text:
Date of Submission 28-Dec-2019
Date of Acceptance 08-Feb-2020
Keywords: Accommodation, Family, Family involvement, Obsessive-compulsive disorder
Heidari T, Azimi Lolaty H. Psychological Interventions Affecting Obsessive-compulsive disorder Patients' Family Members' Accommodative Behaviors: A Narrative Review. J Nurs Midwifery Sci 2020;7:206-15
Heidari T, Azimi Lolaty H. Psychological Interventions Affecting Obsessive-compulsive disorder Patients' Family Members' Accommodative Behaviors: A Narrative Review. J Nurs Midwifery Sci [serial online] 2020 [cited 2021 Jan 19];7:206-15. Available from: https://www.jnmsjournal.org/text.asp?2020/7/3/208/290546
Obsessive–compulsive disorder (OCD) is a very debilitating psychological disorder characterized by the presence of unwanted, disturbing thoughts and anxiety or repetitive behaviors causing obvious distress, its time consuming and leads to occupational and social dysfunction.[1] The prevalence of this disorder is relatively constant around 2%–3%[2],[3] and 1.8% in Iran, reported as 0.7% and 2.8% among men and women, respectively.[4]
Although OCD is an individual disorder, as regard obsessive–compulsive (OC) behaviors occur at home and in the family context, family members are involved and their functioning is impaired.[5],[6] The distress and worry reported by the relatives of OCD suffering adults ranges between 60% and 90%.[7] Caring patient with OCD has detrimental effects on family interactions[8] and family members of patients with OCD (adults or pediatric) reported greater caregiver burden and distress.[9],[10],[11]
Family reactions and coping strategies in dealing with the patients' symptoms can have important consequences in maintaining or improving the patients' OC symptoms.[12] The family's response includes antagonistic behaviors, accommodation, or a combination of these two styles. Antagonistic family members refuse to ignore or get involved in OC behaviors and tend to be rigid, serious, and critical, which may lead to increased stress and exacerbating symptoms. Accommodation includes any changes in family members' behavior to prevent or reduce ritual behaviors or distress related to their obsessive symptoms.[6],[13] Evidence indicates that family accommodation is quite common in family members of a patient with OCD and almost 90% of them accommodate with the symptoms to some extent.[14],[15] Based on a review study by Renshaw et al., 82% of relatives are antagonistic and 100% of relatives have accommodative behaviors.[6] Many patients impose accommodation behaviors on their families and may be aggressive if faced with their opposition.[16],[17] Family accommodation was associated with a poorer treatment outcome both in adults and in children or adolescents with OCD.[18] Caregivers of patients with OCD with higher empathy regardless of the future consequences of the accommodative behaviors more involved in accommodation, so it is not surprising that the severity of OC symptoms is higher in patients in these families.[10] Therefore, family accommodation should be considered as an important and interpersonal phenomenon which negatively impacts OCD treatment in the treatment of patients with OCD.[10] In contrast to accommodative behaviors as the ones with undesirable consequences, it seems that family involvement in the patient's treatment can lead to more effective treatment. A review of the literature suggested that the families' participation in the treatment process decreased the symptoms of OCD.[12],[19],[20]
Although once thought that OCD to be treatment-resistant but results of investigations have shown that psychological therapies, especially cognitive behavioral therapy (CBT) reduce symptoms.[21] Given the important role of the family in maintaining or ameliorating the symptoms of OCD, the involvement of family members in the psychological interventions of patients with OCD is important and it seems that family-based psychological interventions to be more effective.[15],[22],[23]
Based on the results of the previous study, accommodation research is also in its infancy, and further investigation is needed to understand its various dimensions and effects.[10] Given the negative effects of accommodation on the treatment process of patients, this study has been conducted to review the Psychological Interventions' Effect on Accommodative Behaviors of Family Members of Patients with OCD. It is hoped that the results of the present study will pave the way for performing some novel study cases in this field.
The present study is a narrative review that includes a review of all experimental studies and the review and meta-analysis studies. The inclusion criteria are: (1) The studies were written in English, (2) adult participants, and (3) the studies conducted between 2000 and 2018. Searching the literature was done in the databases: Google, Google Scholar, Science Direct, Scopus, Ovid, and Medline. The titles have been searched using the terms: "Obsessive-Compulsive Disorder" or "OCD," "Family," "Family Members," "Relative," "Treatment," "OCD Treatment," "Accommodation," "Family Accommodation," "Family Involvement," and "Family Participation." Full-text studies haven't been available or the ones done about children and adolescents have been excluded.
Initially, 127 articles were extracted through searching the databases and 9 articles were searched in other sources (including the articles' references). Overall, 136 articles have been searched. Fifty-three articles have been removed after entering the information into Endnote Software Endnote version X7(Thomson Reuters, London, united kingdom). The researchers have studied the abstracts of the articles, and the articles possessing the inclusion criteria have been included in the study. Out of 83 articles, 70 haven't met the above criteria and excluded and finally, 13 articles have been applied to prepare the present article. Having read the full text of the relevant articles, the data needed for writing this review article have been extracted, sorted and summarized. At last, the findings related to the review of Psychological Interventions' Effect on Accommodative Behaviors of Family Members of Patients with OCD have been reported as this narrative article.
In all of the above studies, Diagnostic and Statistical Manual of Mental Disorders-IV was used to diagnose the patients with OCD. Yale Brown's OC Obsessive–Compulsive Scale has also been applied to identify the patient's OC dimensions. Of the above studies, nine cases are from the United States and four cases are from Brazil, England, India, and The Netherlands. The demographic information in these articles includes age, sex, race, education, employment status and clinical information such as the age at the onset of illness, the previous psychotherapy and the current drug use. The results of these studies have been divided into two groups: the findings from the experimental studies and those from the review and meta-analysis studies.
Experimental studies derived findings
Gomez et al. (2016) performed a clinical trial with the goal to analyze the effect of cognitive-behavioral group therapy with the family member's involvement on the family accommodation, in which 98 pairs (the patient and family member) entered the study (52 pairs in the intervention group and 46 pairs in the control group). Their intervention consisted of twelve 2 h' sessions whose main focus has been on OCD–based Psychoeducation and exposure and response prevention (ERP). In the intervention group, the family members have only participated in the first and eighth sessions, the main focus of these sessions were Psychoeducation (about OCD, CBT) and family accommodative behaviors. After the intervention, the Family Accommodation Scale (FAS) was completed. Compared with the control group (from 18.4 ± 1.72 in pre-test to 18.8 ± 1.69 in the post-test), a meaningful decrease observed in the family accommodation in the intervention group (from 13.9 ± 1.2 in pre-test to 9.39 ± 1.38 in the post-test, P < 0.001). In addition, the patients' OC symptoms had a significant decrease in the intervention group (from 27.3 ± 0.79 to 13.08 ± 1.26) in compared with the control group (from 26.4 ± 0.8 to 24.7 ± 0.86, P < 0.001). Another goal of the study was to determine the predictors of the patients' family members' accommodation. Results showed that the patients' level of education, comorbidity with other psychiatric disorders, previous drug-taking, marital status and the patients' OC symptoms' severity are the factors influencing the family members' accommodative behaviors.[24] Family accommodative behaviors' decline can be associated with the patient's recovery since when the patients progress in the treatment, they may get involved in a challenge and not demand the family members to join in the rituals, the issue which reduces family accommodation.[13] Family members usually accommodate with the patient's OC symptoms because they assume that this will reduce the patient's anxiety, but when they participate in the training sessions, they get familiar with the negative effects of accommodative behaviors on maintaining the patient's OC symptoms, feel more comfortable, better able to help the patient in their treatment process and use appropriate alternative behaviors for accommodative behaviors. Moreover, in this research, the reduced accommodation of the family members has been correlated with the characteristics of the patients and those of the family members, especially that the present study findings indicated that the comorbidity of OCD with unipolar disorder has a negative effect on family accommodation and mitigates the positive intervention effects.[24] The results of a study of adolescents with both OCD and depression also showed that this comorbidity led to more severe OC symptoms and greater family accommodation.[25] Furthermore, according to a study derived findings, the family members' perception of the patients' ability or inability to control their OC thoughts and behaviors plays a significant role in the family members' response such as accommodation.[19]
In another open clinical trial with the goal to analyze the immediate and long-term effects of couple-based intervention in OCD, 21 adult couples with OCD participated (in which one of the couples suffering from OCD) in the couple-based intervention. This was a single group study and the primary evaluations have been done after the intervention getting over and 6 and 12 months after the intervention. The intervention included sixteen 90–120 min sessions in which both couples have participated with each other in all sessions. The training sessions' content also covered OCD-oriented psychoeducation, ERP, training the couples on how to help the patient, the strategies to reduce accommodation with the patients' symptoms and to replace them with appropriate behaviors, some appropriate techniques for expressing emotions and better communication. The findings revealed a significant reduction of the mean family accommodation scores from 34.63 ± 12.79 to 25.12 ± 13.19 in the posttest and this descending trend has also been maintained during the follow-up. There was a significant difference between pre- and post-test scores (P < 0.001), but there was no significant difference between family accommodation scores in posttest and 6th and 12th months(P < 0.99). In other words, the mean scores of family accommodation have significantly declined but after that, it has been fixed. In the present study, after the intervention, the insight about OCD has improved and the patients have expressed higher satisfaction and Constructive communication between couples improved.[26]
It seems that training communicative techniques, increasing knowledge about the disease's nature, and its treatments have led to positive effects and the long-term treatment outcomes' maintenance. On the one hand, the intervention has motivated the couples to take part in more activities with each other and enjoy life regardless of OCD rituals or avoidance behaviors.
The clinical trial by Thompson-Hollands et al. (2015) conducted to determine the brief family-oriented intervention's effect on family members' accommodation, in which the final sample size of this study was 36 individuals (18 pairs of the patients and family members). The patients in both groups received treatment ERP. In the family-oriented group, only the family members have participated in the training sessions, but in the control group, family has not participated in the intervention. The intervention encompassed 2-h sessions. The first session's content included OCD and ERP-oriented psychoeducation, the concept of family accommodative behaviors and family accommodative styles, the family participation manner in the treatment practiced as the practical role play with the family and trained them how to respond to the patients' reactions. The second session covered problem-solving, planning, and answering the family members' questions. The evaluation was done initially and during the 4th, 8th, 16th, and 25th weeks. The mean scores of family accommodation in both groups decreased but in the intervention group where the family members participated in the intervention, it has declined significantly compared to the control group and the highest decrease has been of the 4th and 8th weeks, so that the mean scores of accommodation in the intervention group from 12.33 ± 9.57 at first has reached to 5.22 ± 5.24 in the 4th week and the 8th week it has been 4.33 ± 7.78 and in the 25th week, it has declined as 4.62 ± 8.12. In the control group, the mean scores of family accommodation have reduced from 12.89 ± 7.51 at first to 10.11 ± 12.06 in the 25th week. Despite the significant decline of the intervention group accommodation scores (with the brief family intervention) compared with the control group, no significant difference has been obtained between the two groups. The mean scores of the control group accommodative behaviors have remained up to 78% of the basic level but in the intervention group, it has declined up to 37%. The control group's accommodative remained almost unchanged, while it decreased significantly in the intervention group. It seems that the slight decrease of such behaviors in the control group was due to the decrease in the OC symptoms of the patients as patients in both groups were treated with ERP.[13]
In the results gained by Thompson-Hollands' study suggested that through the presence of family merely in several sessions, it is possible to achieve significant results, of course, if these sessions are thoughtful and purposeful. On the one hand, in the above research, only two training sessions have been held. It seems that more training sessions with shorter content volume in each session will lower the participants' fatigue and encourage them to participate in the following sessions. Besides, the above study extracted results demonstrated that the patients participating with their family members in the training sessions have exhibited significant decrease in the OC symptoms in the 8th and 16th weeks and this descending trend has lasted up to the 25th week, indicating the powerful effect of the family members' presence in the patient's treatment process and the importance of the family accommodation in OCD pathologic course.
Baruah et al., (2018) conducted a clinical trial following the purpose to answer this question, "if brief family-oriented interventions along with the treatment with serotonin reuptake inhibitors in OCD sufferers exerts higher effect compared with relaxation exercises accompanied with serotonin reuptake inhibitors?" At first, 300 individuals registered in the study and after the screening, 64 ones entered the study as the eligible ones and divided into two groups through computer program randomization method (n = 30 in brief family-oriented intervention group and n = 34 in the relaxation exercises). All patients received a fixed dose of serotine reuptake inhibitors. The brief family-oriented intervention including six 90–120 min sessions during 3–4 weeks, has been briefer than the standard cognitive-behavioral treatments lasting for about 2–3 months. In all these sessions, the patients and family members participated along with each other. The sessions' content has focused on OCD and ERP-oriented psychoeducation, the concept of family accommodation and appropriate strategies to avoid getting involved in the patient's accommodative behaviors, manage negative emotions, caregivers burden and its destructive effect on the family. In the control group, six 30–45 min sessions with psychoeducation content on OCD and its drug-based treatment necessity, relaxation exercises including Jacobson's deep breathing and muscle relaxing exercises have been held. The data were collected at baseline, 1 and 3 months after the intervention. The results of the this study showed that at first, the mean scores of family accommodation in the family-oriented group were 21 ± 6.09 and in the relaxation group as 18.85 ± 5.49, but 1 and 3 months after the intervention, it has significantly declined in the family-oriented group (1 month later: 13.63 ± 6.27 and 3 months later: 11.26 ± 6.61) but in the control group (relaxation exercises), no meaningful decrease has been seen (1 month later: 18.23 ± 5.36 and 3 months later: 17.55 ± 5.24). Moreover, comparing the mean scores of family accommodation in the two groups revealed a significant difference between the two groups 3 months after the intervention (P < 0.001).[27]
It seems that the family member participation-based intervention effects may not appear immediately after the intervention, while its impact gets vivid after a while. The long-term effects can be due to utilizing the techniques trained to the family and the patient.
In a study by Grunes et al. (2001) aimed to determine the impact of family participation on behavioral therapies for OCD, 28 pairs (the patient and family member) participate in the study, who were randomly divided into two 14-subject groups. In both groups, the patients received ERP treatment. In the intervention group, 8 weekly training sessions (during 8 weeks) were held for the family members. The content of the training sessions included psychoeducation, family members' guidance for being a co-therapist and coping skills, while in the control group, the family hasn't participated in the training sessions. The assessment was performed at baseline in the 4th week, the 8th week and 1 month after the intervention. The results indicated a significant decrease in OC symptoms, anxiety, and depression of the patients in the family-oriented group. In addition, accommodative behaviors of family members and their anxiety and depression in this group meaningfully declined. The mean scores of family members' accommodation have reached from 43 ± 16.69 at baseline to 26.3 ± 13.26 at 1 month after the intervention, while in the control group, it has reached from 28.8 ± 13.14 to 30.7 ± 14.51, respectively, that showed no significant difference between the two groups.[28] According to Grunes' study findings, accommodation with the patients' OC symptoms is associated with marital dissatisfaction and poor outcomes of OCD treatment. The results of this study also indicated that the anxiety and depression of the family members participating in the intervention have significant decrease.
Another pilot study conducted to assess the effect of brief family-oriented intervention with focusing on both coping and accommodative behaviors in patients with OCD. Sixteen family members participated in this study. The intervention protocol included five 90-min weekly sessions. The content of the sessions also included reducing family antagonistic behaviors, avoiding family members' accommodative behaviors and planning for collaborative activities. Based on the study findings, the family members' accommodative behaviors have significantly decreased (from 19.1 ± 7.6 in the pretest to 12.5 ± 11 in the postintervention, P < 0.05).[29]
Findings of this study revealed that both the patient and the family members were satisfied with the treatment, and their social performance and family atmosphere also improved. It seems that family antagonistic behaviors' change has been a tough issue and requires longer interventions.
Belus et al., (2014) performed an open clinical trial to determine the effect of couple-based interventions on the treatment of OCD. Eighteen adult couples participate in six sessions of cognitive-behavioral therapy for OCD. The content of training sessions also was encompassed of psychoeducation about OCD and ERP, how to participate in ERP, to learn the strategies to reduce family members' accommodative behaviors and how to replace them with appropriate behaviors. In all sessions, the couples took part with each other, and they have been given home assignments to do together. The assessment run at the beginning of the study, after the intervention, 6 and 12 months after the intervention. As the study results stated, the couples' antagonistic behaviors to the patients' OC symptoms have been significantly decreased and this decrease has been maintained during the 12-month follow-up, patients' family functioning improved, the productive relationships between the couples also improved and this progress maintained within the next 6 and 12-month follow-up.[20]
It appears that focusing on the couple group work during the intervention might be the reason behind the family functioning improvement. The couples' critical behaviors' reduction may also be due to the change couple's perception of the disease nature after receiving psychoeducation or because of the disease symptoms getting improved. Besides, the above research results showed that the couples experienced the treatment outcomes, particularly productive communication improvement and reduced avoidance behaviors during longer time span that might result from employing the trained techniques in their interactions over time.
Meta-analyses results
In the review study of Renshaw et al., 13 studies with 1818 participants were investigated, the results of which revealed that the studies on family participation suggest it helps the reduction of family members' accommodative behaviors and brings about better treatment outcomes for the patients. In addition, the participation of the family member as an educator or co-therapist in patients with OCD' behavioral treatments such as ERP might increase the patients' response to the treatment.[6]
In another meta-analysis with the goal to analyze family accommodation and the patients with OCD' symptoms' severity, 41 studies were investigated, the findings of which indicated the Patients with OCD' symptoms' high severity being associated with a high level of family members' accommodative behaviors. The results of this meta-analysis also showed that the phenomenon known as accommodation among Patients with OCD' family members is a common issue, and no relationship exists between the factors such as age, gender, and comorbidity, and other anxiety disorders with the family members' accommodative behaviors.[30]
In systematic review by Strauss et al., (2015), the relationship between family accommodation and OC symptoms' severity was investigated. 14 studies with 849 participants were analyzed. Findings of this systematic review showed that family accommodation is significantly associated with OC symptoms severity and family members' participation in the patients' accommodative behaviors plays a critical role in maintaining the patients' OC symptoms. The results of this study have revealed potential family participation induced benefits in the treatment interventions and the treatment outcomes' improvement. Moreover, through analyzing the studies in this systematic review, it has been discovered that families who participated in treatment interventions, reported lower depression and anxiety levels, too.[31]
Another meta-analysis conducted to investigate family accommodation studies in anxiety disorders and OCD. In this meta-analysis, analyzing 57 studies indicated accommodation is a common issue in the patients with OCD' family members and around 90% of such patients' family members have reported compliance with the patients' rituals to some extent. In addition, the results showed the significant relationship between OC symptoms' severity and the family accommodative behaviors. The family members' accommodative behaviors have declined after the patient's treatment. The results of this meta-analysis showed that Patients with OCD' caregivers undergo a high burden which exerts negative effects on their quality of life.[14]
In one meta-analysis conducted by Thompson-Holland et al., 29 studies were surveyed with 1366 participants and the results showed that family-based psychological therapies significantly influenced patients with OCD' symptoms and their overall performance. Findings of this study also showed that age, gender and family-based treatment format (individual or group) influence the treatment outcomes. In the psychological interventions, the factors such as age over 18 years old, the individual intervention format, paying attention to family accommodation and focusing on ERP training have influenced the studies' results and brought about better outcomes.[12]
Family members' participation in the patients' treatment context gives them this to opportunity to strengthen their coping skills and to help patients for better treatment results. These studies derived results are briefly listed in [Table 1] and [Table 2].
Table 1: A brief overview of experimental studies used in this narrative review
Table 2: A brief overview of review and meta-analysis studies used in this narrative review
The current narrative review pursues the objective to determine the Effect of psychological interventions on accommodative Behaviors of family members of patients with OCD. The experimental, review, and meta-analytic studies in this area were reviewed. After reviewing the articles and eliminating the ones that did not meet the inclusion criteria or inconsistent with the objectives of the present study, 13 papers were selected and their results were employed for final writing of this article, 13 papers were reviewed and their results were employed for final writing of this article.
This narrative review results showed that accommodative behaviors are common in patients with OCD' families and evidence suggests that approximately 90% of Patients with OCD' family members have some degree of accommodation and also family accommodation is significantly and positively associated with symptoms' severity and the patients' dysfunction.[14] Given the disruptive nature of family accommodative behaviors both in the patients and in their family, the interventions aimed at reducing family accommodative behaviors result in better therapeutic outcomes such as lower family accommodation, better patient performance, as well as, reduced patient OC symptoms.[32] The above-mentioned papers' review findings also showed that as family members' accommodative behaviors decreased, the therapeutic outcomes also showed a greater improvement indicating the importance of reducing these destructive behaviors to the improvement of patients with OCD' symptoms and their functioning.[12],[13],[24],[26]
In the articles analyzed in this review, the patients and the family members participated in the treatment together or the family members participated separately in the interventions. In some interventions, the family members participated in all sessions;[20],[26],[27] however, in some studies, the family members participate in some sessions.[24] The results gained by Thompson Holland's meta-analysis indicated that family members' participation in all sessions may not be feasible and attending a few meetings can also lead to positive results. Thompson's study derived results also showed that family-centered interventions exclusively involving the family members in the interventions are more effective than group formats (family and patient).[12] The results of the present review also revealed that in a number of studies the family members participated alone in the training sessions[13],[28],[29] and in some interventions, both the patient and the family members participated in the training sessions.[20],[26],[27] It seems that if family members attend private sessions where the patient is not present, they may feel more comfortable for talking over their feelings and expressing the negative effects of patient's symptoms on their quality of life. On the other hand, if the patient and the family participate in the training sessions together, the patient may feel more relaxed and confident and their motivation to continue treatment increases.
In all of the experimental interventions reviewed, psychoeducation has been part of the training sessions' content, which confirms the significance of being aware of the disease.[13],[20],[24],[26] In the psychoeducational interventions, the patients and their family members get the information related to disease and its causes and treatment, the right and wrong behaviors in dealing with its symptoms and the required techniques. As they become more aware, they are more likely to participate in the treatment process and as a result, better treatment outcomes emerge. On the other hand, OC symptoms can also cause problems for the family members, which can reduce their stress through training and teaching them the appropriate coping techniques.[33] In 2006, a study was designed to evaluate family-based treatments for OCD and the results of all of these treatments indicated that family members should be involved in the treatment process. In addition, its results showed that psychoeducation considered as a small part of the treatment should be given more attention to complete OCD treatment.[34]
In these experimental studies reviewed, home assignments were also given to the patients for the patient and the family member so that to do the tasks together.[20],[24],[25],[30],[31],[34] It seems that the participation of family members in performing the assigned tasks as well as supporting their patient in performing the trained techniques is effective in reducing the patients OC symptoms and the family members also feel more relaxed and their accommodative behaviors will decrease.
In the study of Baruah et al., immediately after the intervention, no significant decrease was observed in the family members' accommodative behaviors, but 1 month after the intervention and 3 months later, the accommodative behaviors significantly decreased. It seems that modifying family accommodative behaviors requires a longer time, which is achieved by giving home assignments and pursuing longer follow-up.[29]
Some studies have also investigated the variables affecting family accommodation. According to the findings, the patients' characteristics, lack of comorbidity with other mood disorders, OCD's severity and higher education level of the family members have been reported to be the effective variables in lowering family accommodation. In addition, no effect has been observed due to age and gender on family accommodative behaviors. Comorbidity with anxiety disorders increases family accommodative behaviors and the amount of time spent on family accommodative behaviors is related to OC symptoms' severity. In the families where the patient experiences more positive emotions, better treatment outcomes and fewer relapses have been reported.[24],[33],[35] Based on the results of this narrative review, the questionnaire type also influences the results as demonstrated in the studies in which the FAS self-reporting format yields better results than the interview format, stressing the importance of using standard scales to obtain accurate results. In addition, the sample size and publication year have also exerted effects on the results. The relatives' anxiety and depression can also affect the disease process.
As it is true about any study, there are some limitations in the present study as it follows: The studies on family accommodative behaviors have been conducted mostly in Western societies (especially in the US), indicating the need for doing further studies in other cultures, particularly in Iranian and Asian cultures where family plays an important role in patient care. Also, the studies analyzed in this narrative review have only concentrated on adults, so there is a need to compare different age groups. It is suggested that the personality traits of family members of individuals with OCD be explored in the future researches, as some individuals appear to be more likely to engage in accommodative behaviors and others to be more tolerant. It is also suggested that psychiatrists encourage family members of patients to participate in patient visits. It is also recommended that the patient and family participate in training sessions simultaneously because it seems that participation together in intervention is more effective.
Since a review of the studies indicated that family strategies can play a critical role in maintaining or improving the symptoms of OC patients and on the other hand, accommodative or antagonistic behaviors lead to poor treatment outcomes and exacerbating the symptoms, it's imperative to consider family responses and interpersonal interactions of family members in OCD suffering patients' treatment. Besides, the rich source of family should be employed for participating in the treatment to achieve better treatment outcomes.
Authors' contribution
T. Heidari: Study conception and design, data collection and analysis, drafting of manuscript. H. Azimi Lolaty : critical revisions for important intellectual content, contributions to analysis and interpretation of data, supervision and final approval of the version to be published.
This study was supported by Student Research Committee of Mazandaran University of Medical Sciences.
This narrative review was approved by the Student Research Committee of Mazandaran University of Medical Sciences with the code number of IR.MAZUMS.REC.1398.3653. We would like to express our gratitude to the honourable research council, the Student Research Committee and respected professors for their support.
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Baruah U, Pandian RD, Narayanaswamy JC, Bada Math S, Kandavel T, Reddy YCJ. A randomized controlled study of brief family-based intervention in obsessive compulsive disorder. J Affect Disord 2018;225:137-46.
Grunes M, Neziroglu F. Family involvement in the behavioral treatment of obsessive-compulsive disorder: A preliminary investigation. Behav Ther 2001;32:803-20.
Remmerswaal KC, Batelaan NM, Smit JH, van Oppen P, van Balkom AJ. Feasibility and outcome of a brief cognitive behaviour therapy family intervention for patients with obsessive-compulsive disorder: A pilot study. Psychother Psychosom 2016;85:185-6.
Lebowitz ER, Panz KE, Su J, Bloch MH. Family accommodation in obsessive-compulsive disorder. Anxiety Disord 2012;12:22-238.
Strauss C, Hale L, Stobie B. A meta-analytic review of the relationship between family accommodation and OCD symptom severity. J Anxiety Disord 2015;33:95-102.
Caporino NE, Morgan J, Beckstead J, Phares V, Murphy TK, Storch EA. A structural equation analysis of family accommodation in pediatric obsessive-compulsive disorder. J Abnorm Child Psychol 2012;40:133-43.
Andrighetti H, Semaka A, Stewart SE, Shuman C, Hayeems R, Austin J. Obsessive-compulsive disorder: The process of parental adaptation and implications for genetic counseling. J Genet Couns 2016;25:912-22.
Grunes MS, Neziroglu F, Mckay D. Family involvement in the behavioral treatment of obsessive-compulsive disorder: A preliminary investigation. Behav Ther 2001;32:803-20.
Zareei H, Sardadvar N, Nasirian M. Effectiveness of psycho-educational intervention in improving symptoms of patients with obsessive-compulsive disorder and general family functioning of companions. Iran Red Crescent Med J 2018;20:e58377.


text:
Zooey Deschanel >
Zooey Deschanel Welcomes First Child, Announces Marriage To Jacob...
Zooey Deschanel Welcomes First Child, Announces Marriage To Jacob Pechenik
By Elinor Cosgrave in Lifestyle / Showbiz on 04 August 2015
Follow Zooey Deschanel
Zooey Deschanel Ben Gibbard The Postal Service
Zooey Deschanel and Jacob Pechenik have welcomed a daughter. Deschanel's representative made the announcement and confirmed the two had also secretly married before the arrival of their first child together.
There's two lots of good news for fans of Zooey Deschanel. The New Girl actress has welcomed her first child and, her representative revealed whilst confirming the arrival of the healthy baby girl, is also married!
Zooey Deschanel and Jacob Pechenik at the 66th Primetime Emmy Awards in August 2014.
Read More: Fox Picks Up New Girl For A Fifth Season.
Deschanel's representative confirmed to E! on Monday (3rd August) that the 35-year-old actress had welcomed a daughter with Rock the Kasbah producer Jacob Pechenik. This is the first child for both Deschanel and Pechenik.
Deschanel and Pechenik began dating in 2014. The couple have attempted to keep their relationship as private as possible. They confirmed they were expecting a child together in January of this year and, a week later, announced their engagement.
"Jacob and I are over the moon," Deschanel said shortly after announcing her pregnancy, as ABC reports. "We are so excited to meet our little one."
Details on Deschanel's pregnancy are few but she revealed, whilst appearing on Jimmy Kimmel Live!, they had decided not to find out the gender of their child before the birth.
"We are going to be surprised," Deschanel said of her baby's gender. "It's more fun, you know? Make it into a game."
It is uncertain when Deschanel and Pechenik tied the knot but it was sometime before the arrival of their daughter.
This is Deschanel's second marriage. She was previously married to Ben Gibbard, the lead singer of The Postal Service and Death Cab For Cutie. They married in 2009 and announced their separation in 2011, their divorce was finalised the following year.
Watch The Movie Trailer For Rock the Kasbah, In Which Deschanel Stars And Pechenik Produced:
Zooey Deschanel gushes over life with Jonathan Scott: 'I want a million billion more years with you'
Zooey Deschanel adds name to children's
Zooey Deschanel's birthday tribute to Jonathan Scott
Zooey Deschanel Welcomes Her Second Child
From Zooey Deschanel To Jenna Jameson: Meet The Jewish Converts Of Hollywood And Beyond
Zooey Deschanel Reveals Her Baby Daughter's Unusual Name
Zooey Deschanel's baby daughter's name inspiration
Zooey Deschanel reveals daughter's name
Zooey Deschanel's daughter to run for president
Zooey Deschanel's baby is 'extremely cute'
Zooey Deschanel secretly marries
Zooey Deschanel welcomes first child
A New Girl For New Girl Star Zooey Deschanel
Trolls Movie Review
Almost pathologically buoyant, this brightly colourful animated comedy is so cheeky that it's impossible to...
Rock The Kasbah Trailer
Sometimes, life can really take a turn when you least expect it. For one man,...
From the director of Pineapple Express comes a new fantasy comedy film 'Your Highness' from...
Yes Man Trailer
Jim Carrey is back on form with his new film Yes Man. Carl Allen is...
Surf's Up Trailer
Surf's Up is an animated comedy that delves behind the scenes of the high-octane world...
Bridge To Terabithia Movie Review
One wonders if the makers of Bridge to Terabithia actually have something against all the...
Manic Movie Review
When troubled teen Lyle (Joseph Gordon-Levitt) goes postal, gets put in restraints, and is commited...
Mumford Movie Review
Mumford reminded me how nice it is to forget yourself in the midst of a...
Abandon Movie Review
A timely late October release and a spooky ad campaign suggest that Abandon revolves around...
Eulogy Movie Review
Michael Clancy's Eulogy is sort of a sitcom version of The Royal Tenenbaums, with its...
The New Guy (2002) Movie Review
When the screenwriter responsible for one of the worst movies of one year directs an...

redpajama_set_name: RedPajamaCommonCrawl


text:
Alisal High School soccer alum Enrique Montaño signs with Tulsa Roughnecks
Ayrton Ostly
The Californian
Alisal alumnus Enrique Montaño signed with the Tulsa Roughnecks of the United Soccer League (USL), the second-highest level of professional soccer in the United States.
The signing received league and federation approval Thursday as Montaño and the Rougnecks have agreed to terms on a contract for the 2018 season. This comes a month after Montaño signed with Deportivo Tepic, F.C of Liga Premiere de México, Mexico's Division III soccer level.
He took to the pitch for the Roughnecks' third game of the preseason against Oral Roberts University Tuesday evening and scored the team's first goal in a 3-1 win.
More:Alisal soccer alum Enrique Montaño signs with Mexico's Deportivo Tepic
"Enrique is a very dynamic left-back, who is quick in the tackle with good size and speed," Roughnecks head coach David Vaudreuil said in a statement. "He had a very successful run in Louisville and most recently down in Mexico, and we are excited to have him on the team."
This is the third USL team Montaño has played for in his professional career. He also played for Sacramento Republic F.C. and Louisville City F.C. The Roughnecks, in their fourth season in the USL, are the affiliate team of the Chicago Fire and Vaudreuil is in his second season as head coach.
Montano is one of eight defenders on the current roster for the 2018 season. He'll likely see lots of playing time as Vaudreuil used a 4-2-3-1 formation, one that uses four defenders at a time, for the majority of the matches last season.
The 2011 graduate was a member of the Trojans' Central Coast Section (CCS) Division I title-winning team in 2010. He also helped the Hartnell Panthers to a state runner-up finish in 2011 and played for three years at San Jose State.
The Roughnecks travel to Chicago Saturday to play the Fire and San Antonio F.C. March 10 for their preseason finale. The regular season begins on the road March 17 against OKC Energy F.C.
Alisal Trojans fall 2-0 in CCS Open Division semifinals
Alisal wins 3-1 in CCS quarterfinals
Alisal defeats Alvarez in another classic


Lindsay Lohan has gained 5 pounds since having Adderall taken away during her court-ordered rehab stint, a source close to the actress has said.
Lohan has been at the Betty Ford Clinic after a judge sentenced her to rehab, but she is said to be having a difficult time without her Adderall. As a result, the 26-year-old actress has reportedly been turning to food for comfort.
The result is that Lindsay Lohan has gained 5 pounds.
Though Lindsay is reportedly trying to stay active, she's found it's difficult since being denied Adderall.
"She has been exercising, but she just doesn't have a lot of energy because she is no longer taking Adderall, which is a psychostimulant medication that contains amphetamine," the source said.
Lindsay was worried this might happen. The star reportedly "freaked out" when officials at the Betty Ford Clinic took away her Adderall last week.
"Lindsay has been able to eat whatever she has wanted and not gain weight for years and she attributes this to Adderall … everyone knows that the controversial drug ramps up your metabolism, and can suppress the appetite," a source told RadarOnline last week.
Lohan said she needs the drug to treat her Attention Deficit Disorder.
Lohan was sent to the Betty Ford Clinic for a 90-day stint as part of a plea bargain following her car accident in Santa Monica, California. If staying at the clinic and off Adderall can help her avoid jail, Lindsay Lohan can live with 5 extra pounds.


text:
using System;
using System.Collections.Generic;
using System.Globalization;
using System.Linq;
using System.Text;
using System.Threading.Tasks;
using System.Windows;
using System.Windows.Annotations;
using System.Windows.Annotations.Storage;
using System.Windows.Automation;
using System.Windows.Automation.Peers;
using System.Windows.Controls;
using System.Windows.Controls.Primitives;
using System.Windows.Data;
using System.Windows.Documents;
using System.Windows.Documents.DocumentStructures;
using System.Windows.Documents.Serialization;
using System.Windows.Ink;
using System.Windows.Input;
using System.Windows.Interop;
using System.Windows.Markup;
using System.Windows.Markup.Localizer;
using System.Windows.Markup.Primitives;
using System.Windows.Media;
using System.Windows.Media.Animation;
using System.Windows.Media.Composition;
using System.Windows.Media.Converters;
using System.Windows.Media.Effects;
using System.Windows.Media.Imaging;
using System.Windows.Media.Media3D;
using System.Windows.Media.Media3D.Converters;
using System.Windows.Media.TextFormatting;
using System.Windows.Navigation;
using System.Windows.Resources;
using System.Windows.Shapes;
using System.Windows.Shell;

namespace Alba.JamlTestApp
{
    public partial class FirstWindow
    {

    }
}

redpajama_set_name: RedPajamaGithub


Retreat to this ultimate all-season playground and stay in luxury and comfort. Located centrally to the best golfing, wine touring, shopping, orchards and farmers markets. Any time of year is the perfect time to enjoy your stay at The Castle at Swan Lake.
Featuring close to 1,500 square feet of elegantly decorated flexible function space we are THE Place to Wed. Whether your wedding is large or small, informal or elegant, The Castle at Swan Lake All Suite Hotel creates the perfect setting from 5 to 100 people. As one of the most charming and beautiful facilities in the North Okanagan, The Castle at Swan Lake All Suite Hotel is the perfect place to host your wedding, reunion, retreat, or executive meetings. Our Lake View Meeting Room boasts an octagon shaped space overlooking Swan Lake and all the beauty this area has to offer. Your wedding is as important to us as it is to you! Our flexible, all-inclusive meeting packages enable you to select a style of event that has been designed with you in mind.
The Castle Bistro, is Vernon's only Schnitzel house. Try our many German inspired meals from our many schnitzel selections to our hand rolled rouladen.


text:
Q: printing only even columns I am trying to create a program in python that, once it opens a .csv file, would print (or better, create a new file) with only the even columns.
For example, if my file contains:
A   B   C   D   E
1   2   3   4   5
6   7   8   9   0
The new file would have only:
B   D
2   4
7   9
So far I have this:
import csv
ifile=open('Example.csv', 'r')
reader=csv.reader(ifile)
ofile=open('Example2.csv', 'w')
writer=csv.writer(ofile, delimiter=',')
for row in reader:
    writer.writerow(row[1:2]+row[3:4])
    print(row[1:2]+row[3:4])
ifile.close()
ofile.close()

But if I have a file containing hundreds of columns, I need a neat way to solve the problem.

A: Considering your data looks like this(see no new line between rows):
A B C D E
1 2 3 4 5
6 7 8 9 0

You can modify your program as:
import csv

ifile=open('Example.csv', 'r')
reader=csv.reader(ifile, delimiter=' ')
ofile=open('Example2.csv', 'w')
writer=csv.writer(ofile, delimiter=',')
for row in reader:
    # Here you check for even
    tmp_row = [col for idx, col in enumerate(row) if (idx + 1) % 2 == 0]
    writer.writerow(tmp_row)
ifile.close()
ofile.close()

You loop over each row to get column index and then check for even(odd actually because index starts from 0) columns. Also, you should specify reader=csv.reader(ifile, delimiter=' ') delimiter.

redpajama_set_name: RedPajamaStackExchange


Lee continues her investigation into the processes within the National Industrial Chemicals Notification and Assesment Scheme with the Director of NICNAS, Dr Brian Richards. She asks about their procedure for assessment of individual chemicals for use in cosmetics and also for an update on how many cosmetic ingredients have had applications to NICNAS to accept overseas non-animal tested substances validated in other jurisdictions.
Senator RHIANNON: ...Staying with NICNAS but moving on to cosmetics. Under the reforms to NICNAS that I understand have been rolled out, will NICNAS continue to assess class 3 individual chemicals for use in cosmetics?
Senator RHIANNON: Thank you for explaining that. For cosmetics, it is often the ingredients that are coming into the country. Do I take it from that that sometimes cosmetic ingredients may be class 3, but sometimes they are not; therefore, they are assessed in different ways?
Dr Richards: That is right. This regime relates to new industrial chemicals. So new industrial chemicals are defined as those chemicals that are not already listed on the Australian Inventory of Chemical Substances. They are not necessarily chemicals that have never been used in Australia before, but they are chemicals that are not listed. Under current arrangements, a large number of chemicals are exempt from the current scheme and so each year there are close to 10,000 new chemicals-that is, chemicals not listed on the Inventory of Chemical Substances-that are introduced. But each year probably two-thirds of the 10,000 are the same as the year before and the year before that.
Senator RHIANNON: I am interested in the non-animal tested cosmetics. Is it possible for you to say that they are class 3, or would it just be very variable?
Senator RHIANNON: Right. So I need to have a more specific question, I think.
Senator RHIANNON: Is it possible under this system that you could expect the new process to facilitate or encourage non-animal tested validations?
manufacturers or importers applications to NICNAS to accept overseas non-animal tested substances validated in other jurisdictions?
Dr Richards: I would have to take that on notice. We did an analysis for the 2013-14 year. I am not sure that we have repeated that. It was quite a labour intensive analysis. I am not sure whether we have completed an analysis to allow an updated figure, but I could take on notice whether we have done that analysis.
Senator RHIANNON: I will just add three points, if you could take them on notice. And then I am finished, Chair. In the context of this question, could you provide the categories those ingredients belong to?
Dr Richards: Senator, could you explain. The new system with class 1, class 2, class 3 does not yet exist.
Senator RHIANNON: I see. So that is redundant. How many of those applications were for new ingredients not previously approved in Australia?
Dr Richards: As I said, NICNAS generally only looks at the new chemical ingredients-that is, chemicals not listed on the AICS. So any chemical that is submitted to NICNAS for an assessment is by definition a new chemical.


Thanksgiving is nearly here, as is one of retail's biggest shopping events of the year: Black Friday. Brands have been pumping out special deals for the day leading up to the event with Amazon's "Countdown to Black Friday" event already in play and Walmart already swinging out their Black Friday deals for gaming systems, smart devices and TVs.
As consumers walk through the doors of their favorite stores Nov. 23, what will the customer experience look like for consumers as they browse for potential purchases, and how will retailers fare in the aftermath? Below are some predictions for what we can expect on Black Friday, and what this means for retailers.


text:
package com.kinvey.sample.contentbox;

import android.app.Application;

import com.kinvey.android.Client;

import com.kinvey.android.callback.KinveyUserCallback;
import com.kinvey.sample.contentbox.model.ContentUser;

/**
 * @author edwardf
 */
public class ContentViewrApplication extends Application {

    private Client client;

    public Client getClient(){
        return client;
    }

    public void loadClient(KinveyUserCallback callback){
        if (client == null){
            client = new Client.Builder(getApplicationContext()).setRetrieveUserCallback(callback).setUserClass(ContentUser.class).build();
            client.enableDebugLogging();
        }else{
            if(callback != null){
                if (client.user().isUserLoggedIn()){
                    callback.onSuccess(client.user());
                }else{
                    callback.onFailure(new NullPointerException(""));
                }

            }
        }
    }
}


These days, HVAC systems are being designed with a number of efficient features, designed to provide smart home savings for homeowners. Many of these features are best taken advantage of through the installment of a smart thermostat. The homeowner can lower or raise the temperature through an app downloaded on a smart device. Depending on the features that your system includes, you may also be able to monitor and control humidity, diagnose malfunctions, and be alerted when it's time to schedule maintenance or change filters — all through your smart phone. Remotely operating temperature can help you save money by cutting back on energy use as needed.
Washing machines that can download stain-specific cleaning cycles or be scheduled to run during the night, when electrical rates are lower.
Ovens that notify you that you've left them on and you can then turn them off.
These features not only provide convenience and help you save money, but in some cases, can make your home a safer living environment.
You can operate security cameras inside and outside your home through your smart device. These cameras come with a wide range of capabilities, and may be weatherproof, or offer recording, night vision and talk and listen functions. Installing these cameras may be a cost-saving option for you, when you compare it to the cost of a contract with a security company.
For more ways to save money and increase your HVAC efficiency, contact Jackson and Sons of Eastern North Carolina.


text:
Moscow Dismisses Economic Threats
By Anna Smolchenko
Aug. 25 2008 00:00
Attempts to isolate and punish Russia for its military actions in Georgia will backfire, given Russia's economic muscle and key role in mediating international disputes, senior Russian officials said Friday.
Top officials in President George W. Bush's administration have said Russia's continued military presence in Georgia could jeopardize its membership in the Group of Eight and its bid to join the World Trade Organization, among other things.
"We are a big economy today," said Vladislav Reznik, chairman of the State Duma Financial Markets Committee. "Whether they like it or not, we have to be reckoned with."
Yevgeny Fyodorov, chairman of the Duma's Economic Policy and Entrepreneurship Committee, was even more blunt.
"It's a political bluff," he said. "It's an absolute certainty that the Americans won't [impose any sanctions] because they themselves would suffer."
In the latest U.S. warning, Commerce Secretary Carlos Gutierrez said all of the United States' efforts to help Russia "integrate ... into the world community" were "at risk," according to an interview published Saturday in Germany's Der Spiegel.
Of the two presumptive U.S. presidential nominees, Republican Senator John McCain has been by far the most strident in his anti-Russian rhetoric during the Georgia crisis, reiterating his call for Russia to be thrown out of the G8 and for Moscow's WTO bid to be blocked.
Senator Joe Biden, who was named Democratic candidate Barack Obama's vice presidential running mate on Saturday, has been more tempered in his criticism of Russia, restricting himself to saying there would be "consequences" for U.S.-Russian ties from the conflict. During a trip last week to Tbilisi, Biden proposed a $1 billion aid package for Georgia, but he also stressed that he had long sought to "forge a more constructive relationship with the Kremlin."
Another leading Democrat, former Secretary of State Richard Holbrooke, said Aug. 11 that kicking Russia out of the G8 as McCain advocated was "an impossibility," Bloomberg reported.
But Washington has only limited options for exerting economic pressure on Moscow, and threats to suspend G8 membership would largely be about denting Russian prestige.
"I haven't noticed that they've actively welcomed us into the WTO anyway," Fyodorov said.
Yury Afanasyev, the top trade official in charge of WTO accession talks at the Russian mission in Geneva, said he had not received any signs that the United States planned to withdraw its support of Russia's bid to join the global trade body.
"I am hoping U.S. officials will have enough common sense not to link WTO issues with politics," he said by telephone from Geneva.
Russia has finalized bilateral agreements with all of the WTO's 153 member countries except for Georgia, which rescinded its 2006 backing when Russia severed trade and transport links following a spying dispute between the two countries.
Russia is the biggest economy still outside the WTO, whose members account for more than 95 percent of global trade.
The next meeting to consider Russia's WTO bid has been scheduled for Sept. 18, Afanasyev said.
If the United States moves to reconsider its support for Russia's WTO bid, Moscow will retaliate, Afanasyev said.
Russia has "a rich arsenal" of countermeasures at its disposal, he said, referring to a deal that allows the United States larger import meat quotas, among others.
Sean Spicer, a spokesman for U.S. Trade Representative Susan Schwab, declined to say whether the U.S. administration intended to revoke support for Russia's WTO bid, referring only to comments by Bush on Aug. 13. "This [is] as much as we have stated," Spicer said in e-mailed comments.
In that statement, Bush indicated that Russia might find itself isolated if it lost U.S. support. "In recent years, Russia has sought to integrate into the diplomatic, political, economic, and security structures of the 21st century. The United States has supported those efforts," Bush said. "Now Russia is putting its aspirations at risk by taking actions in Georgia that are inconsistent with the principles of those institutions."
The economic costs of possible sanctions, such as delayed WTO entry, may not be significant, said a senior Western economist who has studied Russia for 15 years.
"Russia would not suffer much -- if any -- immediate economic pain as a result of such a delay, since the direct trade effects of accession (the impact of tariff changes and improved access to foreign markets) will be limited," the economist said on condition of anonymity, because he was not authorized to comment on Russian politics.
Both Russia and the West would only gain from changes such as the "reduction in formal and informal barriers to foreign investment in key service sectors [and] the overhaul of technical regulations," he said.
U.S.-Russian economic interdependence was underlined by Commerce Secretary Gutierrez in June, when he wrote in a commentary in Izvestia that Washington was eager to "expand our economic relationship."
In 2007, there was a 57 percent growth in U.S. imports to Russia and bilateral trade of $27 billion, Gutierrez noted, including "significant growth not only in the extractive industries but in products as diverse as innovative pharmaceuticals, farm machinery, information technology and an increasing array of services."
Among the U.S. companies that rely heavily on a thriving Russian economy are struggling U.S. auto giants General Motors and Ford, whose Russia sales make up some of the gap being felt back home. Also, for U.S. aircraft maker Boeing, whose Moscow engineering center is the company's biggest outside of Seattle, business has been lucrative here.
"Perhaps no other country is able to offer the United States as broad a range of partnership opportunities or capabilities for cooperation in every scientific or technical sphere," the U.S. Embassy in Moscow said on its web site.
Analysts agree that while uncertainty or even animosity in the U.S.-Russia relationship will likely continue at least until the U.S. presidential election in November, another Cold War is out of the question.
"Russia and the West need each other," Troika Dialog wrote in a research note to investors last week. "Russia won't be able to sustain its growth without foreign capital and international experience, while the West needs a strong ally in its fight with global terrorism and Iran. Besides, Russia is the only large energy supplier outside Middle East."
Reznik, the Duma finance committee chairman, pointed to current economic realities and the country's history as to why the West needed Russia.
"We can ask consumers of our gas ... whether they want to be friends with Russia," he said.
"There was a time in world history when Russia was the only superpower on the European continent," said Reznik, referring to the period between the end of the Napoleonic wars in 1815 and the Crimean War in the 1850s.
"We'll find our place in the world," he said.


text:
Ask Ars: Finally upgrading to Windows 7—should I go 32- or 64-bit?
Finally getting around to upgrading to Windows 7 from XP or Vista and …
Peter Bright - Apr 19, 2011 3:05 pm UTC
with 114 posters participating
Ask Ars was one of the first features of the newly born Ars Technica back in 1998. And now, as then, it's all about your questions and our community's answers. Each week, we'll dig into our bag of questions, answer a few based on our own know-how, and then we'll turn to the community for your take. To submit your own question, see our helpful tips page.
Question: I'm finally ready to drop Windows XP and move to Windows 7. Should I go with the 32-bit or 64-bit version of the operating system?
Short answer: 64-bit.
Long answer: 64-bit, but you may not see much real difference. Before explaining why, there is an important contraindication to be aware of: if you use any 16-bit Windows applications or DOS applications, you'll have to either stick with 32-bit Windows, or run those applications in a virtual machine (or, for DOS programs, an environment such as DOSBox). 64-bit Windows supports 64-bit and 32-bit applications, but 16-bit ones are consigned to the trash can of history.
In practice, the only advantage of using 64-bit Windows is that you can install more physical memory. 32-bit versions of desktop Windows are limited to 4GiB of physical memory, and thanks to dubious compatibility restrictions, they can't even offer that much. Every byte of memory in a system has a physical address, a number representing that byte of memory, and on 32-bit desktop Windows, those addresses are only 32 bits long (or rather, the addresses are between 36 and 64 bits long depending on which bit of software is manipulating them, but only 32 bits are actually used by Windows). This should allow 232 addresses, and hence 232 bytes—4GiB—of memory.
But unfortunately, physical memory isn't the only thing using that address range. Peripherals such as video cards also carve out chunks of the address range, so that the CPU can communicate directly with them. Video cards in particular will often attempt to place all of their video memory—hundreds of megabytes, sometimes even gigabytes—within this range. When this happens, the physical memory loses out, and has to be relocated; it is given addresses that require the use of the full 64 bits. Since Windows only uses 32-bit physical addresses, that means that you lose access to some of your RAM.
It wasn't always this way; Windows 2000 and the Windows XP with no service packs installed both set the limit simply to 4GiB total memory, and will use full 64-bit addresses if necessary. Unfortunately, some hardware vendors (notably NVIDIA, though others are also claimed to be responsible) had bugs in their drivers, such that they assumed physical addresses would never use more than 32 bits. When used in a system that required full 64-bit addressing, the drivers would end up corrupting memory and crashing. Rather than forcing hardware vendors to fix their broken software, Microsoft restricted 32-bit desktop Windows to 32-bit addressing (though server versions, with drivers that were in theory server-grade, were never subject to this restriction).
The video card is making a whole gigabyte off-limits, restricting this 4GiB machine to just 3GiB
The result is, if you take a look at the memory graph in Windows 7's Resource Monitor on a 32-bit machine, you'll see a big old chunk of grey, denoting "hardware reserved" memory. That represents physical addresses that have been given up to add-in cards, and hence "lost" physical memory.
All the RAM is available in 64-bit Windows
The 64-bit version has no such restriction. The ability to use memory up to 4GiB—and beyond—remains 64 bit Windows' most compelling feature; it's the one you're most likely to notice day-to-day. It's perhaps a little ironic that this advantage has nothing to do with being 64-bit as such—the 32-bit server versions of Windows can already access all this memory—it's just that 64-bit Windows forces developers to fix the bugs that plagued 32-bit Windows. 64-bit Home Basic raises the limit to 8GiB, Home Premium to 16GiB, and Professional, Enterprise, and Ultimate all take it up to 192GiB. Your motherboard and wallet alike are unlikely to support so much memory.
There are a few other benefits, however, that are genuinely a result of using 64-bit software. Unfortunately, they tend to be less noticeable. Because of architectural improvements made when x86 grew 32 to 64 bits, 64-bit software will typically run faster than 32-bit programs. This will make little difference to typical desktop applications, but for certain kinds of software, particularly number-crunching applications, the speed improvement can be valuable.
Another potential benefit—critically important to few, but essentially irrelevant to most—is that each program gets a much larger address space. On 32-bit Windows, in normal configurations, each program only has a usable address space of about 2GiB, half of the total memory that can be addressed with 32-bit addresses. This means that the amount of RAM that the program can manipulate directly is limited to 2GiB. If the program needs to work on a larger chunk of data, it has to move that data in and out of RAM a piece at a time, usually storing it on disk when it's not in RAM. This 2GiB limit is regardless of the amount of physical memory installed; if you run multiple programs, they each get a 2GiB block of their own, so they can use many gigabytes in total, but any individual program can't readily break through this limit.
Not so with 64-bit programs; 64-bit programs get 64-bit addresses, giving an address space of more than 18 billion gigabytes, of which they can theoretically use half. This limit is "theoretical" because neither current 64-bit x86 processors nor Windows support quite that much. The actual limit in theory is a mere 8TiB, but this is still 4096 times more than 32-bit programs can use.
As with the performance issue, this is of limited importance. Some applications—image editing, databases, and even large spreadsheets—can yield considerable benefits from a 64-bit address space. Many others—e-mail, Web browsers, media players—gain little or nothing from the increase. In truth, if you're running the kind of program that benefits from 64-bit address spaces, you've probably already made the switch.
The other benefit—and again, it's slim—is that 64-bit programs should be a little more secure. One of the security measures included in Windows Vista and Windows 7 is Address Space Layout Randomization, ASLR. ASLR puts system libraries and certain other information at random memory locations, which makes it harder to exploit certain kinds of security flaws. Malicious code can, however, use various techniques to try to work around ASLR. One of these involves filling up a process's address space with specially crafted data, such that if a memory address is chosen at random, it will most likely refer to the specially crafted data. This kind of attack relies, in part, on the fact that a 32-bit process has only a relatively small address space: filling almost all of it is feasible. No such luck in a 64-bit process—it's simply far too big to fill in this way.
This advantage will be most significant on software that is subject to substantial attacks—Web browsers, e-mail clients, Office, Adobe Reader, and Flash being the obvious targets. Unfortunately, not all of these are available in 64-bit versions, limiting the efficacy of this protection. Office 2010 includes full 64-bit support, though using the 64-bit version means forfeiting compatibility with most add-ons and extensions. Internet Explorer has a 64-bit version available, but it's hobbled relative to its 32-bit counterpart; the high-performance JavaScript engine found in Internet Explorer 9 is only available for the 32-bit version. 64-bit versions of Chrome and Firefox are experimental and non-standard. Adobe currently has a beta version of 64-bit Flash, but is unlikely to have a stable version until Flash 11 ships. Adobe Reader is 32-bit. All in all, it's rather disappointing; although in the long run the situation is sure to improve, this (slight) security advantage is at the moment of limited utility.
So all in all, the advantages of going for 64-bit aren't big, in general, but they're there. Most new systems will run up against the physical memory limits of 32-bit Windows, making the 64-bit version the natural choice. 32-bit software had a long reign at the top, but its time is past. Windows Server 2008 R2 is already 64-bit-only, and while Windows 8 will almost certainly be available in a 32-bit version, Windows 9 probably won't be. Might as well make the jump now.


text:
Q: Perform an action on an entity after a fixed time In my Spring project, I have an entity Customer.
Now once we get a new Customer, we persist it in our system, and exactly after one hour, I want to check if the Customer has made any purchase.
If yes, I take some action. If no, the some other.
I contemplated two strategies,
1) Firing up an event when the Customer is persisted. And then having the event listener thread sleep for one hour. I believe this will be a very bad way to handle this.
2) Having a cron check every once in a while for customers for whom one hour has passed since registration. But then, I figure it will be very difficult to be accurate. I would have to run the cron every minute which won't be great.
Any ideas?

A: I believe run the cron every minute is not that bad, how many customers would you handle in one minute?

A: You could use the 'ScheduledThreadPoolExecutor' which as per javadoc is:

A ThreadPoolExecutor that can additionally schedule commands to run after a given delay, or to execute periodically

In your case, when a customer is created, you can use the 'schedule' method to wake up after 1 hour and then perform required activities. This method can also be used if you want those activities to be executed periodically as well.

A: Although not sure why you cannot use the event when a registered Customer will make any purchase i.e. when a particular registered customer will make purchase you can take the action inline as and then.
You described 2 strategies both will work but I would prefer to run cron job which you can configure explicitly. In that way you avoid the overhead of maintaining the threads. If you configure the cron job timing correctly and allow a single job to run at a time I do not see any problem with that. Remember cron jobs are used for batch processing rather than handling events.


主語 + 動詞 + 動名詞+ ・・・.
Reading books is important for us. → To read books is important for us.
Watching TV is a lot of fun. → To watch TV is a lot of fun.
Making breakfast is easy for Yumi. → To make breakfast is easy for Yumi.
I started reading the book. → I started to read the book.


text:
Here's A New Look At Demi Moore's Memoir 'Inside Out'
by Sage Negron
Share Bookstr via:
The life of actress Demi Moore perfectly captures the ups-and-downs of being a leading lady in Hollywood. Despite the extensive media coverage surrounding Moore's multiple marriages and lengthy hiatus from filmmaking, there is still much about the actress that people don't know. Now, Moore is ready to bare it all in her new memoir.
Image Via Amazon
Inside Out sees Moore reflecting on her troubled childhood and the choices she made that led her to where she is now. Moore goes in-depth into her strained relationship with her mother, who attempted suicide when she was 12. The most shocking revelation in this section is that Moore was raped when she was 15, which caused her to move out of her mother's house at 16. This is where Moore began to pursue a career in acting, which lead to a breakout role on General Hospital that blossomed into a successful film career.
Image Via People
In an interview with The New York Times, Moore said that talking about these traumatic events gave more a new sense of vulnerability that she had never experienced before:
"It's exciting, and yet I feel very vulnerable. There is no cover of a character. It's not somebody else's interpretation of me."
Moore is well-known for starring in several box-office successes in the 80's and 90's such as About Last Night, Indecent Proposal, Ghost, and A Few Good Men, but her career stalled after a string of flops. Her marriages to both Bruce Willis and Ashton Kutcher were the subject of intense media scrutiny, and the high salaries that she received for her work led to public shaming by many.
But Moore has nothing to apologize for. In an interview with GMA, Moore is proud of her accomplishments:
"Why shouldn't I? Why shouldn't all women be paid equal to the quality of the work they're doing? Just treat me the same. No better, no worse."
Inside Out is available now.
Featured Image Via Yahoo
Indecent Proposal
Oprah Announces Latest Pick for Book Club Re-debut
Sarah J. Maas Fans: This Queer Sci-Fi Story Explores What Humanity Really Means


Slice Labs Inc., a leading on-demand insurance cloud platform provider, announced today the opening of the Slice Launch Studio in downtown Toronto, which is designed to be an innovation hub for Slice and its partners to ideate, experiment, test and deploy new on-demand insurance products on the Slice Insurance Cloud Services (ICS) platform.
Insurers and technology companies from around the world can come to the Launch Studio to collaborate on Hackathons, a key step in Slices approach to getting product to market quickly. Slice will also host events year-round, bringing together thought leaders from across the globe to discuss and address emerging and increasing risks. Slice is currently working with insurers in the U.S., Canada, UK and SE Asia to launch new on-demand insurance products, using a minimum viable product methodology which allows for launch in under three months.
The Co-operators Group is the pilot partner for the Launch Studio, who recently launched duuo, both its new digital insurance business unit and of its on-demand homeshare insurance product, via Slice ICS. The carrier will host a hackathon on opening day with the goal to build the vision for its next on-demand insurance product.
We couldnt be more excited to be a part of todays launch. Our young partnership with Slice is already spurring all sorts of innovative products and ideas at both duuo and The Co-operators. Slice Launch Studio will take that one step further by bringing together the brightest insurance and technology minds from around the globe, truly putting Canada on the map as a new hub for digital insurance innovation, said Peter Primdahl, Head of Operations at duuo.
We have seen amazing results for ICS users by creating a fun and engaging environment to reinvent one of the worlds most established industries, said Tim Attia, CEO of Slice Labs. On-demand insurance is not just limited to insurers. Opening the Launch Studio to technology companies that are considering integrating on-demand insurance into existing digital products solidifies Slices transition from solely being an on-demand homeshare insurer to an award-winning cloud computing vendor.
The Slice Launch Studio is located on the 42nd floor of the Scotia Plaza (40 King St. West, Toronto), and is open from 9-5 p.m. ET Monday – Friday by appointment to protect the ICS user intellectual capital. Participants can make appointments at www.slice.is/launchstudio.
Slice Labs is a leading on-demand insurance cloud platform provider that empowers insurers to deliver new value to customers through direct insurance or insurance agent models without investing in infrastructure to provide customized on-demand, pay-as-you-go insurance products. The Slice Insurance Cloud Services platform (ICS) is powered by machine learning and advanced big data technologies along with Ph.D. behavioral science expertise. ICS is the foundation for new digital insurance products being released globally by top insurers and is also the base for Slices own digital insurance products serving the new economy. To stay up to date with Slice, visit http://www.slice.is and follow @SliceLabs on Twitter.


text:
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Researchers at the University of Sydney, Swinburne University of Technology and the Australian National University (ANU) have collaborated to develop a solar-absorbing, ultrathin film that has great potential for use in solar thermal energy harvesting.
Described in the journal Nature Photonics, the 90 nm graphene metamaterial is 1000 times finer than a human hair and can be rapidly heated up to 160°C under natural sunlight in an open environment.
"The physical effect causing this outstanding absorption in such a thin layer is quite general and thereby opens up a lot of exciting applications," said study co-author Dr Bjorn Sturmberg, who completed his PhD at the University of Sydney and is now a lecturer at ANU.
The researchers suggest that the material opens new avenues in thermophotovoltaics (the direct conversion of heat to electricity); solar seawater desalination; infrared lighting and heating; optical componentry (modulators and interconnects for communication devices); and photodetection. It could even lead to the development of 'invisible cloaking technology' through developing large-scale thin films enclosing the objects to be 'hidden'.
"Our cost-effective and scalable graphene absorber is promising for integrated, large-scale applications, such as energy harvesting, thermal emitters, optical interconnects, photodetectors and optical modulators," said Dr Han Lin, Senior Research Fellow at Swinburne's Centre for Micro-Photonics and first author on the paper.
"Fabrication on a flexible substrate and the robustness stemming from graphene make it suitable for industrial use," added Dr Keng-Te Lin, another author from Swinburne.
The researchers have developed a 2.5 x 5 cm working prototype to demonstrate the photothermal performance of the graphene-based metamaterial absorber. They have also proposed a scalable manufacture strategy to fabricate the proposed graphene-based absorber at low cost.
"In this work, the reduced graphene oxide layer and grating structures were coated with a solution and fabricated by a laser nanofabrication method, which are both scalable and low cost," said Professor Baohua Jia, Research Leader, Nanophotonic Solar Technology, in Swinburne's Centre for Micro-Photonics.
Image caption: Schematic of the graphene-based metamaterial absorber. Source: Nature Photonics.


text:
Q: How to compute styles on  or  using vue.js? I am using vuejs style bindings to render changes dynamically as the styles are computed.
This works great for everything within the scope of my Vue instance but how can I compute styles for body or html tags?
This used to be possible when you could bind the vue instance to  but vue no longer lets you do it.
I want to dynamically update the background color of  using my computed variables in vue.
edit: added code snippet to demonstrate

var app = new Vue({
  el: '#app',
  data: {
    color: '#666666'
  },
  computed: {
    backgroundColor: function() {
      return {
        'background-color': this.color
      }
    }
  },
  methods: {
    toggleBackground: function() {
      if(this.color=='#666666'){
        this.color = '#BDBDBD'
      } else {
        this.color = '#666666'
      }
    }
  }
})

        lots of content...

      <button @click="toggleBackground"> Click to toggle </button>

A: If you really need to style body itself, you'll need to do it with plain JavaScript in a watcher. A simple example is below.
You should (not something I've tried, but I'm hypothesizing) be able to defeat overscrolling effects by making body and your outer container non-scrolling. Put a scrollable container inside that. When it overscrolls, it will show your outer container, right?
The reasons for not binding to body are here (for React, but applies to Vue).

What's the problem with ? Everybody updates it! Some people have
  non-[Vue] code that attaches modals to it. Google Font Loader will
  happily put  elements into body for a fraction of second, and
  your app will break horribly and inexplicably if it tries to update
  something on the top level during that time. Do you really know what
  all your third party scripts are doing? What about ads or that social
  network SDK?

new Vue({
  el: '#app',
  data: {
    isRed: false
  },
  watch: {
    isRed() {
      document.querySelector('body').style.backgroundColor = this.isRed ? 'red' : null;
    }
  }
});
#app {
  background-color: white;
  margin: 3rem;
}

  <input type="checkbox" v-model="isRed">

A: I think I found better solution than using jQuery/querySelector
You can add tag style right in your Vue template.
And add v-if on this, smth like that:

Thus you can use computed/methods in this v-if and DOM always will update when you need.
Hope this will help someone ;)
UPD:
Using tag "style" in templates is not best idea, but you can create v-style component, then everything will be fine:
Use style tags inside vuejs template and update from data model
My snippet:

Vue.component('v-style', {
  render: function (createElement) {
    return createElement('style', this.$slots.default)
  }
});

new Vue({
  el: '#app',
  data: {
    isRed: false,
    color: 'yellow',
  },
});

  <input type="checkbox" v-model="isRed">
  <v-style v-if="isRed">
    body {
      background: red; /*one more benefit - you can write "background: {{color}};" (computed)*/
    }
  </v-style>


Here's an odd stat about Patriots QB Tom Brady.
A look back at a great Dolphins comeback against the Patriots.
Examining the defensive end position on the Bills.
The Jets are counting on RT Brandon Shell to continue to develop.
The Browns never ran a play when leading by more than one score in 2017.
Steelers WR Antonio Brown and Jaguars CB Jalen Ramsey shared some mutual respect.
Ravens QB Lamar Jackson would love to show up the Chargers.
PFT's argument that Marvin Lewis won't get fired is getting noticed in Cincinnati.
Your reminder that the Texans' pass protection sucked last year.
Here's the Colts' clinching interception against the Patriots to send Indianapolis to the 2006 Super Bowl.
Could Jaguars QB Blake Bortles really be an MVP candidate?
Is Marcus Mariota the top quarterback in the AFC South?
Appreciating the greatness of Von Miller.
More criticism for the NFL's decision not to let Chiefs G Laurent Duvernay-Tardif put M.D. on his jersey.
Here's a look at how the Chargers built their 90-player roster.
Here's an argument from Philly that the Giants will stink this year.
Eagles QB Nick Foles was unreal on third downs in the postseason.
Washington RB Derrius Guice appears to have the inside track for the starting job.
Here's a prediction of the Cowboys' 53-man roster.
Bears RB Tarik Cohen talked about his role in the offense with Jim Rome.
Here's a look back at when some people thought Brian Brohm was better than Aaron Rodgers.
If the Lions' offensive line is going to reach its potential Milan Lucic Jersey Kids , T.J. Lang needs to stay healthy.
Stefon Diggs calls the Vikings a well coached team.
Falcons WR Julio Jones congratulated Steelers WR Antonio Brown on being the top-ranked receiver on the NFL's Top 100 players list.
Panthers QB Cam Newton has been posting some videos of his offseason workouts.
Saints QB Drew Brees has been a Top 10 player on the NFL Network list three times.
The Buccaneers are limiting public access to training camp.
Seahawks LB Shaquem Griffin is a grand marshal for the Special Olympics.
Cardinals DE Chandler Jones says the defense will have less thinking and more doing this season.
The Rams had seven players on the Top 100 list, tied with the Vikings for the most in the NFL.
Remembering the great 49ers WR Dwight Clark.
Kluber (10-2, 1.99 ERA) has gone six starts, 41 innings and 168 consecutive batters since he last walked a hitter. His last walk came over a month ago Jason Spezza Jersey , on May 8.
His two losses were by the scores of 2-1 and 3-2. The score in one of his no-decisions was 3-2. In the other no-decision Colton Parayko Jersey , the Indians were winning 2-0 in the seventh inning when Kluber was removed from the game.
Kluber's mound opponent of Friday will be right-hander Kyle Gibson (1-4, 3.45). Gibson's only win came in his first start of the season, on March 31. Since then Kailer Yamamoto Jersey , he is 0-4 but with a decent 3.75 ERA.
Minnesota's lineup for Friday's game will have a different look after the Twins on Thursday optioned struggling third baseman Miguel Sano to Class A Fort Myers. After hitting .264 with 28 home runs and 77 RBIs last year, Sano this year was batting .203 with seven home runs and 27 RBIs Victor Hedman Jersey , and he had struck out in nearly half (66) of his at-bats (148).