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Sample records for assertive community treatment

  1. Assertive Community Treatment in the Netherlands

    NARCIS (Netherlands)

    M.D. van Vugt (Maaike)

    2015-01-01

    markdownabstract__Abstract__ __Introduction: __ Assertive Community Treatment is a model for care and treatment of patients with the most severe mental illness in the community. Key principles of Assertive Community Treatment (ACT) are: integration of services, low patient–staff ratio, locus of

  2. Assertive Community Treatment (ACT) – metodebeskrivelse

    DEFF Research Database (Denmark)

    Benjaminsen, Lars; Kirkedal Nielsen, Ian; Møller, mikkel Stamp

    2017-01-01

    arbejde med ACT-metoden over for en målgruppe med psykiske vanskeligheder og samtidigt misbrug i en dansk kommunal kontekst. Denne manual beskriver således vigtige elementer i Assertive Community Treatment (ACT) metoden henvendt til personer med psykiske vanskeligheder og samtidigt misbrug, som det har...

  3. Assertive community treatment and associations with delinquency.

    Science.gov (United States)

    van Vugt, Maaike D; Kroon, Hans; Delespaul, Philippe A E G; Mulder, Cornelis L

    This article draws on a prospective longitudinal study in which Assertive Community Treatment (ACT) model fidelity and patient outcomes were assessed in twenty outpatient treatment teams. 530 severely mentally ill patients participated in the study. Delinquency outcomes were assessed three times during a two-year follow-up period. At baseline, 49% of the patients had a recent criminal history, meaning that they had at least one reported contact with the police and/or the justice system in the past year. Patients with a recent criminal history had more serious psychosocial problems at baseline compared to those without a recent criminal history. Delinquency outcomes showed improvement over time, but this was not associated with ACT model fidelity. The study shows an association for homelessness and criminal activity. The persistent criminal activities of some of the patients showed that for this group extra interventions are needed that specifically target reduction of criminal behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Assertive community treatment for elderly people with severe mental illness

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    Mulder Niels CL

    2010-10-01

    Full Text Available Abstract Background Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. Methods We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.. If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. Discussion This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects

  5. Assertive community treatment for elderly people with severe mental illness.

    Science.gov (United States)

    Stobbe, Jolanda; Mulder, Niels C L; Roosenschoon, Bert-Jan; Depla, Marja; Kroon, Hans

    2010-10-19

    Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. The Netherlands National Trial Register NTR1620.

  6. Cognitive adaptation training combined with assertive community treatment

    DEFF Research Database (Denmark)

    Hansen, Jens Peter; Østergaard, Birte; Nordentoft, Merete

    2012-01-01

    Cognitive adaptation training (CAT) targets the adaptive behaviour of patients with schizophrenia and has shown promising results regarding the social aspects of psychosocial treatment. As yet, no reports have appeared on the use of CAT in combination with assertive community treatment (ACT). Our...

  7. Processes underlying treatment success and failure in assertive community treatment.

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    Stull, Laura G; McGrew, John H; Salyers, Michelle P

    2012-02-01

    Processes underlying success and failure in assertive community treatment (ACT), a widely investigated treatment model for persons with severe mental illness, are poorly understood. The purpose of the current study was to examine processes in ACT by (1) understanding how consumers and staff describe the processes underlying treatment success and failure and (2) comparing processes identified by staff and consumers. Investigators conducted semi-structured interviews with 25 staff and 23 consumers from four ACT teams. Both staff and consumers identified aspects of the ACT team itself as the most critical in the process of consumer success. For failure, consumers identified consumer characteristics as most critical and staff identified lack of social relationships. Processes underlying failure were not viewed as merely the opposite of processes underlying success. In addition, there was notable disagreement between staff and consumers on important processes. Findings overlap with critical ingredients identified in previous studies, including aspects of the ACT team, social involvement and employment. In contrast to prior studies, there was little emphasis on hospitalizations and greater emphasis on not abusing substances, obtaining wants and desires, and consumer characteristics.

  8. Perceptions of coercion in the community: a qualitative study of patients in a Danish assertive community treatment team

    DEFF Research Database (Denmark)

    Thøgersen, Marie Høgh; Morthorst, Britt; Nordentoft, Merete

    2010-01-01

    Assertive community treatment (ACT) has been claimed to be paternalistic and coercive, yet little is known about how patients experience the assertive aspects of ACT. To explore views on--and perceptions of--coercion of patients in Danish assertive community teams. In-depth interviews were...

  9. Function assertive community treatment (FACT) and psychiatric service use in patients diagnosed with severe mental illness

    NARCIS (Netherlands)

    Drukker, M.; van Os, J.; Sytema, S.; Driessen, G.; Visser, E.; Delespaul, Ph.

    Aim. Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a

  10. Adding evidence-based interventions to assertive community treatment : a feasibility study

    NARCIS (Netherlands)

    Sytema, Sjoerd; Jörg, Frederike; Nieboer, Roeline; Wunderink, Lex

    OBJECTIVE: This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions. METHODS: A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT

  11. Assessing the efficacy of a modified assertive community-based treatment programme in a developing country

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    Botha Ulla A

    2010-09-01

    Full Text Available Abstract Background A number of recently published randomized controlled trials conducted in developed countries have reported no advantage for assertive interventions over standard care models. One possible explanation could be that so-called "standard care" has become more comprehensive in recent years, incorporating some of the salient aspects of assertive models in its modus operandi. Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country. Methods High frequency service users were randomized into an intervention (n = 34 and a control (n = 26 group. The control group received standard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment. Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end. Symptomatology and functioning were measured at both visits using the PANSS, CDSS, ESRS, WHO-QOL and SOFAS. Results At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS (p = 0.02 as well as positive (p Conclusions Our results indicate that assertive interventions in a developing setting where standard community mental services are often under resourced can produce significant outcomes. Furthermore, these interventions need not be as expensive and comprehensive as international, first-world models in order to reduce inpatient days, improve psychopathology and overall levels of functioning in patients with severe mental illness.

  12. Early detection and assertive community treatment of young psychotics

    DEFF Research Database (Denmark)

    Jørgensen, P; Nordentoft, M; Abel, M B

    2000-01-01

    Recent research indicates that early detection of young persons suffering from psychosis and subsequent intensive intervention enhances treatment response and prognosis, but the data are only preliminary and suggestive....

  13. Staff and consumer perspectives on defining treatment success and failure in assertive community treatment.

    Science.gov (United States)

    Stull, Laura G; McGrew, John H; Salyers, Michelle P

    2010-09-01

    Although assertive community treatment (ACT) has been consistently recognized as effective, there has been little research as to what constitutes success in ACT. The purpose of this study was to understand how ACT consumers and staff define treatment success and failure and to examine whether definitions varied between staff and consumers. Investigators conducted semistructured interviews with 25 staff and 23 consumers from four ACT teams. Across perspectives, success and failure were most clearly related to consumer factors. Other themes included having basic needs met, being socially involved, and taking medications. Reduced hospitalizations were mentioned infrequently. Consumers were more likely than staff to identify the level or type of treatment as defining success and failure, whereas staff were more likely than consumers to discuss substance abuse when defining failure and improved symptoms when defining success. Success in ACT should be viewed more broadly than reduced hospitalizations and include domains such as social involvement.

  14. Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Aagaard, Jørgen

    2015-01-01

    Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi-experime......Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi...... only. Results: Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P

  15. Involuntary admission may support treatment outcome and motivation in patients receiving assertive community treatment.

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    Kortrijk, Hans Erik; Staring, A B P; van Baars, A W B; Mulder, C L

    2010-02-01

    Patients with severe mental illness who are treated in assertive community treatment (ACT) teams are sometimes involuntarily admitted when they are dangerous to themselves or others, and are not motivated for treatment. However, the consequences of involuntary admission in terms of psychosocial outcome and treatment motivation are largely unknown. We hypothesized that involuntary admission would improve psychosocial outcome and not adversely affect their treatment motivation. In the context of routine 6-monthly outcome monitoring in the period January 2003-March 2008, we used the Health of the Nation Outcome Scales (HoNOS) and a motivation-for-treatment scale to assess 260 severely mentally ill patients at risk for involuntary admission. Mixed models with repeated measures were used for data analyses. During the observation period, 77 patients (30%) were involuntarily admitted. Relative to patients who were not involuntarily admitted, these patients improved significantly in HoNOS total scores (F = 17,815, df = 1, p < 0.001) and in motivation for treatment (F = 28.139, df = 1, p < 0.001). Patients who were not involuntarily admitted had better HoNOS and motivation scores at baseline, but did not improve. Involuntary admission in the context of ACT was associated with improvements in psychosocial outcome and motivation for treatment. There are no indications that involuntary admission leads to deterioration in psychosocial outcome or worsening of motivation for treatment.

  16. Moral Decision-Making among Assertive Community Treatment (ACT) Case Managers

    DEFF Research Database (Denmark)

    Lerbæk, Birgitte; Aagaard, Jørgen; Andersen, Mette Braendstrup

    2015-01-01

    The context of care in assertive community treatment (ACT) can be precarious and generate ethical issues involving the principles of autonomy and paternalism. This focus group study examined case managers' situated accounts of moral reasoning. Our findings show how they expressed strong moral...... obligation towards helping the clients. Their moral reasoning reflected a paternalistic position where, on different occasions, the potential benefits of their interventions would be prioritised at the expense of protecting the clients' personal autonomy. The case managers' reasoning emphasised situational...

  17. Assertive community treatment: facilitators and barriers to implementation in routine mental health settings.

    Science.gov (United States)

    Mancini, Anthony D; Moser, Lorna L; Whitley, Rob; McHugo, Gregory J; Bond, Gary R; Finnerty, Molly T; Burns, Barbara J

    2009-02-01

    This study identified barriers and facilitators to the high-fidelity implementation of assertive community treatment. As part of a multistate implementation project for evidence-based practices, training and consultation were provided to 13 newly implemented assertive community treatment teams in two states. Model fidelity was assessed at baseline and at six, 12, 18, and 24 months. Key informant interviews, surveys, and monthly on-site visits were used to monitor implementation processes related to barriers and facilitators. Licensing processes of the state mental health authority provided critical structural supports for implementation. These supports included a dedicated Medicaid billing structure, start-up funds, ongoing fidelity monitoring, training in the model, and technical assistance. Higher-fidelity sites had effective administrative and program leadership, low staff turnover, sound personnel practices, and skilled staff, and they allocated sufficient resources in terms of staffing, office space, and cars. Lower-fidelity sites were associated with insufficient resources, prioritization of fiscal concerns in implementation, lack of change culture, poor morale, conflict among staff, and high staff turnover. In cross-state comparisons, the specific nature of fiscal policies, licensing processes, and technical assistance appeared to influence implementation. State mental health authorities can play a critical role in assertive community treatment implementation but should carefully design billing mechanisms, promote technical assistance centers, link program requirements to fidelity models, and limit bureaucratic requirements. Successful implementation at the organizational level requires committed leadership, allocation of sufficient resources, and careful hiring procedures.

  18. Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

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    Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

    2017-03-01

    Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

  19. Assertive Community Treatment for alcohol dependence (ACTAD: study protocol for a randomised controlled trial

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    Gilburt Helen

    2012-02-01

    Full Text Available Abstract Background Alcohol dependence is a significant and costly problem in the UK yet only 6% of people a year receive treatment. Current service provision based on the treatment of acute episodes of illness and emphasising personal choice and motivation results in a small proportion of these patients engaging with alcohol treatment. There is a need for interventions targeted at the population of alcohol dependent patients who are hard to engage in conventional treatment. Assertive Community Treatment (ACT, a model of care based on assertive outreach, has been used for treating patients with severe mental illnesses and presents a promising avenue for engaging patients with primary alcohol dependence. So far there has been little research on this. Methods/Design In this single blind exploratory randomised controlled trial, a total of 90 alcohol dependent participants will be recruited from community addiction services. After completing a baseline assessment, they will be assigned to one of two conditions: (1 ACT plus care as usual, or (2 care as usual. Those allocated to the ACT plus care as usual will receive the same treatment that is routinely provided by services, plus a trained key worker who will provide ACT. ACT comprises intensive and assertive contact at least once a week, over 50% of contacts in the participant's home or local community, and comprehensive case management across social and health care, for a period of one year. All participants will be followed up at 6 months and 12 months to assess outcome post randomisation. The primary outcome measures will be alcohol consumption: mean drinks per drinking day and percentage of days abstinent measured by the Time Line Follow Back interview. Secondary outcome measures will include severity of alcohol dependence, alcohol related problems, motivation to change, social network involvement, quality of life, therapeutic relationship and service use. Other outcome variables are treatment

  20. Function assertive community treatment (FACT) and psychiatric service use in patients diagnosed with severe mental illness.

    Science.gov (United States)

    Drukker, M; van Os, J; Sytema, S; Driessen, G; Visser, E; Delespaul, P

    2011-09-01

    Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a different pattern of psychiatric service consumption compared to traditional services, which should result in different costing parameters than care as usual (CAU). South-Limburg FACT patients, identified through the local psychiatric case register, were matched with patients from a non-FACT control region in the North of the Netherlands (NN). Matching was accomplished using propensity scoring including, among others, total and outpatient care consumption. Assessment, as an important ingredient of FACT, was the point of departure of the present analysis. FACT patients, compared to CAU, had five more outpatient contacts after the index date. Cost-effectiveness was difficult to assess. Implementation of FACT results in measurable changes in mental health care use.

  1. Associations Between Quality of Life and Functioning in an Assertive Community Treatment Population.

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    Clausen, Hanne; Landheim, Anne; Odden, Sigrun; Heiervang, Kristin Sverdvik; Stuen, Hanne Kilen; Killaspy, Helen; Šaltytė Benth, Jurate; Ruud, Torleif

    2015-11-01

    Level of functioning is positively associated with subjective quality of life for people with severe mental illness, but a detailed relationship between functioning and satisfaction with various life domains is largely unknown, and this gap prompted this study. Demographic and clinical data were obtained from 149 patients engaged with 12 assertive community treatment teams in Norway. Multivariate regression analyses were used to explore associations between subjective quality of life and patient characteristics. Analyses confirmed positive associations between quality of life and age, functioning, and weekly contact with family and friends and a negative association with anxiety and depressive symptoms. Positive associations between several areas of practical and social functioning and satisfaction with related life domains also were found. Although a causal direction of the associations between functioning and life satisfaction has not been determined in this study, the positive findings might indicate that programs aiming to improve functioning could affect patients' quality of life.

  2. Understanding the role of individual consumer-provider relationships within assertive community treatment.

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    Stanhope, Victoria; Matejkowski, Jason

    2010-08-01

    The widespread adoption of assertive community treatment has resulted in a shift from an individual model to a team model of case management. The shift has had implications for individual relationships between case managers and consumers, but still little is known about how these relationships develop in teams. This exploratory mixed methods study looked at how case managers and consumers negotiate individual relationships within a team model. Quantitative methods identified high and low service intensity relationships between consumers and case managers and qualitative methods explored and compared these relationships. Consumers in high service intensity relationships described a preference for certain case managers and the burden of working with multiple people. Case managers invested high service intensity relationships with special therapeutic value, articulated the challenges of coordinating care across the team, and utilized team limit setting techniques. In contrast, low service intensity relationships were more likely to reflect integration with the entire team. Findings suggest that teams need to consider how individual relationships enhance care for their consumers and how to nurture these relationships while maintaining the support necessary for case managers and consumers.

  3. Facilitation of Psychiatric Advance Directives by Peers and Clinicians on Assertive Community Treatment Teams.

    Science.gov (United States)

    Easter, Michele M; Swanson, Jeffrey W; Robertson, Allison G; Moser, Lorna L; Swartz, Marvin S

    2017-07-01

    Psychiatric advance directives (PADs) provide a legal mechanism for competent adults to document care preferences and authorize a surrogate to make treatment decisions. In a controlled research setting, an evidence-based intervention, the facilitated psychiatric advance directive (FPAD), was previously shown to overcome most barriers to PAD completion. This study examined implementation of the FPAD intervention in usual care settings as delivered by peer support specialists and nonpeer clinicians on assertive community treatment (ACT) teams. A total of 145 ACT consumers were randomly assigned, within teams, to FPAD with facilitation by either a peer (N=71) or a clinician (N=74). Completion rates and PAD quality were compared with the previous study's standard and across facilitator type. Logistic regression was used to estimate effects on the likelihood of PAD completion. The completion rate of 50% in the intent-to-treat sample (N=145) was somewhat inferior to the prior standard (61%), but the rate of 58% for the retained sample (those who completed a follow-up interview, N=116) was not significantly different from the standard. Rates for peers and clinicians did not differ significantly from each other for either sample. PAD quality was similar to that achieved in the prior study. Four consumer variables predicted completion: independent living status, problematic substance use, length of time served by the ACT team, and no perceived unmet need for hospitalization in crisis. Peers and clinicians can play a crucial role in increasing the number of consumers with PADs, an important step toward improving implementation of PADs in mental health care.

  4. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

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    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  5. Forensic Assertive Community Treatment in a Continuum of Care for Male Internees in Belgium: Results After 33 Months.

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    Marquant, Thomas; Sabbe, Bernard; Van Nuffel, Meike; Verelst, Rudy; Goethals, Kris

    2018-01-01

    Non-forensic or regular assertive community treatment (ACT) has positive effects on non-forensic outcomes but has poor effects on forensic outcome measures. In this study, we examined non-forensic and forensic outcome measures of a forensic adaptation of ACT (ForACT) within a continuum of care for internees. Data were collected retrospectively from files of 70 participants in the ForACT group who had been released from a forensic hospital. The control group comprised internees who had left prison and entered community-based care (n = 56). The ForACT group demonstrated significantly better outcomes on forensic measures, such as arrests and incarcerations, and had better community tenure. However, this group showed high hospitalization rates. The findings indicate that this type of community-based care can be beneficial for such internees; however, internees continue to experience difficulties reintegrating into society.

  6. A Multiple-City RCT of Housing First With Assertive Community Treatment for Homeless Canadians With Serious Mental Illness.

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    Aubry, Tim; Goering, Paula; Veldhuizen, Scott; Adair, Carol E; Bourque, Jimmy; Distasio, Jino; Latimer, Eric; Stergiopoulos, Vicky; Somers, Julian; Streiner, David L; Tsemberis, Sam

    2016-03-01

    Housing First with assertive community treatment (ACT) is a promising approach to assist people with serious mental illness to exit homelessness. The article presents two-year findings from a multisite trial on the effectiveness of Housing First with ACT. The study design was a randomized controlled trial conducted in five Canadian cities. A sample of 950 participants with serious mental illness who were absolutely homeless or precariously housed were randomly assigned to receive either Housing First with ACT (N=469) or treatment as usual (N=481). Housing First participants spent more time in stable housing than participants in treatment as usual (71% versus 29%, adjusted absolute difference [AAD]=42%, pHousing First participants who entered housing did so more quickly (73 versus 220 days, AAD=146.4, phousing tenures at the study end-point (281 versus 115 days, AAD=161.8, phousing more positively (adjusted standardized mean difference [ASMD]=.17, pHousing First participants reported higher quality of life (ASMD=.15, pHousing First participants showed significantly greater gains in community functioning and quality of life in the first year; however, differences between the two groups were attenuated by the end of the second year. Housing First with ACT is an effective approach in various contexts for assisting individuals with serious mental illness to rapidly exit homelessness.

  7. Recovery concept in a Norwegian setting to be examined by the assertive community treatment model and mixed methods.

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    Lofthus, Ann-Mari; Westerlund, Heidi; Bjørgen, Dagfinn; Lindstrøm, Jonas Christoffer; Lauveng, Arnhild; Rose, Diana; Ruud, Torleif; Heiervang, Kristin

    2018-02-01

    Recovery is a crucial concept in the mental health field. The research of recovery is split into the categories of personal, social and clinical recovery. The purpose of this study was to explore the fragmented concept of recovery in light of assertive community treatment (ACT) in Norway. The study has a mixed methods design with a pragmatic approach. The Questionnaire about the Process of Recovery and open-ended questions posed to 70 participants from 12 ACT teams in Norway, gathered by the "Users interview users" method, are combined with interviews or focus groups with eight of these participants. Surprisingly those under a community treatment order (CTO) report the highest degree of personal recovery. The qualitative material shows that the service users interpreted the concept of recovery differently than researchers and professionals. The ACT service users highlighted three important elements: flexible treatment, medication and access to a car. They emphasized the necessity for basic needs to be met in order to experience a meaningful recovery process, and these basic needs may be of even greater importance to those under CTOs. Their experiences should imply a greater emphasis on securing basic needs such as secure housing, sounder finances and access to the normal benefits offered by society. © 2016 Australian College of Mental Health Nurses Inc.

  8. Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT Team

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    Nicole B. Washington, DO, Assistant Professor

    2012-01-01

    Full Text Available Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers. Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed. Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI, haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable. Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.

  9. [Assertive community treatment: promoting engagement with care of people suffering severe addiction].

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    Morandi, Stéphane; Silva, Benedetta; Monnat, Martine; Bonsack, Charles

    2016-06-08

    Despite the increasing number of specialized addiction services and the constant deployment of health care resources, a coordinated needs-based treatment is not always available for people with severe drugs and/or alcohol problems. Too often the involved health care professionals feel helpless and overwhelmed by the complexity of the situation. In order to promote the treatment engagement of the hard-to-reach substance users, a multidisciplinary mobile team project for addiction (SIMA) was developed in Lausanne, Switzerland, in 20174. This paper describes the model of intervention, the profile of the population followed during the first year of intervention and illustrates, through two clinical cases, the advantages of this approach.

  10. Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings.

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    Ye, Jing; Chen, Timothy F; Paul, Diane; McCahon, Rebecca; Shankar, Sumitra; Rosen, Alan; O'Reilly, Claire L

    2016-09-01

    To describe the perceived experiences of stigma and discrimination among people living with severe and persistent mental illness in assertive community treatment (ACT teams) settings in New South Wales (NSW), Australia. The Discrimination and Stigma Scale (DISC) was used in this cross-sectional study with people living with severe and persistent mental illness. The DISC is a reliable and valid, quantitative and qualitative instrument used to explore and measure levels of negative, anticipated and positive discrimination. Relevant clinical history and socio-demographic information were also collected. A total of 50 clients participated, with 40 (80%) reporting experienced negative discrimination in at least one life area. Negative discrimination was most commonly experienced in being avoided or shunned (n=25, 50%), by neighbours (n=24, 48%) and family (n=23, 46%). Anticipated discrimination was common, with half of participants (n=25, 50%) feeling the need to conceal their mental health diagnosis. Discrimination was highly prevalent in everyday aspects of life. While healthcare professionals often tend to increase perceived stigma and discrimination, this was only experienced in interactions with general health professionals, while interactions with ACT team members decreased perceived stigma and increased positive discrimination. This indicates that healthcare professionals potentially have a significant role in reducing stigma and discrimination in mental health and that such an effect may be optimised in an ACT team setting. © The Author(s) 2016.

  11. Explicit and Implicit Stigma of Mental Illness as Predictors of the Recovery Attitudes of Assertive Community Treatment Practitioners.

    Science.gov (United States)

    Stull, Laura G; McConnell, Haley; McGrew, John; Salyers, Michelle P

    2017-01-01

    While explicit negative stereotypes of mental illness are well established as barriers to recovery, implicit attitudes also may negatively impact outcomes. The current study is unique in its focus on both explicit and implicit stigma as predictors of recovery attitudes of mental health practitioners. Assertive Community Treatment practitioners (n = 154) from 55 teams completed online measures of stigma, recovery attitudes, and an Implicit Association Test (IAT). Three of four explicit stigma variables (perceptions of blameworthiness, helplessness, and dangerousness) and all three implicit stigma variables were associated with lower recovery attitudes. In a multivariate, hierarchical model, however, implicit stigma did not explain additional variance in recovery attitudes. In the overall model, perceptions of dangerousness and implicitly associating mental illness with "bad" were significant individual predictors of lower recovery attitudes. The current study demonstrates a need for interventions to lower explicit stigma, particularly perceptions of dangerousness, to increase mental health providers' expectations for recovery. The extent to which implicit and explicit stigma differentially predict outcomes, including recovery attitudes, needs further research.

  12. Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness

    Science.gov (United States)

    Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie

    2006-01-01

    Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278

  13. Use of integrated dual disorder treatment via assertive community treatment versus clinical case management for persons with co-occurring disorders and antisocial personality disorder.

    Science.gov (United States)

    Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M

    2009-11-01

    We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.

  14. Perceptions of coercion in the community: a qualitative study of patients in a Danish assertive community treatment team

    DEFF Research Database (Denmark)

    Thøgersen, Marie Høgh; Morthorst, Britt; Nordentoft, Merete

    2010-01-01

    conducted with six purposefully selected patients and analysed using thematic analysis. Patients reported lack of influence on treatment process and a poor alliance with case-mangers, not being recognised as an autonomous person, and experiences of staff crossing the line and intruding privacy, as most...... central to perceptions of coercion. A collaborative and mutually trusting relationship, commitment, persistence and availability of staff, and recognition of the need for social support and help with everyday activities, were most important for counteracting such experiences. Perceptions of coercion were...

  15. A prison mental health in-reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending.

    Science.gov (United States)

    McKenna, Brian; Skipworth, Jeremy; Tapsell, Rees; Madell, Dominic; Pillai, Krishna; Simpson, Alexander; Cavney, James; Rouse, Paul

    2015-12-01

    It is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk. To evaluate the impact of implementing an assertive community treatment informed prison in-reach model of care (PMOC) on post-release engagement with community mental health services and on reoffending rates. One hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation. The assertive prison model of care was associated with more pre-release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post-release community mental health service engagements after implementation of this model (Z = -2.388, p = 0.02). There was a trend towards reduction in reoffending rates after release from some of the prisons (Z =1.82, p = 0.07). Assertive community treatment applied to prisoners with mental health problems was superior to 'treatment as usual', but more work is needed to ensure that agencies will engage prisoners in pre-release care. The fact that the model showed some benefits in the absence of any increase in resources suggests that it may be the model per se that is effective. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Assertiveness.

    Science.gov (United States)

    Chambers, David W

    2009-01-01

    Assertiveness means speaking up for one's interpersonal freedoms or as required by one's role responsibilities to engage others in finding viable, stable solutions. Assertiveness is a learnable skill rather than a personality characteristic. The first step in assertiveness is recognizing the nature of one's problem in order to avoid the objectionable and usually ineffective practice of trying to solve other people's problems. A simple assertive approach is to suggest a solution. A more structured technique involves identifying the behavior that is causing a problem and expressing one's feelings about the problem (I-messages). The most powerful technique combines portions of suggested solutions and I-messages with a clear statement of consequences (DESC scripts). Although there may be a small number of circumstances where they are appropriate, acquiescence (temporarily forgoing one's interpersonal freedoms or role responsibilities) or aggression (insisting on one's own solution to the detriment of others) have several disadvantages. An example of justifiable criticism in the case of recognized gross or continuous faulty work by another dentist is presented.

  17. Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

    Science.gov (United States)

    Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

    2011-11-01

    This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Families in Assertive Community Treatment (ACT) Teams in Norway: A Cross-Sectional Study on Relatives' Experiences of Involvement and Alienation.

    Science.gov (United States)

    Weimand, B M; Israel, P; Ewertzon, M

    2017-11-10

    International research shows that relatives of people with mental illness are rarely involved by mental health services. Assertive Community Treatment (ACT) has been recently implemented in Norway. The experience of relatives of ACT users is largely unknown. The aim of this study was to explore relatives' experience with ACT-teams in Norway. Data were collected using the family involvement and alienation questionnaire, consisting of experiences of approach, and alienation from the provision of professional care. 38 Relatives participated in this study. A majority experienced a positive approach (openness, confirmation, and cooperation) from the ACT teams, which also was considered better compared to previous services. They considered openness and cooperation as essential aspects from the professionals. Almost half did not feel alienated (powerlessness and social isolation). Higher level of being approached positively was significantly associated with lower level of feeling alienated. The knowledge of what constituted relatives' positive experiences with the ACT teams should be transferred into practice regarding how to form a positive alliance with relatives.

  19. Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark: 4-year register-based follow-up.

    Science.gov (United States)

    Hastrup, Lene Halling; Aagaard, Jørgen

    2015-02-01

    Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. The study was based on a quasi-experimental design with a control group from the neighbouring region. Costs and retention in mental health services were analysed by using register data 1 year before and 4 years after inclusion in the study. Data on the use of supportive housing were available for the year before baseline and the subsequent 2 years only. Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P < 0.17). Days in supportive housing were lower for the ACT group before baseline and remained so (dropping to zero) for the subsequent 2 years. Over 4 years, the mean total costs per patient in the group receiving ACT were DDK 493,442 (SE = 34,292). Excluding costs of supportive housing, the mean total costs per patient of the control group were DDK 537,218 (SE = 59,371), P < 0.53. If these costs are included, however, the mean total costs for the ACT group are unchanged, whereas costs for the control group rise to DDK 671,500 (SE = 73,671), P < 0.03. While ACT appears to have resulted in a significant reduction in costs for psychiatric hospitalizations, baseline differences in use of supportive housing make the effects of ACT on overall costs more ambiguous. At worst, however, overall costs did not increase. Given the generally acknowledged clinical benefits of ACT over standard outpatient care, the results support further dissemination of ACT in Denmark.

  20. Negative symptoms, anxiety, and depression as mechanisms of change of a 12-month trial of assertive community treatment as part of integrated care in patients with first- and multi-episode schizophrenia spectrum disorders (ACCESS I trial).

    Science.gov (United States)

    Schmidt, Stefanie J; Lange, Matthias; Schöttle, Daniel; Karow, Anne; Schimmelmann, Benno G; Lambert, Martin

    2017-05-24

    Assertive community treatment (ACT) has shown to be effective in improving both functional deficits and quality of life (QoL) in patients with severe mental illness. However, the mechanisms of this beneficial effect remained unclear. We examined mechanisms of change by testing potential mediators including two subdomains of negative symptoms, i.e. social amotivation as well as expressive negative symptoms, anxiety, and depression within a therapeutic ACT model (ACCESS I trial) in a sample of 120 first- and multi-episode patients with a schizophrenia spectrum disorder (DSM-IV). Path modelling served to test the postulated relationship between the respective treatment condition, i.e. 12-month ACT as part of integrated care versus standard care, and changes in functioning and QoL. The final path model resulted in 3 differential pathways that were all significant. Treatment-induced changes in social amotivation served as a starting point for all pathways, and had a direct beneficial effect on functioning and an additional indirect effect on it through changes in anxiety. Expressive negative symptoms were not related to functioning but served as a mediator between changes in social amotivation and depressive symptoms, which subsequently resulted in improvements in QoL. Our results suggest that social amotivation, expressive negative symptoms, depression, and anxiety functioned as mechanisms of change of ACCESS. An integrated and sequential treatment focusing on these mediators may optimise the generalisation effects on functioning as well as on QoL by targeting the most powerful mechanism of change that fits best to the individual patient.

  1. Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia-spectrum and bipolar I disorders: Four-year follow-up of the ACCESS II study.

    Science.gov (United States)

    Schöttle, Daniel; Schimmelmann, Benno G; Ruppelt, Friederike; Bussopulos, Alexandra; Frieling, Marietta; Nika, Evangelia; Nawara, Luise Antonia; Golks, Dietmar; Kerstan, Andrea; Lange, Matthias; Schödlbauer, Michael; Daubmann, Anne; Wegscheider, Karl; Rohenkohl, Anja; Sarikaya, Gizem; Sengutta, Mary; Luedecke, Daniel; Wittmann, Linus; Ohm, Gunda; Meigel-Schleiff, Christina; Gallinat, Jürgen; Wiedemann, Klaus; Bock, Thomas; Karow, Anne; Lambert, Martin

    2018-01-01

    The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years. Over 4 years, only 10 patients disengaged from ACCESS. Another 23 left for practical reasons and were successfully transferred to other services. Hospitalization rates remained low (13.0% in year 3; 9.1% in year 4). Involuntary admissions decreased from 35% in the 2 years prior to ACCESS to 8% over 4 years in ACCESS. Outpatient contacts remained stably high at 2.0-2.4 per week. We detected significant improvements in psychopathology (effect size d = 0.79), illness severity (d = 1.29), level of functioning (d = 0.77), quality of life (d = 0.47) and stably high client satisfaction (d = 0.02) over 4 years. Most positive effects were observed within the first 2 years with the exception of illness severity, which further improved from year 2 to 4. Within continuous intensive 4-year ACCESS-care, sustained improvements in psychopathology, functioning, quality of life, low service disengagement and re-hospitalization rates, as well as low rates of involuntary treatment, were observed in contrast to other studies, which reported a decline in these parameters once a specific treatment model was stopped. Yet, stronger evidence to prove these results is required. Clinical Trial Registration Number: NCT01888627.

  2. Rehousing homeless citizens with assertive community treatment

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    professionals including a psychiatrist, a nurse, an addiction councilor, and social workers with administrative authority from the social office and the job center. In the international research literature ACT has been shown in randomized controlled trials to be a very effective method in bringing individuals...... out of homelessness and into a stable housing situation. The study is based on quantitative outcome measurement on about 80 citizens who have been assigned to the programme and who have received both a housing solution and support from the ACT-team. The study is not a randomized controlled trial...

  3. Assertive outreach in Slovenia; identification of target group and goals of treatment in a new program.

    Science.gov (United States)

    Furlan, Mirjana

    2009-09-01

    A team from the Rehabilitation unit of Ljubljana psychiatric clinic attended a course on community care in London in October and November 2005. Because we decided that the methods presented to us could be of great use in Slovenia where the Health system is lacking such services we decided to implement them after our return. Immediately after we returned we started to carry out our plan. We designated our target group which were patients who poorly participated in treatment or had multiple and severe difficulties functioning and retaining their progress after discharge. Our goals were to improve patient participation in treatment before and after discharge, less and shorter hospitalizations and better integration of patients into society. Initial results are very positive, which leaves me much hope for further implementation of assertive outreach and community care in Slovenia.

  4. Assertiveness training: Effects of treatment, maintenance of change and therapists' contribution in therapy outcome

    Directory of Open Access Journals (Sweden)

    Tovilović Snežana

    2005-01-01

    Full Text Available In this research is shown part of results concerning evaluation study of group assertiveness training. Treatment, which has been organized as structured program of assertiveness training, has been applied on 18 groups of subjects during 9 group sessions. This treatment has been adjusted to non-psychiatric clients from our country. Groups were lead by two therapists. During 20 months of our research 215 voluntary participants of full age have joined training groups. Final sample consisted of 158 subjects who had finished treatment and who had fulfilled criteria for taking repeated measurement. Subjects had taken battery of questionnaires before the treatment and eight weeks after they had completed treatment. Subsample, which included 35 subjects from one therapist’s groups, took retest after twice longer time period. Results of conducted research have confirmed the hypothesis concerning the potentiality of assertiveness training to produce expected and significant improvements of treated subjects. Therapy effect is found on symptomatic level through reduction of symptoms of non-assertive behaviors, which were target of the treatment. Contrary to expectation interactive effect of treatment and therapist to reduction of symptoms of non-assertive behavior has been found, which implies need for further investigation of variables that are related to therapists. Through the medium of treatment therapeutic changes in structural level, in domain of general assertiveness, social anxiety and treated subjects' self-concept are produced. The effect of therapy we might consider stabled and maintained after 16 weeks of finishing the treatment.

  5. Transcendental Meditation and Assertive Training in the Treatment of Social Anxiety.

    Science.gov (United States)

    Wampler, Larry D.; Amira, Stephen B.

    Research indicates that transcendental meditation (TM) may provide relief from accumulated stress and render the meditator better able to cope with future stressful events. Single and combined TM and assertive training programs were compared for effectiveness in the treatment of socially anxious college students. A waiting-list group served as the…

  6. The consequences of increasing assertiveness of trans-national religious communities for international relations

    Directory of Open Access Journals (Sweden)

    Najamudin Najamudin

    2012-12-01

    Full Text Available The transnational communities, or in other terms, the migrant communities whowent to the US and the UK, or to any other European states had strong belief intheir religion in which they might not be contaminated by the secular ideology inthe Western countries. In this respect, the phenomenology of religion in internationalrelations is a relatively new and surprising. Accordingly, this paper aims atinvestigating the implications of the emergence of trans-national religious groupsfor international relations. The paper will argue that the rise of trans-nationalreligious groups has produced a profound impact on international relations. Thefactors that influenced this transformation in international relations is the contemporaryprocesses of globalization which scholars argue, are pivotal to bringingreligion to the centre stage of international relations. In order to deepen theunderstanding of this process, two case scenarios will be analyzed, namely, theSikh Diasporas and the imagined Islamic community, the umma. In this paper, ithas been argued that the rise of trans-national religious actors may affect statesovereignty in one way or another. Under secular ideology, the role of religion ismarginalized from the public sphere, in particular, the domain of politics and religion is being obviously separated. This separation, according to both groups,is problematic. It is therefore, the emergence of Islamic and Sikh communities isconsidered by some liberal democratic countries like India as a peril to its statesovereignty. In Islamic doctrines, the Muslims hold a principle in din wa dawla,the unity of state and religion, while in Sikhism, the Sikhs have to trust miri andpiri, the unification of religious and political institution.Masyarakat transnasional atau dalam terma lain disebut juga sebagai masyarakatmigran yang menetap di Amerika dan Inggris, atau ke negara-negara Eropalainnya memiliki keyakinan yang kuat terhadap agama mereka dan

  7. Effects of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients.

    Science.gov (United States)

    Silverman, Michael J

    2011-01-01

    The purpose of this study was to implement and measure the effectiveness of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients. Participants (N=133) were randomly assigned by group to one of three conditions: (a) Assertiveness Music Therapy, (b) No Music Assertiveness, or (c) Music No Assertiveness. Participants in both assertiveness conditions role played a number of different commonly occurring scenarios at an inpatient psychiatric facility and in the community. There were no significant between-group differences in posttest quality of life, locus of control, or other subscales. However, participants in both assertiveness conditions tended to have slightly higher internal locus of control and overall quality of life scores than participants in the music no assertiveness condition. Additionally, the assertiveness music therapy condition had higher attendance rates than the other conditions. A higher percentage of participants from both the assertiveness music therapy and music no assertiveness conditions indicated they thought their session was the most helpful/therapeutic group therapy session in which they had participated; this was not the case for the assertiveness no music condition. Future research is warranted to measure the effects of protocols that can help psychiatric patients generalize skills learned in treatment.

  8. The New Assertive You.

    Science.gov (United States)

    Bondanza, Julie

    This workbook provides exercises, role-playing activities, and self-evaluation activities to help deaf adolescents become more aware of their level of assertiveness and the ways assertive behavior can assist in daily living situations. Assertiveness is different from aggressiveness and passiveness, and many people learn through their families and…

  9. A social work contribution to suicide prevention through assertive brief psychotherapy and community linkage: use of the Manchester Short Assessment of Quality of Life (MANSA).

    Science.gov (United States)

    Petrakis, Melissa; Joubert, Lynette

    2013-01-01

    There is a striking absence of literature articulating and evaluating clinical social work contributions to suicide prevention, despite considerable practice in this important field. This article reports on a model of assertive brief psychotherapeutic intervention and facilitated linkage to community services utilized in a prospective cohort study of emergency department suicide attempt aftercare. A key outcome measure, the Manchester Short Assessment of Quality of Life (MANSA), was used with 65 patients to assess psychosocial domains at initial presentation, 4-weeks, 3-months, and 6-months. There were significant improvements in the domains of work, finance, leisure, social life, living situation, personal safety and health by 3 months. There were highly significant correlations between psychosocial improvements and improved depression scores.

  10. Debating China's assertiveness

    DEFF Research Database (Denmark)

    He, Kai; Feng, Huiyun

    2012-01-01

    Engaging the recent debate on China's assertive foreign policy, we suggest that it is normal for China – a rising power – to change its policy to a confident or even assertive direction because of its transformed national interests. We argue also that it is better to understand future US–China re...

  11. Assertiveness and Physical Attractiveness.

    Science.gov (United States)

    Kleim, David M.; And Others

    Earlier research investigating the relationship between physical attractiveness and assertiveness found that physically attractive females were more assertive than other females. To investigate this relationship further and to broaden the scope of the study, 69 students were videotaped in groups of five to ten while responding to open-ended…

  12. Assertiveness with 'Special' Children.

    Science.gov (United States)

    Rosenberg, Shelley K.; Stillman-Powell, Patricia

    The author examines issues related to adult assertiveness in controlling and setting limits for handicapped children. Reasons for adults not wishing to be in charge include feelings of guilt, lack of consistency in enforcing rules, and a sense of sympathy for special children. Assertiveness is distinguished from aggressiveness, and suggestions for…

  13. Staff's perceptions of voluntary assertiveness skills training.

    Science.gov (United States)

    McVanel, Sarah; Morris, Beth

    2010-01-01

    Clinicians' ability to be assertive when unsure or concerned about procedures, treatment modalities, or patients' symptoms is key in reducing risk and preventing sentinel events. In this article, the authors provide a framework for generic, voluntary assertiveness communication skills workshops that any educator can implement.

  14. The reciprocal relationship between sexual victimization and sexual assertiveness.

    Science.gov (United States)

    Livingston, Jennifer A; Testa, Maria; VanZile-Tamsen, Carol

    2007-03-01

    Low sexual assertiveness has been proposed as a possible mechanism through which sexual revictimization occurs, yet evidence for this has been mixed. In this study, prospective path analysis was used to examine the relationship between sexual refusal assertiveness and sexual victimization over time among a community sample of women. Results provide support for a reciprocal relationship, with historical victimization predicting low sexual assertiveness and low sexual assertiveness predicting subsequent victimization. The effect of recent sexual victimization on subsequent sexual assertiveness also was replicated prospectively. These findings suggest that strengthening sexual assertiveness may help reduce vulnerability to future victimization.

  15. ASSERT-4 user's manual

    International Nuclear Information System (INIS)

    Judd, R.A.; Tahir, A.; Carver, M.B.; Stewart, D.G.; Thibeault, P.R.; Rowe, D.S.

    1984-09-01

    ASSERT-4 is an advanced subchannel code being developed primarily to model single- and two-phase flow and heat transfer in horizontal rod bundles. This manual is intended to facilitate the application of this code to the analysis of flow in reactor fuel channels. It contains a brief description of the thermalhydraulic model and ASSERT-4 solution scheme, and other information required by users. This other information includes a detailed discussion of input data requirements, a sample problem and solution, and information describing how to access and run ASSERT-4 on the Chalk River computers

  16. Comparing the Costs and Acceptability of Three Fidelity Assessment Methods for Assertive Community Treatment.

    Science.gov (United States)

    Rollins, Angela L; Kukla, Marina; Salyers, Michelle P; McGrew, John H; Flanagan, Mindy E; Leslie, Doug L; Hunt, Marcia G; McGuire, Alan B

    2017-09-01

    Successful implementation of evidence-based practices requires valid, yet practical fidelity monitoring. This study compared the costs and acceptability of three fidelity assessment methods: on-site, phone, and expert-scored self-report. Thirty-two randomly selected VA mental health intensive case management teams completed all fidelity assessments using a standardized scale and provided feedback on each. Personnel and travel costs across the three methods were compared for statistical differences. Both phone and expert-scored self-report methods demonstrated significantly lower costs than on-site assessments, even when excluding travel costs. However, participants preferred on-site assessments. Remote fidelity assessments hold promise in monitoring large scale program fidelity with limited resources.

  17. Vision, knowledge, and assertion.

    Science.gov (United States)

    Turri, John

    2016-04-01

    I report two experiments studying the relationship among explicit judgments about what people see, know, and should assert. When an object of interest was surrounded by visibly similar items, it diminished people's willingness to judge that an agent sees, knows, and should tell others that it is present. This supports the claim, made by many philosophers, that inhabiting a misleading environment intuitively decreases our willingness to attribute perception and knowledge. However, contrary to stronger claims made by some philosophers, inhabiting a misleading environment does not lead to the opposite pattern whereby people deny perception and knowledge. Causal modeling suggests a specific psychological model of how explicit judgments about perception, knowledge, and assertability are made: knowledge attributions cause perception attributions, which in turn cause assertability attributions. These findings advance understanding of how these three important judgments are made, provide new evidence that knowledge is the norm of assertion, and highlight some important subtleties in folk epistemology. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Effects of Assertive Training on Hospitalized Adolescents and Young Adults.

    Science.gov (United States)

    Fiedler, Phyllis E.; And Others

    1979-01-01

    This study focuses on reducing the hostility of hospitalized adolescent and young adult psychiatric patients through assertive training techniques designed to teach appropriate responses to interpersonal conflict. It was predicted that, after treatment, the assertive group would show greater assertiveness, less hostility, and a more positive…

  19. Stress Management: Being Assertive

    Science.gov (United States)

    ... assertively can help you: Gain self-confidence and self-esteem Understand and recognize your feelings Earn respect from others Improve communication Create win-win situations Improve your decision-making skills Create honest relationships Gain more job satisfaction Learning ...

  20. Deinstitutionalization revisited: a 5-year follow-up of a randomized clinical trial of hospital-based rehabilitation versus specialized assertive intervention (OPUS) versus standard treatment for patients with first-episode schizophrenia spectrum disorders

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Øhlenschlæger, Johan; Thorup, Anne Amalie Elgaard

    2010-01-01

    BACKGROUND: The effects of hospital-based rehabilitation including weekly supportive psychodynamic therapy compared with specialized assertive intervention and standard treatment has not previously been investigated in first-episode psychosis. The aim of the study was to examine long-term effect...... in a special part of the Copenhagen OPUS trial and randomized to either the specialized assertive intervention program (OPUS), standard treatment or hospital-based rehabilitation. RESULTS: It was a stable pattern that patients randomized to hospital-based rehabilitation spent more days in psychiatric wards...

  1. Authoritarianism, dominance and assertiveness.

    Science.gov (United States)

    Ray, J J

    1981-08-01

    It is shown that there are definitions of the three constructs of authoritarianism, dominance and assertiveness which read very similarly; so much so that no distinction is immediately evident. It is proposed that authoritarianism might be conceived as aggressive dominance and at least some types of assertiveness as nonaggressive dominance. A new scale of Dominance suitable for general population use was produced, and compared with the existing Ray (1976) behavior inventory of authoritarianism. Both scales showed highly significant correlations with peer rated dominance and submission (the latter being negative in sign) but only the authoritarianism scale showed significant correlations with rated aggressiveness and rigidity. It was concluded that the new definitions could be operationalized into valid scales.

  2. Dimensions of assertiveness: factor analysis of five assertion inventories.

    Science.gov (United States)

    Henderson, M; Furnham, A

    1983-09-01

    Five self report assertiveness inventories were factor analyzed. In each case two major factors emerged, accounting for approximately one-quarter to a third of the variance. The findings emphasize the multidimensional nature of current measures of assertiveness, and suggest the construction of a more systematic and psychometrically evaluated scale that would yield subscale scores assessing the separate dimensions of assertiveness.

  3. A Comparison of Three Covert Assertion Training Procedures.

    Science.gov (United States)

    Twentyman, Craig T.; And Others

    1980-01-01

    Assessed the effectiveness of covert modification procedures in an assertion training program. All treatment groups were superior to the control in behavioral ratings of assertiveness during the posttest in those situations that had been employed previously in treatment; two were superior in those that had not been used, providing evidence of…

  4. Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial

    DEFF Research Database (Denmark)

    Morthorst, Britt; Krogh, Jesper; Erlangsen, Annette

    2012-01-01

    To assess whether an assertive outreach intervention after suicide attempt could reduce the frequency of subsequent suicidal acts, compared with standard treatment.......To assess whether an assertive outreach intervention after suicide attempt could reduce the frequency of subsequent suicidal acts, compared with standard treatment....

  5. [A concept analysis of assertiveness].

    Science.gov (United States)

    Park, Hyoung-Sook; Yang, Young-Ok

    2006-06-01

    The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness. This study used Walker and Avant's process of concept analysis. 1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication. 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions. 3. There are consequences occurring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other. Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.

  6. Assertive behavior: advantages and perception

    Directory of Open Access Journals (Sweden)

    Sheinov V.

    2015-03-01

    Full Text Available In this information-analytical paper analyzes and summarizes the results of all available international research and assertiveness assertive behavior relating to the identification of their strengths and the perception of these phenomena in society. Are some suggestions for overcoming the problems detected.

  7. An Assertiveness Scale for Adolescents.

    Science.gov (United States)

    Lee, Dong Yul; And Others

    1985-01-01

    Developed a 33-item, situation-specific instrument that measures assertiveness of adolescents. Based on data from 682 elementary and secondary school students, adequate reliability and validity of the Assertiveness Scale for Adolescents (ASA) were obtained when tested against several variables about which predictions could be made. (BH)

  8. The Assertiveness Scale for Children.

    Science.gov (United States)

    Peeler, Elizabeth; Rimmer, Susan M.

    1981-01-01

    Described an assertiveness scale for children developed to assess four dimensions of assertiveness across three categories of interpersonal situations. The scale was administered to elementary and middle school children (N=609) and readministered to students (N=164) to assess test-retest reliability. Test-retest reliability was low while internal…

  9. Assertiveness: making yourself heard in district nursing.

    Science.gov (United States)

    Lawton, Sally; Stewart, Fiona

    2005-06-01

    Being assertive is not the same as being aggressive. Assertiveness is a tool for expressing ourselves confidently, and a way of saying 'yes' and 'no' in an appropriate way. This article explores issues concerned with assertiveness in district nurse settings. It outlines helpful techniques to develop assertiveness, such as the broken record, fogging, negative assertion and negative inquiry.

  10. A Historical Approach to Assertiveness

    Directory of Open Access Journals (Sweden)

    Ivelina Peneva

    2013-04-01

    Full Text Available A very important personal quality is to be able to advocate for yourself - your own positions, to achieve your objectives, to overcome difficulties,to be determined, but without harming the rights of others and to be able to control the aggressive impulses. The concept, which expressesthese personal characteristics, is called "assertiveness". Assertiveness is a part of the personal potential. It is a prerequisite for self-actualization.The goal we set in this historical-psychological paper is to explore the genesis, development and stabilization of the term "assertiveness". Inthis context, we will examine, compare and analyze the positions of the leading authors on this issue.

  11. The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial

    DEFF Research Database (Denmark)

    Melau, Marianne; Jeppesen, Pia; Thorup, Anne

    2011-01-01

    . Based on our sample size estimation, 400 patients treated in OPUS for two years will be randomized to further three years of OPUS treatment versus standard treatment. The specialized assertive OPUS treatment consists of three core elements: assertive community treatment, psycho-educational family...... treatment, and social skills training. Discussion It has been hypothesized that there is a critical period from onset up to five years, which represents a window of opportunity where a long-term course can be influenced. Extending the specialized assertive OPUS treatment up to five years may allow...... the beneficial effects to continue beyond the high-risk period, through consolidation of improved social and functional outcome. Trial registration Clinical Trial.gov NCT00914238...

  12. Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China.

    Science.gov (United States)

    Lee, S; Crockett, M S

    1994-01-01

    The purpose of the study was to examine the effectiveness of assertiveness training in improving self-perceived levels of stress and assertiveness among nurses in Taiwan, Republic of China. The two-group experimental design was conducted in a 2,000-bed veteran general hospital. A sample of 60 volunteer Chinese-speaking nurses participated in the study. Subjects were randomly assigned to one of two treatments: assertiveness training (AT) or alternate treatment control (ATC), which served as a control and contained updated knowledge of new computer technology for in patient settings. Subjects in each group participated in six 2-hour workshops in the same two-week period. All subjects were pre-, post-, and follow-up posttested for stress and assertiveness with the Perceived Stress Scale (PSS) and Rathus Assertiveness Schedule (RAS), respectively. Results revealed the following: (1) subjects in both groups of pretest were clearly subassertive and under considerable stress; (2) by the end of training, the AT group scored significantly higher on the rating of assertiveness than those in the ATC group, and had successfully maintained their improvement by the 4-week follow-up; and (3) by the end of training, the AT group reported significantly lower levels of stress than the ATC group as indicated on the PSS, and successfully maintained their improvements at the 4-week follow-up. Overall, the results indicate clear support for the effectiveness of assertiveness training for treating subassertive behaviors and stress in a population of professional nurses in Taiwan.

  13. Adolescent Assertiveness: Problems and Programs.

    Science.gov (United States)

    Reece, Randi S.; Wilborn, Bobbie L.

    1980-01-01

    Assertiveness training programs in the school setting provide a method to work with students with behavior problems. When students can manage their environments more effectively, they view the educational experience more positively and find that their present world and their transition to the adult world proceeds more productively. (Author)

  14. An Assertiveness Inventory for Adults

    Science.gov (United States)

    Gay, Melvin L.; And Others

    1975-01-01

    The Adult Self-Expression Scale is a 48-item, self-report measure of assertiveness designed for use with adults in general. Scale was found to have high test-retest reliability and moderate-to-high construct validity, as established by correlations with Adjective Check List scales and by a discriminant analysis procedure. (Author)

  15. [Community pneumonia - fundamentals of diagnosing and treatment].

    Science.gov (United States)

    Kolek, Vítězslav

    Pneumonia is the most serious respiratory disease which causes more than 3 000 deaths per year in the Czech Republic. Community-acquired pneumonia is contracted in the ordinary life environment outside of hospitals, its development is caused by known infectious agents which mostly exhibit satisfactory sensitivity to antibiotics. Diagnosing, prevention and treatment of the disease are described including considerations of individual evaluation of the risk of complications and possible death. The strategy of administering antibiotics is discussed.Key words: antibiotics - community-acquired pneumonias - diagnosing - treatment.

  16. Treatment of hyperthyroidism in community hospital

    International Nuclear Information System (INIS)

    Gossain, V.V.; Heath, R.C.; Rovner, D.R.

    1989-01-01

    The preferred treatment of hyperthyroidism remains controversial. Most of this data is derived from large, university-based medical centers. We report here our experience with treatment of hyperthyroidism in a community setting. This involves 144 patients with hyperthyroidism who were seen over a 10 year period at Michigan State University Clinical Center and were treated in the community hospitals and private physicians' offices, and by community surgeons. Follow-up data were available on 119 of these patients; 105 of them were hyperthyroid because of Graves' disease and multinodular goiter. Patients were encouraged to make their own decisions regarding choice of therapy, as independently as possible. Sixty-five percent of these patients were treated by 131I, 18% by antithyroid drugs, and 17% by surgery. The mean follow-up period was 2.5 years (range 2 months to 19 years). Hyperthyroidism was controlled in 84% of the patients treated by 131I and 83% of the patients treated by surgery. Forty percent of the patients treated by 131I and 33% treated by surgery became hypothyroid. Fifty percent of the patients achieved remission when treated by antithyroid drugs alone. Our results indicate that when patients are encouraged to make their own decisions regarding the treatment of hyperthyroidism, their choices are similar to those of the thyroidologists. Secondly, the results obtained with different modalities of treatment for hyperthyroidism in a community setting are similar to those obtained in university medical centers

  17. An Effects of Behavioral Assertiveness Training And Cognitive Assertiveness Training on Assertiveness Behavior of Elementary School Studennts in Korea

    OpenAIRE

    金, 奎卓; 野島, 一彦

    2002-01-01

    The purpose of this study was to compare the effects of Behavioral Assertiveness Training (BAT), and those of Cognitive Assertiveness Training (CAT), also to compare the effects of these trainings accoiding to the distinction of sex. The subjects were thirty two elementary school students who voluntarily participated in this study. These thirty two subjects were randomly divided into two groups, behavioral assertiveness training group and cognitive assertiveness training group, and each group...

  18. Aggressiveness, assertiveness and submissiveness among black adolescents

    OpenAIRE

    2014-01-01

    D.Litt. et Phil. (Psychology) Assertiveness, a specific social skill is traced back to its roots in Salter's 1949 Pavlovian model. The impression is gained that the growing interest in assertiveness may be a reaction to the post-Sputnik era of increasing violence and acts of terrorism. In South Africa assertiveness training has particular relevance, as a state of emergency was -declared by the State President in the middle of 1985. It is fitting that assertiveness training be done with bla...

  19. Monadic, prompt lazy assertions in Haskell

    OpenAIRE

    Chitil, Olaf; Huch, Frank

    2007-01-01

    Assertions test expected properties of run-time values without disrupting the normal computation of a program. We present a library for enriching Haskell programs with assertions. Expected properties can be specified in a parser-combinator like language. The assertions are lazy: they do not force evaluation but only examine what is evaluated by the program. They are also prompt: assertion failure is reported as early as possible. The implementation is based on lazy observations and continuati...

  20. Use of Hypnotherapy for Assertive Training and Behavioral Rehearsal: An Active Mode of Therapy.

    Science.gov (United States)

    DeVoge, Susan D.

    This paper describes a treatment approach which uses hypnotherapy techniques in combination with assertive training and behavioral rehearsal. It discusses the use of this treatment with a client who exhibited psychogenic symptoms due to personal anxiety. At the beginning of the treatment the client was shy, non-assertive and extremely…

  1. Assertiveness training for undergraduate midwifery students.

    Science.gov (United States)

    Warland, Jane; McKellar, Lois; Diaz, Monica

    2014-11-01

    Assertiveness can be defined as an interpersonal behaviour that promotes the fact all people in a relationship are equally important. All health professionals including midwives must work with and care for people. At times this will include facilitating interactions that require skilful negotiation and assertiveness. Yet embedding assertiveness education into undergraduate midwifery curricula has not been widely adopted. This paper explores one method of delivering assertiveness training in an undergraduate midwifery course and provides comment on the effectiveness of this strategy in developing assertiveness skills in a cohort of undergraduate midwifery students. We used an assertiveness survey which was administered immediately before and 3-4 months after an assertiveness training workshop. All students (n = 55) attending the training day were invited to participate. Of these 41 (77% response) chose to participate in the pre intervention survey and 32 participated (9 students lost to follow-up) in the follow up survey. There was an overall improvement in self-perceived assertiveness scores following the assertiveness training workshop. These findings provide encouraging evidence that educational institutions that offer specific and targeted assertiveness education will be rewarded with more assertive graduates. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Factors affecting assertiveness among student nurses.

    Science.gov (United States)

    Ibrahim, Sanaa Abd El Azim

    2011-05-01

    This study aimed to investigate the factors affecting assertiveness among student nurses. The study was carried out at Faculty of Nursing, Port-Said University, on 207 student nurses from four different grades. Rathus Assertiveness Schedule, consisted of 30 items, was used to measure the students' assertiveness level and a 12-item scale developed by Spreitzer was used to measure students' psychological empowerment. The study results showed that 60.4% of the students were assertive, while about half of the students were empowered. A positive relation between student assertiveness and psychological empowerment was detected. Moreover, positive relations regarding family income and students' assertiveness and psychological empowerment were determined. The study recommended introduction of specific courses aiming at enhancing the acquisition of assertiveness skills, in addition, nurse educators must motivate their students to express their opinion and personal rights and also they must pay attention for students' empowerment and enhance students' autonomy. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Religious conversion and Dalit assertion amongst a Punjabi Dalit diaspora

    OpenAIRE

    Taylor, Steve

    2014-01-01

    Drawing upon original ethnographic research amongst Punjabi Dalit communities within the UK and India, this paper examines post-transnational migration religious conversion from Sikhism to neo-Buddhism and Christianity, assessing the extent to which this process is simultaneously one of Dalit assertion and resistance to caste-based oppression, thereby facilitating social change within the contemporary Punjabi transnational community. While it is generally accepted that, despite the Ambedkar m...

  4. Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial

    DEFF Research Database (Denmark)

    Morthorst, Britt; Krogh, Jesper; Erlangsen, Annette

    2012-01-01

    . INTERVENTION: Case management through assertive outreach that provided crisis intervention and flexible problem solving. This approach incorporated motivational support and actively assisted patients to scheduled appointments to improve adherence with after-treatment as an add on to standard treatment. MAIN...

  5. Evaluation of assertiveness training for psychiatric patients.

    Science.gov (United States)

    Lin, Yen-Ru; Wu, Mei-Hsuen; Yang, Cheng-I; Chen, Tsai-Hwei; Hsu, Chen-Chuan; Chang, Yue-Cune; Tzeng, Wen-Chii; Chou, Yuan-Hwa; Chou, Kuei-Ru

    2008-11-01

    To investigate the effectiveness of assertiveness training programmes on psychiatric patients' assertiveness, self-esteem and social anxiety. Assertiveness training programmes are designed to improve an individual's assertive beliefs and behaviours, which can help the individual change how they view themselves and establish self-confidence and social anxiety. It is useful for patients with depression, depressive phase of bipolar disorder, anxiety disorder or adjustment disorder. Experimental. There were 68 subjects (28, experimental group; 40, diagnosis-matched comparison group). Subjects in experimental groups participated in experimenter-designed assertiveness training twice a week (two hours each) for four weeks. The comparison groups participated the usual activities. Data were collected in the two groups at the same time: before, after and one month after training programme. Efficacy was measured by assertiveness, self-esteem and social anxiety inventories. A generalised estimating equation was used for analysis. After training, subjects had a significant increase in assertiveness immediately after the assertiveness training programme and one-month follow-up. There was a significant decrease in social anxiety after training, but the improvement was not significant after one month. Self-esteem did not increase significantly after training. With our sample of patients with mixed diagnoses, assertiveness seemed to be improved after assertiveness training. Patients would benefit more from the assertiveness training programme for the change in how they view themselves, improve their assertiveness, properly express their individual moods and thoughts and further establish self-confidence. The assertiveness training protocol could be provided as a reference guide to clinical nurses.

  6. Predicting individual differences in autonomy-connectedness: the role of body awareness, alexithymia, and assertiveness.

    Science.gov (United States)

    Bekker, Marrie H J; Croon, Marcel A; van Balkom, Esther G A; Vermee, Jennifer B G

    2008-06-01

    Autonomy-connectedness is the capacity for being on one's own as well as for satisfactorily engaging in interpersonal relationships. Associations have been shown between autonomy-connectedness components (self-awareness, sensitivity to others, and the capacity for managing new situations) and various indices of psychopathology. Both in a theoretical sense as well as for enhancing treatment and prevention, it is relevant to identify which factors most powerfully predict individual differences in autonomy-connectedness: body awareness, alexithymia, or assertiveness. The present study examined this question in a clinical sample of women who were diagnosed as having autonomy problems (N=52) and in a female nonclinical community sample (N=59). In line with expectations, assertiveness was a strong predictor of (all three components of) autonomy-connectedness, as was emotionalizing, one of the alexithymia-components, but the latter in an opposite direction than we had expected: the higher an individual's ability to emotionalize was, the less self-aware and capable to manage new situations that person was, and the more sensitive to others. Cognitive alexithymia contributed to self-awareness as well as to the capacity for managing new situations, and one of the components of body awareness appeared to predict capacity for managing new situations. Our results indicate that assertiveness training and the enhancement of emotion regulation are important elements of autonomy-connectedness targeted interventions. (c) 2008 Wiley Periodicals, Inc.

  7. Expression of anger as a function of assertiveness and sex.

    Science.gov (United States)

    Doyle, M A; Biaggio, M K

    1981-01-01

    Examined differences between asserters and nonasserters and between the sexes on anger expression. Thirty-seven male and 53 female college students were administered the College Self-Expression Scale, the Buss Durkee Hostility Inventory, and the Anger Self-Report. As hypothesized, asserters and males expressed more anger and aggression, and nonasserters experienced more covert anger. The clinical/treatment implications of these findings were discussed. A finding discrepant with previous research and the present researchers' expectations, that men scored higher than women on guilt and condemnation of anger, was thought to reflect this study's sample rather than an actual population difference.

  8. Assertiveness, submissive behaviour and social comparison.

    Science.gov (United States)

    Gilbert, P; Allan, S

    1994-09-01

    This paper explores the relationship between a new assertiveness measure (the Scale for Interpersonal Behaviour--SIB), social comparison and submissive behaviour. The paper investigates these measures in relation to the personality traits of neuroticism and introversion. Findings suggest: (a) that social comparison may be an important variable in assertiveness and submissive behaviour and shows a strong relationship to neuroticism and introversion; (b) that submissive behaviour is not the mirror opposite of assertive behaviour; and (c) submissive behaviour seems more strongly associated with introversion and neuroticism than assertive performance.

  9. Assertiveness Training for Job-Seeking Skills

    Science.gov (United States)

    Ball, Patricia G.; McLoughlin, Mary Ellen

    1977-01-01

    Assertiveness Training for Job-Seeking Skills includes skill development in initiating the job search; arranging actual interviews; preparing a resume; articulating strengths, weaknesses, and career objectives; responding assertively in interviews; asking appropriate questions; accepting or rejecting job offers; confronting discrimination;…

  10. Assertiveness in Women Reporting Symptoms of Bulimia.

    Science.gov (United States)

    Ruhl, Berenice; McCanne, Thomas R.

    It has been suggested that a lack of assertiveness may be an important component of the psychological make-up of bulimic women, and that bulimic women may experience particular difficulties in asserting themselves in interactions with men. In this study, 23 women reporting the symptoms of bulimia by high scores on the Bulimia Test (BULIT) and 21…

  11. Sex Differences in Assertiveness in College Students

    Science.gov (United States)

    Stebbins, Charles; And Others

    1977-01-01

    Validates the "College Self-Expression Scale." Shows that females are significantly more assertive, and that in one of the criterion situations each sex was significantly more assertive toward members of the same sex than members of the opposite sex. (RL)

  12. Validity of a Measure of Assertiveness

    Science.gov (United States)

    Galassi, John P.; Galassi, Merna D.

    1974-01-01

    This study was concerned with further validation of a measure of assertiveness. Concurrent validity was established for the College Self-Expression Scale using the method of contrasted groups and through correlations of self-and judges' ratings of assertiveness. (Author)

  13. 32 CFR 537.9 - Assertion.

    Science.gov (United States)

    2010-07-01

    ... STATES § 537.9 Assertion. (a) Asserting demands. If a prima facie claim exists under state law, a written...) Lost pay will be obtained from the leave or earnings statement or the active duty pay chart for the... did not receive either due to the length of time off assigned duty. The time off duty will be based on...

  14. Community periodontal treatment needs in South Korea.

    Science.gov (United States)

    Lee, M-Y; Chang, S-J; Kim, C-B; Chung, W-G; Choi, E-M; Kim, N-H

    2015-11-01

    This study aimed to assess the relationship between socio-economic factors and community periodontal treatment needs in Korea. Data were obtained from the year 2009 Korean National Health and Nutrition Examination Survey. Our analysis included 7510 survey participants over the age of 19 years. To assess the relationship between socio-economic factors and the need for periodontal scaling, we performed multivariate logistic regression analyses for data with a complex sampling structure. PASW statistics 19.0 (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analyses, and the results were expressed as odds ratios (OR) with corresponding 95% confidence intervals (CIs). A very high percentage of Korean adults required periodontal scaling (71.5%). After adjusting for sex, age, and socio-economic factors, the need for periodontal scaling was associated with low levels of education (OR: 1.41, 95% CI: 1.03-1.93), low incomes (OR: 1.27, 95% CI: 1.01-1.60), employment as a service and sales worker (OR: 1.39, 95% CI: 1.10-1.77), and employment as a manual worker (OR: 1.31, 95% CI: 1.02-1.69). In South Korea, the need for periodontal scaling was associated with socio-economic factors, such as low levels of education, low incomes, employment as a service and sales worker and employment as a manual worker. Consequently, clinical and community dental hygienists should consider adults with these risk factors as belonging to high-priority subgroups to whom they should respond first. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Assertiveness and problem solving in midwives.

    Science.gov (United States)

    Yurtsal, Zeliha Burcu; Özdemir, Levent

    2015-01-01

    Midwifery profession is required to bring solutions to problems and a midwife is expected to be an assertive person and to develop midwifery care. This study was planned to examine the relationship between assertiveness and problem-solving skills of midwives. This cross-sectional study was conducted with 201 midwives between July 2008 and February 2009 in the city center of Sivas. The Rathus Assertiveness Schedule (RAS) and Problem Solving Inventory (PSI) were used to determine the level of assertiveness and problem-solving skills of midwives. Statistical methods were used as mean, standard deviation, percentage, Student's T, ANOVA and Tukey HSD, Kruskal Wallis, Fisher Exact, Pearson Correlation and Chi-square tests and P problem-solving skills training. A statistically significant negative correlation was found between the RAS and PSI scores. The RAS scores decreased while the problem-solving scores increased (r: -0451, P problem solving skills of midwives, and midwives who were assertive solved their problems better than did others. Assertiveness and problem-solving skills training will contribute to the success of the midwifery profession. Midwives able to solve problems, and display assertive behaviors will contribute to the development of midwifery profession.

  16. Writing executable assertions to test flight software

    Science.gov (United States)

    Mahmood, A.; Andrews, D. M.; Mccluskey, E. J.

    1984-01-01

    An executable assertion is a logical statement about the variables or a block of code. If there is no error during execution, the assertion statement results in a true value. Executable assertions can be used for dynamic testing of software. They can be employed for validation during the design phase, and exception and error detection during the operation phase. The present investigation is concerned with the problem of writing executable assertions, taking into account the use of assertions for testing flight software. They can be employed for validation during the design phase, and for exception handling and error detection during the operation phase The digital flight control system and the flight control software are discussed. The considered system provides autopilot and flight director modes of operation for automatic and manual control of the aircraft during all phases of flight. Attention is given to techniques for writing and using assertions to test flight software, an experimental setup to test flight software, and language features to support efficient use of assertions.

  17. THE ASSERTIVENESS OF PEOPLE WHO PRACTICE KARATE

    Directory of Open Access Journals (Sweden)

    Szark-Eckardt Miroslawa

    2012-04-01

    Full Text Available Assertiveness is the ability to express your thoughts, beliefs and opinions without the feeling of internal tension, that is why it is a desired trait of character. One of the examples of sports disciplines in which assertiveness can play a desired role is karate. One of the aims of this paper was to answer the question, whether the act of doing karate influences the level of assertiveness among people who practice it and to compare the results with the level of assertiveness declared by people who do other sports. The method applied in this paper was the diagnostics survey, while the tool was the questionnaire form based on the Rathus Assertiveness Scale. 50 students who practice karate on regular basis and 50 students who do other sports participated in the research. It is undeniable that the level of assertiveness among people who practice karate is higher in comparison to people who do other sports. Karate doers, both men and women obtained better results compared to the second group of sportsmen/women. This regularity can be observed among men, but it is more perceptible among women. As the research presents, people who attend karate trainings at least three times a week are characterized by a higher level of assertiveness in comparison to those who attend the training once a week.

  18. A Principal Components Analysis of the Rathus Assertiveness Schedule.

    Science.gov (United States)

    Law, H. G.; And Others

    1979-01-01

    Investigated the adequacy of the Rathus Assertiveness Schedule (RAS) as a global measure of assertiveness. Analysis indicated that the RAS does not provide a unidimensional index of assertiveness, but rather measures a number of factors including situation-specific assertive behavior, aggressiveness, and a more general assertiveness. (Author)

  19. Social Desirability Responding in the Measurement of Assertive Behavior.

    Science.gov (United States)

    Kiecolt, Janice; McGrath, Ellen

    1979-01-01

    Women completed behavioral measures of assertion and anxiety before and after assertiveness training. High social desirability scorers described themselves as more assertive and less anxious, but were behaviorally less assertive than low scorers. Although all scorers improved their assertion skills, high scorers did not appear less anxious after…

  20. Community-Based Psychosocial Treatment Has an Impact on Social Processing and Functional Outcome in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Eszter Varga

    2018-06-01

    Full Text Available Schizophrenic patients have serious impairments in social cognition, which often persists after significant reduction in clinical symptoms. Community-based psychosocial treatments aim to recover social functioning for mentally ill individuals. Our aim was to examine prospective changes in social cognition and functional outcomes in two groups of schizophrenic patients involved in two forms of community-based psychosocial treatments namely case management (CM and community-based club (CC compared to a matched, treatment as usual (TAU group of patients. We hypothesized that CC and CM groups would exhibit better functional and social cognitive outcomes after a 6-month long psychosocial treatment period. Seventy-five patients participated either in CC, CM or TAU. Both CC and CM took part in community-based psychosocial treatment programs including trainings, such as communication and assertiveness trainings. In addition, CC provided group therapeutic treatments and a continuously available day care where patients had the possibility to participate in various social interactions. All participants were in remission, and on maintenance antipsychotic treatment. Participants were assessed on all study variables at two time points: baseline and after 6 months with a battery of questionnaires that examined affective face perception, affective prosody perception, pragmatic language comprehension and ToM. Our results showed that functional outcomes improved significantly in the CC as well as in the CM groups, in contrast to the TAU group. While analyzing summary scores of social cognition, it was found that only the CC group increased its performance in social cognition. In addition, a significant between-group difference in social cognitive function was found after 6 months between the three groups, with the CC group performing best. When investigating associations between changes in social cognition and changes in functional outcomes during a 6-month long

  1. Congruent Validity of the Rathus Assertiveness Schedule.

    Science.gov (United States)

    Harris, Thomas L.; Brown, Nina W.

    1979-01-01

    The validity of the Rathus Assertiveness Schedule (RAS) was investigated by correlating it with the six Class I scales of the California Psychological Inventory on a sample of undergraduate students. Results supported the validity of the RAS. (JKS)

  2. Assertions and Conditionals: A Historical and Pragmatic Stance

    Directory of Open Access Journals (Sweden)

    Chiffi Daniele

    2017-03-01

    Full Text Available The assertion candidate expresses a potential logical-linguistic object that can be asserted. It differs from both the act and the product of assertion; it needs not to be actually asserted and differs from the assertion made. We investigate the medieval origins of this notion, which are almost neglected in contemporary logic. Our historical analysis suggests an interpretation of the assertion candidate within the system of logic for pragmatics.

  3. Asserting as Commitment to Knowing. An Essay on the Normativity of Assertion

    OpenAIRE

    Milić, Ivan

    2016-01-01

    [eng] In this thesis, I propose and defend a theory according to which committing oneself to knowing the proposition expressed counts as an assertion of that proposition. A consequence of this view is the knowledge account of assertion, according to which one asserts that p correctly only if one knows that p. In support of this approach, I offer a strategy of identifying an assertion’s “normative consequences”, types of act that normally take place as a result of one’s making an assertion inc...

  4. Inducing Assertive Behavior in Chronic Schizophrenics: A Comparison of Socioenvironmental Desensitization, and Relaxation Therapies

    Science.gov (United States)

    Weinman, Bernard; And Others

    1972-01-01

    It is concluded that systematic desensitization or relaxation therapy is not effective in inducing assertive behavior in the male chronic schizophrenic. The treatment of choice for the older chronic male schizophrenic remains socioenvironmental therapy. (Author)

  5. Treatment of radioactive liquid organic waste using bacteria community

    International Nuclear Information System (INIS)

    Rafael Vicente de Padua Ferreira; Solange Kazumi Sakata; Maria Helena Bellini; Julio Takehiro Marumo; Fernando Dutra; Patricia Busko Di Vitta; Maria Helena Tirollo Taddei

    2012-01-01

    Waste management plays an important role in radioactive waste volume reduction as well as lowering disposal costs and minimizing the environment-detrimental impact. The employment of biomass in the removal of heavy metals and radioisotopes has a significant potential in liquid waste treatment. The aim of this study is to evaluate the radioactive waste treatment by using three different bacterial communities (BL, BS, and SS) isolated from impacted areas, removing radioisotopes and organic compounds. The best results were obtained in the BS and BL community, isolated from the soil and a lake of a uranium mine, respectively. BS community was able to remove 92% of the uranium and degraded 80% of tributyl phosphate and 70% of the ethyl acetate in 20 days of experiments. BL community removed 81% of the uranium and degraded nearly 60% of the TBP and 70% of the ethyl acetate. SS community collected from the sediment of Sao Sebastiao channel removed 76% of the uranium and 80% of the TBP and 70% of the ethyl acetate. Both americium and cesium were removed by all communities. In addition, the BS community showed to be more resistant to radioactive liquid waste than the other communities. These results indicated that the BS community is the most viable for the treatment of large volumes of radioactive liquid organic waste. (author)

  6. Influence of technological treatments on bacterial communities in ...

    African Journals Online (AJOL)

    Influence of technological treatments on bacterial communities in tilapia ( Oreochromis niloticus ) as determined by 16S rDNA fingerprinting using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE)

  7. Relationship Between the Children's Assertiveness Inventory (CAI) and the Revised Behavioral Assertiveness Test for Children (BAT-CR)

    Science.gov (United States)

    Ollendick, Thomas H.; And Others

    1986-01-01

    The relationship between a self-report measure of assertive behavior in children and a role-play measure was examined in 69 elementary school children. Self-report of positive assertion related more closely to role-play measures and expert ratings of assertiveness than did self-report of negative assertion. (Author/LHW)

  8. The Development of the Sexual Assertiveness Questionnaire (SAQ): A Comprehensive Measure of Sexual Assertiveness for Women.

    Science.gov (United States)

    Loshek, Eevett; Terrell, Heather K

    2015-01-01

    Sexual assertiveness has been defined in a number of ways by many researchers, with different aspects of sexual assertiveness emphasized in different measures. Most previous measures have included condom insistence as an important aspect of sexual assertiveness, but this may not translate well to women at all life stages or in varied types of relationships. The goal of the current study was to develop a comprehensive measure of sexual assertiveness that encompasses the aspects of sexual assertiveness that have been emphasized by previous researchers, with the exception of condom insistence. Items were generated based on previous measures and definitions, and an exploratory factor analysis was conducted (Study 1) to better understand the dimensions of sexual assertiveness. The proposed scale was revised and further refined using both exploratory factor analysis and confirmatory factor analysis in Study 2. The final scale consisted of 18 items that seem to capture three dimensions of sexual assertiveness: the ability to initiate and communicate about desired sex, the ability to refuse unwanted sex, and the ability to communicate about sexual history and risk. Model fit indices indicate that this three-factor solution fits the data well. Implications and suggestions for future research are discussed.

  9. A Proposal for Evaluating Cognition in Assertiveness

    Science.gov (United States)

    Vagos, Paula; Pereira, Anabela

    2010-01-01

    This article presents the development process and initial psychometric features of an instrument for evaluating cognition in assertiveness. This is an essential social skill for adolescent development and seems to encompass emotional, behavioral, and cognitive aspects. The instrument was created by combining both empirical and theoretical methods…

  10. The structure of assertiveness : a confirmatory approach

    NARCIS (Netherlands)

    ARRINDELL, WA; SANDERMAN, R; VANDERMOLEN, H; VANDERENDE, J; MERSCH, PP

    1988-01-01

    By using confirmatory factor analysis, distress and performance factors of assertion identified previously in a sample of predomi- nantly agoraphobic club members (N = 703) employing the Scale for Interpersonal Behavior (SlB) - the factors being (I) Display of negative feelings; (II) Expression of

  11. Feminist consciousness and assertiveness in Ifeoma Okoye's ...

    African Journals Online (AJOL)

    Okoye is an African feminist who advocates feminist consciousness as a concept through which women can be enlightened for consciousness-raising, empowerment and assertiveness in her novels, Behind the Clouds and Chimere, while emphasizing education, economic independence and sisterhood as avenues for ...

  12. A community-driven hypertension treatment group in rural Honduras.

    Science.gov (United States)

    Reiger, Sheridan; Harris, Jeffrey R; Chan, Kwun Chuen Gary; Oqueli, Hector Lopez; Kohn, Marlana

    2015-01-01

    We formed a self-funded hypertension treatment group in a resource-poor community in rural Honduras. After training community health workers and creating protocols for standardized treatment, we used group membership fees to maintain the group, purchase generic medications in bulk on the local market, and hire a physician to manage treatment. We then assessed whether participation in the group improved treatment, medication adherence, and hypertension control. This is a program evaluation using quasi-experimental design and no control group. Using data from the 86 members of the hypertension treatment group, we analyzed baseline and follow-up surveys of members, along with 30 months of clinical records of treatment, medication adherence, and blood pressure readings. Our initial hypertension needs assessment revealed that at baseline, community hypertensives relied on the local Ministry of Health clinic as their source of anti-hypertensive medications and reported that irregular supply interfered with medication adherence. At baseline, hypertension group members were mainly female, overweight or obese, physically active, non-smoking, and non-drinking. After 30 months of managing the treatment group, we found a significant increase in medication adherence, from 54.8 to 76.2% (p<0.01), and hypertension control (<140/90 mmHg), from 31.4 to 54.7% (p<0.01). We also found a mean monthly decrease of 0.39 mmHg in systolic blood pressure (p<0.01). At the end of the 30-month observation period, the local Ministry of Health system had increased provision of low-cost anti-hypertensive medications and adopted the hypertension treatment group's treatment protocols. Formation of a self-funded, community-based hypertension treatment group in a rural, resource-poor community is feasible, and group participation may improve treatment, medication adherence, and hypertension control and can serve as a political driver for improving hypertension treatment services provided by the public

  13. Community Trial of a Comprehensive Psychosocial Treatment for HFASDs

    Science.gov (United States)

    Lopata, Christopher; Toomey, Jennifer A.; Thomeer, Marcus L.; McDonald, Christin A.; Fox, Jeffery D.; Smith, Rachael A.; Meichenbaum, David L.; Volker, Martin A.; Lee, Gloria K.; Lipinski, Alanna M.

    2015-01-01

    This community effectiveness trial examined the feasibility and efficacy of a comprehensive psychosocial treatment for 28 children, aged 7 to 10 years with high-functioning autism spectrum disorders (HFASDs). Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition skills, interest expansion, and…

  14. The effectiveness of assertiveness training for school-aged children on bullying and assertiveness level.

    Science.gov (United States)

    Avşar, Fatma; Ayaz Alkaya, Sultan

    The aim of this study was to determine the effectiveness of an assertive training for school-aged children on peer bullying and assertiveness. A quasi-experimental design using pre- and post-testing was conducted. Data were collected using a demographic questionnaire, an assertiveness scale, and the peer victimization scale. The training program was comprised of eight sessions which were implemented to intervention group. Descriptive characteristics were not statistically different between the groups (p>0.05). The peer victimization victim dimension results show that post-test mean scores of the students in the intervention group were lower than the pre-test mean scores (p0.05). A comparison of the mean pre-test/post-test scores of peer-victimization bully dimension of the students' intervention and control groups revealed that the mean post-test scores of the students in the each group decreased (p>0.05). An assertiveness training program increased the assertiveness level and reduced the state of being victims, but did not affect the state of being bullies. The results of this study can help children acquire assertive behaviors instead of negative behaviors such as aggression and shyness, and help them to build effective social communication. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Enhancing assertiveness in district nurse specialist practice.

    Science.gov (United States)

    Green, Julie

    2016-08-02

    District nurse (DN) care delivery has undergone substantial change in recent years due to changing demographics and service delivery demands that have called for a move of care delivery from secondary to primary care. The title District Nurse is recorded with the Nursing and Midwifery Council (NMC) on completion of the Specialist Practice Qualification in District Nursing (SPQ DN), which purports to be a 'transformational' course that prepares future caseload holders to manage their team and prioritise care delivery effectively. This article explores the need for assertiveness skills in this role in response to Australian research, and outlines the pedagogic interventions implemented during the SPQ DN course to enhance this skill. Assertiveness scores were monitored for the duration of the course and demonstrated a significant increase-a topic that is now the subject of a future, funded study.

  16. [Relationship of perception conflict and assertiveness in nurses].

    Science.gov (United States)

    Stojčić, Živko; Perković, Lada; Stašević, Ina; Stojčić, Nevena; Ropac, Darko

    2014-06-01

    At their workplace, nurses are exposed to a number of conflict situations. On dealing with such situations, a significant role is played by assertiveness skills. Assertiveness is the necessity of efficient communication between nurses and patients. Thus, development of these skills can enhance patient confidence in the nursing profession. The aim of the study was to determine whether there are differences in assertiveness with respect to age and sex, and whether there is and what is the connection between assertiveness, potential sources of conflict at work, conflicts due to the behavior of associates, resolving conflicts and self-assessment in resolving conflicts. The survey included 87 hospital nurses. The questionnaire included assessment of assertiveness. On processing the results, we calculated the indicators of descriptive statistics, carried out the variance analysis and t-test, and calculated Pearson's correlation coefficients. It was found that the majority of subjects expressed a medium level of assertiveness, i.e. they could be considered as relatively assertive persons. There were significant differences in assertiveness according to age of the subjects and length of service, where the oldest age group was significantly less assertive. More assertive subjects frequently observed behaviors that may be a source of conflict and problems in the organization of work. At the same time, they often had conflicts because of such behavior, which indicated that more assertive subjects were bolder and more secure. More assertive subjects believed that they were more successful in resolving conflicts than non-assertive subjects.

  17. Cognitive versus pharmacological effects of alcohol on assertiveness

    OpenAIRE

    2015-01-01

    M.A. (Clinical Psychology) The present study investigated the effect of expectancy and alcohol consumption on the assertive behaviour of female social drinkers, utilising a balanced-placebo design (Marlatt, Demming & Reid, 1973). Using the College Self Expression Scale (CSES) (Galassi et al, 1974) as the self report measure of assertiveness, and the Behavioral Assertiveness Test-Revised (Eisler et al. 1975) as the behavioural measure of assertiveness, analyses of variance were computed on ...

  18. Consumer Behavior: Developing Skills for Assertiveness. Consumer Education Training Module.

    Science.gov (United States)

    Thayer, Lou

    The goal of this inservice guide for teaching consumer education at the secondary and adult level is to help consumers become more assertive when buying goods and services. A major section in the guide defines assertiveness. The four basic components of assertive behavior are the ability to express emotions openly, the capacity to exercise one's…

  19. Beyond Assertiveness Training: A Problem-Solving Approach.

    Science.gov (United States)

    Scott, Nancy A.

    1979-01-01

    Assertiveness training models show shortcomings in those situations where assertiveness results in stalemates or conflicts, or both. Deadlocks may occur when antagonists demonstrate appropriate assertive behavior. Conflict management using problem-solving skills allows individuals to learn appropriate methods of dealing with conflictual or…

  20. A Self-Report Measure of Assertiveness in Young Adolescents.

    Science.gov (United States)

    Connor, Jane M.; And Others

    1982-01-01

    Reported a self-report measure of adolescents' assertiveness. Items for the scale were presented to sixth-grade students. Factor analysis revealed factors of submissiveness, aggressiveness, and assertiveness. After the validational study, a small assertiveness training program indicated that training effects were obtained and could be generalized…

  1. Dimensions of Assertiveness in an Asian-American Student Population.

    Science.gov (United States)

    Fukuyama, Mary A.; Greenfield, Tom K.

    1983-01-01

    Analyzed components of assertiveness, assessed by the College Self-Expression Scale, for Asian-American (N=105) and Caucasian (N=135) students. Results showed a significant difference in full-scale assertion scores indicating lower levels of overall assertion in Asian Americans, interpreted as consistent with value differences between…

  2. Physical Attractiveness, Locus of Control, Sex Role, and Conversational Assertiveness.

    Science.gov (United States)

    Campbell, Keith F.; And Others

    1990-01-01

    Analyzes the relationship among physical attractiveness, locus of control, sex role orientation, and assertiveness in undergraduate students. Reviews videotapes of mixed-sex student groups engaged in discussion. Finds an internal locus of control positively correlated with assertiveness. Uses a behavioral measure of assertiveness rather than…

  3. Diagnosis and Treatment of Community-Acquired Pneumonia in Children

    Directory of Open Access Journals (Sweden)

    I.A. Karymdzhanov

    2016-02-01

    The initial antibiotic therapy of community-acquired pneumonia is carried out empirically. In the treatment of severe community-acquired pneumonia in children from 2 months to 5 years, the drug of choice is amoxicillin orally. Macrolides are the drugs of choice for children aged 5 to 16 years. In severe pneumonia, drugs of choice are amoxicillin clavulanate, 2nd–4th generation cephalosporins. In general, the duration of antibiotic therapy in the community-acquired pneumonia caused by typical bacteria is 7–10 days, by atypical bacteria — 10–14 days. In the real clinical practice, the errors associated with the choice of drug, route of administration, dosage, regimen of application, length of treatment are frequent during antibacterial therapy.

  4. The relationship between attitude, assertiveness and condom use.

    Science.gov (United States)

    Treffke, H; Tiggemann, M; Ross, M W

    1992-01-01

    The Australian study investigated condom-specific assertiveness and condom use as a means of prevention infection from sexually transmitted diseases. 211 men participated including 83 homosexual men (aged 19-62 years) and 128 heterosexual men (aged 17-49) who completed a questionnaire that comprised demographic details such as age, monogamy, and sexual activity as well as attitudinal and assertiveness measures. General assertiveness was measured by the Rathus Assertiveness Schedule (RAS) which had been widely used across a wide range of social situations. Assertiveness relating specifically to situations involving condoms was measured by the Condom Assertiveness Scale (CAS). Intention to use condoms was positively related to favorable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. For both groups, the condom-specific measure of assertiveness was positively correlated with attitudes toward condoms. Condom-specific assertiveness was positively related to general social assertiveness as measured by the Rathus Assertiveness Schedule for the homosexual, but not for the heterosexual men. The negative relationship between general assertiveness and attitude to condoms among the heterosexual men implies that the risk reducing behavior of condom use did not seem to accord with the perceptions of masculinity and social assertiveness among heterosexual men. Thus, female partners of such heterosexual men exhibiting negative attitudes toward condom use combined with assertiveness would have to overcome resistance to insist on the use of condoms. Recently some advertising campaigns have been directed at women. The promotion of condom use among heterosexual men has to deal with the perceptions of condom use as unmasculine behavior.

  5. Guiding therapy and adjunctive treatment in community-acquired pneumonia

    NARCIS (Netherlands)

    Spoorenberg, S.M.C.

    2018-01-01

    Background: Despite the availability of effective antibiotics and vaccines, community-acquired pneumonia (CAP) remains the cause of significant morbidity and mortality worldwide.A major problem is that in absence of full spectrum rapid microbiology diagnostics, the antibiotic treatment at start is

  6. ASSERT and COBRA predictions of flow distribution in vertical bundles

    International Nuclear Information System (INIS)

    Tahir, A.; Carver, M.B.

    1983-01-01

    COBRA and ASSERT are subchannel codes which compute flow and enthalpy distributions in rod bundles. COBRA is a well known code, ASSERT is under development at CRNL. This paper gives a comparison of the two codes with boiling experiments in vertical seven rod bundles. ASSERT predictions of the void distribution are shown to be in good agreement with reported experimental results, while COBRA predictions are unsatisfactory. The mixing models in both COBRA and ASSERT are briefly discussed. The reasons for the failure of COBRA-IV and the success of ASSERT in simulating the experiments are highlighted

  7. Trial and evaluation of assertion training involving nursing students.

    Science.gov (United States)

    Nishina, Yuko; Tanigaki, Shizuko

    2013-09-01

    The concept of assertion and conceptual/practical methods of assertion (assertiveness) training were originally developed in the United States and Europe. These principles were embraced and adapted in Japan in 1970's. However, only a few studies relating to assertion (assertiveness) have been undertaken thus far in Japan, especially so in the domain of nursing students in comparison with other countries. The purpose of this study was to design and implement assertion training with nursing students and to clarify its effects. The participants were all volunteers, invited from a class of 3rd year nursing students. Ten students (intervention group) participated in the assertion training comprised of five sessions in February 2006. Fifty-six students (control group) were participated only in the questionnaire. Both groups were asked to complete the same questionnaire twice, before and after the assertion training. The questionnaire measured levels of assertiveness, social skills, self-esteem, social support and satisfaction with university life. The results and variances, both before and after assertion training, between the intervention group and the control group were analyzed. The effectiveness of the assertion training was determined by changes in pre and post training questionnaire scores. The scores for social skills in the control group had a tendency to decline while the scores for social skills in the intervention group remained constant. Although there were no statistically significant results in the intervention group, the present study highlights areas appropriate for further study.

  8. Treatment technology for removing radon from small community water supplies

    International Nuclear Information System (INIS)

    Kinner, N.E.; Quern, P.A.; Schell, G.S.; Lessard, C.E.; Clement, J.A.

    1989-01-01

    Radon contamination of drinking water primarily affects individual homeowners and small communities using ground-water supplies. Presently, three types of treatment processes have been used to remove radon: granular activated carbon adsorption (GAC), diffused-bubble aeration, and packed-tower aeration. In order to obtain data on these treatment alternatives for small communities water supplies, a field evaluation study was conducted on these three processes as well as on several modifications to aeration of water in storage tanks considered to be low cost/low technology alternatives. The paper presents the results of these field studies conducted at a small mobile home park in rural New Hampshire. The conclusion of the study was that the selection of the appropriate treatment system to remove radon from drinking water depends primarily upon: (1) precent removal of process; (2) capital operating and maintenance costs; (3) safety (radiation); and (4) raw water quality (Fe, Mn, bacteria and organics)

  9. A dismantling study of assertive outreach services: comparing activity and outcomes following replacement with the FACT model.

    Science.gov (United States)

    Firn, Mike; Hindhaugh, Keelyjo; Hubbeling, Dieneke; Davies, Gwyn; Jones, Ben; White, Sarah Jane

    2013-06-01

    Financial constraints and some disappointing research evaluations have seen English assertive outreach (AO) teams subject to remodelling, decommissioning and integration into standard care. We tested a specific alternative model of integrating the AO function from two AO teams into six standard community mental health teams (CMHT). The Flexible Assertive Community Treatment model (FACT) was adopted from the Netherlands (Van Veldhuizen, Commun Mental Health J 43(4):421-433, 2007; Bond and Drake, Commun Mental Health J 43(4):435-438, 2007). We aimed to demonstrate non-inferiority in clinical effectiveness and thereby show cost efficiencies associated with FACT. Outcomes were compared in a mirror-image study of the 12 months periods pre- and post-service change with eligible individuals from the AO teams' caseloads (n = 112) acting as their own controls. We also conducted a cost-consequence analysis of the changes. Outcome data regarding admissions, use of crisis and home treatment, frequency of contact and DNA rate were extracted from the electronic patient record. The results show AO patients (n = 112) transferred to standard CMHTs with FACT had significantly fewer admissions and a halving of bed use (21 fewer admission and 2,394 fewer occupied bed days) whilst being in receipt of a less intensive service (2,979 fewer contacts). This was offset by significantly poorer engagement but not by increased use of crisis and home treatment services. Enhancing multi-disciplinary CMHTs with FACT provides a clinically effective alternative to AO teams. FACT offers a cost-effective model compared to AO.

  10. Java interface for asserting interactive telerobotic control

    Science.gov (United States)

    DePasquale, Peter; Lewis, John; Stein, Matthew R.

    1997-12-01

    Many current web-based telerobotic interfaces use HyperText Markup Language (HTML) forms to assert user control on a robot. While acceptable for some tasks, a Java interface can provide better client-server interaction. The Puma Paint project is a joint effort between the Department of Computing Sciences at Villanova University and the Department of Mechanical and Materials Engineering at Wilkes University. THe project utilizes a Java applet to control a Unimation Puma 1760 robot during the task of painting on a canvas. The interface allows the user to control the paint strokes as well as the pressure of a brush on the canvas and how deep the brush is dipped into a paint jar. To provide immediate feedback, a virtual canvas models the effects of the controls as the artist paints. Live color video feedback is provided, allowing the user to view the actual results of the robot's motions. Unlike the step-at-a-time model of many web forms, the application permits the user to assert interactive control. The greater the complexity of the interaction between the robot and its environment, the greater the need for high quality information presentation to the user. The use of Java allows the sophistication of the user interface to be raised to the level required for satisfactory control. This paper describes the Puma Paint project, including the interface and communications model. It also examines the challenges of using the Internet as the medium of communications and the challenges of encoding free ranging motions for transmission from the client to the robot.

  11. Assertiveness process of Iranian nurse leaders: a grounded theory study.

    Science.gov (United States)

    Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim

    2009-06-01

    The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.

  12. Separation-individuation and assertiveness in late adolescents

    OpenAIRE

    Aslan, Sevda

    2013-01-01

    An adolescent can experience some problems regarding assertiveness during the course of separation-individuation from their caregivers. The purpose of this study is to describe the relationship between separation-individuation and assertiveness, which was examined in terms of how assertiveness predicts the separation-individuation of Turkish late adolescents. The sampling group consisted of 283 university students. The data gathered were analyzed by involving several simple regression analysi...

  13. Relation of assertiveness and anxiety among Iranian University students.

    Science.gov (United States)

    Larijani, T T; Aghajani, M; Baheiraei, A; Neiestanak, N S

    2010-12-01

    • The findings from the present study revealed that less than 30% of nursing and midwifery students have high assertiveness and only half of them have low anxiety. • Assertiveness and anxiety have negative correlations in nursing and midwifery students and affect the mental health and educational and occupational performance of the students. • Many factors such as years of education and working while studying influence the level of assertiveness in the students. • The anxiety in students had a significant relation with the father's level of education, family income, etc. The simultaneous existence of low assertiveness and high anxiety in nursing and midwifery students leads to the disruption of study performance. There exists little information concerning their assertiveness. The purpose of this study was to determine the relation of assertiveness and anxiety in nursing and midwifery students. In this correlational, cross-sectional study, 173 nursing students (68 males and 105 females) and 77 midwifery students were recruited from the Tehran University of Medical Sciences in Iran. Data were collected using a questionnaire including personal-social factors, the Spielberger Trait Anxiety Inventory and the Assertion Inventory of Gambrill and Richey. More than half of the nursing and midwifery students (59.5% and 59.7%, respectively) had moderate assertiveness. Also, 43.3% and 36.4% of them had moderate and high levels of anxiety. Pearson correlation test revealed that assertiveness and anxiety had negative correlations in nursing (r=-0.51, P assertiveness and anxiety among the students. Considering the relation of assertiveness and anxiety and its effects on mental health and educational and occupational performance, students should be informed of the required skills for positive interaction with others and to increase assertiveness and decrease anxiety. © 2010 Blackwell Publishing.

  14. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers.

    Science.gov (United States)

    Saw, Anne; Tang, Hao; Tsoh, Janice Y; Chen, Moon S; Tong, Elisa K

    2017-11-01

    Non-smokers' assertive behaviour towards smokers by asking them not to smoke is important in promoting smoke-free environments. Korean and Chinese Americans come from countries where most women are non-smokers and assertive behaviour may not be prevalent but may increase after migration because of social-ecological factors. This study assessed the extent to which Korean and Chinese American non-smokers ask someone not to smoke and associated factors. The 2003 California Chinese American and Korean American Tobacco Use Surveys were analysed. Multivariate logistic regression analyses examined factors related to non-smoker self-reports that they asked someone not to smoke within the past year. About 40% reported past-year assertive behaviour against smoking, with higher rates among Koreans than Chinese (60.4% vs. 34.5%), those living with smokers (63.5%), ever exposed with a smoke-free home rule (62.3%), recently exposed at work without a smoke-free work policy (67.6%) and regularly exposed at other locations (52.3%). In combined multivariate analyses of both ethnic groups, assertive behaviour was associated with individual factors (single vs. married; tobacco exposure knowledge), family factors (living with smokers, exposed at home despite a smoke-free rule), community factors (exposed at work with no smoke-free policy, exposed at other locations) and cultural factors (Korean vs. Chinese ethnicity; lower acculturation). Chinese and Korean American non-smokers report assertive behaviour against smoking, which is associated with social-ecological factors. Results help identify target groups and strategies for future intervention, including the need to implement or enforce smoke-free environments and promote empowerment. [Saw A, Tang H, Tsoh JY, Chen MS Jr, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  15. SVA the power of assertions in SystemVerilog

    CERN Document Server

    Cerny, Eduard; Havlicek, John; Korchemny, Dmitry

    2015-01-01

    This book is a comprehensive guide to assertion-based verification of hardware designs using System Verilog Assertions (SVA). It enables readers to minimize the cost of verification by using assertion-based techniques in simulation testing, coverage collection and formal analysis. The book provides detailed descriptions of all the language features of SVA, accompanied by step-by-step examples of how to employ them to construct powerful and reusable sets of properties.?The book also shows how SVA fits into the broader System Verilog language, demonstrating the ways that assertions can interact

  16. Relationship between Gender Roles and Sexual Assertiveness in Married Women.

    Science.gov (United States)

    Azmoude, Elham; Firoozi, Mahbobe; Sadeghi Sahebzad, Elahe; Asgharipour, Neghar

    2016-10-01

    Evidence indicates that sexual assertiveness is one of the important factors affecting sexual satisfaction. According to some studies, traditional gender norms conflict with women's capability in expressing sexual desires. This study examined the relationship between gender roles and sexual assertiveness in married women in Mashhad, Iran. This cross-sectional study was conducted on 120 women who referred to Mashhad health centers through convenient sampling in 2014-15. Data were collected using Bem Sex Role Inventory (BSRI) and Hulbert index of sexual assertiveness. Data were analyzed using SPSS 16 by Pearson and Spearman's correlation tests and linear Regression Analysis. The mean scores of sexual assertiveness was 54.93±13.20. According to the findings, there was non-significant correlation between Femininity and masculinity score with sexual assertiveness (P=0.069 and P=0.080 respectively). Linear regression analysis indicated that among the predictor variables, only Sexual function satisfaction was identified as the sexual assertiveness summary predictor variables (P=0.001). Based on the results, sexual assertiveness in married women does not comply with gender role, but it is related to Sexual function satisfaction. So, counseling psychologists need to consider this variable when designing intervention programs for modifying sexual assertiveness and find other variables that affect sexual assertiveness.

  17. Assertiveness in Indian Context: Perspectives of Women in Coastal Karnataka

    Directory of Open Access Journals (Sweden)

    Vinita A Acharya

    2016-07-01

    Full Text Available Introduction: Assertiveness is considered to be an important communication skill influencing our interpersonal relations. It is known to play a role in stress management, conflict resolution and developing a positive self-concept. However, it is often suggested that Indians may not be as assertive as their Western counterparts. Indian women in particular have an image of being docile and submissive in a patriarchal society bowing down to cultural norms. Method: This study is a qualitative inquiry to explore the views of Indian women about assertiveness. Four focus group discussions were conducted with women from different social strata around Udupi and Mangalore to understand their perspectives on assertiveness. Findings: Three key themes emerged from the analysis of the data. Perceptions of others to one being assertive, sense of freedom after having expressed one’s emotions assertively and consequences of being assertive appeared to be major concerns in being assertive. Conclusion: Exploring the role of assertiveness in women empowerment and social development is recommended.

  18. The assertive communication: a current need of the learning process

    Directory of Open Access Journals (Sweden)

    Georgina Amayuela Mora

    2015-09-01

    Full Text Available The fundamental purpose of this article is to characterize the assertiveness as a component of the communicative competence. The study of the communicative process is a current need, since from the quality of the communication depends to a great extent the student’s formation. The learning process in the university context requires an assertive communicative process. In this paper the assertiveness is defined as a communicative skill and is valued the importance of an assertive behavior through its positive impact in the learning process.

  19. Assertion Training with Korean College Students: Effects on Self-Expression and Anxiety.

    Science.gov (United States)

    Hong, Kyung-Ja; Cooker, Philip G.

    1984-01-01

    Examined the effects of assertiveness training on the self-expression skills of 65 Korean college students. Results showed the treatment group scored significantly higher on the College Self Expression Scale than placebo or control groups, and males scored significantly higher than females. (JAC)

  20. 28 CFR 43.1 - Administrative determination and assertion of claims.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Administrative determination and assertion of claims. 43.1 Section 43.1 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.1 Administrative...

  1. 75 FR 44951 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

    Science.gov (United States)

    2010-07-30

    ... such treatment. Certain businesses, however, do not meet the definition of ``affected business,'' and... definition of ``affected business,'' and are not covered by today's notice. They consist of any business that... Businesses Assert Business Confidentiality Claims AGENCY: Environmental Protection Agency (EPA). ACTION...

  2. 76 FR 362 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

    Science.gov (United States)

    2011-01-04

    ... claims for such treatment. Certain businesses, however, do not meet the definition of ``affected business.... Certain businesses, however, do not meet the definition of ``affected business,'' and are not covered by... Businesses Assert Business Confidentiality Claims AGENCY: Environmental Protection Agency (EPA). ACTION...

  3. Soil microbial community responses to acid exposure and neutralization treatment.

    Science.gov (United States)

    Shin, Doyun; Lee, Yunho; Park, Jeonghyun; Moon, Hee Sun; Hyun, Sung Pil

    2017-12-15

    Changes in microbial community induced by acid shock were studied in the context of potential release of acids to the environment due to chemical accidents. The responses of microbial communities in three different soils to the exposure to sulfuric or hydrofluoric acid and to the subsequent neutralization treatment were investigated as functions of acid concentration and exposure time by using 16S-rRNA gene based pyrosequencing and DGGE (Denaturing Gradient Gel Electrophoresis). Measurements of soil pH and dissolved ion concentrations revealed that the added acids were neutralized to different degrees, depending on the mineral composition and soil texture. Hydrofluoric acid was more effectively neutralized by the soils, compared with sulfuric acid at the same normality. Gram-negative ß-Proteobacteria were shown to be the most acid-sensitive bacterial strains, while spore-forming Gram-positive Bacilli were the most acid-tolerant. The results of this study suggest that the Gram-positive to Gram-negative bacterial ratio may serve as an effective bio-indicator in assessing the impact of the acid shock on the microbial community. Neutralization treatments helped recover the ratio closer to their original values. The findings of this study show that microbial community changes as well as geochemical changes such as pH and dissolved ion concentrations need to be considered in estimating the impact of an acid spill, in selecting an optimal remediation strategy, and in deciding when to end remedial actions at the acid spill impacted site. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

    Science.gov (United States)

    Kirby, Kimberly C.; Versek, Brian; Kerwin, MaryLouise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia; Meyers, Robert J.

    2015-01-01

    We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however,…

  5. Community recognition and beliefs about anorexia nervosa and its treatment.

    Science.gov (United States)

    Darby, Anita M; Hay, Phillipa J; Mond, Jonathan M; Quirk, Frances

    2012-01-01

    Mental Health Literacy (MHL), namely recognition, and beliefs about treatment concerning Anorexia Nervosa (AN) were examined in a community sample of male and female (n = 983) aged 15-94 years. A vignette describing a women suffering from the symptoms of AN was presented, followed by a respondent-based structured interview concerning recognition of the problem and treatment beliefs. The majority of participants could identify the problem as that of an eating disorder, although only 16.1% could specifically identify it as AN. Many also believed the problem was primarily one of low self-esteem (32.5%). General practitioners and psychiatrists or psychologists were considered the most helpful treatment providers, while obtaining information about the problem and available services, followed by family therapy, were considered the most helpful treatments. Less than one-third of participants believed complete recovery was possible. Better AN MHL was found in younger, higher educated, and metropolitan domiciled females. This study offers encouraging results in regard to AN MHL. In particular, there was moderate regard for the use of mental health specialists in the treatment of the disorder. However, there appears to be a misconception that AN is largely the manifestation of low self-esteem and confusion concerning the distinction between AN and bulimia nervosa. AN MHL was poorer in males and those with higher social and health disadvantage. Copyright © 2010 Wiley Periodicals, Inc.

  6. Relative effectiveness of assertive training, modelling and their ...

    African Journals Online (AJOL)

    The study investigated the Relative Effectiveness of Assertive Training (AT), modelling (M) and a combination of Assertive Training and Modelling (AT & M) techniques in improving the social skills of primary school isolates and consequently reduce their isolate behaviour. The study is a quasi experimental research that ...

  7. Assertiveness Training: A Program for High School Students.

    Science.gov (United States)

    Jean-Grant, Deborah S.

    1980-01-01

    Proposes an assertiveness training program suitable for adolescents in a high school group setting. After role-playing examples, students should begin formulating their own responses. Early work in this area indicates that students eagerly participate in assertiveness training groups, and are quick to pick up the skills required for assertive…

  8. [Lack of assertiveness in patients with eating disorders].

    Science.gov (United States)

    Behar A, Rosa; Manzo G, Rodrigo; Casanova Z, Dunny

    2006-03-01

    Low self-assertion has been noted as an important feature among patients with eating disorders. To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p assertiveness on the RAS (p Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.

  9. Enhancement of Self-Regulation, Assertiveness, and Empathy.

    Science.gov (United States)

    Sanz de Acedo Lizarraga, M. Luisa; Ugarte, M. Dolores; Cardelle-Elawar, Maria; Iriarte, M. Dolores; Sanz de Acedo Baquedano, M. Teresa

    2003-01-01

    Examined the effects of teaching self-regulation strategies and social skills to 40 middle school students who presented difficulties in self-reflection, self-inquiry, assertiveness, and empathy. Significant gains were observed in the experimental group in self-regulation of learning, self-control of behavior, assertiveness, empathy, and…

  10. Can Assertiveness be Distinguished From Aggressiveness Using Self Report Data?

    Science.gov (United States)

    Mauger, Paul A.; And Others

    The differences between aggressiveness and assertiveness were examined using the Interpersonal Behavior Survey (IBS), a 136-item self-report questionnaire which was developed to distinguish between assertive and aggressive behaviors. Item level factor analysis was used in scale construction. Results indicated that: (1) the correlation between the…

  11. Assertion Training and Cognitive Restructuring With College Women.

    Science.gov (United States)

    Terrill, Marilyn J.

    The process of assertive behavior change of college women who received assertion training (AT) and cognitive restructuring was examined to assess the relative effects of different durations of exposure to cognitive restructuring. Undergraduate and graduate women students (N=27) at a state university volunteered and were screened for AT groups.…

  12. Assertion and Overcontrolled Hostility among Mentally Disordered Murderers.

    Science.gov (United States)

    Quinsey, Vernon L.; And Others

    1983-01-01

    Studied whether men (N=19) who had committed very severe assaults and who score high on the Overcontrolled Hostility (O-H) scale had assertion deficits that could be measured behaviorally. Results showed the high O-H group was significantly less assertive than control groups in role playing tasks and on questionnaire items. (WAS)

  13. Separation-individuation and assertiveness in late adolescents

    Directory of Open Access Journals (Sweden)

    Aslan, Sevda

    2013-07-01

    Full Text Available An adolescent can experience some problems regarding assertiveness during the course of separation-individuation from their caregivers. The purpose of this study is to describe the relationship between separation-individuation and assertiveness, which was examined in terms of how assertiveness predicts the separation-individuation of Turkish late adolescents. The sampling group consisted of 283 university students. The data gathered were analyzed by involving several simple regression analysis method. The findings revealed that aassertiveness predicts separation anxiety in a meaningful way. Furthermore, the assertiveness predicts engulfment anxiety, peer enmeshment, need denial, practicing-mirroring, rejection expectancy, and healthy separation. These findings suggest that psycho-educational studies improving assertiveness can be carried out for the late adolescents who experience separation-individuation problems.

  14. Evaluation of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction.

    Science.gov (United States)

    Lin, Yen-Ru; Shiah, I-Shin; Chang, Yue-Cune; Lai, Tzu-Ju; Wang, Kwua-Yun; Chou, Kuei-Ru

    2004-11-01

    This study's objective was to evaluate the effect of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Using a longitudinal research design, 69 participants whose scores on the Assertive Scale were assertiveness) and who were willing to participate were included and assigned to an experimental group (33 subjects) or comparison group (36 participants; participants were matched with the experimental group by grade and sex). Participants in the experimental group received eight 2-h sessions of assertiveness training once a week. Data were collected before and after training and again one month after the end of the training using the Rotter's Internal versus External Control of Reinforcement Scale, Sex Role Inventory, Assertive Scale, Esteem Scale, and Interpersonal Communication Satisfaction Inventory. The generalized estimated equation (GEE) method was used for statistical analysis. The assertiveness and self-esteem of the experimental group were significantly improved in nursing and medical students after assertiveness training, although interpersonal communication satisfaction of the experimental group was not significantly improved after the training program.

  15. Effect of the Creative Drama-Based Assertiveness Program on the Assertiveness Skill of Psychological Counsellor Candidates

    Science.gov (United States)

    Gundogdu, Rezzan

    2012-01-01

    The purpose of this quasi-experimental research is to study the effects of the creative drama-based assertiveness program (CDBAP) on the assertiveness skill of Psychological Counselling and Guidance (PCG) department students. The opinions of experimental group students on the program were obtained through the CDBAP evaluation form. The sample of…

  16. Levels of Assertiveness and Peer Pressure of Nursing Students

    Directory of Open Access Journals (Sweden)

    Esin Arslan

    2013-01-01

    Full Text Available Background: The research was conducted in order to determine levels of assertiveness and peer pressure of the nursing students.Methodology: This descriptive research has been performed with 154 nursing students in Bozok University, The data were collected with Questionnaire Form, Rathus Assertiveness Inventory and Peer Pressure Scale. We used the data one way Anova, two samples t test, the relationship between several independent variables and scales were evaluated by Pearson correlation technique in order to evaluate the data with normal distribution.Results: It was seen that 69.5% of the students was assertive and mean scores for assertiveness of the male students (19.4±17.9 were higher than that of the female students (29.0±14.1. However, mean scores for peer pressure of the male students (56.6±12.4 were higher than that of the female students (44.0±8.8. It was found out that there was a positive direction middle level significant correlation between mean assertiveness scores and mean peer pressure scores of the studentsConclusion: Although we did not find any significant correlation between mean assertiveness scores and mean peer pressure scores, it was seen that male students were more assertive than female students and male students experienced peer pressure more than female students.

  17. Nurses in OR are more assertive than radiographers.

    Science.gov (United States)

    Johnson, L

    1993-01-01

    This study investigated two hypotheses: that there is a positive correlation between assertiveness and self-esteem, and that nurses rate lower than non-nurses on the constructs. A self-report survey incorporating scales for general assertiveness, situationally-specific assertiveness, global self-esteem and differentiated self-esteem was utilised. For the sample of 83 operating room nurses and 81 radiographers, correlations significant at the p scales supported the first hypothesis. Analysis of variance yielded no significant differences between the two groups on either self-esteem measures or general assertiveness, with the nurses scoring significantly higher than radiographers on the situationally-specific assertiveness scale. Findings challenge the stereotype of the 'shrinking violet' nurse. Additional analysis revealed that the power component of differentiated self-esteem had a higher correlation with global self-esteem and with both assertiveness measures than any other component. Further, the operating room nurses were significantly more power-oriented than radiographers. The pre-eminence of power in the findings suggests that assertiveness and self-esteem are issues relating to the empowerment of nurses.

  18. To assert or not to assert: conflict management and occupational therapy students.

    Science.gov (United States)

    Landa-Gonzalez, Belkis

    2008-01-01

    As occupational therapists prepare to fulfill the vision of the profession and face the challenges of this century, asserting themselves professionally and effectively collaborating with others is of critical importance. The conflict resolution behaviors used to manage current and future practice environments have significant implications for job retention, work climate, patient care and the development of professional relationships. The literature suggests that occupational therapy students tend to use unassertive forms of conflict management. In an effort to identify potential inconsistencies between students' tendencies and professional demands, this study examined the conflict resolution behaviors that graduate, traditional, and nontraditional occupational therapy students, are likely to use (n = 145). The design of the study was descriptive and correlational. The Thomas Kilmann's MODE instrument and a Conflict Case questionnaire were used as measures of the conflict resolution styles. Results indicated that traditional students favored collaborating while nontraditional students preferred competing and avoiding. The management strategies used by the two groups differed based on the outcome focus and the power relationship between disputants. Findings are relevant for occupational therapy education and continuing professional development. Training in conflict management strategies that would strengthen students' assertiveness and interpersonal skills would be helpful in fostering the leadership needed for fulfilling the profession's vision.

  19. Recent developments in ASSERT-PV code for subchannel thermalhydraulics

    International Nuclear Information System (INIS)

    Rao, Y.F.; Hammouda, N.

    2003-01-01

    This paper summarises recent development of ASSERT-PV, and provides examples of applications to CANDU fuel bundles in predicting flow, heat transfer and sheath temperatures. The development work is intended to improve computational and phenomenological modelling capabilities of ASSERT-PV in simulating various flow scenarios in CANDU fuel bundles. The latest version of ASSERT-PV can be used for simulations of steady state or transient, subchannel thermalhydraulics in CANDU bundles under conditions up to and including post-dryout heat transfer. (author)

  20. The drift flux model in the ASSERT subchannel code

    International Nuclear Information System (INIS)

    Carver, M.B.; Judd, R.A.; Kiteley, J.C.; Tahir, A.

    1987-01-01

    The ASSERT subchannel code has been developed specifically to model flow and phase distributions within CANDU fuel bundles. ASSERT uses a drift-flux model that permits the phases to have unequal velocities, and can thus model phase separation tendencies that may occur in horizontal flow. The basic principles of ASSERT are outlined, and computed results are compared against data from various experiments for validation purposes. The paper concludes with an example of the use of the code to predict critical heat flux in CANDU geometries

  1. Pesticides from wastewater treatment plant effluents affect invertebrate communities.

    Science.gov (United States)

    Münze, Ronald; Hannemann, Christin; Orlinskiy, Polina; Gunold, Roman; Paschke, Albrecht; Foit, Kaarina; Becker, Jeremias; Kaske, Oliver; Paulsson, Elin; Peterson, Märit; Jernstedt, Henrik; Kreuger, Jenny; Schüürmann, Gerrit; Liess, Matthias

    2017-12-01

    We quantified pesticide contamination and its ecological impact up- and downstream of seven wastewater treatment plants (WWTPs) in rural and suburban areas of central Germany. During two sampling campaigns, time-weighted average pesticide concentrations (c TWA ) were obtained using Chemcatcher® passive samplers; pesticide peak concentrations were quantified with event-driven samplers. At downstream sites, receiving waters were additionally grab sampled for five selected pharmaceuticals. Ecological effects on macroinvertebrate structure and ecosystem function were assessed using the biological indicator system SPEAR pesticides (SPEcies At Risk) and leaf litter breakdown rates, respectively. WWTP effluents substantially increased insecticide and fungicide concentrations in receiving waters; in many cases, treated wastewater was the exclusive source for the neonicotinoid insecticides acetamiprid and imidacloprid in the investigated streams. During the ten weeks of the investigation, five out of the seven WWTPs increased in-stream pesticide toxicity by a factor of three. As a consequence, at downstream sites, SPEAR values and leaf litter degradation rates were reduced by 40% and 53%, respectively. The reduced leaf litter breakdown was related to changes in the macroinvertebrate communities described by SPEAR pesticides and not to altered microbial activity. Neonicotinoids showed the highest ecological relevance for the composition of invertebrate communities, occasionally exceeding the Regulatory Acceptable Concentrations (RACs). In general, considerable ecological effects of insecticides were observed above and below regulatory thresholds. Fungicides, herbicides and pharmaceuticals contributed only marginally to acute toxicity. We conclude that pesticide retention of WWTPs needs to be improved. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Effectiveness of the Community Treatment Order in streamlining psychiatric services.

    Science.gov (United States)

    Awara, Mahmoud A; Jaffar, Khalid; Roberts, Pauline

    2013-04-01

    The implementation of the Community Treatment Order (CTO) has created controversy surrounding its beneficence. The study aims at examining the effectiveness of the CTO in reducing the rate and duration of revolving door admissions for patients who were made subject to this Order. All patients who were made subject to CTO between November 2008 and August 2009 in South Essex were involved in the study where patients acted as their own control through comparing their pre-CTO, during CTO and post-CTO's admission rate and duration. There was a significant reduction in the rate and duration of admissions in the period during and post-CTO state. The CTO proved to be effective in reducing revolving door admissions and it has a beneficial carryover effect in the post-CTO state.

  3. Comparing Locus of Control, Assertiveness and General Health among Young Drug Addicts in Iran

    Directory of Open Access Journals (Sweden)

    Shahriar Shahidi

    2009-04-01

    Full Text Available "n "nObjective:The aim of this research was to compare the characteristics of assertiveness, locus of control and general health among young drug dependent patients in Iran. "n "nMethods: Three groups of Iranians: were choosed. The first group included drug dependent patients who had volunteered for treatment and had registered in the local Welfare Organization; the second group included dependent patients who were in the prison; and the third group held nondependent patients. All the participants were male and were matched for age and educational level . The following instruments were used in the present study: locus of control  uestionnaire , Assertiveness Scale and the General Health Questionnaire, GHQ. "n "nResults: The results of the present research showed that there were significant differences among the three groups in ssertiveness, locus of control and GHQ scores. It was found that participants in the non addictive group were more assertive and more internal in their locus of control and had higher GHQ scores than the other two groups. The participants in the prison group reported less assertiveness and lower GHQ scores than the non addictive group ; and their locus of control was more external. Conclusion: "n The results this study may be useful in terms of possible strategies for changing an attributive style in young adults in the framework of psychotherapy

  4. On the Comparison of Interpersonal Sensitivity and Assertiveness between Drug-Dependent Persons and Ordinary People

    Directory of Open Access Journals (Sweden)

    Babak Vojudi

    2015-02-01

    Full Text Available Objective: The present study was aimed at comparing interpersonal sensitivity and assertiveness between drug-dependent persons and ordinary people. Method: The research method was causal-comparative. The statistical population of the study consisted of all narcotic addicts of Tabriz City who referred to Addiction Treatment Centers while the research was being conducted. The number of 30 addicted persons was selected through cluster sampling and 30 ordinary persons as control group through convenience sampling method. Gmbryl & Ritchie’s assertiveness questionnaire (1975 and Boyce & Parker’s Interpersonal Sensitivity Measure (IPSM 1989 were used for data collection purposes. Results: The results showed that there was a statistically significant difference between two groups in terms of interpersonal sensitivity and assertiveness. The addicts showed less assertiveness and more interpersonal sensitivity in comparison with their healthy counterparts. Conclusion: The findings show that people who are unable to express themselves and exert sensitivity in interpersonal relationships are more likely at high risk of substance dependence. However, it is possible to prevent these persons from turning to addiction by teaching them these skills.

  5. MOTIVATIONAL AND VALUE-SEMANTIC DETERMINANTS OF INDIVIDUAL ASSERTIVENESS

    Directory of Open Access Journals (Sweden)

    Lebedeva Inga Viktorovna

    2013-04-01

    Full Text Available The paper attempts to reveal the concept of "determinants of assertiveness" of a personality, which are determined by motivational characteristics and life value and meaning orientations of the individual. The immediate driving force of human action is the motive or the system of motives. The system of motives of human behavior in different situations of activities, communication and cognition is determined by the personal world view (set of ideas, interests, and beliefs. The value orientation, influencing the direction of human activity, determines a person's behavior and is a personality determinant in the manifestations of assertive behavior and assertiveness. Therefore, the significant psychological factors that contribute to the development of assertiveness are high motivation to success, positive attitudes, and such values as compassion, tolerance, mutual understanding, sympathy, concern that oppose to violence, domination, suppression and submission. The article also presents the results of an empirical study of motivational and value-semantic characteristics of the individual.

  6. Anxiety and assertiveness in the relatives of alcoholics and controls.

    Science.gov (United States)

    Schuckit, M A

    1982-06-01

    The Rathus Assertiveness Schedule (RAS) and the Spielberger State-Trait Anxiety Inventory A-Trait Scale (STAI) were administered to male university students and nonacademic staff. Subjects classified as "at-risk" on the basis of a history of alcoholism in a first-degree relative (N = 30) were compared to controls with no such family histories (N = 30). The two groups were matched on demographic variables and drinking history. No significant differences were found between the groups on the traits of anxiety or assertiveness, although the subjects hypothesized to be at higher risk for alcoholism showed a trend toward higher assertiveness scores. These findings are not consistent with the hypothesis that higher levels of anxiety and/or lower levels of assertiveness predispose an individual toward the development of alcoholism.

  7. Assertion: A Technique for Handling Troublesome Library Patrons.

    Science.gov (United States)

    Groark, James J.

    1979-01-01

    Encourages the use of assertion training for librarians to aid them in providing reference service, interviewing for employment, and handling difficult patrons. A list of references and a selection of readers' comments on the article is included. (FM)

  8. Social competence: evaluation of assertiveness in Spanish adolescents.

    Science.gov (United States)

    Castedo, Antonio López; Juste, Margarita Pino; Alonso, José Domínguez

    2015-02-01

    Relations between assertiveness in adolescents' social behavior and demographic variables were assessed in 4,943 Spanish adolescents, ages 12 to 17 years, enrolled in 32 schools for Compulsory Secondary Education. Province of residence, school size, age, grade, and academic focus were statistically significant sources of variance in assertiveness scores. All effects were small. Patterns in responses indicate the items should be reviewed to improve the measure for adolescents, and as a tool for addressing teens' social competence in real life situations.

  9. Levels of Assertiveness and Peer Pressure of Nursing Students

    OpenAIRE

    Esin Arslan; Nazan Kiliç Akça; Mürüvvet Baser

    2013-01-01

    Background: The research was conducted in order to determine levels of assertiveness and peer pressure of the nursing students.Methodology: This descriptive research has been performed with 154 nursing students in Bozok University, The data were collected with Questionnaire Form, Rathus Assertiveness Inventory and Peer Pressure Scale. We used the data one way Anova, two samples t test, the relationship between several independent variables and scales were evaluated by Pearson correlation tech...

  10. Assertiveness and tolerance in cross-cultural interaction

    Directory of Open Access Journals (Sweden)

    Pochebut L.G.

    2017-10-01

    Full Text Available The article is devoted to the theoretical analysis of the concepts of tolerance and assertiveness. Problem of contemporary cross-cultural interaction is the need to shift strategy of tolerance on strategy of assertiveness. Considered the practice of multiculturalism based on the idea of tolerance. Six barriers to cross-cultural communication. Comparison of understanding tolerance in European, Arab, Eastern cultures and in Russia. Boundaries are considered manifestations of tolerance. Developed rules of tolerant behavior. Proposed in scientific analysis and in actual practice, intercultural strategy move to assertiveness. Tolerance is respect for the views of another person, provided that he respects your opinion. Assertiveness is the respect for the rights of another person, provided that it also respects your rights. Describes the ways in assertive behavior: the willingness to cooperate, the openness of conduct, allocation of responsibilities, defend their rights and interests, defining the way forward. Tactics developed in assertive behavior: “interests”, “anti-discrimination”, “achievement”, “standards”, “activity”, “goodwill”.

  11. How repeated 15-minute assertiveness training sessions reduce wrist cutting in patients with borderline personality disorder.

    Science.gov (United States)

    Hayakawa, Masaya

    2009-01-01

    The aim of this work was to examine a possible treatment for patients with borderline personality disorder who have wrist-cutting syndrome, a condition characterized by repeated, superficial wrist cutting in a non-suicidal fashion. Within the current healthcare system in Japan, the average amount of time a doctor can spend with a psychiatric outpatient is about 8 to 15 minutes. We, therefore, examined whether repeated 15-minute psychotherapy sessions to improve patient assertiveness would be effective for reducing wrist cutting and possibly other forms of self-mutilation. We treated 13 patients diagnosed with borderline personality disorder and wrist-cutting syndrome with assertiveness training during 15-minute, biweekly therapy sessions over a course of one to four years. At the conclusion of psychotherapeutic treatment, 69% of outpatients showed a statistically significant reduction in wrist-cutting behavior.

  12. Training addiction professionals in empirically supported treatments: perspectives from the treatment community.

    Science.gov (United States)

    Hartzler, Bryan; Rabun, Carl

    2014-01-01

    Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. In this mixed-method study, data were collected in 64 semistructured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and 2 direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, "Seeking Safety," and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMMs and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as well as practical obstacles that challenge

  13. Attachment, Sexual Assertiveness, and Sexual Outcomes in Women with Provoked Vestibulodynia and Their Partners: A Mediation Model.

    Science.gov (United States)

    Leclerc, Bianca; Bergeron, Sophie; Brassard, Audrey; Bélanger, Claude; Steben, Marc; Lambert, Bernard

    2015-08-01

    Provoked vestibulodynia (PVD) is a prevalent women's sexual pain disorder, which is associated with sexual function difficulties. Attachment theory has been used to understand adult sexual outcomes, providing a useful framework for examining sexual adaptation in couples confronted with PVD. Research to date indicates that anxious and avoidant attachment dimensions correlate with worse sexual outcomes in community and clinical samples. The present study examined the association between attachment, pain, sexual function, and sexual satisfaction in a sample of 101 couples in which the women presented with PVD. The actor-partner interdependence model was used in order to investigate both actor and partner effects. This study also examined the role of sexual assertiveness as a mediator of these associations via structural equation modeling. Women completed measures of pain intensity and both members of the couple completed measures of romantic attachment, sexual assertiveness, sexual function, and satisfaction. Results indicated that attachment dimensions did not predict pain intensity. Both anxious and avoidant attachment were associated with lower sexual satisfaction. Only attachment avoidance predicted lower sexual function in women. Partner effects indicated that higher sexual assertiveness in women predicted higher sexual satisfaction in men. Finally, women's sexual assertiveness was found to be a significant mediator of the relationship between their attachment dimensions, sexual function, and satisfaction. Findings highlight the importance of examining how anxious and avoidant attachment may lead to difficulties in sexual assertiveness and to less satisfying sexual interactions in couples where women suffer from PVD.

  14. Gender and performance of community treatment assistants in Tanzania.

    Science.gov (United States)

    Jenson, Alexander; Gracewello, Catherine; Mkocha, Harran; Roter, Debra; Munoz, Beatriz; West, Sheila

    2014-10-01

    To examine the effects of gender and demographics of community treatment assistants (CTAs) on their performance of assigned tasks and quantity of speech during mass drug administration of azithromycin for trachoma in rural Tanzania. Surveys of CTAs and audio recordings of interactions between CTAs and villagers during drug distribution. Mass drug administration program in rural Kongwa district. Fifty-seven randomly selected CTAs, and 3122 residents of villages receiving azithromycin as part of the Kongwa Trachoma Project. None. Speech quantity graded by Roter interaction analysis system, presence of culturally appropriate greeting and education on facial hygiene for trachoma prevention from coded analysis of audio-recorded interactions. At sites with all female CTAs, each CTA spent more time and spoke more in each interaction in comparison with CTAs at sites with only male CTAs and CTAs at 'mixed gender' sites (sites with both male and female CTAs). At 'mixed gender' sites, males spoke significantly more than females. Female CTAs mentioned trachoma prevention with facial cleanliness more than twice as often as male CTAs; however, both genders mentioned hygiene in genders had culturally appropriate greetings in Gender dynamics affect the amount of time that CTAs spend with villagers during drug distribution, and the relative amount of speech when both genders work together. Both genders are not meeting expectations for trachoma prevention education and greeting villagers, and novel training methods are necessary. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  15. [Community acquired pneumonia in children: Outpatient treatment and prevention].

    Science.gov (United States)

    Moreno-Pérez, D; Andrés Martín, A; Tagarro García, A; Escribano Montaner, A; Figuerola Mulet, J; García García, J J; Moreno-Galdó, A; Rodrigo Gonzalo de Lliria, C; Ruiz Contreras, J; Saavedra Lozano, J

    2015-12-01

    There have been significant changes in community acquired pneumonia (CAP) in children in the last decade. These changes relate to epidemiology and clinical presentation. Resistance to antibiotics is also a changing issue. These all have to be considered when treating CAP. In this document, two of the main Spanish pediatric societies involved in the treatment of CAP in children, propose a consensus concerning therapeutic approach. These societies are the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases. The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) has also been involved in the prevention of CAP. An attempt is made to provide up-to-date guidelines to all paediatricians. The first part of the statement presents the approach to ambulatory, previously healthy children. We also review the prevention with currently available vaccines. In a next second part, special situations and complicated forms will be addressed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  16. The Level of Depression and Assertiveness among Nursing Students.

    Science.gov (United States)

    Rezayat, Fatemeh; Dehghan Nayeri, Nahid

    2014-07-01

    Nursing students are susceptible to a higher risk of depression. Recognition of depression, assertiveness and the relationship between them is important since if a relationship exists, probably enhancing the level of assertiveness can reduce depression in this high risk group. We aimed to investigate depression and assertiveness levels and the relationship between them in nursing students of Tehran University of Medical Sciences. The target population of this cross-sectional study was bachelor nursing students of Tehran University of Medical Sciences, as the largest and one of the most prestigious Iranian universities. For selecting samples, the convenience sampling method was used. Having no previous information about classes, the researcher selected the students from the courses held while the researcher was present for sampling at the faculty and studied all the students willing to participate in the study in selected classes. The questionnaire consisted of demographic information, Gambrill and Richey assertion inventory, and Beck's depression inventory. SPSS software, version 16, was used to analyze the data. ANOVA and independent samples t test were used for as appropriated. 55.6% of students indicated average and low levels of assertiveness and 38.7% were suffering from mild to severe depression. Pearson correlation test showed a significant inverse relationship (r=0.314 and Passertiveness and depression. There were significant relationships between depression and interest in the field of study (P=0.001) and between assertiveness and gender (P=0.035). There was an inverse significant relationship between depression and assertiveness among nursing students. We suggest a cohort study design that can determine the effect of these variables on each other completely.

  17. The connection between young women's body esteem and sexual assertiveness.

    Science.gov (United States)

    Auslander, Beth A; Baker, Jaqwiana; Short, Mary B

    2012-04-01

    Healthy sexuality includes having positive feelings about one's body and developing positive romantic relationships. Previous research predicts that women dissatisfied with their bodies may be less likely to enforce their rights of sexual autonomy (i.e., sexual assertiveness). We assessed whether the body esteem of young women was related to their reports of sexual assertiveness. Young women from local colleges (N = 127) completed a questionnaire that included demographics, self reported weight and height, sexual history, along with body esteem and sexual assertiveness. Overall, body esteem was related to sexual assertiveness regarding condom use when controlling for other variables. Women with less body esteem were less likely to insist that their partner use a condom. Individual components of body esteem did not independently predict insistence of condom use. Body esteem was not related to initiation of sex or refusal of unwanted sex. The current study found relationships between body esteem and sexual assertiveness regarding STI prevention behaviors. Given these findings, implications for STI prevention programs are discussed. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  18. Gender by assertiveness interaction in delayed auditory feedback.

    Science.gov (United States)

    Elias, J W; Rosenzweig, C M; Dippel, R L

    1981-04-01

    The College Self-Expression and the Marlowe-Crowne Social Desirability Scales were given to 144 undergraduates. High (N; 10 M; 10 F) and Low (N; 10 M 10 F) Assertiveness Ss were given a DAF test with a 'Phonic Mirror" and the Stroop test (naming the color of a word printed in a different color). DAF performance did not differ among the 4 subgroups (M and F, High and Low Assertiveness), except that Low Assertiveness women showed significantly greater DAF interference than the other subgroups. There was no significant correlation between the continuous interference of the DAF vs the discontinuous of the Stroop test. The difference may reside in the time available and the consequent reduction in anxiety, for the next stimulus in the Stroop test. These data show that, under certain circumstances, personality factors such as assertiveness can interact with gender to affect speech fluency and production. The ability to overcome feedback-related disfluencies in speech may be partially aided by improvement in self-concept or specific training in such behaviors as assertiveness, and this may be more important for females than males.

  19. Cultural factors influencing Japanese nurses' assertive communication. Part 1: Collectivism.

    Science.gov (United States)

    Omura, Mieko; Stone, Teresa E; Levett-Jones, Tracy

    2018-02-06

    Culture influences the way health-care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally-appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally. © 2018 John Wiley & Sons Australia, Ltd.

  20. Centralized Drinking Water Treatment Operations Shape Bacterial and Fungal Community Structure.

    Science.gov (United States)

    Ma, Xiao; Vikram, Amit; Casson, Leonard; Bibby, Kyle

    2017-07-05

    Drinking water microbial communities impact opportunistic pathogen colonization and corrosion of water distribution systems, and centralized drinking water treatment represents a potential control for microbial community structure in finished drinking water. In this article, we examine bacterial and fungal abundance and diversity, as well as the microbial community taxonomic structure following each unit operation in a conventional surface water treatment plant. Treatment operations drove the microbial composition more strongly than sampling time. Both bacterial and fungal abundance and diversity decreased following sedimentation and filtration; however, only bacterial abundance and diversity was significantly impacted by free chlorine disinfection. Similarly, each treatment step was found to shift bacterial and fungal community beta-diversity, with the exception of disinfection on the fungal community structure. We observed the enrichment of bacterial and fungal taxa commonly found in drinking water distribution systems through the treatment process, for example, Sphingomonas following filtration and Leptospirillium and Penicillium following disinfection. Study results suggest that centralized drinking water treatment processes shape the final drinking water microbial community via selection of community members and that the bacterial community is primarily driven by disinfection while the eukaryotic community is primarily controlled by physical treatment processes.

  1. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  2. Effects of using winter grazing as a fuel treatment on Wyoming big sagebrush plant communities

    Science.gov (United States)

    More frequent wildfires and incidences of mega-fires have increased the pressure for fuel treatments in sagebrush (Artemisia) communities. Winter grazing has been one of many fuel treatments proposed for Wyoming big sagebrush (A. tridentata Nutt. subsp. wyomingensis Beetle and A. Young) communitie...

  3. Community case management improves use of treatment for ...

    African Journals Online (AJOL)

    Objective: Evaluate the performance of volunteers in providing Community Case Management (CCM) for diarrhea, fever and pneumonia – in a pre-HEW setting in Liben Woreda, Oromiya Regional State. Methods: Save the Children supported Ministry of Health and communities to deliver child survival interventions from ...

  4. Community awareness about malaria, its treatment and mosquito ...

    African Journals Online (AJOL)

    Background: Despite the rapid expansion of malaria into highland areas of Ethiopia and the movement of malaria inexperienced people to endemic areas, there is no enough information about how highland communities perceive malaria. Objective: To assess communities' awareness of malaria and its mosquito vector in ...

  5. PENINGKATAN SELF ESTEEM SISWA KORBAN BULLYING MELALUI TEKNIK ASSERTIVE TRAINING

    Directory of Open Access Journals (Sweden)

    Mujiyati Mujiyati

    2015-01-01

    Full Text Available This study is based on students’ problem who undergone the decreasing of self-esteem due to bullying that students receive in their environment. The long-term goal which going to be achieved is related to self esteem problem of students bullying victims that is capable to solve problem by using effective and tested product through counseling with assertive training technique. This study used research and development method. The steps are: (1 preliminary research; (2 designing model; (3 developing model; (4 testing model restrictively; (5 analysing model; (6 revising model; (7 testing model widely; (8 dissemination of model; and (9 recommending tested model. The result of study showed that the model of counseling through assertive training was empirically proven effective to improve self esteem of students bullying victims.Keywords: Self Esteem, Bullying, Assertive Training

  6. The Effects of Assertive Training on Performance in Highly Anxious Adolescents.

    Science.gov (United States)

    Wehr, Sara H.; Kaufman, Melvin E.

    1987-01-01

    Investigated the effects of assertive training on measures of assertiveness, state anxiety, and mathematics performance in highly anxious ninth graders (N=96). Found that assertive training resulted in increased assertiveness and decreased state anxiety, with no significant effect on mathematics performance, and no significant effect due to sex.…

  7. The effect of assertiveness training on student's academic anxiety.

    Science.gov (United States)

    Mohebi, S; Sharifirad, G H R; Shahsiah, M; Botlani, S; Matlabi, M; Rezaeian, M

    2012-03-01

    Academic anxiety is an important educational problem that affects millions of students in colleges and schools over the world each year. Although a low level of anxiety can cause positive motivation for improvement of educational functioning, high levels of it can cause a disturbance in concentration, attention, storage of knowledge, recall and educational reduction. It has also been recently determined that there is a relationship between anxiety and assertiveness. Therefore, this study is an attempt to determine the effect of assertiveness training on reducing anxiety levels in pre-college academic students in Gonabad city in 2008. In this clinical trial study, all the pre-college students of Gonabad city were invited to participate and 89 students were divided into experimental and control groups. There were 3 questionnaires, namely demographic, academic anxiety and assertiveness Rathus questionnaires in which the validity and reliability were calculated and approved. The intervention for the experimental group was 5 sessions of assertiveness training using the PRECEDE model and 1 session for parents and teachers to help and support the intervention program. We had a post-test 8 weeks after the last training session for each group was conducted. The data was analyzed by SPSS. The results showed that anxiety levels and decisiveness in the target group were moderate to high and it is seen as a significant reverse relationship between these two factors (r = -0.69 and p anxiety decrease in the experimental group after the intervention. On the one hand, there was a significant increase in decisiveness for both groups, but there was not a significant difference between academic anxiety and assertiveness in the control group.before and after the intervention. Due to a significant decrease in anxiety and increased decisiveness in the experimental group, it can be claimed that assertiveness training is an effective non-pharmacological method for reducing academic anxiety

  8. TAX TREATMENT SPECIFIC TO INTRA COMMUNITY COMMERCIAL BUSINESS TRANSACTIONS - ACQUISITION AND INTRA-COMMUNITY SUPPLY OF GOODS

    Directory of Open Access Journals (Sweden)

    Paliu -Popa Lucia

    2009-11-01

    Full Text Available Romania's accession to the European Union has imposed harmonize national legislation with Community law, registering significant changes in the tax area, particularly on value added tax. In order to determine the person liable to pay value added tax, related to intra-community commercial transactions, must to clarify tax matters for those operations. Given the complexity of intra-community commercial transactions and their taxation, in the following issues we will address the intra-community trade in goods, with reference to specific tax treatment of supplies and intra-community acquisitions of goods. To do this we will consider more specific situations that arise in trade relationship between EU Member States, examples that will allow us to draw some conclusions on tax matters arising in intracommunity commercial relationship

  9. Efforts to increase junior high school students confidencethrough assertive training

    Directory of Open Access Journals (Sweden)

    Romia Hari Susanti

    2016-12-01

    Full Text Available One of important aspects of personality in human life, especially teenagers is confidence. Counseling teachers can increase student confidence through assertive training. Through the training, students are expected to understand that everyone has the right to express their feelings, opinions, beliefs, and attitudes to do a thing without a doubt, but do not hurt other people's feelings, so that confidence can be increased. This study aims to improve students' confidence through assertive training using classroom action research. Subjects in this study were students of SMP Brawijaya Smart School Malang who have low-confidence criteria

  10. Secure bindings of SAML assertions to TLS sessions

    DEFF Research Database (Denmark)

    Kohlar, Florian; Schwenk, Jörg; Jensen, Meiko

    2010-01-01

    In recent research work, two approaches to protect SAML based Federated Identity Management (FIM) against man-in-the-middle attacks have been proposed. One approach is to bind the SAML assertion and the SAML artifact to the public key contained in a TLS client certificate. Another approach...... is to strengthen the Same Origin Policy of the browser by taking into account the security guarantees TLS gives. In this paper, we present a third approach which is of further interest beyond IDM protocols: we bind the SAML assertion to the TLS session that has been agreed upon between client and the service...

  11. Cost-effectiveness of ceftriaxone in the treatment of community ...

    African Journals Online (AJOL)

    1998-03-03

    Mar 3, 1998 ... community-acquired pneumonia (CAP) in adults in a private hospital ... organism is susceptible, and adversely affected by delayed or inappropriate ... serious loss in terms of representativeness and usefulness of the study ...

  12. Alexithymia, emotion perception, and social assertiveness in adult women with Noonan and Turner syndromes.

    Science.gov (United States)

    Roelofs, Renée L; Wingbermühle, Ellen; Freriks, Kim; Verhaak, Chris M; Kessels, Roy P C; Egger, Jos I M

    2015-04-01

    Noonan syndrome (NS) and Turner syndrome (TS) are associated with cognitive problems and difficulties in affective information processing. While both phenotypes include short stature, facial dysmorphisms, and a webbed neck, genetic etiology and neuropsychological phenotype differ significantly. The present study examines putative differences in affective information processing and social assertiveness between adult women with NS and TS. Twenty-six women with NS, 40 women with TS, and 40 female controls were matched on age and intelligence, and subsequently compared on (1) alexithymia, measured by the Bermond-Vorst Alexithymia Questionnaire, (2) emotion perception, evaluated by the Emotion Recognition Task, and (3) social assertiveness and social discomfort, assessed by the Scale for Interpersonal Behavior. Women with TS showed higher levels of alexithymia than women with NS and controls (P-values assertiveness and the level of social discomfort. Women with NS and TS demonstrated different patterns of impairment in affective information processing, in terms of alexithymia and emotion perception. The present findings suggest neuropsychological phenotyping to be helpful for the diagnosis of specific cognitive-affective deficits in genetic syndromes, for the enhancement of genetic counseling, and for the development of personalized treatment plans. © 2015 Wiley Periodicals, Inc.

  13. Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness.

    Science.gov (United States)

    Rutten, Elisabeth A P; Bachrach, Nathan; van Balkom, Anton J L M; Braeken, Johan; Ouwens, Machteld A; Bekker, Marrie H J

    2016-12-01

    Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness. © 2015 The British Psychological Society.

  14. Do treatment manuals undermine youth–therapist alliance in community clinical practice?

    OpenAIRE

    Langer, David A.; McLeod, Bryce D.; Weisz, John R

    2011-01-01

    Objective: Some critics of treatment manuals have argued that their use may undermine the quality of the client–therapist alliance. This notion was tested in the context of youth psychotherapy delivered by therapists in community clinics. Method: Seventy-six clinically referred youths (57% female, age 8–15 years, 34% Caucasian) were randomly assigned to receive nonmanualized usual care or manual-guided treatment to address anxiety or depressive disorders. Treatment was provided in community c...

  15. Assertiveness Among Young Rural Adolescents: Relationship to Alcohol Use

    Science.gov (United States)

    Goldberg-Lillehoj, Catherine J.; Spoth, Richard; Trudeau, Linda

    2005-01-01

    There is evidence of higher prevalence rates for alcohol use among rural adolescents relative to urban adolescents. Strategies aimed at preventing adolescent alcohol use typically include the development of social skills to resist peer pressure; among the social skills frequently targeted is assertiveness. Self-report data were collected from a…

  16. Assertion checking environment (ACE) for formal verification of C programs

    International Nuclear Information System (INIS)

    Sharma, Babita; Dhodapkar, S.D.; Ramesh, S.

    2003-01-01

    In this paper we describe an Assertion Checking Environment (ACE) for compositional verification of programs, which are written in an industrially sponsored safe subset of C programming language called MISRA C [Guidelines for the Use of the C Language in Vehicle Based Software, 1998]. The theory is based on Hoare logic [Commun. ACM 12 (1969) 576] and the C programs are verified using static assertion checking technique. First the functional specifications of the program, captured in the form of pre- and post-conditions for each C function, are derived from the specifications. These pre- and post-conditions are then introduced as assertions (also called annotations or formal comments) in the program code. The assertions are then proved formally using ACE and theorem proving tool called Stanford Temporal Prover [The Stanford Temporal Prover User's Manual, 1998]. ACE has been developed by us and consists mainly of a translator c2spl, a GUI and some utility programs. The technique and tools developed are targeted towards verification of real-time embedded software

  17. Assertiveness by Older Adults with Visual Impairment: Context Matters

    Science.gov (United States)

    Ryan, Ellen Bouchard; Anas, Ann P.; Mays, Heather

    2008-01-01

    Within a communication predicament of aging and disability framework, this study examined the impact of two types of contextual variation on perceptions of older adult assertiveness within problematic service encounters. Young (N = 66) and older (N = 66) participants evaluated conversational scenarios in which a visually-impaired older woman…

  18. Teaching Social Skills and Assertiveness to Students with Disabilities

    Science.gov (United States)

    Moffett, Aaron; Alexander, Melissa G. F.; Dummer, Gail M.

    2006-01-01

    This article discusses teaching social skills and assertiveness to students with disabilities. The National Association for Sport and Physical Education (NASPE) content standards for physical education emphasize teaching responsible personal and social behaviors to students of all abilities, to help them develop an understanding of and respect for…

  19. Teacher Assertiveness in the Development of Students' Social Competence

    Science.gov (United States)

    Villena Martínez, M. D.; Justicia, F. Justicia; Fernández de Haro, E.

    2016-01-01

    Introduction: Social competence in school students has been studied extensively in terms of their being socially competent or not. However, there has been little analysis of how teachers contribute to the development of these skills. This research assesses the influence of teachers' assertiveness on the social competence of their students and on…

  20. A Measure of Cognition within the Context of Assertion.

    Science.gov (United States)

    Golden, Morrie

    1981-01-01

    Described the development and evaluation of a measure of cognitive belief systems and thinking styles. Reliability and validity results were poor for junior college students. For university and nonstudent populations, cognition scores discriminated social anxiety. The Cognition Scale of Assertiveness is a reliable and valid measure of cognitive…

  1. Assessing Assertion: An Investigation of Construct Validity and Reliability.

    Science.gov (United States)

    Kern, Jeffrey M.; MacDonald, Marian L.

    The reliability and meaning of assertiveness tests were explored using 120 female undergraduates. Several self-report inventories (the College Self-Expression Scale, Conflict Resolution Inventory, and a global rating from one to seven) were administered, as were three anxiety measures (Timed Behavior Checklist, response latency, and response…

  2. Person, Situational, and Interactional Influences on Assertive Behavior.

    Science.gov (United States)

    Kirschner, Stuart M.; Galassi, John P.

    1983-01-01

    Explored the validity of the College Self-Expression Scale (CSES) for 144 students in the context of three alternative models of behavior--personism, situationalism, and interactionalism. Results supported the concurrent validity of the CSES and the role of both person and situational, but not interactional, influences on assertion. (WAS)

  3. MOTIVATIONAL AND VALUE-SEMANTIC DETERMINANTS OF INDIVIDUAL ASSERTIVENESS

    Directory of Open Access Journals (Sweden)

    Инга Викторовна Лебедева

    2013-04-01

    Full Text Available The paper attempts to reveal the concept of "determinants of assertiveness" of a personality, which are determined by motivational characteristics and life value and meaning orientations of the individual. The immediate driving force of human action is the motive or the system of motives. The system of motives of human behavior in different situations of activities, communication and cognition is determined by the personal world view (set of ideas, interests, and beliefs. The value orientation, influencing the direction of human activity, determines a person's behavior and is a personality determinant in the manifestations of assertive behavior and assertiveness. Therefore, the significant psychological factors that contribute to the development of assertiveness are high motivation to success, positive attitudes, and such values as compassion, tolerance, mutual understanding, sympathy, concern that oppose to violence, domination, suppression and submission.The article also presents the results of an empirical study of motivational and value-semantic characteristics of the individual.DOI: http://dx.doi.org/10.12731/2218-7405-2013-4-15

  4. Treatment Seeking and Ebola Community Care Centers in Sierra Leone: A Qualitative Study.

    Science.gov (United States)

    Carter, Simone E; O'Reilly, Marion; Frith-Powell, Jack; Umar Kargbo, Alpha; Byrne, Daniel; Niederberger, Eva

    2017-01-01

    Ebola Treatment Units were able to provide only 60% of necessary treatment beds in Sierra Leone. As a result, the Government of Sierra Leone decided to construct Community Care Centers. These were intended to increase treatment-seeking behavior and reduce the community-level spread of Ebola by facilitating access to care closer to communities. Through qualitative data collection in 3 districts, this study seeks to understand the perceived impact that proximity to such Centers had on treatment-seeking behavior. Feedback from community members and Community Health Volunteers indicates that proximity to treatment reduced fears, especially those arising from the use of ambulances, lack of familiarity with medical Centers, and loss of contact with family members taken for treatment. Participants report that having a Center close to their home enables them to walk to treatment and witness survivors being discharged. Living close to Centers also enables communities to be involved in their design and daily operation, helping to build trust in them as acceptable treatment facilities. Further research is required to understand the appropriate design, operation, and epidemiological impact of Centers. Further investigation should incorporate the effect of an outbreak's severity and the stage (duration) of the outbreak on potential acceptance of Centers.

  5. Effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder. A randomized clinical trial

    DEFF Research Database (Denmark)

    Ohlenschlæger, Johan; Nordentoft, Merete; Thorup, Anne

    2008-01-01

    of assertive community treatment, psycho-educational multi-family groups, and social skills training. Data on coercion were extracted from the register from the National Board of Health, and data on continuity from medical records. Even though the level of continuity seemed higher in integrated treatment...

  6. A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment

    Science.gov (United States)

    Nemeth, Lynne S.; Jenkins, Carolyn; Jauch, Edward C.; Conway, Sharon; Pearlman, Adam; Spruill, Ida J.; Brown, Lynette J.; Linnen, Joyce; Linnen, Florene; Andrews, Jeannette O.

    2016-01-01

    Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stake-holder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. PMID:27545591

  7. Permanence of Two Self-Managed Treatments of Overweight in University and Community Populations

    Science.gov (United States)

    And Others; Hall, Robert G.

    1974-01-01

    Males and females from community and university samples were assigned to two self-management treatments, nonspecific, or no-treatment controls. At six month follow-up, differences were not significant. Results are discussed in terms of conceptualizations of self-management and the utility of treatments employed. (Author)

  8. Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men.

    Science.gov (United States)

    Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim; McQuaid, John R; Patterson, Thomas L

    2011-10-01

    Drug assertiveness skills have been demonstrated to be effective in reducing substance use behaviors among patients with alcohol or heroin use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. A collaborative community-based treatment program for offenders with mental illness.

    Science.gov (United States)

    Roskes, E; Feldman, R

    1999-12-01

    The paper describes initial results of collaboration between a mental health treatment program at a community mental health center in Baltimore and a probation officer of the U.S. federal prison system to serve the mental health needs of offenders on federal probation, parole, supervised release, or conditional release in the community. A forensic psychiatrist in the treatment program and a licensed social worker in the probation office facilitate the close working relationship between the agencies. Treatment services provided or brokered by the community mental health center staff include psychiatric and medical treatment, intensive case management, addictions treatment, urine toxicology screening, psychosocial or residential rehabilitation services, intensive outpatient care, partial hospitalization, and inpatient treatment. Among the 16 offenders referred for treatment during the first 24 months of the collaborative program, 14 were male and 14 were African American. Three of the 16 violated the terms of their release due to noncompliance with stipulated mental health treatment; only one of the three had been successfully engaged in treatment. One patient died, two completed their terms of supervision, and ten remained in treatment at the time of the report. The major strength of this collaboration is the cooperation of the treatment and monitoring agencies with the overall goal of maintaining the offender in the community. Further research is needed to confirm the effectiveness of the clinical model in reducing recidivism and retaining clients.

  10. Therapeutic Engagement as a Predictor of Retention in Adolescent Therapeutic Community Treatment

    Science.gov (United States)

    Abdel-Salam, Sami; Gunter, Whitney D.

    2014-01-01

    The adolescent drug problem places a huge toll on society and a heavy burden on the criminal justice system. Research regarding the benefits of therapeutic community (TC) treatment for adolescents has shown it to be effective. Despite the ability of therapeutic communities to lower drug relapse and reduce criminality, a great deal remains unknown…

  11. Adapting Evidence-Based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

    Science.gov (United States)

    Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B., Jr.

    2009-01-01

    This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for…

  12. Influence of salinity on fungal communities in a submerged fixed bed bioreactor for wastewater treatment

    NARCIS (Netherlands)

    Cortés-Lorenzo, C.; González-Martínez, A.; Smidt, H.; González-López, J.; Rodelas, B.

    2016-01-01

    Salinity is known to influence the performance of biological wastewater treatment plants. While its impact on bacterial communities has been thoroughly studied, its influence on fungal communities has been largely overlooked. To address this knowledge gap, we assessed the effect of saline

  13. Predicting delay to treatment of urinary incontinence among urban community-dwelling women in China

    Directory of Open Access Journals (Sweden)

    Chen Wu

    2015-03-01

    Conclusion: Women who were older, had lower subjective UI severity, and who reported only stress or urgency UI tended to delay treatment longer; such patients should be targeted for health education and intervention regarding UI in urban communities.

  14. Notification: Hotline Complaint – Drinking Water Treatment Plant at the Fort Belknap Indian Community

    Science.gov (United States)

    Project #OA-FY13-0076, November 13, 2012. On March 22, 2012, the Office of Inspector General (OIG) received a hotline complaint on the construction of the Drinking Water Treatment Plant (DWTP) at the Fort Belknap Indian Community.

  15. Development of an improved compact package plant for small community waste-water treatment

    CSIR Research Space (South Africa)

    Hulsman, A

    1993-01-01

    Full Text Available The challenges facing the design and operation of small community wastewater treatment plants are discussed. The package plant concept is considered and the consequent development of a compact intermittently aerated activated sludge package plant...

  16. Are we strong enough to assert our rights in quality healthcare?

    Directory of Open Access Journals (Sweden)

    Loris Brunetta

    2014-12-01

    Full Text Available The title of this speech is an important challenge for me, for a patient I mean, to face because it’s not easy to state today if we are really strong enough to assert our rights for a quality healthcare. At first sight, and in an optimistic vision, we could answer to this question YES, we are, but I think we need to explore better the field before to confirm that this is the right answer to the question. The first thing to assess is what we mean with the pronoun WE: the patients and parents’ community represented from TIF? The whole community that plays around thalassemia and hemoglobinopathies, meaning patients and parents and scientists? What else?

  17. Microbial Communities in Danish Wastewater Treatment Plants with Nutrient Removal

    DEFF Research Database (Denmark)

    Mielczarek, Artur Tomasz

    Activated sludge treatment plants are the most used wastewater treatment systems worldwide for biological nutrient removal from wastewater. Nevertheless, the treatment systems have been for many years operated as so called “black-box”, where specific process parameters were adjusted without...... that plants with return sludge Side-Stream Hydrolysis (SSH) instead of the normal anaerobic process tank tended to have significantly fewer unwanted GAOs in contrast to many plants with traditional mainstream anaerobic tank and thus it was proposed that this system might be an effective strategy of control...

  18. A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry.

    Science.gov (United States)

    Gordon, Michael S; Kinlock, Timothy W; Schwartz, Robert P; Fitzgerald, Terrence T; O'Grady, Kevin E; Vocci, Frank J

    2014-09-01

    Buprenorphine is a promising treatment for heroin addiction. However, little is known regarding its provision to pre-release prisoners with heroin dependence histories who were not opioid-tolerant, the relative effectiveness of the post-release setting in which it is provided, and gender differences in treatment outcome in this population. This is the first randomized clinical trial of prison-initiated buprenorphine provided to male and female inmates in the US who were previously heroin-dependent prior to incarceration. A total of 211 participants with 3-9 months remaining in prison were randomized to one of four conditions formed by crossing In-Prison Treatment Condition (received buprenorphine vs. counseling only) and Post-release Service Setting (at an opioid treatment center vs. a community health center). Outcome measures were: entered prison treatment; completed prison treatment; and entered community treatment 10 days post-release. There was a significant main effect (p=.006) for entering prison treatment favoring the In-Prison buprenorphine Treatment Condition (99.0% vs. 80.4%). Regarding completing prison treatment, the only significant effect was Gender, with women significantly (pPrison buprenorphine Treatment Condition (47.5% vs. 33.7%). Buprenorphine appears feasible and acceptable to prisoners who were not opioid-tolerant and can facilitate community treatment entry. However, concerns remain with in-prison treatment termination due to attempted diversion of medication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Correlates of substance abuse treatment completion among disadvantaged communities in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Pasche Sonja

    2010-03-01

    Full Text Available Abstract Background Completion of substance abuse treatment is a proximal indicator of positive treatment outcomes. To design interventions to improve outcomes, it is therefore important to unpack the factors contributing to treatment completion. To date, substance abuse research has not examined the factors associated with treatment completion among poor, disadvantaged communities in developing countries. This study aimed to address this gap by exploring client-level factors associated with treatment completion among poor communities in South Africa. Methods Secondary data analysis was conducted on cross-sectional survey data collected from 434 persons residing in poor communities in Cape Town, South Africa who had accessed substance abuse treatment in 2006. Results Multiple regression analyses revealed that therapeutic alliance, treatment perceptions, abstinence-specific social support, and depression were significant partial predictors of treatment completion. Conclusions Findings suggest that treatment completion rates of individuals from poor South African communities can be enhanced by i improving perceptions of substance abuse treatment through introducing quality improvement initiatives into substance abuse services, ii strengthening clients' abstinence-oriented social networks and, iii strengthening the counselor-client therapeutic alliance.

  20. Bacterial communities in full-scale wastewater treatment systems

    OpenAIRE

    Cydzik-Kwiatkowska, Agnieszka; Zieli?ska, Magdalena

    2016-01-01

    Bacterial metabolism determines the effectiveness of biological treatment of wastewater. Therefore, it is important to define the relations between the species structure and the performance of full-scale installations. Although there is much laboratory data on microbial consortia, our understanding of dependencies between the microbial structure and operational parameters of full-scale wastewater treatment plants (WWTP) is limited. This mini-review presents the types of microbial consortia in...

  1. Smart Dialogue for Smart Citizens: Assertive Approaches for Strategic Planning

    Directory of Open Access Journals (Sweden)

    Isidoro Fasolino

    2014-05-01

    Full Text Available It is very important to know how to communicate, but even more important is knowing how to listen. There is no dialogue without listening. Listening and speaking can generate a virtuous cycle that, enriching the field of information, allows the introduction of essential elements of innovation. It is relevant in this context the assertive ability of who manages and coordinates the decision-making processes. The potential of new approaches based on assertiveness are the new frontier of research discipline that is able to meet future challenges aiming to contribute to the construction of places and forms of living together in the growing interest of fairness and justice. Assertive facilitator knows how to guide difficult people and handle very hard situations without adopting manipulative behaviors. He is able to detect the potential conflict and to bring to light the reasons for disagreement , softening the tone and avoiding any possible uncontrolled escalation. He encourages debates and open discussions; he has to build links too, fueling reports profits, collaborating with others toward common goals; speaking and discussing in groups and among groups; seeking solutions in which, both parties, come out winning. So the view expressed is argument of discussion in the development of the tools of urban structure, with the aim of implementing a participatory methodology in the development of planning tools. We propose an application in the series of meetings of initial preparatory participation to the formation of a Preliminary Plan for a medium size town.

  2. Relationship between assertiveness and burnout among nurse managers.

    Science.gov (United States)

    Suzuki, Eiko; Saito, Miyuki; Tagaya, Akira; Mihara, Rieko; Maruyama, Akiko; Azuma, Tomomi; Sato, Chifumi

    2009-12-01

    We aimed to clarify the relationship between assertiveness and burnout among nurse managers at university hospitals. The directors at three university hospitals agreed to cooperate with our study. During a one-month period from May to June 2007, a self-administered questionnaire was distributed to 203 nurse managers (head and sub-head nurses). The Japanese version of the Rathus Assertiveness Schedule (J-RAS) and the Japanese version of the Maslach Burnout Inventory (MBI) were used as scales. Burnout was operationally defined as a total MBI score in the highest tertile. Valid responses were obtained from 172 nurse managers. The mean J-RAS score of the burnout group (-14.3) was significantly lower than that of the non-burnout group (-3.3). Responses about work experience and age showed no significant group difference. Total MBI score was inversely correlated with J-RAS score (R = -0.30, P assertiveness and satisfaction with own care provision contributes to preventing burnout among Japanese nurse managers.

  3. Self esteem and assertiveness of final year Turkish university students.

    Science.gov (United States)

    Karagözoğlu, Serife; Kahve, Emine; Koç, Oznur; Adamişoğlu, Derya

    2008-07-01

    This study developed a quantitative methodology to ascertain the level of self esteem and assertiveness of last year students in baccalaureate degree programs at Cumhuriyet University Nursing School, School for Health Sciences' Midwifery School, Education Faculty's Mathematics Teacher, Classroom Teacher, and Social Sciences Teacher programs and to determine if there is a correlation between self esteem and assertiveness. The research population was a total of 372 students who were in their final year of university in these programs. Sampling was not done in the research, the entire population was studied. However there was a total of 82 students who were not included in the research because of illness, absenteeism, registration on hold, who could not be found on campus or who did not want to participate in the research and who did not correctly complete the survey form. The research was conducted with total of 290 students. Total response rate was 77.9%. The data were collected using a "Personal Information Form," Stanley Coopersmith Self Esteem Inventory (SEI) and Rathus Assertiveness Schedule (RAS). Frequency distribution, t test, correlation and variance analysis were used in the analysis of the data. The results of the study were that the nursing students had the highest scores from SEI (80.64+/-15.83). Similarly the nursing students had the highest scores on the RAS (36.29+/-25.33).

  4. Ignored fungal community in activated sludge wastewater treatment plants: diversity and altitudinal characteristics.

    Science.gov (United States)

    Niu, Lihua; Li, Yi; Xu, Lingling; Wang, Peifang; Zhang, Wenlong; Wang, Chao; Cai, Wei; Wang, Linqiong

    2017-02-01

    Fungi are important contributors to the various functions of activated sludge wastewater treatment plants (WWTPs); however, the diversity and geographic characteristics of fungal populations have remained vastly unexplored. Here, quantitative polymerase chain reaction and 454 pyrosequencing were combined to investigate the abundance and diversity of the activated sludge fungal communities from 18 full-scale municipal WWTPs in China. Phylogenetic taxonomy revealed that the members of the fungal communities were assigned to 7 phyla and 195 genera. Ascomycota and Basidiomycota were the most abundant phyla, dominated by Pluteus, Wickerhamiella, and Penicillium. Twenty-three fungal genera, accounting for 50.1 % of the total reads, were shared by 18 WWTPs and constituted a core fungal community. The fungal communities presented similar community diversity but different community structures across the WWTPs. Significant distance decay relationships were observed for the dissimilarity in fungal community structure and altitudinal distance between WWTPs. Additionally, the community evenness increased from 0.25 to 0.7 as the altitude increased. Dissolved oxygen and the C/N ratio were determined to be the most dominant contributors to the variation in fungal community structure via redundancy analysis. The observed data demonstrated the diverse occurrence of fungal species and gave a marked view of fungal community characteristics based on the previously unexplored fungal communities in activated sludge WWTPs.

  5. What breaks a leader: the curvilinear relation between assertiveness and leadership.

    Science.gov (United States)

    Ames, Daniel R; Flynn, Francis J

    2007-02-01

    The authors propose that individual differences in assertiveness play a critical role in perceptions about leaders. In contrast to prior work that focused on linear effects, the authors argue that individuals seen either as markedly low in assertiveness or as high in assertiveness are generally appraised as less effective leaders. Moreover, the authors claim that observers' perceptions of leaders as having too much or too little assertiveness are widespread. The authors linked the curvilinear effects of assertiveness to underlying tradeoffs between social outcomes (a high level of assertiveness worsens relationships) and instrumental outcomes (a low level of assertiveness limits goal achievement). In 3 studies, the authors used qualitative and quantitative approaches and found support for their account. The results suggest that assertiveness (and other constructs with nonlinear effects) might have been overlooked in research that has been focused on identifying what makes a leader rather than on identifying what breaks a leader. ((c) 2007 APA, all rights reserved).

  6. Wastewater treatment plant effluent introduces recoverable shifts in microbial community composition in urban streams

    Science.gov (United States)

    Ledford, S. H.; Price, J. R.; Ryan, M. O.; Toran, L.; Sales, C. M.

    2017-12-01

    New technologies are allowing for intense scrutiny of the impact of land use on microbial communities in stream networks. We used a combination of analytical chemistry, real-time polymerase chain reaction (qPCR) and targeted amplicon sequencing for a preliminary study on the impact of wastewater treatment plant effluent discharge on urban streams. Samples were collected on two dates above and below treatment plants on the Wissahickon Creek, and its tributary, Sandy Run, in Montgomery County, PA, USA. As expected, effluent was observed to be a significant source of nutrients and human and non-specific fecal associated taxa. There was an observed increase in the alpha diversity at locations immediately below effluent outflows, which contributed many taxa involved in wastewater treatment processes and nutrient cycling to the stream's microbial community. Unexpectedly, modeling of microbial community shifts along the stream was not controlled by concentrations of measured nutrients. Furthermore, partial recovery, in the form of decreasing abundances of bacteria and nutrients associated with wastewater treatment plant processes, nutrient cycling bacteria, and taxa associated with fecal and sewage sources, was observed between effluent sources. Antecedent moisture conditions impacted overall microbial community diversity, with higher diversity occurring after rainfall. These findings hint at resilience in stream microbial communities to recover from wastewater treatment plant effluent and are vital to understanding the impacts of urbanization on microbial stream communities.

  7. Microbial Community Profiles in Wastewaters from Onsite Wastewater Treatment Systems Technology.

    Directory of Open Access Journals (Sweden)

    Łukasz Jałowiecki

    Full Text Available The aim of the study was to determine the potential of community-level physiological profiles (CLPPs methodology as an assay for characterization of the metabolic diversity of wastewater samples and to link the metabolic diversity patterns to efficiency of select onsite biological wastewater facilities. Metabolic fingerprints obtained from the selected samples were used to understand functional diversity implied by the carbon substrate shifts. Three different biological facilities of onsite wastewater treatment were evaluated: fixed bed reactor (technology A, trickling filter/biofilter system (technology B, and aerated filter system (the fluidized bed reactor, technology C. High similarities of the microbial community functional structures were found among the samples from the three onsite wastewater treatment plants (WWTPs, as shown by the diversity indices. Principal components analysis (PCA showed that the diversity and CLPPs of microbial communities depended on the working efficiency of the wastewater treatment technologies. This study provided an overall picture of microbial community functional structures of investigated samples in WWTPs and discerned the linkages between microbial communities and technologies of onsite WWTPs used. The results obtained confirmed that metabolic profiles could be used to monitor treatment processes as valuable biological indicators of onsite wastewater treatment technologies efficiency. This is the first step toward understanding relations of technology types with microbial community patterns in raw and treated wastewaters.

  8. Treatment of unruptured arteriovenous malformation. Experience in a community hospital

    International Nuclear Information System (INIS)

    Hirai, Osamu; Matsumoto, Masato; Hirata, Eishu

    2006-01-01

    We experienced 17 patients with unruptured arteriovenous malformation (AVM) in our department. Eight patients presented with epileptic seizure and 9 cases were diagnosed incidentally. Management strategies were as follows: extirpation following embolization in 3, extirpation alone in 2, stereotactic radiosurgery (SRS) alone in 3, SRS following embolization in 1 while no treatment was given on 8 patients based on informed consent. The mean follow-up period was 55.1 months. Disappearance of the lesion was confirmed in 8 of 9 patient with some treatment. In the group, there was no mortality. The 2 morbidities involved postoperative epidural abscess and epilepsy in 1, and transient hemiparesis and motor aphasia following embolization in the other. No hemorrhage was reported in patients with no treatment during the follow-up period. One patient with a frontal AVM has been bothered by intractable seizures in reaction to anticonvulsant medication. Reviewing the literatures, the mean risk of bleeding of the unruptured AVMs is 1 to 3% per year, while factors predicting hemorrhage are controversial. The prescribed treatment, nonetheless, should be defined from an objective assessment of what is optimal for each individual patient as well as from local expertise. (author)

  9. diagnosis and treatment of heart failure in the community

    African Journals Online (AJOL)

    Enrique

    gestion/fluid overload) and institution of basic, standard treatment where appro- priate. .... measures. These include: ..... According to a study of our ancestors' teeth, we evolved into meat-eaters around 2.5 million years ago. Analysis by an ...

  10. The effect of high and low assertiveness on locus of control and health problems.

    Science.gov (United States)

    Williams, J M; Stout, J K

    1985-03-01

    The effect of high and low assertiveness on locus of control and health problems was examined with 78 direct-service workers in mental health and mental retardation settings in northeastern Pennsylvania. The direct-service workers completed the Rathus (1973) Assertiveness Schedule, the Rotter (1966) Internal-External Locus of Control Scale, and a health-problems inventory. Highly assertive individuals were found to be more internally controlled and to experience fewer health problems than were individuals low in assertiveness.

  11. Changes in Personality Disorder Traits Following 2 Years of Treatment in a Secure Therapeutic Community Milieu

    Science.gov (United States)

    Morrissey, Catrin; Taylor, Jon

    2014-01-01

    Therapeutic community treatment models have not previously been applied to forensic patients with mild intellectual disabilities (IDs) with a comorbid diagnosis of personality disorder. Thirteen patients with mild IDs were allocated to a unit within a high secure psychiatric service operating a model of treatment based on the principles and…

  12. Community-based rehabilitation offers cost-effective epilepsy treatment in rural Guinea-Bissau

    NARCIS (Netherlands)

    van Diessen, Eric; van der Maas, Frank; Cabral, Vladimir; Otte, Willem M

    Treatment of epilepsy in low-income countries is a challenge considering the lack of resources, availability of antiepileptic drugs, and cultural beliefs. We used a community-based rehabilitation (CBR) service for the detection, monitoring, and treatment of epilepsy. A local network of trained

  13. Phospholipid fatty acid patterns of microbial communities in paddy soil under different fertilizer treatments

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qi-chun; WANG Guang-huo; YAO Huai-ying

    2007-01-01

    The microbial communities under irrigated rice cropping with different fertilizer treatments, including control (CK), PK, NK, NP, NPK fertilization, were investigated using phospholipid fatty acid (PLFA) profile method. The results of this study revealed that the fertilizer practice had an impact on the community structure of specific microbial groups. The principal components analysis (PCA) showed that proportion of the actinomycete PLFAs (10Me 18:0 and 10Me 16:0) were the lowest in the PK treatment and the highest in the NPK treatment, which means that soil nitrogen status affected the diversity of actinomycetes, whereas nitrogen cycling was related to the actinomycets. Under CK treatment, the ratio of Gram-positive to Gram-negative bacteria was lower compared with that in fertilizer addition treatments, indicating that fertilizer application stimulated Gram-positive bacterial population in paddy soil. The fatty acid 18:2ω6, 9, which is considered to be predominantly of fungal origin, was at low level in all the treatments. The ratio of cy19:0 to 18:1ω7, which has been proposed as an indicator of stress conditions, decreased in PK treatment. Changes of soil microbial community under different fertilizer treatments of paddy soil were detected in this study; however, the causes that lead to changes in the microbial community still needs further study.

  14. Influence of microbial community diversity and function on pollutant removal in ecological wastewater treatment.

    Science.gov (United States)

    Bai, Yaohui; Huo, Yang; Liao, Kailingli; Qu, Jiuhui

    2017-10-01

    Traditional wastewater treatments based on activated sludge often encounter the problems of bulking and foaming, as well as malodor. To solve these problems, new treatment technologies have emerged in recent decades, including the ecological wastewater treatment process, which introduces selected local plants into the treatment system. With a focus on the underlying mechanisms of the ecological treatment process, we explored the microbial community biomass, composition, and function in the treatment system to understand the microbial growth in this system and its role in pollutant removal. Flow cytometry analysis revealed that ecological treatment significantly decreased influent bacterial quantity, with around 80% removal. 16S rRNA gene sequencing showed that the ecological treatment also altered the bacterial community structure of the wastewater, leading to a significant change in Comamonadaceae in the effluent. In the internal ecological system, because most of microbes aggregate in the plant rhizosphere and the sludge under plant roots, we selected two plant species (Nerium oleander and Arundo donax) to study the characteristics of rhizosphere and sludge microbes. Metagenomic results showed that the microbial community composition and function differed between the two species, and the microbial communities of A. donax were more sensitive to seasonal effects. Combined with their greater biomass and abundance of metabolic genes, microbes associated with N. oleander showed a greater contribution to pollutant removal. Further, the biodegradation pathways of some micropollutants, e.g., atrazine, were estimated.

  15. Comparison of microbial community shifts in two parallel multi-step drinking water treatment processes.

    Science.gov (United States)

    Xu, Jiajiong; Tang, Wei; Ma, Jun; Wang, Hong

    2017-07-01

    Drinking water treatment processes remove undesirable chemicals and microorganisms from source water, which is vital to public health protection. The purpose of this study was to investigate the effects of treatment processes and configuration on the microbiome by comparing microbial community shifts in two series of different treatment processes operated in parallel within a full-scale drinking water treatment plant (DWTP) in Southeast China. Illumina sequencing of 16S rRNA genes of water samples demonstrated little effect of coagulation/sedimentation and pre-oxidation steps on bacterial communities, in contrast to dramatic and concurrent microbial community shifts during ozonation, granular activated carbon treatment, sand filtration, and disinfection for both series. A large number of unique operational taxonomic units (OTUs) at these four treatment steps further illustrated their strong shaping power towards the drinking water microbial communities. Interestingly, multidimensional scaling analysis revealed tight clustering of biofilm samples collected from different treatment steps, with Nitrospira, the nitrite-oxidizing bacteria, noted at higher relative abundances in biofilm compared to water samples. Overall, this study provides a snapshot of step-to-step microbial evolvement in multi-step drinking water treatment systems, and the results provide insight to control and manipulation of the drinking water microbiome via optimization of DWTP design and operation.

  16. The Effects of Assertiveness Training on Enhancing the Social Skills of Adolescents with Visual Impairments.

    Science.gov (United States)

    Kim, Young-il

    2003-01-01

    A study of the effects of assertiveness training to enhance the social/assertiveness skills of 36 adolescents with visual impairments found that parents, the students, teachers, and observers judged the adolescents' social skills differently. However, the training did have some specific effect on increasing assertiveness. (Contains references.)…

  17. Inter-Group and Intra-Group Assertiveness: Adolescents' Social Skills Following Cultural Transition

    Science.gov (United States)

    Korem, Anat; Horenczyk, Gabriel; Tatar, Moshe

    2012-01-01

    The goals of this study were to examine intra-group and inter-group assertiveness among adolescents, and to compare these two domains of assertiveness between cultural groups in Israel. Measures of intra-group and inter-group assertiveness were developed, and questionnaires were administrated to 441 immigrants from the Former Soviet Union (FSU),…

  18. Dimensions of Assertiveness: Differential Relationships to Substance Use in Early Adolescence.

    Science.gov (United States)

    Wills, Thomas Ashby; And Others

    1989-01-01

    Tested multidimensional formulation of assertiveness and substance use in 3 metropolitan-area school samples (N=675, N=1,430, and N=5,545) of adolescents including White, Black, and Hispanic students aged 12-14 years. Found Substance-specific Assertiveness inversly associated with substance use and Social Dating Assertiveness positively associated…

  19. Assertiveness expectancies: how hard people push depends on the consequences they predict.

    Science.gov (United States)

    Ames, Daniel R

    2008-12-01

    The present article seeks to explain varying levels of assertiveness in interpersonal conflict and negotiations with assertiveness expectancies, idiosyncratic predictions people make about the social and instrumental consequences of assertive behavior. This account complements motivation-based models of assertiveness and competitiveness, suggesting that individuals may possess the same social values (e.g., concern for relationships) but show dramatically different assertiveness due to different assumptions about behavioral consequences. Results clarify the form of assertiveness expectancies, namely that most people assume increasing assertiveness can yield positive social and instrumental benefits up to a point, beyond which benefits decline. However, people vary in how assertive this perceived optimal point is. These individual differences in expectancies are linked in 4 studies to assertiveness, including self-reported assertiveness, rated behavioral preferences in assorted interpersonal conflict scenarios, partner ratings of participants' behavior in a face-to-face dyadic negotiation, and work colleague ratings of participants' assertiveness in the workplace. In each case, the link between expectancies and behavior remained after controlling for values. The results suggest a place for expectancies alongside values in psychological models of interpersonal assertiveness.

  20. Personality Correlates of Self-Report, Role-Playing, and In Vivo Measures of Assertiveness.

    Science.gov (United States)

    Green, Samuel B.; And Others

    1979-01-01

    Undergraduates completed self-report inventories of assertiveness, participated in behavior role-playing tasks and in vivo measures of assertiveness, and completed the Personality Research Form E (PRF-E). Of 22 PRF-E scales, 11 had at least one significant correlation with assertiveness measures. Some composites of PRF-E scales were related to…

  1. Children's Assertive Behavior: The Reliability and Validity of Three Self-Report Measures.

    Science.gov (United States)

    Scanlon, Elizabeth M.; Ollendick, Thomas H.

    1985-01-01

    The internal consistency and validity of three new scales for measuring assertiveness in children were tested. Two of the scales were able to "unbind" aggressive from assertive behavior, while the third was able to "unbind" submissive from assertive behavior. At present, a combination of the three scales is recommended. (KH)

  2. Application of the Elaboration Likelihood Model of Attitude Change to Assertion Training.

    Science.gov (United States)

    Ernst, John M.; Heesacker, Martin

    1993-01-01

    College students (n=113) participated in study comparing effects of elaboration likelihood model (ELM) based assertion workshop with those of typical assertion workshop. ELM-based workshop was significantly better at producing favorable attitude change, greater intention to act assertively, and more favorable evaluations of workshop content.…

  3. Bacterial communities in full-scale wastewater treatment systems.

    Science.gov (United States)

    Cydzik-Kwiatkowska, Agnieszka; Zielińska, Magdalena

    2016-04-01

    Bacterial metabolism determines the effectiveness of biological treatment of wastewater. Therefore, it is important to define the relations between the species structure and the performance of full-scale installations. Although there is much laboratory data on microbial consortia, our understanding of dependencies between the microbial structure and operational parameters of full-scale wastewater treatment plants (WWTP) is limited. This mini-review presents the types of microbial consortia in WWTP. Information is given on extracellular polymeric substances production as factor that is key for formation of spatial structures of microorganisms. Additionally, we discuss data on microbial groups including nitrifiers, denitrifiers, Anammox bacteria, and phosphate- and glycogen-accumulating bacteria in full-scale aerobic systems that was obtained with the use of molecular techniques, including high-throughput sequencing, to shed light on dependencies between the microbial ecology of biomass and the overall efficiency and functional stability of wastewater treatment systems. Sludge bulking in WWTPs is addressed, as well as the microbial composition of consortia involved in antibiotic and micropollutant removal.

  4. Biomass, Leaf Area, and Resource Availability of Kudzu Dominated Plant Communities Following Herbicide Treatment

    Energy Technology Data Exchange (ETDEWEB)

    L.T. Rader

    2001-10-01

    Kudzu is an exotic vine that threatens the forests of the southern U.S. Five herbicides were tested with regard to their efficacy in controlling kudzu, community recover was monitored, and interactions with planted pines were studied. The sites selected were old farm sites dominated by kudzu.These were burned following herbicide treatment. The herbicides included triclopyr, clopyralid, metsulfuron, tebuthiuron, and picloram plus 2,4-D. Pine seedlings were planted the following year. Regression equations were developed for predicting biomass and leaf area. Four distinct plant communities resulted from the treatments. The untreated check continued to be kudzu dominated. Blackberry dominated the clopyradid treatment. Metsulfron, trychlopyr and picloram treated sites resulted in herbaceous dominated communities. The tebuthiuron treatment maintained all vegetation low.

  5. Costs of day hospital and community residential chemical dependency treatment.

    Science.gov (United States)

    Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane

    2008-03-01

    Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs

  6. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  7. Comparative efficacy of amoxicillin, cefuroxime and clarithromycin in the treatment of community acquired pneumonia in children

    International Nuclear Information System (INIS)

    Aurangzeb, B.; Hameed, A.

    2003-01-01

    Objective: To compare the clinical response to amoxicillin, cefuroxime and clarithromycin in the treatment of community-acquired pneumonia in children and to see the cost effectiveness of each treatment. Subjects and Methods: Patients between 3 to 72 months of age, admitted in the hospital with community acquired pneumonia, were randomly divided into three groups 1,2,3. They were started on amoxicillin, cefuroxime and clarithromycin respectively. The patients were assessed daily. If there was no clinical improvements at 48 hours the antibiotic was changed. ANOVA statistical test was applied to see the clinical response to the treatment in the three groups. Cost effectiveness of the treatment was compared. Results: There was no statistical difference in the clinical response at 48 hours of initiating treatment and discharge (p>0.01 each). The mean hospital stay in group 1 and 2 was 3.3 days and group 3 was 3.2 days respectively (p>0.01). Ninety-seven percent patients in group 1 and 3, and 95% patients in group 2 showed clinical improvement. The cost of treatment of community acquired pneumonia for 8 days was Rs. 496/-, 730/-, 1018/- for amoxicillin, clarithromycin and cefuroxime respectively. Conclusion: Amoxicillin was found in the most cost effective followed by clarithromycin and cefuroxime respectively in the treatment of non-severe and severe community-acquired pneumonia. (author)

  8. Experiences from a community based substance use treatment centre in an urban resettlement colony in India.

    Science.gov (United States)

    Balhara, Yatan Pal Singh; Ranjan, Rajeev; Dhawan, Anju; Yadav, Deepak

    2014-01-01

    Background. There are limited community based treatment services for drug dependence in India. Rural areas and urban resettlement colonies are in particular deficient in such services. Aims. The current study aimed at preliminary assessment of substance use disorder management services at a community based substance use treatment clinic in an urban resettlement colony. Methods. The study was carried out at community based substance use treatment centre in a resettlement colony in India. The records of the centre were chart reviewed. Results. A total of 754 patients were registered at the clinic during the study period. Heroin was the primary drug of abuse for 63% of the patients. The mean duration of follow-up for the patients with opioid and alcohol dependence was 13.47 (SD ± 10.37; range 0-39) months. A total of 220 patients of opioid dependence were prescribed substation or abstinence directed therapy. Buprenorphine (87), slow release oral morphine (SROM) (16), and dextropropoxyphene (98) were used for opioid substitution. Conclusion. It is possible to deliver substance use disorder treatment services in community setting. There is a need to develop area specific community based treatment services for substance abuse in socially disadvantaged populations such as urban resettlement colonies.

  9. The Cascade of Care for an Australian Community-Based Hepatitis C Treatment Service.

    Directory of Open Access Journals (Sweden)

    Amanda J Wade

    Full Text Available Hepatitis C treatment uptake in Australia is low. To increase access to hepatitis C virus treatment for people who inject drugs, we developed a community-based, nurse-led service that linked a viral hepatitis service in a tertiary hospital to primary care clinics, and resulted in hepatitis C treatment provision in the community.A retrospective cohort study of patients referred to the community hepatitis service was undertaken to determine the cascade of care. Logistic regression analyses were used to identify predictors of hepatitis C treatment uptake.Four hundred and sixty-two patients were referred to the community hepatitis service; 344 attended. Among the 279 attendees with confirmed chronic hepatitis C, 257 (99% reported ever injecting drugs, and 124 (48% injected in the last month. Of 201 (72% patients who had their fibrosis staged, 63 (31% had F3-F4 fibrosis. Fifty-five patients commenced hepatitis C treatment; 26 (47% were current injectors and 25 (45% had F3-F4 fibrosis. Nineteen of the 27 (70% genotype 1 patients and 14 of the 26 (54% genotype 3 patients eligible for assessment achieved a sustained virologic response. Advanced fibrosis was a significant predictor of treatment uptake in adjusted analysis (AOR 2.56, CI 1.30-5.00, p = 0.006.Our community hepatitis service produced relatively high rates of fibrosis assessment, hepatitis C treatment uptake and cure, among people who inject drugs. These findings highlight the potential benefits of providing community-based hepatitis C care to people who inject drugs in Australia-benefits that should be realised as direct-acting antiviral agents become available.

  10. Verification of reliability and validity of a Japanese version of the Rathus Assertiveness Schedule.

    Science.gov (United States)

    Suzuki, Eiko; Kanoya, Yuka; Katsuki, Takeshi; Sato, Chifumi

    2007-07-01

    To verify the reliability and validity of a Japanese version of the Rathus Assertiveness Schedule in novice nurses to contribute to nursing management. An adequate scale is needed to measure the assertiveness and the effect of assertion training for Japanese nurses and to compare them with those in other countries. Rathus Assertiveness Schedule was adapted to Japanese with back-translation and its validity was examined in 989 novice nurses. The Japanese version showed a high coefficient of reliability in a split-half reliability test (r=0.76; PAssertiveness Schedule. The Japanese version of Rathus Assertiveness Schedule was verified.

  11. The relationship of extraversion and neuroticism to two measures of assertive behavior.

    Science.gov (United States)

    Vestewig, R E; Moss, M K

    1976-05-01

    One hundred forty-four college students completed the Eysenck Personality Inventory and the Rathus Assertiveness Schedule (RAS) and wrote their behavioral reactions to five scenarios in which an assertive behavior was an appropriate response. Extraversion showed a significant positive correlation with the RAS in both males and females. Neuroticism was negatively correlated with RAS in both sexes. Extraversion and RAS correlated significantly with rated Assertiveness in the scenarios only in the male sample. The RAS predicted variance in Assertiveness beyond that predicted by Extraversion. Overall low correlations of the measures with rated Assertiveness were discussed in terms of the low internal consistency reliability of that scale.

  12. Fertility treatment for the transgender community: a public opinion study.

    Science.gov (United States)

    Goldman, Randi H; Kaser, Daniel J; Missmer, Stacey A; Farland, Leslie V; Scout; Ashby, Rachel K; Ginsburg, Elizabeth S

    2017-11-01

    The purposes of this study were to evaluate public opinion regarding fertility treatment and gamete cryopreservation for transgender individuals and identify how support varies by demographic characteristics. This is a cross-sectional web-based survey study completed by a representative sample of 1111 US residents aged 18-75 years. Logistic regression was used to calculate odd ratios (ORs) and 95% confidence intervals (CIs) of support for/opposition to fertility treatments for transgender people by demographic characteristics, adjusting a priori for age, gender, race, and having a biological child. Of 1336 people recruited, 1111 (83.2%) agreed to participate, and 986 (88.7%) completed the survey. Most respondents (76.2%) agreed that "Doctors should be able to help transgender people have biological children." Atheists/agnostics were more likely to be in support (88.5%) than Christian-Protestants (72.4%; OR = 3.10, CI = 1.37-7.02), as were younger respondents, sexual minorities, those divorced/widowed, Democrats, and non-parents. Respondents who did not know a gay person (10.0%; OR = 0.20, CI = 0.09-0.42) or only knew a gay person without children (41.4%; OR = 0.29, CI = 0.17-0.50) were more often opposed than those who knew a gay parent (48.7%). No differences in gender, geography, education, or income were observed. A smaller majority of respondents supported doctors helping transgender minors preserve gametes before transitioning (60.6%) or helping transgender men carry pregnancies (60.1%). Most respondents who support assisted and third-party reproduction also support such interventions to help transgender people have children.

  13. Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium.

    Science.gov (United States)

    Goethals, Ilse; Vanderplasschen, Wouter; Vandevelde, Stijn; Broekaert, Eric

    2012-10-11

    Research on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients' early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument. Data was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients' early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process). Clients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients' ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients' ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores. Special attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients' (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the

  14. Comparison of ASSERT subchannel code with Marviken bundle data

    International Nuclear Information System (INIS)

    Tahir, A.; Carver, M.B.

    1984-04-01

    In this paper ASSERT predictions are compared with the Marviken 6-rod bundle and 36+1 rod bundle. The predictions are presented for two experiments in the 6-rod bundle and four experiments in the 36+1 rod bundle. For low inlet subcooling, the void predictions are in good agreement with the experimental data. For high inlet subcooling, however, the agreement is not as good. This is attributed to the fact that in the high inlet subcooling experiments, single phase turbulent mixing plays a more important role in determining flow conditions in the bundle

  15. Metagenomic analysis of an ecological wastewater treatment plant's microbial communities and their potential to metabolize pharmaceuticals.

    Science.gov (United States)

    Balcom, Ian N; Driscoll, Heather; Vincent, James; Leduc, Meagan

    2016-01-01

    Pharmaceuticals and other micropollutants have been detected in drinking water, groundwater, surface water, and soil around the world. Even in locations where wastewater treatment is required, they can be found in drinking water wells, municipal water supplies, and agricultural soils. It is clear conventional wastewater treatment technologies are not meeting the challenge of the mounting pressures on global freshwater supplies. Cost-effective ecological wastewater treatment technologies have been developed in response. To determine whether the removal of micropollutants in ecological wastewater treatment plants (WWTPs) is promoted by the plant-microbe interactions, as has been reported for other recalcitrant xenobiotics, biofilm microbial communities growing on the surfaces of plant roots were profiled by whole metagenome sequencing and compared to the microbial communities residing in the wastewater. In this study, the concentrations of pharmaceuticals and personal care products (PPCPs) were quantified in each treatment tank of the ecological WWTP treating human wastewater at a highway rest stop and visitor center in Vermont. The concentrations of detected PPCPs were substantially greater than values reported for conventional WWTPs likely due to onsite recirculation of wastewater. The greatest reductions in PPCPs concentrations were observed in the anoxic treatment tank where Bacilli dominated the biofilm community. Benzoate degradation was the most abundant xenobiotic metabolic category identified throughout the system. Collectively, the microbial communities residing in the wastewater were taxonomically and metabolically more diverse than the immersed plant root biofilm. However, greater heterogeneity and higher relative abundances of xenobiotic metabolism genes was observed for the root biofilm.

  16. Assertive communication in condom negotiation: Insights from late adolescent couples’ subjective ratings of self and partner

    Science.gov (United States)

    Schmid, Amy; Leonard, Noelle R.; Ritchie, Amanda S.; Gwadz, Marya V.

    2015-01-01

    Purpose Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically-involved couples in the context of a condom negotiation task. Methods Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners’ level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Results Individuals’ assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, while moderate levels of assertiveness were associated with higher condom use. Conclusions Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths’ ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. PMID:25937470

  17. Assertive Communication in Condom Negotiation: Insights From Late Adolescent Couples' Subjective Ratings of Self and Partner.

    Science.gov (United States)

    Schmid, Amy; Leonard, Noelle R; Ritchie, Amanda S; Gwadz, Marya V

    2015-07-01

    Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically involved couples in the context of a condom negotiation task. Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners' level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Individuals' assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, whereas moderate levels of assertiveness were associated with higher condom use. Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths' ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Bacterial community composition of a wastewater treatment system reliant on N{sub 2} fixation

    Energy Technology Data Exchange (ETDEWEB)

    Reid, N.M.; Bowers, T.H.; Lloyd-Jones, G. [Scion, Rotorua (New Zealand)

    2008-05-15

    The temporal stability and change of the dominant phylogenetic groups of the domain bacteria were studied in a model plant-based industrial wastewater treatment system showing high levels of organic carbon removal supported by high levels of N{sub 2} fixation. Community profiles were obtained through terminal restriction fragment length polymorphism analysis and cloning of 16S rRNA amplicons followed by sequencing. Bacterial community profiles showed that ten common terminal restriction fragments made up approximately 50% of the measured bacterial community. As much as 42% of the measured bacterial community could be monitored by using quantitative PCR and primers that targeted three dominant operational taxonomic units. Despite changes in wastewater composition and dissolved oxygen levels, the bacterial community composition appeared stable and was dominated by {alpha}-Proteobacteria and {beta}-Proteobacteria, with a lesser amount of the highly diverse bacterial phylum Bacteroidetes. A short period of considerable change in the bacterial community composition did not appear to affect treatment performance indicating functional redundancy in this treatment system. (orig.)

  19. Treatment technology for removing radon from small community water supplies

    International Nuclear Information System (INIS)

    Kinner, N.E.; Quern, P.A.; Schell, G.S.; Lessard, C.E.; Clement, J.A.

    1990-01-01

    This paper reports on the selection of an appropriate treatment system to remove radon from drinking water which depends primarily upon percent removal; capital and operating and maintenance costs; safety; raw water quality with respect to parameters such as Fe, Mn, bacteria, and organics. The radon removal efficiency of the diffused bubble and packed tower aeration exceeded 99% at A:W ratios of 15:1 and 5:1, respectively; the GAC system averaged 81 ± 7.7%. Though our field evaluations indicated that GAC systems may not be as efficient as aeration systems, the system tested was operated above design requirements for most of the study period. Other researchers have found removals of greater than 99% with GAC point-of-entry applications. Therefore, each of these processes has the potential to consistently remove 99% of the radon applied. However, even this percent removal may not be sufficient to meet an MCL in the range of 200 to 1000 pCi/L if the raw water contained more than 20,000 to 100,000 pCi/L, respectively

  20. Gambling severity, impulsivity, and psychopathology: comparison of treatment- and community-recruited pathological gamblers.

    Science.gov (United States)

    Knezevic, Bojana; Ledgerwood, David M

    2012-01-01

    Because most studies of pathological gambling gather data from participants recruited from treatment, this study compared community and treatment-enrolled pathological gamblers (PGs) with respect to demographics, gambling severity, impulsivity, and psychopathology. One hundred six PGs were recruited as part of two larger studies in Farmington, Connecticut (n= 61) and Windsor, Ontario (n= 45) using radio advertising, word of mouth, and/or newspaper ads, as well as a gambling treatment program at each location. Community (n= 49) and treatment-enrolled (n= 57) PGs did not differ on age, education, gender, race, employment, or marital status. Treatment-enrolled PGs were more likely to report past year illegal behaviors, preoccupation with gambling, and higher scores on the Barratt Impulsiveness Scale (BIS) Attention Impulsivity subscale. Assessment of psychopathology in the Ontario study indicated that treatment-enrolled PGs were more likely to present with Major Depressive and Dysthymic Disorders. Community-recruited PGs in the Connecticut study were overall more likely to present with any substance use disorder relative to their treatment-enrolled counterparts. Our findings inform intervention and research within the field of pathological gambling. Specifically, the distressing aspects of pathological gambling, such as legal issues, preoccupation with gambling, and depression, may be present more in treatment-enrolled PGs than in those recruited from the community. Such emotional disturbances should be further explored to increase motivation and treatment adherence in PGs. In addition, due to relative absence of overall differences between the groups, research findings utilizing treatment-enrolled PGs may be a good representation of both groups. Copyright © American Academy of Addiction Psychiatry.

  1. Antibiotic treatment of urinary tract infection by community pharmacists: a cross-sectional study.

    Science.gov (United States)

    Booth, Jill L; Mullen, Alexander B; Thomson, David A M; Johnstone, Christopher; Galbraith, Susan J; Bryson, Scott M; McGovern, Elizabeth M

    2013-04-01

    Urinary tract infections (UTIs) are one of the most common conditions seen in female patients within primary care. Community pharmacists are familiar with symptomatic UTI management and supplying trimethoprim under patient group direction (PGD) for moderate-to-severe uncomplicated UTIs could improve patient access to treatment. To compare the care pathway of patients with UTI symptoms attending GP services with those receiving management, including trimethoprim supply under PGD, via community pharmacies. Prospective, cross-sectional, mixed methods approach in 10 community pharmacies within NHS Greater Glasgow and Clyde. Pharmacies invited a purposive sample of female patients to participate. Pharmacists had the option of supplying trimethoprim under PGD to patients with moderate-to-severe infection meeting the PGD inclusion criteria. Data from patient (questionnaires and semi-structured telephone interviews) and pharmacist (questionnaires and semi-structured, face-to-face interviews) were quantitatively and qualitatively analysed. Data were recorded on 153 patients, 97 presenting with GP prescriptions and 56 presenting directly in the pharmacy with symptoms suggestive of UTI, of whom 41 received trimethoprim via PGD and 15 received symptomatic management. Both GP adherence to local infection management guidelines and pharmacist application of PGD inclusion/exclusion criteria required improvement. There was demand and support, from patients and pharmacists, for access to antibiotic treatments for UTIs, without prescription, through community pharmacies. Operating within PGD controls, antibiotic treatments for UTIs could be provided via community pharmacy to improve patient access to treatment which may also maintain antibiotic stewardship and reduce GP workload.

  2. Barriers to community-based drug dependence treatment: implications for police roles, collaborations and performance indicators

    Science.gov (United States)

    Ma, Yi; Du, Chunhua; Cai, Thomas; Han, Qingfeng; Yuan, Huanhuan; Luo, Tingyan; Ren, Guoliang; Mburu, Gitau; Wang, Bangyuan; Golichenko, Olga; Zhang, Chaoxiong

    2016-01-01

    Introduction Worldwide, people who use drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based drug dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based drug treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based drug dependence treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results We identified three challenges to community-based drug treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of treatment. We also identified the take-home methadone maintenance treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions To overcome barriers to effective community-based drug treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust

  3. Ammonia oxidizing bacteria community dynamics in a pilot-scale wastewater treatment plant.

    Directory of Open Access Journals (Sweden)

    Xiaohui Wang

    Full Text Available BACKGROUND: Chemoautotrophic ammonia oxidizing bacteria (AOB have the metabolic ability to oxidize ammonia to nitrite aerobically. This metabolic feature has been widely used, in combination with denitrification, to remove nitrogen from wastewater in wastewater treatment plants (WWTPs. However, the relative influence of specific deterministic environmental factors to AOB community dynamics in WWTP is uncertain. The ecological principles underlying AOB community dynamics and nitrification stability and how they are related are also poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: The community dynamics of ammonia oxidizing bacteria (AOB in a pilot-scale WWTP were monitored over a one-year period by Terminal Restriction Fragment Length Polymorphism (T-RFLP. During the study period, the effluent ammonia concentrations were almost below 2 mg/L, except for the first 60 days, indicting stable nitrification. T-RFLP results showed that, during the test period with stable nitrification, the AOB community structures were not stable, and the average change rate (every 15 days of AOB community structures was 10% ± 8%. The correlations between T-RFLP profiles and 10 operational and environmental parameters were tested by Canonical Correlation Analysis (CCA and Mantel test. The results indicated that the dynamics of AOB community correlated most strongly with Dissolved Oxygen (DO, effluent ammonia, effluent Biochemical Oxygen Demand (BOD and temperature. CONCLUSIONS/SIGNIFICANCE: This study suggests that nitrification stability is not necessarily accompanied by a stable AOB community, and provides insight into parameters controlling the AOB community dynamics within bioreactors with stable nitrification.

  4. Achieving Security Assurance with Assertion-based Application Construction

    Directory of Open Access Journals (Sweden)

    Carlos E. Rubio-Medrano

    2015-12-01

    Full Text Available Modern software applications are commonly built by leveraging pre-fabricated modules, e.g. application programming interfaces (APIs, which are essential to implement the desired functionalities of software applications, helping reduce the overall development costs and time. When APIs deal with security-related functionality, it is critical to ensure they comply with their design requirements since otherwise unexpected flaws and vulnerabilities may consequently occur. Often, such APIs may lack sufficient specification details, or may implement a semantically-different version of a desired security model to enforce, thus possibly complicating the runtime enforcement of security properties and making it harder to minimize the existence of serious vulnerabilities. This paper proposes a novel approach to address such a critical challenge by leveraging the notion of software assertions. We focus on security requirements in role-based access control models and show how proper verification at the source-code level can be performed with our proposed approach as well as with automated state-of-the-art assertion-based techniques.

  5. The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities.

    Science.gov (United States)

    Legha, Rupinder Kaur; Novins, Douglas

    2012-07-01

    Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.

  6. Seasonal variations of microbial community in a full scale oil field produced water treatment plant

    Directory of Open Access Journals (Sweden)

    Q. Xie

    2016-01-01

    Full Text Available This study investigated the microbial community in a full scale anaerobic baffled reactor and sequencing batch reactor system for oil-produced water treatment in summer and winter. The community structures of fungi and bacteria were analyzed through polymerase chain reaction–denaturing gradient gel electrophoresis and Illumina high-throughput sequencing, respectively. Chemical oxygen demand effluent concentration achieved lower than 50 mg/L level after the system in both summer and winter, however, chemical oxygen demand removal rates after anaerobic baffled reactor treatment system were significant higher in summer than that in winter, which conformed to the microbial community diversity. Saccharomycotina, Fusarium, and Aspergillus were detected in both anaerobic baffled reactor and sequencing batch reactor during summer and winter. The fungal communities in anaerobic baffled reactor and sequencing batch reactor were shaped by seasons and treatment units, while there was no correlation between abundance of fungi and chemical oxygen demand removal rates. Compared to summer, the total amount of the dominant hydrocarbon degrading bacteria decreased by 10.2% in anaerobic baffled reactor, resulting in only around 23% of chemical oxygen demand was removed in winter. Although microbial community significantly varied in the three parallel sulfide reducing bacteria, the performance of these bioreactors had no significant difference between summer and winter.

  7. Seasonal variations of microbial community in a full scale oil field produced water treatment plant

    International Nuclear Information System (INIS)

    Xie, Q.; Bai, S.; Li, Y.; Liu, L.; Wang, S.; Xi, J.

    2016-01-01

    This study investigated the microbial community in a full scale anaerobic baffled reactor and sequencing batch reactor system for oil-produced water treatment in summer and winter. The community structures of fungi and bacteria were analyzed through polymerase chain reaction–denaturing gradient gel electrophoresis and Illumina high throughput sequencing, respectively. Chemical oxygen demand effluent concentration achieved lower than 50 mg/L level after the system in both summer and winter, however, chemical oxygen demand removal rates after anaerobic baffled reactor treatment system were significant higher in summer than that in winter, which conformed to the microbial community diversity. Saccharomycotina, Fusarium, and Aspergillus were detected in both anaerobic baffled reactor and sequencing batch reactor during summer and winter. The fungal communities in anaerobic baffled reactor and sequencing batch reactor were shaped by seasons and treatment units, while there was no correlation between abundance of fungi and chemical oxygen demand removal rates. Compared to summer, the total amount of the dominant hydrocarbon degrading bacteria decreased by 10.2% in anaerobic baffled reactor, resulting in only around 23% of chemical oxygen demand was removed in winter. Although microbial community significantly varied in the three parallel sulfide reducing bacteria, the performance of these bioreactors had no significant difference between summer and winter.

  8. Impact of 3 years ivermectin treatment on onchocerciasis in Yanomami communities in the Brazilian Amazon.

    Science.gov (United States)

    Banic, Dalma M; Calvão-Brito, Regina H S; Marchon-Silva, Verônica; Schuertez, Joana C; de Lima Pinheiro, Luís Renerys; da Costa Alves, Marilene; Têva, Antônio; Maia-Herzog, Marilza

    2009-11-01

    In the current study, it was assessed, for the first time, the effect of ivermectin treatment administered twice a year on the prevalence and morbidity of onchocerciasis in the hyperendemic Yanomami communities of the Roraima State (Brazil). Physical and parasitological examinations were carried out every 6 months until six drug rounds of treatment were completed. The coverage during the six rounds of ivermectin treatment ranged from 89% to 92% of the eligible Yanomami population. Overall, comparison of results at pre-treatment with results after six rounds of treatment, the prevalence of infection had declined from 87% to 42% (P0.05, for both). These findings suggest that mass population treatment should continue without interruption and achieve higher levels of drug coverage in order to alleviate disease manifestations and interrupt infection transmission to hasten the elimination of onchocerciasis in Yanomami communities. In addition, the sensitivity of iliac crest snips for parasitological assessment in epidemiological surveillance of Yanomami communities may increase the acceptance of the population in biopsy sampling and seems to be a good choice for assessing the success of control programs.

  9. Motivation and treatment credibility predict alliance in cognitive behavioral treatment for youth with anxiety disorders in community clinics.

    Science.gov (United States)

    Fjermestad, K W; Lerner, M D; McLeod, B D; Wergeland, G J H; Haugland, B S M; Havik, O E; Öst, L-G; Silverman, W K

    2017-11-16

    We examined whether motivation and treatment credibility predicted alliance in a 10-session cognitive behavioral treatment delivered in community clinics for youth anxiety disorders. Ninety-one clinic-referred youths (mean age  = 11.4 years, standard deviation = 2.1, range 8-15 years, 49.5% boys) with anxiety disorders-rated treatment motivation at pretreatment and perceived treatment credibility after session 1. Youths and therapists (YT) rated alliance after session 3 (early) and session 7 (late). Hierarchical linear models were applied to examine whether motivation and treatment credibility predicted YT early alliance, YT alliance change, and YT alliance agreement. Motivation predicted high early YT alliance, but not YT alliance change or alliance agreement. Youth-rated treatment credibility predicted high early youth alliance and high YT positive alliance change, but not early therapist alliance or alliance agreement. Conclusion Efforts to enhance youth motivation and treatment credibility early in treatment could facilitate the formation of a strong YT alliance. © 2017 Wiley Periodicals, Inc.

  10. Modified Therapeutic Community Treatment for Offenders with Co-Occurring Disorders: Mental Health Outcomes

    Science.gov (United States)

    Sullivan, Christopher J.; Sacks, Stanley; McKendrick, Karen; Banks, Steven; Sacks, Joann Y.; Stommel, Joseph

    2007-01-01

    This paper examines outcomes 12 months post-prison release for offenders with co-occurring disorders (n = 185) randomly assigned to either a mental health control treatment (C) or a modified therapeutic community (E). Significant between-group differences were not found for mental health measures, although improvements were observed for each…

  11. Capacity Enhancement of Hepatitis C Virus Treatment through Integrated, Community-Based Care

    Directory of Open Access Journals (Sweden)

    Warren D Hill

    2008-01-01

    Full Text Available BACKGROUND: An estimated 250,000 Canadians are infected with the hepatitis C virus (HCV. The present study describes a cohort of individuals with HCV referred to community-based, integrated prevention and care projects developed in British Columbia. Treatment outcomes are reported for a subset of individuals undergoing antiviral therapy at four project sites.

  12. Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

    Science.gov (United States)

    Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

    2013-01-01

    A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

  13. Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

    Science.gov (United States)

    DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

    2012-01-01

    Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

  14. Treatment Plans in Psychiatric Community Housing Programs : Do They Reflect Rehabilitation Principles?

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Visser, Ellen; Caro-Nienhuis, Annemarie D.; van Weeghel, Jaap; Sytema, Sjoerd; Wiersma, Durk

    2012-01-01

    Objective: This study examined the extent to which treatment plans of service users of community housing programs measure up to rehabilitation principles according to the Choose-Get-Keep model of psychiatric rehabilitation. The study evaluates whether these plans correspond with service-user and

  15. Integration of treatment wetlands as sustainable wastewater management systems for small communities

    Energy Technology Data Exchange (ETDEWEB)

    Dahab, M.F.; Surampalli, R.Y. [Univ. of Nebraski-Lincoln, Dept. of Civil Engineering, Lincoln, NE (United States)

    2002-06-15

    This paper discuses the applicability as well as the integration of the constructed wetlands technology within the environmental infrastructure in small communities. To that end, a case study involving the use of Constructed wetlands (CW) for waste management in the Nebraska plains is presented. CW systems have been shown to be effective treatment alternatives in resource-limited small communities; and hence, can contribute to improving the economic well-being and the sustainability of many small communities. The paper specifically discusses the performance of subsurface-flow constructed wetlands systems used as the wastewater treatment process for a small community in eastern Nebraska and outlines operational experience gained through five years of plant operation. The results show that effective and sufficient CW seasonal removals of TSS, VSS, CBOD{sub 5}, COD, and fecal coliform were achieved. Wastewater temperatures seemed to affect CBOD{sub 5} and COD removal rates. Nitrogen and phosphorus reductions were not as effective and varied seasonally, as well as with wastewater temperature. The addition of a sand filter, to aid in further nitrification and disinfection following CW treatment, markedly improved the performance of the wetlands system. After a few years of operation, the performance of the system was dampened by apparent clogging and subsequent eruption of wastewater at the head-end of the treatment cells. While clogging was partially caused by biomass build-up in the wetlands substrate, visual observations suggest that excessive vegetation and relaxed maintenance may also be responsible. (author)

  16. Recommendations for the diagnosis, treatment and prevention of the pneumonia acquired in the community in adults

    International Nuclear Information System (INIS)

    2003-01-01

    The pneumonia acquired in the community in adults, is the acute infection of the pulmonary parenchyma that is developed away from the hospital environment, it is manifested in the first 48 hours from the entrance to the hospital or after seven days of having left. The supplement includes clinical square, epidemiology, etiology classification, diagnostic, treatment and prevention among others

  17. Integration of treatment wetlands as sustainable wastewater management systems for small communities

    International Nuclear Information System (INIS)

    Dahab, M.F.; Surampalli, R.Y.

    2002-01-01

    This paper discuses the applicability as well as the integration of the constructed wetlands technology within the environmental infrastructure in small communities. To that end, a case study involving the use of Constructed wetlands (CW) for waste management in the Nebraska plains is presented. CW systems have been shown to be effective treatment alternatives in resource-limited small communities; and hence, can contribute to improving the economic well-being and the sustainability of many small communities. The paper specifically discusses the performance of subsurface-flow constructed wetlands systems used as the wastewater treatment process for a small community in eastern Nebraska and outlines operational experience gained through five years of plant operation. The results show that effective and sufficient CW seasonal removals of TSS, VSS, CBOD 5 , COD, and fecal coliform were achieved. Wastewater temperatures seemed to affect CBOD 5 and COD removal rates. Nitrogen and phosphorus reductions were not as effective and varied seasonally, as well as with wastewater temperature. The addition of a sand filter, to aid in further nitrification and disinfection following CW treatment, markedly improved the performance of the wetlands system. After a few years of operation, the performance of the system was dampened by apparent clogging and subsequent eruption of wastewater at the head-end of the treatment cells. While clogging was partially caused by biomass build-up in the wetlands substrate, visual observations suggest that excessive vegetation and relaxed maintenance may also be responsible. (author)

  18. Onchocerciasis control in Nigeria: will households be able to afford community-directed treatment with ivermectin?

    Science.gov (United States)

    Onwujekwe, O; Shu, E; Onwuameze, O; Ndum, C; Okonkwo, P

    2001-12-21

    To determine the level of affordability of community-directed treatment with ivermectin (CDTI) to households living in two onchocerciasis endemic Nigerian communities namely Toro in the north and Nike in the south. The proportion of the cost of treating people with ivermectin will deplete in average monthly/projected annual household expenditure on food and health care, and on average monthly and projected annual household income were respectively calculated and used to determine the level of affordability of CDTI. Questionnaires administered to heads of households or their representatives were used to collect information on the household expenditures and income. The suggested unit CDTI cost of $0.20 was used. However, as a test of sensitivity, we also used the unit cost of $0.056 which some community based distributors are charging per treatment. Using $0.20 as the unit treatment cost, this will consume less than 0.05% of average annual household income in both communities. It will equally deplete 0.05% of combined annual household expenditures on food and health care in both communities. However, using $0.056 as the unit treatment cost, then 0.02% of average annual household expenditure on health care, 0.01% average annual expenditure on combined health care and food, and 0.01% of average annual household income will be depleted. The households living in both communities may be able to afford CDTI schemes. However, the final decision on levels of affordability lies with the households. They will decide whether they can afford to trade-off some household income for ivermectin distribution.

  19. Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

    Science.gov (United States)

    Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

    2017-09-01

    Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues

  20. Intensive treatment models and coercion

    DEFF Research Database (Denmark)

    Ohlenschlaeger, Johan; Thorup, Anne; Petersen, Lone

    2007-01-01

    . Hospital-based Rehabilitation, an intensified inpatient treatment model, Integrated Treatment, an intensified model of Assertive Community Treatment, and standard treatment were compared for patients with first-episode schizophrenia-spectrum disorders. Ninety-four patients with first-episode schizophrenia......Little evidence exists concerning the optimal treatment for patients with first-episode schizophrenia-spectrum disorders and the effect on traditional outcomes. The aim was to investigate whether optimal treatment models have an effect on the level of use of coercion and on traditional outcomes......-spectrum disorders estimated to benefit from long-term hospitalization were included consecutively from the Copenhagen OPUS-trial and randomized to the three treatment models. At 1-year follow-up, Hospital-based Rehabilitation and Integrated Treatment had better scores on symptoms in the negative dimension...

  1. Follow-up at a Dutch addiction hospital and effectiveness of therapeutic community treatment.

    Science.gov (United States)

    van de Velde, J C; Schaap, G E; Land, H

    1998-06-01

    This paper reports on inpatient treatment of addicts. Attention is paid to the Therapeutic Community (TC) model employed with alcoholics. A sample of 881 patients was assessed at intake and was followed up. The results demonstrate that the patients improved on a variety of outcome measures. Some associations were found between patient variables and improvement. Treatment variables predicting a positive outcome were sustained treatment in a TC and attending AA meetings. The relative efficacy of TCs, originally created by drug users, holds for alcoholics as well. It is concluded that an important precondition to a positive treatment outcome is the continuity of the treatment process. Pursuing that continuity seems to be an excellent mediate goal for both addicts and treatment personnel.

  2. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

    Directory of Open Access Journals (Sweden)

    Yoshito Kawakatsu

    2017-02-01

    Full Text Available Abstract Background The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW. The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. Methods The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS. In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Results Factors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Conclusions Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate

  3. Self-reported assertiveness in Swedish and Turkish adolescents: a cross-cultural comparison.

    Science.gov (United States)

    Eskin, Mehmet

    2003-02-01

    The present cross-cultural study compared self-reported assertiveness in 652 Swedish and 654 Turkish high school students by using a multi-dimensional measure called the Scale for Interpersonal Behavior (SIB). Four hypotheses were tested in the study. First, the hypothesis that Swedish adolescents would be more assertive than their Turkish counterparts was supported by the data. Second, the expectation that Turkish boys would be more assertive than Turkish girls, while there would be no differences between Swedish girls and boys, was not confirmed. In general, girls were found to be more skilled than boys in expressing and dealing with personal limitations. Third, as expected, more assertive adolescents in both Sweden and Turkey reported having more friends and receiving more social support than their less assertive peers. Finally, the data supported the expectation that older adolescents would be more assertive than younger ones. The results are discussed in terms of cultural and gender differences.

  4. Number of sexual partners and sexual assertiveness predict sexual victimization: do more partners equal more risk?

    Science.gov (United States)

    Walker, Dave P; Messman-Moore, Terri L; Ward, Rose Marie

    2011-01-01

    In previous studies, number of sexual partners and sexual assertiveness were examined as independent risk factors for sexual victimization among college women. Using a sample of 335 college women, this study examined the interaction of number of sexual partners and sexual assertiveness on verbal sexual coercion and rape. Approximately 32% of the sample reported unwanted sexual intercourse, 6.9% (n = 23) experienced verbal sexual coercion, 17.9% (n = 60) experienced rape, and 7.2% (n = 24) experienced both. As number of sexual partners increased, instances of verbal sexual coercion increased for women low in relational sexual assertiveness but not for women high in relational sexual assertiveness. A similar relationship was not found for rape. Among women who experienced both verbal sexual coercion and rape, increases in number of partners in the context of low refusal and relational assertiveness were associated with increases in verbal sexual coercion and rape. Findings suggest sexual assertiveness is related to fewer experiences of sexual coercion.

  5. What is SAMHSA Doing to Help Communities Make Good Decisions About the Allocation of Scarce Treatment Resources?

    National Research Council Canada - National Science Library

    Iguchi, Maetin

    2000-01-01

    .... For example, a single person may be enrolled in drug treatment, may be getting treatment for depression at a community mental health center, may be on Medicaid, and could be involved with a criminal...

  6. Significance of microcystin production by benthic communities in water treatment systems of arid zones.

    Science.gov (United States)

    Hurtado, I; Aboal, M; Zafra, E; Campillo, D

    2008-02-01

    The study of the dynamics of phytobenthic and phytoplankton communities was undertaken, during a year, in the regulation reservoir associated with a water treatment plant (WTP), which provides the city of Murcia (Spain) with drinking water. Water samples were collected in different stages of the treatment. In the reservoir, the presence of dissolved and intracellular microcystins is constant, both in benthos and in plankton. The collected samples show a positive correlation between the dissolved microcystins and the benthic ones in the reservoir itself, as well as in an upstream reservoir (Ojós Reservoir). The treatment process (ozone+clarification+ozone+activated carbon) is very effective in the removal of toxins, and the drinking water produced is totally free of microcystins. The incorporation of the benthic communities in the routine check for the presence of microcystins is recommended, since it is not compulsory according to the current legislation.

  7. Community

    Science.gov (United States)

    stability Science & Innovation Collaboration Careers Community Environment Science & Innovation Recruitment Events Community Commitment Giving Campaigns, Drives Economic Development Employee Funded neighbor pledge: contribute to quality of life in Northern New Mexico through economic development

  8. Irish nursing students' changing levels of assertiveness during their pre-registration programme.

    Science.gov (United States)

    Begley, Cecily M; Glacken, Michèle

    2004-10-01

    Stress and bullying have been found to be common problems in a number of studies of Irish nursing and midwifery. Victims of bullying need high levels of assertiveness to enable them to withstand the stress of victimization. It was deemed important to measure nursing students' level of assertiveness prior to, and near completion of, their pre-registration education programme. Aim. To ascertain nursing students' perceived levels of assertiveness prior to, and nearing the completion of, their three-year pre-registration programme. Ethical approval was given. The students commencing general nurse education programmes in two schools in Southern Ireland agreed to take part (n=72). A questionnaire adapted from a number of assertiveness scales, and tested for validity and reliability in this population, was used to collect data. In general, students' reported assertiveness levels rose as they approached completion of their three-year education programme. The resource constrained health service of the 21st century requires nurses who are assertive to meet the needs of its users. Nursing students' assertiveness skills could be augmented through concentrated efforts from nurse educationalists and clinicians to reduce the communication theory practice gap in nurse education today. To address the multi-dimensional nature of assertiveness, strategies to increase assertiveness should operate at the individual, interface and organisational level. The students in this study reported an increase in levels of assertiveness as they approached completion of their three-year education programme. To function as effective, safe practitioners registered nurses need to be assertive, therefore education in assertiveness should be an integral part of their preparation. The precise composition and mode of delivery of this education requires exploration and evaluation.

  9. Considering communities in forest management planning in western Oregon.

    Science.gov (United States)

    Ellen M. Donoghue; N. Lynnae Sutton; Richard W. Haynes

    2007-01-01

    A recurrent theme in the development of U.S. forest policies has been the assertion of strong positive relations among communities, economies, and natural resource management. Now as a new round of federal land management planning is getting underway, questions are being raised about the strength of that assertion and how to view communities following a decade of...

  10. Treatment of Pancreatic and Periampullary Cancers at a Community Hospital: Successful Application of Tertiary Care Treatment Standards

    Science.gov (United States)

    Moesinger, Robert C.; Davis, Jan W.; Hill, Britani; Johnston, W. Cory; Gray, Carl; Johnson, Harold; Ingersoll, Leslye; Whipple, Gary; Reilly, Mark; Harris, Robert; Hansen, Vincent

    2011-01-01

    Background. The treatment of pancreatic cancer and other periampullary neoplasms is complex and challenging. Major high-volume cancer centers can provide excellent multidisciplinary care of these patients but almost two-thirds of pancreatic cancer patients are treated at low volume centers. There is very little published data from low volume community cancer programs in regards to the treatment of periampullary cancer. In this study, a review of comprehensive periampullary cancer care at two low volume hospitals with comparison to national standards is presented. Methods. This is a retrospective review of 70 consecutive patients with periampullary neoplasms who underwent surgery over a 5-year period (2006–2010) at two community hospitals. Results. There were 51 successful resections of 70 explorations (73%) including 34 Whipple procedures. Mortality rate was 2.9%. Comparison of these patients to national standards was made in terms of operative mortality, resectability rate, administration of adjuvant therapy, clinical trial participation and overall survival. The results in these patients were comparable to national standards. Conclusions. With adequate commitment of resources and experienced surgical and oncologic practitioners, community cancer centers can meet national tertiary care standards in terms of pancreatic and periampullary cancer care. PMID:22312532

  11. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Directory of Open Access Journals (Sweden)

    Alicia K. Matthews

    2013-01-01

    Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.

  12. Ibuprofen removal in horizontal subsurface flow constructed wetlands: treatment performance and fungal community dynamics.

    Science.gov (United States)

    Zhang, Dongqing; Luo, Jinxue; Lee, Zarraz May Ping; Gersberg, Richard M; Liu, Yu; Tan, Soon Keat; Ng, Wun Jern

    2016-01-01

    The treatment performance of ibuprofen (IBP)-enriched wastewater by horizontal subsurface flow constructed wetlands planted with cattail (Typha angustifolia) and unplanted control mesocosms was investigated. Removal efficiencies of IBP were significantly (p fungal community in these wetland systems. The overall diversity of the fungal community was reduced under the IBP exposure. Taxonomic analysis revealed that 62.2% of the fungal sequences were affiliated with Basidiomycota, followed by Ascomycota (37.4%) at the phylum level. Uncultured fungus (48.2%), Chaetomium sp. (14.2%), Aspergillus sp. (12.4%), Trichoderma sp. (5.7%), Cladosporium sp. (5.4%), and Emericellopsis sp. (5.2%) were identified as dominant genera. At the genus level, a distinct profile of the fungal community in the IBP-enriched mesocosms was observed as compared to the control beds, and as well specific fungal genera were enhanced in the planted beds, regardless of IBP enrichment. However, despite these differences, the composition of the fungal community (as measured by Bray-Curtis similarity) was mostly unaffected by the significant IBP enrichment. On the other hand, a consistent similarity pattern of fungal community structure in the planted mesocosms suggests that the presence of higher macrophytes in the wetland systems may well help shape the fungal community structure.

  13. Inter-group and intra-group assertiveness: adolescents' social skills following cultural transition.

    Science.gov (United States)

    Korem, Anat; Horenczyk, Gabriel; Tatar, Moshe

    2012-08-01

    The goals of this study were to examine intra-group and inter-group assertiveness among adolescents, and to compare these two domains of assertiveness between cultural groups in Israel. Measures of intra-group and inter-group assertiveness were developed, and questionnaires were administrated to 441 immigrants from the Former Soviet Union (FSU), 242 immigrants from Ethiopia and 333 non-immigrants. Compared to non-immigrants, FSU and Ethiopian immigrants' inter-group assertiveness was lower. Girls reported higher levels of inter-group assertiveness than boys. Each of the immigrant groups rates itself as equally assertive as the non-immigrant group and more assertive than the other immigrant group. Also, a difference between inter-group and intra-group assertiveness was found among the FSU immigrants. It is argued that adolescents' assertiveness following cultural transition is associated with socio-cultural context, and the implications of this conclusion are discussed. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  14. The test of truth: an experimental investigation of the norm of assertion.

    Science.gov (United States)

    Turri, John

    2013-11-01

    Assertion is fundamental to our lives as social and cognitive beings. Philosophers have recently built an impressive case that the norm of assertion is factive. That is, you should make an assertion only if it is true. Thus far the case for a factive norm of assertion been based on observational data. This paper adds experimental evidence in favor of a factive norm from six studies. In these studies, an assertion's truth value dramatically affects whether people think it should be made. Whereas nearly everyone agreed that a true assertion supported by good evidence should be made, most people judged that a false assertion supported by good evidence should not be made. The studies also suggest that people are consciously aware of criteria that guide their evaluation of assertions. Evidence is also presented that some intuitive support for a non-factive norm of assertion comes from a surprising tendency people have to misdescribe cases of blameless rule-breaking as cases where no rule is broken. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Electricity Generation and Community Wastewater Treatment by Microbial Fuel Cells (MFCs)

    Science.gov (United States)

    Rakthai, S.; Potchanakunakorn, R.; Changjan, A.; Intaravicha, N.; Pramuanl, P.; Srigobue, P.; Soponsathien, S.; Kongson, C.; Maksuwan, A.

    2018-05-01

    The attractive solution to the pressing issues of energy production and community wastewater treatment was using of Microbial Fuel Cells (MFCs). The objective of this research was to study the efficiency of electricity generation and community wastewater treatment of MFCs. This study used an experimental method completely randomized design (CRD), which consisted of two treatment factors (4×5 factorial design). The first factor was different solution containing organic matter (T) and consisting of 4 level factors including T1 (tap water), T2 (tap water with soil), T3 (50 % V/V community wastewater with soil), and T4 (100% community wastewater with soil). The second factor was the time (t), consisting of 5 level factors t1 (day 1), t2 (day 2), t3 (day 3), t4 (day 4), and t5 (day 5). There were 4 experimental models depending on containing organic matter (T1-T4). The parameter measured consisted of Open Circuit Voltage (OCV), Chemical Oxygen Demand (COD), Total Dissolve Solid (TDS), acidity (pH), Electric Conductivity (EC) and number of bacteria. Data were analysed by ANOVA, followed by Duncan test. The results of this study showed that, the T3 was the highest voltage at 0.816 V (P<0.05) and T4, T2, and Ti were 0.800, 0.797 and 0.747 V, respectively. The T3 was the lowest COD at 24.120 mg/L and T4 was 38.067 mg/L (P<0.05). The best model for electricity generation and community wastewater treatment by Microbial Fuel Cells was T3. This model generated highest voltage at 0.816 V, and reduction of COD at 46.215%.

  16. Profile of tobacco users amongst treatment seekers: A comparison between clinic and community sample

    Directory of Open Access Journals (Sweden)

    Savita Malhotra

    2017-01-01

    Full Text Available Background and objectives: Despite the huge burden of tobacco use or addiction, there has been a glaring scarcity of resources to tackle the problem. Although some of the tobacco users want to quit, very few have the opportunity to seek help from available treatment facilities. The study aimed to find out the profile of treatment seekers from clinic and community programs and also to compare the two groups. Method: This is a cross sectional, retrospective study of subjects enrolled in the clinic and various community outreach programs of a Tobacco Cessation Centre from the year 2002-2011. Modified intake form developed by the WHO was administered to the subjects. Results: Significant difference was found between the two groups with regard to the age of treatment seeking, education and socio economic status. Older subjects reported in greater numbers to the clinic, whereas younger subjects belonged to the community group. Community group had lower level of education, belonged to lower or upper lower socio economic status whereas clinic group had higher level of education and were from the middle or upper socio economic status. Curiosity (Z score = 3.2,P = 0.001 played a significant role in initiating the use in clinic group whereas role model (Z score = 5.1, P = <0.0001 and low self esteem (Z score = 2.0, P = 0.023 were significantly associated with community sample. Presence of medical complications (Z score = 12.5, P = <0.0001, awareness of physical harm of nicotine (Z score = 5.0, P = <0.0001 and awareness of addiction was significantly more in the clinic group. Interpretation and Conclusions: The difference in the socio-demographic and clinical profile of tobacco users in these two treatment groups is noteworthy, and is expected to offer useful information for the clinicians and as well as for the policy makers.

  17. Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers.

    Science.gov (United States)

    Guerrero, Erick G; Padwa, Howard; Lengnick-Hall, Rebecca; Kong, Yinfei; Perrigo, Judith L

    2015-07-01

    Using a random sample of 48 outpatient mental health programs in low-income and racial and ethnic minority communities, this study examined directorial leadership, drug treatment licensure, and implementation of evidence-based protocols and practices to address co-occurring mental health and substance abuse disorders (COD). Understanding of findings was enhanced with focus groups at six clinics. Most programs (81 %) offered COD treatment. Directorial leadership was positively associated with COD treatment (β = 0.253, p = 0.047, 95 % CI 0.003, 0.502) and COD supervision and training (β = 0.358, p = 0.002, 95 % CI 0.142, 0.575). Licensure was negatively associated with COD treatment (β = -0.235, p = 0.041, 95 % CI -0.460, -0.010) and COD supervision and training (β = -0.195, p = 0.049, 95 % CI -0.389, -0.001). Although lack of financial integration may limit the effect of licensing on COD treatment implementation, the response of leaders to regulation, funding, and human resources issues may encourage COD treatment practices. Implications for leadership interventions and policy are discussed in the context of health care reform.

  18. A new service model for the treatment of severe anorexia nervosa in the community: the Anorexia Nervosa Intensive Treatment Team

    Science.gov (United States)

    Munro, Calum; Thomson, Victoria; Corr, Jean; Randell, Louise; Davies, Jennie E.; Gittoes, Claire; Honeyman, Vicky; Freeman, Chris P.

    2014-01-01

    Aims and method A community intensive treatment service for severe anorexia nervosa is described. The service is multidisciplinary but driven by a focus on psychological formulation. Psychological and dietetic interventions are grounded in a process of active risk management. Evaluations of safety, cost and acceptability of the service are described. Results Patients are highly satisfied with their care. A relatively low mortality rate for such a high-risk population was observed. In-patient bed use and costs were substantially reduced. Clinical implications There is a case for greater use of intensive community care for patients with severe anorexia nervosa, as it can be acceptable to patients, relatively safe and cost less than admission. PMID:25285220

  19. Reasons for the treatment of users of crack in a therapeutic community

    Directory of Open Access Journals (Sweden)

    Maycon Rogério Seleghim

    2015-07-01

    Full Text Available Objective: Knowing the motivation of crack users for treatment in hospital environments. Method: Descriptive and qualitative search, using the design of some cases. Twenty male crack users, aged over 18 years old, hospitalized in a Therapeutic Community in Southern Brazil, were interviewed. A semi-structured interview was used and the data were analyzed by their thematic content. Results: Were found three categories that reflect the treatment motivations: perception of the crack harmful consequences; the compulsive use of drugs as the treatment initiation; and, the family participation looking for a treatment. Conclusion: Significant events (turning points favored the interruption of the crack use and the family assumed a very important place to the users behavior in relation to the use of the drug, exclusively. Descriptors: Street drugs, Crack Cocaine, Substance Abuse Treatment Centers, Family.

  20. Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Antisocial Personality Disorder and Treatment Outcomes

    Science.gov (United States)

    McKendrick, Karen; Sullivan, Christopher; Banks, Steven; Sacks, Stanley

    2006-01-01

    Treatment outcomes 1 year after release from prison were compared for two subgroups of male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders, those with a diagnosis for Antisocial Personality Disorder (APD), and those without a diagnosis of APD. The foundation study had randomly assigned inmates to either…

  1. Youth motivation as a predictor of treatment outcomes in a community mental health system.

    Science.gov (United States)

    Merrill, Brett M; Warren, Jared S; Garcia, Darren J; Hardy, Sam A

    2017-03-01

    The purpose of this study was to examine the relationship between youth motivation and psychotherapy outcomes in routine community mental health settings. One hundred fifty youth, ages 12-17, from three community mental health clinics completed the Youth Outcome Questionnaire and Treatment Support Measure at frequent intervals over the course of treatment. Increases in motivation followed a curvilinear trajectory. On average, youth motivation significantly increased over the course of therapy according to both self- and parent reports (p motivation over the course of therapy was negatively associated with the slope for mental health symptoms (p motivation did not predict overall change or the rate of change in symptoms. However, there was significant individual variability in patterns of youth motivation. Our findings demonstrate that youth show increases in motivation over the course of therapy with most gains occurring in the first few sessions. Because increases in motivation over the course of therapy were related to decreases in mental health symptoms, further research is needed to examine how treatment interventions or other factors such as parent motivation may moderate this relationship. Additional research examining the likely complex relationship between initial youth motivation and treatment outcomes in community mental health settings is needed.

  2. The red road to wellness: cultural reclamation in a Native First Nations community treatment center.

    Science.gov (United States)

    Gone, Joseph P

    2011-03-01

    This article explores how Native American cultural practices were incorporated into the therapeutic activities of a community-controlled substance abuse treatment center on a "First Nations" reserve in the Canadian north. Analysis of open-ended interviews with nineteen staff and clients-as contextualized by participant observation, program records, and existing ethnographic resources-yielded insights concerning local therapeutic practice with outpatients and other community members. Specifically, program staff adopted and promoted a diverse array of both western and Aboriginal approaches that were formally integrated with reference to the Aboriginal symbol of the medicine wheel. Although incorporations of indigenous culture marked Lodge programs as distinctively Aboriginal in character, the subtle but profound influence of western "therapy culture" was centrally evident in healing activities as well. Nuanced explication of these activities illustrated four contributions of cultural analysis for community psychology.

  3. Assertive Anger Mediates Effects of Dialectical Behaviour-informed Skills Training for Borderline Personality Disorder: A Randomized Controlled Trial.

    Science.gov (United States)

    Kramer, Ueli; Pascual-Leone, Antonio; Berthoud, Laurent; de Roten, Yves; Marquet, Pierre; Kolly, Stéphane; Despland, Jean-Nicolas; Page, Dominique

    2016-05-01

    Dialectical behaviour therapy (DBT)-informed skills training for borderline personality disorder (BPD) aims at the development of specific emotion regulation skills in patients, particularly with regard to the regulation of problematic anger. While the effects of dialectical behaviour skills training have been shown, their processes of change are rarely examined. Neacsiu, Rizvi and Linehan (2010) found that patient's self-reported use of emotion regulation skills was a mediator of therapeutic change in these treatments; however, they found no effect for problematic anger. From an integrative perspective on anger (Pascual-Leone & Greenberg, 2007; Pascual-Leone & Paivio, 2013), there are several forms of anger, varying in their degree of therapeutic productivity. The present add-on randomized controlled trial included n = 41 patients with BPD (n = 21 DBT-informed skills training versus n = 20 treatment as usual). The first study examined the outcome of the DBT-informed skills training encompassing basic components of training in mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. Results showed that symptom reduction was significantly greater in the DBT-informed skills training, compared with the treatment as usual. The second study used process assessment, for which all patient completers underwent a 50-min-long psychological interview both early and late in treatment, which was rated using the Classification of Affective Meaning States. DBT-informed skills training produced increased levels of primary 'assertive' anger, as compared with the treatment as usual, whereas no effect was found for 'rejecting' secondary anger. Most importantly, we showed that changes in assertive anger mediated the reported symptom reduction, in particular in patient's social roles. We discuss these results in the context of underlying mechanisms of change in DBT skills group treatments, in particular towards developing more productive forms of

  4. The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study.

    Science.gov (United States)

    Lee, Tso-Ying; Chang, Shih-Chin; Chu, Hsin; Yang, Chyn-Yng; Ou, Keng-Liang; Chung, Min-Huey; Chou, Kuei-Ru

    2013-11-01

    In this study, we investigated the effects of group assertiveness training on assertiveness, social anxiety and satisfaction with interpersonal communication among patients with chronic schizophrenia. Only limited studies highlighted the effectiveness of group assertiveness training among inpatients with schizophrenia. Given the lack of group assertiveness training among patients with schizophrenia, further development of programmes focusing on facilitating assertiveness, self-confidence and social skills among inpatients with chronic schizophrenia is needed. This study used a prospective, randomized, single-blinded, parallel-group design. This study employed a prospective, randomized, parallel-group design. Seventy-four patients were randomly assigned to experimental group receiving 12 sessions of assertiveness training, or a supportive control group. Data collection took place for the period of June 2009-July 2010. Among patients with chronic schizophrenia, assertiveness, levels of social anxiety and satisfaction with interpersonal communication significantly improved immediately after the intervention and at the 3-month follow-up in the intervention group. The results of a generalized estimating equation (GEE) indicated that: (1) assertiveness significantly improved from pre- to postintervention and was maintained until the follow-up; (2) anxiety regarding social interactions significantly decreased after assertiveness training; and (3) satisfaction with interpersonal communication slightly improved after the 12-session intervention and at the 3-month follow-up. Assertivenss training is a non-invasive and inexpensive therapy that appears to improve assertiveness, social anxiety and interpersonal communication among inpatients with chronic schizophrenia. These findings may provide a reference guide to clinical nurses for developing assertiveness-training protocols. © 2013 Blackwell Publishing Ltd.

  5. Increased Mental Health Treatment Financing, Community-Based Organization's Treatment Programs, and Latino-White Children's Financing Disparities.

    Science.gov (United States)

    Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve

    2017-09-01

    Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional

  6. Depression Screening at a Community Health Fair: Descriptives and Treatment Linkage.

    Science.gov (United States)

    Opperman, Kiel J; Hanson, Devin M; Toro, Paul A

    2017-08-01

    Health fairs are a cost-efficient platform for dissemination of preventive services to vulnerable populations. Effectiveness of depression screenings and associated treatment linkage via community health fairs warrants investigation. This study offers the first examination of a depression screening at a community health fair in 261 adult men (18-87years). The PHQ-9 was administered via interview by graduate students and on-site psychiatric nurses were available for a brief consultation for those interested. Over a quarter of participants screened positive for at least moderate depressive symptomatology. Of those who screened positive, 35.8% met with an on-site psychiatric nurse for a consultation. At six-month follow-up, none of the participants given a referral made an appointment at the community mental health agency. This suggests the importance of providing on-site clinician consultations at health fairs and the need for a more coordinated system to schedule future appointments while at the event. Community health fairs reach vulnerable populations, such as those who are uninsured and who have not spoken with a professional about mental health concerns. By conducting depression screening and providing onsite access to a mental health consultation at community health fairs, participants are better able to identify their depressive symptoms and are introduced to ways to treat depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Microbial community functional structures in wastewater treatment plants as characterized by GeoChip.

    Science.gov (United States)

    Wang, Xiaohui; Xia, Yu; Wen, Xianghua; Yang, Yunfeng; Zhou, Jizhong

    2014-01-01

    Biological WWTPs must be functionally stable to continuously and steadily remove contaminants which rely upon the activity of complex microbial communities. However, knowledge is still lacking in regard to microbial community functional structures and their linkages to environmental variables. To investigate microbial community functional structures of activated sludge in wastewater treatment plants (WWTPs) and to understand the effects of environmental factors on their structure. 12 activated sludge samples were collected from four WWTPs in Beijing. A comprehensive functional gene array named GeoChip 4.2 was used to determine the microbial functional genes involved in a variety of biogeochemical processes such as carbon, nitrogen, phosphorous and sulfur cycles, metal resistance, antibiotic resistance and organic contaminant degradation. High similarities of the microbial community functional structures were found among activated sludge samples from the four WWTPs, as shown by both diversity indices and the overlapped genes. For individual gene category, such as egl, amyA, lip, nirS, nirK, nosZ, ureC, ppx, ppk, aprA, dsrA, sox and benAB, there were a number of microorganisms shared by all 12 samples. Canonical correspondence analysis (CCA) showed that the microbial functional patterns were highly correlated with water temperature, dissolved oxygen (DO), ammonia concentrations and loading rate of chemical oxygen demand (COD). Based on the variance partitioning analyses (VPA), a total of 53% of microbial community variation from GeoChip data can be explained by wastewater characteristics (25%) and operational parameters (23%), respectively. This study provided an overall picture of microbial community functional structures of activated sludge in WWTPs and discerned the linkages between microbial communities and environmental variables in WWTPs.

  8. Microbial community functional structures in wastewater treatment plants as characterized by GeoChip.

    Directory of Open Access Journals (Sweden)

    Xiaohui Wang

    Full Text Available BACKGROUND: Biological WWTPs must be functionally stable to continuously and steadily remove contaminants which rely upon the activity of complex microbial communities. However, knowledge is still lacking in regard to microbial community functional structures and their linkages to environmental variables. AIMS: To investigate microbial community functional structures of activated sludge in wastewater treatment plants (WWTPs and to understand the effects of environmental factors on their structure. METHODS: 12 activated sludge samples were collected from four WWTPs in Beijing. A comprehensive functional gene array named GeoChip 4.2 was used to determine the microbial functional genes involved in a variety of biogeochemical processes such as carbon, nitrogen, phosphorous and sulfur cycles, metal resistance, antibiotic resistance and organic contaminant degradation. RESULTS: High similarities of the microbial community functional structures were found among activated sludge samples from the four WWTPs, as shown by both diversity indices and the overlapped genes. For individual gene category, such as egl, amyA, lip, nirS, nirK, nosZ, ureC, ppx, ppk, aprA, dsrA, sox and benAB, there were a number of microorganisms shared by all 12 samples. Canonical correspondence analysis (CCA showed that the microbial functional patterns were highly correlated with water temperature, dissolved oxygen (DO, ammonia concentrations and loading rate of chemical oxygen demand (COD. Based on the variance partitioning analyses (VPA, a total of 53% of microbial community variation from GeoChip data can be explained by wastewater characteristics (25% and operational parameters (23%, respectively. CONCLUSIONS: This study provided an overall picture of microbial community functional structures of activated sludge in WWTPs and discerned the linkages between microbial communities and environmental variables in WWTPs.

  9. Microbes in biological processes for municipal landfill leachate treatment: Community, function and interaction

    DEFF Research Database (Denmark)

    Zhang, Duoying; Vahala, Riku; Wang, Yu

    2016-01-01

    Landfill leachate (LFL) contains high strength of ammonium and complex organic substances including biodegradable volatile fatty acids (VFAs), refractory aquatic humic substances (AHS) and micro-scale xenobiotic organic chemicals (XOCs), which promotes the diverse microbial community in LFL...... treatment bioreactors. These microbes cooperate to remove nitrogen, biodegrade organic matters, eliminate the toxicity of XOCs and produce energy. In these diverse microbes, some show dominant in the bioreactor and are prevalent in many kinds of LFL treatment bio-processes, such as Brocadia from the phylum...

  10. Bacterial Community Structure Shifted by Geosmin in Granular Activated Carbon System of Water Treatment Plants.

    Science.gov (United States)

    Pham, Ngoc Dung; Lee, Eun-Hee; Chae, Seon-Ha; Cho, Yongdeok; Shin, Hyejin; Son, Ahjeong

    2016-01-01

    We investigated the relation between the presence of geosmin in water and the bacterial community structure within the granular activated carbon (GAC) system of water treatment plants in South Korea. GAC samples were collected in May and August of 2014 at three water treatment plants (Sungnam, Koyang, and Yeoncho in Korea). Dissolved organic carbon and geosmin were analyzed before and after GAC treatment. Geosmin was found in raw water from Sungnam and Koyang water treatment plants but not in that from Yeoncho water treatment plant. Interestingly, but not surprisingly, the 16S rRNA clone library indicated that the bacterial communities from the Sungnam and Koyang GAC systems were closely related to geosmin-degrading bacteria. Based on the phylogenetic tree and multidimensional scaling plot, bacterial clones from GAC under the influence of geosmin were clustered with Variovorax paradoxus strain DB 9b and Comamonas sp. DB mg. In other words, the presence of geosmin in water might have inevitably contributed to the growth of geosmin degraders within the respective GAC system.

  11. Mental Health Treatment Seeking Among Veteran and Civilian Community College Students.

    Science.gov (United States)

    Fortney, John C; Curran, Geoffrey M; Hunt, Justin B; Lu, Liya; Eisenberg, Daniel; Valenstein, Marcia

    2017-08-01

    A Web-based survey examined treatment seeking among community college students to inform the design of engagement interventions. Veteran and civilian community college students (N=765) were screened for mental disorders and reported perceptions of treatment need, effectiveness, and stigma, as well as service use. Regression analysis identified predictors of pharmacotherapy and psychotherapy use. Of the 511 students who screened positive for a current mental disorder or reported a perceived need for treatment (149 veterans and 362 civilians), 30% reported past-year use of psychotropic medications. Predictors were perceived treatment need (odds ratio [OR]=7.81, p<.001) and the perception that psychotropic medications are effective (OR=3.38, p=.012). Eleven percent of participants reported past-year psychotherapy use, and predictors were a positive screen for posttraumatic stress disorder (OR=2.78, p=.04) and poorer financial status. Modifiable barriers, including perceived need for and effectiveness of treatment, were correlated with pharmacotherapy use and should be targeted by engagement interventions.

  12. Characteristics of microbial community functional structure of a biological coking wastewater treatment system.

    Science.gov (United States)

    Joshi, Dev Raj; Zhang, Yu; Zhang, Hong; Gao, Yingxin; Yang, Min

    2018-01-01

    Nitrogenous heterocyclic compounds are key pollutants in coking wastewater; however, the functional potential of microbial communities for biodegradation of such contaminants during biological treatment is still elusive. Herein, a high throughput functional gene array (GeoChip 5.0) in combination with Illumina HiSeq2500 sequencing was used to compare and characterize the microbial community functional structure in a long run (500days) bench scale bioreactor treating coking wastewater, with a control system treating synthetic wastewater. Despite the inhibitory toxic pollutants, GeoChip 5.0 detected almost all key functional gene (average 61,940 genes) categories in the coking wastewater sludge. With higher abundance, aromatic ring cleavage dioxygenase genes including multi ring1,2diox; one ring2,3diox; catechol represented significant functional potential for degradation of aromatic pollutants which was further confirmed by Illumina HiSeq2500 analysis results. Response ratio analysis revealed that three nitrogenous compound degrading genes- nbzA (nitro-aromatics), tdnB (aniline), and scnABC (thiocyanate) were unique for coking wastewater treatment, which might be strong cause to increase ammonia level during the aerobic process. Additionally, HiSeq2500 elucidated carbozole and isoquinoline degradation genes in the system. These findings expanded our understanding on functional potential of microbial communities to remove organic nitrogenous pollutants; hence it will be useful in optimization strategies for biological treatment of coking wastewater. Copyright © 2017. Published by Elsevier B.V.

  13. Microbial community and treatment ability investigation in AOAO process for the optoelectronic wastewater treatment using PCR-DGGE biotechnology.

    Science.gov (United States)

    Chen, Hsi-Jien; Lin, Yi-Zi; Fanjiang, Jen-Mao; Fan, Chihhao

    2013-04-01

    This study aimed to explore the microbial community variation and treatment ability of a full-scale anoxic-aerobic-anoxic-aerobic (AOAO) process used for optoelectronic wastewater treatment. The sludge samples in the biological treatment units were collected and subsequently subjected to polymerase chain reaction (PCR) amplification and denaturing gradient gel electrophoresis identification and the wastewater components such as BOD5 and NH3-N were evaluated during the processes. The group specific primers selected were targeting at the kingdom Bacteria, the Acidobacterium, the α-proteobacteria, the β-proteobacteria ammonia oxidizers, Actinobacteria and methyllotrophs, and the 16S rDNA clone libraries were established. Ten different clones were obtained using the Bacteria primers and eight different clones were obtained using the β-proteobacteria ammonia oxidizer primers. Over 95 % of BOD5 and 90 % of NH3-N were removed from the system. The microbial community analysis showed that the Janthinobacterium sp. An8 and Nitrosospira sp. were the dominant species throughout the AOAO process. Across the whole clone library, six clones showed closely related to Janthinobacterium sp. and these species seemed to be the dominant species with more than 50 % occupancy of the total population. Nitrosospira sp. was the predominant species within the β-proteobacteria and occupied more than 30 % of the total population in the system. These two strains were the novel species specific to the AOAO process for optoelectronic treatment, and they were found strongly related to the system capability of removing aquatic contaminants by inspecting the wastewater concentration variation across the system.

  14. Bill (declared urgency) asserting the national commitment for the environment

    International Nuclear Information System (INIS)

    2009-01-01

    The bill asserting the French national commitment for the environment (also named 'Grenelle 2') is considered as the juridical tool-box of the French environmental policy. It confirms, strengthens, and concretizes the objectives defined by the Grenelle 1 law. The main dispositions of the bill concern the following domains: settlement and urbanism with the improvement of the energy efficiency, energy conservation and life-cycle of buildings; transports with the development of sustainable transportation systems; energy with the creation of regional climate, air and energy schemes with the aim of developing renewable energies (with some restrictions concerning wind power) and reducing CO 2 emissions; biodiversity with the creation of ecological pathways between protected areas for the migration of flora and fauna species; environment and waste management with the reinforcement of measures for the abatement of environmental pollutant effects. Among the numerous dispositions involving more than 20 codes (urbanism, environment, buildings etc..) one concerns the progressive implementation of a 'carbon price' index taking into account the greenhouse gas emission costs during the whole life cycle of a product, another one concerns the monitoring of indoor air quality in public buildings. This document is made of three parts. Part 1 is the exposition of the intentions of each article of the bill, part 2 is the bill itself and part 3 is the impact study of the bill in terms of economical, social and environmental impact. (J.S.)

  15. Virtual world for helping teens practice assertiveness skills

    Science.gov (United States)

    Nemire, Kenneth; Beil, Joshua; Swan, Ronald W.

    1999-05-01

    Smoking is on the rise among adolescents. This pilot project combined the well-documented benefits of Life Skills Training (LST) with the unique multisensory, 3D qualities of virtual environment (VE) technology to address some of the disadvantages of traditional prevention programs by engaging teens better, presenting information more persuasively, and making prevention programs continuously available in computer labs. In an eight-week pilot study, 45 seventh- grade students were randomly assigned to LST, VE, or non- intervention control groups. The VE system included goggles, synthesized speech, head and hand trackers, hand-held controller, and speech recognition. Questionnaires measured participants' smoking knowledge and behavior,a participants' reports on the usability of the VE system, and reports of simulator sickness symptoms. Structured interviews with randomly selected participants from each group revealed more detailed information. Data indicated the VE group retained more information and had more positive experiences learning about dangers of smoking and assertiveness skills than did the LST group. Usability data showed ease of use and learning of the VE system, with no significant symptoms of simulator sickness. These data indicated that this VE application is a promising tool for keeping teens healthy.

  16. Noradrenaline might enhance assertive human social behaviours: an investigation in a flatmate relationship.

    Science.gov (United States)

    Tse, W S; Bond, A J

    2006-09-01

    The aim of the present study was to explore the role of noradrenaline on the social behaviour of healthy volunteers when they were interacting with a familiar person, their flatmate. Interaction with the flatmate was explored in a cooperative game situation. Ten pairs of same-sex healthy volunteer flatmates aged 18-25 years were recruited for the experiment. All volunteers gave written informed consent and the study was approved by the institutional ethical committee. A randomised, double blind, placebo-controlled crossover trial of reboxetine versus placebo was conducted. In each of the 10 pairs of volunteers, one (subject) volunteered to take the tablets and the other (flatmate) received no treatment. Reboxetine (4 mg/bd) and placebo were administered orally as identical capsules for 2 weeks. The subjects were randomly assigned to receive either reboxetine or placebo first and there was a two-week washout period following the first treatment. At baseline and the end of each treatment, they filled in the Beck Depression Inventory (BDI), Social Adapation Self-Evaluation Scale (SASS), and Aggression Questionnaire (AQ). Then, they were instructed to play the Tangrams game. This task elicits face-valid social behaviours such as cooperation, giving commands and unilateral grasps. Analysis of covariance showed that there was a statistical trend for reboxetine treatment to increase commands (p=0.055). This study presents preliminary evidence that two weeks' enhancement of noradrenaline transmission induced by reboxetine makes healthy volunteers more self-confident and assertive.

  17. A Study of Assertive Discipline and Recommendations for Effective Classroom Management Methods.

    Science.gov (United States)

    Ellis, David W.; Karr-Kidwell, PJ

    Lee Canter's Assertive Discipline method was studied using a survey of 72 high school teachers' attitudes. Assertive Discipline calls for firm but fair rules, negative consequences for inappropriate behavior, and positive consequences for positive behavior, all set by the teacher. After a lengthy literature review, the survey is discussed.…

  18. Examining China’s Assertiveness through the Eyes of Chinese IR Scholars

    DEFF Research Database (Denmark)

    Feng, Huiyun; He, Kai

    China’s assertive diplomacy in recent years has ignited intense debates among International Relations (IR) scholars. Some argue that China’s assertive behavior is rooted in its perception of increasing power and capabilities. Others suggest that it is U.S. policies that triggered China’s assertiv...

  19. Sexual Assertiveness Mediates the Effect of Social Interaction Anxiety on Sexual Victimization Risk among College Women

    Science.gov (United States)

    Schry, Amie R.; White, Susan W.

    2013-01-01

    Sexual victimization is prevalent among college women and is associated with adverse psychological consequences. Social anxiety, particularly related to interpersonal interaction, may increase risk of sexual victimization among college women by decreasing sexual assertiveness and decreasing the likelihood of using assertive resistance techniques.…

  20. Correlates of Adolescent Assertiveness with HIV Avoidance in a Four-Nation Sample

    Science.gov (United States)

    Onuoha, Francis N.; Munakata, Tsunetsugu

    2005-01-01

    Adolescents are frequently admonished to be socially assertive in order to confront negative interpersonal peer influences. Since the advent of HIV/AIDS in human social chemistry, the admonition has become more critical than ever. But the warning is often proffered in the misguided presumption that social assertiveness is the all-required…

  1. Four-Year Results of a Youth Smoking Prevention Program Using Assertiveness Training.

    Science.gov (United States)

    Del Greco, Linda; And Others

    1986-01-01

    Seventh graders (N=161) participated in health education classes consisting of either an innovative smoking education program, the program plus assertiveness training, or a traditional smoking education program. Data collected four years later revealed no significant differences in smoking behavior, changes in assertion, or sex differences among…

  2. The Rathus Assertiveness Schedule: Reliability at the Junior High School Level

    Science.gov (United States)

    Vaal, Joseph J.; McCullagh, James

    1977-01-01

    This research was an attempt to determine the usefullness of the Rathus Assertiveness Schedule with pre-adolescent and early adolescent students. Previously it has been used with outpatients, institutionalized adults, or with college students. The RAS is a thirty item schedule that was developed for measuring assertiveness. (Author/RK)

  3. Conversational Skills for Autistic Adolescents: Teaching Assertiveness in Naturalistic Game Settings.

    Science.gov (United States)

    McGee, Gail G.; And Others

    1984-01-01

    A naturalistic social skills training program was used to teach assertive responses to three autistic adolescents in the context of two game situations. Results demonstrated the effectiveness of the procedure in generating high levels of positive and negative assertions that maintained across a 4.5-month follow-up interval. (Author/CL)

  4. Assertiveness and Attitudes of HIV/AIDS Orphaned Girls Towards Education in Kampala (Uganda).

    Science.gov (United States)

    Kitara, David Lagoro; Amongin, Hellen Christine; Oonyu, Joseph C; Baguma, Peter K

    2013-08-09

    Whereas HIV/AIDS prevalence has been declining in Uganda from 30% to less than 10% in the last 2 decades, the number of HIV/AIDS orphaned girls in secondary schools is still high and girl children have tended to carry the heaviest burdens of family responsibilities thereby adversely affecting their assertiveness and attitudes towards education. Assertiveness is a critical life skill that enables a person to state an opinion, claim a right, or establish authority and it is important to improve attitude towards education. This study examined the relationship between assertiveness and attitude towards education of HIV/AIDS orphaned and non-orphaned adolescent school girls in Kampala. The California Psychological Inventory (CPI) Dominance (Do) Assertiveness Scale and the Attitude Scale were administered to 225 students consecutively selected from 6 secondary schools in Kampala. HIV/AIDS Orphaned girls had lower levels of assertiveness and most had a negative attitude towards education compared to non-orphaned girls. Girls orphaned to HIV/AIDS were less assertive compared to those orphaned by other causes. There was a positive relationship between assertiveness and attitude towards education among orphaned adolescent secondary school girls in Kampala. Girls orphaned to HIV/AIDS were less assertive compared to other school girls and have a poor attitude towards education.

  5. Assertive Skills and Academic Performance in Primary and Secondary Education, Giftedness, and Conflictive Students

    Science.gov (United States)

    Marugan de Miguelsanz, Montserrat; Carbonero Martin, Miguel Angel; Palazuelo Martinez, Ma Marcela

    2012-01-01

    Introduction: This study explores the level of assertiveness in various samples of students from Primary and Secondary Education. With the data obtained, on the one hand, we analyzed the relation between assertiveness and academic performance and, on the other, we verified whether students who are excluded from the norm, either because of their…

  6. High estradiol and low progesterone are associated with high assertiveness in women.

    Science.gov (United States)

    Blake, Khandis R; Bastian, Brock; O'Dean, Siobhan M; Denson, Thomas F

    2017-01-01

    Sexual selection theory posits that women are more selective than men are when choosing a mate. This evolutionary theory suggests that "choosiness" increases during the fertile window because the costs and benefits of mate selection are highest when women are likely to conceive. Little research has directly investigated reproductive correlates of choice assertion. To address this gap, in the present research we investigated whether fertility, estradiol, and progesterone influenced general assertiveness in women. We recruited 98 naturally cycling, ethnically diverse women. Using a within-subjects design and ovarian hormone concentrations at fertile and non-fertile menstrual cycle phases, we measured implicit assertiveness and self-reported assertive behavior. To see if fertility-induced high assertiveness was related to increased sexual motivation, we also measured women's implicit sexual availability and interest in buying sexy clothes. Results showed that high estradiol and low progesterone predicted higher assertiveness. Sexual availability increased during periods of high fertility. Low progesterone combined with high estradiol predicted greater interest in buying sexy clothes. Results held when controlling for individual differences in mate value and sociosexual orientation. Our findings support the role of fluctuating ovarian hormones in the expression and magnitude of women's assertiveness. High assertiveness during the fertile window may be a psychological adaptation that promotes mate selectivity and safeguards against indiscriminate mate choice when conception risk is highest. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

    Science.gov (United States)

    Segal, Daniel

    2005-01-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

  8. An Investigation of High School Seniors' Assertiveness Levels Based on Their Demographic Characteristics

    Science.gov (United States)

    Çam, Ibrahim

    2015-01-01

    High school students who are in the development age or in the last class and have chance to win the university exams or disposal stage of the business life must also have a high level of assertiveness. In this context, the purpose of this research is to compare the assertiveness levels of high school seniors. The study group consists of 312 high…

  9. Effects of Gender, Age, and Education on Assertiveness in a Nigerian Sample

    Science.gov (United States)

    Onyeizugbo, Eucharia U.

    2003-01-01

    Two hundred fourteen (214) married persons, 101 men and 113 women aged 20-60, with at least high school education, participated in the study which investigated the effects of gender, age, and educational attainment on assertiveness among married persons in Nigeria. The Assertive Behavior Assessment scale (ABAS; Onyeizugbo, 1998) was used to…

  10. Aggression, Assertion, and Openness to Experience: A Comparison of Men and Women

    Science.gov (United States)

    Wyrick, Linda C.; And Others

    1977-01-01

    Investigates the degree of correlation between social constriction, i.e., lack of assertiveness as measured by the Bates-Zimmerman scale (1971), and assertiveness, as measured by the College Self-Expression Scale (1974) and further examines the relationship of scores on both of these scales to aggression/hostility as measured by the Buss-Durkee…

  11. Relation between Assertiveness, Academic Self-Efficacy, and Psychosocial Adjustment among International Graduate Students.

    Science.gov (United States)

    Poyrazli, Senel; Arbona, Consuelo; Nora, Amaury; McPherson, Robert; Pisecco, Stewart

    2002-01-01

    Rathus Assertiveness Schedule, Academic Self-Efficacy Scale, The Inventory for Student Adjustment Strain, and UCLA Loneliness Scale were used to examine a total of 122 graduate international students. Findings indicate that English proficiency, assertiveness, and academic self-efficacy contributed uniquely to the variance in students' general…

  12. Community.

    Science.gov (United States)

    Grauer, Kit, Ed.

    1995-01-01

    Art in context of community is the theme of this newsletter. The theme is introduced in an editorial "Community-Enlarging the Definition" (Kit Grauer). Related articles include: (1) "The Children's Bridge is not Destroyed: Heart in the Middle of the World" (Emil Robert Tanay); (2) "Making Bridges: The Sock Doll…

  13. Characterization of shifts of koala (Phascolarctos cinereus intestinal microbial communities associated with antibiotic treatment

    Directory of Open Access Journals (Sweden)

    Katherine E. Dahlhausen

    2018-03-01

    Full Text Available Koalas (Phascolarctos cinereus are arboreal marsupials native to Australia that eat a specialized diet of almost exclusively eucalyptus leaves. Microbes in koala intestines are known to break down otherwise toxic compounds, such as tannins, in eucalyptus leaves. Infections by Chlamydia, obligate intracellular bacterial pathogens, are highly prevalent in koala populations. If animals with Chlamydia infections are received by wildlife hospitals, a range of antibiotics can be used to treat them. However, previous studies suggested that koalas can suffer adverse side effects during antibiotic treatment. This study aimed to use 16S rRNA gene sequences derived from koala feces to characterize the intestinal microbiome of koalas throughout antibiotic treatment and identify specific taxa associated with koala health after treatment. Although differences in the alpha diversity were observed in the intestinal flora between treated and untreated koalas and between koalas treated with different antibiotics, these differences were not statistically significant. The alpha diversity of microbial communities from koalas that lived through antibiotic treatment versus those who did not was significantly greater, however. Beta diversity analysis largely confirmed the latter observation, revealing that the overall communities were different between koalas on antibiotics that died versus those that survived or never received antibiotics. Using both machine learning and OTU (operational taxonomic unit co-occurrence network analyses, we found that OTUs that are very closely related to Lonepinella koalarum, a known tannin degrader found by culture-based methods to be present in koala intestines, was correlated with a koala’s health status. This is the first study to characterize the time course of effects of antibiotics on koala intestinal microbiomes. Our results suggest it may be useful to pursue alternative treatments for Chlamydia infections without the use of

  14. Characterization of shifts of koala (Phascolarctos cinereus) intestinal microbial communities associated with antibiotic treatment.

    Science.gov (United States)

    Dahlhausen, Katherine E; Doroud, Ladan; Firl, Alana J; Polkinghorne, Adam; Eisen, Jonathan A

    2018-01-01

    Koalas ( Phascolarctos cinereus ) are arboreal marsupials native to Australia that eat a specialized diet of almost exclusively eucalyptus leaves. Microbes in koala intestines are known to break down otherwise toxic compounds, such as tannins, in eucalyptus leaves. Infections by Chlamydia , obligate intracellular bacterial pathogens, are highly prevalent in koala populations. If animals with Chlamydia infections are received by wildlife hospitals, a range of antibiotics can be used to treat them. However, previous studies suggested that koalas can suffer adverse side effects during antibiotic treatment. This study aimed to use 16S rRNA gene sequences derived from koala feces to characterize the intestinal microbiome of koalas throughout antibiotic treatment and identify specific taxa associated with koala health after treatment. Although differences in the alpha diversity were observed in the intestinal flora between treated and untreated koalas and between koalas treated with different antibiotics, these differences were not statistically significant. The alpha diversity of microbial communities from koalas that lived through antibiotic treatment versus those who did not was significantly greater, however. Beta diversity analysis largely confirmed the latter observation, revealing that the overall communities were different between koalas on antibiotics that died versus those that survived or never received antibiotics. Using both machine learning and OTU (operational taxonomic unit) co-occurrence network analyses, we found that OTUs that are very closely related to Lonepinella koalarum , a known tannin degrader found by culture-based methods to be present in koala intestines, was correlated with a koala's health status. This is the first study to characterize the time course of effects of antibiotics on koala intestinal microbiomes. Our results suggest it may be useful to pursue alternative treatments for Chlamydia infections without the use of antibiotics or the

  15. Effects of music on assertive behavior during exercise by middle-school-age students.

    Science.gov (United States)

    Mills, B D

    1996-10-01

    The purpose of this study was to assess the association of a particular style of music and assertive behavior in middle-school-aged students during exercise. Participants were students enrolled in a public middle school (Grades 6, 7, and 8, N = 502). A statistically significant relationship was found between the number of assertive behaviors occurring while listening to fast tempo music and grades and between difference scores and grades. Difference scores were obtained by subtracting the number of assertive behaviors occurring while listening to fast tempo music from those while listening to slow tempo music. Discriminant function analysis showed the number of assertive behaviors when listening to fast tempo music and difference scores were predictive of membership by grade. The higher the more assertive behaviors were emitted when listening to fast tempo music.

  16. Effectiveness of Group Training of Assertiveness on Social Anxiety among Deaf and Hard of Hearing Adolescents.

    Science.gov (United States)

    Ahmadi, Hamed; Daramadi, Parviz Sharifi; Asadi-Samani, Majid; Givtaj, Hamed; Sani, Mohammad Reza Mahmoudian

    2017-06-01

    The present study was conducted to compare the effectiveness of assertiveness group training on social anxiety (SAD) between deaf and hearing impaired adolescents. Forty eight (24 deaf and 24 hearing impaired) people participated in this study. First, participants with SAD, i.e. attaining the scores above 40 for Connor's Social Inventory Scale 2000 (SPIN), were selected according to convenience sampling and randomly assigned to two groups, i.e. intervention and control. Then, assertiveness group training was conducted for intervention group within 10 sessions, and immediately after completion of the training sessions, SPIN was re-administered to the two groups. ANCOVA showed that the effectiveness of assertiveness group training on SAD is different between deaf and hearing impaired participants, i.e. assertiveness group training was effective on improvement of SAD in hearing impaired participants but not deaf ones. Therefore, it is recommended to incorporate assertiveness group training in the educational programs developed for adolescents with ear disorders especially hearing impairment.

  17. Predictors of sexual assertiveness: the role of sexual desire, arousal, attitudes, and partner abuse.

    Science.gov (United States)

    Santos-Iglesias, Pablo; Sierra, Juan Carlos; Vallejo-Medina, Pablo

    2013-08-01

    This study was conducted to test interpersonal, attitudinal, and sexual predictors of sexual assertiveness in a Spanish sample of 1,619 men and 1,755 women aged 18-87 years. Participants completed measures of sexual assertiveness, solitary and dyadic sexual desire, sexual arousal, erectile function, sexual attitudes, and frequency of partner abuse. In men, higher sexual assertiveness was predicted by less non-physical abuse, more positive attitudes toward sexual fantasies and erotophilia, higher dyadic desire, and higher sexual arousal. In women, higher sexual assertiveness was predicted by less non-physical abuse, less solitary sexual desire and higher dyadic sexual desire, arousal, erotophilia, and positive attitudes towards sexual fantasies. Results were discussed in the light of prevention and educational programs that include training in sexual assertiveness skills.

  18. [Development and Effects of Assertiveness Training applying Dongsasub Training for Nursing Students in Clinical Practice].

    Science.gov (United States)

    Kim, Myoungsuk

    2016-08-01

    This study was conducted to develop assertiveness training applying Dongsasub training for junior nursing students, and to verify effectiveness of the training on assertiveness behavior, self-esteem, clinical practice stress, and clinical competence. The study design was a non-equivalent control group non-synchronized design. Participants were 63 nursing students in clinical training (31 students in the experimental group and 32 students in the control group). The assertiveness training applying Dongsasub training consisted of four sessions. Outcome variables included assertiveness behavior, self-esteem, clinical practice stress, and clinical competence. Data were analyzed using Chi-square, Fisher's exact test and independent samples t-test with SPSS/WIN 21.0. Scores of assertiveness behavior (t=-2.49, p=.015), self-esteem (t=-4.80, passertiveness training applying Dongsasub training can be used as a nursing intervention to lower clinical practice stress and improve the clinical competence of nursing students.

  19. Relations of children's proactive and reactive assertiveness to peer acceptance: moderating effects of social interest.

    Science.gov (United States)

    Lee, Han-Jong

    2014-06-01

    Previous studies on the social outcome of assertiveness reported mixed findings, failing to support the assumption that assertiveness promotes peer acceptance. In an attempt to provide explanations for the inconsistencies in prior findings, this study proposed making a distinction between proactive and reactive assertiveness and examined the moderating effects of social interest. A total of 441 fifth and sixth graders (232 boys, 209 girls; M age = 10.6 yr., SD = 0.6) participated in the study. Results indicated that proactive assertiveness was positively related to peer acceptance regardless of social interest. By contrast, reactive assertiveness was positively related to peer acceptance but only when social interest is high. When social interest is low, it was negatively associated with peer acceptance.

  20. The relationship between psychosocial maturity and assertiveness in males and females.

    Science.gov (United States)

    Goldman, J A; Olczak, P V

    1981-02-01

    The relationship between psychosocial maturity (psychological health) and assertiveness was investigated in a sample of United States college males and females. Results revealed a moderately high positive relationship between psychosocial maturity (PSM) and self-reported assertiveness on the Rathus and Galassi scales for both sexes. This relationship was slightly stronger (in terms of variance accounted for) for males than females, significant differences being obtained for Intimacy on the Rathus scale and PSM and Intimacy on the Galassi scale. Multiple regression analyses revealed that the personality components most consistently accounting for major portions of the variance in predicting male assertiveness scores on both the Rathus Assertiveness Schedule and the College Self-Expression Scale were Intimacy and Initiative, while in predicting female assertiveness, only Initiative was involved. The findings were related to previous research, recent work on the androgyny construct (instrumental vs. expressive behaviors), and exhortations for increased cooperation between schools of psychotherapy to establish it as a more unified discipline.

  1. Prediction of Addiction Potential on the Basis of Aggression and Assertiveness in University Students

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    Mehrdad Hajihasani

    2012-02-01

    Full Text Available Introduction: The aim of present research was the prediction of addiction potential on the basis of aggression and assertiveness in Allameh Tabbatabaei girl students. Method: The research method was correlational design and population of research was girl students of Allameh Tabatabaei university. By available sampling 150 girls were selected and Ahvaz Aggression Questionnaire, Gambril & Rigy Assertiveness questionnaire and Zargari Addiction Potential Questionnaire administered among selected sample. Findings: the results of the Pearson correlation showed that the relationship between aggression, assertiveness, and addiction potential was significant. Also, the results of multivariate regression analysis showed that aggression, assertiveness and depression can predict the Addiction Potential. Conclusion: Addiction potential can be predicted by aggression and assertiveness.

  2. Association between community pharmacy loyalty and persistence and implementation of antipsychotic treatment among individuals with schizophrenia.

    Science.gov (United States)

    Zongo, Frank E; Moisan, Jocelyne; Grégoire, Jean-Pierre; Lesage, Alain; Dossa, Anara Richi; Lauzier, Sophie

    2018-01-01

    Non-adherence is a major obstacle to optimal treatment of schizophrenia. Community pharmacists are in a key position to detect non-adherence and put in place interventions. Their role is likely to be more efficient when individuals are loyal to a single pharmacy. To assess the association between the level of community pharmacy loyalty and persistence with and implementation of antipsychotic drug treatment among individuals with schizophrenia. A cohort study using databases from the Quebec health insurance board (Canada) was conducted among new antipsychotic users insured by Quebec's public drug plan. Level of community pharmacy loyalty was assessed as the number of pharmacies visited in the year after antipsychotics initiation. Persistence was defined as having an antipsychotic supply in the user's possession on the 730 th day after its initiation and implementation as having antipsychotics in the user's possession for ≥80% of the days in the second year after antipsychotics initiation (among persistent only). Generalized linear models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (95%CI). 6,251 individuals were included in the cohort and 54.1% had their drug prescriptions filled in >1 pharmacy. When compared to those who had their prescriptions filled in a single pharmacy, those who had their prescriptions filled in ≥4 different pharmacies were 22% more likely to be non-persistent (aPR = 1.22; 95%CI = 1.10-1.37) and 49% more likely to have an antipsychotic for loyalty in the context of severe mental illness indicates that this healthcare organisation factor might be associated with antipsychotics persistence and implementation. Identification of individuals with low community pharmacy loyalty and initiatives to optimize community pharmacy loyalty could contribute to enhanced persistence and implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. [Involuntary treatment of mental patients in the community: legal and ethical dilemmas].

    Science.gov (United States)

    Mitrossili, M

    2014-01-01

    This article focuses on the measure of involuntary treatment of mental patients in the community, not only with regard to human rights and more specifically those of persons with mental disorders, but also with regard to ethics and deontology in mental healthcare delivery service. In this light, the important role of informed consent in psychiatry with regard to the psychiatric act is examined. Informed consent of mental patients in treatment when they are in need of voluntary or involuntary hospitalization is further examined, while emphasis is being put on the case of involuntary treatment. The Convention for Human Rights and Biomedicine (Convention of Οviedo), the European Convention of Human Rights, other documents of International Organizations (UN) and specialized national legislation (A. 2071/1992, Chapter vi, Greek law) constitute basic reference and interpretation points. The examination of consent and the demarcation of the exceptions are important issues that need to be approached. More particularly, our interest lies with the article 7 of the Convention for Human Rights and Biomedicine, which specifically refers to the protection of person who suffers from a mental disorder. The opinion that informed consent in psychiatric treatment and involuntary treatment are concepts and processes which are distinct but not always mutually exclusive is enhanced. In any case, involuntary treatment causes major dilemmas as far as informed consent in the psychiatric act is concerned, as it raises issues that affect the autonomy of the person. Today, however, there are many factors which influence public politics towards the adoption of the measure of involuntary treatment within the community. How is it that this paradoxical link is legitimized and justified: involuntary treatment and community? The enactment of the above mentioned measure in many European and North American countries has created new paths in the practice of contemporary psychiatry. Nonetheless, it

  4. Evolution of microbial communities during electrokinetic treatment of antibiotic-polluted soil.

    Science.gov (United States)

    Li, Hongna; Li, Binxu; Zhang, Zhiguo; Zhu, Changxiong; Tian, Yunlong; Ye, Jing

    2018-02-01

    The evolution of microbial communities during the electrokinetic treatment of antibiotic-polluted soil (EKA) was investigated with chlortetracycline (CTC), oxytetracycline (OTC) and tetracycline (TC) as template antibiotics. The total population of soil microorganisms was less affected during the electrokinetic process, while living anti-CTC, anti-OTC, anti-TC and anti-MIX bacteria were inactivated by 10.48%, 31.37%, 34.76%, and 22.08%, respectively, during the 7-day treatment compared with antibiotic-polluted soil without an electric field (NOE). Accordingly, samples with NOE treatment showed a higher Shannon index than those with EKA treatment, indicating a reduction of the microbial community diversity after electrokinetic processes. The major taxonomic phyla found in the samples of EKA and NOE treatment were Proteobacteria, Bacteroidetes, Firmicutes and Actinobacteria. And the distribution of Actinobacteria, Cyanobacteria, and Chloroflexi was greatly decreased compared with blank soil. In the phylum Proteobacteria, the abundance of Alphaproteobacteria was greatly reduced in the soils supplemented with antibiotics (from 13.40% in blank soil to 6.43-10.16% after treatment); while Betaproteobacteria and Deltaproteobacteria showed a different trend with their abundance increased compared to blank soil, and Gammaproteobacteria remained unchanged for all treatments (2.36-2.78%). The varied trends for different classes indicated that the major bacterial groups changed with the treatments due to their different adaptability to the antibiotics as well as to the electric field. SulI being an exception, the reduction ratio of the observed antibiotic resistance genes (ARGs) including tetC, tetG, tetW, tetM, intI1, and sulII in the 0-2cm soil sampled with EKA versus NOE treatment reached 55.17%, 3.59%, 99.26%, 89.51%, 30.40%, and 27.92%, respectively. Finally, correlation analysis was conducted between antibiotic-resistant bacteria, ARGs and taxonomic bacterial classes. It

  5. Community intervention to promote rational treatment of acute respiratory infection in rural Nepal.

    Science.gov (United States)

    Holloway, Kathleen A; Karkee, Shiba B; Tamang, Ashalal; Gurung, Yam Bahadur; Kafle, Kumud K; Pradhan, Ramesh; Reeves, Barnaby C

    2009-01-01

    To evaluate a community education program about treatment of acute respiratory infection (ARI). First, community case definitions for severe and mild ARI were developed. The intervention was then evaluated using a controlled before-and-after design. Household surveys collected data about ARI treatment in 20 clusters, each based around a school and health facility. Treatment indicators included percentages of cases attending health facilities and receiving antibiotics. The intervention consisted of an education program in schools culminating in street theater performances, discussions with mothers after performances and training for community leaders and drug retailers by paramedics. The intervention was conducted in mid-2003. Indicators were measured before the intervention in Nov/Dec 2002 and again in Dec 2003/Jan 2004. Two thousand and seven hundred and nineteen households were surveyed and 3654 under-fives were identified, of whom 377 had severe ARI. After implementing the intervention, health post (HP) attendance rose by 13% in under-fives with severe ARI and fell by 9% in under-fives with mild ARI (test of interaction, P = 0.01). Use of prescribed antibiotics increased in under-fives with severe ARI by 21% but only by 1% in under-fives with mild ARI (test of interaction, P = 0.38). Irrespective of ARI severity, the use of non-prescribed antibiotics dropped by 5% (P = 0.002), and consultation with female community health volunteers (FCHVs)and use of safe home remedies increased by 6.7% (P not estimated) and 5.7% (P = 0.008) respectively. The intervention was implemented using local structures and in difficult circumstances, yet had a moderate impact. Thus it has the potential to effect large scale changes in behaviour and merits replication elsewhere.

  6. Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment

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    Kuruvilla Thomas

    2003-01-01

    Full Text Available Abstract Background Uncontrolled hypertension (HT is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community. Method We used a 1 in 4 random selection of subjects who were ≥ 20 years of age. A questionnaire was administered and the blood pressure (BP was measured by a doctor. HT was defined as diastolic blood pressure (DBP ≥ 90 mm Hg ± systolic pressure (SBP ≥ 140 mm Hg. Isolated systolic hypertension (ISH was defined as SBP ≥ 160 mm Hg with DBP Results 2879 subjects ≥ 20 years of age were randomly selected of which 2415 (84% participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives ≥ 60 years had ISH. Conclusion This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community.

  7. Effectiveness of Ebola treatment units and community care centers - Liberia, September 23-October 31, 2014.

    Science.gov (United States)

    Washington, Michael L; Meltzer, Martin L

    2015-01-30

    Previous reports have shown that an Ebola outbreak can be slowed, and eventually stopped, by placing Ebola patients into settings where there is reduced risk for onward Ebola transmission, such as Ebola treatment units (ETUs) and community care centers (CCCs) or equivalent community settings that encourage changes in human behaviors to reduce transmission risk, such as making burials safe and reducing contact with Ebola patients. Using cumulative case count data from Liberia up to August 28, 2014, the EbolaResponse model previously estimated that without any additional interventions or further changes in human behavior, there would have been approximately 23,000 reported Ebola cases by October 31, 2014. In actuality, there were 6,525 reported cases by that date. To estimate the effectiveness of ETUs and CCCs or equivalent community settings in preventing greater Ebola transmission, CDC applied the EbolaResponse model to the period September 23-October 31, 2014, in Liberia. The results showed that admitting Ebola patients to ETUs alone prevented an estimated 2,244 Ebola cases. Having patients receive care in CCCs or equivalent community settings with a reduced risk for Ebola transmission prevented an estimated 4,487 cases. Having patients receive care in either ETUs or CCCs or in equivalent community settings, prevented an estimated 9,100 cases, apparently as the result of a synergistic effect in which the impact of the combined interventions was greater than the sum of the two interventions. Caring for patients in ETUs, CCCs, or in equivalent community settings with reduced risk for transmission can be important components of a successful public health response to an Ebola epidemic.

  8. Efficacy of Biofeedback Therapy in the Treatment of Dyssynergic Defecation in Community-Dwelling Elderly Women.

    Science.gov (United States)

    Simón, Miguel A; Bueno, Ana M

    The aim of this study was to evaluate the efficacy of biofeedback therapy in the treatment of dyssynergic defecation in chronically constipated community-dwelling elderly women. After an initial assessment phase carried out during 1 month, 20 chronically constipated women with dyssynergic defecation were randomly assigned to either electromyographic biofeedback (EMG-BF) group (n=10) or control group (n=10). Outcome measures used to evaluate the efficacy of treatment were weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, mean EMG-activity (μV) of the external anal sphincter during straining to defecate and Anismus index. The results obtained in this randomized controlled trial showed significant differences between the groups in all the dependent variables after 1 month of treatment. Moreover, there was no difference between the groups neither in age nor in the duration of chronic constipation symptoms. At the follow-up, 3 months later, clinical gains were maintained. This study demonstrates that the EMG-BF is an effective behavioral therapy for the treatment of dyssynergic defecation in community-dwelling elderly women.

  9. Coolmine Therapeutic Community, Dublin: a 40-year history of Ireland's first voluntary drug treatment service.

    Science.gov (United States)

    Butler, Shane

    2016-02-01

    To document the evolution over 40 years (from 1973 to 2013) of Coolmine Therapeutic Community (Ireland's first voluntary drug treatment service) against a background of broader drug policy developments in the Republic of Ireland and elsewhere during this period. Data were gathered by means of archival research within Coolmine, complemented by semi-structured interviews with former clients, current and former Coolmine management and staff, and representatives of outsider stakeholder interests. Coolmines's history has three phases: (1) an early and uncontentious phase, in which external authorities provided financial support for Coolmine without questioning its work practices or outcomes; (2) a middle, controversial phase, in which Coolmine struggled for survival in an external policy environment now dominated by harm reduction strategies; and (3) a final phase in which, through the use of conventional corporate governance, Coolmine management sought to repair its damaged reputation by introducing evidence-based clinical practices. Coolmine Therapeutic Community was established when drug treatment services in Ireland were in their infancy, and its changing fortunes over subsequent decades reflected changing perceptions of what constitutes appropriate addiction treatment-and in particular the role to be played by former addicts within addiction treatment systems-as well as changing perceptions of funding relationships between statutory authorities and voluntary providers of health and social services. © 2015 Society for the Study of Addiction.

  10. Substance use and treatment of substance use disorders in a community sample of transgender adults.

    Science.gov (United States)

    Keuroghlian, Alex S; Reisner, Sari L; White, Jaclyn M; Weiss, Roger D

    2015-07-01

    Transgender people have elevated substance use prevalence compared with the U.S. general population, however no studies have comprehensively examined the relationship of psychosocial risk factors to substance use and substance use disorder (SUD) treatment among both male-to-female (MTF) and female-to-male (FTM) transgender adults. Secondary data analysis of a 2013 community-based survey of transgender adults in Massachusetts (N=452) was conducted. Adjusted multivariable logistic regression models were fit to examine the relationship of four risk factor domains with SUD treatment history and recent substance use: (1) demographics; (2) gender-related characteristics; (3) mental health; (4) socio-structural factors. Adjusted Odds Ratios (aOR) and 95% Confidence Intervals (95% CI) were estimated. Ten percent of the sample reported lifetime SUD treatment. Factors associated with significant increase in odds of lifetime SUD treatment alongside recent substance use (all pdiscrimination (aOR=1.90; 95% CI=1.22-2.95), unstable housing (aOR=1.80; 95% CI=1.21-2.67), and sex work (aOR=2.48; 95% CI=1.24-4.95). Substance use and SUD treatment among transgender adults are associated with demographic, gender-related, mental health, and socio-structural risk factors. Studies are warranted that identify SUD treatment barriers, and integrate SUD treatment with psychosocial and structural interventions for a diverse spectrum of transgender adults. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient?

    Science.gov (United States)

    Kirby, Kimberly C; Benishek, Lois A; Kerwin, MaryLouise E; Dugosh, Karen L; Carpenedo, Carolyn M; Bresani, Elena; Haugh, James A; Washio, Yukiko; Meyers, Robert J

    2017-11-01

    Community Reinforcement and Family Training (CRAFT) assists family members with a treatment-resistant loved one. The most consistent outcome of CRAFT is increased treatment entry of the identified treatment-resistant person (IP). This led us to question whether all 6 components of CRAFT are necessary. In a randomized clinical trial, 115 concerned significant others (CSOs) of an IP received 12-14 sessions of the full CRAFT intervention, 4-6 sessions focused on Treatment Entry Training (TEnT), or 12-14 sessions of Al-Anon/Nar-Anon Facilitation (ANF). We monitored treatment entry, attendance, and substance use of the IP and the CSO's mood and functioning. Data were collected at baseline and 4, 6, and 9 months after the baseline. We found significant reductions in time to treatment entry (χ(2)2 = 8.89, p = .01) and greater treatment entry rates for CRAFT (62%; odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.1-6.9) and TEnT (63%; OR = 2.9, 95% CI = 1.2-7.5) compared with ANF (37%), but CRAFT and TEnT did not differ significantly from each other (OR = 1.1, 95% CI = 0.4-2.7). No between-group differences in IP drug use were reported by CSOs, but days of drug use decreased over time for all groups (F(3, 277) = 13.47, p CRAFT produces greater treatment entry rates than ANF and found similar treatment entry rates for CRAFT and TEnT. This suggests that treatment entry training is sufficient for producing the best established outcome of CRAFT. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Multistage A-O Activated Sludge Process for Paraformaldehyde Wastewater Treatment and Microbial Community Structure Analysis

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    Danyang Zheng

    2016-01-01

    Full Text Available In recent years, the effect of formaldehyde on microorganisms and body had become a global public health issue. The multistage combination of anaerobic and aerobic process was adopted to treat paraformaldehyde wastewater. Microbial community structure in different reaction stages was analyzed through high-throughput sequencing. Results showed that multistage A-O activated sludge process positively influenced polyformaldehyde wastewater. The removal rates of formaldehyde were basically stable at more than 99% and those of COD were about 89%. Analysis of the microbial diversity index indicated that the microbial diversity of the reactor was high, and the treatment effect was good. Moreover, microbial community had certain similarity in the same system. Microbial communities in different units also showed typical representative characteristics affected by working conditions and influent concentrations. Proteobacteria, Firmicutes, and Bacteroidetes were the dominant fungal genera in the phylum level of community composition. As to family and genus levels, Peptostreptococcaceae was distributed at various stages and the dominant in this system. This bacterium also played an important role in organic matter removal, particularly decomposition of the acidified middle metabolites. In addition, Rhodobacteraceae and Rhodocyclaceae were the formaldehyde-degrading bacteria found in the reactor.

  13. Treatment of Biofilm Communities: An Update on New Tools from the Nanosized World

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    Federico Bertoglio

    2018-05-01

    Full Text Available Traditionally regarded as single cell organisms, bacteria naturally and preferentially build multicellular communities that enable them to react efficiently to external stimuli in a coordinated fashion and with extremely effective outcomes. These communities are bacterial biofilms, where single cells or microcolonies are embedded in self-built Extracellular Polymeric Substance (EPS, composed of different macromolecules, e.g., polysaccharides, proteins, lipids, and extracellular DNA (eDNA. Despite being the most common form in nature and having many biotechnologically useful applications, biofilm is often regarded as a life-threatening form of bacterial infection. Since this form of bacterial life is intrinsically more resistant to antibiotic treatment and antimicrobial resistance is reaching alarming levels, we will focus our attention on how nanotechnology made new tools available to the medical community for the prevention and treatment of these infections. After a brief excursus on biofilm formation and its main characteristics, different types of nanomaterials developed to prevent or counteract these multicellular forms of bacterial infection will be described. A comparison of different classifications adopted for nanodrugs and a final discussion of challenges and future perspectives are also presented.

  14. Community resources support adherence to treatment for childhood cancer in El Salvador.

    Science.gov (United States)

    Rossell, Nuria; Salaverria, Carmen; Hernandez, Angelica; Alabi, Soad; Vasquez, Roberto; Bonilla, Miguel; Lam, Catherine G; Ribeiro, Raul; Reis, Ria

    2018-01-01

    In order to reduce nonadherence and treatment abandonment of children with cancer in El Salvador, institutions located nearby the patients' homes were involved to provide support. Methodological approach: Health clinics and municipality offices in the patients' communities were asked to assist families who were not promptly located after missing hospital appointments, or those whose financial limitations were likely to impede continuation of treatment. Data was collected about the number of contacted institutions, the nature of help provided, staff's time investments, and parents' perceptions about the intervention. Local institutions (133 from 206 contacts) conducted home visits (83), and/or provided parents with money (55) or transportation (60). Parents found this support essential for continuing the treatment but they also encountered challenges regarding local institutions' inconsistencies. Nonadherence and abandonment decreased. Economic burden was reduced on both the families and the hospital. Involvement of external institutions might become regular practice to support families of children with cancer.

  15. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in Bale Zone, Southeast Ethiopia

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    Hussen Awol

    2012-06-01

    Full Text Available Abstract Background Tuberculosis (TB is a major public health problem in Africa with Ethiopia being the most affected. Treatment delay is an important indicator of access to TB diagnosis and treatment. However, little is known about factors associated with treatment delay of pulmonary TB among pastoralists. Health facility based cross sectional study was conducted on 129 pulmonary TB patients in pastoralist community. The study was conducted in three health centers and a hospital. Time between onset of TB symptoms and first visit to a professional health care provider (patient delay, and the time between first visits to the professional health care provider to the date of diagnosis (provider's delay were analyzed using SPSS 16.0 statistical software. Findings A total of 129 new smear positive pulmonary TB patients participated in the study. The median total delay was 97 days. The median patient and health provider delays were 63 and 34 days, respectively. Ninety six percent of the patients were delayed for more than the twenty one days cutoff point. Patient delay was positively associated with first visit to traditional healer/private clinic/drug shop, rural residence, being illiterate, living in more than 10 kilometers from health facility; severity of illness at first presentation to health facility. Provider delay was positively associated with rural residence, being illiterate, patient with good functional status, patients in contact with more than two health providers, and place of first visit being traditional healer/private clinic/drug shop. Conclusions This study showed that majority of smear positive patients delayed either for diagnosis or treatment, thus continue to serve as reservoirs of infection. This indicates that there is a need for intervention to decrease patient and provider delays. Effort to reduce delays in pastoralist communities should focus on improving access to services in rural communities, engaging traditional and

  16. [Medical treatment support to tuberculous patients--from the standpoint of community support].

    Science.gov (United States)

    2001-11-01

    A symposium with "Medical Treatment Support to Tuberculous Patients--From the standpoint of community support" as its theme was held at the 76th Annual Meeting of the Japanese Society for Tuberculosis (April 20, 2001). "Once, It is infected with tuberculosis, one have to complete medication with a sensitive antituberculosis drug by observing the prescribed dose and duration for successful treatment". For this to be promoted community, it is necessary that (1) to manage patient's medication by medical facilities, (2) to support patient's medication by health center and (3) to support patient's living by welfare offices. Not that each facilities takes such responsibilities alone, but various community must fulfill them continuously in liaison with one another. On what measures should be taken to that end, reports based on practical examples from Nagoya City, Yokohama City and Kanagawa Prefecture have been compiled as follows. 1. It was in-office liaison by conference that supported the DOTS activities of health nurses. 2. It is cooperating, without health, medical treatment, and welfare going out, as follows. (1) A system for hospitals and clinics to carry out DOTS treatment consistently has been kept in good condition. (2) For a patient to take a drug in front of a nurse has become common, causing the patients to be motivated. (3) Assignment of MSW and nurses in charge of DOTS sent from hospitals has make it possible to offer or exchange information smoothly among those concerned. (4) A system for many persons concerned to support patients timely has been kept in good condition. This resulted in an increase in the cure rate of tuberculosis in the areas which have day laborers' lodgings. 3. By DOTS for in-patients, the number of self-discharges has decreased by 1/3, and the treatment completion rate was 94%. 4. In promotion of DOTS for the patients who have health problems other than tuberculosis, the role MSW plays is great. 5. As conditions for supporting DOTS

  17. Assessment of MLA assertiveness training for librarians: students' behavior changes after taking C.E. 669, Assertiveness and Human Relations Skills.

    Science.gov (United States)

    Caputo, J S

    1985-01-01

    C.E. 669, offered for three years, was MLA's first personal development continuing education course. Participants were asked to respond to a follow-up survey about their current assertive philosophy, awareness, and behavioral repertoire. They were also assessed by the Librarian's Assertiveness Inventory, a tool that indicates patterns of behavioral responses, for which some normative data were available from librarians who had not taken the class. Class participants were found to be more likely to behave assertively and less likely to behave aggressively than librarians who had not taken the class. In nine out of ten situational categories, librarians who had taken the class demonstrated assertive response patterns. They also reported remembering and using more than one third of the behavioral techniques covered in class, with particular use of the nonverbal techniques. A majority saw themselves as more assertive since taking the class, although most believed that others viewed them much the same as they had prior to the class. Positive progress toward reaching specific behavioral goals was also reported. PMID:4052676

  18. Factors associated with compliance with community directed treatment with ivermectin for onchocerciasis control in Southwestern Ethiopia

    Directory of Open Access Journals (Sweden)

    Wondafrash Mekite

    2010-06-01

    Full Text Available Abstract Background Although ivermectin is distributed free of charge through the African Programme for Onchocerciasis Control (APOC, not all eligible individuals within communities receive the annual treatment. This poses a serious threat to efforts aimed to control onchocerciasis. This study attempts to determine factors associated with compliance to Community Directed Treatment with Ivermectin (CDTI and provides a basis for trying to understand how best to sustain long-term compliance in order to achieve success in the control of onchocerciasis. Methods An unmatched case-control study was conducted in Bebeka coffee plantation southwest Ethiopia. Cases were, compliant i.e., those individuals who had been registered on the relevant treatment registers and had taken all the five annual doses of Ivermectin. Controls were non-compliant, i.e. those individuals who had been recorded in the relevant treatment registers during the first treatment round(2003, and did not take at least two doses of which one being in the last treatment round (2007. Data were collected using a pre-tested interviewer administered structured questionnaire. Data were edited, cleaned, coded and analyzed using SPSS version 12.0.1 for Microsoft Windows. Multiple logistic regression models was used to identify factors associated with compliance to ivermectin. Results From the total of 456 individuals selected for administration of the survey questionnaire, 450(225 cases and 225 controls were contacted and completed the study 2 refused and 4 were unavailable. Five factors associated with compliance were identified: high risk perception [Adjusted Odds Ratio(AOR = 1.98, 95% Confidence Interval (CI, 1.32-2.95], one's family support [AOR = 1.86, 95% CI, 1.22-2.84], perceiving that the Community Drug Distributors (CDDs are doing their work well [AOR = 2.84, 95% CI, 1.50-5.37] and perceiving measuring height is the best way to determine a person's treatment dose [AOR = 6.37, 95% CI, 2

  19. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  20. PSYCOSOCIAL FACTORS EVALUATION ON PREVENTION AND TREATMENT OF DIARRHEIC DISEASES IN YAQUI COMMUNITIES

    Directory of Open Access Journals (Sweden)

    Guadalupe Valenzuela Avendaño y Jesús Francisco Laborín Álvarez

    2007-04-01

    Full Text Available To analyze knowledge and some psychosocial factors influence on prevention and treatment of diarrheic diseases in Yaqui communities. By a non-probabilistic sampling, 209 mothers were selected from Yaqui families having at least one six years old child or younger, and that they had attended at least one diarrhoea episode within 72 hours previous the interview. A non-experimental, correlational and cross-sectional design was used to analyse data. The knowledge level that mothers show about causes, symptoms and care during the diarrhoea is medium. Data also demonstrate a low to moderate level of correlation among the factors of the reasoned action model. The theory of reasoned action was not 100% suitable for Yaqui communities, because this model was originally proposed for urban areas and studied populations, therefore we recommend combine it quantitative and qualitative techniques with the purpose of collecting more reliable data, as include in the evaluation referring aspects to the culture and idiosyncrasy.

  1. A novel approach for harnessing biofilm communities in moving bed biofilm reactors for industrial wastewater treatment

    Directory of Open Access Journals (Sweden)

    Joe A. Lemire

    2015-10-01

    Full Text Available Moving bed biofilm reactors (MBBRs are an effective biotechnology for treating industrial wastewater. Biomass retention on moving bed biofilm reactor (MBBR carriers (biofilm support materials, allows for the ease-of-operation and high treatment capacity of MBBR systems. Optimization of MBBR systems has largely focused on aspects of carrier design, while little attention has been paid to enhancing strategies for harnessing microbial biomass. Previously, our research group demonstrated that mixed-species biofilms can be harvested from an industrial wastewater inoculum [oil sands process water (OSPW] using the Calgary Biofilm Device (CBD. Moreover, the resultant biofilm communities had the capacity to degrade organic toxins (naphthenic acids—NAs that are found in OSPW. Therefore, we hypothesized that harnessing microbial communities from industrial wastewater, as biofilms, on MBBR carriers may be an effective method to bioremediate industrial wastewater.Here, we detail our methodology adapting the workflow employed for using the CBD, to generate inoculant carriers to seed an MBBR.In this study, OSPW-derived biofilm communities were successfully grown, and their efficacy evaluated, on commercially available MBBR carriers affixed within a modified CBD system. The resultant biofilms demonstrated the capacity to transfer biomass to recipient carriers within a scaled MBBR. Moreover, MBBR systems inoculated in this manner were fully active 2 days post-inoculation, and readily degraded a select population of NAs. Together, these findings suggest that harnessing microbial communities on carriers affixed within a modified CBD system may represent a facile and rapid method for obtaining functional inoculants for use in wastewater MBBR treatment systems.

  2. Self-Assertion in the Public Sphere: The Jewish Press on the Eve of Legal Emancipation

    Directory of Open Access Journals (Sweden)

    Dieter J. Hecht

    2016-08-01

    Full Text Available Jews like Adolf Fischhof and Ludwig August Frankl were prominent participants in the revolution of 1848. Their speeches, poems, and portraits circulated in Vienna and throughout the Empire. With the suppression of the revolution, most of these prominent Jews had to either leave Vienna or retreat to the private sphere. Only in the late 1850s did Jews regain their public presence, starting with the opening of the Leopoldstaedter Tempel in 1858 and the building of the Ringstrasse from 1860 onwards. Many Jews hoped that the new liberal era would grant them civil rights and legal emancipation. Jewish intellectuals and journalists supported this struggle from within and outside the growing Jewish community. An important weapon in their struggle were Jewish newspapers. These newspapers not only provided information, but also served as mouthpieces for different Jewish movements. They featured biographies with portraits (in words and images of distinguished Jewish leaders (mostly men and a few women, which were supposed to present the social achievements of a certain group within Jewish society to a broader audience. In fact, these portraits served as a form of self-assertion for the publisher as well as for the audience. It projected the message that Jews not only merited emancipation, but also struggled for it on various levels. The paper therefore addresses questions of biography and the (Jewish identity these portraits at once reflected and shaped.

  3. Impact of drug awareness and treatment camps on attendance at a community outreach de-addiction clinic

    Directory of Open Access Journals (Sweden)

    Om Prakash Giri

    2015-01-01

    Full Text Available Background: Substance misuse is an increasing problem in urban and rural India. The utility of community-based interventions and preventive strategies are increasingly emphasized in this context. The drug de-addiction and treatment center, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, has been running a drug de-addiction and treatment clinic at Kharar Civil Hospital, Kharar, District Mohali, Punjab, since 1998. As part of an effort to enhance this community outreach program, community-based drug awareness and treatment camps have been organized since March 2004 in villages in and around Tehsil Kharar of Mohali. Aim: To study the impact of the drug awareness and treatment camps on the attendance of patients at the community outreach drug de-addiction and treatment clinic at Kharar Civil Hospital. Methods: Sociodemographic and clinical variables, including treatment outcome-related variables, of patients attending the clinic at Kharar Civil Hospital, before and after the camps were compared. Discussion and Conclusion: The study showed a positive impact on drug awareness and treatment camps held in the community on outpatient attendance at a community outreach clinic, with attendance increasing more than 1.8 times.

  4. [Psychosocial functioning in non-psychiatric acute and chronic inpatients: depression, alexithymia and lack of assertiveness].

    Science.gov (United States)

    Arancibia, Marcelo; Behar, Rosa; Marín, Sofía; Inzunza, Nicolás; Madrid, Eva

    2016-11-01

    Depression, alexithymia, and lack of assertiveness interfere with individual psychosocial functioning and may result in longer hospitalization stay and poorer therapeutic results. To analyze the psychosocial functioning in acute and chronic patients and its association with psychological, clinical and sociodemographic variables. We performed a cross-sectional study that included 80 inpatients of both sexes with organic pathology, aged between 18 to 70 years old, without any current psychiatric disorder. Clinical and sociodemographic data were collected from a semi-structured interview and hospital records. Beck Depression Inventory-IA, Toronto Alexithymia Scale-20 and Rathus Assertiveness Scale were administered. Fifty five percent of patients had some degree of depression, 33% alexithymia and 34% lack of assertiveness. The levels of depression, alexithymia and lack of assertiveness in chronic patients were significantly higher than those observed in acute patients. Women and participants older than 60 years exhibited the highest degrees of depression. Alexithymia and lack of assertiveness were associated with a lower educational level. A negative significant correlation between alexithymia and assertiveness scores was observed among acute patients. Participants with chronic diseases had a lower psychosocial functioning. Less educated patients showed more alexithymic and less assertive features. We emphasized the need of a better management of these aspects by the health team, since social functioning might interfere with the outcome of physical illnesses.

  5. [The effect of assertiveness training on communication related factors and personnel turnover rate among hospital nurses].

    Science.gov (United States)

    Kang, Myung Ja; Lee, Haejung

    2006-08-01

    The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

  6. Undergraduate nursing students' level of assertiveness in Greece: a questionnaire survey.

    Science.gov (United States)

    Deltsidou, Anna

    2009-09-01

    A number of studies of nursing and midwifery have found stress and bullying to be frequent problems. Those suffering from bullying and stress need to have high levels of assertiveness to resist and to cope successfully. Hence, it was considered vital to assess the assertiveness level of nursing students throughout their training curriculum. The study population was composed of nursing students in different semesters at one school in Central Greece (n=298) who agreed to complete a questionnaire on assertiveness level assessment, which had been translated into Greek and adapted to this population. All students present in class completed the questionnaire, representing 80% of the total population of active students. Mean assertiveness scores between semesters were compared by ANOVA and comparisons between the responses of the first semester students and responses of advanced semester students were done by Pearson's chi square. The main finding of this study was that the assertiveness levels displayed by students increase slightly in advanced semesters by comparison to those displayed by first-semester students. Assertive behavior should be encouraged through learning methods. Nurses should preferably obtain this training throughout their studies. Instructors have an essential role in the improvement and achievement of assertiveness training curriculums for undergraduate nursing students.

  7. The Effect of Assertiveness Training on the Mobbing That Nurses Experience.

    Science.gov (United States)

    Karakaş, Sibel Asi; Okanli, Ayşe

    2015-10-01

    This research was designed to determine the impact of assertiveness training on the mobbing experience of nurses. This study was conducted in two phases. In the first phase, 218 nurses completed the mobbing scale; the education group consisted of 38 nurses who received a score at or above 204 points. A total of 180 nurses were excluded from the education group because they received less than 204 points. The study was conducted with 30 nurses because 8 nurses did not agree to participate in the study. The 30 nurses received the assertiveness training program. Six months after training, the nurses completed the mobbing scale and Rathus Assertiveness Inventory (RAI) again. The assertiveness training positively affected the assertiveness and mobbing scores (p = .000). After the training, the assertiveness scores increased and the mobbing condition score decreased (p Assertiveness training is an effective method for decreasing mobbing. In line with these results, training programs, which support nurses' personal development by providing counseling and support to nurse victims of mobbing, are recommended. © 2015 The Author(s).

  8. Effect of streptomycin treatment on bacterial community structure in the apple phyllosphere.

    Directory of Open Access Journals (Sweden)

    Erika Yashiro

    Full Text Available We studied the effect of many years of streptomycin use in apple orchards on the proportion of phyllosphere bacteria resistant to streptomycin and bacterial community structure. Leaf samples were collected during early July through early September from four orchards that had been sprayed with streptomycin during spring of most years for at least 10 years and four orchards that had not been sprayed. The percentage of cultured phyllosphere bacteria resistant to streptomycin at non-sprayed orchards (mean of 65% was greater than at sprayed orchards (mean of 50% (P = 0.0271. For each orchard, a 16S rRNA gene clone library was constructed from leaf samples. Proteobacteria dominated the bacterial communities at all orchards, accounting for 71 of 104 OTUs (determined at 97% sequence similarity and 93% of all sequences. The genera Massilia, Methylobacterium, Pantoea, Pseudomonas, and Sphingomonas were shared across all sites. Shannon and Simpson's diversity indices and Pielou's evenness index were similar among orchards regardless of streptomycin use. Analysis of Similarity (ANOSIM indicated that long-term streptomycin treatment did not account for the observed variability in community structure among orchards (R = -0.104, P = 0.655. Other variables, including time of summer, temperature and time at sampling, and relative distance of the orchards from each other, also had no significant effect on bacterial community structure. We conclude that factors other than streptomycin exposure drive both the proportion of streptomycin-resistant bacteria and phylogenetic makeup of bacterial communities in the apple phyllosphere in middle to late summer.

  9. Can you please put it out? Predicting non-smokers' assertiveness intentions at work.

    Science.gov (United States)

    Aspropoulos, Eleftherios; Lazuras, Lambros; Rodafinos, Angelos; Eiser, J Richard

    2010-04-01

    The present study aimed to identify the psychosocial predictors of non-smoker employee intentions to ask smokers not to smoke at work. The predictive effects of past behaviour, anticipated regret, social norms, attitudinal, outcome expectancy and behavioural control beliefs were investigated in relation to the Attitudes-Social influence-self-Efficacy (ASE) model. Data were collected from Greek non-smoker employees (n=137, mean age=33.5, SD=10.5, 54.7% female) in 15 companies. The main outcome measure was assertiveness intention. Data on participants' past smoking, age, gender and on current smoking policy in the company were also collected. The majority of employees (77.4%) reported being annoyed by exposure to passive smoking at work, but only 37% reported having asked a smoker colleague not to smoke in the last 30 days. Regression analysis showed that the strongest predictor of non-smokers' assertiveness intentions was how often they believed that other non-smokers were assertive. Perceived control over being assertive, annoyance with secondhand smoke (SHS) exposure at work and past assertive behaviour also significantly predicted assertiveness intentions. Assertiveness by non-smoker employees seems to be guided mainly by normative and behavioural control beliefs, annoyance with SHS exposure at work, and past behaviour. Interventions to promote assertiveness in non-smokers might benefit from efficacy training combined with conveying the messages that the majority of other non-smokers are frequently annoyed by exposure to SHS, and that nearly half of all non-smokers are assertive towards smokers.

  10. Community Oncologists' Decision-Making for Treatment of Older Patients With Cancer.

    Science.gov (United States)

    Mohile, Supriya G; Magnuson, Allison; Pandya, Chintan; Velarde, Carla; Duberstein, Paul; Hurria, Arti; Loh, Kah Poh; Wells, Megan; Plumb, Sandy; Gilmore, Nikesha; Flannery, Marie; Wittink, Marsha; Epstein, Ronald; Heckler, Charles E; Janelsins, Michelle; Mustian, Karen; Hopkins, Judith O; Liu, Jane; Peri, Srihari; Dale, William

    2018-03-01

    Background: This study's objectives were to describe community oncologists' beliefs about and confidence with geriatric care and to determine whether geriatric-relevant information influences cancer treatment decisions. Methods: Community oncologists were recruited to participate in 2 multisite geriatric oncology trials. Participants shared their beliefs about and confidence in caring for older adults. They were also asked to make a first-line chemotherapy recommendation (combination vs single-agent vs no chemotherapy) for a hypothetical vignette of an older patient with advanced pancreatic cancer. Each oncologist received one randomly chosen vignette that varied on 3 variables: age (72/84 years), impaired function (yes/no), and cognitive impairment (yes/no). Other patient characteristics were held constant. Logistic regression models were used to identify associations between oncologist/vignette-patient characteristics and treatment decisions. Results: Oncologist response rate was 61% (n=305/498). Most oncologists agreed that "the care of older adults with cancer needs to be improved" (89%) and that "geriatrics training is essential" (72%). However, decision to treat: younger age (adjusted odds ratio [aOR], 5.01; 95% CI, 2.73-9.20), normal cognition (aOR, 5.42; 95% CI, 3.01-9.76), and being functionally intact (aOR, 3.85; 95% CI, 2.12-7.00). Accounting for all vignettes across all scenarios, 161 oncologists (52%) said they would offer chemotherapy. All variables were independently associated with prescribing single-agent over combination chemotherapy (older age: aOR, 3.22; 95% CI 1.43-7.25, impaired cognition: aOR, 3.13; 95% CI, 1.36-7.20, impaired function: aOR, 2.48; 95% CI, 1.12-5.72). Oncologists' characteristics were not associated with decisions about providing chemotherapy. Conclusion: Geriatric-relevant information, when available, strongly influences community oncologists' treatment decisions. Copyright © 2018 by the National Comprehensive Cancer Network.

  11. A comparative analysis of pressure sore treatment modalities in community settings

    Directory of Open Access Journals (Sweden)

    N. Small

    2002-09-01

    Full Text Available The management of pressure sores in community settings, poses a clinical problem which challenges the patient’s tolerance and the clinician’s diligence and ingenuity. Pressure sores can be painful, lead to infection and are associated with considerable morbidity and increased mortality (Patterson & Bennett, 1995:919; Bale, Banks, Hagelstein & Harding, 1998:65. Treatment costs of these wounds are high in terms of resources (Colin 1995:65; Wood, Griffiths & Stoner, 1997:256. However, since there are untold cost in terms of pain and suffering to the patient, it is impossible to calculate the true cost of pressure sores (Dealey, 1994:87.

  12. The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

    2017-11-01

    Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

  13. ASSERT-PV simulations of two-phase flow in horizontal and vertical subchannels

    International Nuclear Information System (INIS)

    Park, J.-W.; Chae, K.M.; Choi, H.

    1999-01-01

    This is a part of the effort to assess the ASSERT-PV code which is supposedly capable of quantifying the effect of small flow boundary changes in the fuel channel of CANDU reactors. Two independently performed subchannel experiments are simulated by the ASSERT-PV code. The result includes the pressure and the void fraction distributions in each subchannel. It is found that the ASSERT-PV predicts both experimental data quite well by selecting the void diffusion constant properly for the adiabatic two-phase flows. (author)

  14. Modeling approach for annular-fuel elements using the ASSERT-PV subchannel code

    International Nuclear Information System (INIS)

    Dominguez, A.N.; Rao, Y.

    2012-01-01

    The internally and externally cooled annular fuel (hereafter called annular fuel) is under consideration for a new high burn-up fuel bundle design in Atomic Energy of Canada Limited (AECL) for its current, and its Generation IV reactor. An assessment of different options to model a bundle fuelled with annular fuel elements is presented. Two options are discussed: 1) Modify the subchannel code ASSERT-PV to handle multiple types of elements in the same bundle, and 2) coupling ASSERT-PV with an external application. Based on this assessment, the selected option is to couple ASSERT-PV with the thermalhydraulic system code CATHENA. (author)

  15. Groebner Bases Based Verification Solution for SystemVerilog Concurrent Assertions

    Directory of Open Access Journals (Sweden)

    Ning Zhou

    2014-01-01

    of polynomial ring algebra to perform SystemVerilog assertion verification over digital circuit systems. This method is based on Groebner bases theory and sequential properties checking. We define a constrained subset of SVAs so that an efficient polynomial modeling mechanism for both circuit descriptions and assertions can be applied. We present an algorithm framework based on the algebraic representations using Groebner bases for concurrent SVAs checking. Case studies show that computer algebra can provide canonical symbolic representations for both assertions and circuit designs and can act as a novel solver engine from the viewpoint of symbolic computation.

  16. Sewage treatment processes: The methodology for the resort communities; Tecnologias de Depuracion: la metodologia de seleccion para poblaciones turisticas

    Energy Technology Data Exchange (ETDEWEB)

    Nieves de la Vega, G.; Kovacs, Z. [AQUA/PLAN, S.A. (Spain)

    1995-06-01

    The selection of adequate sewage treatment processes for resort communities has to be based upon a detailed knowledge of the characteristics of sewerage discharges. In order to define a methodology, the most representative variables such as climatology, seasonal variation, required treatment efficiency, sewage characteristics and availability of land, are identified. A wide range of available treatment processes is defined and the relationship between variables and priority criteria is analysed. Finally, a decision-diagram allowing the selection of the most adequate treatment process in each particular case is presented. The methodology is applied to mountain resort communities. (Author)

  17. Perceived Need for Treatment and Engagement in Mental Health Services Among Community-Referred Racial/Ethnic Minority Adolescents.

    Science.gov (United States)

    Fisher, Jacqueline Horan; Lichvar, Emily; Hogue, Aaron; Dauber, Sarah

    2018-03-10

    This study examines clinical and family predictors of perceived need for treatment and engagement in mental health treatment services among community-referred racial/ethnic minority adolescents and their primary caregivers. Findings indicated that the majority of families perceived a need for treatment, but that perceived need was not associated with treatment engagement. Family factors (i.e., low cohesion and high conflict within the family) predicted perceived need for treatment among adolescents, whereas clinical factors (i.e., adolescent internalizing and externalizing symptomatology) predicted caregiver perceived need for adolescent treatment. Neither clinical nor family factors predicted treatment engagement.

  18. [Home treatment--a treatment model of integrated care in Hamburg].

    Science.gov (United States)

    Schöttle, Daniel; Ruppelt, Friederike; Karow, Anne; Lambert, Martin

    2015-03-01

    Treatment models like "Crisis Resolution and Hometreatment (CRHT)" or "Assertive Community Treatment" (ACT), were found to be effective, enhancing the qualitative level of treatment for patients with severe mental disorders. In Germany, these are implemented only sporadically until today, often as part of a cross-sectoral Integrated Care (IC) treatment system. We will present the implementation of an "Assertive Community Treatment" embedded into an IC-treatment model in Hamburg and discuss the 3-year-outcomes. The IC-treatment model has been designed for severe mentally ill patients with psychotic disorders. Since May 2007 the model is financed by different health insurances as a managed-care "capitation-model" and its effectiveness gets continuously evaluated. The model proved to be effective in earlier studies were compared with standard care low rates of service disengagement were found as well as significantly improved psychopathology, psychosocial functioning, quality of life, satisfaction with care and adherence, while being cost effective. The rates of involuntary admissions declined to 10% in comparison to the years before. In 2011 the model was specified to the indication "first-episode adolescents and young adults in the age of 12-29" in a government-funded study "Integrated Care in Early Psychosis, ICEP Study". In this study an interdisciplinary team of child, adolescent and adult psychiatrists was implemented and since 2012 it is financed by the involved health insurances throughout an expansion of the §140 SGB V agreement. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

    Science.gov (United States)

    Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

    2018-01-01

    The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

  20. Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS.

    Science.gov (United States)

    Santiago, Catherine Decarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H

    2013-12-01

    This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.

  1. Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark

    DEFF Research Database (Denmark)

    Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang

    2017-01-01

    BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin...... penicillin-G/V using logistic regression analysis. RESULTS: We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated...... with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). CONCLUSION: The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin...

  2. Dental health and treatment needs among children in a tribal community.

    Science.gov (United States)

    Viragi, Prashant S; Dwijendra, K S; Kathariya, Mitesh D; Chopra, Kirti; Dadpe, Mahesh V; Madhukar, H S

    2013-07-01

    To assess the dental health status and treatment needs among children of 'Pardhi' tribal community. A total of 185 children were examined over a period of 2 months using WHO proforma. The statistical software namely SPSS version 15.0 and data was analyzed using Student's t-test and ANOVA test at p filling, i.e. 29.40%, followed by pulp care and restoration (19.30%), two or more surface fillings (15.60%) and extraction (11.70%). The study subjects were characterized by a lack of dental care services, high prevalence of dental caries and treatment needs. Therefore, implementation of a basic oral health care program for this tribal population is a high priority.

  3. Integrating the child into home and community following the completion of cancer treatment.

    Science.gov (United States)

    Labay, Larissa E; Mayans, Sherri; Harris, Michael B

    2004-01-01

    The present article examines the period of time immediately following the completion of treatment for childhood cancer. The unique concerns experienced by families at this stage of the cancer treatment are examined, and the specific challenges that children face as they renegotiate roles and relationships that are necessary for successful reintegration into family, school, and community settings are discussed. Obstacles to successful reintegration that are frequently encountered by patients and families are reviewed, as well as variables that may promote optimal adjustment during this transitional period. The need for continued research in this area is highlighted, and specific research questions are identified. An emphasis is placed on applying a socioecological framework to research and clinical work with pediatric oncology patients at this stage of the cancer experience.

  4. Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

    Science.gov (United States)

    Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

    2011-01-01

    This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…

  5. Measurement of Assertive Behavior: Construct and Predictive Validity of Self-Report, Role-Playing, and In-Vivo Measures.

    Science.gov (United States)

    Burkhart, Barry R.

    1979-01-01

    Seventy-five subjects, who spanned the range of assertiveness, completed two self-report measures of assertiveness, eight role-playing situations involving positive and negative assertiveness, and a telephone in-vivo task. Correlations between the three measurement methods were examined. (Author/SJL)

  6. Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.

    Science.gov (United States)

    Greene, Gregory S; West, Sheila K; Mkocha, Harran; Munoz, Beatriz; Merbs, Shannath L

    2015-12-01

    Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs) to use during Mass Drug Administration (MDA) was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania. A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50) as those assigned to usual care (n = 9, p card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.

  7. Microbial communities in riparian soils of a settling pond for mine drainage treatment.

    Science.gov (United States)

    Fan, Miaochun; Lin, Yanbing; Huo, Haibo; Liu, Yang; Zhao, Liang; Wang, Entao; Chen, Weimin; Wei, Gehong

    2016-06-01

    Mine drainage leads to serious contamination of soil. To assess the effects of mine drainage on microbial communities in riparian soils, we used an Illumina MiSeq platform to explore the soil microbial composition and diversity along a settling pond used for mine drainage treatment. Non-metric multidimensional scaling analysis showed that the microbial communities differed significantly among the four sampling zones (influent, upstream, downstream and effluent), but not seasonally. Constrained analysis of principal coordinates indicated heavy metals (zinc, lead and copper), total sulphur, pH and available potassium significantly influenced the microbial community compositions. Heavy metals were the key determinants separating the influent zone from the other three zones. Lower diversity indices were observed in the influent zone. However, more potential indicator species, related to sulphur and organic matter metabolism were found there, such as the sulphur-oxidizing genera Acidiferrobacter, Thermithiobacillus, Limnobacter, Thioprofundum and Thiovirga, and the sulphur-reducing genera Desulfotomaculum and Desulfobulbus; the organic matter degrading genera, Porphyrobacter and Paucimonas, were also identified. The results indicated that more microorganisms related to sulphur- and carbon-cycles may exist in soils heavily contaminated by mine drainage. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Community occupancy responses of small mammals to restoration treatments in ponderosa pine forests, northern Arizona, USA.

    Science.gov (United States)

    Kalies, E L; Dickson, B G; Chambers, C L; Covington, W W

    2012-01-01

    In western North American conifer forests, wildfires are increasing in frequency and severity due to heavy fuel loads that have accumulated after a century of fire suppression. Forest restoration treatments (e.g., thinning and/or burning) are being designed and implemented at large spatial and temporal scales in an effort to reduce fire risk and restore forest structure and function. In ponderosa pine (Pinus ponderosa) forests, predominantly open forest structure and a frequent, low-severity fire regime constituted the evolutionary environment for wildlife that persisted for thousands of years. Small mammals are important in forest ecosystems as prey and in affecting primary production and decomposition. During 2006-2009, we trapped eight species of small mammals at 294 sites in northern Arizona and used occupancy modeling to determine community responses to thinning and habitat features. The most important covariates in predicting small mammal occupancy were understory vegetation cover, large snags, and treatment. Our analysis identified two generalist species found at relatively high occupancy rates across all sites, four open-forest species that responded positively to treatment, and two dense-forest species that responded negatively to treatment unless specific habitat features were retained. Our results indicate that all eight small mammal species can benefit from restoration treatments, particularly if aspects of their evolutionary environment (e.g., large trees, snags, woody debris) are restored. The occupancy modeling approach we used resulted in precise species-level estimates of occupancy in response to habitat attributes for a greater number of small mammal species than in other comparable studies. We recommend our approach for other studies faced with high variability and broad spatial and temporal scales in assessing impacts of treatments or habitat alteration on wildlife species. Moreover, since forest planning efforts are increasingly focusing on

  9. Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort.

    Directory of Open Access Journals (Sweden)

    Walter Kipp

    Full Text Available In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART. We tested the utility of a health centre (HC/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.The HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL after two years of treatment. Adherence was determined through weekly pill counts.Successful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12, and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560. In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04.Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a

  10. Associations of Sexual Victimization, Depression, and Sexual Assertiveness with Unprotected Sex: A Test of the Multifaceted Model of HIV Risk Across Gender

    Science.gov (United States)

    Morokoff, Patricia J.; Redding, Colleen A.; Harlow, Lisa L.; Cho, Sookhyun; Rossi, Joseph S.; Meier, Kathryn S.; Mayer, Kenneth H.; Koblin, Beryl; Brown-Peterside, Pamela

    2014-01-01

    This study examined whether the Multifaceted Model of HIV Risk (MMOHR) would predict unprotected sex based on predictors including gender, childhood sexual abuse (CSA), sexual victimization (SV), depression, and sexual assertiveness for condom use. A community-based sample of 473 heterosexually active men and women, aged 18–46 years completed survey measures of model variables. Gender predicted several variables significantly. A separate model for women demonstrated excellent fit, while the model for men demonstrated reasonable fit. Multiple sample model testing supported the use of MMOHR in both men and women, while simultaneously highlighting areas of gender difference. Prevention interventions should focus on sexual assertiveness, especially for CSA and SV survivors, as well as targeting depression, especially among men. PMID:25018617

  11. Avian community responses to juniper woodland structure and thinning treatments on the Colorado Plateau

    Science.gov (United States)

    Crow, Claire; van Riper, Charles

    2011-01-01

    Federal land managers are increasingly implementing fuels-reduction treatments throughout the western United States with objectives of ecological restoration and fire hazard reduction in pinyon-juniper (Pinus spp.-Juniperus spp.) woodlands. The pinyon-juniper woodland ecosystem complex is highly variable across the western landscape, as is bird community composition. We investigated relations between breeding birds and vegetation characteristics in modified pinyon-juniper woodlands at three sites (BLM, USFS, NPS) on the Colorado Plateau. During the breeding seasons of 2005 and 2006, we surveyed birds and measured vegetation in 74 study plots. These plots were each 3.1 hectares (ha; 7.6 acres), located across the range of natural variation, with 41 control sites and 33 plots in areas previously thinned by hand-cutting or chaining. We found that relations of avian pinyon-juniper specialists and priority species to vegetation characteristics were generally in agreement with the findings of previous studies and known nesting and feeding habits of those birds. Relatively high density of pinyon pines was important to species richness and abundance in 6 of 14 species. Abundance of all species was related to treatment method, and we found no difference in bird communities at chaining and hand-cut sites.

  12. Conversion of sulfur compounds and microbial community in anaerobic treatment of fish and pork waste.

    Science.gov (United States)

    He, Ruo; Yao, Xing-Zhi; Chen, Min; Ma, Ruo-Chan; Li, Hua-Jun; Wang, Chen; Ding, Shen-Hua

    2018-04-07

    Volatile sulfur compounds (VSCs) are not only the main source of malodor in anaerobic treatment of organic waste, but also pose a threat to human health. In this study, VSCs production and microbial community was investigated during the anaerobic degradation of fish and pork waste. The results showed that after the operation of 245 days, 94.5% and 76.2% of sulfur compounds in the fish and pork waste was converted into VSCs. Among the detected VSCs including H 2 S, carbon disulfide, methanethiol, ethanethiol, dimethyl sulfide, dimethyl disulfide and dimethyl trisulfide, methanethiol was the major component with the maximum concentration of 4.54% and 3.28% in the fish and pork waste, respectively. The conversion of sulfur compounds including total sulfur, SO 4 2- -S, S 2- , methionine and cysteine followed the first-order kinetics. Miseq sequencing analysis showed that Acinetobacter, Clostridium, Proteus, Thiobacillus, Hyphomicrobium and Pseudomonas were the main known sulfur-metabolizing microorganisms in the fish and pork waste. The C/N value had most significant influence on the microbial community in the fish and pork waste. A main conversion of sulfur compounds with CH 3 SH as the key intermediate was firstly hypothesized during the anaerobic degradation of fish and pork waste. These findings are helpful to understand the conversion of sulfur compounds and to develop techniques to control ordor pollution in the anaerobic treatment of organic waste. Copyright © 2018. Published by Elsevier Ltd.

  13. Safer sexual practices among African American women: intersectional socialisation and sexual assertiveness.

    Science.gov (United States)

    Brown, Danice L; Blackmon, Sha'Kema; Shiflett, Alexandra

    2018-06-01

    Scholars have posited that childhood socialisation experiences may play a key role in influencing behaviours and attitudes that contribute to the acquisition of HIV. This study examined the links between past ethnic-racial and gender socialisation, sexual assertiveness and the safe sexual practices of African American college women utilising a cluster analytic approach. After identifying separate racial-gender and ethnic-gender socialisation profiles, results indicated that ethnic-gender socialisation cluster profiles were directly associated with sexual assertiveness and safer sex behaviour. Greater levels of ethnic socialisation and low traditional gender role socialisation were found to be associated with greater sexual assertiveness and safer sex behaviour. Further analysis showed that sexual assertiveness mediated the links between the identified ethnic-gender socialisation profiles and safer sex behaviour. Implications for policy and programme development are discussed.

  14. Relationships of assertiveness, depression, and social support among older nursing home residents.

    Science.gov (United States)

    Segal, Daniel L

    2005-07-01

    This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age = 75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r = -.33), but the correlations between social support and depression (r = -.15) and between social support and assertiveness (r = -.03) were small and nonsignificant. The correlation between overall physical health (a subjective self-rating) and depression was strong and negative (r = -.50), with lower levels of health associated with higher depression. An implication of this study is that an intervention for depression among nursing home residents that is targeted at increasing assertiveness and bolstering health status may be more effective than the one that solely targets social support.

  15. [Causal relationship between assertiveness and adjustment in children: A short-term longitudinal study].

    Science.gov (United States)

    Eguchi, Megumi; Hamaguchi, Yoshikazu

    2015-08-01

    This study examined the causal relationships between assertiveness and both internal and external adjustment in children. Elementary school children in grades four through six (N = 284) participated in the study, which used a short-term longitudinal design. The children completed questionnaires twice during a 6-months period. They responded to assertiveness questionnaires that included two components: "self-expression" and "consideration of others". They also completed a self-esteem scale as an index of internal adjustment, and the Class Life Satisfaction scale as an index of external adjustment. There was a positive causative relationship between "self-expression" and internal adjustment and between "consideration for others" and external adjustment. In addition, the effects on adjustment varied according to the type of assertiveness. Cluster analysis and MANOVA indicated that the group with high "self-expression" and "consideration for others" had high internal and external adjustment, while the children with poor assertiveness showed the lowest degree of adaptivity.

  16. [Relationship between members' egoistic self-assertion and captains' leadership in athletic clubs].

    Science.gov (United States)

    Yoshimura, Hitoshi

    2005-02-01

    This study examined the relationships between club members' egoistic self-assertion and their captains' leadership with respect to the adjustment to activities in extracurricular athletic clubs. Participants were 638 junior high school students who belong to the athletic clubs. The research was conducted by means of a questionnaire and the following results were obtained. When the captains took a laissez-faire command, club members who did not assert themselves egoistically were not satisfied with their captains, and did not participate in the club activities very diligently. On the other hand, when the captains took an authoritative command, the members who asserted themselves egoistically were not satisfied with club activities. These results suggest that the relationships between egoistic self-assertion by club members and leadership by captains have a great influence on the adjustment to club activities.

  17. The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review.

    Science.gov (United States)

    Omura, Mieko; Maguire, Jane; Levett-Jones, Tracy; Stone, Teresa Elizabeth

    2017-11-01

    Communication errors have a negative impact on patient safety. It is therefore essential that healthcare professionals have the skills and confidence to speak up assertively when patient safety is at risk. Although the facilitators to and barriers of assertive communication have been the subject of previous reviews, evidence regarding the effectiveness of interventions designed to enhance assertive communication is lacking. Thus, this paper reports the findings from a systematic review of the effectiveness of assertiveness communication training programs for healthcare professionals and students. The objective of this review is to identify, appraise and synthesise the best available quantitative evidence in relation to the effectiveness of assertiveness communication training programs for healthcare professionals and students on levels of assertiveness, communication competence and impact on clinicians' behaviours and patient safety. The databases included: CINAHL, Cochrane library, EMBASE, Informit health collection, MEDLINE, ProQuest nursing and allied health, PsycINFO, Scopus and Web of Science. The search for unpublished studies included: MedNar, ProQuest Dissertations & Theses A&I. Studies published in English from 2001 until 2016 inclusive were considered. The review included original quantitative research that evaluated (a) any type of independent assertiveness communication training program; and (b) programs with assertiveness training included as a core component of team skills or communication training for healthcare professionals and students, regardless of healthcare setting and level of qualification of participants. Studies selected based on eligibility criteria were assessed for methodological quality and the data were extracted by two independent researchers using the Joanna Briggs Institute critical appraisal and data extraction tools. Eleven papers were critically appraised using the Joanna Briggs Institute critical appraisal checklists. Eight

  18. MENGURANGI PERILAKU SISWA TIDAK TEGAS MELALUI PENDEKATAN REBT DENGAN TEKNIK ASSERTIVE TRAINING

    Directory of Open Access Journals (Sweden)

    Tri Jayanti

    2012-11-01

    Full Text Available Penelitian ini bertujuan untuk mengurangi perilaku siswa tidak tegas terhadap te-man-teman sekelasnya yang tidak bersahabat melalui pendekatan Rational Emo-tive Behavior Therapy (REBT dengan teknik assertive training. Penelitian ini dilak-sanakan dengan menggunakan metode kombinasi (mixed methods dengan modelconcurrent embedded (campuran tidak berimbang. Subyek dalam penelitian iniadalah 3 siswa kelas VIII di SMP Teuku Umar Semarang yang berperilaku tidak te-gas terhadap teman-teman sekelasnya yang tidak bersahabat. Metode pengumpulandata yang digunakan adalah wawancara, observasi, dan dokumentasi. Teknik anali-sis data yang digunakan adalah analisis data interaktif Miles and Huberman, sertaanalisis deskriptif persentase. Hasil penelitian adalah ketiga klien mampu men-gubah keyakinan irrasional menjadi rasional, sehingga ketiga klien mampu men-gubah perilaku tidak tegas menjadi perilaku tegas terhadap teman-teman sekelasnyayang tidak bersahabat. Perilaku tidak tegas ketiga klien berkurang dari frekuensi ser-ing menjadi jarang. Dengan ketiga klien berperilaku asertif terjalin hubungan baikantara ketiga klien dengan teman-teman sekelasnya yang tidak bersahabat. Simpu-lan dari penelitian ini adalah perilaku siswa tidak tegas terhadap teman-teman seke-lasnya yang tidak bersahabat dapat dikurangi melalui pendekatan REBT denganteknik assertive training The purpose of the research is to decrease the students non assertive behavior toward their notfriendly classmate through the Rational Emotive Behavior Therapy (REBT approach withthe assertive training technique. This research uses the mixed methods with the concurrentembedded design. The Subject of this research is the students at eighth grade of Junior HighSchool Teuku Umar Semarang that consist of three students who had non assertive behaviortoward their not friendly classmate. The methods for collecting data are interview, observation,and documentation. The data analysis technique uses the analysis

  19. Freedom Lessons: Black Mothers Asserting "Smartness" of Their Children

    Science.gov (United States)

    Sankofa Waters, Billye

    2016-01-01

    It is imperative to explore multiple approaches to intelligence and public education that fundamentally integrate the ideas and lived experiences of students--with particular interest to those who are most disenfranchised. Within various black communities, the oral traditions transmitted at home are life-affirming "freedom lessons,"…

  20. Sexual Behavior, Risk Beliefs, and Assertiveness among Adolescents.

    Science.gov (United States)

    Lang, Michelle A.

    HIV risk behaviors were examined with 457 adolescents, ages 12 to 19, from four environments (community, high school, and two youth conferences). Over half reported being sexually experienced, with an average age of 13.6 for willingly engaging in first sexual intercourse. Boys reported engaging in intercourse at a significantly younger age than…

  1. Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study.

    Science.gov (United States)

    Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang; Petersen, Pelle Trier; Lindhardt, Bjarne Ørskov; von Plessen, Christian; Rohde, Gernot; Ravn, Pernille

    2017-04-20

    Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy. Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis. We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.

  2. A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

    DEFF Research Database (Denmark)

    Mollerup, Pernille Maria; Gamborg, Michael Orland; Trier, Cæcilie

    2017-01-01

    BACKGROUND: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. METHODS: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS......) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations...... was invested per child per year. CONCLUSION: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility....

  3. Integrating software testing and run-time checking in an assertion verification framework

    OpenAIRE

    Mera, E.; López García, Pedro; Hermenegildo, Manuel V.

    2009-01-01

    We have designed and implemented a framework that unifies unit testing and run-time verification (as well as static verification and static debugging). A key contribution of our approach is that a unified assertion language is used for all of these tasks. We first propose methods for compiling runtime checks for (parts of) assertions which cannot be verified at compile-time via program transformation. This transformation allows checking preconditions and postconditions, including conditional...

  4. Essentials for effective communication in oncology nursing: assertiveness, conflict management, delegation, and motivation.

    Science.gov (United States)

    Walczak, M B; Absolon, P L

    2001-01-01

    The ability to communicate effectively with a multidisciplinary team in an assertive manner to resolve conflict, motivate others, and delegate tasks is a prerequisite skill to promote a harmonious work environment. Acquisition of this skill is often a combination of inherent attributes and learned experiences. This article describes a program on assertiveness, conflict resolution, motivation of others, and delegation. Nurses are encouraged to seek expertise from other departments (e.g., Human Resources) to help them develop similar programs.

  5. Wu’s Characteristic Set Method for SystemVerilog Assertions Verification

    Directory of Open Access Journals (Sweden)

    Xinyan Gao

    2013-01-01

    Full Text Available We propose a verification solution based on characteristic set of Wu’s method towards SystemVerilog assertion checking over digital circuit systems. We define a suitable subset of SVAs so that an efficient polynomial modeling mechanism for both circuit descriptions and assertions can be applied. We present an algorithm framework based on the algebraic representations using characteristic set of polynomial system. This symbolic algebraic approach is a useful supplement to the existent verification methods based on simulation.

  6. The Relationship Between Cultural Sensitivity and Assertiveness in Nursing Students from Turkey.

    Science.gov (United States)

    Kılıç, Serap Parlar; Sevinç, Sibel

    2017-07-01

    As foreigners live in and visit Turkey for various reasons, it is essential to provide culturally appropriate health care. This study was conducted to determine the relationship between cultural sensitivity and assertiveness in university nursing students. This descriptive, cross-sectional study was conducted at two universities in the cities of Kilis and Elazığ, Turkey. The study sample consisted of 444 nursing students. Data collection tools included a questionnaire about participant sociodemographic characteristics, Chen and Starosta's Intercultural Sensitivity Scale, and the Rathus Assertiveness Scale. The mean age of participants was 21.09 years. Most students (71.6%) were female and 34.7% of the students stayed at the hostel. Of the students, 44.4%, 27.5%, and 28.2% attended were the second-, third-, and fourth-year students, respectively. Participants were asked about problems related to caring for patients who speak different languages. The mean score for the Intercultural Sensitivity Scale was 89.42 ± 13.55 and the total score for all students for the Assertiveness Scale was 112.64 ± 15.61. We identified a positive relationship between total scores for the Intercultural Sensitivity Scale and the Assertiveness Scale ( p assertiveness and year of nursing education and want to work overseas. Nursing students at both schools had a moderate level of cultural sensitivity and assertiveness. It has been determined that as assertiveness level of the students increased, intercultural sensitivity of them also increased. Consequently, it is concluded that training as assertive and self-confident individuals during the nursing education of students has a contribution to making patient-specific and culture-sensitive care.

  7. Why Community Works: The Use of Alfred Adler's Individual Psychology as a Foundational Theory.

    Science.gov (United States)

    Glenn, Robert K.; Keith, Edwin M.

    2002-01-01

    Asserts that the Individual Psychology of Alfred Adler should be used as a foundational theory for student affairs work. The success of community building programs is explained and the concepts of Individual Psychology are summarized. Also asserts that the current drive to develop programs to develop community on college campuses is firmly rooted…

  8. Perceptions of sexual assertiveness among adolescent girls: initiation, refusal, and use of protective behaviors.

    Science.gov (United States)

    Auslander, Beth A; Perfect, Michelle M; Succop, Paul A; Rosenthal, Susan L

    2007-06-01

    We describe adolescent girls' perceptions of sexual assertiveness and examine the relationship of these perceptions with developmental and interpersonal variables. Cross-sectional analysis. Participants were recruited from a school-based health clinic and local colleges, and through snowballing to participate in a 6-month study examining microbicide acceptability. 106 sexually experienced girls (ages 14 through 21 years). Girls described their demographics, sexual history, and romantic relationships and completed the Sexual Assertiveness Scale for Women (SAS-W), which assesses perceptions of sexual assertiveness: Initiation of Sex, Refusal of Unwanted Sex, and Pregnancy-STD Prevention. Girls perceived themselves as asserting themselves between 50% and 75% of the time with their current or most recent partner. The Initiation subscale was not related to the other two subscales. In final models, girls with a prior pregnancy perceived themselves as initiating sex more than girls without a prior pregnancy. Having a greater number of lifetime partners was related to perceptions of less refusal, whereas greater number of partners, being sexually experienced longer, and engaging in more unprotected sex were related to perceptions of less implementation of preventive methods. None of the relationship variables were related to scores on any subscale. Most of these girls perceived themselves as sexually assertive. Given that sexual experience, not relationship factors, were related to perceptions of sexual assertiveness, the design of counseling messages should incorporate sexual experience. These messages should find effective ways to help girls both to communicate their sexual desires and to enhance their ability to protect themselves.

  9. The Comparison of assertiveness level of physically disabled athletes who played in different sport branches.

    Directory of Open Access Journals (Sweden)

    Gonca İNCE

    2017-03-01

    Full Text Available Aim: The aim of this study was the comparison of assertiveness level of physically disabled athletes who played in different sport branches. Material and Methods: Totally 60 disabled athletes (35 athletes, 25 swimmers joined in to the study voluntarily. The means of ages, sports year and sport statues were found 19.73±5.08, 2.48±1.75 years, day number in per week:3.63±1.52, hour numberin per day: 2.91±1.53 respectively. Rathus Assertiveness Schedule was used for evaluating assertiveness and questionnaire of athletes' demograpic features was performed by researcher. For statistical analyses, the SPSS 11.5 computer packet program (frequency, mean, standard deviation and independent t test was performed. Results: We say that no association was detected between branches (p>0.05. The means of assertiveness of swimmers and athletes were found 14.67±6.62, 12.70±4.67 respectively. Both swimming (19 person, %76 and athletics (25 person, %71.4 were seen shyness more than assertiveness. Conclusions: We think that branches of different sports may be alike effect on the assertiveness characteristics of the physically disabled individuals.

  10. Validation of the ASSERT subchannel code for MAPLE-X10 reactor conditions

    International Nuclear Information System (INIS)

    Carver, M.B.; Kiteley, J.C.; Junop, S.V.; Wasilewicz, J.F.

    1993-01-01

    The ASSERT subchannel analysis code has been developed specifically to model flow and phase distributions within CANDU fuel channels. Recently, ASSERT has been adapted for use in simulating the MAPLE-X10 reactor. ASSERT uses an advanced drift-flux model, which permits the phases to have unequal velocities and unequal temperatures (UVUT), and thus can model non-equilibrium effects such as phase separation tendencies and subcooled boiling. Modelling subcooled boiling accurately is particularly important for MAPLE-X10. This paper briefly summarizes the non-equilibrium model used in the ASSERT code, the equations used to represent these models, and the algorithms used to solve the equations numerically. Very few modifications to the ASSERT models were needed to address MAPLE conditions. These centered on the manner in which finned fuel rods are treated, and they are discussed in the paper. The paper also gives results from validation exercises, in which the ASSERT code predictions of subcooled boiling void-fraction and critical heat flux were compared to experiments using MAPLE-X10 finned fuel elements in annuli and various bundles. 18 refs., 13 figs., 3 tabs

  11. Assertion Practices and Beliefs Among Nurses and Physicians on an Inpatient Pediatric Medical Unit.

    Science.gov (United States)

    Reese, Jennifer; Simmons, Ryan; Barnard, Juliana

    2016-05-01

    Teamwork and communication are critical elements of safe and effective patient care. Standardized communication tools have been implemented in many health care organizations, but little is known about attitudes and perceptions of assertion, the willingness to "speak up," by nurses and physicians at an academic pediatric institution. We conducted 6 focus groups with nurses, residents, and attending physicians using a standardized semistructured focus group guide to promote discussion. Focus groups were recorded and transcribed, and results were analyzed by 2 independent reviewers to identify thematic content. Three themes emerged: (1) interpersonal factors, (2) organizational factors, and (3) complexity of care environment. Subthemes were the roles of hierarchy, relationships, and communication and personality style; the value of using standardized communication tools such as SBAR (Situation, Background, Assessment, Recommendation), direct face-to-face communication, and geographic and technology factors; and the need for coordinated communication and agreement across care team members about the care plans. Nurses reported reliance on peers for decision-making, on when and how to assert on behalf of patient care. Nurses and residents experienced barriers to assertion from concerns of relationships and their position within professional hierarchies. Attending physicians were supportive of being asserted to by any care team provider. Interpersonal relationships, power dynamics, and organizational factors impact care team providers' willingness to assert in the inpatient setting. Standardized communication tools are effective. Further development and implementation of communication models that support experience, peer reliance, and direct face-to-face communication are warranted to improve assertion communication in the inpatient setting

  12. Sexual victimization, fear of sexual powerlessness, and cognitive emotion dysregulation as barriers to sexual assertiveness in college women.

    Science.gov (United States)

    Zerubavel, Noga; Messman-Moore, Terri L

    2013-12-01

    The current study examined sexual victimization and two barriers to young women's sexual assertiveness: fear of sexual powerlessness and cognitive emotion dysregulation. College women (N = 499) responded to surveys and indicated that fear of sexual powerlessness and, to a lesser extent, cognitive emotion dysregulation were barriers to sexual assertiveness. Compared with nonvictims, sexually victimized women had greater problems with sexual assertiveness, fear of sexual powerlessness, and cognitive emotion dysregulation. Among victims, fear of sexual powerlessness and emotion dysregulation interacted to impede sexual assertiveness. Findings support targeting identified barriers in interventions to improve sexual assertiveness and reduce risk for unwanted sexual experiences and sexual victimization.

  13. Microbial community functional structure in response to antibiotics in pharmaceutical wastewater treatment systems.

    Science.gov (United States)

    Zhang, Yu; Xie, Jianping; Liu, Miaomiao; Tian, Zhe; He, Zhili; van Nostrand, Joy D; Ren, Liren; Zhou, Jizhong; Yang, Min

    2013-10-15

    It is widely demonstrated that antibiotics in the environment affect microbial community structure. However, direct evidence regarding the impacts of antibiotics on microbial functional structures in wastewater treatment systems is limited. Herein, a high-throughput functional gene array (GeoChip 3.0) in combination with quantitative PCR and clone libraries were used to evaluate the microbial functional structures in two biological wastewater treatment systems, which treat antibiotic production wastewater mainly containing oxytetracycline. Despite the bacteriostatic effects of antibiotics, the GeoChip detected almost all key functional gene categories, including carbon cycling, nitrogen cycling, etc., suggesting that these microbial communities were functionally diverse. Totally 749 carbon-degrading genes belonging to 40 groups (24 from bacteria and 16 from fungi) were detected. The abundance of several fungal carbon-degrading genes (e.g., glyoxal oxidase (glx), lignin peroxidase or ligninase (lip), manganese peroxidase (mnp), endochitinase, exoglucanase_genes) was significantly correlated with antibiotic concentrations (Mantel test; P functional genes have been enhanced by the presence of antibiotics. However, from the fact that the majority of carbon-degrading genes were derived from bacteria and diverse antibiotic resistance genes were detected in bacteria, it was assumed that many bacteria could survive in the environment by acquiring antibiotic resistance and may have maintained the position as a main player in nutrient removal. Variance partitioning analysis showed that antibiotics could explain 24.4% of variations in microbial functional structure of the treatment systems. This study provides insights into the impacts of antibiotics on microbial functional structure of a unique system receiving antibiotic production wastewater, and reveals the potential importance of the cooperation between fungi and bacteria with antibiotic resistance in maintaining the

  14. Effect of High-Intensity Wildfire and Silvicultural Treatments on Reptile Communities in Sand-Pine Scrub

    Science.gov (United States)

    Cathryn H. Greenberg; Daniel G. Neary; Larry D. Harris

    1994-01-01

    We tested whether the herpetofuunal response to clearcutting followed by site preparation was similar to high-intensity wildfire foIlowed by salvage logging in sand- pine scrub. Herpetofaunal communities were compared in three replicated 5- to 7-yearpost-disturbance treatments and mature sand-pine forest. The three disturbance treatments were (1) high-intensity...

  15. Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, A K; Schultz Hansen, K; Bygbjerg, I C

    2008-01-01

    whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer IPTp with sulphadoxine-pyrimethamine (SP) to pregnant women, reach those at greatest risk of malaria, and increase access and compliance with IPTp. STUDY DESIGN...... of the intervention on access to malaria treatment, antenatal care, other services and related costs. RESULTS: More women (67.5%) received two doses of SP through the community approach compared with health units (39.9%; P... in the community had sought malaria treatment (70.3%), suggesting the possibility that the novel approach had a positive impact on care seeking for malaria. Similarly, utilization of antenatal care, insecticide-treated nets and delivery care by women in the community was high. The total costs per woman receiving...

  16. Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony; Hansen, Kristian Schultz; Bygbjerg, Ib

    2008-01-01

    whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilizers can administer IPTp with sulphadoxine-pyrimethamine (SP) to pregnant women, reach those at greatest risk of malaria, and increase access and compliance with IPTp. Study design...... of the intervention on access to malaria treatment, antenatal care, other services and related costs. Results: More women (67.5%) received two doses of SP through the community approach compared with health units (39.9%; P... in the community had sought malaria treatment (70.3%), suggesting the possibility that the novel approach had a positive impact on care seeking for malaria. Similarly, utilization of antenatal care, insecticide-treated nets and delivery care by women in the community was high. The total costs per woman receiving...

  17. Community-directed treatment with ivermectin in two Nigerian communities: an analysis of first year start-up processes, costs and consequences.

    Science.gov (United States)

    Onwujekwe, Obinna; Chima, Reginald; Shu, Elvis; Okonkwo, Paul

    2002-10-01

    To determine the start-up processes, costs and consequences of community-directed treatment with ivermectin (CDTI) in two onchocerciasis endemic rural towns of Southeast Nigeria; namely Achi and Nike. The other objectives were to discover the community-financing mechanisms, local ivermectin distribution strategies and communities' organisational capacity to handle the programme. Structured questionnaires, informal interviews, observations, discussions with community members at general village assemblies and community outreach lectures were used at different stages of the study. The towns had the organisational capacity to implement the programme. Coverage with ivermectin was between 31-73% in Achi (mean = 58.6%), and 36.6-72% in Nike (mean = 61.95%). The unit financial costs were $0.17 in Nike and $0.13 in Achi, but the unit aggregate cost was $0.37 in Nike and $0.39 in Achi. When research costs were removed, the unit aggregate cost was $0.22 in Achi and $0.20 in Nike. Provider's financial costs and communities' non-financial costs were the biggest contributors to the aggregate cost. The cost would decrease in subsequent years since the research cost and parts of the mobilisation and training costs would not be incurred after the first year. Governments and sponsors of CDTI should find means of continuously strengthening the programme and providing technical support to the communities. As both CDTI and communities are dynamic entities, continuous health education campaigns are needed to keep reminding the people of the benefit of long-term ivermectin distribution, together with the need for community ownership of the programme.

  18. Application of Ion Torrent Sequencing to the Assessment of the Effect of Alkali Ballast Water Treatment on Microbial Community Diversity

    Science.gov (United States)

    Fujimoto, Masanori; Moyerbrailean, Gregory A.; Noman, Sifat; Gizicki, Jason P.; Ram, Michal L.; Green, Phyllis A.; Ram, Jeffrey L.

    2014-01-01

    The impact of NaOH as a ballast water treatment (BWT) on microbial community diversity was assessed using the 16S rRNA gene based Ion Torrent sequencing with its new 400 base chemistry. Ballast water samples from a Great Lakes ship were collected from the intake and discharge of both control and NaOH (pH 12) treated tanks and were analyzed in duplicates. One set of duplicates was treated with the membrane-impermeable DNA cross-linking reagent propidium mono-azide (PMA) prior to PCR amplification to differentiate between live and dead microorganisms. Ion Torrent sequencing generated nearly 580,000 reads for 31 bar-coded samples and revealed alterations of the microbial community structure in ballast water that had been treated with NaOH. Rarefaction analysis of the Ion Torrent sequencing data showed that BWT using NaOH significantly decreased microbial community diversity relative to control discharge (pbased principal coordinate analysis (PCoA) plots and UPGMA tree analysis revealed that NaOH-treated ballast water microbial communities differed from both intake communities and control discharge communities. After NaOH treatment, bacteria from the genus Alishewanella became dominant in the NaOH-treated samples, accounting for alkali ballast water treatment in reducing ballast water microbial diversity and demonstrated the application of new Ion Torrent sequencing techniques to microbial community studies. PMID:25222021

  19. Life cycle assessment of wastewater treatment options for small and decentralized communities.

    Science.gov (United States)

    Machado, A P; Urbano, L; Brito, A G; Janknecht, P; Salas, J J; Nogueira, R

    2007-01-01

    Sustainability has strong implications on the practice of engineering. Life cycle assessment (LCA) is an appropriate methodology for assessing the sustainability of a wastewater treatment plant design. The present study used a LCA approach for comparing alternative wastewater treatment processes for small and decentralised rural communities. The assessment was focused on two energy-saving systems (constructed wetland and slow rate infiltration) and a conventional one (activated sludge process). The low environmental impact of the energy-saving wastewater treatment plants was demonstrated, the most relevant being the global warming indicator. Options for reduction of life cycle impacts were assessed including materials used in construction and operational lifetime of the systems. A 10% extension of operation lifetime of constructed wetland and slow rate infiltration systems led to a 1% decrease in CO2 emissions, in both systems. The decrease in the abiotic depletion was 5 and 7%, respectively. Also, replacing steel with HDPE in the activated sludge tank resulted in a 1% reduction in CO2 emission and 1% in the abiotic depletion indicator. In the case of the Imhoff tank a 1% reduction in CO2 emissions and 5% in the abiotic depletion indicator were observed when concrete was replaced by HDPE.

  20. Barriers and Facilitators of Partner Treatment of Chlamydia: A Qualitative Investigation with Prescribers and Community Pharmacists

    Directory of Open Access Journals (Sweden)

    Helen Wood

    2018-02-01

    Full Text Available Chlamydia trachomatis is the most frequently-notified sexually transmitted infection in Australia. Effective and timely partner treatment of chlamydia is essential to reduce overall prevalence and the burden of infection. Currently in most of Australia, the only avenue for partner treatment of chlamydia (“standard partner therapy” is a tedious, and often inconvenient, process. The barriers and facilitators of standard partner therapy, and newer models of accelerated partner therapy (APT, need to be identified in the Australian setting. Additionally, the potential role of community pharmacists need to be explored. Semi-structured interview guides for two key stakeholder groups (prescribers and pharmacists were developed and piloted. Eleven prescribers (general practitioners, sexual health clinicians and nurse practitioners and twelve pharmacists practicing in the Perth metropolitan region were interviewed. Key reported barriers to standard partner therapy were lack of or delayed chlamydia testing. Key facilitators included ability to test and educate sexual partner. Key barriers for APT included prescribers’ legal responsibility and potential for medication-related adverse effects. Healthcare provider consultation and chlamydia testing were seen as potential facilitators of APT. Pharmacists were receptive to the idea of expanding their role in chlamydia treatment, however, barriers to privacy must be overcome in order to be acceptable to prescribers and pharmacists.

  1. The microbial community of a biofilm contact reactor for the treatment of winery wastewater.

    Science.gov (United States)

    de Beer, D M; Botes, M; Cloete, T E

    2018-02-01

    To utilize a three-tiered approach to provide insight into the microbial community structure, the spatial distribution and the metabolic capabilities of organisms of a biofilm in the two towers of a high-rate biological contact reactor treating winery wastewater. Next-generation sequencing indicated that bacteria primarily responsible for the removal of carbohydrates, sugars and alcohol were more abundant in tower 1 than tower 2 while nitrifying and denitrifying bacteria were more abundant in tower 2. Yeast populations differed in each tower. Fluorescent in situ hybridization coupled with confocal microscopy showed distribution of organisms confirming an oxygen gradient across the biofilm depth. The Biolog system (ECO plates) specified the different carbon-metabolizing profiles of the two biofilms. The three-tiered approach confirmed that the addition of a second subunit to the bioreactor, expanded the treatment capacity by augmenting the microbial and metabolic diversity of the system, improving the treatment scope of the system. A three-tiered biofilm analysis provided data required to optimize the design of a bioreactor to provide favourable conditions for the development of a microbial consortium, which has optimal waste removal properties for the treatment requirements at hand. © 2017 The Society for Applied Microbiology.

  2. Treatment outcomes of obstructive sleep apnoea in obese community-dwelling children: the NANOS study.

    Science.gov (United States)

    Alonso-Álvarez, María Luz; Terán-Santos, Joaquin; Navazo-Egüia, Ana Isabel; Martinez, Mónica Gonzalez; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Cordero-Guevara, José Aurelio; Kheirandish-Gozal, Leila; Gozal, David

    2015-09-01

    The first line of treatment of obstructive sleep apnoea syndrome (OSAS) in children consists of adenotonsillectomy (T&A). The aim of the present study was to evaluate treatment outcomes of OSAS among obese children recruited from the community.A cross-sectional, prospective, multicentre study of Spanish obese children aged 3-14 years, with four groups available for follow-up: group 1: non-OSAS with no treatment; group 2: dietary treatment; group 3: surgical treatment; and group 4: continuous positive airway pressure treatment.117 obese children (60 boys, 57 girls) with a mean age of 11.3±2.9 years completed the initial (T0) and follow-up (T1) assessments. Their mean body mass index (BMI) at T1 was 27.6±4.7 kg·m(-2), corresponding to a BMI Z-score of 1.34±0.59. Mean respiratory disturbance index (RDI) at follow-up was 3.3±3.9 events·h(-1). Among group 1 children, 21.2% had an RDI ≥3 events·h(-1) at T1, the latter being present in 50% of group 2, and 43.5% in group 3. In the binary logistic regression model, age emerged as a significant risk factor for residual OSAS (odds ratio 1.49, 95% confidence interval 1.01-2.23; p<0.05) in obese children surgically treated, and RDI at T0 as well as an increase in BMI emerged as significant risk factors for persistent OSAS in obese children with dietary treatment (OR 1.82, 95% CI 1.09-3.02 (p<0.03) and OR 8.71, 95% CI 1.24-61.17 (p=0.03)).Age, RDI at diagnosis and obesity are risk factors for relatively unfavourable OSAS treatment outcomes at follow-up. Copyright ©ERS 2015.

  3. Configuration of biological wastewater treatment line and influent composition as the main factors driving bacterial community structure of activated sludge

    OpenAIRE

    Jaranowska, Paulina; Cydzik-Kwiatkowska, Agnieszka; Zieli?ska, Magdalena

    2013-01-01

    The structure of microbial consortia in wastewater treatment facilities is a resultant of environmental conditions created by the operational parameters of the purification process. In the research, activated sludge from nine Polish wastewater treatment plants (WWTPs) was investigated at a molecular level to determine the impact of the complexity of biological treatment line and the influent composition on the species structure and the diversity of bacterial consortia. The community fingerpri...

  4. Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.

    Directory of Open Access Journals (Sweden)

    Gregory S Greene

    2015-12-01

    Full Text Available Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs to use during Mass Drug Administration (MDA was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania.A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50 as those assigned to usual care (n = 9, p < 0.05. While specificity was above 90% for both groups, the sensitivity for the novel screening tool was 31.2% compared to 5.6% for the usual care group (p < 0.05.CTAs appear to be viable resources for the identification of TT cases. Additional training and use of a TT screening card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.

  5. Pioneering Annual Colorectal Cancer Screening and Treatment Targeting Low Income Communities in Malaysia (20102015).

    Science.gov (United States)

    Tze, Christina Ng Van; Fitzgerald, Henry; Qureshi, Akhtar; Tan, Huck Joo; Low, May Lee

    2016-01-01

    The aim of this study was to assess the rate of uptake of a customised annual Colorectal Cancer Awareness, Screening and Treatment Project (CCASTP) using faecal immunohistochemical test (FIT) kits in low income communities in Malaysia. The immediate objectives were (1) to evaluate the level of adherence of CRC screening among lowincome groups, (2) to assess the knowledge and awareness of the screened population and (3) to assess the accuracy of FIT kits. A total of 1,581 FIT kits were distributed between years 2010 to 2015 to healthy asymptomatic participants of the annual CCASTP organized by Empowered the Cancer Advocacy Society of Malaysia. Data for sociodemographic characteristics, critical health and lifestyle information of the registered subjects were collected. Findings for use of the FIT kits were collected when they were returned for stool analyses. Those testingd positive were invited to undergo a colonoscopy examination. A total of 1,436 (90.8%) of the subjects retuned the FITkits, showing high compliance. Among the 129 subjects with positive FIT results, 92 (71.3%) underwent colonoscopy. Six cases (6.5%) of CRC were found. Based on the data collected, the level of awareness of stool examination and knowledge about CRC was poor amongst the participants. Gender, age group, ethnicity and risk factors (i.e. smoking, lack of exercise and low consumption of fresh fruits) were associated with positive FITkit results. In conclusion, CRC screening can be performed in the community with a single FITkit. Although CRC knowledge and awareness is poor in lowincome communities, the average return rate of the FIT kits and rate of colonoscopy examination were 91.2% and 70.3%, respectively.

  6. Community response to intermittent preventive treatment of malaria in infants (IPTi in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Senn Nicolas

    2010-12-01

    Full Text Available Abstract Background Building on previous acceptability research undertaken in sub-Saharan Africa this article aims to investigate the acceptability of intermittent preventive treatment of malaria in infants (IPTi in Papua New Guinea (PNG. Methods A questionnaire was administered to mothers whose infants participated in the randomised placebo controlled trial of IPTi. Mothers whose infants participated and who refused to participate in the trial, health workers, community reporters and opinion leaders were interviewed. Men and women from the local community also participated in focus group discussions. Results Respondents viewed IPTi as acceptable in light of wider concern for infant health and the advantages of trial participation. Mothers reported complying with at-home administration of IPTi due to perceived benefits of IPTi and pressure from health workers. In spite of patchy knowledge, respondents also demonstrated a demand for infant vaccinations and considered non-vaccination to be neglect. There is little evidence that IPTi has negative impacts on attitudes to EPI, EPI adherence or existing malaria prevention practices. Conclusion The degree of similarity between findings from the acceptability studies undertaken in sub-Saharan Africa and PNG allows some generalization relating to the implementation of IPTi outside of Africa: IPTi fits well with local health cultures, appears to be accepted easily and has little impact on attitudes towards EPI or malaria prevention. The study adds to the evidence indicating that IPTi could be rolled out in a range of social and cultural contexts.

  7. Annual glyphosate treatments alter growth of unaffected bentgrass (Agrostis weeds and plant community composition.

    Directory of Open Access Journals (Sweden)

    Collin W Ahrens

    Full Text Available Herbicide resistance is becoming more common in weed ecotypes and crop species including turfgrasses, but current gaps in knowledge limit predictive ecological risk assessments and risk management plans. This project examined the effect of annual glyphosate applications on the vegetative growth and reproductive potential of two weedy bentgrasses, creeping bentgrass (CB and redtop (RT, where the glyphosate resistance (GR trait was mimicked by covering the bentgrass plants during glyphosate application. Five field plots were studied in habitats commonly inhabited by weedy bentgrasses including an agricultural hayfield, natural meadow, and wasteland. Results showed that annual glyphosate treatment improved bentgrass survivorship, vegetative growth, and reproductive potential compared with bentgrass in unsprayed subplots. In the second year of growth, RT plants had an 86-fold increase in flower number in glyphosate-treated subplots versus controls, while CB plants had a 20-fold increase. At the end of the three year study, plant community composition had changed in glyphosate-treated subplots in hayfield and meadow plots compared to controls. Soils in subplots receiving glyphosate had higher nitrate concentrations than controls. This is the first study to mimic the GR trait in bentgrass plants with the goal of quantifying bentgrass response to glyphosate selection pressure and understanding the impacts on surrounding plant communities.

  8. Cost-effective non-surgical treatment of chronic pressure ulcers in the community.

    Science.gov (United States)

    Dale, Megan; Cox-Martin, Bill; Shaw, Paula; Carolan-Rees, Grace

    2014-03-01

    The Salisbury Pressure Ulcer Outreach Service successfully treats patients with chronic pressure ulcers that have not healed during routine community treatment. These patients have grade 4 pressure ulcers, involving extensive destruction, or damage to muscle and bone. A combination of scientific, seating and tissue viability expertise with a holistic approach results in non-surgical healing for 70% of patients. For those who still require surgery, outcomes are more successful with this approach, resulting in low recurrence rates. Prior to creation of the outreach service, patients were referred directly for surgical closure, resulting in high recurrence levels and long waiting lists. The authors compared costs of the Pressure Ulcer Outreach Service with the previous system of surgical closure. The model base case found that the Pressure Ulcer Outreach Service saved £8588 per patient, and that cost savings could be even greater if the outreach service was extended into preventative work.

  9. Membrane bioreactor wastewater treatment plants reveal diverse yeast and protist communities of potential significance in biofouling.

    Science.gov (United States)

    Liébana, Raquel; Arregui, Lucía; Belda, Ignacio; Gamella, Luis; Santos, Antonio; Marquina, Domingo; Serrano, Susana

    2015-01-01

    The yeast community was studied in a municipal full-scale membrane bioreactor wastewater treatment plant (MBR-WWTP). The unexpectedly high diversity of yeasts indicated that the activated sludge formed a suitable environment for them to proliferate, with cellular concentrations of 2.2 ± 0.8 × 10(3) CFU ml(-1). Sixteen species of seven genera were present in the biological reactor, with Ascomycetes being the most prevalent group (93%). Most isolates were able to grow in a synthetic wastewater medium, adhere to polyethylene surfaces, and develop biofilms of variable complexity. The relationship between yeast populations and the protists in the MBR-WWTP was also studied, revealing that some protist species preyed on and ingested yeasts. These results suggest that yeast populations may play a role in the food web of a WWTP and, to some extent, contribute to membrane biofouling in MBR systems.

  10. Microbial Communities Shaped by Treatment Processes in a Drinking Water Treatment Plant and Their Contribution and Threat to Drinking Water Safety

    Science.gov (United States)

    Li, Qi; Yu, Shuili; Li, Lei; Liu, Guicai; Gu, Zhengyang; Liu, Minmin; Liu, Zhiyuan; Ye, Yubing; Xia, Qing; Ren, Liumo

    2017-01-01

    Bacteria play an important role in water purification in drinking water treatment systems. On one hand, bacteria present in the untreated water may help in its purification through biodegradation of the contaminants. On the other hand, some bacteria may be human pathogens and pose a threat to consumers. The present study investigated bacterial communities using Illumina MiSeq sequencing of 16S rRNA genes and their functions were predicted using PICRUSt in a treatment system, including the biofilms on sand filters and biological activated carbon (BAC) filters, in 4 months. In addition, quantitative analyses of specific bacterial populations were performed by real-time quantitative polymerase chain reaction (qPCR). The bacterial community composition of post-ozonation effluent, BAC effluent and disinfected water varied with sampling time. However, the bacterial community structures at other treatment steps were relatively stable, despite great variations of source water quality, resulting in stable treatment performance. Illumina MiSeq sequencing illustrated that Proteobacteria was dominant bacterial phylum. Chlorine disinfection significantly influenced the microbial community structure, while other treatment processes were synergetic. Bacterial communities in water and biofilms were distinct, and distinctions of bacterial communities also existed between different biofilms. By contrast, the functional composition of biofilms on different filters were similar. Some functional genes related to pollutant degradation were found widely distributed throughout the treatment processes. The distributions of Mycobacterium spp. and Legionella spp. in water and biofilms were revealed by real-time quantitative polymerase chain reaction (qPCR). Most bacteria, including potential pathogens, could be effectively removed by chlorine disinfection. However, some bacteria presented great resistance to chlorine. qPCRs showed that Mycobacterium spp. could not be effectively removed by

  11. Assessment of the Effectiveness of Extracorporeal Shock Wave Therapy (ESWT) For Soft Tissue Injuries (ASSERT): An Online Database Protocol.

    Science.gov (United States)

    Maffulli, G; Hemmings, S; Maffulli, N

    2014-09-01

    Soft tissue injuries and tendinopathies account for large numbers of chronic musculoskeletal disorders. Extracorporeal shockwave therapy (ESWT) is popular, and effective in the management of chronic tendon conditions in the elbow, shoulder, and pain at and around the heel. Ethical approval was granted from the South East London Research Ethics Committee to implement a database for the Assessment of Effectiveness of Extracorporeal Shock Wave Therapy for Soft Tissue Injuries (ASSERT) to prospectively collect information on the effectiveness of ESWT across the UK. All participants will give informed consent. All clinicians follow a standardised method of administration of the ESWT. The primary outcome measures are validated outcome measures specific to the condition being treated. A Visual Analogue Score for pain and the EuroQol will be completed alongside the condition specific outcome tool at baseline, 3, 6, 12 and 24 months post treatment. The development of the ASSERT database will enable the evaluation of the effectiveness of ESWT for patients suffering from chronic conditions (plantar fasciopathy, tennis elbow, Achilles tendinopathy, greater trochanter pain syndrome and patellar tendinopathy). The results will aid the clinicians in the decision making process when managing these patients.

  12. A modified culture-based study of bacterial community composition in a tannery wastewater treatment plant.

    Science.gov (United States)

    Desta, Adey F; Dalhammer, Gunnel; Kittuva, Gunatrana R

    2010-01-01

    Though culture-independent methods have been used in preference to traditional isolation techniques for characterization of microbial community of wastewater treatment plants, it is difficult to widely apply this approach in resource-poor countries. The present study aimed to develop a test to identify the culturable portion of bacterial community in a high-strength wastewater. Wastewater samples were collected from nitrification-denitrification and settling tanks of the treatment plant of Elmo Leather AB tannery located in Borås, Sweden. After cultivating on nutrient agar with the optimal dilution (10⁻²), phenotypic and biochemical identification of the bacteria were done with colony morphology, Gram reaction, growth on MacConkey, phenylethanol media, triple sugar Iron agar slants, catalase and oxidase tests. Biochemical grouping of the isolates was done based on their test results for MacConkey, phenylethanol media, triple sugar Iron agar and oxidase test reaction. From the biochemical groups, isolates were randomly selected for API test and 16SrRNA gene sequencing. The isolates from the denitrification, nitrification tank were identified to be Paracoccus denitrificans (67%), Azoarcus spp (3%) and Spingomonas wittichii (1%). From the settling tank, Paracoccus denitrificans (22%), Corynebacterium freneyi (20%) and Bacillus cereus (1%) were identified. The grouping based on biochemical test results as well as the identification based on sequencing has shown coherence except for discrepancies with the API test. The preliminary implications of the grouping based on culture-based characteristics and its potential application for resource-limited environmental microbial studies is discussed.

  13. Canine-assisted therapy for children with ADHD: preliminary findings from the positive assertive cooperative kids study.

    Science.gov (United States)

    Schuck, Sabrina E B; Emmerson, Natasha A; Fine, Aubrey H; Lakes, Kimberley D

    2015-02-01

    The objective of this study was to provide preliminary findings from an ongoing randomized clinical trial using a canine-assisted intervention (CAI) for 24 children with ADHD. Project Positive Assertive Cooperative Kids (P.A.C.K.) was designed to study a 12-week cognitive-behavioral intervention delivered with or without CAI. Children were randomly assigned to group therapy with or without CAI. Parents of children in both groups simultaneously participated in weekly parent group therapy sessions. Across both treatment groups, parents reported improvements in children's social skills, prosocial behaviors, and problematic behaviors. In both groups, the severity of ADHD symptoms declined during the course of treatment; however, children who received the CAI model exhibited greater reductions in the severity of ADHD symptoms than did children who received cognitive-behavioral therapy without CAI. Results suggest that CAI offers a novel therapeutic strategy that may enhance cognitive-behavioral interventions for children with ADHD. © 2013 SAGE Publications.

  14. Effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder. A randomized clinical trial

    DEFF Research Database (Denmark)

    Ohlenschlaeger, Johan; Nordentoft, Merete; Thorup, Anne

    2008-01-01

    The effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder in Denmark is not known. A total of 328 patients were randomly assigned to integrated treatment (167 patients) or standard treatment (161 patients). Integrated treatment consisted...... of assertive community treatment, psycho-educational multi-family groups, and social skills training. Data on coercion were extracted from the register from the National Board of Health, and data on continuity from medical records. Even though the level of continuity seemed higher in integrated treatment...

  15. Predictors for individual patient antibiotic treatment effect in hospitalized community-acquired pneumonia patients.

    Science.gov (United States)

    Simonetti, A F; van Werkhoven, C H; Schweitzer, V A; Viasus, D; Carratalà, J; Postma, D F; Oosterheert, J J; Bonten, M J M

    2017-10-01

    Our objective was to identify clinical predictors of antibiotic treatment effects in hospitalized patients with community-acquired pneumonia (CAP) who were not in the intensive care unit (ICU). Post-hoc analysis of three prospective cohorts (from the Netherlands and Spain) of adult patients with CAP admitted to a non-ICU ward having received either β-lactam monotherapy, β-lactam + macrolide, or a fluoroquinolone-based therapy as empirical antibiotic treatment. We evaluated candidate clinical predictors of treatment effects in multiple mixed-effects models by including interactions of the predictors with empirical antibiotic choice and using 30-day mortality, ICU admission and length of hospital stay as outcomes. Among 8562 patients, empirical treatment was β-lactam in 4399 (51.4%), fluoroquinolone in 3373 (39.4%), and β-lactam + macrolide in 790 (9.2%). Older age (interaction OR 1.67, 95% CI 1.23-2.29, p 0.034) and current smoking (interaction OR 2.36, 95% CI 1.34-4.17, p 0.046) were associated with lower effectiveness of fluoroquinolone on 30-day mortality. Older age was also associated with lower effectiveness of β-lactam + macrolide on length of hospital stay (interaction effect ratio 1.14, 95% CI 1.06-1.22, p 0.008). Older age and smoking could influence the response to specific antibiotic regimens. The effect modification of age and smoking should be considered hypothesis generating to be evaluated in future trials. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Perceptions of a literate community regarding causation, presentation and treatment practices of intestinal worms among children

    International Nuclear Information System (INIS)

    Mubeen, S.M.; Subhani, A.; Hassan, S.S.

    2007-01-01

    To find out the perceived common causes of intestinal worms, their presentations and treatment options taken by the respondents, among children. A total of 2000 families responded to a self-administered questionnaire that was designed to obtain the study objectives. A single adult individual from each family was asked to respond to the questionnaire. Families having health care workers or health professionals were excluded. Medical students were properly trained to ensure competence in collecting a reliable data. The majority of the total respondents were females (66.3%) and were between 15-25 years of age (mean age = 25.4 years) with 100% literacy rate. A noticeable number of respondents (31%) revealed that overeating of sugar causes intestinal worms and that they mainly presented as altered eating habits / appetite (51.8%), abdominal pain (40.8%) and generalized weakness (26.3%). Regarding perceptions of drug treatment, nearly 2/3 of the respondents felt that the de-worming agent should be given to suspected child only (p < 0.001), whereas 65% of the participants expected to observe worms after de-worming treatment (p < 0.001). Contrary to the common use of self-medication in most other illnesses, self-treatment of worms on suspicion was declared by only 21.5% of the respondents (p < 0.0001). This study confirms that misconceptions about intestinal worms in children were prevalent within the community. In addition to the issue of environmental sanitation, removal of the mistaken beliefs is a prerequisite for an effective and long-lasting parasitic control among children. (author)

  17. Application of ion torrent sequencing to the assessment of the effect of alkali ballast water treatment on microbial community diversity.

    Science.gov (United States)

    Fujimoto, Masanori; Moyerbrailean, Gregory A; Noman, Sifat; Gizicki, Jason P; Ram, Michal L; Green, Phyllis A; Ram, Jeffrey L

    2014-01-01

    The impact of NaOH as a ballast water treatment (BWT) on microbial community diversity was assessed using the 16S rRNA gene based Ion Torrent sequencing with its new 400 base chemistry. Ballast water samples from a Great Lakes ship were collected from the intake and discharge of both control and NaOH (pH 12) treated tanks and were analyzed in duplicates. One set of duplicates was treated with the membrane-impermeable DNA cross-linking reagent propidium mono-azide (PMA) prior to PCR amplification to differentiate between live and dead microorganisms. Ion Torrent sequencing generated nearly 580,000 reads for 31 bar-coded samples and revealed alterations of the microbial community structure in ballast water that had been treated with NaOH. Rarefaction analysis of the Ion Torrent sequencing data showed that BWT using NaOH significantly decreased microbial community diversity relative to control discharge (pPCoA) plots and UPGMA tree analysis revealed that NaOH-treated ballast water microbial communities differed from both intake communities and control discharge communities. After NaOH treatment, bacteria from the genus Alishewanella became dominant in the NaOH-treated samples, accounting for microbial community structure between PMA-processed and non-PMA samples occurred in intake water samples, which exhibited a significantly higher amount of PMA-sensitive cyanobacteria/chloroplast 16S rRNA than their corresponding non-PMA total DNA samples. The community assembly obtained using Ion Torrent sequencing was comparable to that obtained from a subset of samples that were also subjected to 454 pyrosequencing. This study showed the efficacy of alkali ballast water treatment in reducing ballast water microbial diversity and demonstrated the application of new Ion Torrent sequencing techniques to microbial community studies.

  18. Supportive-Expressive Dynamic Psychotherapy in the Community Mental Health System: A Pilot Effectiveness Trial for the Treatment of Depression

    Science.gov (United States)

    Connolly Gibbons, Mary Beth; Thompson, Sarah M.; Scott, Kelli; Schauble, Lindsay A.; Mooney, Tessa; Thompson, Donald; Green, Patricia; MacArthur, Mary Jo; Crits-Christoph, Paul

    2013-01-01

    The goal of the current article is to present the results of a randomized pilot investigation of a brief dynamic psychotherapy compared with treatment-as-usual (TAU) in the treatment of moderate-to-severe depression in the community mental health system. Forty patients seeking services for moderate-to-severe depression in the community mental health system were randomized to 12 weeks of psychotherapy, with either a community therapist trained in brief dynamic psychotherapy or a TAU therapist. Results indicated that blind judges could discriminate the dynamic sessions from the TAU sessions on adherence to dynamic interventions. The results indicate moderate-to-large effect sizes in favor of the dynamic psychotherapy over the TAU therapy in the treatment of depression. The Behavior and Symptom Identification Scale-24 showed that 50% of patients treated with dynamic therapy moved into a normative range compared with only 29% of patients treated with TAU. PMID:22962971

  19. Effect of Copper Treatment on the Composition and Function of the Bacterial Community in the Sponge Haliclona cymaeformis

    KAUST Repository

    Tian, R.-M.

    2014-11-04

    Marine sponges are the most primitive metazoan and host symbiotic microorganisms. They are crucial components of the marine ecological system and play an essential role in pelagic processes. Copper pollution is currently a widespread problem and poses a threat to marine organisms. Here, we examined the effects of copper treatment on the composition of the sponge-associated bacterial community and the genetic features that facilitate the survival of enriched bacteria under copper stress. The 16S rRNA gene sequencing results showed that the sponge Haliclona cymaeformis harbored symbiotic sulfur-oxidizing Ectothiorhodospiraceae and photosynthetic Cyanobacteria as dominant species. However, these autotrophic bacteria decreased substantially after treatment with a high copper concentration, which enriched for a heterotrophic-bacterium-dominated community. Metagenomic comparison revealed a varied profile of functional genes and enriched functions, including bacterial motility and chemotaxis, extracellular polysaccharide and capsule synthesis, virulence-associated genes, and genes involved in cell signaling and regulation, suggesting short-period mechanisms of the enriched bacterial community for surviving copper stress in the microenvironment of the sponge. Microscopic observation and comparison revealed dynamic bacterial aggregation within the matrix and lysis of sponge cells. The bacteriophage community was also enriched, and the complete genome of a dominant phage was determined, implying that a lytic phage cycle was stimulated by the high copper concentration. This study demonstrated a copper-induced shift in the composition of functional genes of the sponge-associated bacterial community, revealing the selective effect of copper treatment on the functions of the bacterial community in the microenvironment of the sponge. IMPORTANCE This study determined the bacterial community structure of the common sponge Haliclona cymaeformis and examined the effect of copper

  20. [Duration of treatment and oral administrad on of antibiotics in community acquired pneumonia].

    Science.gov (United States)

    Bernal-Vargas, Mónica A; Cortés, Jorge A

    2016-04-01

    Community acquired pneumonia (CAP) is an important cause of morbidity and mortality around the world, with high treatment costs due to hospitalization and complications (adverse events due to medications, antibiotic resistance, healthcare associated infections, etc.). It has been proposed administration of short courses and early switch of intravenous administration to oral therapy to avoid costs and complications. There are recommendations about these topics in national and intemational guidelines, based on clinical trials which do not demónstrate diffe-rences in mortality and complications when there is an early change from intravenous administration to the oral route. There are no statistically significant differences in safety and resolution of the disease when short and long treatment schemes were compared. In this review we present the most important guidelines and clinical studies, taking into account the pharmacological differences between different medications. It is considered that early switch from intravenous to oral administration route and use of short cycles in CAP is safe and brings benefits to patients and institutions.

  1. The Effect of Group Counseling Program on 8th Grade Students’ Assertiveness Levels

    Directory of Open Access Journals (Sweden)

    İsmail SEÇER

    2014-06-01

    Full Text Available This study is conducted to determine the effects of group counseling program on elementary school 8th grade students’ assertiveness skills. Study group was formed of 100 students getting educated in Erzurum Kültür Elementary School in 2011-2012 education years. RAE-Rathus Assertiveness Schedule was applied on this group to gather data. 30 students getting lower scores from the inventory have been randomly divided into experimental and control groups. Each group is formed of 15 students. Group counseling program has been carried out for 8 weeks on the experimental group to improve the students’ assertiveness skills. Single-way and two-way analysis of covariance (ANCOVA has been used in the analysis of the data. The data is analyzed with SPSS 19.00. The results of the study show that assertiveness skills of the students who participate in the group counseling program has increased significantly compared to the control group and to the preexperimental circumstances. Besides, it is determined that the change observed in the experimental group has been occurred separately from the age and socio-economic level variables, and it is determined with the monitoring test applied after four months that this affect is continued. According to this result, it can be said that the applied group counseling program is an effective means to improve the assertiveness skills of elementary school students

  2. Rape myth acceptance and rape acknowledgment: The mediating role of sexual refusal assertiveness.

    Science.gov (United States)

    Newins, Amie R; Wilson, Laura C; White, Susan W

    2018-05-01

    Unacknowledged rape, defined as when an individual experiences an event that meets a legal or empirical definition of rape but the individual does not label it as such, is prevalent. Research examining predictors of rape acknowledgment is needed. Sexual assertiveness may be an important variable to consider, as an individual's typical behavior during sexual situations may influence rape acknowledgment. To assess the indirect effect of rape myth acceptance on rape acknowledgment through sexual refusal assertiveness, an online survey of 181 female rape survivors was conducted. The indirect effects of two types of rape myths (He didn't mean to and Rape is a deviant event) were significant and positive. Specifically, acceptance of these two rape myths was negatively related to sexual refusal assertiveness, which was negatively associated with likelihood of rape acknowledgment. The results of this study indicate that sexual refusal assertiveness is associated with lower likelihood of rape acknowledgment among rape survivors. As a result, it appears that, under certain circumstances, women high in rape myth acceptance may be more likely to acknowledge rape when it results in decreased sexual refusal assertiveness. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Assessment of subchannel code ASSERT-PV for flow-distribution predictions

    International Nuclear Information System (INIS)

    Nava-Dominguez, A.; Rao, Y.F.; Waddington, G.M.

    2014-01-01

    Highlights: • Assessment of the subchannel code ASSERT-PV 3.2 for the prediction of flow distribution. • Open literature and in-house experimental data to quantify ASSERT-PV predictions. • Model changes assessed against vertical and horizontal flow experiments. • Improvement of flow-distribution predictions under CANDU-relevant conditions. - Abstract: This paper reports an assessment of the recently released subchannel code ASSERT-PV 3.2 for the prediction of flow-distribution in fuel bundles, including subchannel void fraction, quality and mass fluxes. Experimental data from open literature and from in-house tests are used to assess the flow-distribution models in ASSERT-PV 3.2. The prediction statistics using the recommended model set of ASSERT-PV 3.2 are compared to those from previous code versions. Separate-effects sensitivity studies are performed to quantify the contribution of each flow-distribution model change or enhancement to the improvement in flow-distribution prediction. The assessment demonstrates significant improvement in the prediction of flow-distribution in horizontal fuel channels containing CANDU bundles

  4. Women's condom use assertiveness and sexual risk-taking: effects of alcohol intoxication and adult victimization.

    Science.gov (United States)

    Stoner, Susan A; Norris, Jeanette; George, William H; Morrison, Diane M; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M

    2008-09-01

    This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N=161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex - perceived health consequences and situational condom insistence - and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication.

  5. Perceived and Actual Behavior in Female Sexual Assertiveness: A Within-Couple Analysis in Hong Kong.

    Science.gov (United States)

    Zhang, Huiping; Yip, Paul S F

    2018-01-02

    Studies in female sexual assertiveness have generally focused on individuals rather than couples, and little research has been conducted in the Chinese context. This study examined perceived and actual female sexual assertiveness at the couple level, and also explored its impact on marital and sexual satisfaction with a representative sample of 770 couples in Hong Kong. The results showed that husbands reported a higher level of acceptance of female sexual assertiveness in both perception and actual behavior; furthermore, couples reported greater congruence in their perception of female sexual initiation than actual behavior. Multiple logistic regressions showed that actual female sexual assertiveness, not the perception of it, affects both spouses' marital and sexual satisfaction. Compared with couples in which neither accepted female sexual initiation in practice, husbands where both spouses accepted this were more likely to be satisfied with the marriage. Husbands who accepted female sexual refusal whilst their wives did not were also more likely to be satisfied with both the marital and sexual relationship. Similarly, wives who did accept female sexual assertiveness but whose husbands did not were more likely to be satisfied with both the marital and sexual relationship.

  6. Probability of assertive behaviour, interpersonal anxiety and self-efficacy of South African registered dietitians.

    Science.gov (United States)

    Paterson, Marie; Green, J M; Basson, C J; Ross, F

    2002-02-01

    There is little information on the probability of assertive behaviour, interpersonal anxiety and self-efficacy in the literature regarding dietitians. The objective of this study was to establish baseline information of these attributes and the factors affecting them. Questionnaires collecting biographical information and self-assessment psychometric scales measuring levels of probability of assertiveness, interpersonal anxiety and self-efficacy were mailed to 350 subjects, who comprised a random sample of dietitians registered with the Health Professions Council of South Africa. Forty-one per cent (n=145) of the sample responded. Self-assessment inventory results were compared to test levels of probability of assertive behaviour, interpersonal anxiety and self-efficacy. The inventory results were compared with the biographical findings to establish statistical relationships between the variables. The hypotheses were formulated before data collection. Dietitians had acceptable levels of probability of assertive behaviour and interpersonal anxiety. The probability of assertive behaviour was significantly lower than the level noted in the literature and was negatively related to interpersonal anxiety and positively related to self-efficacy.

  7. LEVEL OF SELF-RESPECT AND ASSERTIVENESS SKILLS AND TEACHERS’ EDUCATIONAL COMPETENCES

    Directory of Open Access Journals (Sweden)

    Anna Romanowska-Tolloczko

    2015-05-01

    Full Text Available Purpose: determining of self-respect level and assertiveness of teachers. Verification of whether there is a relationship between the measured trait and the correlation of educational competence. Material and methods: the study used three tools: Polish adaptation of SES M.Rosenberg's Self Esteem Scale, a questionnaire to determine the levels of assertiveness - P.Majewicz's Scale "I and others" and a questionnaire to examine the professional competence of teachers by A.Romanowska-Tołłoczko. The study examined 275 primary school teachers of different subjects. Results: after the statement of the research’s results in the field of self-respect and assertiveness, it turns out that there is some regularity in relation to the level of the studied traits. People with high self-respect also receive higher scores assertive skills compared with those of average and low self-respect. This pattern is seen in all groups of teachers. Conclusions: although the observed differences are not great and statistically significant, they show some evidence of the occurrence trend of interdependence in a range of predispositions. Moreover, a positive correlation between the level of self-respect and assertiveness and parental perception of their competence was noted.

  8. Input modelling of ASSERT-PV V2R8M1 for RUFIC fuel bundle

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joo Hwan; Suk, Ho Chun

    2001-02-01

    This report describes the input modelling for subchannel analysis of CANFLEX-RU (RUFIC) fuel bundle which has been developed for an advanced fuel bundle of CANDU-6 reactor, using ASSERT-PV V2R8M1 code. Execution file of ASSERT-PV V2R8M1 code was recently transferred from AECL under JRDC agreement between KAERI and AECL. SSERT-PV V2R8M1 which is quite different from COBRA-IV-i code has been developed for thermalhydraulic analysis of CANDU-6 fuel channel by subchannel analysis method and updated so that 43-element CANDU fuel geometry can be applied. Hence, ASSERT code can be applied to the subchannel analysis of RUFIC fuel bundle. The present report was prepared for ASSERT input modelling of RUFIC fuel bundle. Since the ASSERT results highly depend on user's input modelling, the calculation results may be quite different among the user's input models. The objective of the present report is the preparation of detail description of the background information for input data and gives credibility of the calculation results.

  9. Input modelling of ASSERT-PV V2R8M1 for RUFIC fuel bundle

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joo Hwan; Suk, Ho Chun

    2001-02-01

    This report describes the input modelling for subchannel analysis of CANFLEX-RU (RUFIC) fuel bundle which has been developed for an advanced fuel bundle of CANDU-6 reactor, using ASSERT-PV V2R8M1 code. Execution file of ASSERT-PV V2R8M1 code was recently transferred from AECL under JRDC agreement between KAERI and AECL. SSERT-PV V2R8M1 which is quite different from COBRA-IV-i code has been developed for thermalhydraulic analysis of CANDU-6 fuel channel by subchannel analysis method and updated so that 43-element CANDU fuel geometry can be applied. Hence, ASSERT code can be applied to the subchannel analysis of RUFIC fuel bundle. The present report was prepared for ASSERT input modelling of RUFIC fuel bundle. Since the ASSERT results highly depend on user's input modelling, the calculation results may be quite different among the user's input models. The objective of the present report is the preparation of detail description of the background information for input data and gives credibility of the calculation results.

  10. Input modelling of ASSERT-PV V2R8M1 for RUFIC fuel bundle

    International Nuclear Information System (INIS)

    Park, Joo Hwan; Suk, Ho Chun

    2001-02-01

    This report describes the input modelling for subchannel analysis of CANFLEX-RU (RUFIC) fuel bundle which has been developed for an advanced fuel bundle of CANDU-6 reactor, using ASSERT-PV V2R8M1 code. Execution file of ASSERT-PV V2R8M1 code was recently transferred from AECL under JRDC agreement between KAERI and AECL. SSERT-PV V2R8M1 which is quite different from COBRA-IV-i code has been developed for thermalhydraulic analysis of CANDU-6 fuel channel by subchannel analysis method and updated so that 43-element CANDU fuel geometry can be applied. Hence, ASSERT code can be applied to the subchannel analysis of RUFIC fuel bundle. The present report was prepared for ASSERT input modelling of RUFIC fuel bundle. Since the ASSERT results highly depend on user's input modelling, the calculation results may be quite different among the user's input models. The objective of the present report is the preparation of detail description of the background information for input data and gives credibility of the calculation results

  11. Assessment of subchannel code ASSERT-PV for flow-distribution predictions

    Energy Technology Data Exchange (ETDEWEB)

    Nava-Dominguez, A., E-mail: navadoma@aecl.ca; Rao, Y.F., E-mail: raoy@aecl.ca; Waddington, G.M., E-mail: waddingg@aecl.ca

    2014-08-15

    Highlights: • Assessment of the subchannel code ASSERT-PV 3.2 for the prediction of flow distribution. • Open literature and in-house experimental data to quantify ASSERT-PV predictions. • Model changes assessed against vertical and horizontal flow experiments. • Improvement of flow-distribution predictions under CANDU-relevant conditions. - Abstract: This paper reports an assessment of the recently released subchannel code ASSERT-PV 3.2 for the prediction of flow-distribution in fuel bundles, including subchannel void fraction, quality and mass fluxes. Experimental data from open literature and from in-house tests are used to assess the flow-distribution models in ASSERT-PV 3.2. The prediction statistics using the recommended model set of ASSERT-PV 3.2 are compared to those from previous code versions. Separate-effects sensitivity studies are performed to quantify the contribution of each flow-distribution model change or enhancement to the improvement in flow-distribution prediction. The assessment demonstrates significant improvement in the prediction of flow-distribution in horizontal fuel channels containing CANDU bundles.

  12. Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hot Spot Fishing Community in Rakai, Uganda.

    Science.gov (United States)

    Long, Amanda; Mbabali, Ismail; Hutton, Heidi E; Thomas, Alvin G; Bugos, Eva; Mulamba, Jeremiah; Amico, Kathy Rivet; Nalugoda, Fred; Gray, Ronald H; Wawer, Maria J; Nakigozi, Gertrude; Chang, Larry W

    Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The intervention, utilizing a novel, theory-based approach, trained 10 community residents in an HIV hot spot fishing community to use motivational interviewing strategies and a mobile phone-based counseling application. During the first 3 months, 771 residents (median 82/health scout, range 27-160) were counseled. A directly observed Motivational Interviewing Treatment Integrity scale-based evaluation found adequate performance (median score 20/25, range 11-23). The health scout intervention was feasible to implement in a high HIV-prevalence fishing community, and its impact on HIV care outcomes will be evaluated in an ongoing cluster randomized trial. If found to be effective, it may be an important strategy for responding to HIV in high-burden settings.

  13. Ethnomedicinal practices in different communities of Uttara Kannada district of Karnataka for treatment of wounds.

    Science.gov (United States)

    Bhat, Pradeep; Hegde, Gurumurthi; Hegde, Ganesh R

    2012-09-28

    Uttara Kannada district is located in the heart of the Western Ghats, one of the biodiversity hotspots, in Karnataka state of India. The thick evergreen forests are home to several ethnic communities. The study was under taken for documentation and analysis of ethnomedicinal plants in the treatment of wounds. Field trips were made in Uttara Kannada district to identify the key informants. The collection of information was through semi-structured open ended interviews with a questionnaire. The questionnaire was designed to obtain the information about their experience in the field of treatment, number of patients treated per week, knowledge about the medicinal plants, vernacular names, parts of the plants used and other ingredients added during the drug formulations. Plants mentioned for treatment were photographed in the field, cuttings of the samples were taken and voucher specimens are deposited in the herbarium of P.G. Department of Botany, Karnatak University, Dharwad. The information such as botanical name, status, family, vernacular name habit and habitat, statistical analysis like percentage of parts used, Use value (UV) and Informants Consensus Factor (ICF) are provided. Present study resulted in recording 106 medicinal plant species of 55 families and 86 formulations to treat different types of wounds by 44 key informants. Among the 106 plants recorded four species are endemic to India and 22 species have the nativity outside India. Rest of the species have nativity both in India and elsewhere. The highest number of species belonged to Apocynaceae and Rubiaceae (6 species each). Trees are used more often (35.84%), followed by herbs (28.30%), shrubs (23.58%), climbers (11.32) and parasites (0.80%). Leaves are the major part of the plants used in the formulations (28.57%). The highest Use value is for Calycopteris floribunda (1.80), followed by Rauvolfia serpentina and Achyranthes aspera (1.67). The different types of wounds treated by traditional healers

  14. The opinion of Iranian students about the society's perception on using surrogacy as an infertility treatment in the future community.

    Science.gov (United States)

    Salehi, Kobra; Shakour, Mahsa; Pashaei Sabet, Fatemeh; Alizadeh, Shiva

    2015-03-01

    Surrogacy is one of the challengeable treatments for infertility; therefore, it seems necessary to learn the attitutude of people toward it, especially the opinion of those who are working in infertility treatment. Students studying midwifery, medicine, psychology and law are involved in this process to various degrees. The aim of this study was to investigate the students' opinions about the perception of the society on using surrogacy. This study was a descriptive cross-sectional survey. The sample of this study included 200 students of the Isfahan University and Isfahan University of Medical Sciences from the following courses: Midwifery, Medicine, Psychology and Law. Since the number of students in different discipline was not equal, we therefore used quota sampling. The data collection instrument was a researcher-made questionnaire. The questionnaire included questions on their knowledge, attitude and surrogacy acceptance in the future in Iran. The students of the medical course were mostly in the category "strongly agree" and "agree" with surrogacy (43 students which constitute 79.6%), then, midwifery students (15 students which constitute 78.9%) and finally, the students of other courses agreed less with this method. According to chi-square test, there was no significant difference between attitudes of students (P=0.08). Individuals mostly assert their acceptance of this method through "increasing tendency to this method in the future" (77.1%). Students in this study had a positive attitude toward surrogacy and they accepted it as a norm; despite this, it is essential to make some changes within cultures to improve the situation. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

    Science.gov (United States)

    Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

    2016-01-01

    Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

  16. Community engagement and the social context of targeted malaria treatment: a qualitative study in Kayin (Karen) State, Myanmar.

    Science.gov (United States)

    Sahan, Kate; Pell, Christopher; Smithuis, Frank; Phyo, Aung Kyaw; Maung, Sai Maung; Indrasuta, Chanida; Dondorp, Arjen M; White, Nicholas J; Day, Nicholas P J; von Seidlein, Lorenz; Cheah, Phaik Yeong

    2017-02-14

    The spread of artemisinin-resistance in Plasmodium falciparum is a threat to current global malaria control initiatives. Targeted malaria treatment (TMT), which combines mass anti-malarial administration with conventional malaria prevention and control measures, has been proposed as a strategy to tackle this problem. The effectiveness of TMT depends on high levels of population coverage and is influenced by accompanying community engagement activities and the local social context. The article explores how these factors influenced attitudes and behaviours towards TMT in Kayin (Karen) State, Myanmar. Semi-structured interviews were conducted with villagers from study villages (N = 31) and TMT project staff (N = 14) between March and July 2015. Community engagement consisted of a range of activities to communicate the local malaria situation (including anti-malarial drug resistance and asymptomatic malaria), the aims of the TMT project, and its potential benefits. Community engagement was seen by staff as integral to the TMT project as a whole and not a sub-set of activities. Attitudes towards TMT (including towards community engagement) showed that developing trusting relationships helped foster participation. After initial wariness, staff received hospitality and acceptance among villagers. Offering healthcare alongside TMT proved mutually beneficial for the study and villagers. A handful of more socially-mobile and wealthy community members were reluctant to participate. The challenges of community engagement included time constraints and the isolation of the community with its limited infrastructure and a history of conflict. Community engagement had to be responsive to the local community even though staff faced time constraints. Understanding the social context of engagement helped TMT to foster respectful and trusting relationships. The complex relationship between the local context and community engagement complicated evaluation of the community strategy

  17. Reasons for Schizophrenia Patients Remaining out of Treatment: Results from a Prospective Study in a Rural South Indian Community.

    Science.gov (United States)

    Kumar, Channaveerachari Naveen; Thirthalli, Jagadisha; Suresha, Kudumallige Krishnappa; Venkatesh, Basappa K; Kishorekumar, Kengeri V; Arunachala, Udupi; Gangadhar, Bangalore N

    2016-01-01

    A few studies have examined the factors associated with schizophrenia patients remaining untreated in India. We identified 184 schizophrenia patients in a rural community, offered the treatment with antipsychotics and followed them up in their Primary Health Centers for 1-year. Twenty-nine (15.8%) patients remained untreated at both the baseline and 1-year follow-up despite our best attempts to keep them under the treatment umbrella. They were interviewed in detail regarding the reasons for remaining untreated. This group was compared with another group of patients (n = 69) who had stopped the treatment at baseline but were successfully brought under the treatment umbrella throughout the 1-year follow-up period. The reasons for remaining untreated were (n; %): (a) Unsatisfactory improvement with previous treatment attempts (19; 65.5%), (b) poor bond between the patients and the families (6; 20.7%), (c) active symptoms not allowing any treatment efforts from the family members (6; 20.7%), (d) magico-religious beliefs about the illness and its treatment (4; 13.8%), (e) poor social support (3; 10.3%), (f) adverse effects of the medications (2; 6.9%), and (g) perception of recovery and cure (1; 3.4%). For many patients, a constellation of these reasons was responsible for them remaining untreated. In contrast, the common reasons for those who restarted medications to have stopped the treatment at some time were the lack of awareness, the need to continue medications (47; 68.1%), and the financial constraints (28; 40.6%). The predominant reason for schizophrenia patients not remaining on the treatment in this rural community was the families' lack of faith in antipsychotic treatment. Provision of comprehensive treatment package including medical, psychosocial and rehabilitative services, and sensitizing the community about benefits of the treatment may help in ensuring that all patients with psychosis receive the best care.

  18. Separate treatment of hospital and urban wastewaters: A real scale comparison of effluents and their effect on microbial communities.

    Science.gov (United States)

    Chonova, Teofana; Keck, François; Labanowski, Jérôme; Montuelle, Bernard; Rimet, Frédéric; Bouchez, Agnès

    2016-01-15

    Hospital wastewaters (HWW) contain wider spectrum and higher quantity of pharmaceuticals than urban wastewaters (UWW), but they are generally discharged in sewers without pretreatment. Since traditional urban wastewater treatment plants (WWTP) are not designed to treat HWWs, treated effluents may still contain pollutants that could impair receiving aquatic environments. Hence, a better understanding of the effect of pharmaceuticals in the environment is required. Biofilms are effective "biological sensors" for assessing the environmental effects of pharmaceuticals due to their ability to respond rapidly to physical, chemical and biological fluctuations by changes in their structure and composition. This study evaluated the efficiency of biological treatment with conventional activated sludge system performed parallel on HWW and UWW. Furthermore, six successive monthly colonizations of biofilms were done on autoclaved stones, placed in grid-baskets in the hospital treated effluents (HTE) and urban treated effluents (UTE). The biomass of these biofilms as well as the structure and diversity of their bacterial communities were investigated. Results showed better treatment efficiency for phosphate and nitrite/nitrate during the treatment of UWW. Pharmaceuticals from all investigated therapeutic classes (beta-blockers, nonsteroidal anti-inflammatory drugs, antibiotics, analgesics and anticonvulsants) were efficiently removed, except for carbamazepine. The removal efficiency of the antibiotics, NSAIDs and beta-blockers was higher during the treatment of HWW. HTE and UTE shaped the bacterial communities in different ways. Higher concentrations of pharmaceuticals in the HTE caused adapted development of the microbial community, leading to less developed biomass and lower bacterial diversity. Seasonal changes in solar irradiance and temperature, caused changes in the community composition of biofilms in both effluents. According to the removal efficiency of pharmaceuticals

  19. Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Katrina V Deardorff

    2018-02-01

    Full Text Available Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%, distributor incentives (n = 2, +25.3%, distribution along kinship networks (n = 1, +24.5%, intensified information, education, and communication activities (n = 8, +21.6%, fixed-point delivery (n = 1, +21.4%, door-to-door delivery (n = 1, +14.0%, integrated service distribution (n = 9, +12.7%, conversion from school- to community-based delivery (n = 3, +11.9%, and management by a non-governmental organization (n = 1, +5.8%.Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

  20. Metabolic biomarkers in community obese children: effect of obstructive sleep apnea and its treatment.

    Science.gov (United States)

    Alonso-Álvarez, María Luz; Terán-Santos, Joaquin; Gonzalez Martinez, Mónica; Cordero-Guevara, José Aurelio; Jurado-Luque, María José; Corral-Peñafiel, Jaime; Duran-Cantolla, Joaquin; Ordax Carbajo, Estrella; MasaJimenez, Fernando; Kheirandish-Gozal, Leila; Gozal, David

    2017-09-01

    Obesity and obstructive sleep apnea in children have been associated with metabolic morbidities. The present study aimed to evaluate the presence of metabolic alterations among obese children recruited from the community, with and without obstructive sleep apnea syndrome (OSAS), and the impact of treatment of OSAS on metabolic profiles. A cross-sectional, prospective, multicenter study of Spanish children aged 3-14 years with a body mass index (BMI) ≥95th percentile for age and sex were randomly selected in the first phase. Four groups emerged for follow-up: (1) no treatment; (2) dietary intervention; (3) surgical treatment of OSA; and (4) continuous positive airway pressure (CPAP) treatment of OSA. Fasting blood tests were performed at baseline (T0) and approximately one year after the intervention (T1). A total of 113 obese children with a mean age of 11.3 ± 2.9 years completed T0 and T1 assessments. Their mean BMI z-score at T1 was 1.34 ± 0.59, and mean Respiratory Disturbance Index was 8.6 ± 13.0 at T0 and 3.3 ± 4.0/hour total sleep time at T1. Only glucose fasting levels differed among metabolic parameters in obese children with OSAS and without OSAS at baseline (T0) (p = 0.018). There were statistically significant differences between surgically treated OSAS (p = 0.002), and CPAP-treated OSAS (p = 0.024) versus the non-OSAS group in the glucose levels between baseline (T0) and follow-up (T1) after controlling for age and change in BMI. Significant univariate associations between BMI and C-reactive protein, insulin, and homeostasis model assessment of insulin resistance emerged at both T0 and T1. Concurrent obesity and OSAS could promote metabolic and inflammatory alterations, and the latter appeared to be sensitive to OSAS treatment outcomes. ClinicalTrials.gov Identifier: NCT01322763. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. The Hurst exponent over time: testing the assertion that emerging markets are becoming more efficient

    Science.gov (United States)

    Cajueiro, Daniel O.; Tabak, Benjamin M.

    2004-05-01

    This paper is concerned with the assertion found in the financial literature that emerging markets are becoming more efficient over time. To verify whether this assertion is true or not, we propose the calculation of the Hurst exponent over time using a time window with 4 years of data. The data used here comprises the bulk of emerging markets for Latin America and Asia. Our empirical results show that this assertion seems to be true for most countries, but it does not hold for countries such as Brazil, The Philippines and Thailand. Moreover, in order to check whether or not these results depend on the short term memory and the volatility of returns common in such financial asset return data, we filter the data by an AR-GARCH procedure and present the Hurst exponents for this filtered data.

  2. Body Type, Self-Esteem and Assertiveness among High School Students in Ghana

    Directory of Open Access Journals (Sweden)

    Daniel Bruce

    2016-08-01

    Full Text Available The aim of this study was to examine the relationship between body type, self-esteem and assertiveness among adolescents of ages between 13 and 19 years. To achieve this aim, the study sampled 56 male and 94 female adolescents of the Senior High School in Accra, Ghana. Results showed that, higher self-esteem leads to assertiveness. Results also showed that body type perception affects self-esteem. It is, therefore, recommended that Guidance and Counselling officers in our schools should educate adolescent students on the three body types and the advantages associated with being one of these body types. This may help prevent developing body dysmorphic disorder, low self-esteem and non-assertiveness among students with negative perceptions of their body types and the possible effects on their personal relationships with peers, general academic performance and in- school and out-of- school life.

  3. Drivers of microbial community composition in mesophilic and thermophilic temperature-phased anaerobic digestion pre-treatment reactors.

    Science.gov (United States)

    Pervin, Hasina M; Dennis, Paul G; Lim, Hui J; Tyson, Gene W; Batstone, Damien J; Bond, Philip L

    2013-12-01

    Temperature-phased anaerobic digestion (TPAD) is an emerging technology that facilitates improved performance and pathogen destruction in anaerobic sewage sludge digestion by optimising conditions for 1) hydrolytic and acidogenic organisms in a first-stage/pre-treatment reactor and then 2) methogenic populations in a second stage reactor. Pre-treatment reactors are typically operated at 55-65 °C and as such select for thermophilic bacterial communities. However, details of key microbial populations in hydrolytic communities and links to functionality are very limited. In this study, experimental thermophilic pre-treatment (TP) and control mesophilic pre-treatment (MP) reactors were operated as first-stages of TPAD systems treating activated sludge for 340 days. The TP system was operated sequentially at 50, 60 and 65 °C, while the MP rector was held at 35 °C for the entire period. The composition of microbial communities associated with the MP and TP pre-treatment reactors was characterised weekly using terminal-restriction fragment length polymorphism (T-RFLP) supported by clone library sequencing of 16S rRNA gene amplicons. The outcomes of this approach were confirmed using 454 pyrosequencing of gene amplicons and fluorescence in-situ hybridisation (FISH). TP associated bacterial communities were dominated by populations affiliated to the Firmicutes, Thermotogae, Proteobacteria and Chloroflexi. In particular there was a progression from Thermotogae to Lutispora and Coprothermobacter and diversity decreased as temperature and hydrolysis performance increased. While change in the composition of TP associated bacterial communities was attributable to temperature, that of MP associated bacterial communities was related to the composition of the incoming feed. This study determined processes driving the dynamics of key microbial populations that are correlated with an enhanced hydrolytic functionality of the TPAD system. Copyright © 2013 Elsevier Ltd. All rights

  4. Quality of life improves in children and adolescents during a community-based overweight and obesity treatment

    DEFF Research Database (Denmark)

    Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine

    2017-01-01

    PURPOSE: The quality of life is compromised in children and adolescents with overweight or obesity. The aim of this study was to evaluate whether the quality of life improves during a community-based overweight and obesity treatment, and whether improvements depend on reductions in the degree...... of obesity. METHODS: Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) 4.0 in children and adolescents aged 3-18 years with overweight or obesity [body mass index (BMI) ≥85th percentile] upon entry into a community-based chronic care overweight and obesity treatment based...... upon The Children's Obesity Clinic's Treatment protocol, and upon follow-up after 10-30 months of treatment. Height and weight were measured at each consultation and converted into a BMI standard deviation score (SDS). RESULTS: Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys...

  5. Effect of Meta-Cognitive Therapy on Self Assertiveness Skill in Patients with

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Bahadori

    2014-05-01

    Full Text Available Background: Self assertiveness can be considered as hearth of interpersonal behavior and weakness in this area is one of the obvious characteristic in the patients with social phobia disorder. This study aimed to determine the effect of meta-cognitive therapy on the rate of self assertiveness skill in patients with social phobia disorder. Materials and Methods: This experimental study was conducted with pretest-posttest and follow-up design, using control group. From all social phobia disorder patients visited in psychology clinics in Shiraz, south western part of Iran in 2012, 22 patients were selected through the objective sampling method and randomly divided into two experimental (11 persons and control (11 persons groups. The instruments of this study were social phobia symptoms assessment questioner (SPSAQ and self assertiveness scale (SAS. The experimental group received 8 weeks of Wells’ meta-cognitive therapy sessions. Data were analyzed through covariance analysis method. Results: The results showed that the mean of the self assertiveness scores in post-test and follow up in the experimental group is significantly higher than that of the control group (p<0.05. The results of analysis of multivariate covariance showed that MCT had a significant effect on increscent of the self assertiveness skill scores of posttest (0.39 and follow up (0.38 in patients with social phobia disorder (p<0.001. Conclusion: This intervention is believed to improve self assertiveness skill in SPD patients by facilitating transmission from the object mode to the meta-cognitive mode and enhancing the efficient and flexible coping skills.

  6. Assessment of ASSERT-PV for prediction of post-dryout heat transfer in CANDU bundles

    International Nuclear Information System (INIS)

    Cheng, Z.; Rao, Y.F.; Waddington, G.M.

    2014-01-01

    Highlights: • Assessment of the new Canadian subchannel code ASSERT-PV 3.2 for PDO sheath temperature prediction. • CANDU 28-, 37- and 43-element bundle PDO experiments. • Prediction improvement of ASSERT-PV 3.2 over previous code versions. • Sensitivity study of the effect of PDO model options. - Abstract: Atomic Energy of Canada Limited (AECL) has developed the subchannel thermalhydraulics code ASSERT-PV for the Canadian nuclear industry. The recently released ASSERT-PV 3.2 provides enhanced models for improved predictions of subchannel flow distribution, critical heat flux (CHF), and post-dryout (PDO) heat transfer in horizontal CANDU fuel channels. This paper presents results of an assessment of the new code version against PDO tests performed during five full-size CANDU bundle experiments conducted between 1992 and 2009 by Stern Laboratories (SL), using 28-, 37- and 43-element bundles. A total of 10 PDO test series with varying pressure-tube creep and/or bearing-pad height were analyzed. The SL experiments encompassed the bundle geometries and range of flow conditions for the intended ASSERT-PV applications for existing CANDU reactors. Code predictions of maximum PDO fuel-sheath temperature were compared against measurements from the SL PDO tests to quantify the code's prediction accuracy. The prediction statistics using the recommended model set of ASSERT-PV 3.2 were compared to those from previous code versions. Furthermore, separate-effects sensitivity studies quantified the contribution of each PDO model change or enhancement to the improvement in PDO heat transfer prediction. Overall, the assessment demonstrated significant improvement in prediction of PDO sheath temperature in horizontal fuel channels containing CANDU bundles

  7. Assessment of ASSERT-PV for prediction of critical heat flux in CANDU bundles

    International Nuclear Information System (INIS)

    Rao, Y.F.; Cheng, Z.; Waddington, G.M.

    2014-01-01

    Highlights: • Assessment of the new Canadian subchannel code ASSERT-PV 3.2 for CHF prediction. • CANDU 28-, 37- and 43-element bundle CHF experiments. • Prediction improvement of ASSERT-PV 3.2 over previous code versions. • Sensitivity study of the effect of CHF model options. - Abstract: Atomic Energy of Canada Limited (AECL) has developed the subchannel thermalhydraulics code ASSERT-PV for the Canadian nuclear industry. The recently released ASSERT-PV 3.2 provides enhanced models for improved predictions of flow distribution, critical heat flux (CHF), and post-dryout (PDO) heat transfer in horizontal CANDU fuel channels. This paper presents results of an assessment of the new code version against five full-scale CANDU bundle experiments conducted in 1990s and in 2009 by Stern Laboratories (SL), using 28-, 37- and 43-element (CANFLEX) bundles. A total of 15 CHF test series with varying pressure-tube creep and/or bearing-pad height were analyzed. The SL experiments encompassed the bundle geometries and range of flow conditions for the intended ASSERT-PV applications for CANDU reactors. Code predictions of channel dryout power and axial and radial CHF locations were compared against measurements from the SL CHF tests to quantify the code prediction accuracy. The prediction statistics using the recommended model set of ASSERT-PV 3.2 were compared to those from previous code versions. Furthermore, the sensitivity studies evaluated the contribution of each CHF model change or enhancement to the improvement in CHF prediction. Overall, the assessment demonstrated significant improvement in prediction of channel dryout power and axial and radial CHF locations in horizontal fuel channels containing CANDU bundles

  8. Evidence for the Treatment of Osteoporosis with Vitamin D in Residential Care and in the Community Dwelling Elderly

    Directory of Open Access Journals (Sweden)

    John A. A. Geddes

    2013-01-01

    Full Text Available Introduction. Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts. Aims. To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers. Methods. We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required. Results. Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty. Discussion. A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.

  9. Abundance and composition of indigenous bacterial communities in a multi-step biofiltration-based drinking water treatment plant.

    Science.gov (United States)

    Lautenschlager, Karin; Hwang, Chiachi; Ling, Fangqiong; Liu, Wen-Tso; Boon, Nico; Köster, Oliver; Egli, Thomas; Hammes, Frederik

    2014-10-01

    Indigenous bacterial communities are essential for biofiltration processes in drinking water treatment systems. In this study, we examined the microbial community composition and abundance of three different biofilter types (rapid sand, granular activated carbon, and slow sand filters) and their respective effluents in a full-scale, multi-step treatment plant (Zürich, CH). Detailed analysis of organic carbon degradation underpinned biodegradation as the primary function of the biofilter biomass. The biomass was present in concentrations ranging between 2-5 × 10(15) cells/m(3) in all filters but was phylogenetically, enzymatically and metabolically diverse. Based on 16S rRNA gene-based 454 pyrosequencing analysis for microbial community composition, similar microbial taxa (predominantly Proteobacteria, Planctomycetes, Acidobacteria, Bacteriodetes, Nitrospira and Chloroflexi) were present in all biofilters and in their respective effluents, but the ratio of microbial taxa was different in each filter type. This change was also reflected in the cluster analysis, which revealed a change of 50-60% in microbial community composition between the different filter types. This study documents the direct influence of the filter biomass on the microbial community composition of the final drinking water, particularly when the water is distributed without post-disinfection. The results provide new insights on the complexity of indigenous bacteria colonizing drinking water systems, especially in different biofilters of a multi-step treatment plant. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. [Relationship between four components of assertiveness and mental health among high school students].

    Science.gov (United States)

    Watanabe, Asami

    2009-04-01

    This study examines the relationship between four components of assertiveness ("open expression", "control of emotion", "consideration for others" and "self-direction") and mental health. In Study 1, the analysis of interviews with thirteen high school students suggested that some components did not have a positive relationship with mental health. In Study 2, 176 high school students completed a questionnaire which included the UCLA isolation scale, the General Health Questionnaire (GHQ) and a scale to measure the four components of assertiveness. The results showed that an excessively high score for "consideration for others" was associated with mental unhealthiness. This component probably has an optimum level to maintain mental health.

  11. [Between anxiety and depression. The status of assertiveness disorders and social phobias].

    Science.gov (United States)

    Granger, B; Azais, F; Albercque, C; Debray, Q

    1995-05-01

    The authors try to answer the question of the nosological status of social phobias and assertiveness difficulties, which are usually included in the large group of anxious troubles. The correlation between Rathus Rating Scale, Hamilton Depression Rating Scale (HDRS) and sub-scores of HDRS were studied in two populations; the first one was constituted by anxious and/or depressed patients, the second, extracted from the first one, by anxious patients only. The results show that lack of assertiveness has probably both affective and anxious components. These results are important from a nosological and therapeutic point of view.

  12. SystemVerilog assertions and functional coverage guide to language, methodology and applications

    CERN Document Server

    Mehta, Ashok B

    2013-01-01

    This book provides a hands-on, application-oriented guide to the language and methodology of both SystemVerilog Assertions and SytemVerilog Functional Coverage.  Readers will benefit from the step-by-step approach to functional hardware verification, which will enable them to uncover hidden and hard to find bugs, point directly to the source of the bug, provide for a clean and easy way to model complex timing checks and objectively answer the question 'have we functionally verified everything'.  Written by a professional end-user of both SystemVerilog Assertions and SystemVerilog Functional Co

  13. Assertive speech acts as an expressive mean of insincere discourse

    Directory of Open Access Journals (Sweden)

    Andryukhina N.V.

    2017-03-01

    Full Text Available according to the author insincerity is an integral feature of the modern society, that is why nowadays there is a preoccupation in the study of insincerity from the point of view of linguistics. Insincerity externalizes itself in insincere discourse. The aim of the article is to analyze assertive speech acts as an expressive mean of insincere discourse in English political texts. Having analyzed the examples, the author comes to a conclusion, that assertive speech acts are the effective means of expressing an insincere discourse.

  14. Plants used for treatment of dysentery and diarrhoea by the Bhoxa community of district Dehradun, Uttarakhand, India.

    Science.gov (United States)

    Gairola, Sumeet; Sharma, Jyotsana; Gaur, R D; Siddiqi, T O; Painuli, R M

    2013-12-12

    Dysentery and diarrhoea are major causes of morbidity and mortality in rural communities of developing world. The Bhoxa community is an important primitive indigenous community of Uttarakhand, India. In this paper we have tried to scientifically enumerate ethnomedicinal plants and herbal preparations used by Bhoxa community to treat dysentery and diarrhoea, and discuss their antidiarrhoeal properties in the light of previous ethnomedicinal, pharmacological, microbiological and phytochemical studies. To record plants and herbal preparations used by Bhoxa community of district Dehradun, Uttarakhand, India in treatment of dysentery and diarrhoea, and to discuss antidiarrhoeal and antimicrobial properties of the recorded plants. Ethnomedicinal survey was conducted in different villages of Bhoxa community located in district Dehradun, Uttarakhand, India. Thirty Bhoxa traditional healers were interviewed to collect information on plants used by them for treating dysentery and diarrhoea. For each of the recorded plant species the use value (UV) and fidelity level (FL) was calculated. Detailed literature survey was conducted to summarize ethnomedicinal, pharmacological, microbiological and phytochemical information on the medicinal plants listed in the present study. Fifty medicinal plants (45 genera and 30 families) were used by Bhoxa community to treat dysentery and diarrhoea, among which 27 species were used for dysentery, 41 for diarrhoea and 18 for both dysentery and diarrhoea. Three plants viz., Dioscorea bulbifera L., Euphorbia thymifolia L. and Prunus persica (L.) Stokes, recorded in the present survey have been reported for the first time in treatment of dysentery and diarrhoea by any indigenous communities in India. FL and UV values revealed that most preferred species for the treatment of dysentery and diarrhoea by Bhoxa community are Euphorbia hirta L. followed by Holarrhena pubescens Wall., Helicteres isora L. and Cassia fistula L. Earlier pharmacological

  15. The Relationship Between Self-concept with Assertiveness in Class X Students Kesatrian 2 Senior High School Semarang

    OpenAIRE

    Pusparani, Anindyta; Masykur, Achmad Mujab

    2014-01-01

    Assertiveness is important for teenagers, that allows teens to put themselves and perform the strategic, directed, controlled and steady activities, so teens can avoid the negative behavior. Assertiveness is consist of by several factors, one of which is influenced by self-esteem. A person with a positive self-esteem has a positive self-concept. This study aims to empirically examine the relationship of self-concept with assertiveness in class X Kesatrian 2 Semarang High School. The sample...

  16. Analysis of the bacterial community changes in soil for septic tank effluent treatment in response to bio-clogging.

    Science.gov (United States)

    Nie, J Y; Zhu, N W; Zhao, K; Wu, L; Hu, Y H

    2011-01-01

    Soil columns were set up to survey the bacterial community in the soil for septic tank effluent treatment. When bio-clogging occurred in the soil columns, the effluent from the columns was in poorer quality. To evaluate changes of the soil bacterial community in response to bio-clogging, the bacterial community was characterized by DNA gene sequences from soil samples after polymerase chain reaction coupled with denaturing gradient gel electrophoresis process. Correspondence analysis showed that Proteobacteria related bacteria were the main bacteria within the soil when treating septic tank effluent. However, Betaproteobacteria related bacteria were the dominant microorganisms in the normal soil, whereas Alphaproteobacteria related bacteria were more abundant in the clogged soil. This study provided insight into changes of the soil bacterial community in response to bio-clogging. The results can supply some useful information for the design and management of soil infiltration systems.

  17. Effects of iron and calcium carbonate on contaminant removal efficiencies and microbial communities in integrated wastewater treatment systems.

    Science.gov (United States)

    Zhao, Zhimiao; Song, Xinshan; Zhang, Yinjiang; Zhao, Yufeng; Wang, Bodi; Wang, Yuhui

    2017-12-01

    In the paper, we explored the influences of different dosages of iron and calcium carbonate on contaminant removal efficiencies and microbial communities in algal ponds combined with constructed wetlands. After 1-year operation of treatment systems, based on the high-throughput pyrosequencing analysis of microbial communities, the optimal operating conditions were obtained as follows: the ACW10 system with Fe 3+ (5.6 mg L -1 ), iron powder (2.8 mg L -1 ), and CaCO 3 powder (0.2 mg L -1 ) in influent as the adjusting agents, initial phosphorus source (PO 4 3- ) in influent, the ratio of nitrogen to phosphorus (N/P) of 30 in influent, and hydraulic retention time (HRT) of 1 day. Total nitrogen (TN) removal efficiency and total phosphorus (TP) removal efficiency were improved significantly. The hydrolysis of CaCO 3 promoted the physicochemical precipitation in contaminant removal. Meanwhile, Fe 3+ and iron powder produced Fe 2+ , which improved contaminant removal. Iron ion improved the diversity, distribution, and metabolic functions of microbial communities in integrated treatment systems. In the treatment ACW10, the dominant phylum in the microbial community was PLANCTOMYCETES, which positively promoted nitrogen removal. After 5 consecutive treatments in ACW10, contaminant removal efficiencies for TN and TP respectively reached 80.6% and 57.3% and total iron concentration in effluent was 0.042 mg L -1 . Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. [Fecal incontinence in community-dwelling elderly: findings from a study of prevalence, consultation of physicians, psychosocial aspects and treatment

    NARCIS (Netherlands)

    Verhagen, T.E.M.; Lagro-Janssen, A.L.M.

    2001-01-01

    OBJECTIVE: To gain insight into the prevalence of faecal incontinence, looking for medical attention, treatment and the impact of faecal incontinence on the quality of life in community-residing men and women of 60 years and over. DESIGN: Enquiry and interview. METHOD: A questionnaire about the

  19. Targeted Expansion Project for Outreach and Treatment for Substance Abuse and HIV Risk Behaviors in Asian and Pacific Islander Communities

    Science.gov (United States)

    Nemoto, Tooru; Iwamoto, Mariko; Kamitani, Emiko; Morris, Anne; Sakata, Maria

    2011-01-01

    Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence…

  20. Impact of a wastewater treatment plant on microbial community composition and function in a hyporheic zone of a eutrophic river

    NARCIS (Netherlands)

    Atashgahi, S.; Aydin, R.; Rocha Dimitrov, M.; Sipkema, D.; Hamonts, K.; Lahti, Leo; Maphosa, F.; Kruse, T.; Saccenti, E.; Springael, D.; Dejonghe, W.; Smidt, H.

    2015-01-01

    The impact of the installation of a technologically advanced wastewater treatment plant (WWTP) on the benthic microbial community of a vinyl chloride (VC) impacted eutrophic river was examined two years before, and three and four years after installation of the WWTP. Reduced dissolved organic carbon

  1. Community-Based Promotional Campaign to Improve Uptake of Intermittent Preventive Antimalarial Treatment in Pregnancy in Burkina Faso

    NARCIS (Netherlands)

    Gies, Sabine; Coulibaly, Sheick O.; Ky, Clotilde; Ouattara, Florence T.; Brabin, Bernard J.; d'Alessandro, Umberto

    2009-01-01

    Malaria preventive strategies in pregnancy were assessed in a health center randomized trial comparing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) with and without community based promotional activities in rural Burkina Faso. The study involved 2,240 secundigravidae

  2. Self-Stigma and Quality of Life among People with Mental Illness Who Receive Compulsory Community Treatment Services

    Science.gov (United States)

    Livingston, James

    2012-01-01

    The present study was designed to examine the relationship between self-stigma and quality of life over a one year time period for 71 people with mental illness who were receiving compulsory community mental health treatment. It was hypothesized that, over time, self-stigma would have the direct effect of eroding quality of life among people with…

  3. Effect of Copper Treatment on the Composition and Function of the Bacterial Community in the Sponge Haliclona cymaeformis

    KAUST Repository

    Tian, R.-M.; Wang, Y.; Bougouffa, Salim; Gao, Z.-M.; Cai, L.; Zhang, W.-P.; Bajic, Vladimir B.; Qian, P.-Y.

    2014-01-01

    and poses a threat to marine organisms. Here, we examined the effects of copper treatment on the composition of the sponge-associated bacterial community and the genetic features that facilitate the survival of enriched bacteria under copper stress. The 16S

  4. Population dynamics of iron-oxidizing communities in pilot plants for the treatment of acid mine waters.

    Science.gov (United States)

    Heinzel, Elke; Janneck, Eberhard; Glombitza, Franz; Schlömann, Michael; Seifert, Jana

    2009-08-15

    The iron-oxidizing microbial community in two pilot plants for the treatment of acid mine water was monitored to investigate the influence of different process parameters such as pH, iron concentration, and retention time on the stability of the system to evaluate the applicability of this treatment technology on an industrial scale. The dynamics of the microbial populations were followed using T-RFLP (terminal restriction fragment length polymorphism) over a period of several months. For a more precise quantification, two TaqMan assays specific for the two prominent groups were developed and the relative abundance of these taxa in the iron-oxidizing community was verified by real-time PCR. The investigations revealed that the iron-oxidizing community was clearly dominated by two groups of Betaproteobacteria affiliated with the poorly known and not yet recognized species "Ferrovum myxofaciens" and with strains related to Gallionella ferruginea, respectively. These taxa dominated the microbial community during the whole investigation period and accelerated the oxidation of ferrous iron despite the changing characteristics of mine waters flowing into the plants. Thus, it is assumed that the treatment technology can also be applied to other mine sites and that these organisms play a crucial role in such treatment systems.

  5. Application of standard treatment guidelines in rural community health centres, Timor-Leste.

    Science.gov (United States)

    Higuchi, Michiyo; Okumura, Junko; Aoyama, Atsuko; Suryawati, Sri; Porter, John

    2012-08-01

    To analyse nurses' and midwives' knowledge of and attitudes towards standard treatment guidelines (STGs), which were developed to help their practices at rural community health centres (CHCs) in Timor-Leste. Fifty-five nurses and midwives were individually interviewed. Data were analysed qualitatively using the Framework approach. Overall, the standard treatments for acute respiratory tract infections, malaria and diarrhoea were well known by the respondents. Clinical nurses showed precise and detailed knowledge, especially for antibiotic use. The respondents were willing to use STGs and believed that they 'should' follow them. This feeling arose due to their self-awareness as frontline health workers and, at the same time, as peripheral civil servants. The changes brought about by the introduction of STGs were positively perceived. Three components of the change were observed: the concept, daily practice and perceived patient satisfaction. The respondents had previously felt a lack of confidence and hoped to improve their capacity as health care workers; they became confident in their practices by using STGs. Self-confidence was identified more clearly in the clinical nurse interviews. Few difficulties in using STGs were indicated, and the respondents suggested ways to deal with these difficulties. By using the STGs, the nurses/midwives gained knowledge and self-confidence. The positive perception of the changes promoted further use of the STGs. Clinical nurse training positively influenced the knowledge of and attitudes towards the STGs. Few difficulties in applying STGs in daily practice were identified, which is contrary to previous studies that targeted physicians in the Western world. Development of STGs within a health policy framework was considered a key factor. The STGs exist across related policies and various programmes, which are interconnected. The Timor-Leste experience indicates the value of STGs for non-physician health care providers at the

  6. Measurement of assertive behavior: construct and predictive validity of self-report, role-playing, and in-vivo measures.

    Science.gov (United States)

    Burkhart, B R; Green, S B; Harrison, W H

    1979-04-01

    Examined the predictive validity and construct equivalence of the three major procedures used to measure assertive behavior: Self-report, behavioral role-playing, and in-vivo assessment. Seventy-five Ss, who spanned the range of assertiveness, completed two self-report measures of assertiveness, the Rathus Assertiveness Scale (RAS) and the College Self-Expression Scale (CSES); two scales from the Endler S-R Inventory of General Trait Anxiousness, the interpersonal and general anxiety scales; eight role-playing situations that involved the expression of positive and negative assertiveness; and a telephone in-vivo task. In general, the study revealed the following: (1) assertiveness measures are task-dependent in that there was more overlap within task than between tasks; (2) there is a moderate degree of correspondence between self-report and role-playing measures, although this was true only for negative assertion; (3) positive and negative assertion do not appear to have the same topography of responding; and (4) there appears to be no consistent relationship between the in-vivo measure and any other type of assertiveness measure.

  7. Increased use of antipsychotic long-acting injections with community treatment orders.

    Science.gov (United States)

    Patel, Maxine X; Matonhodze, Jane; Baig, Mirza K; Gilleen, James; Boydell, Jane; Holloway, Frank; Taylor, David; Szmukler, George; Lambert, Tim; David, Anthony S

    2011-04-01

    Community treatment orders (CTOs) are increasingly being used, despite a weak evidence base, and problems continue regarding Second Opinion Appointed Doctor (SOAD) certification of medication. The aim of the current study was to describe current CTO usage regarding patient characteristics, prescribed medication and CTO conditions. A 1-year prospective cohort study with consecutive sampling was conducted for all patients whose CTO was registered in a large mental health trust. Only the first CTO for each patient was included. Measures included sociodemographic variables, psychiatric diagnosis, CTO date of initiation and conditions, psychotropic medication and date of SOAD certification for medication. This study was conducted in the first year of CTO legislation in England and Wales. A total of195 patients were sampled (mean age 40.6 years, 65% male, 52% black ethnic origin). There was significant geographical variability in rates of CTO use (χ(2) = 11.3, p = 0.012). A total of 53% had their place of residence specified as a condition and 29% were required to allow access into their homes. Of those with schizophrenia, 64% were prescribed an antipsychotic long-acting injection (LAI). Of the total group, 7% received high-dose antipsychotics, 10% were prescribed two antipsychotics and only 15% received SOAD certification in time. There was geographical and ethnic variation in CTO use but higher rates of hospital detention in minority ethnic groups may be contributory. Most patients were prescribed antipsychotic LAIs and CTO conditions may not follow the least restrictive principle.

  8. Relationship power and sexual risk among women in community-based substance abuse treatment.

    Science.gov (United States)

    Campbell, Aimee N C; Tross, Susan; Dworkin, Shari L; Hu, Mei-Chen; Manuel, Jennifer; Pavlicova, Martina; Nunes, Edward V

    2009-11-01

    Relationship power has been highlighted as a major factor influencing women's safer sex practices. Little research, however, has specifically examined relationship power in drug-involved women, a population with increased risk for HIV transmission. Using baseline data from a National Institute on Drug Abuse Clinical Trials Network multisite trial of a women's HIV prevention intervention in community-based drug treatment programs, this paper examined the association between sexual relationship power and unprotected vaginal or anal sex. The Sexual Relationship Power Scale, a measure of relationship control and decision-making dominance, was used to assess the association between power and unprotected sex in relationships with primary male partners. It was hypothesized that increased relationship power would be associated with decreased unprotected sexual occasions, after controlling for relevant empirical and theoretical covariates. Findings show a more complex picture of the association between power and sexual risk in this population, with a main effect in the hypothesized direction for decision-making dominance but not for relationship control. Possible explanations for these findings are discussed, and future research directions for examining power constructs and developing interventions targeting relationship power among drug-involved women are suggested.

  9. Determinants of compliance with nasal continuous positive airway pressure treatment applied in a community setting.

    Science.gov (United States)

    Ball, E M.; Banks, M B.

    2001-05-01

    Objectives: To assess determinants of nasal continuous positive airway pressure (CPAP) compliance when applied in a community setting.Background: One-third of obstructive sleep apnea patients eventually refuse CPAP therapy. Treatment outcomes may be improved by identifying predictors of CPAP failure, including whether management by primary care physicians without sleep consultation affects results.Methods: Polysomnogram, chart review, and questionnaire results for regular CPAP users (n=123) were compared with those returning the CPAP machine (n=26).Results: Polysomnographic data and the presence of multiple sleep disorders were only modestly predictive of CPAP compliance. Striking differences in questionnaire responses separated CPAP users from non-users, who reported less satisfaction with all phases of their diagnosis and management. Rates of CPAP use were not significantly different between patients managed solely by their primary care physician or by a sleep consultant.Conclusions: Polysomnographic findings are unlikely to identify eventual CPAP non-compliers in a cost-effective fashion. Improvements in sleep apnea management may result from addressing the role of personality factors and multiple sleep disorders in determining compliance. In this practice setting, management by primary care physicians did not significantly degrade CPAP compliance.

  10. Still mesoendemic onchocerciasis in two Cameroonian community-directed treatment with ivermectin projects despite more than 15 years of mass treatment

    Directory of Open Access Journals (Sweden)

    Guy-Roger Kamga

    2016-11-01

    Full Text Available Abstract Background After more than a decade of community-directed treatment with ivermectin (CDTI in Centre and Littoral Regions of Cameroon, onchocerciasis endemicity was still high in some communities according to the 2011 epidemiological evaluations. Some corrective measures were undertaken to improve the CDTI process and therefore reduce the burden of the disease. The objective of the present study was to assess the progress made towards the elimination of onchocerciasis in the Centre 1 and Littoral 2 CDTI projects where the worst performances were found in 2011. To this end, a cross-sectional survey was conducted in April 2015 in eight communities in two health districts (HD, Bafia in Centre 1 and Yabassi in Littoral 2, chosen because assessed at baseline and in 2011. All volunteers living for at least five years in the community, aged five years or more, underwent clinical and parasitological examinations. Individual compliance to ivermectin treatment was also assessed. Analyses of data were weighted proportionally to age and gender distribution in the population. Results In the Bafia and Yabassi HD, 514 and 242 individuals were examined with a mean age of 35.1 (standard deviation, SD: 20.7 and 44.6 (SD: 16.3 years, respectively. In the Bafia HD, the weighted prevalences varied from 24.4 to 57.0 % for microfilaridermia and from 3.6 to 37.4 % for nodule presence across the surveyed communities. The community microfilarial load (CMFL, expressed in microfilariae/skin snip (mf/ss, significantly dropped from 20.84–114.50 mf/ss in 1991 to 0.31–1.62 mf/ss in 2015 in all the surveyed communities. In the Yabassi HD, the weighted prevalences varied from 12.3 to 59.3 % for microfilaridermia and from 1.5 to 3.7 % for nodule presence across the surveyed communities, while a significant drop was observed in CMFL, from 20.40–28.50 mf/ss in 1999 to 0.48–1.74 mf/ss in 2015. The 2014 weighted therapeutic coverage of participants varied from 65

  11. Community participation for malaria elimination in tafea province, vanuatu: part ii. social and cultural aspects of treatment-seeking behaviour

    Directory of Open Access Journals (Sweden)

    Riley Ian

    2011-07-01

    Full Text Available Abstract Background Early diagnosis and prompt effective case management are important components of any malaria elimination strategy. Tafea Province, Vanuatu has a rich history of traditional practices and beliefs, which have been integrated with missionary efforts and the introduction of modern constructions of health. Gaining a detailed knowledge of community perceptions of malarial symptomatology and treatment-seeking behaviours is essential in guiding effective community participation strategies for malaria control and elimination. Method An ethnographic study involving nine focus group discussions (FGD, 12 key informant interviews (KII and seven participatory workshops were carried out on Tanna Island, Vanuatu. Villages in areas of high and low malaria transmission risk were selected. Four ni-Vanuatu research officers, including two from Tanna, were trained and employed to conduct the research. Data underwent thematic analysis to examine treatment-seeking behaviour and community perceptions of malaria. Results Malaria was perceived to be a serious, but relatively new condition, and in most communities, identified as being apparent only after independence in 1980. Severe fever in the presence of other key symptoms triggered a diagnosis of malaria by individuals. Use of traditional or home practices was common: perceived vulnerability of patient and previous experience with malaria impacted on the time taken to seek treatment at a health facility. Barriers to health care access and reasons for delay in care-seeking included the availability of health worker and poor community infrastructure. Conclusion Due to programme success of achieving low malaria transmission, Tafea province has been identified for elimination of malaria by 2012 in the Government of Vanuatu Malaria Action Plans (MAP. An effective malaria elimination programme requires interactions between the community and its leaders, malaria workers and health providers for success in

  12. Women are Warmer but No Less Assertive than Men: Gender and Language on Facebook.

    Directory of Open Access Journals (Sweden)

    Gregory Park

    Full Text Available Using a large social media dataset and open-vocabulary methods from computational linguistics, we explored differences in language use across gender, affiliation, and assertiveness. In Study 1, we analyzed topics (groups of semantically similar words across 10 million messages from over 52,000 Facebook users. Most language differed little across gender. However, topics most associated with self-identified female participants included friends, family, and social life, whereas topics most associated with self-identified male participants included swearing, anger, discussion of objects instead of people, and the use of argumentative language. In Study 2, we plotted male- and female-linked language topics along two interpersonal dimensions prevalent in gender research: affiliation and assertiveness. In a sample of over 15,000 Facebook users, we found substantial gender differences in the use of affiliative language and slight differences in assertive language. Language used more by self-identified females was interpersonally warmer, more compassionate, polite, and-contrary to previous findings-slightly more assertive in their language use, whereas language used more by self-identified males was colder, more hostile, and impersonal. Computational linguistic analysis combined with methods to automatically label topics offer means for testing psychological theories unobtrusively at large scale.

  13. A Study of the Relationship between Assertive Parenting Styles and Career Indecision in College Students

    Science.gov (United States)

    Cullen, Keith C.

    2013-01-01

    For a variety of reasons, higher levels of parental assertiveness have begun to impact even the basic conflicts college students encounter while in attendance. Called "helicopter parenting" within the popular press, these parents are described as involving themselves in the minutia of their child's college experience, engaging with…

  14. Gender roles in relation to assertiveness and Eysenckian personality dimensions : Replication with a Spanish population sample

    NARCIS (Netherlands)

    Arrindell, W.A.; Vergara, A.I; Torres, B.; Caballo, V.E.; Sanderman, R.; Calvo, M G; Vanderende, J.; Oosterhof, L.; Castro, J

    The objective of the present study was to evaluate the cross-national replicability of the usual pattern of associations observed in Anglo-Saxon samples between masculinity and femininity on the one hand and difficulty and distress in assertiveness and the major Eysenckian dimensions of personality

  15. Perceived Social Support and Assertiveness as a Predictor of Candidates Psychological Counselors' Psychological Well-Being

    Science.gov (United States)

    Ates, Bünyamin

    2016-01-01

    In this research, to what extent the variables of perceived social support (family, friends and special people) and assertiveness predicted the psychological well-being levels of candidate psychological counselors. The research group of this study included totally randomly selected 308 candidate psychological counselors including 174 females…

  16. Assertiveness Training Melalui Bermain Peran dalam Bimbingan Kelompok untuk Meningkatkan Komunikasi Interpersonal

    Directory of Open Access Journals (Sweden)

    Kristinus Sembiring

    2017-06-01

    Full Text Available Interpersonal communication skills are one of the ability students to interact with others. Students who have interpersonal communication problems can be hinder the process of development of creativity and improved academic  achievement. The purpose of this study is to investigate interpersonal communication skills of score experimental group after assertiveness training through a role playing methods in group guidance to help improve. This research applied quasi-experimental approach by pretest-posttest control group design. The subjects were 10 students of class Eleven IPS (experimental group and 10 students of class Eleven  IPA (the control group. To select subjects for experimental and control groups using purposive sampling technique through data analysis pretest. It was considered in some criteria such as with low average scores of interpersonal communication skills. The data was collected through by scale of interpersonal communication skills that have been tested for validity and reliability. The data analysis technique used is nonparametric statistics by Mann Whitney U Test. From the results of post-test, the student interpersonal communication skills improved. It was indicated by the results of quantitative analysis that assertiveness training through a role playing methods in group guidance was effective to improve students interpersonal communication skills from group guidance without assertiveness training through a role playing method, with the result that assertiveness training through role-play methods can be used as one method of group guidance services to enhance the interpersonal communication skills of students.

  17. 48 CFR 252.227-7019 - Validation of asserted restrictions-Computer software.

    Science.gov (United States)

    2010-10-01

    ..., creates or implies privity of contract between the Government and the Contractor's subcontractors or... AND CONTRACT CLAUSES Text of Provisions And Clauses 252.227-7019 Validation of asserted restrictions..., unless otherwise specifically indicated, the term “Contractor” means the Contractor and its...

  18. Differentiating between Confrontive and Coercive Kinds of Parental Power-Assertive Disciplinary Practices

    Science.gov (United States)

    Baumrind, Diana

    2012-01-01

    In this essay, I differentiate between coercive and confrontive kinds of power assertion to elucidate the significantly different effects on children's well-being of authoritarian and authoritative styles of parental authority. Although both parenting styles (in contrast to the permissive style) are equally demanding, forceful, and…

  19. Further Examination of the Reliability of the Modified Rathus Assertiveness Schedule.

    Science.gov (United States)

    Del Greco, Linda; And Others

    1986-01-01

    Examined the reliability of the 30-item Modified Rathus Assertiveness Schedule (MRAS) using the test-retest method over a three-week period. The MRAS yielded correlations of .74 using the Pearson product and Spearman Brown correlation coefficient. Correlations for males yielded .77 and .72. For females correlations for both tests were .72.…

  20. ASSERT-PV 3.2: Advanced subchannel thermalhydraulics code for CANDU fuel bundles

    International Nuclear Information System (INIS)

    Rao, Y.F.; Cheng, Z.; Waddington, G.M.; Nava-Dominguez, A.

    2014-01-01

    Highlights: • Introduction to a new version of the Canadian subchannel code, ASSERT-PV 3.2. • Enhanced models for flow-distribution, CHF and post-dryout heat transfer prediction. • Model changes focused on unique features of horizontal CANDU bundles. • Detailed description of model changes for all major thermalhydraulics models. • Discussion on rationale and limitation of the model changes. - Abstract: Atomic Energy of Canada Limited (AECL) has developed the subchannel thermalhydraulics code ASSERT-PV for the Canadian nuclear industry. The most recent release version, ASSERT-PV 3.2 has enhanced phenomenon models for improved predictions of flow distribution, dryout power and CHF location, and post-dryout (PDO) sheath temperature in horizontal CANDU fuel bundles. The focus of the improvements is mainly on modeling considerations for the unique features of CANDU bundles such as horizontal flows, small pitch to diameter ratios, high mass fluxes, and mixed and irregular subchannel geometries, compared to PWR/BWR fuel assemblies. This paper provides a general introduction to ASSERT-PV 3.2, and describes the model changes or additions in the new version to improve predictions of flow distribution, dryout power and CHF location, and PDO sheath temperatures in CANDU fuel bundles