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Anticipating risks in software development is always challenging, but particularly so when the software application is part of a novel sociotechnical system with various human and physical components. Our interdisciplinary team of software engineering and human factors researchers is designing such a system. In order to identify and mitigate the risks latent in this previously unexplored space, we have used the premortem method at an early stage in system design. In the premortem, the team ideated failure scenarios across the range of system use, then collaborated on ways to eliminate, mitigate, or monitor the risks of these failures. We have found the premortem method valuable in recognizing and mitigating previously unanticipated risks and in enriching team communication.

Background: Nicaragua initiated a national program of vitamin A fortification of its domestic sugar supply starting with the 1999-2000 sugarcane harvest. Objective: This study was conducted to document any change in the vitamin A status of a cohort of children during the first year of the program. Design: The vitamin A status of 21 Nicaraguan schoolchildren (mean age: 6.7 y; range: 5.3-9.3 y) was assessed in March 2000 and in March 2001. Total-body vitamin A stores and liver vitamin A concentrations were estimated with the deuterated-retinol-dilution (DRD) technique at a dose of 5 mg [[sup.2][H.sub.4]]retinyl acetate at baseline and 5 mg [[sup.2][H.sub.8]]retinyl acetate during the repeat test 1 y later. Plasma retinol and carotenoids were measured by HPLC. Results: Median total-body vitamin A stores increased from 0.33 to 0.72 mmol (P = 0.0001), liver vitamin A concentrations from 0.52 to 0.78 [micro]mol/g (P = 0.0003), and plasma retinol concentrations increased from 0.97 to 1.17 [micro]mol/L (P = 0.01). Conclusion: The vitamin A status of Nicaraguan schoolchildren improved during the year after the initial distribution of vitamin A-fortified sugar in Nicaragua. KEY WORDS Vitamin A, total-body vitamin A stores, liver vitamin A, deuterated retinol dilution, stable-isotope dilution, retinol, carotenoids, [beta]-carotene, vitamin A-fortified sugar, Nicaraguan children

Objective: This study evaluated the effectiveness and replicability of psychoeducational modules designed to improve the social and instrumental competencies of severely mentally ill patients. Method: Staff in seven facilities used the modules to teach 108 severely mentally ill patients. Staff received 2 days of formal training followed by periodic consultation. Each module's effectiveness was measured by a test of the patients' knowledge and performance of the skills taught in that module. Staff's adherence to the instructional techniques specified in the modules was measured by directly observing them and assessing the fidelity of their behaviors to those specified in the modules. Results: The patients' skills significantly improved and were maintained during a 1-year follow-up, and staff accurately followed the modules with minimal consultation. Conclusions: These training modules are effective and replicable techniques for teaching social and instrumental skills to severely mentally ill patients. The modules can be easily disseminated to a variety of facilities and used as components in a comprehensive rehabilitation program. (Am J Psychiatry 1992; 149:654-658)

AimsTotal knee arthroplasty (TKA) using functional alignment aims to implant the components with minimal compromise of the soft-tissue envelope by restoring the plane and obliquity of the non-arthritic joint. The objective of this study was to determine the effect of TKA with functional alignment on mediolateral soft tissue balance as assessed using intraoperative sensor-guided technology.MethodsThis prospective study included 30 consecutive patients undergoing robotic-assisted TKA using the Stryker PS Triathlon implant with functional alignment. Intraoperative soft tissue balance was assessed using sensor-guided technology after definitive component implantation; soft tissue balance was defined as intercompartmental pressure difference (ICPD) of < 15 psi. Medial and lateral compartment pressures were recorded at 10°, 45°, and 90° of knee flexion. This study included 18 females (60%) and 12 males (40%) with a mean age of 65.2 years (SD 9.3). Mean preoperative hip-knee-ankle deformity was 6.3° varus (SD 2.7°).ResultsTKA with functional alignment achieved balanced medial and lateral compartment pressures at 10° (25.0 psi (SD 6.1) vs 23.1 psi (SD 6.7), respectively; p = 0.140), 45° (21.4 psi (SD 5.9) vs 20.6 psi (SD 5.9), respectively; p = 0.510), and 90° (21.2 psi (SD 7.1) vs 21.6 psi (SD 9.0), respectively; p = 0.800) of knee flexion. Mean ICPD was 6.1 psi (SD 4.5; 0 to 14) at 10°, 5.4 psi (SD 3.9; 0 to 12) at 45°, and 4.9 psi (SD 4.45; 0 to 15) at 90° of knee flexion. Mean postoperative limb alignment was 2.2° varus (SD 1.0°).ConclusionTKA using the functional alignment achieves balanced mediolateral soft tissue tension through the arc of knee flexion as assessed using intraoperative pressure-sensor technology. Further clinical trials are required to determine if TKA with functional alignment translates to improvements in patient satisfaction and outcomes compared to conventional alignment techniques.

The article focuses on chairman Emilio Botín of the Spanish banking group Banco Santander. It comments on problems Botín is facing with the ongoing crises faced by the European financial industry, including reports that Banco Santander's earnings fell 36 percent in 2011. It talks about Botín's business strategy where he acquires prominent foreign banks that have a minimum 10 percent market share that are suffering financial difficulties. It mentions Santander's state-of-the-art computer system that has allowed the bank to cut back-office expenses at its subsidiaries. It also comments on reduced profits Santander has suffered due to its heavy exposure in Spain, resulting in European authorities forcing it to raise 20 billion dollars in new capital.

Discusses potential terrorist threats in the U.S. from the al-Qaeda network. Suicide bombings in Tunisia and Pakistan which have been linked to al-Qaeda; Suggestion that al-Qaeda leader Osama bin Laden is in hiding and is still able to send messages to followers; Proposed reasons that there have not been more attacks, including the war in Afghanistan; Arrest of Abu Zubaydah who is suspected of being responsible for organizing attacks in Europe and North America.

Reports on the international investigation to link Osama bin Laden to the terrorist attacks in the United States. Allegations in the British white paper detailed in a speech by British Prime Minister Tony Blair; Evidence implicating bin Laden's al-Qaeda terrorist network; Discussion of information given by Djamel Beghal, a Frenchman of Algerian origin who was arrested using a fake passport in the United Arab Emirates and was a veteran of the Al-Qaeda training camps. INSET: THE EUROPEAN CONNECTION.

Reports on the investigation into the September 11, 2001 terrorist attacks on the United States. Role of the U.S. Federal Bureau of Investigation; Worries that associates of the airline hijackers remain in communities; Concerns over attacks abroad; Details of suspects who have been arrested; Disputes about identities; Terrorist strategies; Speculation on financing; Why Osama bin Laden is the top suspect. INSETS: MANHUNT IN AMERICA;LOOKING FOR PATTERNS.

Focuses on the ways in which Europe is creating a respectable technology industry and market. Example of smart cards, the Airbus Industrie, the telecommunication technology of Nokia and Mannesmann, and others; Role of the euro in reducing market fragmentation; Political aspects of this industry; Outlook for the growth of technology in Europe.

Discusses the role of United States banks in offering credit cards to Europeans as of October 1998. Mention of the offer of the World Cup credit card to Britains by Capital One; US banks that have gained a foothold in Europe, such as MBNA, Citibank, HFC International, American Express and Capital One; Two basic strategies; The fraction of credit card debt that Europeans carry compared to US citizens.

Focuses on how Jack Levy, managing director in charge of Merrill Lynch's mergers and acquisitions (M&A) department helped to bring Merrill to the top of the United States rankings. Examples of mergers where Merrill was present; Total amount of fees collected in 1997; The intention of Merrill when it set out to build its M&A department. INSET: Trying harder in Europe by Charles Wallace.

Discusses the financial situation of German shoemaker Adidas Corp. Struggle to recover from the brink of bankruptcy; Report that the company's revenue jumped from $1.7 billion in 1992 to $2.8 billion in 1996; Efforts made by Adidas president Robert Louis-Dreyfus, to boost the company's performance in the all-important American market.

Focuses on two exiles, former Wall Street financier Michael D. Dingman and a Czech investor Viktor Kozeny. Their promise to teach Czech industry Western management methods; Plummeting value of most of the public companies associated with Kozeny and Dingman; Exploitation of Eastern Europe's emerging financial markets by Kozeny; What investors have learned about the pitfalls of emerging markets.

Reports on the progress Giovanni Agnelli is making as chairman of Piaggio. Details of the Agnelli empire; The Agnelli lineage; Piaggio's scooters, especially the Vespa' His personal history; Management history of Fiat; Giovanni as eventually taking over Fiat. INSET: The birth of a cultural icon.

Discusses the role of Europeans in the information revolution as of September 1998, such as in the case of a British company called Psion, headed by David Potter. Details about a joint venture, called Symbian, that will license Psion's software as the underlying brains behind a generation of devices, ranging from mobile telephones to laptop computers; Marketing innovations that have helped boost demand in Europe.

Discusses the implications of a weak U.S. dollar for the world economy. Concerns over the dollar's long slide; Options for cutting the federal deficit; Why the weak dollar is a big factor in the revived manufacturing sector; Possibility that a weak dollar could lead to inflation, higher interest rates and a global recession; Benefits of a strong dollar, which helped finance the budget deficit and kept interest rates low; How the weak dollar is causing pain overseas, in particular Europe; Concerns of Asians; Views of economists; Outlook. INSET: TIME AND MONEY.

Discusses the art theft of paintings such as Edvard Munch's 'The Scream,' 'Madonna' from the Munch Museum in Oslo, Norway. How two men in hooded sweatshirts and ski masks held a pistol to the guards in order to steal the art; Lack of insurance for the Munch paintings due to the high cost of premiums on famous pictures; Consideration of how thieves disguised as policemen stole 13 pictures from the Isabella Gardner Museum in Boston in 1990; Development of tracking devices which can be used by museums to follow stolen items that are removed from the premises; Vulnerability of 'The Scream' painting because it was painted on cardboard.

Describes the increase in corporate mergers in Europe. Example of the purchase of Telecom Italia by Olivetti; Role of United States investors in the mergers; Impact of globalization and the euro on merger activity; Most mergers occurring within countries; Importance of corporate size in banking; Other industries which may face mergers; Value of mergers for European shareholders.

Reports on David Potter and his company Psion PLC which Bill Gates believes is one of Microsofts' greatest threats. Description of Psion; Psions joint venture formed with Nokia, Ericsson, and Motorola named Symbian; Why the phone companies decided to join Symbian.

Discusses Philips Electronics and its history of poor performance. How its stock traded in 1996 at the same price it did in 1969; Comments from Dudley Eustace, chief financial officer for Philips; Success of competitor Sony Corp.; Impact on stock prices that the appointment of Cor Boonstra as president and chief executive had; Boonstra's promises; His experience; The effectiveness of his reform efforts; Criticism of his seemingly slow progress.

Looks at the efforts of Body Shop founder Anita Roddick to get her company back on track. The company's problems, including weak United States sales and press attacks on its image; Dramatic drop in share price between 1992 and April 1996; Body Shop's aggressive global expansion plan, with a focus on Asia, not reassuring investors; More.

Presents several letters to the editor. Reference to the article "Shakespeare as a Man Among Men," published in an earlier issue of the periodical ; Grounds on which writers in the American press incline toward the Liberal Party; Discussion on implementation of the corporation tax law.

A student-centered innovative method of teaching veterinary parasitology was launched and evaluated at the Ross University School of Veterinary Medicine (RUSVM) in St. Kitts, where Parasitology is a required course for second-semester veterinary students. A novel method, named Iron Parasitology, compared lecturer-centered teaching with student-centered teaching and assessed the retention of parasitology knowledge of students in their second semester and again when they reached their seventh semester. Members of five consecutive classes chose to participate in Iron Parasitology with the opportunity to earn an additional 10 points toward their final grade by demonstrating their knowledge, communication skills, clarity of message, and creativity in the Iron Parasitology exercise. The participants and nonparticipants were assessed using seven parameters. The initial short-term study parameters used to evaluate lecturer- versus student-centered teaching were age, gender, final Parasitology course grade without Iron Parasitology, RUSVM overall grade point average (GPA), RUSVM second-semester GPA, overall GPA before RUSVM, and prerequisite GPA before RUSVM. The long-term reassessment study assessed retention of parasitology knowledge in members of the seventh-semester class who had Iron Parasitology as a tool in their second semester. These students were invited to complete a parasitology final examination during their seventh semester. There were no statistically significant differences for the parameters measured in the initial study. In addition, Iron Parasitology did not have an effect on the retention scores in the reassessment study.

Among daily computer users who are proficient, some are flexible at accomplishing unfamiliar tasks on their own and others have difficulty. We hypothesize that extrinsically motivated users have difficulty with unfamiliar computer tasks and skill transfers, whereas intrinsically motivated daily users accomplish unfamiliar tasks readily. Nine extrinsically motivated users and seven intrinsic users were directed and observed with qualitative ethnographic methods using a think-aloud-type verbal protocol. The observations were coded based on a rubric. The coding was checked with two additional raters, and inter-rater reliability was greater than 90%. The data were then statistically analyzed. Findings show that extrinsically motivated users in all age groups and competence levels have weak productivity when faced with unfamiliar tasks or software, while intrinsically motivated users have few difficulties. This work draws attention to an underrepresented group of competent but extrinsically motivated computer users who become unproductive when operating in unfamiliar conditions. The data suggest that researchers should control for motivation style when evaluating user interface designs.

Endothelial progenitor cells isolated from umbilical cord blood (CB-EPCs) represent a promising source of endothelial cells for synthetic vascular grafts and tissue-engineered blood vessels since they are readily attainable, can be easily isolated, and possess a high proliferation potential. The objective of this study was to compare the functional behavior of late outgrowth CB-EPCs with human aortic endothelial cells (HAECs). CB-EPCs and HAECs were cultured on either smooth muscle cells in a coculture model of a tissue-engineered blood vessels or fibronectin adsorbed to Teflon-AF™–coated glass slides. Late outgrowth CB-EPCs expressed endothelial cell–specific markers and were negative for the monocytic marker CD14. CB-EPCs have higher proliferation rates than HAECs, but are slightly smaller in size. CB-EPCs remained adherent under supraphysiological shear stresses, oriented and elongated in the direction of flow, and expressed similar numbers of α5β1and αvβ3integrins and antithrombotic genes compared to HAECs. There were some differences in mRNA levels of E-selectin and vascular cell adhesion molecule 1 between CB-EPCs and HAECs; however, protein levels were similar on the two cell types, and CB-EPCs did not support adhesion of monocytes in the absence of tumor necrosis factor-α stimulation. Although CB-EPCs expressed significantly less endothelial nitric oxide synthase protein after exposure to flow than HAECs, nitric oxide levels induced by flow were not significantly different. These results suggest that late outgrowth CB-EPCs are functionally similar to HAECs under flow conditions and are a promising cell source for cardiovascular therapies.

This study aimed at determining the effectiveness of group cognitive behavior therapy (CBT) for recent onset psychosis in comparison with a recognized intervention for individuals with severe mental illness–social skills training. One hundred twenty-nine participants took part in a single-blind randomized controlled trial with repeated measures (baseline, 3 months, and 9 months). Participants were randomized to 1 of 3 conditions: group CBT, group social skills training for symptom management, or a wait-list control group. Both interventions were delivered by mental health staff with minimal training. Both treatments resulted in improvements on positive and negative symptoms compared with the wait-list control group, with the CBT group having significant effects over time on overall symptoms, and post-treatment effects on self-esteem, and active coping skills compared with the wait-list control group and lower drop-out rates than the skills training group. Therapist fidelity was adequate for both treatment conditions. Group CBT for psychosis is a promising intervention for individuals with recent onset of psychosis and their mental health professionals.

The article focuses on issues related to the war against terrorism in Europe after the bombings in Madrid, Spain, on March 11, 2004. The bombings in Madrid by Islamic terrorist sent shivers across Europe. Osama bin Laden, the number one leader of al-Qaeda, has given many countries reason to worry. The Madrid attacks represent a self-evident failure by Spanish counterterror services, who let the prime suspect in the case slip through their fingers in 2001.

Discusses the efforts of European leaders Jacques Chirac, Tony Blair, and Gerhard Schröder to promote a new constitution for the European Union. Consideration of the public disapproval ratings for Blair regarding the inability of U.S. and British forces to find weapons of mass destruction in Iraq; Need for the three leaders to work together to shape EU domestic policy; How Germany and France violated the Stability and Growth Pact in 2003; Proposals for economic reform in the state sectors; Significance of the friendly meeting between the three in Berlin, Germany.

Describes the frequency of hate crimes against groups such as Jews, Muslims, Roma, and gays in Europe. Consideration of the arson attack at a high school in France; Hatred towards Muslims in Netherlands expressed online; How hate crimes are often not recognized by the police and press in Europe; Rise in the anti-Semitic and xenophobic attacks in 2002; Attacks against Pakistanis in Athens, Greece.

The article features a successful career woman, Freya Van den Bossche whom at 28 is Belgium's Minister of Environment, Sustainable Development and Consumer Affairs. She was the youngest cabinet minister in the country's history with a portfolio that includes food safety and protecting children online. She won her first election in 2000, becoming an alderwoman in Ghent, without the help of legislation.

Discusses the loss of manufacturing jobs in Berlin, Germany since German reunification in 1990. Impact of unemployment and welfare provisions on the city; How the city has imposed a hiring freeze; Poverty in Germany; Lack of growth in knowledge-based industries; Cuts for funding of the public school system; Reduction of the numbers of law-enforcement agents.

Foucses on the role of Christianity and faith in Europe as of 2003. Number of Christians in Europe; How governments are severing ties with religions; How lack of interest in religion does not mean a lack of belief in God; Religious beliefs of immigrants; Accessibility to religion.