastroesophageal reflux disease. RESULTS: The search in the selected journals retrieved 49 papers, 36 (74%) in clinical journals, 5 (10%) in surgical journals, 2 (4%) in general medicine journals, and 6 (12%) in the neutral journal. Thirty one (63%) had a clinical origin, 13 (26%) a surgical origin, and 5 (10%) a neutral origin. Surgical journals published only surgical papers and general medicine journals published only clinical papers. Clinical journals and general medicine journals showed a higher proportion of clinical/surgical references compared to surgical journals (p<0.001) and the neutral journal (p<0.001). There was no differences in the proportion of clinical/surgical references when surgical and the neutral journal were compared (p=0.06). Clinical journals and general medicine journals showed a similar proportion of clinical/surgical references (p=0.06). CONCLUSION: Clinicians make significantly less references to surgical journals than surgeons do to clinical journals.RACIONAL: Várias doenças podem ser tratadas médica ou cirurgicamente; no entanto, a terapêutica clínica ou cirúrgica não é muitas vezes usada como diferente opção para o mesmo paciente, mas sim como diferente filosofia médica na abordagem. OBJETIVO: Verificar se os principais periódicos cirúrgicos e clínicos fazem referências aos seus congêneres, tendo a doença do refluxo gastroesofágico como um modelo de doença clínico/cirúrgica. MÉTODO: Foram revistos os cinco primeiros periódicos classificados na área de gastroenterologia, cirurgia geral e medicina geral e um jornal neutro. Os números do ano 2008 dos periódicos selecionados foram pesquisados no como lidar com a doença do refluxo gastroesofágico. RESULTADOS: Foram selecionados 49 trabalhos, 36 (74%) em revistas clínicas, 5 (10%) em revistas de cirurgia, 2 (4%) em revistas de medicina geral e 6 (12%) no jornal neutro. Trinta e um (63%) tiveram origem clínica, 13 (26%) cirúrgica, e 5 (10%) a origem foi neutra. Revistas cirúrgicas publicaram apenas artigos cirúrgicos e revistas de medicina geral, publicaram apenas trabalhos clínicos. Revistas e jornais de medicina clínica geral mostraram maior proporção de referências clínico/cirúrgicas em relação às revistas de cirurgia (p<0,001) e do jornal neutro (p<0,001). Não houve diferenças na proporção de referências clínico/cirúrgicas quando revistas cirúrgicas e a neutra foram comparadas (p= 0,06). Revistas clínicas e de medicina geral mostraram semelhante proporção de referências clínico/cirúrgicas (p=0,06). CONCLUSÃO: Os clínicos fazem referências significativamente menores para revistas cirúrgicas do que os cirurgiões fazem para as revistas clínicas.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departmento de CirurgiaUniversity of Chicago Department of SurgeryUNIFESP, EPM, Departmento de CirurgiaSciEL

Worm Epidemics in Wireless Adhoc Networks

A dramatic increase in the number of computing devices with wireless communication capability has resulted in the emergence of a new class of computer worms which specifically target such devices. The most striking feature of these worms is that they do not require Internet connectivity for their propagation but can spread directly from device to device using a short-range radio communication technology, such as WiFi or Bluetooth. In this paper, we develop a new model for epidemic spreading of these worms and investigate their spreading in wireless ad hoc networks via extensive Monte Carlo simulations. Our studies show that the threshold behaviour and dynamics of worm epidemics in these networks are greatly affected by a combination of spatial and temporal correlations which characterize these networks, and are significantly different from the previously studied epidemics in the Internet

Simulation-Based Graph Similarity

We present symmetric and asymmetric similarity measures for labeled directed rooted graphs that are inspired by the simulation and bisimulation relations on labeled transition systems. Computation of the similarity measures has close connections to discounted Markov decision processes in the asymmetric case and to perfect-information stochastic games in the symmetric case. For the symmetric case, we also give a polynomial-time algorithm that approximates the similarity to any desired precision

Simulations of Large-scale WiFi-based Wireless Networks: Interdisciplinary Challenges and Applications

Wireless Fidelity (WiFi) is the fastest growing wireless technology to date. In addition to providing wire-free connectivity to the Internet WiFi technology also enables mobile devices to connect directly to each other and form highly dynamic wireless adhoc networks. Such distributed networks can be used to perform cooperative communication tasks such ad data routing and information dissemination in the absence of a fixed infrastructure. Furthermore, adhoc grids composed of wirelessly networked portable devices are emerging as a new paradigm in grid computing. In this paper we review computational and algorithmic challenges of high-fidelity simulations of such WiFi-based wireless communication and computing networks, including scalable topology maintenance, mobility modelling, parallelisation and synchronisation. We explore similarities and differences between the simulations of these networks and simulations of interacting many-particle systems, such as molecular dynamics (MD) simulations. We show how the cell linked-list algorithm which we have adapted from our MD simulations can be used to greatly improve the computational performance of wireless network simulators in the presence of mobility, and illustrate with an example from our simulation studies of worm attacks on mobile wireless adhoc networks.Comment: Future Generation Computer Systems, Article in Pres