Defining Early Positive Response to Psychotherapy: An Empirical Comparison Between Clinically Significant Change Criteria and Growth Mixture Modeling

Several different approaches have been applied to identify early positive change in response to psychotherapy so as to predict later treatment outcome and length as well as use this information for outcome monitoring and treatment planning. In this study, simple methods based on clinically significant change criteria and computationally demanding growth mixture modeling (GMM) are compared with regard to their overlap and uniqueness as well as their characteristics in terms of initial impairment, therapy outcome, and treatment length. The GMM approach identified a highly specific subgroup of early improving patients. These patients were characterized by higher average intake impairments and higher pre- to-posttreatment score differences. Although being more specific for the prediction of treatment success, GMM was much less sensitive than clinically significant and reliable change criteria. There were no differences between the groups with regard to treatment length. Because each of the approaches had specific advantages, results suggest a combination of both methods for practical use in routine outcome monitoring and treatment planning

Methodological Background of Decision Rules and Feedback Tools for Outcomes Management in Psychotherapy

Systems to provide feedback regarding treatment progress have been recognized as a promising method for the early identification of patients at risk for treatment failure in outpatient psychotherapy. The feedback systems presented in this article rely on decision rules to contrast the actual treatment progress of an individual patient and his or her expected treatment response (ETR). Approaches to predict the ETR on the basis of patient intake characteristics and previous treatment progress can be classified into two broad classes: Rationally derived decision rules rely on the judgments of experts, who determine the amount of progress that a patient has to achieve for a given treatment session to be considered “on track.” Empirically derived decision rules are based on expected recovery curves derived from statistical models applied to aggregated psychotherapy outcomes data. Examples of each type of decision rule and of feedback systems based on such rules are presented and reviewed

What Happened to the ‘Development’ in Sustainable Development? Business Guidelines Two Decades After Brundtland

ABSTRACTOver 20 years ago Our Common Future presented a conceptualization and explanation of the concept of sustainable development. Since then, numerous alternative definitions of the concept have been offered, of which at least some are exclusive to each other. At the same time, the role of business in the transition to sustainable development has increasingly received attention. Bringing these two trends in sustainable development together, this paper returns to the Brundtland version of the concept to examine to what extent the original principles of sustainable development are still embedded within key business guidelines, namely the UN Global Compact, the OECD Guidelines for Multinational Enterprises, the ICC Business Charter for Sustainable Development, the CAUX Principles, the Global Sullivan Principles and the CERES Principles. The findings suggest that these business guidelines tend to emphasize environmental rather than social aspects of sustainable development, in particular to the detriment of the original Brundtland prioritization of the needs of the poorest. Furthermore, the attention to environmental aspects stresses win–win situations and has a clear managerialist focus; whereas more conceptual environmental issues concerning systems interdependencies, critical thresholds or systemic limits to growth find little attention. The normative codes and principles targeted at the private sector therefore not only add another voice to the multiple discourses on sustainable development but also contribute to a reinterpretation of the original agenda set by Brundtland towards conceptualizations of sustainable development around the needs of industrialized rather than developing countries. Copyright © 2011 John Wiley &amp; Sons, Ltd and ERP Environment.</jats:p

Factors influencing stresses in the lumbar spine after the insertion of intervertebral cages: finite element analysis

Abstract.: Intervertebral cages in the lumbar spine have been an advancement in spinal fusion to relieve low back pain. Even though initial stability is accepted as a requirement for fusion, there are other factors. The load transfer and its effect on the tissues adjacent to the cage may also play an essential role, which is not easily detectable with experimental tests. In this study the effects of an intervertebral cage insertion on a lumbar functional spinal unit were investigated using finite element analyses. The influences of cage material, cancellous bone density and spinal loading for the stresses in a functional spinal unit were evaluated. Three-dimensional (3D) finite element models of L2-L3 were developed for this purpose. An anterior approach for a monobloc, box-shaped cage was modelled. Models with cage were compared to the corresponding intact ones. The results showed that inserting a cage increased the maximum von Mises stress and changed the load transfer in the adjacent structures. Varying the cage material or the loading conditions had a much smaller influence than varying the cancellous bone density. The denser the cancellous bone, the more the stress was concentrated underneath the cage, while the remaining regions were unloaded. This study showed that the density of the underlying cancellous bone is a more important factor for the biomechanical behaviour of a motion segment stabilized with a cage, and its eventual clinical success, than the cage material or the applied load. Inserting an intervertebral cage markedly changed the load transfer. The altered stress distribution may trigger bone remodelling and explain damage of the underlying vertebra

The importance of the endplate for interbody cages in the lumbar spine

Intervertebral cages in the lumbar spine represent an advancement in spinal fusion to relieve low back pain. Different implant designs require different endplate preparations, but the question of to what extent preservation of the bony endplate might be necessary remains unanswered. In this study the effects of endplate properties and their distribution on stresses in a lumbar functional spinal unit were investigated using finite-element analyses. Three-dimensional finite-element models of L2-L3 with and without a cage were used. An anterior approach for a monobloc, box-shaped cage was modelled. The results showed that inserting a cage increased the maximum von Mises stress and changed the load distribution in the adjacent structures. A harder endplate led to increased concentration of the stress peaks and high stresses were propagated further into the vertebral body, into areas that would usually not experience such stresses. This may cause structural changes and provide an explanation for the damage occurring to the underlying bone, as well as for the subsequent subsidence of the cage. Stress distributions were similar for the two endplate preparation techniques of complete endplate preservation and partial endplate removal from the centre. It can be concluded that cages should be designed such that they rely on the strong peripheral part of the endplate for support and offer a large volume for the graft. Furthermore, the adjacent vertebrae should be assessed to ensure that they show sufficient density in the peripheral regions to tolerate the altered load transfer following cage insertion until an adequate adaptation to the new loading situation is produced by the remodelling proces

An Integrated Approach to Studying Rare Neuromuscular Diseases Using Animal and Human Cell-Based Models.

As sequencing technology improves, the identification of new disease-associated genes and new alleles of known genes is rapidly increasing our understanding of the genetic underpinnings of rare diseases, including neuromuscular diseases. However, precisely because these disorders are rare and often heterogeneous, they are difficult to study in patient populations. In parallel, our ability to engineer the genomes of model organisms, such as mice or rats, has gotten increasingly efficient through techniques such as CRISPR/Cas9 genome editing, allowing the creation of precision human disease models. Suc

Phosphorus transformations in plant-based and bio-waste materials induced by pyrolysis

Strategies are needed to increase the sustainability of phosphorus (P) fertiliser management in agriculture. This paper reports on the potential of pyrolysis treatment to recycle P from renewable materials previously regarded as wastes. The study used K-edge X-ray absorption near-edge structure (XANES) spectroscopy to examine chemical forms of P in the waste feedstock materials and corresponding biochars (pyrolysis at 480–500oC) of four ligno-cellulosic, plant-based residues and five relatively P-rich livestock and water-treatment byproducts, to acquire information on changes in potential P fertiliser value. Pyrolysis enriched P in the biochars by factors of 1.3–4.3, thus offering wide-ranging P fertiliser potential. XANES spectroscopy revealed hydroxyapatite (HAP) as one of the dominant chemical P compounds in the feedstocks, ranging from 14% (rice husks) to 98% (animal bone) of total P. For most materials, pyrolysis increased the proportion of HAP, and pyrophosphates were generated in several cases. These alterations possibly lead to diversity in the P solubility characteristics of the biochars if used as soil amendments; this is an important property of environmentally sound P fertiliser

The Non-Indigenous Ant, Solenopsis invicta, Reduces Loggerhead Shrike and Native Insect Abundance

The red imported fire ant (Solenopsis invicta Buren) is an aggressive, non-indigenous species that is a threat to native biota in the southeastern United States. We determined the effect of S. invicta on loggerhead shrike (Lanius ludovicianus L.) abundance and investigated a possible mechanism of impact, which is a reduction in insect prey availability. We used a fire ant bait (hydramethylnon) to reduce fire ant populations on one randomly chosen member of each of five pairs of 202-ha study areas in the Texas coastal Bend region, and also measured shrike relative abundance and a volumetric index of insect biomass on the study areas. Loggerhead shrike relative abundance was assessed at five counting stations established along 3.2-km transects through prairie habitat on each study area during the fall of 1992 and 1993. We sampled non-S. invicta invertebrates with 13.3-L capacity UV light traps and found that insect volume, species richness, and diversity were greater on treated sites. More shrikes were observed on areas where S. invicta populations had been reduced. Both insect biomass and shrike abundance were negatively correlated to the level of S. invicta infestation. Our data suggest that shrikes may avoid areas on wintering habitats that have been invaded by S. invicta and that this avoidance may result from reduced insect availability