below are the first 10 and last 10 pages of uncorrected machine - read text ( when available ) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole. intended to provide our own search engines and external engines with highly rich, chapter - representative searchable text on the opening pages of each chapter. because it is uncorrected material, please consider the following text as a useful but insufficient proxy for the authoritative book pages. do not use for reproduction, copying, pasting, or reading ; exclusively for search engines. ocr for page 467 reducing risks for mental disorders : frontiers for preventive intervention research 13 conclusions and recommendations : an agenda for the next decade when president roosevelt announced in 1937 that “ one third of our nation are ill housed, ill clad, ill nourished, ” our country was galvanized into action. yet today, when careful population studies tell us that as many as one third of american adults will suffer a diagnosable mental disorder sometime in their life and that 20 percent have a mental disorder at any given time, there is little alarm. the institute of medicine ' s committee on prevention of mental disorders believes that strong action is warranted, and with this report it calls on the nation to mount a significant program to prevent mental disorders. although research on the causes and treatment of mental disorders remains vitally important — and indeed major advances are leading to better lives for increasing numbers of people — much greater effort than ever before needs to be directed to prevention. public health experience has shown that when a critical mass of knowledge regarding a specific health problem accumulates and a core group of expert researchers have been identified, the time is ripe for launching a larger, coordinated research and training endeavor. the committee believes that such a moment has arrived for the field of mental health. opportunities now exist to effectively exploit existing knowledge to launch a promising research agenda on the prevention of mental disorders. therefore the committee strongly recommends that an enhanced research agenda to prevent mental disorders be initiated and supported across all relevant federal agencies, including, but not limited to, the departments of health and human services, education, justice, labor, defense, and ocr for page 468 reducing risks for mental disorders : frontiers for preventive intervention research housing and urban development, as well as state governments, universities, and private foundations. this agenda should facilitate development in three major areas : building the infrastructure to coordinate research and service programs and to train and support new investigators. expanding the knowledge base for preventive interventions. conducting


, as well as state governments, universities, and private foundations. this agenda should facilitate development in three major areas : building the infrastructure to coordinate research and service programs and to train and support new investigators. expanding the knowledge base for preventive interventions. conducting well - evaluated preventive interventions. as previously stated, the committee ' s recommendations for funding of rigorous preventive intervention research are based on its best estimates of current efforts and its judgment of needed resources to create a robust federal research agenda. the committee finds the need for prevention of mental disorders so great and the current opportunities for success so abundant that it recommends an increased investment across all federal agencies over the next five years ( 1995 through 1999 ) to facilitate the development of these three major areas of the research agenda. it recommends increased support of $ 50. 5 million per year for the next two years, $ 53 million in year three, and $ 61 million per year in years four and five. these are modest increases considering the magnitude of the problem of mental illness in this country, and congress may decide that an even greater investment is warranted. funding for the second five years should be recommended by a new coordinating body, such as a national scientific council on the prevention of mental disorders. the amount appropriated in year six should be no less than the amount of support in fy 1999. on the basis of positive results in the first five years, a considerably larger investment could be warranted during the second five years. the three major areas to be developed are recommended in conjunction with use of the definitions of interventions for mental disorders and of prevention research developed in this report. the term prevention is reserved for only those interventions that occur before the initial onset of a disorder. these preventive interventions can be further classified into universal, selective, and indicated types. the term prevention research refers only to preventive intervention research and is distinct from research that builds a broad scientific base for preventive interventions. building an enhanced infrastructure for preventive intervention research preventive intervention research for mental disorders cannot thrive without providing for its infrastructure. two areas are particularly important for moving ahead — coordination and research training. ocr for page 469 reducing risks for mental disorders : frontiers for preventive intervention research the coordination role and structure coordination among federal agencies is needed for four reasons : ( 1 ) variation in the application of definitions has made it virtually impossible to assess the current activities and expenditures in preventive intervention research ; ( 2 ) duplication of research activities and the lack of piggybacking of smaller projects onto larger ones contribute to waste of dollars and time


application of definitions has made it virtually impossible to assess the current activities and expenditures in preventive intervention research ; ( 2 ) duplication of research activities and the lack of piggybacking of smaller projects onto larger ones contribute to waste of dollars and time, and, at the same time, gaps in research go undetected ; ( 3 ) agencies conduct research or provide interventions for mental disorders ( including addictions ), educational disabilities, criminal behavior, and physical disorders as though these were separate conditions, whereas, more often than not, coexisting disorders or problems occur ; and ( 4 ) agencies have different strengths ; for example, some are better at applying rigorous research methodologies to intervention programs, whereas others are better at reaching out into communities and forging alliances. in arriving at its recommendations about coordination, the committee reviewed various alternatives. the decisions to be made include ( 1 ) how best to coordinate the various relevant activities, ( 2 ) where the coordination function should reside within the federal government, and ( 3 ) staffing and funding issues. the structure and function of the coordination mechanism are inextricably intertwined, so decisions 1 and 2 above cannot be readily separated. staff and funding should be attached to the coordination mechanism wherever it is located. four alternatives were considered regarding where the coordination function should reside. although the committee does express a preference for coordination at the highest possible level, it believes that establishing a successful coordination mechanism across federal departments is more important than the details of where it is housed. initially, the committee considered the model of putting a coordination role in one agency, such as the national institute of mental health ( nimh ) or the national institutes of health ' s ( nih ) office of disease prevention. locating the coordination role in a single agency is a natural way to keep coordination close to the science, because the personnel in nimh or the director ' s office at nih are likely to be more closely connected to the scientific network than those higher in the government. although single agencies have mediated coordination among other parts of the same department and even among branches of different executive departments in the past, the breadth and extent of the need for multiagency collaboration in this case make a single agency lead seem unrealistic. one possible exception is the centers for disease control and prevention ( cdc ), which has a public health mandate for ocr for page 470 reducing risks for mental disorders : frontiers for preventive intervention research prevention activities and considerable experience in working collaboratively with federal, state, and local agencies. coordination from


and prevention ( cdc ), which has a public health mandate for ocr for page 470 reducing risks for mental disorders : frontiers for preventive intervention research prevention activities and considerable experience in working collaboratively with federal, state, and local agencies. coordination from an office within one department that serves as an umbrella over several relevant agencies is a second alternative. the office of the assistant secretary for health within the department of health and human services ( dhhs ) already contains an office for disease prevention and health promotion. this office could be charged with forming a subcommittee or task group to focus specifically on the coordination of research aimed at preventing mental disorders and substance abuse. these preventive efforts share many features with other disorders already subject to coordination within this office, but the involvement of the criminal justice system, the educational system, child and spousal protective services, civilian and military family support services, and other nonmedical services necessarily encompasses activities in an even broader array of federal agencies. many of these services are housed in entirely separate cabinet departments. the committee thus believes that coordination at the departmental level is preferable to coordination by a single agency ( with the possible exception of cdc ), but the nature of the problem may well necessitate a higher - level coordination mechanism. as a third alternative, the committee considered models developed within congress, such as the physician payment review commission ( pprc ) and the prospective payment assessment commission ( propac ), for which appointments are made by an independent body — the office of technology assessment. the question regarding these models is how well they would work in the prevention field, where many of the activities center on coordination of ongoing programs conducted within the executive branch. as a fourth alternative, the committee considered other successful models — the ongoing white house conferences, various presidential commissions, and the office of science and technology policy ( ostp ) — within the white house. ostp was originally created by president eisenhower to focus national attention on science ; after being disbanded, it was reestablished by president ford upon the recommendation of the national academy of sciences ( 1974 ). this model has three components : ( 1 ) an office having coordinating responsibility regarding national science policy, ( 2 ) an individual who serves as the president ' s science advisor, and ( 3 ) a council with expertise in a broad range of scientific matters. the advantages of having a coordination structure under the white house are that it is at a natural level for coordinating activities of different cabinet departments and that it places a premium on interagency cooperation, which the committee believes is an essential element. o


matters. the advantages of having a coordination structure under the white house are that it is at a natural level for coordinating activities of different cabinet departments and that it places a premium on interagency cooperation, which the committee believes is an essential element. ocr for page 471 reducing risks for mental disorders : frontiers for preventive intervention research the committee thus leans toward the establishment of an overarching federal council, operated out of the white house office of science and technology policy or another coordinating office within the executive office of the president, to coordinate preventive intervention research. it recognizes that research and services related to the prevention of mental disorders have high relevance to the many other agendas and priorities of congress and the president. these include the lack of high - quality education, deteriorating cities, drug problems, the lack of housing, poverty, and the lack of universal health care. mental disorders contribute to these problems and vice versa ; therefore the ultimate solutions must be broad in scope. adequate staffing and resources are essential to successful coordination of prevention research regardless of where it is located in the federal government. moreover, the quality of leadership and extent of commitment among agencies are often far more important than the precise location of a coordination office. leadership and commitment cannot be fully controlled, no matter how careful the plans may be. the competence of the particular individuals chosen to lead the effort and the politics of the day often determine whether interagency coordination is truly successful or merely an effort that consumes staff time and wastes increasingly scarce federal dollars. despite these caveats, the committee nonetheless believes that a coordinating committee at the highest possible level with adequate staffing is necessary to weave together disparate federal activities in many different departments. the committee strongly recommends that a mechanism be created to coordinate research and services on prevention of mental disorders across the federal departments. one model for accomplishing this would be the establishment of a national scientific council on the prevention of mental disorders by congress and / or the president. such an overarching federal council could be operated out of the white house office of science and technology policy or another coordinating office within the executive office of the president. this council should formulate policies regarding preventive intervention research, evaluation of prevention services, knowledge exchange, coordination of interagency research efforts, and training. because prevention activities span different departments, the members of the council should be appointed after soliciting nominations from a wide constituency who are willing to use the definitions and rigorous methodological criteria developed in this report to foster policies that will reduce the onset of mental disorders and related


span different departments, the members of the council should be appointed after soliciting nominations from a wide constituency who are willing to use the definitions and rigorous methodological criteria developed in this report to foster policies that will reduce the onset of mental disorders and related problems. members should include — as equal partners — ex - officio high - level representatives of relevant federal agencies, including but not limited to the departments of ocr for page 472 reducing risks for mental disorders : frontiers for preventive intervention research health and human services, justice, labor, education, defense, and housing and urban development, as well as representatives from state agencies, private foundations, universities, and the public at large. a broad range of disciplines, including medicine ( pediatrics, child psychiatry, psychiatry, primary care ), psychology, nursing, social work, public health, sociology, and epidemiology, should be represented. the council should meet regularly to coordinate collaborative research across public and private agencies and should monitor the standards for rigorous methodological approaches to preventive intervention research. terms on the council for nonfederal representatives should be limited. to provide ongoing executive leadership, the chair of the council should be appointed by the president. other leadership positions could be selected from the nonfederal representatives. the council should have its own paid staff, including a coordinator with staff, who operates out of an office of prevention of mental disorders. the office should oversee and coordinate the daily operations of preventive intervention activities in all areas that are related to mental health across the federal government. the staff of the office should be responsible to the council. the council should report regularly, at least once a year, to the congress and the president. the committee also strongly recommends that congress encourage the establishment of offices for prevention of mental disorders at the state level. the current number of such offices is small even though the states have resources for prevention available to them through the state block grants. a mechanism to encourage the development of state offices would be a requirement attached to the block grants, and as health care reform is developed other possibilities may occur. the functions of these offices should be similar to those of the proposed national scientific council on the prevention of mental disorders. states that do establish such offices should, as a group, elect representatives to the national scientific council. agencies must be required to identify their funded programs for the prevention of mental disorders, separately accounting for universal, selective, and indicated preventive interventions, using the definitions developed in this report. congress should ask for separate accounting of these different kinds of preventive interventions


must be required to identify their funded programs for the prevention of mental disorders, separately accounting for universal, selective, and indicated preventive interventions, using the definitions developed in this report. congress should ask for separate accounting of these different kinds of preventive interventions when agencies report on the activities they support. the national institute of mental health ( nimh ), the national institute on alcohol abuse and alcoholism ( niaaa ), and the national institute on drug abuse ( nida ) should consider including prevention researchers with broad mental health perspectives on their national advisory councils. the prevention research field must produce more researchers of international stature who can serve on such advisory councils. ocr for page 473 reducing risks for mental disorders : frontiers for preventive intervention research mental health reimbursement from existing health insurance should be provided for preventive interventions that have proved effective under rigorous research standards such as those described in this report. dissemination activities should receive much higher priority than they have in the past. agencies should disseminate results of research trials as well as evaluations of preventive intervention service programs. funding of research trials should be continued only when investigators demonstrate a good publication record ( including theoretical formulations and data from research trials ). interagency research conferences should be encouraged. a federal clearinghouse on preventive interventions in the mental health field should be considered, either as part of the council ' s function or as a separately funded initiative. research training training is an immediate and critical need in preventive intervention research. congress and federal agencies should immediately take steps to develop and support the training of additional researchers who can develop new preventive intervention research trials as well as evaluate the effectiveness of current service projects. this training effort should include consortiums, seminars, fellowships, and research grants to attract existing researchers into prevention research, training programs for new investigators, and expansion of the training component of the specialized prevention research centers. research training should be focused on two groups — mid - career scientists and postdoctoral students. training for these groups should be developed simultaneously, but the expectation is that the training efforts for these groups will produce two waves of personnel. as an immediate strategy, training opportunities with adequate stipends should be developed to attract talented mid - career scientists from related fields, such as risk research, epidemiology, treatment effectiveness research, and research on prevention of physical illnesses, who seek to make the transition to research on prevention of mental disorders. this could be done through existing fellowships and career development awards and through the development of creative consortiums, seminars, and mentoring. all


research, and research on prevention of physical illnesses, who seek to make the transition to research on prevention of mental disorders. this could be done through existing fellowships and career development awards and through the development of creative consortiums, seminars, and mentoring. all training should be tailored to the needs and schedules of these scientists. such training could have a substantial impact on the number of personnel within three years if there is a simultaneous increase in the funds available for peer - reviewed research projects ( ro1s ). as a second strategy, training opportunities with sufficient stipends should be developed to attract talented postdoctoral - level trainees to preventive intervention research. much more effort should be made to ocr for page 474 reducing risks for mental disorders : frontiers for preventive intervention research attract trainees from a wide range of disciplines, including psychiatry, pediatrics, social work, nursing, public health, epidemiology, neuroscience, anthropology, and sociology, as well as psychology, which dominates the field today. if efforts to boost doctoral training begin concurrently with mid - career training, we might expect to see the benefits of an increased pool of researchers capable of securing their own research grants by year five of a 10 - year plan. the number of institutional training programs focusing on preventive intervention research should be increased from 5 to 12 over the next five years, including one at every specialized prevention research center, known at nimh as preventive intervention research centers ( pircs ), that is productive. training of mid - career scientists and postdoctoral students should occur within every specialized prevention research center. to ensure that this happens, funding of specialized prevention research centers should be continued only when they demonstrate good track records in the production of published research and in the training of researchers capable of procuring their own research grants. in addition to the specialized prevention research centers, research training should be supported by federal agencies, schools of public health, and schools traditionally linked to service, such as social work, education, nursing, and medicine. support for faculty within institutional training programs should be increased. such support should increase the capacity of the faculty, program, and university to train preventive intervention researchers. a major effort should be made to encourage the prevention research training of minorities. support should be offered to minority mental health research centers and other centers that focus on specific populations, such as low - income groups, the elderly, and minority groups. this would add more researchers to the field, but even more importantly, they would be researchers who specialize in populations with special needs. the


other centers that focus on specific populations, such as low - income groups, the elderly, and minority groups. this would add more researchers to the field, but even more importantly, they would be researchers who specialize in populations with special needs. the proposed national scientific council on the prevention of mental disorders should reevaluate the training needs for preventive intervention research after the first five years. at that point the emphasis on mid - career scientists might be able to be decreased. if so, support for predoctoral training could be increased. an emphasis on postdoctoral training should be consistently high throughout the decade. funding coordination and training are the two most immediate and important needs in preventive intervention research on mental disorders ( see ocr for page 475 reducing risks for mental disorders : frontiers for preventive intervention research table 13. 1 recommendations for federal government support above 1993 level of support ( dollars in millions ) 1995 1996 1997 1998 1999 infrastructure council / office / dissemination 2. 0 2. 0 2. 0 2. 0 2. 0 training 12. 0 12. 0 12. 0 12. 0 12. 0 knowledge base research risk and protective factor research ( biological / psychosocial interaction ) 6. 5 6. 5 6. 5 6. 5 6. 5 child epidemiological study 2. 5 2. 5 2. 5 2. 5 2. 5 population studies 5. 0 5. 0 5. 0 5. 0 5. 0 mental health promotion study 0. 5 0. 5 0 0 0 prevention research preventive intervention research projects 20. 0 20. 0 20. 0 25. 0 25. 0 preventive intervention research centers 2. 0 2. 0 5. 0 8. 0 8. 0 total budget 50. 5 50. 5 53. 0 61. 0 61. 0 note : figures are based on 1993 dollar amounts and are not adjusted for inflation. these recommendations for support are based on the committee ' s best estimates of current efforts and its judgment of needed resources to create a robust preventive intervention research agenda for mental disorders across the federal government. table 13. 1 ). the national scientific council on the prevention of mental disorders and the office of prevention of mental disorders should have a combined budget of $ 1 million per year for five years. dissemination activities should be budgeted at $ 1 million per year for five years. support for training should be budgeted at $ 12 million above the current level for year one, and this level of funding should be maintained for each of the next four years. in the first


budgeted at $ 1 million per year for five years. support for training should be budgeted at $ 12 million above the current level for year one, and this level of funding should be maintained for each of the next four years. in the first few years, these researchers are needed for evaluating current prevention service projects ; gradually, they also will be conducting original preventive intervention research projects. stipends for mid - career scientists should be in the $ 60, 000 to $ 120, 000 range, plus travel expenses. stipends for postdoctoral trainees should be in the $ 30, 000 to $ 60, 000 range, plus travel expenses. expanding the knowledge base the committee believes, based on the review of literature for this report, that a viable research agenda for prevention of mental disorders rests on a firm stratum of health research in other fields. this knowledge base includes basic and applied research in the core sciences that is aimed at the causes and prevention of mental disorders. included in this ocr for page 476 reducing risks for mental disorders : frontiers for preventive intervention research knowledge base are neurosciences, genetics, epidemiology, psychiatry, behavioral sciences ( including developmental psychopathology ), and risk research. it also includes evidence and lessons from other fields of research, such as prevention of physical illness and treatment of mental disorders. research to expand the knowledge base for preventive interventions should be continued. knowledge base research should continue to be supported for all five disorders reviewed in this report, in addition to other mental disorders. basic research is essential to the understanding of mental disorders. new funds for the development of other knowledge base areas and for preventive intervention research should not be taken from funds currently used to support basic science. the committee also recommends that support be increased for the three specific knowledge base areas outlined below. support of basic research will ensure the quality and continuity of the existing research effort and attract new investigators to those fields. support for research on potentially modifiable biological and psychosocial risk and protective factors for the onset of mental disorders should be increased. priority should be given to research, regardless of the type of mental disorder, that illuminates the interaction of potentially modifiable biological and psychosocial risk and protective factors, rather than restricting the research to either biological or psychosocial factors. nimh should support a series of prospective studies on well - defined general populations under the age of 18 to provide initial benchmark estimates of the prevalence and incidence of mental disorders and problem behaviors in this age group. these


or psychosocial factors. nimh should support a series of prospective studies on well - defined general populations under the age of 18 to provide initial benchmark estimates of the prevalence and incidence of mental disorders and problem behaviors in this age group. these epidemiological investigations should be oriented toward diagnosis but also should record a range of symptomatology, so that future changes in the diagnostic system, or developmental changes in individuals, do not preclude understanding of the development of psychopathology throughout this age range and into adult life. these prospective studies also should be oriented toward identification of modifiable risk factors in this age group with the explicit goal of recommending modifiable targets for preventive interventions in the future. a population laboratory should be established with the capacity for conducting longitudinal studies over the entire life span in order to generate understanding as to how risk factors and developmental transitions combine to influence the development of psychopathology. the primary goal of this laboratory should be the enhancement of knowledge for prevention and the development of new knowledge for the implementation of preventive intervention trials. special attention should be paid to developmental transitions, such as childhood to adolescence, adolescence to adult - ocr for page 477 reducing risks for mental disorders : frontiers for preventive intervention research hood, entry into marriage, and loss of a spouse ; precursor signs and symptoms, prodromal periods, age periods just prior to when a specific mental disorder is most likely to occur ; and the effects of race, ethnicity, and gender. well - designed preventive intervention research trials might be conducted with these populations during the follow - up, as long as the goal of obtaining benchmark estimates of epidemiological data, especially in regard to developmental transitions, is not threatened. the population laboratory could be established as a branch in the intramural program of nimh, although there are advantages to making it a multiagency project funded through agreements among dhhs agencies such as the centers for disease control and prevention ( cdc ), substance abuse and mental health administration ( samhsa ), national institute on drug abuse ( nida ), national institute on alcohol abuse and alcoholism ( niaaa ), national institute of mental health ( nimh ), national institute of child health and human development ( nichd ), and maternal and child health bureau ( mchb ), and departments such as the departments of justice, education, and defense. it could also be established as a unit outside the federal government funded through a special mechanism. an extragovernmental advisory


and maternal and child health bureau ( mchb ), and departments such as the departments of justice, education, and defense. it could also be established as a unit outside the federal government funded through a special mechanism. an extragovernmental advisory panel, including experts in epidemiology, psychopathology, and prevention, should be formed to provide continuing scientific oversight to the population laboratory. data from investigations of the population laboratory should be made available in anonymous form in a regular and timely fashion. whenever possible, research proposals relevant to the knowledge base for preventive interventions should explicitly state this connection, such as identification of potentially modifiable risk factors and possible avenues for preventive interventions. this requirement should be applied across all federal agencies, and especially to research proposals funded from the additional support recommended by this committee. this clarification of relevance to prevention will help decrease confusion regarding definitions of prevention research and lead to findings relevant to preventive interventions. treatment intervention research conducted under rigorous methodological standards that is directly relevant to preventive intervention research should continue to be supported — but not from the prevention research budget. the criteria for “ direct relevance ” should be reviewed by prevention researchers. collaboration between treatment researchers and prevention researchers should be fostered. principles from treatment research can and should be borrowed for use in prevention. specialty areas in treatment research that are likely to yield payoffs for preventive intervention research include clinical psychopharmacology, cognitive - behavior therapy, and applied behavior analysis. ocr for page 478 reducing risks for mental disorders : frontiers for preventive intervention research research should continue to be supported to determine which risk and protective factors are similar and which ones are different for treatment and prevention of a variety of mental disorders. identifying potentially modifiable factors that are unique to first onset of a disorder increases possibilities for prevention. research should be supported to study the effects of social environments, such as families, peers, neighborhoods, and communities, on the individual and the effects of context on the onset of various mental disorders. researchers working on relevant research in the core sciences should be encouraged to participate in activities such as forums and colloquia with preventive intervention researchers. a comprehensive, descriptive inventory of the activities in which the public engages to promote psychological well - being and mental health should be developed and supported. this catalog of mental health promotion activities is expected to be substantial. preliminary efforts should also be made to craft outcome criteria for these activities that could be used in rigorous evaluations down the road. funding the committee recommends that $ 6. 5 million be


. this catalog of mental health promotion activities is expected to be substantial. preliminary efforts should also be made to craft outcome criteria for these activities that could be used in rigorous evaluations down the road. funding the committee recommends that $ 6. 5 million be budgeted each year for the next five years for risk research on the complex interaction between biological and psychosocial risk and protective factors. this would augment the research base for those mental disorders furthest along the continuum in the understanding of etiology, emphasizing the identification of malleable risk factors that would augur well for further preventive intervention research. a child epidemiological study should be budgeted at a minimum of $ 2. 5 million per year over the next five years, and a population laboratory should be budgeted at $ 5 million per year over the next five years. over a two - year period, $ 1 million should be allocated to catalog mental health promotion activities and to craft outcome criteria. conducting well - evaluated interventions the knowledge base for some mental disorders is now advanced enough that preventive intervention research programs, targeted at risk factors for these disorders, can rest on sound conceptual and empirical foundations. increased methodological rigor in all research trials, demonstration projects, and service program evaluations should be required. wherever ocr for page 479 reducing risks for mental disorders : frontiers for preventive intervention research possible, the standards developed in this report, including hypothesis - driven randomized controlled trials and assessment of multiple outcome measures over time, should be instituted. the concept of risk reduction, including the strengthening of protective factors, should be used as the best available theoretical model for guiding interventions to prevent the onset of mental disorders. other models for preventive interventions should continue to be explored ; for example, as more becomes known about the mechanisms that link the presence of causal risk factors and absence of protective factors to the initial onset of symptoms, the possibilities for intervention may be increased. universal preventive interventions should continue to be supported in the areas of prenatal care, immunization, safety standards such as the use of seat belts and helmets, and control of the availability of alcohol. these programs decrease brain injury and mental retardation, which are conditions associated with mental disorders. although the main benefit of these interventions is the prevention of physical illness or injury, they may reduce the incidence of mental disorders as well. more evaluation is needed to assess their impact on mental disorders. research on selective and indicated interventions targeting high - risk groups and individuals should be given high priority. many of the programs described


or injury, they may reduce the incidence of mental disorders as well. more evaluation is needed to assess their impact on mental disorders. research on selective and indicated interventions targeting high - risk groups and individuals should be given high priority. many of the programs described in this report are selective preventive intervention research programs, targeting multiple risk factors including poverty, job loss, caregiver burden, bereavement, medical problems, divorce, peer rejection, academic failure, and family conflict. these programs provide an impressive base for more rigorous research trials with larger samples. priority should be given to preventive intervention research proposals that address well - validated clusters of biological and psychosocial risk and protective factors within a developmental life - span framework. trials should measure short - and long - term outcomes for targeted disorders and should continue past the average age of onset. sample size should be adequate for determining the validity of outcome measures. increased attention should be given to preventive intervention research that addresses the overlap between physical and mental illness. for example, prevention trials with primary care populations should include examination of effects on physical well - being, use of health care ( which at times may mean increased use ), and social functioning. research support should be developed in two waves over the next decade, initially focusing primarily on increasing research grant support for individual investigators and later on increasing support for specialized prevention research centers throughout the appropriate federal agencies. this strategy is based on the principle of building a prevention science from the ground up, rather than the top down. individual investigators should compete for ocr for page 480 reducing risks for mental disorders : frontiers for preventive intervention research research grant support. as their academic track record becomes established, they should be encouraged to increase the size and scope of their trials and join with other solid investigators to form preventive intervention research centers. in the first wave, lasting five years, there should be a substantial increase in the funds available for peer - reviewed research projects. preventive intervention research programs should be supported for any mental disorder for which there is well - validated evidence of risk factors that appear to be modifiable. after five years, with the impact of new mid - career researchers joining the field and evidence from five years of research programs, a review should be made of the evidence. it is highly likely that several other preventive intervention research centers could be warranted at that time. research grant support should not decrease at this time. research on sequential preventive interventions aimed at multiple risks in infancy, early childhood, and elementary school age to prevent onset of multiple behavioral


other preventive intervention research centers could be warranted at that time. research grant support should not decrease at this time. research on sequential preventive interventions aimed at multiple risks in infancy, early childhood, and elementary school age to prevent onset of multiple behavioral problems and mental disorders should be increased immediately and substantially. this should include a large number of new research grants and at least one new specialized prevention research center. the knowledge base regarding multiple risk factors in infancy and childhood interacting in complex causal chains and resulting in multiple disorders is extensive. data on the direct linkage to specific disorders that emerge in adolescence and adulthood are becoming available. many rigorously designed preventive intervention programs document impacts on risk and protective factors that are likely to reduce incidence rates of mental disorders. addressing clusters of risk and protective factors increases the chances of preventing multiple disorders, especially major depressive disorder and conduct disorder. a number of separate randomized controlled trials have demonstrated the efficacy, and in some studies the effectiveness, of specific preventive interventions across development from the prenatal period through adolescence in reducing risk factors and enhancing protective factors. these should now be combined and delivered in sequence to high - risk populations. the interventions should include high - quality prenatal care, childhood immunizations, home visiting and high - quality day care ( such as the prenatal / early infancy project and the infant health and development program ), high - quality preschool ( such as the perry preschool program ), parenting training, and enhancement of social competence and academic performance. high priority should be given to interagency sponsorship of this research, including the specialized prevention research centers. the department of health and human services ( including the maternal and child health bureau ( mchb ), national institute of child health and human development ocr for page 481 reducing risks for mental disorders : frontiers for preventive intervention research ( nichd ), administration on children, youth, and families ( acyf ), substance abuse and mental health services administration ( samhsa ), and the national institute of mental health ( nimh ) ) and the departments of education, justice, and defense might be interested in sponsoring such research. research on preventive interventions aimed at major depressive disorder should be increased immediately and substantially. this should include a large number of new research grants and at least one new specialized prevention research center. the knowledge base in this area is extensive, and promising preventive interventions have been empirically tested across the life span. research to prevent depressive disorders should be more focused on preventing co - morbid


and at least one new specialized prevention research center. the knowledge base in this area is extensive, and promising preventive interventions have been empirically tested across the life span. research to prevent depressive disorders should be more focused on preventing co - morbid mental disorders than it has been in the past. also, outcomes often extend beyond traditional boundaries of mental disorders. for example, prevention of depression has strong implications for reducing suicides, lost work productivity, and physical disorders. high priority should be given to interagency agreements for research projects and specialized prevention research centers. gradually over the next five years, other new specialized prevention research centers should be initiated to focus on depression and co - occurring conditions. links between these new centers and other research sites are essential, and monies should be set aside to provide for ongoing collaboration. research on preventive interventions aimed at alcohol abuse should be increased immediately. the knowledge base is extensive, and promising preventive interventions have been empirically tested. a less categorical approach to alcohol abuse preventive intervention research is needed. coexisting illnesses, such as depressive disorders and physical disorders, must be carefully studied. prevention of alcohol abuse has strong implications for reducing drug abuse, spouse and child maltreatment, and physical injury. the outcomes of preventive interventions on these problems also should be considered. for alcohol abuse, it may be best to target children and young adolescents to delay the initiation of alcohol use. support for pilot and confirmatory preventive intervention trials should be increased for conduct disorder. priority should be given to research that addresses multiple risk factors for young children with early onset of aggressiveness, including parental psychopathology, poverty, and neurodevelopmental deficits in the child. research should be supported on alternative forms of intervention for the caregivers and family members of individuals with mental disorders, especially alzheimer ' s disease and schizophrenia, to prevent the onset of stress - induced disorders among these caregivers. ocr for page 482 reducing risks for mental disorders : frontiers for preventive intervention research over the next decade, as new specialized prevention research centers are initiated, priority should be given to those that are sponsored through interagency agreement. in addition to the national institute of mental health ( nimh ), national institute on alcohol abuse and alcoholism ( niaaa ), and national institute on drug abuse ( nida ), other federal agencies, such as those in the departments of justice, education, and defense should be encouraged to become involved. over the next 10 years, in


and alcoholism ( niaaa ), and national institute on drug abuse ( nida ), other federal agencies, such as those in the departments of justice, education, and defense should be encouraged to become involved. over the next 10 years, in addition to the new centers focusing on multiple childhood risks and depressive disorders, specialized prevention research centers could be developed for other risk factors or disorders if a review of the evidence suggests that such action is warranted. knowledge base research at the specialized prevention research centers should be supported by new research grants ( ro1s ) that do not use preventive intervention research dollars. specialized prevention research centers provide the structure, the personnel, and the study populations that could be used to increase the knowledge base for prevention through risk research and epidemiological studies as well as for increasing knowledge about preventive intervention research programs. when these two areas of research are combined in the same center, the definition of prevention research will be especially important. dissemination mechanisms, including publication in peer - reviewed journals, and knowledge exchange opportunities with other researchers and with representatives from the community should be mandated as part of the mission of each specialized prevention research center. the preventive intervention research cycle as described in this report should be used as a conceptual model for designing, conducting, and analyzing research programs. preventive intervention research should proceed from pilot studies to confirmatory and replication trials to large - scale field trials and finally be transferred into the community as service programs with rigorous evaluation. increased attention to cultural diversity, ethical considerations, and benefit - cost and cost - effectiveness analyses should be an essential component of preventive intervention research. community involvement should be increased to help identify disorders and problems that merit research and to support preventive intervention research programs. the committee believes strongly that the long - term interests of communities throughout the nation are best served if prevention services are based on well - crafted and thoroughly evaluated trial programs. community groups that hope for the best long - term outcomes need to express an increased willingness to have service projects more rigorously evaluated and to bring promising prevention programs into the research cycle for a more complete analysis of efficacy and effectiveness. ocr for page 483 reducing risks for mental disorders : frontiers for preventive intervention research funding preventive intervention research ( excluding the specialized prevention research centers ) should be budgeted at $ 20 million above the fy 1993 level of support in years one, two, and three, with an additional $ 5 million ( from $ 20 million to $ 25 million ) in year four and year five. support for new specialized prevention research centers


$ 20 million above the fy 1993 level of support in years one, two, and three, with an additional $ 5 million ( from $ 20 million to $ 25 million ) in year four and year five. support for new specialized prevention research centers is budgeted at $ 2 million per year in years one and two, $ 5 million in year three, and $ 8 million per year in years four and five. ( the nimh pircs receive, on average, $ 500, 000 for core support per year. ) some of this support could come from reallocation and more prudent use of federal resources that currently are available for prevention in a broad sense. for example, huge demonstration projects are rarely warranted ; scaling up from confirmatory and replication trials to large - scale field trials is a more cautious and constructive use of resources. finding out the effectiveness of programs before they are widely disseminated is likely to save money in the long term. the support that is requested in this report is not necessarily new money, but it is new for the field of preventive intervention research for mental disorders. much of the support should come from a wide array of federal agencies already supporting prevention services that currently lack rigorous evaluation. a final word there could be no wiser investment in our country than a commitment to foster the prevention of mental disorders and the promotion of mental health through rigorous research with the highest of methodological standards. such a commitment would yield the potential for healthier lives for countless individuals and the general advancement of the nation ' s well - being. even with the support of the federal government, the effort will not be easy. there will be no “ magic bullet. ” no single prevention strategy or method of changing people ' s life - style, behavior, or environment will work across the broad range of risk factors and mental disorders that will be encountered. a program designed to prevent one public health problem will not exactly fit the needs and goals of another. dedication to prevention service programs will not necessarily bring success without a corresponding commitment to rigorous evaluation to determine the effectiveness of these services. no single agency can accomplish the task outlined above. overall, the effort will require the cooperation of numerous federal, state, and local agencies, universities, foundations, researchers, and communities. ocr for page 484 reducing risks for mental disorders : frontiers for preventive intervention research hardly a family in america has been untouched by mental illness. the need for effective preventive intervention programs is clear. it is equally clear that to obtain such programs we need to


the plasma spray – physical vapor deposition ( ps - pvd ) rig at nasa ' s glenn research center uses new technology to create super thin ceramic coatings. here, bryan harder, the lead for the ps - pvd, installs a sample in the rig. image credit : nasa turbines, or rotary engines that create power, have a multitude of uses. they are used in machines that perform work on earth and are essential components of airplanes. currently, most turbines are built using metallic based components, and these metal components require cooling to avoid reaching their thermal limits. new, more efficient engine technology requires components that can survive higher temperatures and reduced cooling. silicon based ceramic components show great potential for use in advanced, higher efficiency engines, as they are capable of withstanding higher temperatures and weigh less than metal components. however, when unprotected, these silicon based ceramic components react and erode in turbine engine environments due to the presence of water vapor. new coating processing technology is being pioneered at nasa glenn ' s research center in cleveland. the technology is used to protect advanced silicon based ceramic engine components that are being developed for future engines. this coating processing technology will enable more complex and thinner coatings than are currently possible. this is important for coating turbine blades, which need to endure engine environments and stress conditions, while still remaining smooth to avoid the disruption of airflow. this coating processing technology, called plasma spray – physical vapor deposition ( ps - pvd ), has the potential to radically improve the capabilities of ceramic composite turbine components. " ps - pvd technology is really necessary for the integration of silicon - based ceramic airfoil components into turbine engines. the use of these silicon - based ceramics as engine airfoil components would increase engine operation temperature, which translates into higher efficiencies, " says bryan harder, the lead for the ps - pvd facility at glenn. plasma spray – physical vapor deposition the ps - pvd rig uses a system of vacuum pumps and a blower to remove air from the chamber, reducing the pressure to one torr ( 1 / 760th of normal atmospheric pressure ). image credit : nasa it has been known for decades that enveloping metals and other substances, such as silicon based ceramic components, with a ceramic coating can protect them. but there is new, cutting - edge technology that can create ceramic coatings in an extremely precise, uniform fashion — the coatings can be controlled to a thickness of ten microns ( a micron is one - millionth of a meter ). this technology is


new, cutting - edge technology that can create ceramic coatings in an extremely precise, uniform fashion — the coatings can be controlled to a thickness of ten microns ( a micron is one - millionth of a meter ). this technology is made possible by glenn ' s plasma spray – physical vapor deposition ( ps - pvd ) facility. the plasma spray – physical vapor deposition ( ps - pvd ) coater was completed at glenn in 2010. created in collaboration with sulzer metco, the ps - pvd rig is one of only two such facilities in the u. s. a. and one of four in the entire world. the ps - pvd rig, which is currently a research and development facility, uses a state of the art processing method of creating thin ceramic coatings. planning began for the facility in 2007, and construction began in 2008 ( previously constructed infrastructure was reused and is now the base for the new rig ). the rig is nearing completion of its capabilities testing and assessment phase. a team of five, led by bryan harder, a materials research engineer, has put the rig through its paces. the rig will soon begin supporting the supersonic project within nasa ' s aeronautics research mission directorate at glenn. eventually, the rig could be of service to many other areas and projects within glenn, other nasa centers and governmental entities, and private industry partners. " when you have something that has broad capabilities like this, it really allows us to work with a lot of different areas, which is a great thing, " says bryan harder. super thin ceramic coatings ceramic powder is pumped into the ps - pvd rig. it will be transformed inside the chamber to become a thin, precise, accurate ceramic coating. image credit : nasa the plasma spray - physical vapor deposition ( ps - pvd ) rig creates thin, extremely precise ceramic coatings. these coatings are created on metal, ceramic, or other appropriate materials. " to create these coatings, ceramic powder is injected into a very high power plasma flame under a vacuum. during operation, the plasma is approximately 7 feet long and 3 feet wide. the ceramic material is vaporized within the plasma, and condenses onto the target component, " says bryan harder. the coatings can be single or multilayer, and they protect the components from environmental and thermal impact. the extremely high heat and the vacuum within the chamber allow the ceramic coating to be precisely applied, creating durable, long - lasting, effective coatings. " if you can reduce the thickness, and


and they protect the components from environmental and thermal impact. the extremely high heat and the vacuum within the chamber allow the ceramic coating to be precisely applied, creating durable, long - lasting, effective coatings. " if you can reduce the thickness, and still provide an effective barrier layer — you can reduce the weight, you can reduce your cost. there are a lot of benefits that come from this technology, " harder says. inside the chamber within the ps - pvd, an extremely hot plasma flame is created. the plasma can reach a temperature of 10, 000 degrees celsius — ten times hotter than a candle flame. image credit : nasa located at glenn, the plasma spray – physical vapor deposition ( ps - pvd ) is installed in a dedicated room. a large, blimp - shaped chamber is made of stainless steel. the exterior metal, which is welded to a second sheet of stainless steel beneath, has cool water pumped through it to keep the chamber from getting too warm. inside the chamber is a steel arm which holds a plate made of a nickel - based superalloy. this plate holds the component that will be coated. several feet away from this plate is the torch, where the ceramic powder is injected into the plasma. once the chamber is closed, a system of vacuum pumps and a blower remove air from the chamber, reducing the pressure to one torr ( 1 / 760th of normal atmospheric pressure ). then, helium and argon gases are introduced to the torch. an arc is created between the anode and cathode inside the chamber, ionizing the gases and creating the high temperature plasma. the plasma, which can grow to seven feet in length, can be observed through one of three portals on the side of the rig. its steady, fierce, concentrated glow resembles a lightsaber from the star wars movies. once the vacuum and plasma are stable, the ceramic powder is introduced to the torch. the plasma immediately begins to change colors. depending on which ceramic powder is introduced, the plasma dramatically erupts into oranges, yellows, aquas, purples and blues. the gas stream moves at a speed of mach 2 — a rate of more than 2, 000 feet per second. as the ceramic powder and the plasma blast the arm and plate where the component being coated is attached, the plasma appears to envelop the component and splash around it. the plasma, which appeared like a lightsaber, seems to morph into the effect of the undulating stream of magic that


and plate where the component being coated is attached, the plasma appears to envelop the component and splash around it. the plasma, which appeared like a lightsaber, seems to morph into the effect of the undulating stream of magic that occurs when harry potter ' s wand meets with lord voldemort ' s wand, in the harry potter movies. inside the ps - pvd, ceramic powder is introduced into the plasma flame. the plasma vaporizes the ceramic powder, which then condenses to form the ceramic coating. image credit : nasa the entire process is over in about five minutes. the plasma is extinguished and the exhaust system clears the chamber. the pressure is returned to normal atmospheric conditions, and then the chamber can be opened. the newly - coated component glows red hot and must cool down for an hour before it can be handled. the plasma within the chamber can reach a scorching 10, 000 degrees celsius — ten times hotter than a candle flame. after the sample cools, it will be tested and evaluated to ensure the coating is an effective barrier. and then the sample — be it a small test button or an essential component of a supersonic aircraft — is ready to go. the front, sides and inside of the sample can be coated — a capability never previously available from vapor deposition techniques. " the ps - pvd allows us to do things that you can ' t do anywhere else, " harder says. this newly developed technology could have myriad applications, both within nasa and with potential industry partners. the potential applications are only beginning to be discovered — from membrane technology to fuel cells to ion conductors and beyond. the rig is a game - changing technology ; glenn is maturing and developing a technology that doesn ' t exist elsewhere, while making direct contributions to the nasa mission. " this is new ground, " bryan harder says. " this was only developed in the last couple of years … and we don ' t even know the limits of what it [ ps - pvd ] is capable of. " - tori woods, sgt inc. nasa ' s glenn research center


scientists have kept a close watch on the dazzling northern lights on earth and other planets in our solar system, but now they have the chance to explore the auroras of alien planets orbiting distant stars, a new study suggests. auroras on earth occur when charged particles from the sun are funneled to the planet ' s poles and interact with the upper atmosphere, sparking spectacular light shows. similar processes have been observed on other planets in the solar system, with jupiter ' s auroras more than 100 times brighter than those on earth, scientists said. now, scientists are finding evidence of aurora displays on exoplanets for the first time. researchers used the low - frequency array radio telescope based in the netherlands to observe radio emissions most likely caused by powerful auroras from planets outside of our solar system. " these results strongly suggest that auroras do occur on bodies outside our solar system, and the auroral radio emissions are powerful enough — 100, 000 times brighter than jupiter ' s — to be detectable across interstellar distances, " study lead author jonathan nichols of the university of leicester in england said in a statement. jupiter ' s auroras are caused by an interaction of charged particles shot from its volcanic moon, io, and the rotation of the planet itself. the gas giant turns on its axis once every 10 hours, dragging its magnetic field along for the ride, and effectively creating a whirl of electricity at each of the planet ' s poles. space news from nbcnews. com teen ' s space mission fueled by social media - buzz aldrin ' s vision for journey to mars - giant black hole may be cooking up meals - watch a ' ring of fire ' solar eclipse online - teen ' s space mission fueled by social media auroras akin to earth ' s have been spotted on saturn. but these newest findings show that auroras on exoplanets probably aren ' t formed from charged particles traveling on the solar wind. instead, the auroras on the dim, " ultracool dwarf " stars and " failed stars " known as brown dwarfs that nichols studied probably behave more like jupiter ' s northern and southern lights. by studying these radio emissions, scientists will gain more insight into the strength of a planet ' s magnetic field, how it interacts with its parent star, whether it has any moons and even the length of its day. the new research is detailed in a recent issue of the astrophysical journal. - saturn ' s aurora - the movie - aurora guide : how the northern lights work ( infographic ) -


orthotist and prosthetist what is an orthotist? an orthotist is a health care professional who makes and fits braces and splints ( orthoses ) for patients who need added support for body parts that have been weakened by injury, disease, or disorders of the nerves, muscles, or bones. they work under a doctor ' s orders to adapt purchased braces or create custom - designed braces. braces are often named for the body part they support, such as : an afo brace is an ankle - foot orthosis. a kafo brace is a knee - ankle - foot orthosis, or long leg brace. a halo brace is a brace that surrounds the head and is held in place with small screws in the skull. it is used to stabilize the neck and prevent further damage to the spinal cord after injury. what is a prosthetist? a prosthetist is a health care professional who makes and fits artificial limbs ( prostheses ) for patients with disabilities. this includes artificial legs and arms for patients who have had amputations due to conditions such as cancer, diabetes, or injury. orthotists and prosthetists receive special education and training in undergraduate programs and / or apprenticeships. they may practice in a variety of settings, including the following : inpatient rehabilitation centers outpatient rehabilitation centers industrial health centers


psychology introduction 2 available in 2013 | callaghan campus | | semester 2 | previously offered in 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004 this course continues on from psyc1010 by introducing some additional key areas in psychology, including - sensation and perception, - motivation and emotion, - learning, and - memory and cognition. where psyc1010 focussed on how the world around us influences our thoughts and behaviour, psyc1020 looks at the internal mechanisms of behaviour. the course forms part of a sequence of courses that have been approved by the australian psychology accreditation council. the course cannot be counted with psyc1030. | objectives | | the course will : 1. introduce some key areas in psychology that control behaviour which include sensation and perception, motivation and emotion, learning and memory and cognition. 2. demonstrate an understanding of the relationship between the research / scientific approach and the content of the course. 3. demonstrate competence in report writing for science in psychology at an introductory level. 4. demonstrate competence skills in data collection, manipulation, graphing and reporting at an introductory level. 5. develop the ability to report and discuss psychology in a clear and concise manner and using a professional style. as a consequence of studying this course students will build their : 4. library and research skills 5. research / data collection / measurement skills 7. problem solving skills 8. critical evaluation skills | content | | psychology is the science of mind and behaviour. psyc1020 provides an introduction to some of the classic and contemporary concepts, theories, and evidence in psychology. psyc1020 is focused on the mechanisms of behaviour. psyc1020 includes the following four modules : 1. biological mechanisms of behavioural emotion 3. sensation and perception 4. memory and cognition | assumed knowledge | | psyc1010 recommended | | modes of delivery | | internal mode | | contact hours | | laboratory : for 1 hour ( s ) per week for full term lecture : for 3 hour ( s ) per week for full term | timetables | | 2013 course timetables for psyc1020 |


09 august 2011 real time operating system architectures are important for medical designers medical device manufacturers understand the importance of the operating system ( os ) and, contrary to common practice for embedded systems design, often select the os before they choose the board. the business needs which drive os selection for medical devices are much like those for most other devices and require little elaboration : cost, quality, time to market, portability, support, vendor history, ecosystem, and vendor track record. however, before a medical device can go to market, it must comply with legislation in the jurisdictions where it will be sold : for example, in the us, the fda 510 ( k ) pre market notification ; in europe, the medical devices directive ( mdd ) ; and myriad national standards. though agencies such as the us food and drugs administration ( fda ) evaluate devices as a whole, compliance can also be affected by how the os and other device components are developed and by how their functional safety claims are validated. things to look for from an os vendor include : • development in a good manufacturing process / quality management environment ( for example, iso 9001 ) • validation of functional safety claims, including testing data, proven in use data and design verification, with the appropriate certification ( such as iec 61508 and iec 62304 ) • a tool set that can provide concrete evidence of functionality and behaviours in a given system : code coverage, system profiling and memory analysis artefacts. for the purposes of this discussion, consumer grade medical devices, whose failure implies nothing more than an inconvenience, are excluded. for devices whose failure carries serious consequences, we can group key os characteristics as follows : • dependability : a correct and timely response to events, for as long as required • connectivity : communication with diverse equipments and systems, either directly or through networks • data integrity and security : safe storage of data and protection from unauthorised scrutiny to these we can add : • power management : important for any device running on battery power, even temporarily • graphics capabilities : support for the user interface design that the device requires, including the concurrent use of multiple technologies such as opengl es, adobe flash and qt • platform independence : an os that can run on different hardware architectures allows development of modular systems that can be reused for different products • multicore support : future projects will almost certainly require multicore processing while each of these characteristics merits in depth discussion, we will focus on the one that is, arguably, most important – dependability. gp


systems that can be reused for different products • multicore support : future projects will almost certainly require multicore processing while each of these characteristics merits in depth discussion, we will focus on the one that is, arguably, most important – dependability. gpos or rtos? dependability is a combination of availability ( how often the system responds to requests in a timely manner ) and reliability ( how often these responses are correct ). a realtime os is engineered explicitly to guarantee availability and reliability and is, therefore, a better candidate than a general purpose operating system, which can only offer best effort performance. since an os ' s architecture has a profound effect on a system ' s dependability, it should be the first item under scrutiny. the three most common rtos architectures are real time executive, monolithic, and microkernel. with the real time executive model, all software components ( kernel, networking stacks, file systems, drivers and applications ) run together in one memory address space. though efficient, this architecture has two immediate drawbacks : a pointer error in any module can corrupt memory used by the kernel or another module and cause a system failure ; and the system can crash without leaving diagnostic information. some rtoss use a monolithic architecture, where user applications run as memory protected processes. while this architecture protects the kernel from errant user code, kernel components still share the same address space as file systems, protocol stacks, drivers and other system services. hence, a programming error in any service can cause the entire system to fail. in a microkernel rtos ( see fig 2 ), device drivers, file systems, networking stacks and applications reside outside the kernel in separate address spaces, which means they are isolated from the kernel and from each other. a fault in one component will not bring down the entire system, memory faults in a component cannot corrupt other processes or the kernel and the os can restart any failed component without a system reboot. • real time commitments to ensure that high priority processes always get the cpu cycles they need, the rtos must allow kernel operations to be preempted. however, the time windows during which preemption may not occur should be extremely brief and there should be an upper limit on how long preemption is held off and interrupts disabled. further, the rtos kernel must be simple, so there is a limit on the longest non preemptible code path through the kernel. • protect against priority inversions priority inversion infamously plagued the mars pathfinder project in july 1997


disabled. further, the rtos kernel must be simple, so there is a limit on the longest non preemptible code path through the kernel. • protect against priority inversions priority inversion infamously plagued the mars pathfinder project in july 1997. it is a condition where a low priority task prevents a higher priority task from completing its work. priority inheritance is a technique for preventing priority inversions by assigning the priority of a blocked higher priority task to the lower priority thread doing the blocking until the blocking task completes ( see fig 3 ). • guaranteed availability for many systems, guaranteeing resource availability is critical. for example, a heart monitor that loses connectivity may fail to trigger an alarm – with dire consequences for the patient. time partitioning addresses resource starvation by enforcing cpu budgets and preventing processes or threads from monopolising cpu cycles. two time partitioning approaches are possible : fixed and adaptive. with fixed partitioning, the system designer divides tasks into partitions, allocating a portion of cpu time to each. no task in any partition may consume more than that partition ' s percentage of cpu time. adaptive partitioning enforces resource budgets, but when cpu cycles are available, it uses a dynamic scheduling algorithm to reassign them from partitions that are not using them those which can benefit from extra processing time. • monitor, stop, and restart processes safeguards against process failures cascading through the system and self healing capabilities are crucial to a highly dependable os. devices that require availability or safety guarantees may implement hardware based high availability solutions, as well as a software watchdog. a software watchdog monitors the system and performs multistage recoveries or clean shutdowns as required. this process must be self monitoring and resilient to internal failures ; if it is stopped abnormally, it must reconstruct its own state immediately and completely by handing over to a mirror process. it ' s the os, it ' s the vendor device manufacturers can improve their products ' chances of success by paying careful attention to the os. devices that cannot be allowed to fail and reboot are best served by a microkernel rtos, as this architecture is best - suited for ensuring system dependability and can support a full range of features and capabilities. an rtos from a supplier with a track record of successful safety and security certifications can help reduce the costs associated with obtaining fda, mdd and other certifications. justin moon is product manager, medical, for qnx software systems. qnx software systems ltd this material is


mammosite® 5 - day targeted radiation therapy is an advanced high - dose partial breast irradiation method for breast cancer treatment. commonly, mammosite is used following lumpectomy as a breast conservation strategy. for some women, it is an alternative to mastectomy ( removal of the entire breast. ) mammosite targets the area where cancer recurrence is most likely to develop. because it is specifically targeted, minimal radiation is delivered to other surrounding healthy tissues. it is especially appropriate for early stage breast cancers. with mammosite, the duration of treatment is shortened from several weeks to just 5 days - - without compromising the outcome. after cancerous tissues are surgically removed, radiation therapy may be used to help keep the cancer from coming back. radiation therapy uses high - energy radiation beams to destroy cancer cells. radiation disrupts the growth of cancer cells. radiated cancer cells are not able to repair themselves or replicate, which helps to keep the cancer from coming back. radiation damages all cells, both healthy and cancerous, in the exposed area. mammosite spares as many healthy cells as possible because it directs a high - dose of radiation to only a specific area surrounding the lumpectomy cavity. mammosite following lumpectomy is a breast conservation strategy. for some women, it is an alternative to mastectomy ( removal of the entire breast. ) mammosite is a type of targeted radiation therapy, also referred to as brachytherapy. targeted radiation therapy delivers a high - dose of radiation from inside of the body. tiny sources of radiation called “ seeds ” are placed in the body and removed after a short period of time. mammosite is an outpatient procedure. the radiation is delivered two times a day for five days. traditional radiation methods usually take six to seven weeks to complete. most women experience little or no discomfort during the treatment or when the catheter is removed. mammosite appears to be well tolerated and is associated with short - term mild side effects.


the memory problems that many women experience in their 40s and 50s as they approach and go through menopause are both real and appear to be most acute during the early period of post menopause. that is the conclusion of a study which appears today in the journal menopause. " women going through menopausal transition have long complained of cognitive difficulties such as keeping track of information and struggling with mental tasks that would have otherwise been routine, " said miriam weber, ph. d. a neuropsychologist at the university of rochester medical center ( urmc ) and lead author of the study. " this study suggests that these problems not only exist but become most evident in women in the first year following their final menstrual period. " the study followed 117 women, who were grouped into categories based on criteria established in 2011 by the stages of reproductive aging workshop + 10, which consisted of an international consortium of researchers. study participants took a variety of tests assessing their cognitive skills, reported on menopause - related symptoms such as hot - flashes, sleep disturbance, depression and anxiety, and gave a sample of blood to determine current levels of estradiol ( an indicator of estrogen levels ) and follicle stimulating hormone. results were analyzed to determine if there were group differences in cognitive performance, and if these differences were due to menopausal symptoms. the study grouped participants into four stages : late reproductive, early and late menopausal transition, and early post menopause. the late reproductive period is defined as when women first begin to notice subtle changes in their menstrual periods, such as changes in flow amount or duration, but still have regular menstrual cycles. women in the transitional stage experience greater fluctuation in menstrual cycles - from a difference of 7 days or more in the early phase of transition to 60 days or longer in the later phase. hormone levels also begin to fluctuate significantly during this time. this transition period can last for several years. the researchers also evaluated women in early post menopause, defined as the first year after which a woman experienced her last menstrual period. the study participants were assessed with a comprehensive battery of tests to evaluate a variety of cognitive skills. these included tests of attention, verbal learning and memory, fine motor skills and dexterity, and " working memory " - or the ability to not only take in and store new information, but also manipulate it. these tests are similar to daily tasks such as


webmd medical news louise chang, md feb. 2, 2010 - - lower levels of the hormone serotonin may help explain why some infants succumb to sudden infant death syndrome ( sids ), according to a new in the u. s., sids deaths have declined by more than 50 % since 1990. experts say that ' s partly due to practices believed to minimize the risk, such as putting infants to sleep on their backs rather than their stomach and avoiding soft bedding, which could lead to asphyxiation. but sids is still the leading cause of death among infants age 1 - 12 months, accounting for about 2, 750 u. s. deaths annually. it ' s defined as the death of an infant before his or her first birthday that can ' t be explained even after a complete autopsy, investigation of the death scene and circumstances, and a review of the medical history of the child and family. now, the new research suggests that a deficiency of serotonin in the brain stem ( which controls vital functions during sleep, such as breathing, heart rate, and blood pressure ) may help explain most of the deaths, says study researcher hannah kinney, md, a professor of pathology at harvard medical school and a neuropathologist at children ' s hospital boston. " it is not going to explain all sids deaths, " kinney tells webmd. however, she adds, " it will explain the majority. " her study is published in the journal of the american medical association. sids research is a ' ' controversial area, " kinney says. many experts look to the " triple risk " model to explain it, believing that sids results from an underlying vulnerability, a critical developmental period, and an outside ' ' the real risk period is the first six months, " kinney says of the critical period in which most deaths occur. but experts disagree on what the vulnerability is. kinney ' s research suggests low levels of the neurotransmitter serotonin, and probably other brain chemicals yet to be identified, are what make infants vulnerable. other experts suspect other vulnerabilities, such as infections. yet others say sids is due simply to suffocation, she says. " we say, yes, some babies will die if they are severely asphyxiated, " kinney tells webmd. but she adds, " what we are saying is in the majority of cases, the babies have an underlying defect that puts them at risk that makes them unable


babies will die if they are severely asphyxiated, " kinney tells webmd. but she adds, " what we are saying is in the majority of cases, the babies have an underlying defect that puts them at risk that makes them unable to respond to a stressor, such as having their face compressed [ while sleeping on the stomach or becoming tangled in soft bedding ]. " in previous research, kinney and her colleagues found defects in the serotonin system of sids babies, including defects in the serotonin receptors, which are crucial for serotonin to work. ' ' but we never knew if there was too little or too much serotonin, " she says. " in this study, we actually measured the levels of serotonin and the enzyme that makes serotonin. " kinney and colleagues evaluated serotonin and tryptophan hydroxylase ( tph2 ), the enzyme that helps make serotonin, in 35 infants who died from sids. they compared these measurements with those from two groups - - five infants who died suddenly for whom a cause of death was established and five infants who died while hospitalized for having insufficient oxygen to the tissues. they retrieved tissue samples from the autopsies to measure the enzyme and they found that : finding the deficiency in serotonin levels isn ' t the whole story, kinney says. " we think there are probably several neurotransmitter systems involved in the new research seems to verify the suspicions of many experts who have thought abnormalities of respiratory control contribute to sids, says richard martin, md, director of neonatology at rainbow babies and children ' s hospital and professor of pediatrics at case western reserve university " serotonin is important for arousal, " he says. " if serotonin production is diminished in patients at risk for sids, that all makes sense. " i think the message is there is something inherently wrong in some of these babies, " he says. " on the other hand, in no way should that subtract from the public health message - - to avoid prone position, avoid fluffy bedding and pillows, avoid exposure to cigarette smoking, and don ' t overheat your while researchers have been focusing on brain stem abnormalities to explain sids for many years, the new research ' ' tells us more about what is wrong with that part of the brain, the brain stem, " says marian willinger, phd, special assistant for sids at the eunice kennedy shriver


nih research matters february 14, 2011 rare artery disease linked to gene variant scientists have discovered a genetic cause for a rare disorder that leads to calcium deposits in arteries in the lower half of the body and in the joints of patients ' hands and feet. the culprit is a mutation in the gene encoding cd73, a protein that normally helps to prevent calcium buildup. the researchers hope that understanding the basis for this disease, which they call arterial calcification due to deficiency of cd73 ( acdc ), will help them find a cure. currently, 9 patients are known to have acdc, and all come from 3 families. the patients experienced pain in their buttocks, legs and joints, but doctors could find no signs of rheumatoid arthritis or other recognized problems that might cause the symptoms. a research team that included scientists from nih ’ s national heart, lung and blood institute ( nhlbi ) and national human genome research institute ( nhgri ) examined members of 2 affected families to search for a common thread. mri and x - rays showed that members of the 2 families all had calcium buildup in arteries in the lower half of their bodies, but not around their hearts. in one family, 5 siblings but neither parent was affected by the disorder. the researchers suspected that symptoms might be due to a recessive gene variant. recessive variants only show their effects when found in both copies of the gene. to test this theory, the team, led by dr. william gahl of nhgri, compared dna from the parents of the family to their children ' s. they found a region of dna that was present only once in the parents, but twice in the children. the team then compared this region to the same region in 200 unaffected people. the results were published on february 3, 2011, in the new england journal of medicine. the researchers found a variant in a gene called nt5e that unaffected people didn ’ t have. nt5e makes a protein called cd73, which produces a small molecule called adenosine that helps regulate many processes in the body. the nhlbi team, led by dr. manfred boehm and dr. cynthia st. hilaire, cultured the patients ’ cells to examine the effects of the mutation on an enzyme called tnap ( tissue - nonspecific alkaline phosphatase ). tnap is known to degrade a calcium buildup inhibitor and thus contribute to calcium deposits. the researchers found that the mutant


of the mutation on an enzyme called tnap ( tissue - nonspecific alkaline phosphatase ). tnap is known to degrade a calcium buildup inhibitor and thus contribute to calcium deposits. the researchers found that the mutant cells produced higher levels of tnap. adding adenosine to the cell cultures restored normal levels of tnap. in addition, while mutant cells made more calcium phosphate crystals in culture, restoring cd73 expression in the cells prevented crystal formation. " vascular calcification often results from poor diet and lack of exercise, " says gahl, who is nhgri clinical director and director of the nih undiagnosed diseases program. " the calcium buildup in arteries of our patients, however, arises because the systems to inhibit it are not working in their cells. we hope that an understanding of this faulty mechanism will guide us in providing helpful treatments for these patients. " - nih radio : nih researchers identify genetic cause of new vascular - nhlbi heart and vascular information : - interview with dr. william gahl : nih research matters bldg. 31, rm. 5b64a, msc 2094 bethesda, md 20892 - 2094 about nih research matters harrison wein, ph. d., editor vicki contie, assistant editor nih research matters is a weekly update of nih research highlights from the office of communications and public liaison, office of the director, national institutes of health.


archive / file : people / e / erichsen. hugo / cremation - of - the - dead last - modified : 1998 / 05 / 25 " [ the belgian government ] dispatched colonel creteur to examine into the grievances, and, if possible, remove them. one ' s hair stands on end when one reads the report of the colonel on the condition of the sedan battle - field. the only way to remedy the evil was to destroy the dangerous cadavers by cremation, which was a difficult task, under the circumstances, but which was nevertheless accomplished by the ingenious creteur. the colonel ' s report is full of horrible facts. the bodies of german soldiers in a trench at laid - trou were covered so little by earth that carnivorous animals had already devoured part of the hands and faces. rain - water had caused 30 large pits, containing the remains of bavarians, to cave in, and had laid bare the bodies. between belan and bazailles, the owners of a field had leveled the elevation of a bavarian grave. relics of the dead protruded from the ground. the bodies were covered only by a thin layer of earth, in which corn flourished luxuriantly. wild bears, foxes, and dogs, relishing the human flesh, helped to scratch away the soil over the remains, as did the numerous crows upon the pit in which the horses had been buried. dogs, having once feasted on this fare, would not eat anything else. creteur at first could not obtain men to carry out his plans, as every one who attempted to open the trenches contracted phlyctaena, an eruption of the skin. finally, by promising good pay, he enlisted 27 workmen, whom he endeavored to protect by saturating their clothing and moistening the graves with a solution of carbolic acid. but this only intensified the phlyctaena. he then determined to cover the graves with a layer of chloride of lime, and to pour diluted muriatic acid upon them subsequently. by this means he succeeded in laying bare the topmost layer of the corpses. he then had large quantities of coal tar poured into the pit, which trickled down among the bodies to the bottom, thoroughly covering the remains. he then had more chloride of lime heaped upon the corpses, and finally had bundles of hay, previously saturated with kerosene, thrown burning into the pit. creteur declares that from 200 to 300 bodies were consumed within 50 to 60 minutes


introduction to rocks and minerals examine the characteristics of common rocks and minerals and learn identification procedures. find out all about the physical properties of minerals including hardness, luster and color as well as the chemical compositions of important rock - forming minerals. information in the video is accurate, but narration is somewhat monotone. run time 03 : 34. dr. loopy ' s blinding you with science # 9 : rocks and minerals this is another in the blinding you with science series i produced to help elementary students learn science concepts. in this episode dr. loopy and his friends use music, comedy and parody to teach students about different types of rocks and minerals. run time 25 : 00. rocks don ' t roll : the science of rocks and minerals this is a clip from a longer video i produced in my blinding you with science series. the series is designed to help elementary students with science concepts. this is a musical parody about rocks and minerals. run time 06 : 34. differences between rocks & minerals a general difference between rocks and minerals is that minerals are chemical substances, while rocks are made from volcanoes and bodies of water. discover how granite and igneous rocks are formed with information from a science teacher in this video. vincent van gogh part 1 van gogh was born in 1853 in groot — zundert, a small village in the southern netherlands near the belgian border. the oldest son of a protestant minister, young van gogh was moody, quiet, introverted, but he grew up with a love of nature and the arts. van gogh attended school as a young boy, but at the age of sixteen he left home for the hague to work as an apprentice to an uncle, a dealer at goupil and co., an international art firm. van gogh subsequently worked for the firm in london and pa math trick for your fingers - easy multiplication a quick way for students to learn basic multiplication using their fingers. goes fast so you may need to watch it a couple of times. students will love it. learn how to count in sign language for small children i absolutely love the signing time videos made for babies and toddlers to learn sign language. my toddler learned how to sign through these videos way before he could talk which made it possible for him to communicate rather then throw tantrums. in this video you learn how to count through sign. run time 0 : 31. chanting and enchanting animals - chap. 2 / 6 ecuador as a country has among the largest diversity of frog and toad species in the world. discover through this film


video you learn how to count through sign. run time 0 : 31. chanting and enchanting animals - chap. 2 / 6 ecuador as a country has among the largest diversity of frog and toad species in the world. discover through this film the fascinating world of frogs in ecuador : their night life, when thousands of love - stricken males get together and sing at mating time ; their birth and transformation from beings of water to beings of dry lands ; their survival tricks and mysterious ways of life ; their importance in the discovery of medicines ; and their great variety of beautiful patterns and colors, discover th animal mothers : newborn gators watch how this protective alligator mother uses her " jaws of love " to protect her newborns from danger in the florida everglades. unlike crocs, the gator babies stay close to mom for their first year because they are a common food source for predators. run time 02 : 24. dolphin bay - where dolphins swim with humans near st. andrews state park in panama city is an area where the dolphins will swim right up to you to check you out and see what ' s happening. gabrielle has been swimming with this same pod since she was four years old. they ' re extremely friendly and curious, and love to pose for a picture. most of the video is set to music. run time 03 : 49 this video discusses the evening or morning star, venus. earth ' s sister planet has a symbol derived from a hand mirror, because venus was the roman goddess of love and beauty, it is also the symbol for women. discusses the size, atmosphere and its temperature. it also discusses the solar landers that went to venus. it discusses mariner 10, which went to venus. in this video various scientists discuss venus. video is of good quality and is approp from an outsider ' s perspective, storm chasing might appear to involve hours and hours of boredom, accentuated by a few moments of unimaginable excitement — or terror — depending on one ' s love or fear of tornadoes. but to tornado researchers, the effort and expense they expend in search of a single tornado - producing storm reflect the importance of these events in terms of their impact on lives and property. this video segment adapted from nova follows some of the scientists who study these vi touch and vision in this episode of the human senses, they explore the two most highly used senses, touch and vision. in this video they test the amazing things we do with our eyes, how we can instantly spot attractive people in a crowded room


vi touch and vision in this episode of the human senses, they explore the two most highly used senses, touch and vision. in this video they test the amazing things we do with our eyes, how we can instantly spot attractive people in a crowded room, and how our eyes guide us around the world with astonishing accuracy. when it comes to touch they reveal why we love the feel of some things and loath others. discover what our skin a glacier investigation from dragonfly tv. deborah and brittani live in juneau, alaska, which is home to 38 glaciers flowing from the gigantic juneau ice field. the girls love being outside, especially in the short alaskan summers, so they decided to check out a glacier up close at the mendenhall glacier visitor center. the center has cool exhibits that explain the science behind glaciers - like the fact that a glacier is a river of ice that moves because of its own weight and that the mendenhall glacier receives abo king minus is a cute video to introduce or review basic subtraction. the animations are great, and fun. any early elementary child will love this one! how to teach children to read : favorite children ' s authors learn about popular authors for children ' s books from a professional librarian, debbie noah, in this children ' s video. parents, this video is a great tool to use to help you choose great books that your children will love. how to teach children to read : favorite children ' s authors : part 2 learn about favorite authors of children ' s books from a professional librarian in this free children ' s video with expert : debbie noah. this is a great video for helping parents to choose reading material that young children will love. interview with phyllis reynolds naylor ( part 3 ) in this section phyllis reynolds naylor, winner of the aspca roger caras award, answers the question, " shiloh is included on the recommended book list for many school districts and is assigned reading for many students each year. what are your thoughts about the wide appeal of shiloh and the impact you have made with this book for countless children... and animals? " in her answer happy about the impact the books have had. she also commented that one teacher told her how children who have been abu lois ehlert interview lois ehlert ' s unique children ' s books, such as color zoo, reflect her creative and curious mind. in this exclusive video interview, lois ehlert discusses her early love for art and how she continually strives to create highly