Those reports have yielded many useful recommendations, some of which are repeated in this report. However, the applicability of those reports to child mental health issues is complex because of some unique aspects of children, their development, and their contexts, which are valuable to consider. In response to these challenges, the workgroup has framed the following guiding principles, which undergird the thought, interpretation, and recommendations of this report:.
Two broad conceptual models, shown in Figures 1 and 2, also guide the development of this report. The first model addresses the relationship between basic science and child mental health services. The second model describes a developmental framework linking neuroscience, behavioral science, and intervention across the life span. In this section, we describe each model and its relevance to the themes of the report.
A primary goal of this report is to describe, illustrate, and encourage the application of a model for the links between basic science and the provision of mental health services to children and adolescents. This model, depicted in Figure 1, envisions a cyclical sequence of processes. The sequence we envision is never expected to reach a terminus at which all the answers are known and all service interventions are perfected.
For this reason, we do not attempt here to provide an exhaustive list of the most important findings of basic science or the best-supported interventions. Instead, our goal—in the model and throughout the report—is to describe a model, or strategy, for building knowledge and building interventions by maintaining a strong linkage between science and practice. Implicit in the model, and throughout this report, is our view that best practice in mental health requires a close connection to the state of the science and that best science requires ongoing feedback from real-world experience.
Figure 1 begins with Basic Research and Theory. This box encompasses basic science with both human and infrahuman species in such fields as learning, development, and neurobiology. In the model, concepts and findings in these fields are used to stimulate Research on Intervention Development and Refinement.
Such research may include psychosocial treatments, medications, combined psychosocial-pharmacological interventions, and prevention programs targeting mental health. Note that the arrow between basic research and research on intervention development is bidirectional, reflecting our view that basic research may both inform and be informed by intervention development research. This bidirectional influence characterizes all pairs of elements or steps in the model, reflecting our view that the connections between science and practice are neither unidirectional nor linear. Research on intervention development and refinement typically leads to Research on Intervention Testing.
Within this box, we envision a continuum of methods, ranging from carefully controlled university experiments with recruited symptomatic youth to randomized trials with clinically referred youth treated in service settings by practicing clinicians. Where a particular study falls along the continuum will be dictated in part by the level of development of the intervention and the goals of the researcher. However, one conclusion emerging from our discussions is that there has been too little research to date on developing and testing interventions in the clinical settings for which they are ultimately intended; this situation has weakened prospects for effective dissemination.
Here we refer to efforts by reviewers to apply rules of evidence to the clinical trials literature so as to identify specific, empirically supported or evidence-based interventions. Relevant procedures may include systematic literature reviews, meta-analyses, and efforts by various committees and task forces to code studies for their methodological adequacy and gauge the level of support they provide for various interventions. A fifth process highlighted in the model is Intervention Deployment.
Included here are efforts to take evidence-based interventions into the field and encourage their use by providers, paired with efforts to understand the process, the outcome, and factors that may influence whether the interventions are adopted, whether they are used appropriately, and whether they are beneficial. Thoughtful research addressing these questions about deployment, and what makes it succeed or fail, will certainly require input from providers, community partners, parents and other caregivers, and the children and adolescents the interventions are intended to help.
As the diagram suggests, the model holds that information gained via research on deployment should be used to inform each of the other four processes described in the model: Basic Research and Theory, Research on Intervention Development and Refinement, Research on Intervention Testing, and Review and Synthesis of Research Findings to Identify Interventions that Work. Finally, we consider the multidirectionality and multisequentiality of the model. The spatial layout of the model may suggest a unidirectional sequence in which basic research and theory leads to research on development and refinement of a specific intervention, then to intervention testing.
This is followed by review and synthesis that identifies the intervention as empirically supported in multiple studies, at which point the intervention is deployed in service settings. Although this sequence may unfold in some cases, we do not see such a linear progression as essential to progress in the field, and we suspect that it may be unduly limiting. For example, a strong argument can be made that, for some interventions, deployment and outcome assessment in service settings should be a part of intervention development and testing so that problems in treatment delivery in real-world settings may be identified and solved early in the evolution of the intervention.
The general point is that the model shown in Figure 1 depicts processes that are needed to keep science and practice linked, but the order of these processes may be quite varied from one intervention to another, and there may be considerable blending of these processes as interventions are envisioned, developed, tested, and disseminated. Critical to this cyclic feedback model is the involvement of youth, family, providers, and community input at every level of the process to ensure the credibility of the interventions developed. The second conceptual model guiding this report is depicted in Figure 2.
As the figure illustrates, a developmental perspective is essential to the task of linking basic neuroscience, behavioral science, and opportunities for intervention. The figure shows a developmental trajectory across stages beginning with conception and gestation, passing through childhood and adolescence, and progressing into adulthood. Across this trajectory, developmental competencies e.
The growth of these competencies is not a smooth course involving uniform increments, but rather a series of spurts and plateaus. The darkened circles along the timeline represent the interplay of biological and behavioral development at multiple points in development. In the preschool years, for example, biological changes such as myelination, dendritic and axonal arborization, neurogenesis, synaptic stabilization, and sculpting of neural circuits are associated with behavioral changes such as improved regulation of attention and affect, impulse control, and task focus.
These changes set the stage for subsequent learning in school settings and for new kinds of social relationships involving empathy and cooperation. These points of biological-behavioral interface represented by the darkened circles along the curve are particularly important to the developmental model and to this report. They illustrate what we believe are exciting opportunities for cross-pollination among neuroscientists, behavioral scientists, and intervention researchers.
Enriched collaboration among these disciplines could stimulate a new generation of biobehavioral developmental theory and research and, in turn, new models of prevention and treatment. New models of prevention and treatment are needed for diverse forms of risk processes and competencies. We offer a few illustrations in Figure 2, indicated by the letter R. Of course, each form of risk process can be seen as one end of a continuum, at the other end of which is a particular form of competence. A range of developmental outcomes may accrue from the various risk processes and competencies.
As an example, low birth weight, irritable temperament in infancy coupled with caregiver stress, attentional deficits, and poor frustration tolerance at school age may confer negative outcomes such as ADHD, learning disabilities, and associated difficulties in peer relations. A central idea is that at each point in development, biological, behavioral, and environmental processes carry potential risks and potential opportunities for the development of new adaptive skills. An overarching goal of this report is to identify strategies for enriching our understanding of these developmental processes and their interplay, and to foster the development and deployment of interventions that can reduce risk and maximize adaptive skills.
Throughout this report, we provide a few examples of evidence-based interventions Science Cases in Point to explain aspects of the conceptual models and developmental framework. A clinical case study of childhood-onset depression see appendix B is used to illustrate how knowledge generated from interdisciplinary research can be meaningfully brought to bear on clinical practice.
Shifting evidence-based interventions into real-world settings will likely be an expensive endeavor. Before estimating the costs of this effort, the current resource context must first be understood. That is:. These funding amounts do not need to remain fixed, even if that were feasible. Instead, what is needed is a starting place to assess the relationship between mental health dollars expended and the number of youth served. A complete estimate is not likely to be attainable, owing to missing information about costs both direct and indirect and services provided in other critical child-serving sectors i.
Treatment dollars and service use in those sectors are significant, given very high rates of need in youth involved with child welfare up to 50 percent and juvenile justice up to 80 percent systems. Many of the youth in those sectors are high-end or high-cost service users, and the research base for treating this critical subpopulation is more limited than for youth with single disorders.
Additional questions that arise out of the relationship between resources and the services provided include:. Such information can offer a gauge for considering policies governing fiscal and clinical practices relative to unmet need, including access to care and appropriate provision of care.
The service utilization data constitute a measure of access, and that rate, when contrasted with epidemiological estimates of mental health need, creates a measure of unmet need. Nonetheless, cost and utilization information about the resources used for interventions that lack evidence i. Key findings from this report include the following:. Observations about these data are both encouraging and discouraging. This rate is still, however, well below the estimated need for care; only 5 to 7 percent of children receive some specialty mental health services, in contrast to an estimated 20 percent with a diagnosable mental disorder U.
There has been a significant decrease in the proportion of mental health dollars spent on institutional care since the last national estimate of costs and service use Burns, , but the rate of hospital use has changed little since The reduction in the percentage of institutional care costs is largely attributable to reductions in length of stay, second to discounting inpatient rates, and third to other factors such as the rise in outpatient treatment.
The finding here is that of a reduced proportion of the mental health dollar being spent on institutional care. In absolute value, the cost of institutional care has actually doubled not adjusted for inflation since the estimate Burns, The question of how to redirect both hospital and outpatient resources when not evidence-based into more effective care is both a research and policy issue. Further, studies to identify the necessary and appropriate use of inpatient care are needed, as are studies to examine the relationship between the availability of comprehensive community-based services and the use of inpatient treatment.
Stronger evidence of cost-effectiveness of community-based interventions could also be of use to policymakers considering changes in reimbursement and treatment strategies. Access to any type of mental health service appears to be a problem for the multiple groups identified above.
Medicaid coverage is clearly instrumental in creating access to services; of note is that uninsured youth receive care at half the rate of their Medicaid counterparts. Preschool-age children rarely receive any care, and racial disparities in service use persist despite higher rates of need. The preceding access issues require attention to understand their origins e. The variation in the number of specialty mental health visits based on type of insurance raises an appropriateness of care question. Although the adequacy of care cannot be fully determined without more information about the specific type and amount of care per treated child, it is clear that uninsured and privately insured youth are at a disadvantage compared with Medicaid-insured youth.
To illustrate the potential of the science base for improving mental health care for children, adolescents, and their families, this section systematically highlights progress from key scientific areas, including basic neuroscience, behavioral science, prevention, treatments, and services. Each subsection delineates opportunities for crossing the boundaries to link knowledge bases, identifies obstacles that present research challenges, and outlines specific recommendations for knowledge development within each area that can facilitate interdisciplinary efforts to solve targeted problems in child and adolescent mental health.
The major goal of such research is to translate and integrate findings from basic neuroscience into clinical investigations in order to develop and test specific hypotheses about the neurobiological substrates and etiologies of complex mental disorders. Such investigations include early-life neural antecedents of disorders that are expressed later in life, neural substrates of disorders that appear during childhood, neural circuitry activity, and genomic manipulations.
The deficiencies in the latter are frequently so staggering that even the brightest scenarios for solutions from basic neuroscience research seem likely to make only small contributions toward the alleviation of the problems. However, research into the environmental and genetic interactions that bring about brain and behavioral development must run in parallel with psychological and sociological solutions to the problems faced by children in our society if lasting solutions to these problems are to be achieved.
Knowledge pertaining to the natural history and organic nature of mental illness and to its etiology during childhood will be fundamentally important in establishing credible milestones of improvement as a result of behavioral intervention. Such knowledge is also vitally important for accurately diagnosing mental illness and developing early interventions. In addition, the identification of the biological bases of emotional and cognitive dysfunction should help to alleviate the social stigma associated with poor mental health.
This stigma curbs societal efforts to provide both adequate child-care and medical coverage, and also keeps families from seeking professional help even when medical coverage is available. Poor nutrition, physical or emotional abuse, neglect that produces prolonged stress, substance abuse, and environments that do not evoke active participation have been shown to produce detrimental effects on brain cell survival, neuron density, brain vascularization, and the normal development of brain circuitry.
For many of these risk factors, there are strong data supporting behavioral correlates of these anatomical and physiological changes. It is very reasonable to expect that even if, having survived some of these insults, a child matures into a competent adult, there is a high probability that he or she will suffer some emotional or cognitive handicap that prevents optimal function.
This is a waste of human resources. It also has been demonstrated that the early plasticity of brain circuitry can play a positive role in optimizing the brain for the environment in which it develops. This has been most dramatically illustrated in functional imaging studies of individuals born with sensory deficits and therefore forced to use other modalities for the basic skills of reading or speaking.
Brain regions not normally utilized in such skills are incorporated into new brain circuits. However, this adaptation occurs only if the unusual modalities are utilized for these purposes during early childhood. Such findings suggest that a mechanistic understanding, or even a behavioral, time-line keyed map of functional human brain development could help educators and clinicians to develop far more efficient strategies for using brain plasticity to facilitate learning or to aid in recovery from disease or trauma.
A growing number of linkage studies of families with emotional disorders and breeding studies of animals also make it clear that the genetic makeup of an individual will play a role in the behavioral and cognitive outcome of nongenetic effects on brain development. Genetic manipulation is one of many potential techniques for creating animal models of mental illness, and such work has revealed critically important information about disease processes at the cellular and molecular levels.
Unfortunately, in almost all instances, the way the genetic program of brain development interacts with epigenetic or environmental factors is not understood. Despite the explosion in neuroscience research within the past decade, we are still far from understanding the brain loci that are altered or involved when behaviors involving perception, projection, learning, memory, and emotion are performed, even in adults.
Some animal research has begun to illuminate the interplay between genes and environmental factors. Francis and colleagues at McGill University have found that normal variations in maternal care predict patterns of maternal care displayed by the adult offspring. In the rat, variations in maternal care measured as frequency and duration of licking and grooming behaviors appear to influence the development of behavioral and endocrine responses to stress in the offspring.
Remarkably, they found that if the pups born to low licking and grooming mothers were cross-fostered by high licking and grooming mothers, these pups grew up to be high licking and grooming mothers. The opposite was also true: The pups born to high licking and grooming mothers when cross-fostered by low licking and grooming mothers grew up to be low licking and grooming mothers.
The results of cross-fostering studies reported here provide evidence for 1 a causal relationship between maternal behavior and stress reactivity in the offspring and 2 the transmission of such individual differences in maternal behavior from one generation of females to the next. Moreover, an environmental manipulation imposed during early development that alters maternal behavior can then affect the pattern of transmission in subsequent generations.
It is important to note that the low licking mothers and pups showed heightened stress responsivity as adults and were more anxious and fearful of novel environments. Taken together, these findings indicate that variations in maternal care can serve as the basis for a nongenomic behavioral transmission of individual differences in stress reactivity across generations.
The next phase of this research is seeking to identify critical behavioral and neurochemical changes associated with the effects of early environment on later susceptibility to adverse effects of stress. These studies are relevant to understanding predisposing factors contributing to the development of anxiety and depression in humans. She found that infants of withdrawn, depressed mothers show dysregulation as early as the neonatal period unresponsive behavior, low activity level, indeterminate sleep, low vagal tone, right frontal electroencephalogram [EEG] activation, elevated norepinephrine, and low dopamine levels.
Infants of mothers who remain depressed for 1 year after birth have a distinct profile of behavioral, physiologic, and biochemical dysregulation. Their mothers also have a distinct profile that can be used to target those in need of intervention Field, These interventions may include mood induction, massage therapy, interaction coaching, and natural buffers such as nondepressed fathers and caregivers. The next phase of this research will work on identifying infants of depressed mothers who are most at risk, as well as suggesting specific interventions for the depressed mother-infant dyads with a different profile.
For example, Hammen and colleagues tested a stress-sensitization version of a diathesis-stress approach to depression. In a 2-year longitudinal follow-up design, exposure to stressful life events was examined in young women in the transition to adulthood. The authors hypothesized that those who had experienced one or more significant childhood adversities would have a lower threshold for developing a depressive reaction to stressors. Results indicated that women with exposure to one or more childhood adversities—such as family violence, parent psychopathology, or alcoholism—were more likely to become depressed following less total stress than women without such adversity.
The results could not be accounted for by chronic stress or prior depression. Both biological and psychological sensitization mechanisms may be speculated to play a role, but the actual mechanisms of stress sensitization remain to be explored. Insight will be gained into the role of genetic and environmental factors in the etiology of comorbidity. In addition, the development of multivariate genetic models, which include specified environmental risk factors, will provide realistic etiologic models that incorporate all major risk-factor domains.
To do this, models of pathogenesis are needed that can be refined and tested both in the laboratory and in the community. NIMH has already begun to support some efforts to facilitate the translation of basic science knowledge. Several innovative networks have been brought together through a translational research initiative. One such network is investigating the links between glucocorticoid and early experiences in rodents and its potential for helping to explicate disorders related to early adverse conditions in humans.
The network comprises animal researchers, developmental psychologists, psychiatrists, and mental health services researchers who have met over the past 2 years to examine the relation between stress and the hypothalamic-pituitary-adrenal axis HPA. After a thorough discussion of ideas, the group identified potential linkages and is now developing feasible research studies that take advantage of the advances at the interface of basic animal models, neuroscience, and services research to begin to clarify how behavioral and biological factors may interact in the etiology, course, and amelioration of psychopathology.
Broadly speaking, there are four reasons why progress in this area is slow. First, there is still relatively little innovative interaction between clinical research and basic neuroscience research focused on animal models. For example, a review of the NIMH research portfolio shows many studies dealing with the genetics, physiological correlates, environmental determinants, and occasionally gender differences of psychological disorders such as depression, borderline personality disorder, anxiety disorder, tic disorders, schizophrenia, and autism.
All of these disorders affect children or have their onset in adolescence. However, studies are needed using certain animal models of behaviors that have some of the correlates of the human condition in order to study the cellular and circuit basis of the dysfunction. This cross-disciplinary work, or translational research, may ultimately provide more accurate explication of brain dysfuntions that lead to mental illness.
Even in tractable animal models, such as the rodent, where the vast majority of cellular and genetic approaches to brain development are possible, relatively few investigators are using interdisciplinary approaches to study the mechanisms through which activity on an altered hormonal milieu regulates the development of brain synapses and circuits.
With the ability to use imaging in children comes the opportunity to study the development of a number of relevant aspects of cognition e. The slow progress in this area is highlighted by gaps in the current portfolio. For example, most work on activity-dependent brain development has been closely tied to the sensory periphery, whereas work on the epigenetic determinants of limbic system development has been relatively neglected. Even with work on the mature brain, studies correlating the performance of affect-associated tasks with electrophysiological recordings in awake behaving primates are exceptionally scarce.
Yet, such work will be key to linking humans and tractable animal models. In addition, despite the great advances in mouse genetics, there has been relatively little development of behavioral tasks or neurological assays that help to decipher the circuit defects in these animals. There have been very few studies seeking to understand how the brain alters its normal development to adjust for these defects. Given all the activity in genetic linkage studies of human dysfunctions, whose goal is to find the genes responsible for dysfunction, it is exceptionally important to develop approaches using genetically altered mice to determine how brain development and behavior adjust to these primary lesions.
An extensive body of behavioral science research has identified the specificity and variability of basic behavioral processes in normal populations and has developed a range of methodologies and technologies for such research. Applying these sophisticated measurement technologies to clinical populations may lead to refined diagnosis and more precisely identified points of intervention.
Illustrated here is research progress on normative processes that have implications for child and adolescent mental disorders. Significant advances have been made in our understanding of the cognitive capacities of children, particularly those of infants and young children.
Further, the general organization of memory in young infants is the same as that in adults, where memory development primarily involves the acquisition of new information rather than an entirely new structure for organizing information. This work provides a foundation for designing new tests for developmental disorders that can be administered early in life when interventions are likely to be most effective. An emerging body of evidence on the interrelation among temperament, mood, emotions, and cognition has implications for the etiology and course of illness.
A good example of such research is the study of infant temperament, which is defined as the constitutionally based patterns of sociability, activity, physiological reactivity, emotionality, and self-regulation that can be identified very early in development. Temperament is influenced over time by heredity, maturational processes, and experience, and provides a substrate for individual personality. Basic knowledge on infant temperament has been augmented by research on how social and psychobiological substrates of affect may contribute to individual differences.
For example, a number of projects in the current NIMH portfolio focus on measures of temperament and emotion and examine the links between them and early social factors, individual child characteristics, and physiological measures. Research examining the early development of attentional systems and how this development relates to the control of action and emotion has implications for improving the understanding of developmental problems in attention regulation.
For example, studies are examining ways in which the executive attention network linked to frontal lobe development plays a role in the development of higher cognitive capacities and in the self-regulation of emotional states and action Rothbart, MH Because attentional self-regulation can contribute to behavioral problems and difficulties in school, research tracing the normal development of and individual differences in these controls has implications for advancing etiologic understanding of a variety of childhood disorders in which regulatory deficits are implicated e.
This work needs to be extended to include clinical populations, both to test the generalizability of the basic findings and to clarify how, and in which dimension, children with certain illnesses or symptoms express these regulatory functions in different ways. It will also increase the understanding of how behaviors, symptoms, and disabilities actually cluster across disorders.
The fundamental issue is that many adolescents obtain insuffcient amounts of sleep at a time in development pubertal maturation when the biological need for sleep increases. Insufficient sleep can contribute to serious emotional and behavioral health consequences that include short-term as well as possible long-term effects.
Progress in understanding the causes of sleep deprivation and ultimately strategies for early intervention has been informed significantly by research examining interactions between biologic systems, behavioral patterns, and social and cultural influences within a developmental perspective.
Scientific progress includes these main points, made below:. At a time in development pubertal maturation when the physiological need for sleep increases, many adolescents are obtaining less sleep on school nights, largely as a result of late bedtimes combined with early school start times Carskadon, In combination, these factors lead to sleep-onset times that occur at late hours Carskadon et al. Thus, the strong tendency for adolescents to adopt very late schedules bedtime and wake time results in a shift of the circadian system, which adapts more quickly to phase delays than to phase advances thus it is very difficult for adolescents to shift back to the early bedtimes and rise times for school Carskadon, Despite an average bedtime between 11 p.
It is not infrequent for high school students to obtain less than 6 hours of sleep on school nights at a time in development when they typically require 8 to 9. The short- and long-term consequences of insufficient sleep at this point in development are not fully understood. Preliminary data clearly indicate a negative impact on school performance and learning, as well as decrements in mood and self-regulatory abilities.
More specifically, sleep deprivation is associated with irritability, poor concentration, and emotional lability, all of which create additional stress in the lives of many adolescents. Sleep deprivation can also increase stimulant use during the day e. Sleep deprivation, mood disturbance, and impaired concentration and self-regulatory skills can spiral into more severe symptoms of impairment in school and social functioning, which further erodes mood Dahl, Some policy-level decisions are already being enacted to address aspects of these problems; one such policy is adopting later start times for high schools.
Prelimary results from a controlled study of Minnesota school districts that have adopted later start times have been encouraging, with improved grades and mood ratings in the first year after these changes were made Wahlstrom et al. Larger studies are currently in progress. Educational programs for adolescents are also being developed similar to the nutrition education programs enacted in the past 20 years. However, large-scale policy changes and early clinical interventions focused on sleep and circadian aspects of adolescent health will require a great deal more interdisciplinary developmental research to better understand these complex issues.
Advances in the area of basic behavioral research involve our understanding of contextual influences on the development of personality or behavioral traits. Contextual issues play a critical role in the development, onset, and maintenance of mental illness in children. For example, studies have demonstrated that children with difficult temperaments may push the caregiver away, and with the caregiver less available, the child may develop soothing strategies that do not involve the caregiver.
Mothers who were trained to soothe their distress-prone infants and taught how to play with them were able to foster more positive affect and greater involvement of their children with them, with resulting benefits for their children in terms of attachment and sophistication of play Van den Boom, ; To better understand the social processes involved in mother-child transmission of affect, Fogel Fogel, MH is examining the development of emotion and attention in the context of a dyadic mother-infant relationship.
This study will include the observation of normally developing mother-infant dyads across key developmental transitions in the first 2 years of life, and also a larger group of dyads at risk for developmental disorders, who will then be followed longitudinally. One of the goals of this study is to understand the dynamic processes that regulate developmental change and the origins of individual differences in attention-emotion couplings. Another example of the influence of contextual factors relates to the widely documented gender difference in depression, which begins to appear during adolescence.
Biological as well as social and personality factors have been implicated. Findings suggest that social factors e. When these variables were controlled, gender difference in depression became minimal. These findings suggest that the increased incidence of depression among adolescent girls is likely due to factors that socialize them to be more emotionally expressive and to adopt internalizing coping strategies. For example, girls are more likely to engage in self-evaluative mechanisms, which heighten vulnerability to depressive and anxiety symptoms.
Social psychological theory suggests that this type of control is likely to undermine a sense of mastery and self-reliance that is crucial for coping with failures and disruptions, such as those experienced during school transitions. He is a terrorist. The way we organize, label, and relate information influences the way people comprehend that information.
As information architects, we organize information so that people can find the right answers to their questions. We strive to support casual browsing and directed searching. Our aim is to apply organization and labeling systems that make sense to users. And while the description of process research, design, build was pre-agile waterfall, our prescription for learning about users, content, and context remains relevant today.
See more. Who's Afraid of AI? Blueprint is an alliance of organisations and individuals collaborating on integrated design solutions for regenerative human settlements - inspired by the ground-breaking work of Paulo Mellett. Rather, these examples are provided as a prompt to explore available options and resources that can assist in collaborative systems change efforts. Boards Ministerial Advisory Committee About health boards Board appointments Current appointment processes Board education events Board education resources. The fourth edition of the polar bear book hit me like a brick. Carol Sanford.
More than anything, screenshots date the book. In a world of pace layers , surface changes faster than structure. And there are sections that are just so Like I said, everything has changed, and everything remains the same. At pages, this was one fat polar bear. We dove deep into taxonomies, controlled vocabularies, and thesauri, explaining how to use semantic relationships to enhance understanding and findability.
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Then, I used Search Patterns to dig deep into relevance, faceted navigation, interaction design, and the user experience of search. Most recently I wrote Intertwingled as an adventure in systems thinking that connects the dots between authority, Buddhism, classification, synesthesia, quantum entanglement, and volleyball. We moved your item s to Saved for Later. There was a problem with saving your item s for later. You can go to cart and save for later there.
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