Mood Lifters: Increasing Accessibility to Mental Health Care through a Novel Peer-Led Approach

Nearly one in two people will experience a mental illness over the course of their lifetime and only 43% of individuals requiring care will access it (Kessler et al., 2005; National Institute of Mental Health [NIMH], 2017). New interventions, such as e-therapy, mobile applications and workplace wellness programs, have been developed to address barriers to care; however, they have inconsistent support and many introduce new barriers to care (Barak et al., 2008; Lui et al., 2017; Ivandic et al., 2017). A new program, Mood Lifters, an intervention with peer-led skills-based group meetings, was developed to further address barriers to care. Study 1 tested the feasibility of the program and future study structure in a series of pilot studies. Results suggested that the program and study structure were feasible. Study 2 explored the results of the semi-randomized, to treatment or waitlist conditions, control trial to determine the efficacy of the program. Multiple imputation was used to account for unexpected attrition. Results indicated that individuals in the program, when compared to the waitlist control condition, saw statistically significant improvements in anxiety, and that individuals who completed more homework saw statistically significant improvements in anxiety and perceived stress. Study 3 examined the efficacy of peer leaders compared to professional leaders. Results showed that there were no differences between leader types for attendance, homework completion or mood improvement. Overall, the findings from these studies suggest that the Mood Lifters program is feasible, that individuals engaged with the Mood Lifters program experience reductions in anxiety symptoms and perceived stress, and that the program is effectively delivered by peer leaders. Taken together, this dissertation suggests that Mood Lifters may offer hope to millions of individuals struggling with anxiety, depression and problems in living.PHDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/162945/1/cmvotta_1.pd

Bronchoscopy during non-invasive ventilation in a patient with acute respiratory distress syndrome

A 72-year-old man was transferred to our hospital for refractory severe acute respiratory syndrome. On arrival, he was intubated and mechanically ventilated. Furthermore, he required veno-venous extracorporeal membrane oxygenation. Two days later, he was extubated and supported with periods of non-invasive ventilation (NIV), with a new mask. Because of large amounts of bronchial secretions that he was not able to expectorate, flexible fiberoptic bronchoscopy (FFB) was performed to remove the secretions, without interrupting NIV support. During the procedure, the patient remained hemodynamically stable, breathing spontaneously and with just a mild reduction in oxygen saturation (SpO2) (97.9% vs. 96.8%). This case report highlights the possibility of performing upper endoscopic procedures, such as FFB, during non-invasive ventilation in patients in whom this respiratory support is required and its interruption may be harmful

Situational Determinants of a Crying Response: Their Interrelations with Cognitive Structure and Level of Sex-Role Identification

An attempt was made to assess the relationships between an individual\u27s level of sex-role identification, degree of cognitive complexity or simplicity, and reported crying behavior. One hundred sixty six students from an introductory sociology class at the University of Nebraska at Omaha were administered three scales: the Bern Sex Role Inventory to assess their level of sex-role identification; the Millimet Rep Test (Version 1) to assess the degree of cognitive complexity, and the Votta Crying Scale-an instrument devised by the author to measure an individual\u27s propensity to crying and the four major types of situations that will elicit the behavior. A multivariate analysis was performed with gender and level of sex-role identification as independent variables, and the four factors on the Votta Crying Scale (the four major eliciting situations of sadness, aesthetics, nostalgia, and fear) as dependent variables. Level of sexrole identification (F(12,410)=6.17, p .0001), and gender (F(4,155)-14.7, p .0001), were both found to have a highly significant effect on an individuals\u27 crying behavior. Pearson product-moment correlations were computed between the four factors of the Votta Crying Scale and two alternate measures of cognitive complexity. No significant correlations were observed. The potential for future research into the area of emotional-response behaviors, and the possible effects of gender, and level of sex-role identification on the availability and variability of alternate response behaviors is discussed

Conversations-Aspirations: Services reimagined

In the fall of 2013, the Midwest Collaborative for Library Services (MCLS) staff began training in the process and framework of the Harwood Institute for Public Innovation; part of ALA Libraries Transforming Communities initiative. The basic tenet of the Harwood philosophy is the concept of Turning Outward ; literally changing one\u27s orientation to the community and not inward to your own organization. From the Harwood Institute; Turning Outward makes the community and the people the reference point for getting things done. Concurrent with the training MCLS began utilizing the new skills to conduct Harwood community conversations across the region. Conversation attendees were invited from all library types—public, academic, and special. As of spring 2015 MCLS has conducted over 30 community conversations in Indiana and Michigan. These conversations have included hundreds of library staff. The initial purpose for MCLS was primarily to facilitate greater engagement with its membership. However, almost immediately the potential benefits to the greater library community and the communities they serve became apparent. Harwood community conversations are designed to take between 90 minutes and two hours. They are open ended, yet directed conversations with usually from 8-12 participants. The participants begin by reflecting and describing what their aspirations for their community are. The facilitator asks specific questions to explore those concepts deeper. Within the framework of a group conversation information which would not be derived by survey or one on one interview percolates up. This information is what Harwood describes as public knowledge . Working with the public knowledge those leading the process are able to identify themes, purpose, partners, and challenges to the communities\u27 aspirations. According to Harwood, because of the common separation between formal leadership/senior administration and the respective community, this public knowledge is largely and traditionally unknown to the decision makers. The purpose for these conversations is many fold. On one level they open doors for networking and collaboration that librarians of different types, or from different institutions, would never have know existed. On another level these conversations demonstrate to librarians the value of sitting down with their community, whether town, institution or campus. By asking participants the open ended question of what they truly aspire to for their community initiates a positive conversation. Often complete strangers, quickly find common ground and purpose. The information gleaned from the conversations has been distilled and put into the context of community narratives , living documents which reflect the aspirations and challenges the community members believe to be true. Subsequently MCLS has begun to reimagine services. Many current projects sprung directly from the themes unearthed during these community conversations. This Conversations-Aspirations: Services reimagined program, will provide a brief background on the Harwood process, our steps getting to this point, what new programs derived from our conversations, and how our community has responded

A finite strain nonlinear human mitral valve model with fluid structure interaction

A simulated human mitral valve under a physiological pressure loading is developed using a hybrid finite element immersed boundary method, which incorporates experimentally based constitutive laws in a three-dimensional fluid-structure interaction framework. A transversely isotropic material constitutive model is used for characterizing the mechanical behaviour of the mitral valve tissue based on recent mechanical tests of healthy human mitral leaflets. Our results show good agreement, in terms of the flow rate and the closing and opening configurations, with the measurements from the magnetic resonance images. The stresses in the anterior leaflet are found to be higher than those in the posterior leaflet, and concentrated around the annulus trigons and free edges of the valve leaflets. Those areas are located where the leaflet has the highest curvature. Effects of the chordae tendineae in the material model are studied and the results show that these chordae play an important role in providing a secondary orifice for the flow when valve opens. Although there are some discrepancies to be overcome in future works, our simulations show that the developed computational model is promising in mimicking the in vivo mitral valve dynamics and providing important information that are not obtainable by in vivo measurements. This article is protected by copyright. All rights reserved

Preliminary Design Method of a Turbopump Feed System for Liquid Rocket Engine Expander Cycle

Abstract The present research effort deals with simplified theoretical models for the preliminary design and performances assessment of centrifugal pumps for liquid rocket propulsion. These models have been developed within the Concurrent Design Facility, under development at the Italian Aerospace Research Centre (CIRA), in the framework of the HYPROB program. In particular, this work is aimed at developing a theoretical model, via the implementation of a MatLab code, capable to predict the geometry and performance of centrifugal turbopumps, thus providing useful indications for the preliminary design of the turbopump feed system

Sources of stress for pharmacy students in a nationwide sample

Objective: The purpose of this study is to provide insight into the sources of stress experienced by current professional year pharmacy students in the United States. Methods: An online survey related to the sources of stress of current pharmacy students was distributed nationally. The survey included a section in which the respondent could choose any or all of 10 stress factors: coursework, grades, faculty, health concerns, family, current job market, finances, lack of sleep, friends, and “other.” The Perceived Stress Scale (PSS) was also administered. Frequency and distribution of stressors and stress levels across professional year was also assessed. Results: A majority of respondents reported coursework, lack of sleep, finances, and grades as stressors. A minority of participants selected family, job market, faculty, friends, health concerns and “other” stressors. Grades, lack of sleep, and faculty had the largest association with increased PSS scores. P4 students reported significantly fewer stressors than other years. More advanced students were less likely to report lack of sleep, grades, or coursework, but were more likely to select the job market. Conclusion: Academic concerns are a primary source of stress for a large majority of the sample. Development of interventions should focus on earlier professional years and emphasize the importance of sleep and physical health as students in these years report these stressors more frequently than advanced students. Further research is necessary to validate and extend the present findings

What Do Programmers of Parallel Machines Need? A Survey

We performed semistructured, open-ended interviews with 11 professional developers of parallel, scientific applications to determine how their programming time is spent and where tools could improve productivity. The subjects were selected from a variety of research laboratories, both industrial and governmental. The major findings were that programmers would prefer a global over a per-processor view of data structures, struggle with load balancing and optimizations, and need interactive tools for observing the behavior of parallel programs. Furthermore, handling and processing massive amounts of data in parallel is emerging as a new challenge