Client Response Research Articles

Optimal TOU tariff design using robust intuitionistic fuzzy divergence based thresholding

This paper proposes a robust midterm framework to determine optimal time-of-use (TOU) electricity pricing for retailers using intuitionistic fuzzy divergence based thresholding. It will analyze load profile and perform a comprehensive evaluation of load violation and uncertainty as well by exponential intuitionistic fuzzy entropy. The key advantage is that the proposed method will handle uncertain behavior of load and wholesale price with membership and non-membership functions. In the proposed algorithm client response to the retailer prices and the competition among rival retailers have been explicitly taken into account. The proposed scheme can be applied to several pricing policies where the peak-to-average ratio (PAR) will be decreased. The model is implemented on a realistic case in which the superior performance of the proposed method is demonstrated.

Counselor's Self-Talk on the Client's Negative Response to Counseling: A Difference Analysis of Counselor's Experience

Counselor's Self-Talk on the Client's Negative Response to Counseling: A Difference Analysis of Counselor's Experience

Sputum grading and conversion rates and treatment outcomes among tuberculosis cases managed in a teaching hospital in SouthWestern Nigeria: A five year review

Background :Sputum grading and conversion rates are some of the indicators being used to monitor client's progress and response in community TB care.This study assessed sputum grading and conversion rates in relation to TB treatment outcomes among cases managed in LAUTECH teaching hospital in southwestern Nigeria. Methods : Retrospective study involving a review of 176 TB cases managed between 2011 and 2015.A validated checklist was used in collating data from the National TB Control Programme tools. Data was analyzed using the SPSS software version 17.0. Results : The mean age of respondents 39.4+2.3 years, 94.9% had pulmonary TB, while 114 (64.8%) tested smear positive. Majority 144 (79.5%) of the total cases seen were cured while 0.6% had treatment failure. Baseline TB grading showed 33.3% (1+),32.5% (2+),28.9% (3+) and 5.3% (scanty).About 107(93.9%) and 114(100.0%) had sputum conversion after two and five months respectively.Respondents who were cured were about 3 times more likely to have had a sputum conversion compared to those who were not ,(OR 3.8,95%CI 0.9852-14.4865 and p 0.0336) Conclusion :The conversion rate of sputum is associated with initial sputum grading,suggesting the need to maximize the efficiency of TB control programmes. Key words : Tuberculosis, treatment outcomes, sputum grading, sputum conversion rate, Southwestern Nigeria.

The joint impact of management expressed confidence and response timing on auditor professional skepticism in client email inquiries

PurposeWhile academic research has been conducted on auditors’ ability to exercise professional skepticism in face-to-face client interviews, little is known about auditors’ application of professional skepticism in email communication with the client. The purpose of this paper is to examine the factors that impact auditor professional skepticism during client inquiries conducted through email.Design/methodology/approachA 2 × 2 between-subjects experiment was conducted with 69 undergraduate and graduate auditing students as surrogates for auditors. The experimental design crossed two levels of client expressed confidence (high and low) and two levels of client response timing to the auditor’s email inquiry (earlier than expected and later than expected).FindingsResults indicate that management expressed confidence moderates the influence of management response timing on auditor professional skepticism and that auditor perceptions of client credibility mediate this interactive effect. When the client’s response is low in confidence, auditors perceive a later-than-expected response from the manager as less credible than an earlier-than-expected response, which leads to less reliance on management explanations, which signifies more skepticism. However, when confidence is high, response timing does not impact perceptions of the client’s credibility.Practical implicationsThe results imply that junior auditors should be vigilant of how communication cues in client emails may impact their judgments. Even though management response timing and expressed confidence should not influence auditor skepticismper se, auditors seem to vary their level of skepticism with the timing of the client’s response when client confidence is low but not when client confidence is high, despite the information content of the client’s response being held constant.Originality/valueThis study contributes to the literature on professional skepticism by addressing the Public Company Accounting Oversight Board’s concerns about the need for auditors to exercise more professional skepticism in practice, particularly in an environment in which computer-mediated communication is increasing at a fast pace; and assists practitioners in better understanding the factors that influence the degree of skepticism auditors exercise when collecting audit evidence through email. The study should be of interest to audit firms, as it provides evidence on whether auditors use nonverbal cues such as chronemics, or time-related messages, in email communication to judge management and evidence reliability and credibility.

Joint server selection and replica placement in urban content delivery networks

In this article, we formulate the problem of optimum joint replica server deployment and content placement in urban content delivery networks as a bi-objective binary integer programming model namely JSSRPP. The proposed formulation results in an optimum design such that the miss ratio of requests, the client response time and the cost of server deployment are minimised. In practice, the popularity of files may change over the course of time, thus, a novel adaptive file replacement algorithm namely UDCR is also proposed in which files are scored according to different criteria including the time and the number of recent requests and the size of requested files. Then, in discrete points of time, the files with the lowest score are replaced with the one experiencing the highest number of misses. Results of extensive simulation study with NS-2, confirms that the hit ratio of UDCR approaches that of JSSRPP in steady state.

A two-stage robust model to determine the optimal selling price for a distributed generation-owning retailer

Summary In this paper, a two-stage robust model is presented for the distributed generation (DG)-owning retailer to determine the optimal selling price offered to its clients. Uncertainties on the wholesale market prices and clients' consumption are two major difficulties faced by the retailer. In the proposed framework, the stochastic programming method is addressed in the upper sub-problem to model the price uncertainty and specify the minimum expected cost of providing clients' demand. The retailer's expected profit is calculated based on the minimum cost. In the lower sub-problem, the non-probabilistic information-gap decision theory is proposed to model uncertain demands and determine the robust selling price. Robustness of selling price against the demand variations is evaluated such that the profit associated with this price will be more than an acceptable threshold, which is defined by the retailer. Additionally, the client response to the robust retail price is considered in the presented bilevel model. The proposed framework is formulated for risk-averse and risk-taker retailers. The efficiency and performance of the presented framework are analyzed on the sample DG-owning retailer. Copyright © 2015 John Wiley & Sons, Ltd.

A multiple intelligences approach to counseling: Enhancing alliances with a focus on strengths.

This qualitative study investigated the experiences of 8 counselors as they introduced multiple intelligences theory and activities into therapy with adult clients. As research on the application of multiple intelligences in the field of education has revealed many positive psychological benefits, this study explores possible therapeutic benefits from incorporating multiple intelligences within therapy. Semistructured interviews, conducted 3 months post multiple intelligences training, were transcribed and analyzed using interpretative phenomenological analysis. The major themes that emerged included perceptions of enhanced therapeutic alliances, more effective professional work, experiences of increased confidence, positive client response to a strength-based approach, positive client responses to a multiple intelligences preference survey, and positive outcomes from the use of music. Implications include the value of further long-term research on the benefits of using a multiple intelligence approach to therapy as an integrating metatheory, and instructing counseling trainees in the routine assessment of client abilities through the use of the multiple intelligences approach. © 2015 American Psychological Association.;

Obscuring users' identity in VoIP/IMS environments

Next Generation Networks bring together wired and wireless architectures, under the umbrella of an all IP architecture. Architectures such as the IP Multimedia Subsystem (IMS) offer advanced services at very low cost but also inherit IP infrastructure's security and privacy issues. The utilized signalling protocol (i.e. Session Initiation Protocol) and the related specifications are both overlooking users' privacy, leaving public and private identities unprotected to eavesdroppers. Existing solutions require either the existence of a public key infrastructure or the establishment of the appropriate mechanism for managing symmetric keys.We propose a novel one-time identity mechanism for obscuring users' real identity against eavesdroppers. The solution exploits the advantages of commutative functions, enabling the communicating parties to exchange data without pre-established keys nor any modification in the infrastructure. All participating entities generate one-time random identities providing in this way unlinkability and anonymity services as well.We evaluate the proposed mechanism through an open source IMS platform. Results have provided evidence that the client's response times are not considerably affected by the proposed mechanism, while the overhead imposed to the IMS core is negligible.

Zone of proximal development (ZPD) as an ability to play in psychotherapy: A theory‐building case study of very brief therapy

This theory-building case study examined the zone of proximal development (ZPD) in psychotherapy within the assimilation model. Theoretically, the ZPD is the segment of the continuum of therapeutic development within which assimilation of problematic experiences can take place. Work within a problem's current ZPD may be manifested as a Winnicottian ability to play, that is, an ability to adopt a flexible reflexive stance to the presenting problem and be involved in joint examination of possible alternatives. Play may be recognized in the client's receptivity to and creative use of the therapist's formulations of the presenting problems. A case was selected from a comparative clinical trial of two very brief psychotherapies for mild to moderate depression, the Two-Plus-One Project (Barkham, Shapiro, Hardy, & Rees, 1999, J. Consult. Clin. Psychol., 67, 201). Martha, a woman in her late forties, received two sessions of psychodynamic-interpersonal therapy 1 week apart and a follow-up ('plus one') session approximately 3 months later. Dialogical sequence analysis was used to analyse the transcripts of the three sessions. The analysis revealed Martha's problematic action pattern, which remained unchanged throughout the three sessions. Her ability to use and elaborate the therapist's formulations depended on the referential object that the therapist addressed; in particular, she seemed unable to play with the therapist's formulations of her more problematic experiences. The case helped elucidate how the ZPD is content dependent. Winnicott's conception of playing emphasizes the quality of client response as an indicator of this content sensitivity. Differing breadths of major problems' ZPD, manifested as differing abilities to play with therapists' formulations may explain why some clients improve in psychotherapy while some do not. Accessing very problematic content may be very difficult even though the client's ability to mentalize other material appears ordinary. Mildly depressed clients who have developed powerful care-taking coping strategies may not respond to very brief therapeutic interventions. A client's minimal acknowledgements may mislead the therapist into supplementing the client's failing self-reflection rather than addressing the issue that provokes this failure.

Infra-slow Fluctuation Training in Clinical Practice: A Technical History

Infra-slow Fluctuation (ISF) electroencephalogram (EEG) biofeedback is a recent development in neurofeedback training. This form of training is focused on the lowest energy the brain produces (< 0.1 Hz). The intervention is performed with a Direct Current (DC) coupled neurofeedback amplifier. It is distinct from Slow Cortical Potential (SCP) training and Infra-Low Frequency (ILF) training. It shares a similar optimization process with ILF that focuses on emergent state shifts within sessions. These state shifts require frequency adjustments that optimize client response to the training in real time. Due to the technical difficulties inherent in recording these frequencies, EEG investigators largely neglected this low energy until recently. As DC amplifiers improved, the slow frequencies became a signal of increasing interest to researchers. Research has demonstrated an important role for the infra-slow oscillations in clinical work. Positive clinical case outcomes suggest that a larger controlled study is warranted. The technical, clinical, and equipment requirements of the intervention make this form of neurofeedback unique in the pantheon of EEG biofeedback interventions.

A Cross Layer Collaborating Cache Scheme to Improve Performance of HTTP Clients in MANETs

This paper proposes a novel cross layer collaborating cache scheme for HTTP clients. It is designed to accelerate the process that an HTTP client retrieves Web content in mobile ad hoc network environment. Unlike other techniques to exploit Web proxy caching or to build P2P protocol overlay to improve HTTP, our scheme incorporates collaboratively working capability into the HTTP client response cache, and thus there is no impact on the compatibility of upper level applications. In addition, as the sharing file information is diffused with routing information, there is no redundant traffic to maintain the cooperating cache mechanism. Using this scheme, cacheable Web content can be distributed among local peers and retrieved later by a client if needed. In our simulation results, this novel cache scheme significantly decreases the latency experienced by a client to download Web content.

Self‐Compassion in Clinical Practice

Self-compassion is conceptualized as containing 3 core components: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus overidentification, when relating to painful experiences. Research evidence demonstrates that self-compassion is related to psychological flourishing and reduced psychopathology. Mindful Self-Compassion (MSC) is an 8-week training program, meeting 2.5 hours each week, designed to help participants cultivate self-compassion. MSC contains a variety of meditations (e.g., loving-kindness, affectionate breathing) as well as informal practices for use in daily life (e.g., soothing touch, self-compassionate letter writing). A detailed clinical case illustrates the journey of a client through the 8 weeks of MSC training, describing the key features of each session and the client's response.

Engendering Response: Professional Gesture and the Assessment of Eyesight in Optometry Consultations

Many of the procedures undertaken within healthcare require specialized forms of participation that may be unfamiliar, even disturbing, to patients or clients. The practitioner has to encourage and enable participation in the investigation in an appropriate fashion while preserving the structure and integrity of the procedure. In this article, we consider optometry and the deployment of a vision test, known as subject refraction, that provides data to help determine the characteristics of any corrective lens that may be required by clients. The procedure's ability to establish robust and reliable data relies upon the optometrist's ability to encourage the client to respond to a series of stimuli without consideration or reflection. That is, the client is required to produce an unwitting response—conduct that might be considered nonsymbolic rather than symbolic. In this article, we also consider the optometrist's talk and bodily comportment during subjective refraction and how it serves to shape and determine the quality of the client's response and participation, and in turn to produce reliable test results.

Response to McKay: The stakes are high

We are pleased to be in the company of a commentator 1 who has argued previously for expanding the scope of the existing efficacy paradigm 2, 3. Our succinct response is that the bar is high because the stakes are high. The stakes are high because while the explosion of clinical trials from the 1980s to the present has resulted in a range of moderately effective addiction treatments (e.g. 4-7), moderate effectiveness calls for improvement and scarce resources call for efficiency. In addition, the absence of clear comparative efficacy of one treatment over another suggests that developing and testing new treatments is no longer yielding substantive knowledge on how to optimize treatment delivery 8. The key question here is: when the stakes are high, should the direction for the future be more of the same? A paradigm shift in both research and practice that places tests of a treatment's causal theory at the same level of importance as tests of treatment efficacy is something different. It requires that not just the treatment, but the treatment's essential elements be validated in order to achieve the highest level of empirical support. Dr McKay identifies a number of sound arguments on why it may be difficult to specify active treatment ingredients. We agree that therapy process probably works in complex and multi-determined ways. However, this complexity argues for an incremental approach to process research, ‘peeling layers’ of ingredients and mechanisms and the contexts in which they are operative 9. Indeed, research methods in the addictions often reduce the therapy process to the effect of an intervention on a client response, and the effect of that client response on an outcome: in essence, a unidirectional mediation model. This mediational process probably accounts for a portion of causality, but we recognize that more nuanced analytical methods are also needed. These nuances may be at the level of speaker interaction or characterizing the nature of ‘sudden gains’ in addiction treatment, as Dr McKay suggests. Along similar lines is Greenberg's method of task analysis, which emphasizes an event-based approach to identifying key moments in psychotherapy that result in new learning outside the therapy context 10. In sum, we agree that behavioral addiction treatments work in complex ways, which is the very reason further understanding is needed, and only through that understanding can deeper and more complex methodological frameworks be incorporated. Dr McKay also highlights the role of research on common processes of change and queries the implications of evidence demonstrating that the majority of patient change is non-specific to a given modality. Such evidence may be an unfortunate fall-out of the clinical trial paradigm. Specifically, it may be that many treatments have only ‘artificial uniqueness’ and thus fail in tests of comparative efficacy. Many treatments may also impact common client mechanisms of change 8. Common therapy processes are common because they matter. It is the task of treatment developers to show where their treatments rely upon common ingredients and where they incorporate truly unique interventions that are active ingredients and thus critical to the model; or perhaps a future treatment will demonstrate differential efficacy because it has a unique combination of efficient, yet entirely common, ingredients. Yes, active ingredients should account for a meaningful portion of client change, but identifying this portion may first require a far better understanding of changes produced via assessment and control group exposure 9. Therapy is indeed very complicated and unpredictable, yet it is only through intensive and sustained study of treatment processes, active ingredients and client mechanisms of change that it will ever become less complicated and more predictable. We are not overly optimistic, but rather pessimistic that this will happen unless the noted paradigmatic shift is located not only in research, but also in our service infrastructure. None. The present work is supported by a grant awarded by National Institute on Alcohol Abuse and Alcoholism (NIAAA; K23AA018126) to Dr Molly Magill. However, both authors have contributed equally to the completion of this manuscript. This work is the responsibility of the authors and reflects the positions of the authors, and does not represent an official position of NIAAA or the National Institutes of Health.

The effect of drinking goals at treatment entry on longitudinal alcohol use patterns among adults with alcohol dependence

BackgroundDrinking goals at treatment entry are a promising, yet under-studied mechanism of change in alcohol use following treatment. It is not known who, upon treatment entry, is likely to desire abstinence as a drinking goal and whether desiring abstinence as a drinking goal influences alcohol use following treatment. MethodsData from a 2.5-year longitudinal study of alcohol-dependent adults from 3 treatment sites is examined in a secondary data analysis. At treatment entry, participants reported sociodemographic and clinical characteristics, as well as whether they desired abstinence as a drinking goal or not. At each subsequent wave, participants reported their alcohol use. ResultsBivariate analyses showed that individuals from a VA outpatient treatment site, men, and racial or ethnic minorities were most likely to desire abstinence as a drinking goal at treatment entry. Multi-level mixed effects regression models indicated that individuals who at baseline desired abstinence as a drinking goal sustained higher percentage of days abstinent and higher percentage of days since last drink 2.5 years following treatment entry, compared to individuals who did not desire abstinence. ConclusionsUnderstanding who is most likely to desire the specific drinking goal of abstinence can assist clinicians in anticipating client response to goal setting. Furthermore, by understanding the benefits and risks associated with drinking goals, clinicians can focus attention to individuals who desire a more risk-laden goal, including goals of non-abstinence, and tailor interventions, including motivational interviewing techniques, to support effective goals.

Black client, white therapist: Working with race in psychoanalytic psychotherapy in South Africa

In post‐apartheid South Africa we speak about race extensively. It permeates our workplace, weaves a thread through the fabric of our professional and personal lives, as well as our private conversations and public interactions with others. From within psychoanalytic theory, the thread weaves through the unknown content of our racialized unconscious. When there is a focus on race in the South African psychoanalytic context it largely takes the form of the struggle to articulate the complexities of working with difference, as Swartz notes, or the struggle to map out issues of race. Such struggles are not localized in South Africa, but strongly reflect a much broader struggle within the global psychoanalytic community, as mirrored in the expanding focus on race. Although the consulting rooms seem far removed from the ongoing political tensions that have recently emerged in South Africa, psychoanalytic psychotherapy remains a space of meaningful engagement with the other, and where the therapeutic dyad is one of racial difference it permits an encounter with our racialized unconscious. This article seeks to document the experience of my black client and my white response to her racial pain and struggle; in doing so, I describe the racial ‘contact’ between us and within us that triggers a racialized transference and countertransference dynamic, which contains the space for racial healing for both of us.

Achieving better Cloud access experience with server virtualization

Cloud computing is changing the way we work and the way we live. Cloud providers host their Clouds at their data centers. However, the data centers might be far away from end users. The end users would experience long response latency. Client-side proxy servers are close to the end users. They are widely deployed around the Internet. They are the ideal platforms to cache/replicate Cloud applications. However, current proxy servers do not support caching and execution of Cloud applications. In this paper, we utilize virtualization technology to expand the functionalities of proxy servers to support caching and execution of Cloud applications. Specifically, we propose a system model that consists of a virtualization server, a Cloud access request interception mechanism, proxy server extension modules, and a migration protocol. Heterogeneous services hosted by different Cloud providers can be migrated from the Clouds to the virtualization server at the proxy server side. Also, a migration cost function is designed to assist service migration decision making. With our approach, Cloud applications can be moved close to the end users. Our approach can reduce the user perceived response latency and thus it can achieve better user experience during Cloud access. We have utilized the industrial standard e-commerce benchmark TPC-W to conduct experimental studies. The experimental results show that our approach significantly reduces client response latency.

Using text messaging to prevent relapse to smoking: intervention development, practicability and client reactions

The NHS Stop Smoking Service (NHS-SSS) helps approximately half its clients to quit for 4 weeks. However, most initially successful quitters relapse within 6 months. Short message service (SMS) texting has been shown to facilitate stopping smoking. We describe the development, implementation and subsequent evaluation, in terms of practicability and client response, of an SMS text-based relapse prevention intervention (RPI) delivered within routine community and specialist National Health Service (NHS) Stop Smoking Service (SSS) provision in four Primary Care Trusts. Text messages aimed at motivation to remain abstinent, preventing careless lapses and continuing the full course of medicine for smoking cessation were developed and sent weekly to clients' mobile phones for 12 weeks and fortnightly for 6 months. They were asked to respond to some of the texts and contact the NHS SSS if they lapsed. They were also offered free nicotine mini lozenges to be sent via the mail on three occasions. NHS SSS. 202 clients who had been abstinent for 4 weeks. Feasibility of introducing RPI into routine care; response to interactive messages and requests for the medication; rating of the helpfulness of RPI; self-reported and carbon monoxide (CO)-validated smoking status for up to 26 weeks. A text-based RPI was easy to implement within the NHS SSS provided by specialist advisers, but enrollment of clients from services provided by a network of pharmacists was difficult because client contact details were often lacking. Where records of the number of people invited to RPI were available, 94% of eligible participants enrolled. The RPI was well received by both SSS clients and staff, with 70% (n = 63) of clients who completed follow-up considering the intervention helpful. Eighty-five per cent (n = 172) of clients responded to at least one of the nine interactive text messages. Sixty-four clients (32% of the total, 47% of those we managed to contact) reported continuous abstinence at 6 months. Eighteen (9%) clients who relapsed to smoking used the RPI to re-engage with the NHS SSS and 10 (5%) successfully re-established abstinence. In smokers attending National Health Service Stop Smoking Services who are abstinent 4 weeks after their quit date, a relapse prevention intervention based on SMS text messaging was well received, and can be implemented economically and rapidly. A controlled trial is needed to establish whether it has a significant impact on relapse.

Major Retailing Logistics Management Mechanisms

Due to the emergence of the global economy and increased competition, many of the modern fishing companies have recognized that their fisheries rapid product introduction and service innovation to market the importance of supply chain management. To improve their competitiveness, many modern fishing companies have accepted supply chain management to improve organizational effectiveness and achievement of organizational objectives, increase customer value, better use of resources, and improve profitability. Consider adhere to enterprise operational efficiency to improve collaboration and client response in the modern fisheries management advocated by business partners, an additional thrust towards a successful competitive strategy. Supply chain management in the fisheries industry has become part of the agenda of the senior management of the fishery production and the retail industry. Appropriate mechanism to optimize fisheries logistics supply chain design and effective fisheries management method is a reference to the fisheries in this article the major retail logistics supply chain management. Soft computing technology based on the proposed new program, and effectively solve the problems by a variety of dynamic segment of the logistics supply chain of the fisheries of the major retail companies.

A Push Technology Personal Librarian Project

A special library project was established in order to promote library services, increase interaction with clients and grow library usage. Using push technology to provide targeted information to meet client needs proved effective in reaching only some clients. This article describes the research method including the dissemination process and client response. It highlights the importance of not only reaching out to provide information to all clients, but also the importance of matching the correct dissemination method to the client.