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Living with a blood cancer in later life: The complex challenges and related support needs of adults aged 75 and older
- Naomi D. Parker, Easton N. Wollney, Carma L. Bylund, Tithi B. Amin, M. Devyn Mullis, Diliara Bagautdinova, Maria Sae-Hau, Elisa S. Weiss, Lyndsey A. Thomas, Carla L. Fisher
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- Journal:
- Palliative & Supportive Care , First View
- Published online by Cambridge University Press:
- 22 August 2023, pp. 1-7
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Objectives
This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.
MethodsAdults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer.
ResultsParticipants (n = 50) ranged from 75 to 91 years old. Both groups described similar experiences and identified 5 challenges and support needs: (1) socioemotional impact, (2) activities of daily living and instrumental activities of daily living (ADLs/iADLs), (3) uncertainty management, (4) treatment-related stressors, and (5) COVID-19-related strain. Properties for these themes illustrate challenges and support needs, with some differences between groups. For instance, those living with a chronic blood cancer highlighted financial strain with treatment-related stressors, while those with an acute blood cancer focused more on iADLs.
Significance of resultsFindings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.
The use of new technology in prevention and treatment of psychiatric diseases - preliminary results
- A. Häussl, F. Fellendorf, E. Fleischmann, S. Guggemos, E. Schönthaler, T. Stross, I. Zwigl, D. Albert, J. Mosbacher, K. Stix, S. Draxler, G. Lodron, T. Orgel, M. Pszeida, S. Russegger, M. Schneeberger, M. Uray, W. Weiss, M. Fellner, T. Fruhmann, R. Hartmann, P. Hauptmann, R. Pfiszter, G. Pötz, U. Prattner, N. Saran, S. Spat, E. Zweytik, T. Lutz, S. Lindner-Rabl, R. Roller-Wirnsberger, S. Schüssler, J. Zuschnegg, K. Ceron, M. Danilov, C. Grossegger, M. Macher, O. Sokolov, S. Egger-Lampl, B. Roszipal, L. Paletta, M. Lenger, N. Dalkner, E. Reininghaus
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S853-S854
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Introduction
The COVID-19 outbreak is a serious global public health issue with wide-ranging negative effects on people’s lives, which is reflected in steadily rising mental health problems. In order to appropriately respond to the increased occurrence of psychiatric illness, protect mental health and strengthen resilience it is necessary to include new technologies, such as extended reality (XR) or socially assistive robots (SAR) in not only psychiatric treatment but also in the prevention of psychiatric diseases. In this context, the use of new technologies offers innovative ways to strengthen resilience, self-efficacy and stress coping skills and plays an important role in improving psychological wellbeing.
ObjectivesPreliminary results from studies at the Clinical Department of Psychiatry and Psychotherapeutic Medicine in Graz, Austria, dealing with new technologies in psychiatry, show new options for psychiatric settings.
MethodsProject AMIGA: The aim of this study is to test the effectiveness of a cognitive training session, conducted with the SAR named Pepper. In this randomized controlled trial, the effectiveness of SAR on depressive symptoms and correlates is evaluated in a sample of 60 individuals with major depression. While the intervention group will receive cognitive training with the SAR Pepper, the control group will receive “treatment-as-usual” therapy with a common PC software. Participants will receive 30 minutes of training 2 times per week over a period of 3 weeks.
Project XRes4HEALTH: The aim of this study is to develop an XR resilience training to increase resilience and stress coping mechanisms in healthcare workers. A total of 40 people will be included. To test the effectiveness of the resilience training, 3 XR training sessions of 15 minutes each will be held. A pre-post measurement will test the effectiveness of the training on wellbeing and stress levels as well as the acceptance and satisfaction with the training.
Project AI-REFIT: The overall goal of this study is to explore key information to increase resilience in healthy individuals who are at increased risk for mental health problems. Through a usability study, the artificial intelligence-based prototype app of the resilience training will be tested for acceptance, usability, functionality, and efficiency. During the resilience training, participants are wearing a smartwatch which measures psychophysiological parameters. Conclusions about the success of the therapy can be drawn based on digital data acquisition.
ResultsNew technologies including XR and SAR support classical psychiatric treatment in the topics of resilience and cognitive training as an add-on therapy in times of reduced availability of healthcare workers.
ConclusionsThe rapid development of new technologies holds a lot of potential in the treatment of psychiatric disorders, which is why it is important to scientifically evaluate those innovative tools.
Disclosure of InterestNone Declared
Multistate outbreak of Salmonella Paratyphi B variant L(+) tartrate(+) and Salmonella Weltevreden infections linked to imported frozen raw tuna: USA, March–July 2015
- R. Hassan, S. Tecle, B. Adcock, M. Kellis, J. Weiss, A. Saupe, A. Sorenson, R. Klos, J. Blankenship, T. Blessington, L. Whitlock, H. A. Carleton, J. Concepción-Acevedo, B. Tolar, M. Wise, K. P. Neil
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- Journal:
- Epidemiology & Infection / Volume 146 / Issue 11 / August 2018
- Published online by Cambridge University Press:
- 08 June 2018, pp. 1461-1467
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Foodborne non-typhoidal salmonellosis causes approximately 1 million illnesses annually in the USA. In April 2015, we investigated a multistate outbreak of 65 Salmonella Paratyphi B variant L(+) tartrate(+) infections associated with frozen raw tuna imported from Indonesia, which was consumed raw in sushi. Forty-six (92%) of 50 case-patients interviewed ate sushi during the week before illness onset, and 44 (98%) of 45 who specified ate sushi containing raw tuna. Two outbreak strains were isolated from the samples of frozen raw tuna. Traceback identified a single importer as a common source of tuna consumed by case-patients; this importer issued three voluntary recalls of tuna sourced from one Indonesian processor. Four Salmonella Weltevreden infections were also linked to this outbreak. Whole-genome sequencing was useful in establishing a link between Salmonella isolated from ill people and tuna. This outbreak highlights the continuing foodborne illness risk associated with raw seafood consumption, the importance of processing seafood in a manner that minimises contamination with pathogenic microorganisms and the continuing need to ensure imported foods are safe to eat. People at higher risk for foodborne illness should not consume undercooked animal products, such as raw seafood.
Waterfall ice: mechanical stability of vertical structures
- J. Weiss, M. Montagnat, B. Cinquin-Lapierre, P.A. Labory, L. Moreau, F. Damilano, D. Lavigne
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- Journal:
- Journal of Glaciology / Volume 57 / Issue 203 / 2011
- Published online by Cambridge University Press:
- 08 September 2017, pp. 407-415
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We present a study of the mechanical (in)stability of the ephemeral waterfall ice structures that form from the freezing of liquid water seeping on steep rock. Three vertical structures were studied, two near Glacier d’Argentière, France, and one in the Valsavarenche valley, northern Italy. The generation of internal stresses in the ice structure in relation to air- and ice-temperature conditions is analyzed from pressure sensor records. Their role in the mechanical instability of the structures is discussed from a photographic survey of these structures. The main result is that dramatic air cooling (several °Ch−1 over several hours) and low temperatures (<−10°C), generating tensile stresses and brittleness, can trigger a spontaneous or climber-induced mechanical collapse, leading to unfavorable climbing conditions. Ice internal pressure fluctuations are also associated with episodes of marked diurnal air-temperature cycle, with mild days (few above 0) and cool nights (few below 0), through the occurrence of water ↔ ice phase transitions within the structure. These ice internal stress fluctuations seem, however, to have a local influence, are associated with warm (near 0), wet and therefore particularly soft ice and do not trigger a collapse of the structure.
Waterfall ice: formation, structure and evolution
- M. Montagnat, J. Weiss, B. Cinquin-Lapierre, P.A. Labory, L. Moreau, F. Damilano, D. Lavigne
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- Journal:
- Journal of Glaciology / Volume 56 / Issue 196 / 2010
- Published online by Cambridge University Press:
- 08 September 2017, pp. 225-234
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For the first time, to our knowledge, a scientific study of the formation and evolution of waterfall ice, the ephemeral ice structures that form from the freezing of liquid water seeping on steep rock, was performed. We surveyed and analysed three waterfall ice structures near Glacier d’Argentière, Mont Blanc massif, France, between winter 2007 and spring 2009. We reconstruct the global evolution of two vertical ice structures using automatic digital cameras, while the internal ice microstructure was analysed using ice coring and sampling. Macro- and microstructural observations are considered, along with temperature conditions recorded at a nearby meteorological station and directly within the ice structure. They reveal that vertical structures initially grow rapidly from the aggregation of stalactites with microstructures indicative of temperature conditions during their crystallization. After this initial stage, the volume of the ice structure reaches an asymptotic value, as water continues to flow inside the structure, isolated from the outside cold ice; the outer surface remains dry. At the end of the season, the collapse of the free-standing structure does not occur by progressive melting, but is initiated by a horizontal crack propagation at the top. The initiation of this crack seems to be triggered by a drastic temperature decrease.
Personality Polygenes, Positive Affect, and Life Satisfaction
- Alexander Weiss, Bart M. L. Baselmans, Edith Hofer, Jingyun Yang, Aysu Okbay, Penelope A. Lind, Mike B. Miller, Ilja M. Nolte, Wei Zhao, Saskia P. Hagenaars, Jouke-Jan Hottenga, Lindsay K. Matteson, Harold Snieder, Jessica D. Faul, Catharina A. Hartman, Patricia A. Boyle, Henning Tiemeier, Miriam A. Mosing, Alison Pattie, Gail Davies, David C. Liewald, Reinhold Schmidt, Philip L. De Jager, Andrew C. Heath, Markus Jokela, John M. Starr, Albertine J. Oldehinkel, Magnus Johannesson, David Cesarini, Albert Hofman, Sarah E. Harris, Jennifer A. Smith, Liisa Keltikangas-Järvinen, Laura Pulkki-Råback, Helena Schmidt, Jacqui Smith, William G. Iacono, Matt McGue, David A. Bennett, Nancy L. Pedersen, Patrik K. E. Magnusson, Ian J. Deary, Nicholas G. Martin, Dorret I. Boomsma, Meike Bartels, Michelle Luciano
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- Journal:
- Twin Research and Human Genetics / Volume 19 / Issue 5 / October 2016
- Published online by Cambridge University Press:
- 22 August 2016, pp. 407-417
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Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.
Acceptability of internet interventions for youth mental health in Vietnam
- K. Sobowale, M. Nguyen, B. Weiss, T. T. Hai Van, L. T. Trung
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- Journal:
- Global Mental Health / Volume 3 / 2016
- Published online by Cambridge University Press:
- 14 July 2016, e22
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Background.
Despite high levels of mental illness, Vietnamese youth have limited access to mental health care. Internet interventions, evidence-based psychotherapy treatments delivered through the internet, have the potential to increase access to mental health for youth in Vietnam. This study explored the perceptions of youths and parents toward internet interventions for youth mental health.
Methods.Four focus groups were conducted with youths (n = 20) and parents (n = 20) in Danang, Vietnam. The Technology Acceptance Model was used a framework for focus group questions. The data were analyzed using direct content analysis.
Results.Most youths and parents agreed that the internet serves well as a care delivery model. Participants expressed that the web would be useful for psychoeducation and sharing and receiving information with others. Both groups reported lack of awareness of web-based interventions and logistical concerns regarding access as main barriers. In addition, many parents were concerned about internet addiction. Specific adaptations in Vietnam such as standalone internet service centers and partnering with local organizations may benefit uptake of internet interventions.
Conclusion.This study suggests that internet-based programs for youth mental health, particularly interventions incorporating psychoeducation and social networking components, will be well received in Vietnam. Barriers need to be addressed to successfully implement internet-based treatment. Future initiatives should incorporate acceptance models to improve development of internet interventions for youth.
Pediatric Severe Sepsis/Septic Shock Associated with Healthcare-Associated Infections
- Sarah B. Klieger, Julie C. Fitzgerald, Scott L. Weiss, Fran Balamuth, Eva Teszner, Julia S. Sammons, Susan E. Coffin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 37 / Issue 4 / April 2016
- Published online by Cambridge University Press:
- 16 December 2015, pp. 483-485
- Print publication:
- April 2016
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- By Agoston T. Agoston, Syed Z. Ali, Mahul B. Amin, Daniel A. Arber, Pedram Argani, Sylvia L. Asa, Rebecca N. Baergen, Zubair W. Baloch, Andrew M. Bellizzi, Kurt Benirschke, Allen Burke, Kenneth B. Calder, Karen L. Chang, Rebecca D. Chernock, Wang Cheung, Thomas V. Colby, Byron P. Croker, Ronald A. DeLellis, Edward F. DiCarlo, Ralph C. Eagle, Hormoz Ehya, Brett M. Elicker, Tarik M. Elsheikh, Robert E. Fechner, Linda D. Ferrell, Melina B. Flanagan, Douglas B. Flieder, Christopher S. Foster, Lillian Gaber, Karuna Garg, Kim R. Geisinger, Ryan M. Gill, Eric F. Glassy, David J. Glembocki, Zachary D. Goodman, Robert O. Greer, David J. Grignon, Gerardo E. Guiter, Kymberly A. Gyure, Ian S. Hagemann, Michael R. Henry, Jason L. Hornick, Ralph H. Hruban, Phyllis C. Huettner, Peter A. Humphrey, Olga B. Ioffe, Edward C. Klatt, Michael J. Klein, Ernest E. Lack, James N. Lampros, Lester J. Layfield, Robin D. LeGallo, Kevin O. Leslie, James S. Lewis, Virginia A. LiVolsi, Alberto M. Marchevsky, Anne Marie McNicol, Mitra Mehrad, Elizabeth Montgomery, Cesar A. Moran, Christopher A. Moskaluk, George J. Netto, G. Petur Nielsen, Robert D. Odze, Arthur S. Patchefsky, James W. Patterson, Elizabeth N. Pavlisko, John D. Pfeifer, Celeste N. Powers, Richard A. Prayson, Anja C. Roden, Victor L. Roggli, Andrew E. Rosenberg, Sherif Said, Margie A. Scott, Raja R. Seethala, Carlie S. Sigel, Jan F. Silverman, Bruce R. Smoller, Edward B. Stelow, Nora C. J. Sun, Mark W. Teague, Satish K. Tickoo, Thomas M. Ulbright, Paul E. Wakely, Jun Wang, Lawrence M. Weiss, Mark R. Wick, Howard H. Wu, Rhonda K. Yantiss, Charles Zaloudek, Yaxia Zhang, Xiaohui Sheila Zhao
- Edited by Mark R. Wick, University of Virginia, Virginia A. LiVolsi, University of Pennsylvania School of Medicine, John D. Pfeifer, Washington University School of Medicine, St Louis, Edward B. Stelow, University of Virginia, Paul E. Wakely, Jr
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- Book:
- Silverberg's Principles and Practice of Surgical Pathology and Cytopathology
- Published online:
- 13 March 2015
- Print publication:
- 26 March 2015, pp vii-x
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- By Andrew Adesman, Lenard A. Adler, Samuel Alperin, Kira E. Armstrong, L. Eugene Arnold, Amy F. T. Arnsten, Russell A. Barkley, Craig W. Berridge, Joseph Biederman, F. Xavier Castellanos, Barbara J. Coffey, Alison M. Cohn, C. Keith Conners, Joan M. Daughton, Stephen V. Faraone, John Fayyad, Lisa G. Hahn, Laura Hans, Elizabeth Hurt, Gagan Joshi, Rahil Jummani, Jesse M. Jun, Ronald C. Kessler, Scott Haden Kollins, Kimberly Kovacs, Christopher J. Kratochvil, Beth Krone, Nicholas Lofthouse, Michael J. Manos, Francis Joseph McClernon, Joel E. Morgan, Nicholas R. Morrison, Sonali Nanayakkara, Jeffrey H. Newcorn, Phillip L. Pearl, Juan D. Pedraza, Guy M. L. Perry, Steven R. Pliszka, Jefferson B. Prince, J. Russell Ramsay, Anthony L. Rostain, David M. Shaw, Mary V. Solanto, Mark A. Stein, Jonathan R. Stevens, Brigette S. Vaughan, Margaret Weiss, Roy E. Weiss, Timothy E. Wilens, Janet Wozniak
- Edited by Lenard A. Adler, New York University School of Medicine, Thomas J. Spencer, Timothy E. Wilens
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- Book:
- Attention-Deficit Hyperactivity Disorder in Adults and Children
- Published online:
- 05 February 2015
- Print publication:
- 08 January 2015, pp vii-x
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael Selzer, Stephanie Clarke, Leonardo Cohen, Gert Kwakkel, Robert Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 May 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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- By Frank Andrasik, Melissa R. Andrews, Ana Inés Ansaldo, Evangelos G. Antzoulatos, Lianhua Bai, Ellen Barrett, Linamara Battistella, Nicolas Bayle, Michael S. Beattie, Peter J. Beek, Serafin Beer, Heinrich Binder, Claire Bindschaedler, Sarah Blanton, Tasia Bobish, Michael L. Boninger, Joseph F. Bonner, Chadwick B. Boulay, Vanessa S. Boyce, Anna-Katharine Brem, Jacqueline C. Bresnahan, Floor E. Buma, Mary Bartlett Bunge, John H. Byrne, Jeffrey R. Capadona, Stefano F. Cappa, Diana D. Cardenas, Leeanne M. Carey, S. Thomas Carmichael, Glauco A. P. Caurin, Pablo Celnik, Kimberly M. Christian, Stephanie Clarke, Leonardo G. Cohen, Adriana B. Conforto, Rory A. Cooper, Rosemarie Cooper, Steven C. Cramer, Armin Curt, Mark D’Esposito, Matthew B. Dalva, Gavriel David, Brandon Delia, Wenbin Deng, Volker Dietz, Bruce H. Dobkin, Marco Domeniconi, Edith Durand, Tracey Vause Earland, Georg Ebersbach, Jonathan J. Evans, James W. Fawcett, Uri Feintuch, Toby A. Ferguson, Marie T. Filbin, Diasinou Fioravante, Itzhak Fischer, Agnes Floel, Herta Flor, Karim Fouad, Richard S. J. Frackowiak, Peter H. Gorman, Thomas W. Gould, Jean-Michel Gracies, Amparo Gutierrez, Kurt Haas, C.D. Hall, Hans-Peter Hartung, Zhigang He, Jordan Hecker, Susan J. Herdman, Seth Herman, Leigh R. Hochberg, Ahmet Höke, Fay B. Horak, Jared C. Horvath, Richard L. Huganir, Friedhelm C. Hummel, Beata Jarosiewicz, Frances E. Jensen, Michael Jöbges, Larry M. Jordan, Jon H. Kaas, Andres M. Kanner, Noomi Katz, Matthew S. Kayser, Annmarie Kelleher, Gerd Kempermann, Timothy E. Kennedy, Jürg Kesselring, Fary Khan, Rachel Kizony, Jeffery D. Kocsis, Boudewijn J. Kollen, Hubertus Köller, John W. Krakauer, Hermano I. Krebs, Gert Kwakkel, Bradley Lang, Catherine E. Lang, Helmar C. Lehmann, Angelo C. Lepore, Glenn S. Le Prell, Mindy F. Levin, Joel M. Levine, David A. Low, Marilyn MacKay-Lyons, Jeffrey D. Macklis, Margaret Mak, Francine Malouin, William C. Mann, Paul D. Marasco, Christopher J. Mathias, Laura McClure, Jan Mehrholz, Lorne M. Mendell, Robert H. Miller, Carol Milligan, Beth Mineo, Simon W. Moore, Jennifer Morgan, Charbel E-H. Moussa, Martin Munz, Randolph J. Nudo, Joseph J. Pancrazio, Theresa Pape, Alvaro Pascual-Leone, Kristin M. Pearson-Fuhrhop, P. Hunter Peckham, Tamara L. Pelleshi, Catherine Verrier Piersol, Thomas Platz, Marcus Pohl, Dejan B. Popović, Andrew M. Poulos, Maulik Purohit, Hui-Xin Qi, Debbie Rand, Mahendra S. Rao, Josef P. Rauschecker, Aimee Reiss, Carol L. Richards, Keith M. Robinson, Melvyn Roerdink, John C. Rosenbek, Serge Rossignol, Edward S. Ruthazer, Arash Sahraie, Krishnankutty Sathian, Marc H. Schieber, Brian J. Schmidt, Michael E. Selzer, Mijail D. Serruya, Himanshu Sharma, Michael Shifman, Jerry Silver, Thomas Sinkjær, George M. Smith, Young-Jin Son, Tim Spencer, John D. Steeves, Oswald Steward, Sheela Stuart, Austin J. Sumner, Chin Lik Tan, Robert W. Teasell, Gareth Thomas, Aiko K. Thompson, Richard F. Thompson, Wesley J. Thompson, Erika Timar, Ceri T. Trevethan, Christopher Trimby, Gary R. Turner, Mark H. Tuszynski, Erna A. van Niekerk, Ricardo Viana, Difei Wang, Anthony B. Ward, Nick S. Ward, Stephen G. Waxman, Patrice L. Weiss, Jörg Wissel, Steven L. Wolf, Jonathan R. Wolpaw, Sharon Wood-Dauphinee, Ross D. Zafonte, Binhai Zheng, Richard D. Zorowitz
- Edited by Michael E. Selzer, Stephanie Clarke, Leonardo G. Cohen, Gert Kwakkel, Robert H. Miller, Case Western Reserve University, Ohio
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- Book:
- Textbook of Neural Repair and Rehabilitation
- Published online:
- 05 June 2014
- Print publication:
- 24 April 2014, pp ix-xvi
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11 - Negotiation
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- Book:
- The Entrepreneurial Engineer
- Published online:
- 05 June 2014
- Print publication:
- 21 October 2013, pp 326-363
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Summary
In business, you don’t get what you deserve, you get what you negotiate.
Chester L. KarrassYou must never try to make all the money that’s in a deal. Let the other fellow make some money too, because if you have a reputation for always making all the money, you won’t have many deals.
J. Paul GettyThe fellow who says he’ll meet you halfway, usually thinks he’s standing on the dividing line.
Orlando A. BattistaEntrepreneur’s Diary
Like it or not, you often will be negotiating something in life, and always will be negotiating something in an entrepreneurial pursuit. The negotiation could be direct or indirect, obvious or subtle, but as an entrepreneur, you always will be negotiating.
As just one example, my colleague Michael (first author of this text) shared with me a very important lesson in this regard from one of the angel investors that was his first major outside investor, Peter. Peter was seventy-one years old when he first became involved in my friend’s commercial fish farming company. He was the master at just about everything to do with starting a new business. Peter had left a Big 4 accounting firm (probably was the Big 8 back then) to launch his entrepreneurial career, when he had four children and a wife to support at the time. Among other deal points, Peter negotiated with Michael to purchase a 20% equity stake in his company in exchange for Peter’s cash investment. Michael violated a soon-to-be-learned rule, one that Peter was about to teach him the hard way. Peter had originally agreed to invest in the company for 18%, but later simply said that he’d feel a lot better if my friend could “round up” this figure to 20%. It wasn’t necessary, but it would be “nice.” Wanting to get the deal done, given that the parties were so close, and concerned he might otherwise disappoint or aggravate Peter, Michael said, “OK.” Michael didn’t ask what he would get for bumping up Peter’s equity stake or say something such as, “I’ll do that for you if you do XYZ in return.” Peter later told Michael that this was part of the negotiation, not simply a casual request.
6 - Creating Your Company
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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- 21 October 2013, pp 146-168
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People are definitely a company’s greatest asset. It doesn’t make any difference whether the product is cars or cosmetics. A company is only as good as the people it keeps.
Mary Kay Ash (1915–2001; U.S. Business Executive)Entrepreneur’s Diary
You’re making great progress. You’ve got a board, you are about to hire two key employees, and you are just about ready to start executing your company business strategy. But, you need a company structure to embody these attributes. In fact, you can’t even open a bank account without an Employer’s Identification Number (EIN). This is no simple decision. In particular, your board (typically made up of “older” types) will probably steer you in the direction of a conventional commercial corporation, aka C-Corp. Why, because they are familiar with it. People just about always think what they are familiar with is best, else why would they have been doing it all these years? I believe that a limited liability corporation (LLC) is probably your best bet at this point of your company history for a variety of reasons we discuss in this chapter. I’m not a lawyer, and this is where you should seek legal advice once you think you know what you want to do. In fact, never go to a lawyer and ask them an open-ended question such as “What should I do?” They will just about always guide you in the most conservative direction legally, and this may not be best for your company.
Types of Ownership Structures
Before you can decide on an ownership structure for your business, you should learn a little bit about how each structure works. As a good reference on deciding which ownership structure is most suitable for your business, read “Choosing the Best Ownership Structure for Your Business” (go to www.nolo.com/lawcenter).
7 - Financial Accounting
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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- 21 October 2013, pp 169-213
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I have no use for bodyguards, but I have very specific use for two highly trained certified public accountants.
Elvis PresleyEntrepreneur’s Diary
It seems as if addition, subtraction, multiplication, and division should be fairly simple. It is, until you want to apply it to accounting and do your tax calculations! There are many ramifications resulting from your choice of corporate structure on how you end up paying taxes. For example, who in their right mind would choose to pay taxes twice on profits you make from your company? Well, if you choose a C-Corp for your company structure, that’s just what you’ll be doing! But sometimes a C-Corp is the best choice, and you might ask why. I think my accountant was probably the key professional with whom I interacted with during the early days of my start-up. I recommend seeking an accountant’s advice early, before you create your company structure.
Getting Started
At this point in the text, we’ve covered the basic steps of defining your business, developing a marketing strategy, and differentiating your business from the competition. In this chapter, we cover the creation and use of financial accounting statements in the typical business plan, including depreciation and taxation issues. We stress the importance of creating these financial statements from the top down versus the bottom up by basing the figures on details from the demand side of the equation, that is, sales and the costs of production.
Dedication
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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Preface
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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- 21 October 2013, pp xvii-xxii
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Where Are We Going?
If you ask a group of engineers, most of them would probably tell you that they have thought about starting a business. Most did nothing. Some others did some research and preliminary planning. Some of these then invested some personal funds in creating the shell of a company in some legal format. A rare few took their companies forward to the point that they became operational businesses.
Most of us will see opportunities to start a business. This book is for those among us who are contemplating the start of a business and those that may have already taken that big first step. As teachers and successful entrepreneurs, our goal in writing this book is to help you the reader maximize your chances of entrepreneurial success. You will find guidance, instruction, and practical lessons that will assist you, the prospective entrepreneur, with your first steps toward realizing a dream.
12 - Management
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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- 21 October 2013, pp 364-395
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I believe the single most significant decision I can make on a day-to-day basis is my choice of attitude. It is more important than my past, my education, my bankroll, my successes or failures, fame or pain, what other people think of me or say about me, my circumstances, or my position.
Charles SwindollEntrepreneur’s Diary
I teach a course on entrepreneurship, and I always invite numerous successful entrepreneurs to give guest lectures on the subject. One of my favorite speakers is Greg (PhD from Cornell). Greg was raising money for his start-up venture about the same time I was raising money to start my fish business. Greg is now worth millions of dollars (that is another story), but he retains a casual attitude toward his success. When Greg comes to lecture, he typically wears jeans and a knit sport shirt with a fleece jacket. Greg describes the early beginnings of his company and how he hated big-company corporate structure. You know ... having to report to so-and-so ... following this and that procedure ... properly documenting this and that. Greg started his own company so he wouldn’t have to follow all those rules and do a lockstep with corporate ways of doing things. Well, initially, this approach worked okay for Greg. But, then as his company went from 3 employees to 20, to 100, to 300, he found that he had to follow many of those same corporate rules that he hated before. He was having trouble managing under this new structure. It wasn’t as much fun as it used to be. I asked Greg if it had to be this way. He responded with a slouch to his shoulders and a roll of his eyes.
The majority of this chapter was written by my oldest brother James. He was always to me the smartest person I have ever known. It seems appropriate he would author this chapter on management. Enjoy the chapter; I think it has lots of nuggets of wisdom that you will find helpful sometime in your entrepreneurial career. And thanks, Jim, for sharing your management knowledge.
9 - Fund-Raising
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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Start small, but think tall!
Robert H. SchullerEntrepreneur’s Diary
Raising money is hard work. You have to be prepared. Anytime a potential investor senses that you have not properly prepared for a meeting, you instantly will have lost any chance of landing this person as an investor. When I was raising some stage 2 financing for Fingerlakes Aquaculture, I had a meeting with a group of potential investors in Boston, friends and acquaintances of my angel investor, Peter (I think I’ve mentioned him before). We met in the high-rent financial district. Big buildings … marble hallways … all that type of stuff. I had spent many hours refining my presentation down to about twenty minutes to cover selected details so they would ask for more information that I could tell them was covered in the full business plan and that I had copies with me for them if interested. Part of my presentation was to actually prepare some tilapia fillets from my farm so the guests could really “get a taste of what it was all about.” (This was back in 1999, when most people had no idea what a tilapia fillet tasted like or even what a tilapia was!) The meeting was to start at 11:00 a.m. I was getting ready to start my presentation, including the cooking arrangements for the fillets. The invitees (there were five in total) got there about ten to fifteen minutes early and started chatting with my angel investor Peter. It didn’t take long before they became so curious about the product and what it tasted like that I had no choice (in my opinion) but to go ahead with that segment of the presentation, even though it was supposed to be at the end of my planned presentation right about lunch time (I thought this would be perfect timing). They all loved the product. Two of the people in attendance became investors in my company. I never did get to show them my PowerPoint presentation. But if I had, it was a good one. I was prepared.
10 - Rules of Investing
- Michael B. Timmons, Cornell University, New York, Rhett L. Weiss, Cornell University, New York, Daniel P. Loucks, Cornell University, New York, John R. Callister, Cornell University, New York, James E. Timmons
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- The Entrepreneurial Engineer
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It’s only business. Nothing personal.
Michael Corleone (The Godfather)Entrepreneur’s Diary
I recently was involved in raising capital for starting an indoor shrimp farm. Just about everyone likes to eat shrimp. Interestingly, just about all of our shrimp (90%) is imported, creating a fairly obvious market opportunity. So, several years back, we put some seed money together and started working on the constraints that prevented someone from successfully raising shrimp indoors and making a profit. Well, after three years of research and demonstrating a prototype production system, we were ready for our next round of financing (we needed about $500,000). We prepared a presentation and invited a group of high-net-worth individuals. We presented in one of the high-rent office buildings in the financial district of Atlanta. You know, people do like shrimp, but they also like to have a sense of confidence about the people they are dealing with. My cousin John, a businessman in the Atlanta area, brought that credibility to the table. Our challenge was to present the opportunity to the individuals in the room in a form they could understand. We had all the necessary legal documents with us. We knew the rules and followed them. We were successful that night and raised most of the equity capital we needed. The investors all seemed to like and respect my cousin. And they all ate a lot of shrimp that night, too!