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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. Rehousing homeless citizens with assertive community treatment

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    This report presents the results of a study of an ACT-programme (Assertive Community Treatment) in Copenhagen, Denmark, which has been part of the Danish national homelessness strategy. The ACT-programme is aimed at rehousing homeless individuals and providing floating support in the citizens own...... home from a multidisciplinary support team. The target groups of ACT are homeless individuals with complex support needs due to for instance mental illness and/or substance abuse and for whom it is difficult to use mainstream support systems. The team consists of both social support workers and other...... 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 community treatment in the Netherlands: a randomized controlled trial.

    Science.gov (United States)

    Sytema, S; Wunderink, L; Bloemers, W; Roorda, L; Wiersma, D

    2007-08-01

    Assertive community treatment is rapidly implemented by many European mental health services, but recently the evidence base has been questioned. Positive results of randomized trials in the USA were not replicated in the UK. The question is whether the UK findings are representative for other European countries with modern mental health services. Open randomized controlled trial of long-term severely mentally ill patients [Health of the Nation Outcome Scales (HoNOS) total score >or=15], assigned to assertive community treatment (n = 59) or to standard community mental health care (n = 59). sustained contact; housing stability and admission days. This trial is registered as an International Standard Randomized Clinical Trial, number ISRCTN 11281756. Assertive community treatment was significantly better in sustaining contact with patients, but not in reducing admission days. No differences in housing stability, psychopathology, social functioning or quality of life were found. The results are in agreement with UK studies. However, the sustained contact potential of assertive community treatment is important, as too many patients are lost in standard care.

  4. Assertive community treatment in the Netherlands : a randomized controlled trial

    NARCIS (Netherlands)

    Sytema, S.; Wunderink, L.; Bloemers, W.; Roorda, L.; Wiersma, D.

    Objective: Assertive community treatment is rapidly implemented by many European mental health services, but recently the evidence base has been questioned. Positive results of randomized trials in the USA were not replicated in the UK. The question is whether the UK findings are representative for

  5. Cognitive adaptation training combined with assertive community treatment

    DEFF Research Database (Denmark)

    Hansen, Jens Peter; Ostergaard, 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...... purpose was to evaluate the effect of CAT in comparison with ACT, focusing on social functions (primary outcome), symptoms, relapse, re-hospitalisation, and quality of life of outpatients with schizophrenia....

  6. 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

  7. 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

  8. 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...

  9. 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...... 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...

  10. 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.

  11. Moral decision-making among assertive community treatment (ACT) case managers: a focus group study.

    Science.gov (United States)

    Lerbaek, Birgitte; Aagaard, Jørgen; Andersen, Mette Braendstrup; Buus, Niels

    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 awareness, but there was a risk of supporting paternalistic interventions and denying the clients' right to autonomy.

  12. Assertive community treatment for parents with serious mental illnesses: a comparison of "parent-sensitive" assertive community treatment teams versus other teams.

    Science.gov (United States)

    White, Laura M; McGrew, John H; Salyers, Michelle P; Firmin, Ruth L

    2014-09-01

    Assertive Community Treatment (ACT) is an evidence-based practice for individuals living with serious mental illnesses. Although studies estimate that at least half of people with serious mental illnesses are parents, little is known about ACT policies and services for parent consumers. Seventy-three ACT providers from 67 teams completed a survey about treatment services for parent consumers. Teams were divided into "parent-sensitive" and "nonsensitive" teams based on 3 indicators of parent-related services: identifying parental status, discussing parenting issues, and assisting with parenting needs. For each treatment indicator, teams were compared to determine factors that may contribute to parent-supportive services. Providers from parent-sensitive teams that consistently identified consumers' parental status were more likely to talk with consumers about committed relationships and to assist consumers with parent-child communication. Parent-sensitive teams that frequently discussed parenting issues with consumers were less likely to be unsure of consumers' family plans, more likely to find out about parenting during goal setting, and more likely to assist with parent-related needs. Parent-sensitive teams that frequently provided assistance with parenting needs were more likely to serve minority consumers and consumers who want children, spend more time discussing parenting issues, and offer special programs for parent consumers. Findings suggest that simply identifying consumers as parents is not sufficient for ensuring consistent provision of parent-supportive services, whereas discussing parenting issues is associated with increased service provision. More intensive, evidence-based parent-supportive services are needed, as well as continued research on parents with serious mental illnesses and available treatment services. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  13. The teamwork in assertive community treatment (TACT) scale: development and validation.

    Science.gov (United States)

    Wholey, Douglas R; Zhu, Xi; Knoke, David; Shah, Pri; Zellmer-Bruhn, Mary; Witheridge, Thomas F

    2012-11-01

    Team design is meticulously specified for assertive community treatment (ACT) teams, yet performance can vary across ACT teams, even those with high fidelity. By developing and validating the Teamwork in Assertive Community Treatment (TACT) scale, investigators examined the role of team processes in ACT performance. The TACT scale measuring ACT teamwork was developed from a conceptual model grounded in organizational research and adapted for the ACT and mental health context. TACT subscales were constructed after exploratory and confirmatory factor analyses. The reliability, discriminant validity, predictive validity, temporal stability, internal consistency, and within-team agreement were established with surveys from approximately 300 members of 26 Minnesota ACT teams who completed the questionnaire three times, at six-month intervals. Nine TACT subscales emerged from the analyses: exploration, exploitation of new and existing knowledge, psychological safety, goal agreement, conflict, constructive controversy, information accessibility, encounter preparedness, and consumer-centered care. These nine subscales demonstrated fit and temporal stability (confirmatory factor analysis), high internal consistency (Cronbach's alpha), and within-team agreement and between-team differences (rwg and intraclass correlations). Correlational analyses of the subscales revealed that they measure related yet distinctive aspects of ACT team processes, and regression analyses demonstrated predictive validity (encounter preparedness is related to staff outcomes). The TACT scale demonstrated high reliability and validity and can be included in research and evaluation of teamwork in ACT and mental health teams.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Assertive community treatment (ACT) case managers' professional identities: A focus group study.

    Science.gov (United States)

    Lerbaek, Birgitte; Aagaard, Jørgen; Andersen, Mette Braendstrup; Buus, Niels

    2016-12-01

    Assertive community treatment (ACT) case managers provide healthcare services to people with severe and persistent mental illness. These case managers take on generic roles in multidisciplinary teams and provide all-around services in the clients' private homes. This focus group study aimed to gain insight into Danish ACT case managers' professional identity work by examining their discussions of ethical dilemmas and collaboration in their everyday practice. Data were collected during five focus groups at three ACT teams in the North Denmark Region and subjected to discourse analysis emphasizing how identity work was accomplished through talk. The findings indicated that the case managers constructed professional identities by actively positioning themselves and the particular ACT approach in relation to other mental healthcare professionals and clients. They represented themselves as achieving better client-related outcomes by being more assertive and persistent, and as responsible caregivers who provided the help that their clients needed when other services had failed to do so. They depicted their services as being focused on the clients' well-being, and their persistent efforts to establish and sustain interpersonal relationships with clients were an important part of their service. Basic nursing tasks were described as an important part of their everyday work, and even though such tasks were not distinctive for ACT case managers, the representations of their work seemed to give them a sense of worth as professionals and legitimized a unique role in the community mental healthcare services. © 2016 Australian College of Mental Health Nurses Inc.

  17. Transitions from Assertive Community Treatment Among Urban and Rural Teams: Identifying Barriers, Service Options, and Strategies.

    Science.gov (United States)

    LeFebvre, Andrea M; Dare, Bill; Farrell, Susan J; Cuddeback, Gary S

    2017-09-01

    An emerging focus of Assertive Community Treatment (ACT) teams is the transition of clients to less intensive services, which creates space for individuals in need of ACT and is consistent with a recovery orientation of treatment. However, there is limited research on team transition rates, post-ACT services, and strategies to overcome transition barriers. In addition, few studies have examined differences in these factors among urban and rural ACT teams. To address these knowledge gaps, we interviewed eight ACT teams in urban and rural areas of eastern Ontario regarding their transition rates, processes of transitioning ACT clients to less intensive services, transition barriers, and solutions to overcoming these barriers. On average, teams transitioned about 6% of their clients over our 3-year study period. Urban and rural teams described both similar and distinct clinical and systemic barriers, such as client reluctance to transition and finding psychiatric follow-up outside of ACT. Implications for ACT practice and policy are discussed.

  18. Patient experiences of autonomy and coercion while receiving legal leverage in forensic assertive community treatment.

    Science.gov (United States)

    Lamberti, J Steven; Russ, Ann; Cerulli, Catherine; Weisman, Robert L; Jacobowitz, David; Williams, Geoffrey C

    2014-01-01

    Legal leverage is broadly defined as the use of legal authority to promote treatment adherence. It is widely utilized within mental health courts, drug courts, mandated outpatient treatment programs, and other intervention strategies for individuals with mental illness or chemical dependency who have contact with the criminal justice system. Nonetheless, the ethics of using legal authority to promote treatment adherence remains a hotly debated issue within public and professional circles alike. While critics characterize legal leverage as a coercive form of social control that undermines personal autonomy, advocates contend that it supports autonomy because treatment strategies using legal leverage are designed to promote health and independence. Despite the controversy, there is little evidence regarding the impact of legal leverage on patient autonomy as experienced and expressed by patients themselves. This report presents findings from a qualitative study involving six focus groups with severely mentally ill outpatients who received legal leverage through three forensic assertive community treatment (FACT) programs in Northeastern, Midwestern, and West Coast cities. Findings are discussed in the context of the self-determination theory of human motivation, and practical implications for the use of legal leverage are considered.

  19. Metabolic Syndrome Screening and Assertive Community Treatment: A Quality Improvement Study.

    Science.gov (United States)

    Castillo, Enrico G; Rosati, Justin; Williams, Caroline; Pessin, Neil; Lindy, David C

    2015-01-01

    Metabolic syndrome defines a collection of cardiometabolic illnesses that predict risk for poor physical health and early death and is highly prevalent among those with serious mental illness. Despite recommendations for routine monitoring, those with serious mental illness frequently do not receive physical health screenings. We conducted a quality improvement (QI) project to increase rates of metabolic syndrome screening in three New York City Assertive Community Treatment (ACT) teams. The project, conducted from December 2010 to May 2011, involved educational sessions for staff and consumers and a systematic screening protocol. We collected complete metabolic syndrome screening measurements for 71% of participating ACT consumers. We found metabolic risk to be nearly universal among participants, with over half diagnosed with metabolic syndrome. We also found high rates of previously undiagnosed hypertension, diabetes, and dyslipidemia. We describe the resources and obstacles we encountered in our QI project to make systematic metabolic screening a routine part of ACT care. This QI project suggests that ACT teams can take a leadership role in screening their consumers for physical health issues, aligning with recent policy trends to better integrate behavioral health and primary care services. © The Author(s) 2015.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Coronary vascular disease event risk and metabolic syndrome prevalence in patients enrolled in an assertive treatment community program.

    Science.gov (United States)

    Ramudo Cela, Luis; Ávila González, María José; Yáñez Rubal, Juan Carlos; Díaz Platas, Lucía María; Martín Herranz, María Isabel; Díaz Del Valle, Juan Carlos

    2017-11-02

    To examine the risk of coronary vascular disease event (CVDE) and the prevalence metabolic syndrome (MS) and its cardiovascular risk factors (CVRF) in patients with severe mental illnesses enrolled in an assertive treatment community program (ATC) in Spain. We carried out a cross-sectional descriptive study with all of the patients included in an ATC program in 2016 in a health area with 547,328 inhabitants in Galicia, Spain. We identified the CVRF in all the individuals, and calculated MS and 10-year CVDE. We also compared the prevalence of all traits in our cohort and the general population. The 10-year median of coronary vascular disease event (CVDE10) was 8.4%. The percentage of individuals with high CVDE10 (>5%) was 41.2% The CVDE10 median was higher in men than women (10.5% vs 5.1%, penrolled in ATC programs had a 1.5-times higher prevalence of MS and 8 times higher CVDE10 than those reported in the general population. Individual CVRF were also higher in the SMD patients. Prevention, early detection, and comprehensive treatment are important issues for patients with severe mental illnesses. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

  5. 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...... not emphasised in patients' account of their engagement with ACT, and generally only related to patients' initial contact with ACT staff. The study suggests that developing mental health practices that enhance the formation of a therapeutic relationship with patients will minimize circumstances that induce...

  6. 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.

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

    OpenAIRE

    Nicole B. Washington, DO, Assistant Professor; Nancy C. Brahm, PharmD., MS, BCPP, CGP; Bruce R. Winchester, PharmD Candidate; Sarah C. Watkins, PharmD Candidate

    2012-01-01

    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 ps...

  8. Involving clients and their relatives and friends in psychiatric care: Case managers' experiences of training in resource group assertive community treatment.

    Science.gov (United States)

    Nordén, Tommy; Eriksson, Anders; Kjellgren, Anette; Norlander, Torsten

    2012-06-01

    The purpose of this project was to do a qualitative study of an integrated and flexible ACT model, the Resource Group Assertive Community Treatment (RACT), as seen from the perspective of case managers in training. The resource group normally consists of the client, the case manager and other available personnel in the medical and support areas, as well as family members. Nineteen theses were randomly chosen from a set of 80 theses written by a group of Swedish trainee case managers. The exams were conducted as case studies and concerned 19 clients with psychotic problems, 11 men and 8 women. "The Empirical Phenomenological Psychological Method" was used in the analysis, which generated five overarching themes: (a) the RACT program; (b) the resource group; (c) the empowerment of the client; (d) progress in treatment; and (e) the case manager. These together constituted a "therapeutic circle," in which methods and tools used within the RACT made it possible for the resource group to empower the clients who, as a result, experienced progress with treatment, during which the case manager was the unifying and connecting link.

  9. 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.

  10. Thought Stopping And Covert Assertion In The Treatment Of Phobias

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    Rimm, David C.

    1973-01-01

    The present paper describes a method combining thought stopping and covert assertion and reports its application in six case histories the majority of which would usually be classified as phobic rather than obsessional. The paper reports successful followups. (Author/LA)

  11. 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.

  12. Thought Stopping and Covert Assertion in the Treatment of Snake Phobics

    Science.gov (United States)

    Rimm, David C.; And Others

    1975-01-01

    These findings in concert with case history data suggest that the thought-stopping-covert-assertion treatment "package" may hold considerable promise as an efficient and effective clinical tool. (Author)

  13. 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…

  14. The replacement of assertive outreach services by reinforcing local community teams: a four-year observational study.

    Science.gov (United States)

    Firn, Mike; White, Sarah Jane; Hubbeling, Dieneke; Jones, Ben

    2018-02-01

    The introduction of specialist Assertive Outreach (AO) teams has produced only modest differential findings from English studies compared to standard care. Providers have gradually closed AO services over the last 8 years. We previously studied outcomes at 12 months following the dismantling of two AO teams in London. We now report on the longer term outcomes for these patients. To evaluate the longer term outcomes, activity and costs for patients receiving a less intensive service. Observational service level evaluation of 112 patients comparing baseline of AO care with each year of routine care subsequent to the team closure. Patients transferred to standard teams reinforced with the Flexible Assertive Community Treatment (FACT) approach had significantly fewer admissions and bed days at each of the four subsequent years compared to baseline, offset by a significant rise in missed face-to-face appointments. There was no significant change in the use of crisis services. Predictably patients had significantly fewer contacts under standard care. AO patients are remarkably resilient to substantial reductions in the intensity of care. Reinforcing multi-disciplinary community mental health teams (CMHTs) with FACT appears to provide an integrated service that is clinically effective and an affordable alternative to orthodox AO teams.

  15. 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.

  16. Stress Management: Being Assertive

    Science.gov (United States)

    Healthy Lifestyle Stress management Assertiveness can help you control stress and anger and improve coping skills. Recognize and learn assertive behavior ... and earn others' respect. This can help with stress management, especially if you tend to take on ...

  17. Using Assertive Discipline.

    Science.gov (United States)

    King, Debra A.; And Others

    Assertive Discipline (AD) is a modified version of assertion training skills. It is a systematic combination of verbal assertiveness training combined with teachers using everyday rewards and punishments to positively influence relationships and students' behavior. When using the AD model, the teacher must: (1) clearly convey their rules and…

  18. Generating hardware assertion checkers

    CERN Document Server

    Boulé, Marc

    2008-01-01

    Assertion-based design is a powerful new paradigm that is facilitating quality improvement in electronic design. Assertions are statements used to describe properties of the design (I.e., design intent), that can be included to actively check correctness throughout the design cycle and even the lifecycle of the product. With the appearance of two new languages, PSL and SVA, assertions have already started to improve verification quality and productivity. This is the first book that presents an under-the-hood view of generating assertion checkers, and as such provides a unique and consistent pe

  19. 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....

  20. Asserting Performance Expectations (Formerly Performance Assertions: A Performance Diagnosis Tool)

    Energy Technology Data Exchange (ETDEWEB)

    Vetter, J S; Worley, P

    2002-07-24

    Traditional techniques for performance analysis provide a means for extracting and analyzing raw performance information from applications. Users then reason about and compare this raw performance data to their performance expectations for important application constructs. This comparison can be tedious, difficult, and error-prone for the scale and complexity of today's architectures and software systems. To address this situation, we present a methodology and prototype that allows users to assert performance expectations explicitly in their source code using performance assertions. As the application executes, each performance assertion in the application collects data implicitly to verify the assertion. By allowing the user to specify a performance expectation with individual code segments, the runtime system can jettison raw data for measurements that pass their expectation, while reacting to failures with a variety of responses. We present several compelling uses of performance assertions with our operational prototype including raising a performance exception, validating a performance model, and adapting an algorithm to an architecture empirically at runtime.

  1. Changes in individual needs for care and quality of life in Assertive Community Treatment patients: An observational study

    NARCIS (Netherlands)

    H.E. Kortrijk (Hans Erik); A.M. Kamperman (Astrid); C.L. Mulder (Niels)

    2014-01-01

    textabstractBackground: It is largely unknown which unmet needs in the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) need to be resolved in order to improve a patients' subjective quality of life (QoL). We therefore investigated the pattern of individual unmet needs over time and

  2. 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

    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...... on use of institutional care of different intensive interventions for patients with first-episode schizophrenia spectrum disorder on use of psychiatric bed days and days in supported housing.MethodA total of 94 severely ill patients with first-episode schizophrenia spectrum disorders were included...... and in supported housing throughout the 5-year follow-up period compared with the two other groups. Patients in OPUS treatment spent significantly fewer days in psychiatric wards and supported housing in the first 3 years compared with patients in hospital-based rehabilitation. Due to attrition and small sample...

  3. 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…

  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. A study of sertraline in dialysis (ASSertID): a protocol for a pilot randomised controlled trial of drug treatment for depression in patients undergoing haemodialysis.

    Science.gov (United States)

    Friedli, Karin; Almond, Michael; Day, Clara; Chilcot, Joseph; Gane, Maria da Silva; Davenport, Andrew; Guirguis, Ayman; Fineberg, Naomi; Spencer, Benjamin; Wellsted, David; Farrington, Ken

    2015-10-26

    The prevalence of depression in people receiving haemodialysis is high with estimates varying between 20 and 40 %. There is little research on the effectiveness of antidepressants in dialysis patients with the few clinical trials suffering significant methodological issues. We plan to carry out a study to evaluate the feasibility of conducting a randomised controlled trial in patients on haemodialysis who have diagnosed Major Depressive Disorder. The study has two phases, a screening phase and the randomised controlled trial. Patients will be screened initially with the Beck Depression Inventory to estimate the number of patients who score 16 or above. These patients will be invited to an interview with a psychiatrist who will invite those with a diagnosis of Major Depressive Disorder to take part in the trial. Consenting patients will be randomised to either Sertraline or placebo. Patients will be followed-up for 6 months. Demographic and clinical data will be collected at screening interview, baseline interview and 2 weeks, and every month (up to 6 months) after baseline. The primary outcome is to evaluate the feasibility of conducting a randomised, double blind, placebo pilot trial in haemodialysis patients with depression. Secondary outcomes include estimation of the variability in the outcome measures for the treatment and placebo arms, which will allow for a future adequately powered definitive trial. Analysis will primarily be descriptive, including the number of patients eligible for the trial, drug exposure of Sertraline in haemodialysis patients and the patient experience of participating in this trial. There is an urgent need for this research in the dialysis population because of the dearth of good quality and adequately powered studies. Research with renal patients is particularly difficult as they often have complex medical needs. This research will therefore not only assess the outcome of anti-depressants in haemodialysis patients with depression but

  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. Re-assessing community-directed treatment

    DEFF Research Database (Denmark)

    Halwindi, H.; Magnussen, Pascal; Siziya, S.

    2015-01-01

    Cross-sectional surveys with carers, health workers, community drug distributors (CDDs) and neighbourhood health committees were conducted to identify factors associated with utilization of community-directed treatment (ComDT) of soil-transmitted helminths in children aged 12-59 months in Mazabuka...... district, Zambia. The surveys took place in December 2006 and December 2007. In addition child treatment records were reviewed. The factors that were found to be significantly associated (ptreatment of children by the CDDs were: (1) the perception of soil-transmitted helminth infections...... as having significant health importance, (2) the community-based decision to launch and subsequently implement ComDT, (3) the use of the door-to-door method of drug distribution, (4) CDDs being visited by a supervisor, (5) CDDs receiving assistance in mobilizing community members for treatment, (6) CDDs...

  8. ["Treatment at Home" in Lengerich (Westfalia) - A Model of Community-Based Mental Health Care].

    Science.gov (United States)

    Sakellaridou, E; Chrysanthou, C; Nienaber, A

    2016-09-16

    We examined the effectiveness of a new homebased integrated care intervention model for patients with multiple-episode psychosis in a rural area in Germany, which combines elements of 2 other well-defined interventions: Assertive Community Treatment and Home Treatment. The pilot evaluation was conducted in 2 steps, using a quantitative and a qualitative design. In a 24-month follow-up period, patients showed significant improvement in symptoms, illness severity, global functioning and quality of life, as well as larger reduction in the number of days of inpatient treatment needed. The results of the qualitative survey indicate a high level of satisfaction with the care offered. The results are in agreement with other German studies. Home Treatment in Lengerich seems to be a model, which can address the fragmentation of the German healthcare system and provide effective care to long-term patients in a setting outside of psychiatric hospitals. © Georg Thieme Verlag KG Stuttgart · New York.

  9. 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.

  10. 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.

  11. 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.

  12. 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

    Directory of Open Access Journals (Sweden)

    Gluud Christian

    2011-03-01

    Full Text Available Abstract Background The Danish OPUS I trial randomized 547 patients with first-episode psychosis to a two-year early-specialised assertive treatment programme (OPUS versus standard treatment. The two years OPUS treatment had significant positive effects on psychotic and negative symptoms, secondary substance abuse, treatment adherence, lower dosage of antipsychotic medication, and a higher treatment satisfaction. However, three years after end of the OPUS treatment, the positive clinical effects were not sustained, except that OPUS-treated patients were significantly less likely to be institutionalised compared with standard-treated patients. The major objective of the OPUS II trial is to evaluate the effects of five years of OPUS treatment versus two years of OPUS treatment. Methods The OPUS II trial is designed as a randomized, open label, parallel group trial with blinded outcome assessment. 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

  13. 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

  14. Assertive Behavior and Cognitive Performance in Preschool Children

    Science.gov (United States)

    Dorman, Lynn

    1973-01-01

    Assertive behaviors were related to each other and to intelligence test scores. An item analysis revealed that more assertive children did better on certain intelligence test items: comprehension, verbal, and discrimination. (ST)

  15. Social Evaluations of Assertiveness: A Critique and Speech Act Reformulation.

    Science.gov (United States)

    Garvasio, Amy Herstein; Crawford, Mary

    1989-01-01

    Critiques recent research on the social evaluation of assertive speech. Proposes an alternative theoretical framework, based on speech act theory. Assertiveness is viewed as a style of conversation occurring in complex interpersonal contexts. (Author/BJV)

  16. 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…

  17. TEKNIK ASSERTIVE TRAINING (AT UNTUK MENINGKATKAN PERILAKU ASERTIF SISWA

    Directory of Open Access Journals (Sweden)

    author Nurfaizal

    2015-01-01

    Full Text Available This study was conducted based on the problem of low assertive behavior skill. Assertive is a behavior in which person are able to act upon desire. Held the right and not utilized by others. Besides that , going to be assertive means communicating what is expected clearly by respecting personality right and other right. The purpose of the study is to gain the description of effectiveness assertive training technique for improving students’ assertive behavior. This study used quasi-experimental method with non equivalent control group design. The population was students of senior high school Kartika Siliwangi 2 Bandung in academic years 2012/2013. Purposive sampling technique was employed for taking the sample. The result of the study showed that (1 40,7% students’ assertive behavior profile was in the assertive category and 59,3% was not; (2 assertive training technique was effective to improve students’ assertive behavior; (3 there was no the difference of assertive behavior between male and female students.Keywords: assertive training, assertive behavior.

  18. 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.

  19. Rethinking cultural competence: insights from indigenous community treatment settings.

    Science.gov (United States)

    Wendt, Dennis C; Gone, Joseph P

    2012-04-01

    Multicultural professional psychologists routinely assert that psychotherapeutic interventions require culturally competent delivery for ethnoracial minority clients to protect the distinctive cultural orientations of these clients. Dominant disciplinary conceptualizations of cultural competence are "kind of person" models that emphasize specialized awareness, knowledge, and skills on the part of the practitioner. Even within psychology, this approach to cultural competence is controversial owing to professional misgivings concerning its culturally essentialist assumptions. Unfortunately, alternative "process-oriented" models of cultural competence emphasize such generic aspects of therapeutic interaction that they remain in danger of losing sight of culture altogether. Thus, for cultural competence to persist as a meaningful construct, an alternative approach that avoids both essentialism and generalism must be recovered. One means to capture this alternative is to shift focus away from culturally competent therapists toward culturally commensurate therapies. Indigenous communities in North America represent interesting sites for exploring this shift, owing to widespread political commitments to Aboriginal cultural reclamation in the context of postcoloniality. Two examples from indigenous communities illustrate a continuum of cultural commensurability that ranges from global psychotherapeutic approaches at one end to local healing traditions at the other. Location of culturally integrative efforts by indigenous communities along this continuum illustrates the possibility for local, agentic, and intentional deconstructions and reconstructions of mental health interventions in a culturally hybrid fashion.

  20. 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.

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

    African Journals Online (AJOL)

    effectiveness of four intravenous antibiotic treatment regimens in the treatment of severe community-acquired pneumonia (CAP) in adults in a private hospital setting. The study compared some third-generation cephalosporin regimens with a ...

  2. Community treatment orders: exploring the paradox of personalisation under compulsion

    NARCIS (Netherlands)

    Banks, Laura Catherine; Stroud, Julia; Doughty, Karolina

    2016-01-01

    The introduction of supervised community treatment, delivered through community treatment orders (CTOs) in England and Wales, contrasts with the policy of personalisation, which aims to provide service users autonomy and choice over services. This article draws upon findings from a primarily

  3. 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

  4. 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.

  5. Mania and milieu: treatment of manics in a therapeutic community.

    Science.gov (United States)

    Bjork, D; Steinberg, M; Lindenmayer, J P; Pardes, H

    1977-06-01

    The authors observed the management of 35 manic patients admitted to a 32-bed general hospital unit that emphasized milieu treatment. They concluded that the principles of treatment derived from the therapeutic community model--democratization and permissiveness--are generally incompatible with the effective treatment of manic patients, who can be a strong disruptive force on the patient and staff community. The authors describe approaches to managing manic patients in four phases--preadmission evaluation, and the postadmission, middle, and termination phases of inpatient treatment. They stress that milieu modifications are necessary to meet individual treatment needs.

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

    African Journals Online (AJOL)

    Community case management improves use of treatment for childhood diarrhea, malaria and pneumonia in a remote district of Ethiopia. T Degefie, D Marsh, A Gebremariam, W Tefera, G Osborn, K Waltensperger ...

  7. 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)

  8. 40 CFR 350.13 - Sufficiency of assertions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Sufficiency of assertions. 350.13 Section 350.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY... competitive position of such person. To support this conclusion, the facts asserted must show all of the...

  9. 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 ...

  10. 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.

  11. Community treatment orders and antipsychotic long-acting injections.

    Science.gov (United States)

    Lambert, Tim J; Singh, Bruce S; Patel, Maxine X

    2009-11-01

    The community treatment order (CTO) is the legal framework by which people in the community are compelled to accept treatment. Both antipsychotic long-acting injections (LAIs) and CTOs are used to address treatment non-adherence. To investigate the relationship between CTOs and LAI use in patients with schizophrenia. Prescribing, demographic and CTO data were collected for patients from four community mental health clinics in Melbourne, Australia, in 1998 and 2002. Against a background of increasing use of oral second-generation antipsychotic (SGA) medication and decreasing use of LAIs, the rates of CTO implementation doubled from 13% to 26% of patients with schizophrenia between 1998 and 2002. Proportionally more patients with a CTO are prescribed LAIs rather than oral SGAs. The relationship between receiving an LAI and being subject to a CTO is significant, and reflects the consideration given to enhancing adherence in a community mental health setting.

  12. 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...... was devoted into detailed analysis of almost fifty full-scale treatment plants (Microbial Database over Danish Wastewater Treatment Plants.) in order to learn more about the activated sludge communities and the rules that govern their presence and growth. This is one of the first such comprehensive long......-term investigations of the microbial community in full-scale wastewater treatment plants, where conventional identification, molecular identification by quantitative Fluorescent In Situ Hybridization and extensive process information related to treatment plant design and process performance have been compiled...

  13. Antibiotic Treatment Strategies for Community-Acquired Pneumonia in Adults

    NARCIS (Netherlands)

    Postma, Douwe F.; Van Werkhoven, Cornelis H.; Van Elden, Leontine J R; Thijsen, Steven F T; Hoepelman, Andy I M; Kluytmans, Jan A J W; Boersma, Wim G.; Compaijen, Clara J.; Van Der Wall, Eva; Prins, Jan M.; Oosterheert, Jan J.; Bonten, Marc J M

    2015-01-01

    BACKGROUND The choice of empirical antibiotic treatment for patients with clinically suspected community-acquired pneumonia (CAP) who are admitted to non-intensive care unit (ICU) hospital wards is complicated by the limited availability of evidence. We compared strategies of empirical treatment

  14. 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…

  15. 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.

  16. Power assertive discipline, maternal emotional involvement, and child adjustment.

    Science.gov (United States)

    Towe-Goodman, Nissa R; Teti, Douglas M

    2008-08-01

    Despite long-standing research, the relations between power assertive discipline and child adjustment continue to be debated. Disentangling disciplinary practices from the parent-child emotional climate may aid understanding of how such parenting practices impact child adjustment. This study explored longitudinal relations between maternal emotional involvement, power assertive discipline, and child adjustment in a sample of 35 mothers of infant, toddler, and preschool-age children. Results indicate that power assertive discipline may differentially impact child adjustment, depending on levels of maternal emotional involvement.

  17. 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.

  18. 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”.

  19. The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II

    DEFF Research Database (Denmark)

    Melau, Marianne; Jeppesen, Pia; Thorup, Anne

    2011-01-01

    Background The Danish OPUS I trial randomized 547 patients with first-episode psychosis to a two-year early-specialised assertive treatment programme (OPUS) versus standard treatment. The two years OPUS treatment had significant positive effects on psychotic and negative symptoms, secondary subst...

  20. 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

  1. 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.

  2. Six assertions about the salutogenic approach and health promotion

    Directory of Open Access Journals (Sweden)

    Fabrizio Simonelli

    2010-06-01

    Full Text Available

    Background: The concept of health is a continuously changing issue, with ever richer and more comprehensive meanings and definitions. In recent decades, we have witnessed a strong evolution of the scientific paradigms and cultural frameworks that influence health patterns. In particular, in 1986 the Charter of Ottawa gave further dimensions to the concept of health and pushed the concept of health promotion to the forefront. In this context, the salutogenic approach, proposed by A. Antonovsky, represents a theoretical contribution which stimulates discussion about meanings and implications.

    Aim and Methods: The present paper aims to provide a conceptual framework for the interpretation of health patterns and to broaden the theoretical interpretation of the salutogenic approach. In order to do this, a literature review was carried out, taking into account several disciplines and perspectives, including sociology and anthropology. The data collection for this paper was undertaken through two parallel literature reviews and systematisation of the information gathered.

    Results: The following health patterns were identified: the disease treatment pattern, the health care pattern, the disease prevention pattern and the health promotion pattern. These approaches allow one to better analyse and understand the added values of the salutogenic approach.

    Conclusions: The present discussion contributes to the debate surrounding the salutogenesis theory and its applicability to the healthcare setting by proposing six assertions about the salutogenic approach to health promotion

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

    Directory of Open Access Journals (Sweden)

    Sheridan Reiger

    2015-09-01

    Full Text Available Background: 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. Design: 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. Results: 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. Conclusions: 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

  4. 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.

  5. Care-seeking behaviour for malaria treatment among community ...

    African Journals Online (AJOL)

    Care-seeking behaviour for malaria treatment among community primary school teachers ( a cross sectional study) ... Conclusion: The result of this study confirmed previous reports that irrespective of race, the ischio-pubic index for females is significantly greater than that of males and that ischio-pubic index can be ...

  6. Non-adherence to community directed treatment with ivermectin for ...

    African Journals Online (AJOL)

    Non-adherence to community directed treatment with ivermectin for onchocerciasis control in Rungwe district, Southwest Tanzania. ... However, some other factors associated with non-adherence were local beliefs and the lifestyle of alcoholism. Conclusions: Factors identified to affect programme implementation and ...

  7. 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

  8. 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 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 and it can improve academic performance.

  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. 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…

  11. Relationship of Depression and Assertiveness in Normal Population ...

    African Journals Online (AJOL)

    The present study is aimed at exploring the relationship between depression and self-assertiveness. Sample of the study consisted of 100 people (men = 50, women = 50), who were taken from different offices, houses, and hospitals. Their age ranged between 18 to 50 years, and education level was at least middle ...

  12. Assertiveness and attitudes of HIV/AIDS orphaned girls towards ...

    African Journals Online (AJOL)

    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 ...

  13. Secure bindings of SAML assertions to TLS sessions

    DEFF Research Database (Denmark)

    Kohlar, Florian; Schwenk, Jörg; Jensen, Meiko

    2010-01-01

    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...

  14. 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…

  15. 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

  16. Entailments, pragmatic assertion and mood in Spanish complements

    Directory of Open Access Journals (Sweden)

    Errapel Mejías-Bikandi

    2016-06-01

    Full Text Available This paper examines a frequently overlooked class of expressions in Spanish that license the subjunctive mood in a complement clause. This class contains expressions such as poco/a/s “few”, menos de “less than” and solo “only”. The goal of the paper is to offer an account of the use of mood with these expressions that incorporates the data under discussion into previous pragmatic accounts of mood based on notions of assertion and informative value. The paper first offers a semantic characterization of this class of expressions that is based on their monotonic properties (Ladusaw 1980, Ladusaw 1983. Next, it explores the pragmatic effects of their semantic properties. Following Stalnaker (1978, I assume that the effect of a pragmatic assertion is to reduce the set of possible worlds that represents the presuppositions held by a speaker and their audience (referred to as the context set. It is argued that propositions under the scope of an upward entailing expression are more informative, and they are thus more relevant and higher in a scale of assertability (Lunn 1989, in that they allow for inferences that further reduce the context set. Propositions under the scope of expressions that are not upward entailing lose some of their informative value, and thus they are lower in the scale of assertability, which correlates with the possibility of using subjunctive mood in a complement under their scope.

  17. [Practice of Community Psychiatry for the Treatment of Depression].

    Science.gov (United States)

    Miyaoka, Hitoshi

    2015-01-01

    The practice in the psychiatric division of Kitasato University East Hospital and Kitasato University Hospital has been emphasizing community psychiatry. The problems and proposed solutions are discussed. 1. Both hospitals are core hospitals located in Sagamihara City (Kanagawa Prefecture), which has no municipal hospital. 2. Kitasato University East Hospital has 94 beds in two closed wards and is one of the hospitals designated for psychiatric emergencies in Kanagawa Prefecture. 3. Over the last 10 years aroud Sagamihara City, cooperation between psychiatric hospitals and outpatient clinics, the treatment of patients with mental and physical diseases, improvement of the quality of psychiatric practice, emergency psychiatry, and imbalances in the incomes and workloads of psychiatrists have been problematic. 4. Problems that need to be solved in practice to treat depression involve inappropriate pharmacotherapy, disease mongering (the practice of widening the diagnostic boundaries of illnesses in order to expand the markets for drug treatment), clinical skills of psychiatrists, profitability, and medical institutions which cannot cope with regular patients in an emergency. 5. Up to now, we have established a consulting service ("Second opinion" clinic) at Sagamihara Mental Health and Welfare Center (Municipal institution), recommended patients' consultation with family pharmacists, and increased the frequency of conferences for doctors without the support of pharmaceutical companies. 6. In order to develop community psychiatric services for patients with depression, the author is preparing a community-based critical path for depression as well as community-based treatment network in the Sagamihara area. 7. The author believes that the urgent issue necessitates transparency and the increased visibility of psychiatric services.

  18. 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.

  19. "I thought you were Japanese": Ethnic miscategorization and identity assertion.

    Science.gov (United States)

    Trujillo, Matthew D; Garcia, Randi L; Shelton, J Nicole

    2015-10-01

    Across 2 studies we examined how ethnic minorities respond to ethnic miscategorization. Using a 21-day experience sampling procedure (Study 1), we found that ethnic minorities exhibited greater ethnic identity assertion when they had reported being ethnically miscategorized the previous day. Similarly, we found that ethnic minorities who were ethnically miscategorized (vs. not) by a White partner in the laboratory exhibited greater ethnic identity assertion and expressed greater dislike of their partner (Study 2). In both studies, these effects were stronger for individuals whose ethnic identity was central to their self-concept. The implications of these findings for ethnic identity development and intergroup relations are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  20. Between compassionateness and assertiveness: a trust matrix for leaders

    OpenAIRE

    Victor Manuel Monteiro Seco; Miguel Pereira Lopes

    2014-01-01

    Purpose: Construct the structure of trust-building perceived by principals in Portuguese public schools.Design/methodology/approach: A grounded theory approach applied to a survey of open questions answered by school’s principals.Findings: (1) self-trust is the single trait common to all respondents; (2) compassion is a striking antecedent in the process of other-trust; compassionateness and assertiveness must combine with one another to achieve leadership based on smart trust, what is outlin...

  1. Self-esteem, assertiveness and resilience in adolescents institutionalized

    OpenAIRE

    Anastácio, Zélia

    2016-01-01

    The institutionalization of children and adolescents has been an increasingly visible problem in modern society. Unfavourable socio-economic conditions have been joining the behavior problems and school absenteeism. When the family fails in its competence for education, social security or the Court withdraws the child or adolescent to a host institution. The aim of this research was to characterize self-esteem, assertiveness and resilience of institutionalized adolescents in the northern r...

  2. 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).

  3. 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.

  4. Democratic therapeutic community treatment for personality disorder: randomised controlled trial.

    Science.gov (United States)

    Pearce, Steve; Scott, Lisle; Attwood, Gillian; Saunders, Kate; Dean, Madeleine; De Ridder, Ritz; Galea, David; Konstantinidou, Haroula; Crawford, Mike

    2017-02-01

    Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent. To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder. An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation. Number of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group. DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion. © The Royal College of Psychiatrists 2017.

  5. [Development of the Japanese version of the Rathus Assertiveness Schedule].

    Science.gov (United States)

    Shimizu, Takashi; Morita, Shiom; Takezawa, Masako; Shazuki, Ayako; Kubota, Shinya; Mishima, Norio; Nagata, Shoji

    2003-03-01

    The present study investigated the reliability and validity of the Japanese version of the Rathus Assertiveness Schedule (RAS) preparatory to study the relationship between self-expression skills and mental health status of employees at a Japanese worksite. Assertiveness is one of self-expression skills and defined as standing up for one's own rights as well as for others. RAS that the most widely used was developed by Rathus in the U.S.A. and consists of 30 items. We developed the Japanese version of RAS (J-RAS) along with a back-translation. The subjects were 173 participants of a 2-day assertiveness training course from July to December, 2001 and 364 workers in a manufacturing company in the Kyushu area. We sent the J-RAS to the 173 participants before they commenced the course, and of them 170 participants returned sufficient answers for analysis. During the course their trainers completed the objective evaluations on assertive self-expression. We compared their answers with the trainers' evaluations by the Pearson's correlation to certify the J-RAS's validity. We also mailed the J-RAS to the manufacturing workers in June, 2001. Of them, 266 workers returned sufficient answers by the end of the month. We calculated the Cronbach's alpha coefficient by them to certify the internal consistency reliability of the J-RAS. In August, 2001, we mailed the J-RAS again to 98 workers who agreed to retake the test. We studied the Pearson's correlation between the initial answers and the following ones to certify the test-retest reliability of the J-RAS, using the 98 answers of the workers who agreed to be retested. Our results found that 19 item sets, excluding Q3--7, 9, 13, 19, 20, 25, 28, had significantly positive correlation with the objective evaluations. The sum of the 19 items of the J-RAS (19-item J-RAS) had significantly higher correlations with the objective evaluation than that of 30 items of the J-RAS (30-item J-RAS). The internal consistency reliability of the

  6. 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.

  7. Bacterial communities involved in sulfur transformations in wastewater treatment plants.

    Science.gov (United States)

    Meyer, Daniel Derrossi; de Andrade, Pedro Avelino Maia; Durrer, Ademir; Andreote, Fernando Dini; Corção, Gertrudes; Brandelli, Adriano

    2016-12-01

    The main sulfate-reducing (SRB) and sulfur-oxidizing bacteria (SOB) in six wastewater treatment plants (WWTPs) located at southern Brazil were described based on high-throughput sequencing of the 16S rDNA. Specific taxa of SRB and SOB were correlated with some abiotic factors, such as the source of the wastewater, oxygen content, sample type, and physical chemical attributes of these WWTPs. When the 22 families of SRB and SOB were clustered together, the samples presented a striking distribution, demonstrating grouping patterns according to the sample type. For SOB, the most abundant families were Spirochaetaceae, Chromatiaceae, Helicobacteriaceae, Rhodospirillaceae, and Neisseriaceae, whereas, for SRB, were Syntrophaceae, Desulfobacteraceae, Nitrospiraceae, and Desulfovibriaceae. The structure and composition of the major families related to the sulfur cycle were also influenced by six chemical attributes (sulfur, potassium, zinc, manganese, phosphorus, and nitrogen). Sulfur was the chemical attribute that most influenced the variation of bacterial communities in the WWTPs (λ = 0.14, p = 0.008). The OTUs affiliated to Syntrophus showed the highest response to the increase of total sulfur. All these findings can contribute to improve the understanding in relation to the sulfur-oxidizing and sulfate-reducing communities in WWTPs aiming to reduce H2S emissions.

  8. Entailments, pragmatic assertion and mood in Spanish complements

    OpenAIRE

    Mejías-Bikandi, Errapel

    2016-01-01

    This paper examines a frequently overlooked class of expressions in Spanish that license the subjunctive mood in a complement clause. This class contains expressions such as poco/a/s “few”, menos de “less than” and solo “only”. The goal of the paper is to offer an account of the use of mood with these expressions that incorporates the data under discussion into previous pragmatic accounts of mood based on notions of assertion and informative value. The paper first offers a semantic characteri...

  9. Five years of specialised early intervention versus two years of specialised early intervention followed by three years of standard treatment for patients with a first episode psychosis

    DEFF Research Database (Denmark)

    Albert, Nikolai; Melau, Marianne; Jensen, Heidi

    2017-01-01

    of three core elements-modified assertive community treatment, family involvement, and social skill training-with a patient-case manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group...

  10. 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.

  11. 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.

  12. [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.

  13. Grape berry yeast communities: influence of fungicide treatments.

    Science.gov (United States)

    Milanović, Vesna; Comitini, Francesca; Ciani, Maurizio

    2013-02-15

    The yeast communities colonising grape berry surfaces were evaluated for the influence of fungicide treatments in an organic vineyard (copper/sulphur-based products) and a conventional vineyard (commonly used fungicides). Analysis of yeast abundance and diversity was carried out on grape berries and juice during fermentation, using culture-dependent and -independent approaches. Yeast abundance was as generally reported for mature grapes and it was slight higher from grapes treated with conventional fungicides. Initial grape samples showed less yeast species diversity in the organic vineyard compared with the conventional one. In both vineyards, the dominant yeast were Candida zemplinina and Hanseniaspora uvarum (>50%), respectively, typical species that colonise surfaces of mature grape berries. Metschnikowia pulcherrima was widely found in the conventional samples while it was only occasionally found in organic ones. Saccharomyces cerevisiae was isolated only at the end of natural fermentation (conducted in sterile condition), with lower levels in the organic samples. S. cerevisiae strains showed less intraspecies diversity in the organic samples (two genotypes), in comparison with the conventional samples (six genotypes). Copyright © 2012 Elsevier B.V. All rights reserved.

  14. County Government Fleet Purchasing Practices: Financial Efficiency vs. Need Assertion

    Directory of Open Access Journals (Sweden)

    Steve Modlin

    2016-04-01

    Full Text Available An abundant amount of local government services are implemented through the use of automobiles each year. These costs include initial purchase, use, repair, and replacement. Traditional budgeting research is broad and does not isolate fleet costs or the influential actors in the process. This study examines the finance practices and need assertion associated with vehicle purchases and acquisition. Findings indicate most county governments in North and South Carolina choose to purchase vehicles on a cash basis, especially if there is a low resale value for surplus automobiles. In addition, county staff are very influential in additional vehicle purchases, especially if the sheriff can convince the county manager that additional automobiles of a particular make can enhance service delivery.

  15. Between compassionateness and assertiveness: A trust matrix for leaders

    Directory of Open Access Journals (Sweden)

    Victor Manuel Monteiro Seco

    2014-06-01

    Full Text Available Purpose: Construct the structure of trust-building perceived by principals in Portuguese public schools.Design/methodology/approach: A grounded theory approach applied to a survey of open questions answered by school’s principals.Findings: (1 self-trust is the single trait common to all respondents; (2 compassion is a striking antecedent in the process of other-trust; compassionateness and assertiveness must combine with one another to achieve leadership based on smart trust, what is outlined in a matrix model built from the data.Research limitations/implications: The major limitation of this study was the impossibility to conduct face-to-face interviews given the limitation of free time alleged by the principals. In order to solve that limitation we decide to use the grounded theory approach.Practical implications: The consideration of a symbiosis category of the behaviors of principals can trigger positive expectations among the players who until now did not understand how it is possible to bring together the best of the worlds of management and leadership in a balanced way, with efficiency in authenticity.Social implications: The aforementioned dyadic model reflects a psychological state based on the belief that others do not take advantage of us, showing that trust is an essential element in positive human relations and becomes a strategic issue.Originality/value: The present study found that “pure” positive behaviors, as being compassionate, might need to be tempered or complemented with other behaviors such as assertiveness, to become really effective.

  16. THE ROLE OF DIRECT OBSERVED TREATMENT IN TUBERCULOSIS TREATMENT SUCCESSFUL AT COMMUNITY

    Directory of Open Access Journals (Sweden)

    Nursalam Nursalam

    2017-07-01

    Full Text Available Introduction : The succeeded of the tuberculosis treatment depends on the obedience of the patient in taking the tuberculosis’s medication assisted by the direct observed treatment shortcourse (DOTS to refrain resistancy and dropping out of the program. The aimed of this study was to analyze the correlation between DOTS’s role with the successfullness of lung’s tuberculosis treatment program at Bajawa city. Method : A cross sectional simple random sampling design was used in this study. Population were all the Direct Observed Treatment Supervisors and patients who have had finished their treatment of tuberculosis. Sample were 43 respondents. The independent variables in this study were the role of the DOTSs, education level, family support, motivation and the DOTSs attitude. The dependent variables were the patient’s obedience in taking medication and the evaluation of the acid fast bacterias in their sputum. Data were collected by using questionnaire and observation sputum the to evaluate acid fast bacteria. Data were analyzed by using Spearman Rho with significance level with α<0.05.Result : The result showed that role of the DOTSs had significance correlation with the succeeding program of tuberculosis (r=0.023, education level had significance correlation (r=0.043, family support as the DOTS had significance correlation (r=0.021, motivation (r=0.032 and attitude (r=0.014. Analysis : It can be concluded that the role of the DOTS has correlation with succesing tuberculosis treatment. Discussion : The role of PMO cause the succesfully of Tb treatment for the community in Bajawa City, Ngada NTT.

  17. 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.

  18. 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 ...

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

    African Journals Online (AJOL)

    ACIPH_Admin

    Background: Despite the rapid expansion of malaria into highland areas of Ethiopia and the movement of malaria ... Objective: To assess communities' awareness of malaria and its mosquito vector in highland rural communities of ... about 50% of these individuals reported that they or their families had got the disease.

  20. 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

  1. 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

    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...

  2. Assessing assertion in the elderly: an application of the behavioral-analytic model of competence.

    Science.gov (United States)

    Edinberg, M A; Karoly, P; Gleser, G C

    1977-07-01

    This study developed a behavioral measure of assertiveness for older adults. The behavioral assessment device was developed by use of procedures outlined by Goldfried and D'Zurilla (1969) and Price and Bouffard (1974). Four assertion-appropriate situations for older adults were developed. The situations were administered to 33 Ss. Their responses were scored two ways, for overall assertion and content assertion. Generalizability of the device was examined. Reliability of judges' ratings (for assertion and content) was high, as was test-retest reliability. Assertion was shown to be situation-specific since estimated individual by situation uninerse variance was relatively hight. The assessment device showed significant concurrent validity, although the evidence for construct validity was minimal. Despite the rigorousness of the methods involved, the behavioral-analytic model of competence (Goldfried & D'Zurilla, 1969) has both theoretical and practical advantages in constructing other assessment devices for the elderly.

  3. Penerapan teknik assertive training dalam mereduksi konformitas negatif terhadap kelompok sebaya di SMP

    OpenAIRE

    selfi selfi

    2017-01-01

    The objectives of the research (1) the implementation of assertive training technique in reducing negative conformities toward peer group, (2) the students negative conformities before and after being given assertive training technique, (3) assertive training technique in reducing negative conformities toward peer group. The research employed quantitative approach by using true experimental design with pretest-postest control group design. The subjects of the research were 22 students of clas...

  4. Penerapan Teknik Assertive Training dalam Mereduksi Konformitas Negatif terhadap Kelompok Sebaya di SMP

    OpenAIRE

    selfi, selfi

    2017-01-01

    The objectives of the research (1) the implementation of assertive training technique in reducing negative conformities toward peer group, (2) the students negative conformities before and after being given assertive training technique, (3) assertive training technique in reducing negative conformities toward peer group. The research employed quantitative approach by using true experimental design with pretest-postest control group design. The subjects of the research were 22 students of clas...

  5. Community treatment orders and antipsychotic long-acting injections

    National Research Council Canada - National Science Library

    Lambert, Tim J; Singh, Bruce S; Patel, Maxine X

    2009-01-01

    .... To investigate the relationship between CTOs and LAI use in patients with schizophrenia. Prescribing, demographic and CTO data were collected for patients from four community mental health clinics in Melbourne, Australia, in 1998 and 2002...

  6. [Nurses' assertiveness training and cognitive therapy experiences with an outpatient suffering from low self-esteem].

    Science.gov (United States)

    Hou, Shu-Ying; Sul, Yi-Ching; Lan, Chu-Mei

    2004-04-01

    The experiences during nine meetings with a psychotherapy outpatient suffering from low self-esteem between 1/1/02 to 4/10/02. Using comprehensive nursing assessment practices for guidance, two conclusions were arrived at regarding the patient's mental health: a) an imbalance in individual response ability, and b) long-term problems with low self-esteem. This assessment was used to help the authors practice appropriate nursing skills associated with assertiveness training and cognitive therapy and to establish a trusting, caring, and accepting relationship with the client. The treatment plan included attempts to increase personal confidence and to promote suitable skills for improving living functions, enhancing relationships, and practicing social behavior.

  7. Using Fuzzy Logic in Test Case Prioritization for Regression Testing Programs with Assertions

    Directory of Open Access Journals (Sweden)

    Ali M. Alakeel

    2014-01-01

    Full Text Available Program assertions have been recognized as a supporting tool during software development, testing, and maintenance. Therefore, software developers place assertions within their code in positions that are considered to be error prone or that have the potential to lead to a software crash or failure. Similar to any other software, programs with assertions must be maintained. Depending on the type of modification applied to the modified program, assertions also might have to undergo some modifications. New assertions may also be introduced in the new version of the program, while some assertions can be kept the same. This paper presents a novel approach for test case prioritization during regression testing of programs that have assertions using fuzzy logic. The main objective of this approach is to prioritize the test cases according to their estimated potential in violating a given program assertion. To develop the proposed approach, we utilize fuzzy logic techniques to estimate the effectiveness of a given test case in violating an assertion based on the history of the test cases in previous testing operations. We have conducted a case study in which the proposed approach is applied to various programs, and the results are promising compared to untreated and randomly ordered test cases.

  8. 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.

  9. Bioflocculation behaviours of microbial communities in water treatment.

    Science.gov (United States)

    Zhu, Yanbin; Li, Shan; Li, Dengxin; Liu, Chunyan; Ma, Fang

    2014-01-01

    We studied the flocculation behaviours of microbial communities in 21 soil, wastewater and activated sludge samples to clarify the effects of culture medium types on flocculation ability and screening efficiency, and to analyze diverse functions and microbial compositions. The bioflocculants produced by 33% of the microbial communities had flocculating efficiencies higher than 90%. Six out of the eight microbial communities with efficiencies over 94% were screened from the culture medium using dibutyl phthalate (DBP) as the carbon source. BF-BCT, which was derived from the Chinese cabbage soil sample, had the highest flocculating efficiency (99.6%), species diversity and uniformity. Nine highly efficient strains were separated and purified from seven different microbial communities, indicating that flocculating microorganisms are widely distributed in ecosystems. The 16S rRNA gene testing shows that the eight bacterial and the one fungal strains are common soil microorganisms. The flocculating abilities of BB11 (Sphingobacterium multivorum) and SE3 (Galactomyces geotrichum) have never been reported hitherto. Six strains, including the most flocculating-active TB13 and JB17, were screened from the culture medium using DBP as the sole carbon source. In particular, we compared the performance of culture media and analyzed analogous microbial communities with a Biolog automatic micro-analysis system for the first time.

  10. 42 CFR 412.92 - Special treatment: Sole community hospitals.

    Science.gov (United States)

    2010-10-01

    ... from which the hospital draws inpatients) for all inpatient discharges to document the boundaries of... at any time request cancellation of its classification as a sole community hospital, and be paid at... paid on a reasonable cost basis under part 413 of this chapter; and (C) The length of time the hospital...

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

    African Journals Online (AJOL)

    J. Maïworé

    2012-04-26

    Apr 26, 2012 ... This study was carried out to assess the microbial ecology of fish upon technological ... So, water composition, temperature and weather conditions can influence the bacterial community in fish (Austin and. Austin, 1999; Wong et al., 1999; Jallabert et al., ... provide a profile representing genetic diversity of a.

  12. COSTS AND BENEFITS OF HOSPITAL AND DAY TREATMENT WITH COMMUNITY CARE OF AFFECTIVE AND SCHIZOPHRENIC DISORDERS

    NARCIS (Netherlands)

    WIERSMA, D; KLUITER, H; NIENHUIS, FJ; RUPHAN, M; GIEL, R

    Background. A randomised controlled trial of day treatment with community care for patients with schizophrenic and affective disorders, referred for in-patient psychiatric treatment, was conducted to evaluate patterns of treatment and the course of illness with its psychosocial consequences over a

  13. 76 FR 362 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

    Science.gov (United States)

    2011-01-04

    ... AGENCY Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims AGENCY: Environmental... issue: The preliminary inquiry and the notice of opportunity to comment. a. Inquiry To Learn Whether... learn whether the business asserts a claim covering the information. b. Notice of Opportunity To Submit...

  14. 75 FR 44951 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

    Science.gov (United States)

    2010-07-30

    ... Learn Whether Businesses Assert Business Confidentiality Claims AGENCY: Environmental Protection Agency... information at issue: The preliminary inquiry and the notice of opportunity to comment. a. Inquiry To Learn... business to learn whether the business asserts a claim covering the information. b. Notice of Opportunity...

  15. 77 FR 109 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims Regarding Waste Import...

    Science.gov (United States)

    2012-01-03

    ... AGENCY Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims Regarding Waste Import... and the notice of opportunity to comment. a. Inquiry To Learn Whether Affected Businesses (Other Than... office shall contact a responsible official of each such business to learn whether the business asserts a...

  16. 77 FR 25475 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims Regarding Waste Import...

    Science.gov (United States)

    2012-04-30

    ... AGENCY Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims Regarding Waste Import... information at issue: the preliminary inquiry and the notice of opportunity to comment. a. Inquiry To Learn... business to learn whether the business asserts a claim covering the information. b. Notice of Opportunity...

  17. 75 FR 4812 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

    Science.gov (United States)

    2010-01-29

    ... AGENCY Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims AGENCY: Environmental... and the notice of opportunity to comment. a. Inquiry To Learn Whether Affected Businesses (Other Than... office shall contact a responsible official of each such business to learn whether the business asserts a...

  18. Correlates of Postassault Self-Defense/Assertiveness Training Participation for Sexual Assault Survivors

    Science.gov (United States)

    Brecklin, Leanne R.; Ullman, Sarah E.

    2004-01-01

    Past research has shown that self-defense/assertiveness training may have positive implications for sexual assault survivors. However, little is known about the correlates of self-defense/assertiveness training participation for sexually victimized women. In this study we examined the assault characteristics and experiences that relate to women's…

  19. 78 FR 2669 - Waste Import and Export; Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

    Science.gov (United States)

    2013-01-14

    ... AGENCY Waste Import and Export; Inquiry To Learn Whether Businesses Assert Business Confidentiality... 268, and did not assert a claim of business confidentiality covering any of that information at the... of submission, cannot later make a business confidentiality claim.\\13\\ Nevertheless, other businesses...

  20. 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…

  1. Penerapan teknik assertive training dalam mereduksi konformitas negatif terhadap kelompok sebaya di SMP

    Directory of Open Access Journals (Sweden)

    selfi selfi

    2017-08-01

    Full Text Available The objectives of the research (1 the implementation of assertive training technique in reducing negative conformities toward peer group, (2 the students negative conformities before and after being given assertive training technique, (3 assertive training technique in reducing negative conformities toward peer group. The research employed quantitative approach by using true experimental design with pretest-postest control group design. The subjects of the research were 22 students of class IX who were identified they had high negative conformities toward peers. Thw data collection technique employed negative conformitas scale, observation, and interview. The results of the research reveal that (1 the implementation of assertive training technique in reducing negative conformities toward peer group is implemented based on the procedure designed in 5 meetings, (2 negative conformities towards peer group before the implementation of assertive training technique is in high category. However, after the implementation of assertive training technique, peer group is in low category, (3 the implementation of assertive training technique in reducing negative conformities toward peer group at SMPN 1 Sungguminasa, meaning that the students who were given the implementation of assertive training technique showed the reduction of negative conformities toward peer

  2. Using Fuzzy Logic Techniques for Assertion-Based Software Testing Metrics

    Directory of Open Access Journals (Sweden)

    Ali M. Alakeel

    2015-01-01

    Full Text Available Software testing is a very labor intensive and costly task. Therefore, many software testing techniques to automate the process of software testing have been reported in the literature. Assertion-Based automated software testing has been shown to be effective in detecting program faults as compared to traditional black-box and white-box software testing methods. However, the applicability of this approach in the presence of large numbers of assertions may be very costly. Therefore, software developers need assistance while making decision to apply Assertion-Based testing in order for them to get the benefits of this approach at an acceptable level of costs. In this paper, we present an Assertion-Based testing metrics technique that is based on fuzzy logic. The main goal of the proposed technique is to enhance the performance of Assertion-Based software testing in the presence of large numbers of assertions. To evaluate the proposed technique, an experimental study was performed in which the proposed technique is applied on programs with assertions. The result of this experiment shows that the effectiveness and performance of Assertion-Based software testing have improved when applying the proposed testing metrics technique.

  3. Social Skills Training: A Manual for Teaching Assertive Behaviors to Children and Adolescents.

    Science.gov (United States)

    Waksman, Steven A.; Messmer, Cooki Landis

    Providing a program for teaching assertive behavior and social skills to adolescents, this manual contains specific instructions, activities, worksheets, and homework assignments. (Assertive behavior is typically distinguished from both passive behavior and aggressive behavior and is believed to be a component of effective social and psychological…

  4. 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.…

  5. 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…

  6. 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

  7. 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

  8. 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…

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. [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, ptraining applying Dongsasub training can be used as a nursing intervention to lower clinical practice stress and improve the clinical competence of nursing students.

  13. Malaria knowledge and treatment adherence in a Brazilian Amazon community.

    Science.gov (United States)

    Souza, Taisa Guimarães de; Reiners, Annelita Almeida Oliveira; Azevedo, Rosemeiry Capriata de Souza; Fontes, Cor Jesus Fernandes; Ferreira, Rita Graziela; Do Carmo, Priscilla Uiara

    2016-11-24

    Malaria remains an important public health problem despite recent scientific breakthroughs regarding knowledge about malaria and treatment strategies. The objective of this study was to analyze malaria patients' knowledge about the disease, its treatment and prevention, linking it to drug treatment adherence. A descriptive, cross-sectional, epidemiological survey study was conducted in the district of Três Fronteiras-MT. The study included 618 individuals who were interviewed and examined for Plasmodium infection. Of the 52 patients diagnosed with malaria, 27 were visited at home for an interview about malaria knowledge and treatment adherence. Treatment adherence was evaluated by self-reports and drug conference. A total of 18 patients had satisfactory knowledge (66.6%) and 9 were evaluated as having unsatisfactory knowledge (33.4%) about malaria. Of the 27 malaria patients, 21 (77.8%) reported having taken all the medication as prescribed, in the correct period of time and dosage, and had no medication tablets remaining. The majority (72.2%) of patients who had satisfactory knowledge, as well as the majority (88.8%) of those who had unsatisfactory knowledge, adhered to the malaria treatment. This study revealed a high proportion of patients with satisfactory prior knowledge about malaria and revealed that this knowledge was not related to disease treatment adherence. These results have implications for planning strategies for malaria control in the region and could contribute to the reduction in the cases of non-adherence to malaria treatment.

  14. Utilization of community-based outpatient addiction treatment ...

    African Journals Online (AJOL)

    A field-based follow-up survey was administered to determine abstinence rates among clients who participated in treatment. Factors involved in recovery outcomes are discussed. Utilization of outpatient addictions treatment and retention in services increased over the three-year period, and field-based follow up with clients ...

  15. 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.

  16. NPDES Permit for the Blackfeet Community Water Treatment Plant in Montana

    Science.gov (United States)

    Under NPDES permit MT-0030643, the Blackfeet Tribe is authorized to discharge from its Blackfoot Community Water Treatment Plant in Glacier County, Montana, to an unnamed intermittent stream which flows to Two Medicine River.

  17. 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.

  18. Antimicrobial treatment failures in patients with community-acquired pneumonia: causes and prognostic implications

    National Research Council Canada - National Science Library

    Arancibia, F; Ewig, S; Martinez, J A; Ruiz, M; Bauer, T; Marcos, M A; Mensa, J; Torres, A

    2000-01-01

    The aim of the study was to determine the causes and prognostic implications of antimicrobial treatment failures in patients with nonresponding and progressive life-threatening, community-acquired pneumonia...

  19. 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...

  20. 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.

  1. 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; O’Grady, Kevin E.; Vocci, Frank J.

    2014-01-01

    Background 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. Methods 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. Results 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 (pbuprenorphine Treatment Condition (47.5% vs. 33.7%). Conclusions 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. PMID:24962326

  2. 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.

  3. diagnosis and treatment of heart failure in the community

    African Journals Online (AJOL)

    Enrique

    hydralazine if tolerated. ACE inhibitor. + temporary inotropic beta-blockade or ACE inhibitor + ARB if beta- support spironolactone blocker intolerant. Adapted from the Task force report: ESC: Guidelines for the diagnosis and treatment of heart failure.

  4. Avoiding Treatment Interruptions: What Role Do Australian Community Pharmacists Play?

    Directory of Open Access Journals (Sweden)

    Salem Hasn Abukres

    Full Text Available To explore the reported practice of Australian community pharmacists when dealing with medication supply requests in absence of a valid prescription.Self-administered questionnaire was posted to 1490 randomly selected community pharmacies across all Australian states and territories. This sample was estimated to be a 20% of all Australian community pharmacies.Three hundred eighty five pharmacists participated in the study (response rate achieved was 27.9% (there were 111 undelivered questionnaires. Respondents indicated that they were more likely to provide medications to regular customers without a valid prescription compared to non-regular customers (p<0.0001. However, supply was also influenced by the type of prescription and the medication requested. In the case of type of prescription (Standard, Authority or Private this relates to the complexity/probability of obtaining a valid prescription from the prescriber at a later date (i.e. supply with an anticipated prescription. Decisions to supply and/or not supply related to medication type were more complex. For some cases, including medication with potential for abuse, the practice and/or the method of supply varied significantly according to age and gender of the pharmacist, and pharmacy location (p<0.05.Although being a regular customer does not guarantee a supply, results of this study reinforce the importance for patients having a regular pharmacy, where pharmacists were more likely to continue medication supply in cases of patients presenting without a valid prescription. We would suggest, more flexible legislation should be implemented to allow pharmacists to continue supplying of medication when obtaining a prescription is not practical.

  5. The therapeutic community as an adaptable treatment modality across different settings.

    Science.gov (United States)

    Kennard, David

    2004-01-01

    Simple core statements of the therapeutic community as a treatment modality are given, including a "living-learning situation" and "culture of enquiry." Applications are described in work with children and adolescents, chronic and acute psychoses, offenders, and learning disabilities. In each area the evolution of different therapeutic community models is outlined. In work with young people the work of Homer Lane and David Wills is highlighted. For long term psychosis services, the early influence of "moral treatment" is linked to the revitalisation of asylums and the creation of community based facilities; acute psychosis services have been have been run as therapeutic communities in both hospital wards and as alternatives to hospitalisation. Applications in prison are illustrated through an account of Grendon prison. The paper also outlines the geographical spread of therapeutic communities across many countries.

  6. Metagenomic characterization of biofilter microbial communities in a full-scale drinking water treatment plant.

    Science.gov (United States)

    Oh, Seungdae; Hammes, Frederik; Liu, Wen-Tso

    2018-01-01

    Microorganisms inhabiting filtration media of a drinking water treatment plant can be beneficial, because they metabolize biodegradable organic matter from source waters and those formed during disinfection processes, leading to the production of biologically stable drinking water. However, which microbial consortia colonize filters and what metabolic capacity they possess remain to be investigated. To gain insights into these issues, we performed metagenome sequencing and analysis of microbial communities in three different filters of a full-scale drinking water treatment plant (DWTP). Filter communities were sampled from a rapid sand filter (RSF), granular activated carbon filter (GAC), and slow sand filter (SSF), and from the Schmutzdecke (SCM, a biologically active scum layer accumulated on top of SSF), respectively. Analysis of community phylogenetic structure revealed that the filter bacterial communities significantly differed from those in the source water and final effluent communities, respectively. Network analysis identified a filter-specific colonization pattern of bacterial groups. Bradyrhizobiaceae were abundant in GAC, whereas Nitrospira were enriched in the sand-associated filters (RSF, SCM, and SSF). The GAC community was enriched with functions associated with aromatics degradation, many of which were encoded by Rhizobiales (∼30% of the total GAC community). Predicting minimum generation time (MGT) of prokaryotic communities suggested that the GAC community potentially select fast-growers (structure, colonization pattern, and metabolic capacity that potentially contributes to organic matter removal achieved in the biofiltration stages of the full-scale DWTP. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Jałowiecki, Łukasz; Chojniak, Joanna Małgorzata; Dorgeloh, Elmar; Hegedusova, Berta; Ejhed, Helene; Magnér, Jörgen; Płaza, Grażyna Anna

    2016-01-01

    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. PMID:26807728

  9. Bacterial Communities and Antibiotic Resistance Communities in a Full-Scale Hospital Wastewater Treatment Plant by High-Throughput Pyrosequencing

    Directory of Open Access Journals (Sweden)

    Youngho Ahn

    2016-12-01

    Full Text Available The community of whole microbes and antibiotic resistance bacteria (ARB in hospital wastewater treatment plants (WWTP receiving domestic wastewater (DWW and hospital wastewater (HWW was investigated. Samples from an influent of a secondary clarifier, at each treatment train, were characterized for the whole microbial community and ARB on the antibiotic resistance database, based on high-throughput pyrosequencing. The pyrosequencing analysis revealed that the abundance of Bacteroidetes in the DWW sample was higher (~1.6 times than in the HWW sample, whereas the abundance of Proteobacteria in the HWW sample was greater than in the DWW sample. At the top twenty of the genus level, distinct genera were observed—Saprospiraceae in the DWW and Zoogloea in the HWW. Apart from the top twenty genera, minor genera showed various antibiotic resistance types based on the antibiotic resistance gene database.

  10. 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.

  11. Process Design Manual: Wastewater Treatment Facilities for Sewered Small Communities.

    Science.gov (United States)

    Leffel, R. E.; And Others

    This manual attempts to describe new treatment methods, and discuss the application of new techniques for more effectively removing a broad spectrum of contaminants from wastewater. Topics covered include: fundamental design considerations, flow equalization, headworks components, clarification of raw wastewater, activated sludge, package plants,…

  12. Community practice patterns for bacterial corneal ulcer evaluation and treatment.

    Science.gov (United States)

    Park, Jennifer; Lee, Kim M; Zhou, Helen; Rabin, Moriah; Jwo, Kevin; Burton, William B; Gritz, David C

    2015-01-01

    To examine current practice patterns in the management of bacterial keratitis among U.S. ophthalmologists and differences in the management and opinions between cornea specialists and non-cornea specialists. A questionnaire was distributed to randomly selected ophthalmologists in July 2011 using an online survey system. It inquired about the number of patients with corneal ulcers seen monthly, frequency of Gram staining and culturing corneal ulcers, maintenance of diagnostic supplies, opinions on when culturing is necessary for corneal ulcers, treatment preferences for different severities of bacterial corneal ulcers, and opinions regarding relative efficacy of fourth-generation fluoroquinolones and fortified broad-spectrum antibiotics. One thousand seven hundred one surveys were distributed, and 486 (28.6%) surveys were returned. A minority of corneal ulcers was Gram stained (23.7%±34.1%, mean±SD) or cultured (35.1%±38.0%), but cornea specialists were more likely to perform both. The most popular antibiotic for the treatment of less severe ulcers was moxifloxacin (55.4%), and the most popular treatment of more severe ulcers was fortified broad-spectrum antibiotics (62.7%). Cornea specialists were significantly more likely than non-cornea specialists to prescribe fortified antibiotics for more severe corneal ulcers (78.1% vs. 53.7%, P<0.0001). A greater number of cornea specialists stated that fourth-generation fluoroquinolones were less effective than fortified antibiotics for the treatment of more severe corneal ulcers (79.6% of cornea specialists vs. 60.9% of non-cornea specialists, P<0.001). Cornea specialists and non-cornea specialists manage bacterial keratitis differently, with cornea specialists more likely to perform diagnostic testing and prescribe fortified broad-spectrum antibiotics for severe bacterial keratitis. Additional prospective studies demonstrating visual outcomes after differential treatment of bacterial keratitis are needed.

  13. 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,"…

  14. How Outpatient Substance Abuse Treatment Unit Director Activities May Affect Provision of Community Outreach Services

    Science.gov (United States)

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri

    2013-01-01

    Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…

  15. Community-directed treatment of lymphatic filariasis in Kenya and its ...

    African Journals Online (AJOL)

    We conducted a prospective, cross-sectional study to examine and compare treatment coverage of lymphatic filariasis by the health system (HST) and a health system implemented, community-directed treatment for the control of lymphatic filariasis (ComDT/HS) in 44 randomly selected villages in coastal Kenya.

  16. 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…

  17. 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.

  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 assertive...... reactions. Relying on an original survey of China’s IR scholars conducted in Beijing in 2013 and using structural equation modeling (SEM), we empirically examine Chinese IR scholars’ attitude towards Chinese power versus the United States, their perceptions of U.S. policy in Asia, and their preference...

  19. Radar Tomography of Asteroids ASSERT / Marco Polo-R

    Science.gov (United States)

    Herique, A.; Zine, S.; Barucci, A.; Biele, J.; Ho, T.; Kofman, W. W.; Krause, C.; Michel, P.; Plettemeier, D.; Prado, J.; Souyris, J.; Ulamec, S.; Assert Team

    2011-12-01

    The internal structure of NEAs remains largely unknown. It is a key point for the understanding of asteroid accretion and dynamical evolution. From a science point of view, the internal structure is also a key point for the understanding of asteroid accretion and dynamical evolution. For risk management and mitigation, it is required to characterize whether a small asteroid will survive the transit through the atmosphere and also to define a deflection policy. There are some indirect evidences that a rubble pile structure is really common at least for objects larger than a few hundreds of meters in diameter. But a more precise characterisation of the internal structure is required, such as the size and the structure of the main blobs and their distribution within the NEAs main body as well as a statistical characterisation of the surface regolith in term of density and size distribution. Radar tomography is the only way to image the internal structure from decimetric to global scale in order to better understand the nature of the primary object and its posterior alterations. It is also a way to estimate the ratio between micro- and macro-porosity. Bistatic radar tomography is an original technique, developed with the CONSERT Experiment (Rosetta / ESA) to image ant characterize the internal structures of 67P/Churyumov-Gerasimeko with a signal transmitted from the Orbiter to the Lander. By regards to a more classical monostatic radar like Marsis (MarsExpress/ESA), this bistatic configuration requires limited resources (mass, power and dataflow) and increases the capacity of deep sounding. So ASSERT (ASteroid Sounding Experiment by Radiowave Transmission) is proposed to instrument a MASCOT-type lander e.g. as payload of the ESA Marco Polo R mission (ESA). The first addressed question is a rubble pile or a monolithic body: For a rubble pile, the tomography will allow to estimate the size distribution of the boulders by direct imaging or statistical analysis of the

  20. 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.

  1. 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

  2. Treatment-based Markov chain models clarify mechanisms of invasion in an invaded grassland community.

    Science.gov (United States)

    Nelis, Lisa Castillo; Wootton, J Timothy

    2010-02-22

    What are the relative roles of mechanisms underlying plant responses in grassland communities invaded by both plants and mammals? What type of community can we expect in the future given current or novel conditions? We address these questions by comparing Markov chain community models among treatments from a field experiment on invasive species on Robinson Crusoe Island, Chile. Because of seed dispersal, grazing and disturbance, we predicted that the exotic European rabbit (Oryctolagus cuniculus) facilitates epizoochorous exotic plants (plants with seeds that stick to the skin an animal) at the expense of native plants. To test our hypothesis, we crossed rabbit exclosure treatments with disturbance treatments, and sampled the plant community in permanent plots over 3 years. We then estimated Markov chain model transition probabilities and found significant differences among treatments. As hypothesized, this modelling revealed that exotic plants survive better in disturbed areas, while natives prefer no rabbits or disturbance. Surprisingly, rabbits negatively affect epizoochorous plants. Markov chain dynamics indicate that an overall replacement of native plants by exotic plants is underway. Using a treatment-based approach to multi-species Markov chain models allowed us to examine the changes in the importance of mechanisms in response to experimental impacts on communities.

  3. Experiences from a Community Based Substance Use Treatment Centre in an Urban Resettlement Colony in India

    Directory of Open Access Journals (Sweden)

    Yatan Pal Singh Balhara

    2014-01-01

    Full Text Available 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.

  4. A Transformation-Based Approach to Implication of GSTE Assertion Graphs

    Directory of Open Access Journals (Sweden)

    Guowu Yang

    2013-01-01

    its powerful capacity in formal verification of VLSI systems. GSTE is an extension of symbolic trajectory evaluation (STE to the model checking of ω-regular properties. It is an alternative to classical model checking algorithms where properties are specified as finite-state automata. In GSTE, properties are specified as assertion graphs, which are labeled directed graphs where each edge is labeled with two labeling functions: antecedent and consequent. In this paper, we show the complement relation between GSTE assertion graphs and finite-state automata with the expressiveness of regular languages and ω-regular languages. We present an algorithm that transforms a GSTE assertion graph to a finite-state automaton and vice versa. By applying this algorithm, we transform the problem of GSTE assertion graphs implication to the problem of automata language containment. We demonstrate our approach with its application to verification of an FIFO circuit.

  5. [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.

  6. 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

    2017-09-05

    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

  7. 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 relationship between cultural sensitivity and gender and want to work overseas; 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.

  8. Infantile colic: incidence and treatment in a Norfolk community.

    Science.gov (United States)

    Rubin, S P; Prendergast, M

    1984-01-01

    In a prospective study of 1019 infant and mother pairs, 268 infants suffered with 'infantile colic'. Significantly more of these were breast fed, supporting the proposed theory of a colic-producing factor in breast milk. Social class and maternal education were not related to the incidence of colic. Seventy-two percent of our infants with colic suffered from classical evening colic. The symptoms did not disappear from all the infants by 3 months - over 38% continued to have symptoms after 3 1/2 months of age. Treatment is limited, but merbentyl helped to relieve symptoms to a varying degree in over 60% of the infants who tried it. The family relationships are often strained during this period and this appears to persist when at one year of age significantly more of these infants were described as demanding, miserable and bad-tempered by their mothers.

  9. 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

    2017-09-12

    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.

  10. 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.

  11. 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 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).

  12. From source to filter: changes in bacterial community composition during potable water treatment.

    Science.gov (United States)

    Zanacic, Enisa; McMartin, Dena W; Stavrinides, John

    2017-06-01

    Rural communities rely on surface water reservoirs for potable water. Effective removal of chemical contaminants and bacterial pathogens from these reservoirs requires an understanding of the bacterial community diversity that is present. In this study, we carried out a 16S rRNA-based profiling approach to describe the bacterial consortia in the raw surface water entering the water treatment plants of 2 rural communities. Our results show that source water is dominated by the Proteobacteria, Bacteroidetes, and Cyanobacteria, with some evidence of seasonal effects altering the predominant groups at each location. A subsequent community analysis of transects of a biological carbon filter in the water treatment plant revealed a significant increase in the proportion of Proteobacteria, Acidobacteria, Planctomycetes, and Nitrospirae relative to raw water. Also, very few enteric coliforms were identified in either the source water or within the filter, although Mycobacterium was of high abundance and was found throughout the filter along with Aeromonas, Legionella, and Pseudomonas. This study provides valuable insight into bacterial community composition within drinking water treatment facilities, and the importance of implementing appropriate disinfection practices to ensure safe potable water for rural communities.

  13. A village treatment center for malaria: community response in Sri Lanka

    DEFF Research Database (Denmark)

    Konradsen, F; Amerasinghe, P H; Perera, D

    2000-01-01

    . The study reports on the experiences with the establishment of a village health facility and its effect on the treatment-seeking behavior of the population. After the introduction of the village treatment center it quickly took over the role of main provider for diagnosis and treatment of malaria from......Early diagnosis and treatment of malaria cases is one of the basic elements of the current global malaria control strategy. In order to provide this service to people in rural areas there is a need for new cost-effective approaches. To ensure that such new approaches are acceptable to the target...... communities, it is important to know the rationale for people's malaria treatment-seeking behavior. The present study provides insights into the reasons for people's preferences for different types of healthcare facilities and describes variation of these preferences within a rural community in Sri Lanka...

  14. Associations between compulsory community treatment and continuity of care in a three year follow-up of the Oxford Community Treatment Order Trial (OCTET) cohort.

    Science.gov (United States)

    Puntis, Stephen Robert; Rugkåsa, Jorun; Burns, Tom

    2017-04-28

    Most studies investigating the effectiveness of Community Treatment Orders (CTOs) use readmission to hospital as the primary outcome. Another aim of introducing CTOs was to improve continuity of care. Our study was a 3-year prospective follow-up which tested for associations between CTOs and continuity of care. Our study sample included 333 patients recruited to the Oxford Community Treatment Order Trial (OCTET). We collected data on continuity of care using eight previously operationalized measures. We analysed the association between CTOs and continuity of care in two ways. First, we tested the association between continuity of care and OCTET randomisation arm (CTO versus voluntary care via Section 17 leave). Second, we analysed continuity of care and CTO exposure independent of randomisation; using any exposure to CTO, number of days on CTO, and proportion of outpatient days on CTO as outcomes. 197 (61%) patients were made subject to CTO during the 36-month follow-up. Randomisation to CTO arm was significantly associated with having a higher proportion of clinical documents copied to the user but no other measures of continuity. Having a higher proportion of outpatient days on CTO (irrespective of randomisation) was associated with fewer 60 day breaks without community contact. A sensitivity analysis found that any exposure to CTO and a higher proportion of outpatient days on CTO were associated with fewer days between community mental health team contacts and 60 day breaks without contact. We found some evidence of an association between CTO use and better engagement with the community team in terms of increased contact and fewer breaks in care. Those with CTO experience had a higher number of inpatient admissions which may have acted as a mediator of this association. We found limited evidence for an association between CTO use and other measures of continuity of care.

  15. Characterization of bacterial community dynamics in a full-scale drinking water treatment plant.

    Science.gov (United States)

    Li, Cuiping; Ling, Fangqiong; Zhang, Minglu; Liu, Wen-Tso; Li, Yuxian; Liu, Wenjun

    2017-01-01

    Understanding the spatial and temporal dynamics of microbial communities in drinking water systems is vital to securing the microbial safety of drinking water. The objective of this study was to comprehensively characterize the dynamics of microbial biomass and bacterial communities at each step of a full-scale drinking water treatment plant in Beijing, China. Both bulk water and biofilm samples on granular activated carbon (GAC) were collected over 9months. The proportion of cultivable cells decreased during the treatment processes, and this proportion was higher in warm season than cool season, suggesting that treatment processes and water temperature probably had considerable impact on the R2A cultivability of total bacteria. 16s rRNA gene based 454 pyrosequencing analysis of the bacterial community revealed that Proteobacteria predominated in all samples. The GAC biofilm harbored a distinct population with a much higher relative abundance of Acidobacteria than water samples. Principle coordinate analysis and one-way analysis of similarity indicated that the dynamics of the microbial communities in bulk water and biofilm samples were better explained by the treatment processes rather than by sampling time, and distinctive changes of the microbial communities in water occurred after GAC filtration. Furthermore, 20 distinct OTUs contributing most to the dissimilarity among samples of different sampling locations and 6 persistent OTUs present in the entire treatment process flow were identified. Overall, our findings demonstrate the significant effects that treatment processes have on the microbial biomass and community fluctuation and provide implications for further targeted investigation on particular bacteria populations. Copyright © 2016. Published by Elsevier B.V.

  16. 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

    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. 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). 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. 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 between them fostered, using community

  17. 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.

  18. Efficacy of community treatments for schizophrenia and other psychotic disorders: a literature review.

    Science.gov (United States)

    Armijo, Julio; Méndez, Emmanuel; Morales, Ricardo; Schilling, Sara; Castro, Ariel; Alvarado, Rubén; Rojas, Graciela

    2013-10-09

    In Chile, the clinical guidelines "for the treatment of people from first episode of schizophrenia" aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals. This study compiles and synthesizes available scientific evidence from the last 14 years on the effectiveness of community intervention strategies for schizophrenia and related psychotic disorders. An electronic search was carried out using PUBMED, LILACS, and Science Direct as databases. Criteria of inclusion: (i) randomized clinical trials, (ii) Community-based interventions, (iii) diagnosis of schizophrenia or related psychotic disorder (section F2 of ICD-10). (i) treatments exclusively pharmacological, (ii) interventions carried out in inpatient settings, (iii) bipolar affective disorder or substance-induced psychosis (greater than 50% of sample). Sixty-six articles were reviewed. Community strategies for integrated treatment from the first outbreak of schizophrenia significantly reduced negative and psychotic symptoms, days of hospitalization, and comorbidity with substance abuse and improved global functioning and adherence to treatment. In other stages, there were improved outcomes in negative and positive symptoms and general psychopathology. Psychoeducation for patients and families reduced the levels of self-stigma and domestic abuse, as well as improved knowledge of the disease and treatment adherence. Training focused on cognitive, social, and labor skills has been shown to improve yields in social functioning and employment status. Community-based intervention strategies are widely supported in the treatment of patients with schizophrenia.

  19. EFFICACY OF COMMUNITY TREATMENTS FOR SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS: A LITERATURE REVIEW.

    Directory of Open Access Journals (Sweden)

    Julio eArmijo

    2013-10-01

    Full Text Available Background: In Chile, the clinical guidelines For the Treatment of People from First Episode of Schizophrenia aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals.Objectives: This study compiles and synthesizes available scientific evidence from the last 14 years on the effectiveness of community intervention strategies for schizophrenia and related psychotic disorders. Methodology: An electronic search was carried out using PUBMED, LILACS and Science-Direct as databases. Criteria of inclusion: i: randomized clinical trials, ii. Community-based interventions, iii. diagnosis of schizophrenia or related psychotic disorder (section F2 of ICD-10. Exclusion Criteria: i. treatments exclusively pharmacological, ii. Interventions carried out in inpatient settings, ii. bipolar affective disorder or substance-induced psychosis (greater than 50% of sample. Results: 66 articles were reviewed. Community strategies for integrated treatment from the first outbreak of schizophrenia significantly reduced negative and psychotic symptoms, days of hospitalization, and comorbidity with substance abuse and improved global functioning and adherence to treatment. In other stages, there were improved outcomes in negative and positive symptoms and general psychopathology. Psychoeducation for patients and families reduced the levels of self-stigma and domestic abuse, as well as improved knowledge of the disease and treatment adherence. Training focused on cognitive, social, and labor skills has been shown to improve yields in social functioning and employment status. Conclusions: Community-based intervention strategies are widely supported in the treatment of patients with

  20. Innovative community-based approaches doubled tuberculosis case notification and improve treatment outcome in Southern Ethiopia.

    Directory of Open Access Journals (Sweden)

    Mohammed A Yassin

    Full Text Available BACKGROUND: TB Control Programmes rely on passive case-finding to detect cases. TB notification remains low in Ethiopia despite major expansion of health services. Poor rural communities face many barriers to service access. METHODS AND FINDINGS: A community-based intervention package was implemented in Sidama zone, Ethiopia. The package included advocacy, training, engaging stakeholders and communities and active case-finding by female Health Extension Workers (HEWs at village level. HEWs conducted house-to-house visits, identified individuals with a cough for two or more weeks, with or without other symptoms, collected sputum, prepared smears and supervised treatment. Supervisors transported smears for microscopy, started treatment, screened contacts and initiated Isoniazid preventive therapy (IPT for children. Outcomes were compared with the pre-implementation period and a control zone. Qualitative research was conducted to understand community and provider perceptions and experiences. HEWs screened 49,857 symptomatic individuals (60% women from October 2010 to December 2011. 2,262 (4·5% had smear-positive TB (53% women. Case notification increased from 64 to 127/100,000 population/year resulting in 5,090 PTB+ and 7,071 cases of all forms of TB. Of 8,005 contacts visited, 1,949 were symptomatic, 1,290 symptomatic were tested and 69 diagnosed with TB. 1,080 children received IPT. Treatment success for smear-positive TB increased from 77% to 93% and treatment default decreased from 11% to 3%. Service users and providers found the intervention package highly acceptable. CONCLUSIONS: Community-based interventions made TB diagnostic and treatment services more accessible to the poor, women, elderly and children, doubling the notification rate and improving treatment outcome. This approach could improve TB diagnosis and treatment in other high burden settings.

  1. Intensive treatment models and coercion

    DEFF Research Database (Denmark)

    Ohlenschlaeger, Johan; Thorup, Anne; Petersen, Lone

    2007-01-01

    -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....... 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...... and on client satisfaction. Integrated Treatment had fewer bed-days, more patients living in non-supervised accommodation, and better score on quality of life. No differences were found as to the use of coercion. This study adds to the evidence that intensified treatment models are superior to standard...

  2. Organizational implementation of evidence-based substance abuse treatment in racial and ethnic minority communities.

    Science.gov (United States)

    Guerrero, Erick G; He, Amy; Kim, Ahraemi; Aarons, Gregory A

    2014-11-01

    We evaluated organizational factors associated with the implementation of contingency management treatment (CMT) and medication-assisted treatment (MAT) in substance abuse treatment (SAT) programs serving racial and ethnic minority communities. Analysis of cross-sectional data collected in 2010-2011 from a random sample of 148 publicly funded SAT programs showed that accepting private insurance was positively associated with CMT and MAT implementation, whereas larger programs were associated with greater implementation of MAT. Supervisorial openness to and expectations about implementing evidence-based practices (EBPs) and attributes for change were strongly associated with CMT, whereas the interactions between openness to EBPs and programs that accept private insurance and that are governed by parent organizations were positively associated with MAT. These external expectations and managerial attitudes supported the implementation of psychosocial and pharmacotherapy treatments in SAT. Implications for improving standards of care in minority communities are discussed.

  3. Unravelling riverine microbial communities under wastewater treatment plant effluent discharge in large urban areas.

    Science.gov (United States)

    Huo, Yang; Bai, Yaohui; Qu, Jiuhui

    2017-07-05

    In many highly urbanized areas, effluent from wastewater treatment plants (WWTPs) represents a significant proportion of the water source for receiving rivers. Microbial communities are major components of riverine ecosystems and mediate the processes of nutrients and organic matter produced by treated and untreated WWTP effluent. To date, the impacts of WWTP effluent discharge on riverine microbial communities remain poorly understood. Based on 16S rRNA gene sequencing and water quality analysis, we investigated the microbial community compositions and predicted functions in the effluents of five municipal WWTPs and their receiving rivers. The results showed that the microbial compositions in the five WWTP effluents with different treatment processes were similar. Significant differences in the microbial community were not noted between the effluent, upstream, and downstream sites for both sampling months. However, dissimilarity of microbial composition between two sampling periods was observed. The temperature, pH, dissolved oxygen, and ammonium were major environmental factors associated with microbial community changes. Functional annotations of microbial communities based on 16S amplicons identified xenobiotic degradation and metabolism functions in effluent and river samples. Quantitative polymerase chain reaction revealed the dominance of ammonia-oxidizing bacteria (AOB) over ammonia-oxidizing archaea (AOA) in the WWTP effluents and rivers, and significant positive correlation between AOB abundance and nitrate concentration was observed. These findings will help increase our understanding of the impact of effluent discharge on urban river ecosystems.

  4. Microbial community dynamics in Baolige oilfield during MEOR treatment, revealed by Illumina MiSeq sequencing.

    Science.gov (United States)

    You, Jing; Wu, Gang; Ren, Fuping; Chang, Qi; Yu, Bo; Xue, Yanfen; Mu, Bozhong

    2015-10-24

    This study was carried out to understand microbial diversity and function in the microbial enhanced oil recovery (MEOR) process and to assess the impact of MEOR treatment on the microbial community in an oil reservoir. The Illumina MiSeq-based method was used to investigate the structure and dynamics of the microbial community in a MEOR-treated block of the Baolige oilfield, China. The results showed that microbial diversity was high and that 23 phyla occurred in the analyzed samples. Proteobacteria, Firmicutes, Bacteroidetes, Thermotogae, and Euryarchaeota were present in relatively high abundance in all analyzed samples. Injection of bacteria and nutrients resulted in interesting changes in the composition of the microbial community. During MEOR treatment, the community was dominated by the known hydrocarbon-utilizing genera Pseudomonas and Acinetobacter. After the treatment, the two genera decreased in abundance over time while Methanobacteriaceae, as well as known syntrophic genera such as Syntrophomonas, Pelotomaculum, Desulfotomaculum, and Thermacetogenium gradually increased. The change in dominant microbial populations indicated the presence of a succession of microbial communities over time, and the hydrocarbon degradation and syntrophic oxidation of acetate and propionate to methane in the MEOR-treated oilfield. This work contributes to a better understanding of microbial processes in oil reservoirs and helps to optimize MEOR technology.

  5. Psychopathological symptoms of patients with heroin addiction entering opioid agonist or therapeutic community treatment

    OpenAIRE

    Pani, Pier Paolo; Trogu, Emanuela; Vigna-Taglianti, Federica; Mathis, Federica; Diecidue, Roberto; Kirchmayer, Ursula; Amato, Laura; Davoli, Marina; Ghibaudi, Joli; Camposeragna, Antonella; Saponaro, Alessio; Faggiano, Fabrizio; Maremmani, Angelo Giovanni Icro; Maremmani, Icro

    2014-01-01

    Background The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychop...

  6. Efficacy of Community Treatments for Schizophrenia and Other Psychotic Disorders: A Literature Review

    OpenAIRE

    Armijo, Julio; M?ndez, Emmanuel; Morales, Ricardo; Schilling, Sara; Castro, Ariel; Alvarado, Rub?n; Rojas, Graciela

    2013-01-01

    Background: In Chile, the clinical guidelines “for the treatment of people from first episode of schizophrenia” aim to support individuals with schizophrenia to live independently, establishment occupational goals, and gain an adequate quality of life and social interaction. This requires the implementation of a treatment model that integrates psychosocial and pharmacological dimensions. Community intervention strategies ensure the achievement of these goals. Objectives: This study compile...

  7. Can DNA sequencing show differences between microbial communities in Polish and Danish wastewater treatment plants?

    Science.gov (United States)

    Miłobędzka, A; Muszyński, A

    2017-03-01

    The microbial populations in the activated sludge of two Polish wastewater treatment plants (WWTPs) were identified and quantified using Illumina sequencing of 16S ribosomal RNA amplicons over a 2-year period. Their dynamics over time were compared to Danish WWTPs (data collected in previous studies by Center for Microbial Communities, Aalborg University). The bacterial communities in Polish and Danish WWTPs were similar to each other, but the microbial diversity in Polish WWTPs was lower. The dominant genera in Polish WWTPs were more abundant than in Danish WWTPs; 30 of them constituted more than half the of activated sludge community. Polish WWTPs showed a higher abundance of bacteria involved in nitrogen and chemical oxygen demand removal (Proteobacteria and Bacteroidetes), while polyphosphate-acculumating bacteria were the dominant bacterial group in Danish plants. The microbial community structures in the examined Polish WWTPs were relatively similar to each other and showed strong seasonal variations which are not normally observed in Danish WWTPs.

  8. Implementing buprenorphine treatment in community settings in Australia: experiences from the Buprenorphine Implementation Trial.

    Science.gov (United States)

    Lintzeris, Nicholas; Ritter, Alison; Panjari, Mary; Clark, Nicolas; Kutin, Jozica; Bammer, Gabriele

    2004-01-01

    Buprenorphine was registered in Australia as a maintenance and detoxification agent for the management of opioid dependence in November, 2000, and became widely available in August, 2001. This paper provides an overview of key developments in the introduction of buprenorphine treatment in Australia, with an emphasis upon the delivery of services in community-based (primary care) settings. A central study in this work was the Buprenorphine Implementation Trial (BIT), a randomized, controlled trial comparing buprenorphine and methadone maintenance treatment delivered under naturalistic conditions by specialist and community-based service providers (general practitioners and community pharmacists) in 139 subjects across nineteen treatment sites. In addition to conventional patient outcome measures (treatment retention, drug use, psychosocial functioning, and cost effectiveness), the BIT study also involved the development and evaluation of clinical guidelines, training programs for clinicians, and client literature, which are described here. Integration of treatment systems (methadone with buprenorphine, specialist and primary-care programs) and factors thought to be important in the uptake of buprenorphine treatment in Australia since registration are discussed.

  9. Community analysis of ammonia-oxidizing bacteria in activated sludge of eight wastewater treatment systems.

    Science.gov (United States)

    Wang, Xiaohui; Wen, Xianghua; Criddle, Craig; Wells, George; Zhang, Jie; Zhao, Yin

    2010-01-01

    We investigated the communities of ammonia-oxidizing bacteria (AOB) in activated sludge collected from eight wastewater treatment systems using polymerase chain reaction (PCR) followed by terminal restriction fragment length polymorphism (T-RFLP), cloning, and sequencing of the alpha-subunit of the ammonia monooxygenase gene (amoA). The T-RFLP fingerprint analyses showed that different wastewater treatment systems harbored distinct AOB communities. However, there was no remarkable difference among the AOB T-RFLP profiles from different parts of the same system. The T-RFLP fingerprints showed that a full-scale wastewater treatment plant (WWTP) contained a larger number of dominant AOB species than a pilot-scale reactor. The source of influent affected the AOB community, and the WWTPs treating domestic wastewater contained a higher AOB diversity than those receiving mixed domestic and industrial wastewater. However, the AOB community structure was little affected by the treatment process in this study. Phylogenetic analysis of the cloned amoA genes clearly indicated that all the dominant AOB in the systems was closely related to Nitrosomonas spp. not to Nitrosospira spp. Members of the Nitrosomonas oligotropha and Nitrosomonas communis clusters were found in all samples, while members of Nitrosomonas europaea cluster occurred in some systems.

  10. Use of a heparin nomogram for treatment of patients with venous thromboembolism in a community hospital

    NARCIS (Netherlands)

    de Groot, M. R.; Büller, H. R.; ten Cate, J. W.; van Marwijk Kooy, M.

    1998-01-01

    The application of a heparin dosing nomogram in the treatment of patients with venous thromboembolism resulted in improvement of heparin therapy in clinical research settings. In 1992 a heparin nomogram was introduced in our hospital, which is a community hospital where anticoagulant therapy is

  11. Microbial community dynamics in a submerged fixed bed bioreactor during biological treatment of saline urban wastewater

    NARCIS (Netherlands)

    Cortés-Lorenzo, C.; Sipkema, D.; Rodríguez-Díaz, M.; Fuentes, S.; Juárez-Jiménez, B.; Rodelas, B.; Smidt, H.; González-López, J.

    2014-01-01

    The influence of salt (NaCl) on bacterial and archaeal communities in a submerged fixed bed bioreactor system for the treatment of urban wastewater was determined by DGGE and 454 pyrosequencing of PCR-amplified 16S ribosomal RNA gene fragments. Cluster analysis of DGGE fingerprints showed

  12. Diversity and dynamics of microbial communities at each step of treatment plant for potable water generation.

    Science.gov (United States)

    Lin, Wenfang; Yu, Zhisheng; Zhang, Hongxun; Thompson, Ian P

    2014-04-01

    The dynamics of bacterial and eukaryotic community associated with each step of a water purification plant in China was investigated using 454 pyrosequencing and qPCR based approaches. Analysis of pyrosequencing revealed that a high degree diversity of bacterial and eukaryotic communities is present in the drinking water treatment process before sand filtration. In addition, the microbial compositions of the biofilm in the sand filters and those of the water of the putatively clear tanks were distinct, suggesting that sand filtration and chlorination treatments played primary roles in removing exposed microbial communities. Potential pathogens including Acinetobacter, Clostridium, Legionella, and Mycobacterium, co-occurred with protozoa such as Rhizopoda (Hartmannellidae), and fungi such as Penicillium and Aspergillus. Furthermore, this study supported the ideas based on molecular level that biofilm communities were different from those in corresponding water samples, and that the concentrations of Mycobacterium spp., Legionella spp., and Naegleria spp. in the water samples declined with each step of the water treatment process by qPCR. Overall, this study provides the first detailed evaluation of bacterial and eukaryotic diversity at each step of an individual potable water treatment process located in China. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Contingency Management for Attendance to Group Substance Abuse Treatment Administered by Clinicians in Community Clinics

    Science.gov (United States)

    Ledgerwood, David M.; Alessi, Sheila M.; Hanson, Tressa; Godley, Mark D.; Petry, Nancy M.

    2008-01-01

    Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were…

  14. 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.

  15. 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 Treatment Program (TDAT). 550.56 Section 550.56 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF... abuse problem who did not choose to volunteer for RDAP may be required to participate in TDAT as a...

  16. Knowledge of cervical tuberculosis lymphadenitis and its treatment in pastoral communities of the Afar region, Ethiopia

    OpenAIRE

    Mamo Gezahegne; Ameni Gobena; Legesse Mengistu; Medhin Girmay; Bjune Gunnar; Abebe Fekadu

    2011-01-01

    Background Infection with Mycobacterium bovis (Mb) predominantly causes cervical TB lymphadenitis (TBL). Raw milk is considered the main source of Mb infection and raw milk is a major food source for Afar pastoralists. The aim of this study was to assess Afar pastoralists' knowledge concerning cervical TBL and its treatment. Methods A community-based cross-sectional survey involving 818 interviewees w...

  17. COSTS AND BENEFITS OF DAY TREATMENT WITH COMMUNITY CARE FOR SCHIZOPHRENIC-PATIENTS

    NARCIS (Netherlands)

    WIERSMA, D; KLUITER, H; NIENHUIS, FJ; RUPHAN, M; GIEL, R

    1991-01-01

    The feasibility of day treatment with community care for schizophrenic patients was tested by means of a longitudinal randomized experiment with 34 experimentals and 16 controls: 38 percent could be treated satisfactorily in a day program that included a very active ambulatory service. The new

  18. Do Treatment Manuals Undermine Youth-Therapist Alliance in Community Clinical Practice?

    Science.gov (United States)

    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…

  19. 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…

  20. Treatment plans in psychiatric community housing programs : Do they reflect rehabilitation principles?

    NARCIS (Netherlands)

    de Heer-Wunderink, C.; Visser, E.S.; Caro-Nienhuis, A.; Sytema, S.; van Weeghel, J.; Wiersma, D.

    2013-01-01

    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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. An Integrated Clinic-Community Partnership for Child Obesity Treatment: A Randomized Pilot Trial.

    Science.gov (United States)

    Hoffman, Jessica; Frerichs, Leah; Story, Mary; Jones, Jason; Gaskin, Kiah; Apple, Annie; Skinner, Asheley; Armstrong, Sarah

    2018-01-01

    Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unknown. We conducted a randomized clinical trial among children aged 5 to 11 presenting for obesity treatment. We randomized participants to clinical care or clinical care plus community-based programming at a local parks and recreation facility. Primary outcomes were the change in child BMI at 6 months and the intensity of the program in treatment hours. Secondary outcomes included health behaviors, fitness, attrition, and quality of life. We enrolled 97 children with obesity, and retention at 6 months was 70%. Participants had a mean age of 9.1 years and a mean baseline BMI z score of 2.28, and 70% were living in poverty. Intervention participants achieved more treatment hours than controls (11.4 vs 4.4, SD: 15.3 and 1.6, respectively). We did not observe differences in child BMI z score or percent of the 95th percentile at 6 months. Intervention participants had significantly greater improvements in physical activity (P = .010) and quality of life (P = .008). An integrated clinic-community model of child obesity treatment is feasible to deliver in a low-income and racially diverse population. As compared with multidisciplinary treatment, the integrated model provides more treatment hours, improves physical activity, and increases quality of life. Parks and recreation departments hold significant promise as a partner agency to deliver child obesity treatment. Copyright © 2018 by the American Academy of Pediatrics.

  8. Community Entrepreneurship in Deprived Neighbourhoods : Comparing UK Community Enterprises with US Community Development Corporations (discussion paper)

    NARCIS (Netherlands)

    Varady, D.P.; Kleinhans, R.J.; Van Ham, M.

    2015-01-01

    Through a review of the recent American community development literature, this paper tests the assertion that British community enterprises (CEs) are fundamentally similar to American community development corporations (CDCs), and therefore, that CEs can learn from CDCs. In the context of the

  9. From coercion to contract: reframing the debate on mandated community treatment for people with mental disorders.

    Science.gov (United States)

    Bonnie, Richard J; Monahan, John

    2005-08-01

    Approximately half the people receiving treatment in the public sector for mental disorder have experienced some form of "leverage" in which deprivations such as jail or hospitalization have been avoided, or rewards such as money or housing have been obtained, contingent on treatment adherence. We argue in this essay that framing the legal debate on mandated community treatment primarily in terms of "coercion" has become counterproductive and that the debate should be re-framed in terms of "contract." Language derived from the law of contract often yields a more accurate account of the current state of the law governing mandated community treatment, is more likely to be translated into a useful descriptive vocabulary for empirical research, and is more likely to clarify the policy issues at stake than the currently stalemated form of argumentation based on putative rights. Our hope is that adopting the language of contract may help to identify those types and features of mandated community treatment that are genuinely problematic, rather than perpetuating the unhelpful and misleading assumption that all types of leverage amount to "coercion."

  10. A Man's (Precarious) Place: Men's Experienced Threat and Self-Assertive Reactions to Female Superiors.

    Science.gov (United States)

    Netchaeva, Ekaterina; Kouchaki, Maryam; Sheppard, Leah D

    2015-09-01

    Across three studies, we investigate men's reactions to women in superior roles. Drawing from precarious manhood theory, we hypothesize that when a woman occupies a superior organizational role, men in subordinate positions experience threat, which leads them to behave more assertively toward her and advocate for themselves. In Studies 1 and 2, we demonstrate that men feel more threatened (relative to women) by women in superior roles (relative to men in superior roles) and, as a result, engage in more assertive behaviors toward these women. In Study 3, we investigate a boundary condition to this effect and demonstrate that a woman in a superior role who displays qualities associated with administrative agency (e.g., directness, proactivity) rather than ambitious agency (e.g., self-promotion, power-seeking) elicits less assertive behavior from men. We conclude by discussing implications as well as directions for future research. © 2015 by the Society for Personality and Social Psychology, Inc.

  11. 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.

  12. Wastewater treatment plant effluent introduces recoverable shifts in microbial community composition in receiving streams.

    Science.gov (United States)

    Price, Jacob R; Ledford, Sarah H; Ryan, Michael O; Toran, Laura; Sales, Christopher M

    2018-02-01

    Through a combined approach using analytical chemistry, real-time quantitative polymerase chain reaction (qPCR), and targeted amplicon sequencing, we studied the impact of wastewater treatment plant effluent sources at six sites on two sampling dates on the chemical and microbial population regimes within the Wissahickon Creek, and its tributary, Sandy Run, in Montgomery County, Pennsylvania, USA. These water bodies contribute flow to the Schuylkill River, one of the major drinking water sources for Philadelphia, Pennsylvania. Effluent was observed to be a significant source of nutrients, 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, which we hypothesize is controlled by distance from effluent source. Antecedent moisture conditions were observed to impact overall microbial community diversity, with higher diversity occurring after rainfall. Finally, the efficacy of using a subset of the microbial community including the orders of Bifidobacteriales, Bacteroidales, and Clostridiales to estimate the degree of influence due to sewage and fecal sources was explored and verified. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Matthews, Alicia K.; Li, Chien-Ching; Kuhns, Lisa M.; Tasker, Timothy B.; Cesario, John A.

    2013-01-01

    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. PMID:23840237

  14. Alterations in soil microbial communities caused by treatments with penicillin or neomycin.

    Science.gov (United States)

    Zhang, Qichun; Kang, Ouyang; Jabeen, Salma; Dick, Warren A

    2017-06-25

    Antibiotic residues in soils can lead to serious health risk and ecological hazards. In this study, the effects of penicillin and neomycin, two antibiotics widely used in animal production, were investigated on soil bacterial communities. Changes in the community structure were monitored using three 16S ribosomal DNA (rDNA) polymerase chain reaction-based approaches, including denaturing gradient gel electrophoresis (DGGE), amplified rDNA restriction analysis (ARDRA), and terminal-restriction fragment length polymorphism (T-RFLP) analysis. The prominent DGGE bands were excised from gels and sequenced, and the data indicated the prevalence of Gammaproteobacteria in the soils. The total soil bacterial community, including uncultured bacteria, exhibited a higher diversity than that of cultured bacteria. Some microbial strains were capable of surviving and even subsisting on penicillin or neomycin. We also observed toxic effects of the antibiotics on the indigenous soil bacterial communities since some genotypes disappeared after the treatments (e.g., Pseudomonas sp., Stenotrophomonas sp., Salinimonas, and uncultured Acinetobacter sp.). The implications of these findings are that the functions of soil bacterial communities may be negatively affected if key microbial community members are lost.

  15. 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.

  16. Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

    Science.gov (United States)

    Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

    2016-04-01

    Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone.

    Science.gov (United States)

    Yansaneh, Aisha I; George, Asha S; Sharkey, Alyssa; Brieger, William R; Moulton, Lawrence H; Yumkella, Fatu; Bangura, Peter; Kabano, Augustin; Diaz, Theresa

    2016-04-01

    In 2010, at the same time as the national roll out of the Free Health Care Initiative (FHCI), which removed user fees for facility based health care, trained community health volunteers (CHVs) were deployed to provide integrated community case management of diarrhea, malaria and pneumonia to children under 5 years of age (U5) in Kambia and Pujehun districts, Sierra Leone. After 2 years of implementation and in the context of FHCI, CHV utilization rate was 14.0 %. In this study, we examine the factors associated with this level of CHV utilization. A cross-sectional household-cluster survey of 1590 caregivers of 2279 children U5 was conducted in 2012; with CHV utilization assessed using a multiple logistic regression model. Focus groups and in-depth interviews were also conducted to understand communities' experiences with CHVs. Children with diarrhea (OR = 3.17, 95 % CI: 1.17-8.60), from female-headed households (OR = 4.55, 95 % CI: 1.88-11.00), and whose caregivers reported poor quality of care as a barrier to facility care-seeking (OR = 8.53, 95 % CI: 3.13-23.16) were more likely to receive treatment from a CHV. Despite low utilization, caregivers were highly familiar and appreciative of CHVs, but were concerned about the lack of financial remuneration for CHVs. CHVs remained an important source of care for children from female-headed households and whose caregivers reported poor quality of care at health facilities. CHVs are an important strategy for certain populations even when facility utilization is high or when facility services are compromised, as has happened with the recent Ebola epidemic in Sierra Leone.

  18. DETERMINATION OF THE ASSERTIVENESS AND PROBLEM SOLVING SKILLS OF BASKETBALL AND VOLLEYBALL REFEREES

    OpenAIRE

    Ekmekci, Ridvan

    2016-01-01

    It is very important to determine sport officials’ problem solving skills and assertiveness as a manager on the court. The purpose of this study was to examine assertiveness and problem solving skills of basketball and volleyball referees. 214 basketball referees (186 males and 28 females) ranging in age from 21 to 48 years (M = 28.58. SD = 4.69) and 177 volleyball referees (112 males 65 females) ranging in age from 23 to 55 years (M = 39.21. SD = 6.36) participated to this study voluntarily ...

  19. 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

  20. 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

  1. Microbial Community Structures and Dynamics in the O3/BAC Drinking Water Treatment Process

    Directory of Open Access Journals (Sweden)

    Jian Tian

    2014-06-01

    Full Text Available Effectiveness of drinking water treatment, in particular pathogen control during the water treatment process, is always a major public health concern. In this investigation, the application of PCR-DGGE technology to the analysis of microbial community structures and dynamics in the drinking water treatment process revealed several dominant microbial populations including: α-Proteobacteria, β-Proteobacteria, γ-Proteobacteria, Bacteroidetes, Actinobacteria Firmicutes and Cyanobacteria. α-Proteobacteria and β-Proteobacteria were the dominant bacteria during the whole process. Bacteroidetes and Firmicutes were the dominant bacteria before and after treatment, respectively. Firmicutes showed season-dependent changes in population dynamics. Importantly, γ-Proteobacteria, which is a class of medically important bacteria, was well controlled by the O3/biological activated carbon (BAC treatment, resulting in improved effluent water bio-safety.

  2. Microbial community structures and dynamics in the O3/BAC drinking water treatment process.

    Science.gov (United States)

    Tian, Jian; Lu, Jun; Zhang, Yu; Li, Jian-Cheng; Sun, Li-Chen; Hu, Zhang-Li

    2014-06-16

    Effectiveness of drinking water treatment, in particular pathogen control during the water treatment process, is always a major public health concern. In this investigation, the application of PCR-DGGE technology to the analysis of microbial community structures and dynamics in the drinking water treatment process revealed several dominant microbial populations including: α-Proteobacteria, β-Proteobacteria, γ-Proteobacteria, Bacteroidetes, Actinobacteria Firmicutes and Cyanobacteria. α-Proteobacteria and β-Proteobacteria were the dominant bacteria during the whole process. Bacteroidetes and Firmicutes were the dominant bacteria before and after treatment, respectively. Firmicutes showed season-dependent changes in population dynamics. Importantly, γ-Proteobacteria, which is a class of medically important bacteria, was well controlled by the O3/biological activated carbon (BAC) treatment, resulting in improved effluent water bio-safety.

  3. 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.

  4. What Do Ovarian Cancer Patients Expect From Treatment?: Perspectives From an Online Patient Community.

    Science.gov (United States)

    Simacek, Kristina; Raja, Priya; Chiauzzi, Emil; Eek, Daniel; Halling, Katarina

    Advances in ovarian cancer treatment have improved outcomes. However, the gap between patients' hopes and expectations and their actual outcomes remains an understudied aspect of treatment decision making. This gap has been noted to be a predictor of poorer health-related quality of life. Incorporating patient hopes and expectations for treatment into clinical care may improve patient experiences. The aim of this study is to describe the hopes and expectations of ovarian cancer patients at diagnosis and throughout treatment transitions. This study sampled from an online community of patients with ovarian cancer. Thirty members completed an online qualitative survey about their diagnostic and treatment journey, including hopes and expectations around treatment. Initially, ovarian cancer patients hoped for a complete cure or removal of cancer. As they progressed through treatment, hopes and expectations centered on issues related to living with ovarian cancer. A subset of patients emphasized a lack of information about treatment side effects. The shift in expectations from survival to living with ovarian cancer may demonstrate an enhanced understanding of ovarian cancer prognosis as patients learn more about their condition. Patients underscored that a more involved discussion of side effect profiles with clinicians would enhance their treatment decision making and expectation setting process. Expectation setting may be improved by contextualizing treatment in terms of the transitions ovarian cancer patients experience. Providing relevant information that aligns with patient needs, desires, and concerns at critical transitions may improve clinical care and decision making.

  5. Tungiasis-related knowledge and treatment practices in two endemic communities in northeast Brazil.

    Science.gov (United States)

    Winter, Benedikt; Oliveira, Fabíola A; Wilcke, Thomas; Heukelbach, Jorg; Feldmeier, Hermann

    2009-07-01

    Tungiasis, caused by the sand flea Tunga penetrans, is highly prevalent in many resource-poor communities in sub-Saharan Africa, Latin America and the Caribbean. Studies on knowledge and treatment practices related to tungiasis in affected populations are virtually nonexistent. To fill this gap, we performed a study in two resource-poor communities in northeast Brazil where this parasitic skin disease is highly prevalent. Structured interviews were realized in a representative sample of household leaders in an urban slum in Fortaleza, capital of Ceará State (northeast Brazil), and in a traditional fishing village 60 km southeast of the city. Two hundred ninety household leaders were interviewed in the urban slum and 136 in the fishing village. Knowledge about the etiological agent of tungiasis and its transmission was high in both communities: 90% knew the flea as the etiological agent of tungiasis. Transmission of tungiasis was thought to be related to sandy soil (72% and 84% in the urban slum and in the fishing village, respectively), presence of animals (52% and 59%), walking barefoot (5% and 23%), and with the presence of garbage littering the area (23% and 21%). Surgical extraction of embedded sand fleas using unsterile sewing needles was the most commonly treatment applied (97% and 96%). In addition, a variety of topical products and medical ointments was used. Mothers were almost exclusively responsible for treatment and knowledge transfer to the next generation. The health sector neither provided health education nor treatment. In communities of low socio-economic status in northeast Brazil, knowledge on tungiasis was high, but individuals did not follow appropriate treatment. A reduction of intensity of infestation, bacterial superinfection and associated morbidity is feasible with minimum support from the health sector, such as supplying hypodermic needles and disinfectants to mothers, and targeted health education.

  6. 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…

  7. HIV testing in correctional agencies and community treatment programs: the impact of internal organizational structure.

    Science.gov (United States)

    Oser, Carrie B; Tindall, Michele Staton; Leukefeld, Carl G

    2007-04-01

    This study compares the provision of HIV testing in a nationally representative sample of correctional agencies and community-based substance abuse treatment programs and identifies the internal organizational-level correlates of HIV testing in both organizations. Data are derived from the Criminal Justice Drug Abuse Treatment Studies' National Criminal Justice Treatment Practices Survey. Using an organizational diffusion theoretical framework [Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: The Free Press], the impact of Centralization of Power, Complexity, Formalization, Interconnectedness, Organizational Resources, and Organizational Size on HIV testing was examined in correctional agencies and treatment programs. Although there were no significant differences in the provision of HIV testing among correctional agencies (49%) and treatment programs (50%), the internal organizational-level correlates were more predictive of HIV testing in correctional agencies. Specifically, all dimensions, with the exception of Formalization, were related to the provision of HIV testing in correctional agencies. Implications for correctional agencies and community treatment to adopt HIV testing are discussed.

  8. Moxifloxacin pharmacokinetic profile and efficacy evaluation in empiric treatment of community-acquired pneumonia

    DEFF Research Database (Denmark)

    Öbrink-Hansen, Kristina; Hardlei, Tore Forsingdal; Brock, Birgitte

    2015-01-01

    that caution must be taken when moxifloxacin is used as monotherapy to treat community-acquired pneumonia caused by L. pneumophila. In conclusion, this report reveals key information relevant to the empirical treatment of community-acquired pneumonia while highlighting the robust and flexible nature...... the pharmacokinetic (PK) profile of moxifloxacin at 400 mg/day in 18 patients treated empirically for community-acquired pneumonia. We developed a population pharmacokinetic model to assess the potential efficacy of moxifloxacin and to simulate the maximal MICs for which recommended pharmacokinetic...... for each patient were evaluated against epidemiological cutoff MIC values for Streptococcus pneumoniae, Haemophilus influenzae, and Legionella pneumophila. PK-PD targets adopted were a Cmax/MIC of ≥12.2 for all pathogens, an fAUC0-24/MIC of >34 for S. pneumoniae, and an fAUC0-24/MIC of >75 for H...

  9. 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

    2016-12-28

    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 730th 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 <80% of the days (aPR = 1.49; 95%IC = 1.28-1.74). This first exploration of community pharmacy 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

  10. Reduction in symptomatic malaria prevalence through proactive community treatment in rural Senegal.

    Science.gov (United States)

    Linn, Annē M; Ndiaye, Youssoupha; Hennessee, Ian; Gaye, Seynabou; Linn, Patrick; Nordstrom, Karin; McLaughlin, Matt

    2015-11-01

    We piloted a community-based proactive malaria case detection model in rural Senegal to evaluate whether this model can increase testing and treatment and reduce prevalence of symptomatic malaria in target communities. Home care providers conducted weekly sweeps of every household in their village throughout the transmission season to identify patients with symptoms of malaria, perform rapid diagnostic tests (RDT) on symptomatic patients and provide treatment for positive cases. The model was implemented in 15 villages from July to November 2013, the high transmission season. Fifteen comparison villages were chosen from those implementing Senegal's original, passive model of community case management of malaria. Three sweeps were conducted in the comparison villages to compare prevalence of symptomatic malaria using difference in differences analysis. At baseline, prevalence of symptomatic malaria confirmed by RDT for all symptomatic individuals found during sweeps was similar in both sets of villages (P = 0.79). At end line, prevalence was 16 times higher in the comparison villages than in the intervention villages (P = 0.003). Adjusting for potential confounders, the intervention was associated with a 30-fold reduction in odds of symptomatic malaria in the intervention villages (AOR = 0.033; 95% CI: 0.017, 0.065). Treatment seeking also increased in the intervention villages, with 57% of consultations by home care providers conducted between sweeps through routine community case management. This pilot study suggests that community-based proactive case detection reduces symptomatic malaria prevalence, likely through more timely case management and improved care seeking behaviour. A randomised controlled trial is needed to further evaluate the impact of this model. © 2015 John Wiley & Sons Ltd.

  11. Self-stigma, personality traits, and willingness to seek treatment in a community sample.

    Science.gov (United States)

    Ingram, Paul B; Lichtenberg, James W; Clarke, Erik

    2016-08-01

    Stigma has received attention as a major barrier toward effective mental health service delivery, and previous research has demonstrated that the Five-Factor Model (FFM) domain of Openness to Experience is negatively correlated with stigmatized views of mental health. However, a lack of established relationships between personality and self-stigma, as well as how these concepts affect an individual's treatment-seeking intentions, has left a gap in the literature. To address this, our study recruited a low-income community sample and tested (a) the relationship between self-stigma of mental health treatment and the FFM, (b) the relationship between self-stigma and treatment-seeking intentions, and (c) the incremental validity of FFM personality beyond stigma in the prediction of treatment seeking. Results suggest that there is some incongruence with previous research on personality's relationship to stigma, personality does not act as an additive component in the prediction of the relationship between stigma and treatment seeking, and stigma is related only to the perceived need for mental health treatment but not to an individual's openness to seek that treatment. The discussion concludes with implications for the contextualization and treatment of stigma as a barrier for mental health treatment and a general synthesis of the personality trait profiles for those holding stigmatizing views of mental health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. In what ways do communities support optimal antiretroviral treatment in Zimbabwe?

    Science.gov (United States)

    Scott, K; Campbell, C; Madanhire, C; Skovdal, M; Nyamukapa, C; Gregson, S

    2014-12-01

    Little research has been conducted on how pre-existing indigenous community resources, especially social networks, affect the success of externally imposed HIV interventions. Antiretroviral treatment (ART), an externally initiated biomedical intervention, is being rolled out across sub-Saharan Africa. Understanding the ways in which community networks are working to facilitate optimal ART access and adherence will enable policymakers to better engage with and bolster these pre-existing resources. We conducted 67 interviews and eight focus group discussions with 127 people from three key population groups in Manicaland, eastern Zimbabwe: healthcare workers, adults on ART and carers of children on ART. We also observed over 100 h of HIV treatment sites at local clinics and hospitals. Our research sought to determine how indigenous resources were enabling people to achieve optimal ART access and adherence. We analysed data transcripts using thematic network technique, coding references to supportive community networks that enable local people to achieve ART access and adherence. People on ART or carers of children on ART in Zimbabwe report drawing support from a variety of social networks that enable them to overcome many obstacles to adherence. Key support networks include: HIV groups; food and income support networks; home-based care, church and women's groups; family networks; and relationships with healthcare providers. More attention to the community context in which HIV initiatives occur will help ensure that interventions work with and benefit from pre-existing social capital. © The Author (2013). Published by Oxford University Press.

  13. [Treatment of childhood acute lymphoblastic leukemia in a community hospital of the state of Veracruz].

    Science.gov (United States)

    Verduzco-Rodríguez, L; Ibarra-Colado, J

    1998-01-01

    To describe the results of treatment of 36 consecutive children with acute lymphoblastic leukemia attending a second level community hospital in the Mexican State of Veracruz. They were from families with very poor resources seen free of charge. Most (75%) were high risk cases. The most common high risk factors were an age outside the range of 2 to 9 years (53%), a WBC count above 50 thousand/microL (36%) and an L-2 lymphocyte morphology (39%). Disease-free survival was 64% at 36 months whereas event-free survival was 47% at 36 months which are low in comparison with the data in the literature. We believe we were able to obtain good results in the treatment of our leukemic cases which was not only a mostly high risk group but also had to contend with poor nutritional, cultural and socioeconomic conditions and with disease-related factors present in their communities.

  14. 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.

  15. 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.

  16. Thanatomania in an Asmat community. A report of successful "western" treatment.

    Science.gov (United States)

    Amelsvoort, V V

    1976-09-01

    Case report from the Asmat-area, West New Guineaof black magic in a 12-year-old boy, confirmed anthropologically and medically. Successful treatment by western medicine was achieved by removing the emotional pressure exerted by the community on the patient through physical and pharmaceutical isoledical help saving a black magic victim. A follow-up of the medicine and anthropology, permitting a discussion of the medical cultural implication.

  17. Telithromycin: a novel agent for the treatment of community-acquired upper respiratory infections

    OpenAIRE

    Tran, Mai P.

    2004-01-01

    The ketolides are a new subclass of macrolides, and telithromycin is the first of these agents to be approved. Modifications to the basic macrolide structure result in enhanced activity against penicillin- and erythromycin resistant respiratory pathogens. It is therefore an option in the treatment of mild to moderate community-acquired respiratory infections, such as pneumonia, acute exacerbations of chronic bronchitis, pharyngitis/tonsillitis, and sinusitis. Telithromycin also offers the adv...

  18. The Effects of a Sport Education Season on Empathy and Assertiveness

    Science.gov (United States)

    García-López, L. M.; Gutiérrez, D.

    2015-01-01

    Background: One of the objectives of the new Spanish Education Act is for students to develop a series of social skills, largely derived from the ability variables of assertiveness and empathy. Sport Education is an instructional model that is deemed useful in the development of personal and social responsibility and social values. It requires…

  19. Jet m” in 2003, adan: FEMINISM AND SELF-ASSERTION OF ...

    African Journals Online (AJOL)

    Dr Ike

    a: Jet m” in. 2003, adan: FEMINISM AND SELF-ASSERTION OF FEMALE. CHARACTERS IN BUCHI EMECHETA'S SECOND CLASS. CITIZEN AND ZAYNAB ALKALI'S THE STILLBORN. Ifeoma E. Odinye. Abstract. Feminism is a social theory and movement primarily motivated by the experiences of women in society.

  20. Self-Defense or Assertiveness Training and Women's Responses to Sexual Attacks

    Science.gov (United States)

    Brecklin, Leanne R.; Ullman, Sarah E.

    2005-01-01

    Self-defense classes aim to prevent violence against women by strengthening women's capacity to defend themselves; however, little research has examined the effects of self-defense training on women's attempts to fight back during actual attacks. This study investigated the relationship of self-defense or assertiveness training and women's…

  1. Protecting yourself from your assertions: navigating multiple regulatory schemes and disclosure.

    Science.gov (United States)

    Mills, Alicia Griffin; D'Emanuele, Ross

    2009-01-01

    This article discusses the conflicting requirements of and assertions made to the Food and DrugAdministration 510(k) approval process and the United States Patent and Trademark Office patent application process for a medical device. Generally, in a 510(k) submission, a company asserts that its device is a substantial equivalent of a predicate device. Conversely, in a patent application, a company asserts that its device is new and nonobvious over all prior art devices. This article explores the risks that arise for a company, whether as a patent holder or an accused patent infringer, because of assertions made as part of a 510(k) submission. The authors look at the possibility of using a 510(k) submission against a company to invalidate that company's patent, then examine the possibility of using a company's 510(k) submission to show infringement of another company's patent. They discuss how regulatory and patent counsel can work together to navigate both regulatory schemes to minimize associated risks-requiring credible arguments of substantial equivalence simultaneous with arguments of novelty and nonobviousness.

  2. 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.

  3. Women are Warmer but No Less Assertive than Men: Gender and Language on Facebook.

    Science.gov (United States)

    Park, Gregory; Yaden, David Bryce; Schwartz, H Andrew; Kern, Margaret L; Eichstaedt, Johannes C; Kosinski, Michael; Stillwell, David; Ungar, Lyle H; Seligman, Martin E P

    2016-01-01

    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.

  4. Asserting the Right to Belong: Feminist Co-Mentoring among Graduate Student Women

    Science.gov (United States)

    Godbee, Beth; Novotny, Julia C.

    2013-01-01

    This empirical case study aims to identify how graduate student women mentor each other when tutoring writing and, through doing so, assert their right to belong in the academy. Much existing literature on feminist mentoring emphasizes the need for better mentoring for women, whether in work or school environments, in current or future faculty…

  5. Associations between assertiveness, psychological well-being, and self-esteem in adolescents

    NARCIS (Netherlands)

    Sarkova, Maria; Bacikova-Sleskova, Maria; Orosova, Olga; Geckova, Andrea Madarasova; Katreniakova, Zuzana; Klein, Daniel; van den Heuvel, Wim; van Dijk, Jitse P.

    This study explored the associations between adolescents assertive behavior, psychological well-being, and self-esteem. The sample consisted of 1,023 students (14.9 +/-.51; 47.6% boys). Two dimensions of the Scale for Interpersonal Behavior (distress and performance), 2 factors of the General Health

  6. 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…

  7. Assertive Classroom Management Strategies and Students' Performance: The Case of EFL Classroom

    Science.gov (United States)

    Aliakbari, Mohammad; Bozorgmanesh, Bafrin

    2015-01-01

    Ample research findings support the effective role that classroom management strategies play in enhancing students' learning. Drawing upon Iranian high school teachers' classroom management strategies, this article is intended to examine the extent to which these teachers follow assertive classroom management strategies and if these strategies…

  8. 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…

  9. Social Skill in Self-Assertive Strategies of Toddlers with Depressed and Nondepressed Mothers

    Science.gov (United States)

    Dietz, Laura J.; Jennings, Kay Donahue; Abrew, Amy J.

    2005-01-01

    The authors examined the effects of maternal depression on the skillfulness of toddlers' self-assertive strategies in interactions with their mother and with a female examiner. The participants were 110 mothers and their 26-month-old toddlers. Of these mothers, 57 had experienced an episode of clinical depression sometime since their child's…

  10. Do the Big-Five Personality Traits Predict Empathic Listening and Assertive Communication?

    Science.gov (United States)

    Sims, Ceri M.

    2017-01-01

    As personality traits can influence important social outcomes, the current research investigated whether the Big-Five had predictive influences on communication competences of active-empathic listening (AEL) and assertiveness. A sample of 245 adults of various ages completed the self-report scales. Both Agreeableness and Openness uniquely…

  11. 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…

  12. Do as I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention

    Science.gov (United States)

    Mercer Kollar, Laura M.; Davis, Teaniese L.; Monahan, Jennifer L.; Samp, Jennifer A.; Coles, Valerie B.; Bradley, Erin L. P.; Sales, Jessica McDermott; Comer, Sarah K.; Worley, Timothy; Rose, Eve; DiClemente, Ralph J.

    2016-01-01

    Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during…

  13. A Struggle for Leadership Recognition: The AIIB, Reactive Chinese Assertiveness, and Regional Order

    Directory of Open Access Journals (Sweden)

    John H.S. Åberg

    2016-12-01

    Full Text Available The aim of this paper is to contribute to the ongoing debate about “Chinese assertiveness”. The paper dissects the central articles on the topic and evaluates their conceptual and theoretical insights. It ascertains that the concept of assertiveness is poorly substantiated; that proponents of “Chinese assertiveness” largely claim that it derives from structural factors that produced effects in Chinese foreign policy behavior prior to the US pivot to Asia; and ultimately, that critical accounts, since they reject the very concept, lack theories that can explain Chinese assertiveness. This article attempts to address these shortcomings. First, the article reconceptualizes assertiveness and connects it to grand strategy change. Second, this change is reactive and occurs after, not prior to the US pivot. Third, in order to provide greater theoretical adequacy, this article combines material factors with institutional factors and show how they dialectically interact with status aspiration, as part of the struggle for the positional good of leadership. To show the conceptual and theoretical plausibility of the argument, the paper outlines the dialectical interplay between positional barriers in the ADB and the US pivot to Asia, on the one hand, and reactive Chinese assertiveness and the AIIB, on the other.

  14. 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.

  15. 29 CFR 825.220 - Protection for employees who request leave or otherwise assert FMLA rights.

    Science.gov (United States)

    2010-07-01

    ... otherwise assert FMLA rights. (a) The FMLA prohibits interference with an employee's rights under the law, and with legal proceedings or inquiries relating to an employee's rights. More specifically, the law... with” the exercise of an employee's rights would include, for example, not only refusing to authorize...

  16. Assertive Communication and Teamwork: Results of an Intervention Program to the Supervisors of a Company

    Science.gov (United States)

    Montes de Oca, Jesús H.

    2014-01-01

    The study aimed to determine the effect of the implementation of the program "Manage your Talent" on assertive communication and teamwork competences. A quasi-experimental research design was used with pretest - intervention - post-test with control group. The sample included 28 supervisors from a private company, 13 in the experimental…

  17. 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.

  18. Resilience of soil microbial and nematode communities after biofumigant treatment with defatted seed meals

    Science.gov (United States)

    Mocali, Stefano; Landi, Silvia; Curto, Giovanna; Elisabetta, Dallavalle; Infantino, Alessandro; Colzi, Claudia; d'Errico, Giada; Roversi, Pio Federico; D'Avino, Lorenzo; Lazzeri, Luca

    2015-04-01

    The use of alternative biocidal compounds to replace chemical pesticides after the Directive 2009/128/EC has raised renewed interest in the biofumigation technique. In particular, the defatted seed meals (DSM) derived from brassicaceae plant tissues with high glucosinolate content represent an efficient practice to control soil-born plant pathogens and pests that can be applied in synergy to catch crop green manures. For a wider and safer application of this technique, the impacts on non-target soil microorganisms and free-living nematodes have to be investigated in more depth. In this pot-scale experiment a naturally nematode-infected soil was amended with a glucosinolate-containing DSM from Brassica carinata (CAR), a non-glucosinolate-containing DSM from sunflower (SUN) and the metham-sodium fumigant (VAP). Tomato plants were transplanted and checked for the presence of pests and/or pathogens and plant vigour. The response of soil microbial communities was assessed through 454-pyrosequencing analysis of bacterial 16S rRNA and fungal 18S rRNA genes, whereas nematode indices were applied to assess their community structure 0, 10, 32 and 62 days after the treatments. Significant shifts were observed among both bacterial and fungal communities, whereas various changes of nematode communities occurred depending on the nematode family. Similar changes initially occurred in both bacterial and fungal community structure in response to DSM and VAP amendments, but after 62 days fungal communities were more strongly shaped by VAP fumigation than bacteria. The non-biofumigant SUN treatment added organic matter into the soil inducing significant changes in microbial communities, but it was not effective against M. incognita root infestation. Although the free-living nematode structure was negatively influenced by all treatments, B. carinata DMS proved the best compromise between efficiency to control M. incognita and environmental impact. These results confirmed the

  19. Impact of community tracer teams on treatment outcomes among tuberculosis patients in South Africa.

    Science.gov (United States)

    Bronner, Liza E; Podewils, Laura J; Peters, Annatjie; Somnath, Pushpakanthi; Nshuti, Lorna; van der Walt, Martie; Mametja, Lerole David

    2012-08-07

    Tuberculosis (TB) indicators in South Africa currently remain well below global targets. In 2008, the National Tuberculosis Program (NTP) implemented a community mobilization program in all nine provinces to trace TB patients that had missed a treatment or clinic visit. Implementation sites were selected by TB program managers and teams liaised with health facilities to identify patients for tracing activities. The objective of this analysis was to assess the impact of the TB Tracer Project on treatment outcomes among TB patients. The study population included all smear positive TB patients registered in the Electronic TB Registry from Quarter 1 2007-Quarter 1 2009 in South Africa. Subdistricts were used as the unit of analysis, with each designated as either tracer (standard TB program plus tracer project) or non-tracer (standard TB program only). Mixed linear regression models were utilized to calculate the percent quarterly change in treatment outcomes and to compare changes in treatment outcomes from Quarter 1 2007 to Quarter 1 2009 between tracer and non-tracer subdistricts. For all provinces combined, the percent quarterly change decreased significantly for default treatment outcomes among tracer subdistricts (-0.031%; p tracer subdistricts (0.003%; p = 0.03). A significant decrease in the proportion of patient default was observed for all provinces combined over the time period comparing tracer and non-tracer subdistricts (p = 0.02). Examination in stratified models revealed the results were not consistent across all provinces; significant differences were observed between tracer and non-tracer subdistricts over time in five of nine provinces for treatment default. Community mobilization of teams to trace TB patients that missed a clinic appointment or treatment dose may be an effective strategy to mitigate default rates and improve treatment outcomes. Additional information is necessary to identify best practices and elucidate discrepancies across

  20. A review: Driving factors and regulation strategies of microbial community structure and dynamics in wastewater treatment systems.

    Science.gov (United States)

    Chen, Yangwu; Lan, Shuhuan; Wang, Longhui; Dong, Shiyang; Zhou, Houzhen; Tan, Zhouliang; Li, Xudong

    2017-05-01

    The performance and stabilization of biological wastewater treatment systems 1are closely related to the microbial community structure and dynamics. In this paper, the effects and mechanisms of influent composition, process configuration, operating parameters (dissolved oxygen [DO], pH, hydraulic retention time [HRT] and sludge retention time [SRT]) and environmental condition (temperature) to the change of microbial community structure and process performance (nitrification, denitrification, biological phosphorus removal, organics mineralization and utilization, etc.) are critically reviewed. Furthermore, some strategies for microbial community structure regulation, mainly bioaugmentation, process adjustment and operating parameters optimization, applied in the current wastewater treatment systems are also discussed. Although the recent studies have strengthened our understanding on the relationship between microbial community structure and wastewater treatment process performance, how to fully tap the microbial information, optimize the microbial community structure and maintain the process performance in wastewater treatment systems are still full of challenges. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Translational research: are community-based child obesity treatment programs scalable?

    Science.gov (United States)

    Hardy, Louise L; Mihrshahi, Seema; Gale, Joanne; Nguyen, Binh; Baur, Louise A; O'Hara, Blythe J

    2015-07-14

    Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions. Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables. Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

  2. Providing Tobacco Treatment in a Community Mental Health Setting: A Pilot Study.

    Science.gov (United States)

    Okoli, Chizimuzo T C; Mason, Dia A; Brumley-Shelton, Angela; Robertson, Heather

    Individuals with mental illnesses (MIs) are disproportionately affected by tobacco-related disease burden because of higher tobacco use prevalence and poor tobacco treatment outcomes. This pilot study examines the outcomes of delivering an evidence-based tobacco treatment program (the Cooper-Clayton program) in a community mental health setting. A prospective nonequivalent group design was used to assess outcomes. This study included 47 participants, of which 19 were in a community mental health setting and 28 were from two non-mental-health settings. Information on sociodemographic (gender, age, educational level, and current life stressors) and medical, MI, substance use, and tobacco use and cessation histories were obtained. Program completion and smoking cessation at the end of treatment (verified with expired carbon monoxide monitoring) were assessed. The program consists of combining behavioral counseling with nicotine replacement therapy for 12 weeks. Participants from the mental health setting were significantly less educated, had greater medical comorbidities, had greater psychiatric and mental health histories, and had greater perceived secondhand tobacco smoke exposure as compared with those from the non-mental-health settings. Thirty-two percent of the participants (6/19) completed the program in the mental health site as compared with 68% (19/28) from the non-mental-health site. None of those from the mental health site achieved cessation as compared with 68% of those from non-mental-health sites. The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.

  3. 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

    2017-11-30

    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

  4. A framework for conducting a national study of substance abuse treatment programs serving American Indian and Alaska native communities.

    Science.gov (United States)

    Novins, Douglas K; Moore, Laurie A; Beals, Janette; Aarons, Gregory A; Rieckmann, Traci; Kaufman, Carol E

    2012-09-01

    Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research. We developed a framework for studying these substance abuse treatment programs (n ≈ 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve. Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research. This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies.

  5. Changes in bacterial community structure in a full-scale membrane bioreactor for municipal wastewater treatment.

    Science.gov (United States)

    Hashimoto, Kurumi; Tsutsui, Hirofumi; Takada, Kazuki; Hamada, Hiroshi; Sakai, Kousuke; Inoue, Daisuke; Sei, Kazunari; Soda, Satoshi; Yamashita, Kyoko; Tsuji, Koji; Hashimoto, Toshikazu; Ike, Michihiko

    2016-07-01

    This study investigated changes in the structure and metabolic capabilities of the bacterial community in a full-scale membrane bioreactor (MBR) treating municipal wastewater. Microbial monitoring was also conducted for a parallel-running conventional activated sludge (CAS) process treating the same influent. The mixed-liquor suspended solid concentration in the MBR reached a steady-state on day 73 after the start-up. Then the MBR maintained higher rates of removal of organic compounds and nitrogen than the CAS process did. Terminal restriction fragment length polymorphism analysis revealed that the bacterial community structure in the MBR was similar to that in the CAS process at the start-up, but it became very different from that in the CAS process in the steady state. The bacterial community structure of the MBR continued to change dynamically even after 20 months of the steady-state operation, while that of the CAS process was maintained in a stable condition. By contrast, Biolog assay revealed that the carbon source utilization potential of the MBR resembled that of the CAS process as a whole, although it declined transiently. Overall, the results indicate that the bacterial community of the MBR has flexibility in terms of its phylogenetic structure and metabolic activity to maintain the high wastewater treatment capability. Copyright © 2015 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  6. Elucidating the impact of microbial community biodiversity on pharmaceutical biotransformation during wastewater treatment.

    Science.gov (United States)

    Stadler, Lauren B; Delgado Vela, Jeseth; Jain, Sunit; Dick, Gregory J; Love, Nancy G

    2017-10-27

    In addition to removing organics and other nutrients, the microorganisms in wastewater treatment plants (WWTPs) biotransform many pharmaceuticals present in wastewater. The objective of this study was to examine the relationship between pharmaceutical biotransformation and biodiversity in WWTP bioreactor microbial communities and identify taxa and functional genes that were strongly associated with biotransformation. Dilution-to-extinction of an activated sludge microbial community was performed to establish cultures with a gradient of microbial biodiversity. Batch experiments were performed using the dilution cultures to determine biotransformation extents of several environmentally relevant pharmaceuticals. With this approach, because the communities were all established from the same original community, and using sequencing of the 16S rRNA and metatranscriptome, we identified candidate taxa and genes whose activity and transcript abundances associated with the extent of individual pharmaceutical biotransformation and were lost across the biodiversity gradient. Metabolic genes such as dehydrogenases, amidases and monooxygenases were significantly associated with pharmaceutical biotransformation, and five genera were identified whose activity significantly associated with pharmaceutical biotransformation. Understanding how biotransformation relates to biodiversity will inform the design of biological WWTPs for enhanced removal of chemicals that negatively impact environmental health. © 2017 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

  7. Awareness of high blood pressure status, treatment and control in a rural community in Edo State.

    Science.gov (United States)

    Omuemu, V O; Okojie, O H; Omuemu, C E

    2007-09-01

    A cross-sectional study was carried out in Udo, a rural community in Ovia South-west LGA of Edo State to assess the level of awareness of high blood pressure status, treatment and control. Cluster sampling method was used to select participants and data collection was by researcher administered questionnaire. Blood pressure measurement was by standardized method. A total of 590 respondents with mean age 30.7 +/- 14.6 years participated in the study. The prevalence of hypertension was 20.2% using the WHO/ISH criteria of SBP > or = 140 mmHg and/or DBP > or = 90 mmHg. Twenty two (18.5%) of the hypertensives were aware of their high blood pressure status. Awareness was higher in females, increased with age and decreased with higher educational status. Of those aware of their condition, 77.3% were on treatment and ofthese, 29.4% had adequate blood pressure control. This study has revealed a low level of awareness of high blood pressure status and control in this rural community. Therefore, there is urgent need for regular community-based hypertension screening programmes.

  8. Quantifying and Valuing Community Health Worker Time in Improving Access to Malaria Diagnosis and Treatment.

    Science.gov (United States)

    Castellani, Joëlle; Mihaylova, Borislava; Ajayi, IkeOluwapo O; Siribié, Mohamadou; Nsungwa-Sabiiti, Jesca; Afonne, Chinenye; Sermé, Luc; Balyeku, Andrew; Kabarungi, Vanessa; Kyaligonza, Josephine; Evers, Silvia M A A; Paulus, Aggie T G; Petzold, Max; Singlovic, Jan; Gomes, Melba

    2016-12-15

    Community health workers (CHWs) are members of a community who are chosen by their communities as first-line, volunteer health workers. The time they spend providing healthcare and the value of this time are often not evaluated. Our aim was to quantify the time CHWs spent on providing healthcare before and during the implementation of an integrated program of diagnosis and treatment of febrile illness in 3 African countries.  In Burkina Faso, Nigeria, and Uganda, CHWs were trained to assess and manage febrile patients in keeping with Integrated Management of Childhood Illness recommendations to use rapid diagnostic tests, artemisinin-based combination therapy, and rectal artesunate for malaria treatment. All CHWs provided healthcare only to young children usually earnings of persons with similar experience.  During the high malaria season of the intervention, CHWs spent nearly 50 minutes more in daily healthcare provision (average daily time, 30.2 minutes before the intervention vs 79.5 minutes during the intervention; test for difference in means P quality services.  ISRCTN13858170. © 2016 World Health Organization; licensee Oxford Journals.

  9. Musculoskeletal disorders: Epidemiology and treatment seeking behavior of secondary school students in a Nigerian community

    Directory of Open Access Journals (Sweden)

    Adegbehingbe Olayinka

    2009-01-01

    Full Text Available Background: Epidemiological information paucity exists on musculoskeletal disorders (MSD among secondary school students in Nigeria. We aimed to determine the prevalence, pattern, and treatment seeking behaviors (TSB of MSD in Southwest, Nigeria. Materials and Methods: A school-based cross-sectional study was conducted in four randomly selected secondary schools in Ile-Ife in 2007. All the students were screened for MSD using an interviewer-administered questionnaire and physical examination, which involved the use of a scoliometer and a goniometer. Affected children were recommended for follow-up treatment and a plain radiography taken. Results: A total of 133 students had 204 MSD representing a 3.0% prevalence among the 4,441students screened. Eighty-one (60.9% students had congenital disorders and 52 (39.1% were acquired. The lower limbs (93.1% were most commonly affected and 87 (65.4% students presented with a knee deformity. Other abnormalities were limb length discrepancy 6.8%, scoliosis 4.4%, Pes planus 3.9%, and poliomyelitis 2.9%. A total of 100 students (75.2% had no form of treatment, 18.8% receive treatment in the hospital, 3.7% received treatment in a traditional healing home and 2.3% received treatment in a church. Age, family, and school type were significant factors ( P < 0.05 in health-seeking behavior. The factors affecting treatment outcome were the place of treatment, hospital specific treatment, and reasons for stopping treatment. Conclusion: Treatable cases constitute a large proportion of MSD among secondary school students, but TSB was generally poor. Parental socio-economic and health services factors were related to the health-seeking behavior. Strengthening of school health services and improved linkage with orthopedic services, community education on MSD, and education of all cadres of health professionals are recommended.

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

    Science.gov (United States)

    2012-01-01

    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 private health providers and

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

    Directory of Open Access Journals (Sweden)

    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

  12. 22 CFR 40.25 - Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens involved in serious criminal activity who have asserted immunity from prosecution. 40.25 Section 40.25 Foreign Relations DEPARTMENT OF... involved in serious criminal activity who have asserted immunity from prosecution. ...

  13. 40 CFR 2.203 - Notice to be included in EPA requests, demands, and forms; method of asserting business...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Notice to be included in EPA requests, demands, and forms; method of asserting business confidentiality claim; effect of failure to assert claim at time of submission. 2.203 Section 2.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

  14. [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.

  15. 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.

  16. Microbial community structures and functions of wastewater treatment systems in plateau and cold regions.

    Science.gov (United States)

    Fang, Dexin; Zhao, Gen; Xu, Xiaoyi; Zhang, Qian; Shen, Qiushi; Fang, Zhuoyao; Huang, Liping; Ji, Fangying

    2017-10-19

    Wastewater treatment plants (WWTPs) in plateau regions have unique microbial community structures. In this study, Illumina high-throughput sequencing technology was applied to investigate microbial communities of plateau WWTPs. The research showed that microbial diversities and richness were negatively associated with the altitude and positively to the water temperature to a certain extent. The dominant phyla of plateau and control WWTPs were similar, which mainly included Proteobacteria, Bacteroidetes, Chloroflexi and Firmicutes. In plateau WWTPs, the LEfSe analysis found 4 biomarkers which can catabolize aromatic compounds, indicating the microorganisms that can degrade refractory organics might survive better in plateau WWTPs. The analysis of functional genera and enzymes showed that there was no significant difference in abundances of organic degrading bacteria, but the nitrogen removal bacteria were less abundant and phosphorus removal bacteria were more abundant in plateau WWTPs. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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    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

  18. Survey of the Huntington's Disease Patient and Caregiver Community Reveals Most Impactful Symptoms and Treatment Needs.

    Science.gov (United States)

    Simpson, Jennifer A; Lovecky, Debra; Kogan, Jane; Vetter, Louise A; Yohrling, George J

    2016-12-15

    In preparation for a meeting with the U.S. Food and Drug Administration (FDA) on Patient-Focused Drug Development in Huntington's disease, the Huntington's Disease Society of America (HDSA) created and distributed two comprehensive surveys on the symptom experience and treatment approaches for Huntington's disease. The objective of these surveys was to identify the specific symptoms that most impact the daily lives of individuals with Huntington's disease/Juvenile Huntington's disease (HD/JHD) and their caregivers and to solicit input on the types of treatments desired by HD affected families. The data were shared with the FDA to offer background and insight in preparation for the patient-focused meeting, as well as to ensure representation by the community in a manner that would complement those who attended in person. Two distinct surveys were created using SurveyMonkey to capture patient and caregiver perspectives on HD symptoms and current treatments. HDSA distributed the surveys to the HD community in August and September 2014 and collected responses through January 2015. More than 3,600 responses to the two surveys were received. The data showed that both caregivers and individuals with HD were severely impacted by the cognitive and behavioral symptoms of HD with HD patients reporting problems with executive functioning and cognitive decline as most impactful to them. However, 30 percent of caregivers reported that chorea was the most impactful symptom compared to 17 percent of people with HD. Across all the symptom categories, patients reported a lower occurrence of symptoms than were reported by their caregivers. With only one drug approved for treatment of a symptom of Huntington's disease and no disease modifying treatments available, there is a critical need for new medicines to treat the cognitive, psychiatric and motor symptoms associated with HD. While the surveys did not capture risk/benefit data, the data collected do provide new insights around the

  19. 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 ptransgender 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.

  20. Individual Community-Based Treatment of Offenders With Mental Illness: Relationship to Recidivism.

    Science.gov (United States)

    Abracen, Jeffrey; Gallo, Alessandra; Looman, Jan; Goodwill, Alasdair

    2016-06-01

    This study explores the effectiveness of psychological intervention at reducing the risk of recidivism among a group of high-risk, high-need offenders housed in a Community Correctional Centre (CCC) operated by the Correctional Service of Canada (CSC). File reviews on 136 male federal offenders living in a CCC in a large metropolitan area were included in the present investigation. Previous research on this sample by our team indicated that the majority of this sample met diagnostic criteria for a variety of psychiatric conditions. Data on the number of individual counseling sessions received and progress in treatment were collected from official file information for the purpose of the present investigation. After accounting for actuarially assessed risk, moderate doses of treatment were found to be associated with 7.7 times less likelihood of recidivism, and high doses of treatment were found to be associated with 11.6 times less likelihood of recidivism, when compared with offenders who received no treatment or were only assessed for treatment. These results are discussed in the context of correctional models of offender risk assessment and rehabilitation. It is notable that a very simple measure of global mental health treatment attendance, with no consideration of such factors as responsiveness, added considerable incremental predictive validity to the results after having statistically accounted for actuarially assessed risk of recidivism. © The Author(s) 2015.

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

    Directory of Open Access Journals (Sweden)

    Nathan Lothrop

    2015-03-01

    Full Text Available 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(loids, 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 (Odds Ratio [OR] = 1.25; 95% Confidence Interval [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.

  2. State policy influence on the early diffusion of buprenorphine in community treatment programs

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    Abraham Amanda J

    2008-06-01

    Full Text Available Abstract Background Buprenorphine was approved for use in the treatment of opioid dependence in 2002, but its diffusion into everyday clinical practice in community-based treatment programs has been slow. This study examines the net impact of efforts by state agencies, including provision of Medicaid coverage, on program-level adoption of buprenorphine as of 2006. Methods Interviews were conducted with key informants in 49 of the 50 state agencies with oversight responsibility for addiction treatment services. Information from these interviews was integrated with organizational data from the 2006 National Survey of Substance Abuse Treatment Services. A multivariate logistic regression model was estimated to identify the effects of state efforts to promote the use of this medication, net of a host of organizational characteristics. Results The availability of Medicaid coverage for buprenorphine was a significant predictor of its adoption by treatment organizations. Conclusion Inclusion of buprenorphine on state Medicaid formularies appears to be a key element in ensuring that patients have access to this state-of-the-art treatment option. Other potential barriers to the diffusion of buprenorphine require identification, and the value of additional state-level policies to promote its use should be evaluated.

  3. 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…

  4. 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.

  5. Impact of drug awareness and treatment camps on attendance at a community outreach de-addiction clinic

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    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.

  6. Effect of streptomycin treatment on bacterial community structure in the apple phyllosphere.

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    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.

  7. Perceptions Among Psychiatric Staff of Creating a Therapeutic Alliance With Patients on Community Treatment Orders.

    Science.gov (United States)

    Jansson, Susanne; Fridlund, Bengt

    2016-10-01

    A therapeutic alliance with a continuing collaboration between a patient and psychiatric staff is a resource for helping patients cope with the demands of coercive legislation. Knowledge exists describing coercion in inpatient care while the knowledge regarding the perceptions of creating a therapeutic alliance with patients on Community Treatment Orders (CTO) among psychiatric staff is scarce. To describe perceptions among psychiatric staff of creating a therapeutic alliance with patients on CTOs, an exploratory design using a phenomenographic method was employed. Thirteen semi-structured audio-taped interviews were conducted with psychiatric staff responsible for patients on CTOs. The staff worked in five different outpatient clinics and the interviews were conducted at their workplaces. The analysis resulted in in four metaphors: the persevering psychiatric staff, the learning psychiatric staff, the participating psychiatric staff, and the motivating psychiatric staff. Patients on CTOs were more time-consuming for psychiatric staff in care and treatment. Long-term planning is required in which the creation of a therapeutic alliance entails the patient gradually gaining greater self-awareness and wanting to visit the outpatient clinic. The professional-patient relationship is essential and if a therapeutic alliance is not created, the patient's continued care and treatment in the community is vulnerable.

  8. Evidence based approach to the treatment of community-associated methicillin-resistant Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    William J Peppard

    2009-06-01

    Full Text Available William J Peppard1, Anne Daniels1, Lynne Fehrenbacher2, Jamie Winner31Froedtert Hospital Milwaukee, Wisconsin, USA; 2Aurora St Luke’s Medical Center Milwaukee, Wisconsin, USA; 3Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USAAbstract: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA infections have increased dramatically over the last two decades. The types of infections can range from complicated skin and skin structure infections (cSSSI to pneumonia and endocarditis. Oral antimicrobial therapy, such as trimethoprim-sulfamethoxazole, clindamycin, long-acting tetracyclines, or linezolid may provide enhanced benefit to those with uncomplicated cutaneous lesions when used in conjunction with incision and drainage in an outpatient setting. However, resistance, susceptibilities, patient-specific circumstances, and adverse effects can impact a healthcare professional’s choice of antibiotics. In patients with complicated infections requiring hospitalization or parenteral treatment, vancomycin remains the drug of choice, even though increased resistance and decreased efficacy have crept into clinical practice. Linezolid, quinupristin/dalfopristin, daptomycin, and tigecycline are alternative intravenous agents for the treatment of CA-MRSA. Investigational agents such as dalbavancin, telavancin, oritivancin, iclaprim, ceftobiprole, ceftaroline, and others may expand our therapeutic armamentarium for the treatment of infections caused by CA-MRSA in the future.Keywords: community-associated methicillin-resistant Staphylococcus aureus, CA-MRSA, complicated skin and skin structure infections, cSSSI, Panton-Valentine leukocidin, PVL, in vitro activity

  9. COMMUNITY KNOWLEDGE ABOUT MALARIA TREATMENT, BATEALIT AND MAYONG SUBDISTRICTS, JEPARA REGENCY

    Directory of Open Access Journals (Sweden)

    Suharjo Suharjo

    2012-07-01

    Full Text Available Malaria prevalence in endemic areas could result morbidity as well as mortality because of lack of early warning system of malaria program providers in the field and low community participation. A study was conducted in Batealit and Mayong subdistricts to measure of malaria treatment through interview with 100 the knowledge respondents using structured questionnaires. Data analysis was done to obtain descriptive and narrative data regarding education, main occupation, experience of getting and curing malaria. The study revealed that majority of respondent's highest education in Batealit and Mayong was primary school, with the percentage of 37.0% respectively. Most of respondent's occupation in Batealit and Mayong was fishermen, with the proportion of 41% and 24.0% respectively. The number of respondents of suffering malaria in Batealit was lower compared to Mayong, that was 64.0%. The first effort of respondents to cure malaria was curing themselves by taking medicine from vendors, with the percentages of 26,0% in Batealit and in Mayong. The other respondents went to health centers for getting free medicine, with the proportion of 44,0% in Batualit and in Mayong. It seems that level of education would influence the knowledge of respondents and in turn could increase their health status. Therefore, the study suggests that continued dissemination of information regarding malaria and related measures through several kinds of methods would increase community knowledge of malaria treatment. Key words : Malaria, Knowledge, Treatment

  10. Relapse prevention medications in community treatment for young adults with opioid addiction.

    Science.gov (United States)

    Vo, Hoa T; Robbins, Erika; Westwood, Meghan; Lezama, Debra; Fishman, Marc

    2016-01-01

    Despite the well-known effectiveness and widespread use of relapse prevention medications such as extended release naltrexone (XR-NTX) and buprenorphine for opioid addiction in adults, less is known about their use in younger populations. This was a naturalistic study using retrospective chart review of N = 56 serial admissions into a specialty community treatment program that featured the use of relapse prevention medications for young adults (19-26 years old) with opioid use disorders. Treatment outcomes over 24 weeks included retention and weekly opioid-negative urine tests. Patients were of mean age 23.1, 70% male, 86% Caucasian, 82% with history of injection heroin use, and treated with either buprenorphine (77%) or XR-NTX (23%). The mean number of XR-NTX doses received was 4.1. Retention was approximately 65% at 12 weeks and 40% at 24 weeks, and rates of opioid-negative urine were 50% at 12 weeks and 39% at 24 weeks, with missing samples imputed as positive. There were no statistically significant differences in retention (t = 1.87, P = .06) or in rates of weekly opioid-negative urine tests (t = 1.96, P = .06) between medication groups, over the course of 24 weeks. The XR-NTX group had higher rates of weekly negative urine drug tests for other nonopioid substances (t = 2.83, P < .05) compared with the buprenorphine group. Males were retained in treatment longer and had higher rates of opioid-negative weeks compared with females. These results suggest that relapse prevention medications including both buprenorphine and XR-NTX can be effectively incorporated into standard community treatment for opioid addiction in young adults with good results. Specialty programming focused on opioid addiction in young adults may provide a promising model for further treatment development.

  11. Knowledge of cervical tuberculosis lymphadenitis and its treatment in pastoral communities of the Afar region, Ethiopia

    Science.gov (United States)

    2011-01-01

    Background Infection with Mycobacterium bovis (Mb) predominantly causes cervical TB lymphadenitis (TBL). Raw milk is considered the main source of Mb infection and raw milk is a major food source for Afar pastoralists. The aim of this study was to assess Afar pastoralists' knowledge concerning cervical TBL and its treatment. Methods A community-based cross-sectional survey involving 818 interviewees was conducted in two districts of the Afar Region, Ethiopia. In addition, two focus group discussions (FGDs) were conducted in each of the study areas, one with men and the other with women. Results Of the 818 interviewees [357 (43.6%) females and 461 (56.4%) males], 742 (90.7%) reported that they had knowledge of cervical TBL, mentioning that swelling(s) on the neck resulting in a lesion and scar are common symptoms. However, only 11 (1.5%) individuals mentioned that bacteria or germs are the causative agents of TBL. Three interviewees and a male discussant mentioned drinking raw milk as the cause of TBL. A considerable proportion (34.2%) of the interviewees and almost all the discussants suggested herbal medicine as an effective treatment. Male study participants were 1.82 times more likely to have overall knowledge of TBL than female study participants (adjusted OR, 1.82; 95% CI, 1.32 to 2.51, p .001). Conclusion The pastoral community members in the study areas had little biomedical knowledge of the cause, the source of infection and the transmission route of cervical TBL. Furthermore, most community members believed that herbal medicines are the most effective treatment for TBL. Therefore, TB control programs in the Afar Region require the incorporation of public health education introducing current biomedical knowledge of the disease. In addition, further studies are important to elucidate which medicinal plants are used by Afar pastoralists to treat TBL. PMID:21385472

  12. Knowledge of cervical tuberculosis lymphadenitis and its treatment in pastoral communities of the Afar region, Ethiopia

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    Mamo Gezahegne

    2011-03-01

    Full Text Available Abstract Background Infection with Mycobacterium bovis (Mb predominantly causes cervical TB lymphadenitis (TBL. Raw milk is considered the main source of Mb infection and raw milk is a major food source for Afar pastoralists. The aim of this study was to assess Afar pastoralists' knowledge concerning cervical TBL and its treatment. Methods A community-based cross-sectional survey involving 818 interviewees was conducted in two districts of the Afar Region, Ethiopia. In addition, two focus group discussions (FGDs were conducted in each of the study areas, one with men and the other with women. Results Of the 818 interviewees [357 (43.6% females and 461 (56.4% males], 742 (90.7% reported that they had knowledge of cervical TBL, mentioning that swelling(s on the neck resulting in a lesion and scar are common symptoms. However, only 11 (1.5% individuals mentioned that bacteria or germs are the causative agents of TBL. Three interviewees and a male discussant mentioned drinking raw milk as the cause of TBL. A considerable proportion (34.2% of the interviewees and almost all the discussants suggested herbal medicine as an effective treatment. Male study participants were 1.82 times more likely to have overall knowledge of TBL than female study participants (adjusted OR, 1.82; 95% CI, 1.32 to 2.51, p Conclusion The pastoral community members in the study areas had little biomedical knowledge of the cause, the source of infection and the transmission route of cervical TBL. Furthermore, most community members believed that herbal medicines are the most effective treatment for TBL. Therefore, TB control programs in the Afar Region require the incorporation of public health education introducing current biomedical knowledge of the disease. In addition, further studies are important to elucidate which medicinal plants are used by Afar pastoralists to treat TBL.

  13. Knowledge of cervical tuberculosis lymphadenitis and its treatment in pastoral communities of the Afar region, Ethiopia.

    Science.gov (United States)

    Legesse, Mengistu; Ameni, Gobena; Mamo, Gezahegne; Medhin, Girmay; Bjune, Gunnar; Abebe, Fekadu

    2011-03-09

    Infection with Mycobacterium bovis (Mb) predominantly causes cervical TB lymphadenitis (TBL). Raw milk is considered the main source of Mb infection and raw milk is a major food source for Afar pastoralists. The aim of this study was to assess Afar pastoralists' knowledge concerning cervical TBL and its treatment. A community-based cross-sectional survey involving 818 interviewees was conducted in two districts of the Afar Region, Ethiopia. In addition, two focus group discussions (FGDs) were conducted in each of the study areas, one with men and the other with women. Of the 818 interviewees [357 (43.6%) females and 461 (56.4%) males], 742 (90.7%) reported that they had knowledge of cervical TBL, mentioning that swelling(s) on the neck resulting in a lesion and scar are common symptoms. However, only 11 (1.5%) individuals mentioned that bacteria or germs are the causative agents of TBL. Three interviewees and a male discussant mentioned drinking raw milk as the cause of TBL. A considerable proportion (34.2%) of the interviewees and almost all the discussants suggested herbal medicine as an effective treatment. Male study participants were 1.82 times more likely to have overall knowledge of TBL than female study participants (adjusted OR, 1.82; 95% CI, 1.32 to 2.51, p pastoral community members in the study areas had little biomedical knowledge of the cause, the source of infection and the transmission route of cervical TBL. Furthermore, most community members believed that herbal medicines are the most effective treatment for TBL. Therefore, TB control programs in the Afar Region require the incorporation of public health education introducing current biomedical knowledge of the disease. In addition, further studies are important to elucidate which medicinal plants are used by Afar pastoralists to treat TBL.

  14. Equivalence and standard scores of the Hurlbert Index of Sexual Assertiveness across Spanish men and women

    Directory of Open Access Journals (Sweden)

    Pablo Santos-Iglesias

    2014-01-01

    Full Text Available The purpose of the present study was to analyze the measurement invariance and differential item functioning of the Spanish version of the Hurlbert Index of Sexual Assertiveness across gender. The sample was composed of 1,600 women and 1,598 men from Spain, with ages ranging from 18 to 84 years old. The Hurlbert Index of Sexual Assertiveness only showed weak invariance for men and women. The differential item functioning analysis showed that only item 2 ("I feel that I am shy when it comes to sex" flagged moderate uniform differential item functioning. More specifically, women tended to respond "Always" to this item more frequently than did men. Results strongly suggested eliminating item 2, resulting in a final version with 18 items clustered into two dimensions with good reliability values for men and women. Standard scores for both Initiation and No Shyness/Refusal reflected traditional sexual scripts for men and women.

  15. Assertive classroom management strategies and students’ performance: The case of EFL classroom

    Directory of Open Access Journals (Sweden)

    Mohammad Aliakbari

    2015-12-01

    Full Text Available Ample research findings support the effective role that classroom management strategies play in enhancing students’ learning. Drawing upon Iranian high school teachers’ classroom management strategies, this article is intended to examine the extent to which these teachers follow assertive classroom management strategies and if these strategies affect students’ performance. Conducting a survey including 123 female students, it was found out that Iranian teachers apply classroom management strategies of organization, teaching management, teacher–student relationship, and teacher punishment–rewards (consequences with varying degrees. In the results section, Pearson correlation is applied between students’ achievement and each part of teacher management strategies. Finally, a positive relationship between teachers’ assertiveness and students’ performance was approved. The findings led to implications for in-service training programs for EFL teachers.

  16. Qualitative analysis of experiences of members of a psychoeducational assertiveness group.

    Science.gov (United States)

    Argyrakouli, Effi; Zafiropoulou, Maria

    2007-04-01

    This study describes qualitatively a psychoeducational assertiveness intervention for 20 women's perceptions of positive and negative experiences, undertaken to identify whether therapeutic mechanisms operating in group therapy as described by Yalom might be inferred. There were 14 90-min. weekly sessions organized around educational material. Two groups were conducted with 10 university women each (M= 20.9 yr., SD= 1.9). Qualitative analysis of the 20 interviews identified five of Yalom's therapeutic mechanisms, namely, self-understanding, universality, acceptance, catharsis, and self-disclosure. The positive experiences were group cohesiveness, self-understanding, self-disclosure, positive views about the self and learning, and cognitive benefits. Self-disclosing at the early stages of group development was the most frequently reported negative experience or difficulty in the group. Although participants stated they improved interpersonal communication skills, analysis suggested the cultural context was an important mediator of assertive behavior.

  17. Dimensions of assertiveness: factors underlying the college self-expression scale.

    Science.gov (United States)

    Kipper, D A; Jaffe, Y

    1978-02-01

    A total of 447 Israeli students, both males and females, from four educational institutions were administered the College Self-expression Scale, a measure of assertiveness. The obtained responses were factor analyzed using the principal axis solution and the varimax rotation method. The results showed four main factors which included 43 of the 50 items of the original scale. These factors were identified as the willingness to take risks in interpersonal interactions, the ability to communicate feelings, setting rules and rectifying injustices, and the presence or absence of a tendency to invoke a self-punitive attitude. The findings were interpreted as adding support to the validity of the scale as a measure of assertiveness.

  18. Assertiveness and aggressiveness as potential moderators of verbal behaviors following unsatisfactory service.

    Science.gov (United States)

    Swanson, Scott R

    2007-04-01

    This research is an extension of earlier studies that examined Assertiveness and Aggressiveness as potential moderators of verbal intentions. A sample of 127 women and 137 men participated in the survey which used random residential telephone numbers. Respondents ranged in age from 18 to 71 years (M=33.2, SD= 12.4), with men making up 51.9% of the total sample. Those respondents classified as having an Aggressive interaction style were least likely to have discussed their unsatisfactory service encounters. The nature of the verbal communications was negative for all four interaction styles investigated. Similar to previous findings, men and women were equally Assertive, but men were more likely to be Aggressive when engaging in marketplace interactions.

  19. Impact of biocide treatments on the bacterial communities of the Lascaux Cave

    Science.gov (United States)

    Bastian, Fabiola; Alabouvette, Claude; Jurado, Valme; Saiz-Jimenez, Cesareo

    2009-07-01

    The Lascaux Cave contains a remarkable set of paintings from the Upper Palaeolithic. Shortly after discovery in 1940, the cave was modified for public viewing and, in 2001, was invaded by a Fusarium solani species complex. Benzalkonium chloride was used from 2001 to 2004 to eliminate the fungal outbreak. In this study, we carried out a sampling in most of the cave halls and galleries. Sequence analysis and isolation methods detected that the most abundant genera of bacteria were Ralstonia and Pseudomonas. We suggest that, as a result of years of benzalkonium chloride treatments, the indigenous microbial community has been replaced by microbial populations selected by biocide application.

  20. At the intersection of lay and professional social networks: how community ties shape perceptions of mental health treatment providers.

    Science.gov (United States)

    Perry, B L; Pullen, E; Pescosolido, B A

    2016-01-01

    The therapeutic alliance is a critical determinant of individuals' persistence and outcomes in mental health treatment. Simultaneously, individuals' community networks shape decisions about whether, when, and what kind of treatment are used. Despite the similar focus on social relationship influence for individuals with serious mental illness, each line of research has maintained an almost exclusive focus on either 'inside' (i.e. treatment) networks or 'outside' (i.e. community) networks, respectively. For this study, we integrate these important insights by employing a network-embedded approach to understand the therapeutic alliance. Using data from the Indianapolis Network Mental Health Study (INMHS, n = 169, obs = 2206), we target patients experiencing their first major contact with the mental health treatment system. We compare patients' perceptions of support resources available through treatment providers and lay people, and ask whether evaluations of interpersonal dimensions of the therapeutic alliance are contingent on characteristics of community networks. Analyses reveal that providers make up only 9% of the whole social network, but are generally perceived positively. However, when community networks are characterized by close relationships and frequent contact, patients are significantly more likely to report that treatment providers offer useful advice and information. Conversely, when community networks are in conflict, perceptions of treatment providers are more negative. Community-based social networks are critical for understanding facilitators of and barriers to effective networks inside treatment, including the therapeutic alliance. Implications for community-based systems of care are discussed in the context of the USA and global patterns of deinstitutionalization and community reintegration.

  1. The Use of Financial Reporting Assertions at the Various Stages of Audit

    Directory of Open Access Journals (Sweden)

    Alla Aleksandrovna Vasilenko

    2015-12-01

    Full Text Available In the context of unsustainable economic development, the requirements that apply to reliability of financial reporting are growing steadily. From the auditor’s perspective it means actualization of the audit methodology problems which can be solved both at the level of financial reporting and the level of its assertions. The article examines the correlation between the audit stages and the usage of financial reporting assertions by auditor in the context of progressive audit. The author provides the results of the synthesis approaches of researchers to allocation and justification of the audit stages. The audit process consists of two directions: achieving the overall audit objectives and achieving the objectives at the level of individual segments. It is proposed to consider the four audit stages in accordance with International Standards on Auditing: 1 planning an audit; 2 audit procedures and audit evidence; 3 evaluation of misstatements identified during the audit; 4 forming an opinion in the audit report. It is established that financial reporting assertions are applied at the three of four audit stages. The analysis of standards on auditing has revealed strong relationship between the audit procedures and the financial reporting assertions. The links which are described in the article are implemented in the practice of auditing organizations by the development of audit documentation set for the various stages of audit. It allows to structure process of planning and performing audit procedures basing on the requirements of the international standards on auditing. As a result, the optimal conditions are created for expressing the opinion by auditor in his report regarding the reliability of the financial statements.

  2. CONSEQUENCES OF ARISTOTLE'S ASSERTION IN FIRST PART OF NEWTON'S FIRST LAW OF MOTION

    OpenAIRE

    Ajay Sharma*

    2018-01-01

    Objective: One of the fundamental propositions of Aristotelian philosophy is that there is no effect without a cause. Aristotle justified that force is continuously needed to push or pull bodies. It was contradicted by Philonopus and Buridan, and then Galileo established law of inertia. Descartes and Newton’s laws are based on law of inertia. All facts are scientifically and neutrally discussed. However Aristotle’s assertion appears in first part of Newton’s first law of motion. Methods/...

  3. Effects of Assertiveness Training and Expressive Writing on Acculturative Stress in International Students: A Randomized Trial

    OpenAIRE

    Tavakoli, Shedeh; Lumley, Mark A.; Hijazi, Alaa M.; Slavin-Spenny, Olga M.; Parris, George P.

    2009-01-01

    International university students often experience acculturative stress, and culturally appropriate techniques to manage stress are needed. This randomized trial tested the effects of group assertiveness training, private expressive writing, their combination, and a wait-list control on the acculturative stress, affect, and health of 118 international students at an urban, American university. Interventions were conducted at the start of a semester, and assessments were conducted at baseline ...

  4. Assertive and responsive conversational skills of Italian-speaking late talkers.

    Science.gov (United States)

    Bonifacio, Serena; Girolametto, Luigi; Bulligan, Manuela; Callegari, Monica; Vignola, Sandra; Zocconi, Elisabetta

    2007-01-01

    Previous research on the pragmatic abilities of late talkers at 24 months of age indicates that they have difficulties initiating conversational interactions, but possess intact responsiveness skills. This study uses a parent-administered questionnaire for evaluating the conversational skills of late talkers and suggesting pragmatic intervention goals. To examine the conversational assertiveness and responsiveness of late talkers at 2 years of age. A parent report measure, The Social Conversational Skills Rating Scale-Italian version, was administered to 30 parents of late talkers, 30 parents of typically developing children matched for age, and 30 parents of younger, typically developing children matched for vocabulary size. The late talkers received significantly lower ratings for both assertiveness and responsiveness in comparison with their age-matched peers. They did not differ significantly from the younger, vocabulary-matched group. Assertiveness and responsiveness mean ratings were positively correlated with vocabulary size for the age-matched group, but not for either of the other two groups. This study confirms a delay in the development of late talkers' social-conversational skills. An investigation of individual profiles suggests that some late talkers may require goals for vocabulary development as well as independent goals for developing pragmatic skills.

  5. Chinese Assertiveness in the South China Sea and Southeast Asian Responses

    Directory of Open Access Journals (Sweden)

    Carlyle A. Thayer

    2011-01-01

    Full Text Available This article reviews Chinese assertive behaviour towards the Philippines and Vietnam over South China Sea issues in 2011. The article compares and contrasts Chinese diplomatic behaviour in the period before and after the adoption by ASEAN member states and China of Guidelines for the Implementation the Declaration on Conduct of Parties in the South China Sea in July. In the first period China aggressively asserted its claims to sovereignty by interfering with commercial fishing and oil exploration activities of vessels operating in the Exclusive Economic Zones of Vietnam and the Philippines. Both states resisted Chinese actions. The Philippines allocated increased funding for defence modernization, lobbied ASEAN states and shored up its alliance with the United States. Vietnam too protested Chinese action and undertook symbolic steps to defend national sovereignty. In the second period all states moved to contain South China Sea tensions from affecting their larger bilateral relations. It remains to be seen, however, if proposed confidence building measures will ameliorate Chinese assertiveness.

  6. Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings.

    Science.gov (United States)

    Liddle, Howard A

    2016-09-01

    This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, www.mdft.org; and Europe-based organization is www.mdft.nl) all support the potential for continued transfer of MDFT to real-world clinical settings. © 2016 Family Process Institute.

  7. Community

    African Journals Online (AJOL)

    study community related the mode of transmíssion to the bite of infective mosquitoes and 43.7% of ... mosquitoes. Mosquitoes are mainly believed to bite human beings at night (73,2%), breed in stagnant water (71%) and rest in dark places inside houses during daytime (44.3%). ... Maize and enset (false banana) are the.

  8. Self-control as a predictor of relapse and recidivism in adolescent therapeutic community treatment.

    Science.gov (United States)

    Abdel-Salam, Sami

    2013-01-01

    Despite the effectiveness of Therapeutic Communities (TCs), empirical studies of TCs are mostly atheoretical. In this study, concepts related to Gottfredson and Hirschi's General Theory of Crime were used to predict posttreatment delinquency among adolescents. Using data collected as part of Drug Abuse Treatment Outcomes Studies--Adolescents (1993-1996), this study examined whether characteristics associated with low self-control predicted posttreatment substance use and posttreatment crime (N = 727). Contrary to the hypotheses, characteristics associated with low self-control had no relationship with posttreatment delinquency. Although these findings do not support the hypothesis, this study begins the process of linking criminological theory to adolescent TC treatment research. The study's limitations are noted.

  9. 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...

  10. Microbial Community Composition in a Simultaneous Nitrification and Denitrification Bioreactor for Domestic Wastewater Treatment

    Science.gov (United States)

    Chen, Chen; Ouyang, Wukun; Huang, Shan; Peng, Xiaochun

    2018-01-01

    Traditional domestic wastewater treatments rely on aerobic processes followed by anaerobic processes. The aerobic step in which ammonium and organic carbon are oxidized, calls for large oxygen input, while the anaerobic process often requires extra carbon input. The challenge of synchronizing both processes is to maintain an active nitrifiers sludge under low dissolved oxygen (DO) condition. In this study, a membrane bioreactor was established and operated stable with low DO of 0.1-0.4 mg L-1. Chemical indicators were determined daily, and bacterial community was checked by qPCR and 16S rDNA sequencing every month. After 2 months incubation, the bioreactor reached to a stable removal rate of total nitrogen around 50% and total organic carbon around 90% with the retaining time of 12 h. The sludge showed enrichment of low DO nitrifiers (Nitrosomonadaceae, Chitinophagaceae, and Nitrospiraceae) which were different from sludge in other regular wastewater treatment plants with aerobic and anaerobic cycles.

  11. Effects of organic pollutants from wastewater treatment plants on aquatic invertebrate communities.

    Science.gov (United States)

    Bunzel, Katja; Kattwinkel, Mira; Liess, Matthias

    2013-02-01

    Pesticides are a major stressor for stream ecosystem health. They enter surface waters from diffuse agricultural sources but also from point sources such as municipal wastewater treatment plants (WWTPs). However, to date, no studies have focused on the ecological effects of pesticide-contaminated WWTP effluent on macroinvertebrate communities. On the basis of governmental monitoring data of 328 sites in Hesse, Germany, we identified insecticidal long-term effects on the structure of the macroinvertebrate community up to 3 km downstream of WWTPs. The effects were quantified using the trait-based SPEAR(pesticides) index, which has been shown to be an effective tool for identifying community effects of pesticide contamination. In addition, based on the German Saprobic Index, we revealed that WWTPs are still an important source of oxygen-depleting organic pollution, despite the extensive technological improvements in wastewater management over several centuries. In general, our findings emphasize the need to take municipal WWTPs into consideration in the management of river basins under the EU Water Framework Directive to achieve good ecological and chemical status for European streams and rivers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. 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…

  13. Communities of ammonia-oxidizing bacteria in activated sludge of various sewage treatment plants in Tokyo.

    Science.gov (United States)

    Limpiyakorn, Tawan; Shinohara, Yuko; Kurisu, Futoshi; Yagi, Osami

    2005-10-01

    We investigated ammonia-oxidizing bacteria in activated sludge collected from 12 sewage treatment systems, whose ammonia removal and treatment processes differed, during three different seasons. We used real-time PCR quantification to reveal total bacterial numbers and total ammonia oxidizer numbers, and used specific PCR followed by denaturing gel gradient electrophoresis, cloning, and sequencing of 16S rRNA genes to analyze ammonia-oxidizing bacterial communities. Total bacterial numbers and total ammonia oxidizer numbers were in the range of 1.6 x 10(12) - 2.4 x 10(13) and 1.0 x 10(9) - 9.2 x 10(10)cellsl(-1), respectively. Seasonal variation was observed in the total ammonia oxidizer numbers, but not in the ammonia-oxidizing bacterial communities. Members of the Nitrosomonas oligotropha cluster were found in all samples, and most sequences within this cluster grouped within two of the four sequence types identified. Members of the clusters of Nitrosomonas europaea-Nitrosococcus mobilis, Nitrosomonas cryotolerans, and unknown Nitrosomonas, occurred solely in one anaerobic/anoxic/aerobic (A2O) system. Members of the Nitrosomonas communis cluster occurred almost exclusively in association with A2O and anaerobic/aerobic systems. Solid residence time mainly influenced the total numbers of ammonia-oxidizing bacteria, whereas dissolved oxygen concentration primarily affected the ammonia-oxidizing activity per ammonia oxidizer cell.

  14. Treatment outcomes in stage IIIA non-small-cell lung cancer in a community cancer center.

    Science.gov (United States)

    Hanson, Shaun; Persad, Kamleish; Qiao, Xian; Guarino, Michael; Petrelli, Nicholas

    2015-08-01

    Treatment outcomes for non-small-cell lung cancer (NSCLC) patients diagnosed at stage IIIA have been analyzed in many studies, which generally involve patients younger and healthier than the average patient with this disease. To analyze demographics and treatment outcomes in patients with stage IIIA NSCLC at a community cancer center. We reviewed charts of 226 patients diagnosed with stage IIIA NSCLC from January 2003 to December 2008 treated at our community cancer center. Results Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively. Median overall survival for all patients and sequentially and concurrently treated chemoradiation patients were 18 months, and 18 months, and 20 months, respectively. Median overall survival for women and men was 24 months and 16 months, respectively. Study design was retrospective and some medical records were not available. However, this population is likely representative of patients treated in similar settings. In our population, advanced age and male gender were associated with lower median survival. Responses to concurrent and sequential chemoradiation seemed to differ based on age group, which may be useful as a prognostic guideline for similar populations. ©2015 Frontline Medical Communications.

  15. Differences in assertive speech acts produced by children with autism, Asperger syndrome, specific language impairment, and normal development.

    Science.gov (United States)

    Ziatas, Kathryn; Durkin, Kevin; Pratt, Chris

    2003-01-01

    The assertive speech acts of children with autism (n = 12) and Asperger syndrome (n = 12), individually matched to children with specific language impairment (SLI; n = 24) and children with normal development (n = 24) were studied in the context of gently structured conversation. These children also completed the false belief test of theory of mind. The children with autism used significantly lower proportions of assertions involving explanations and descriptions than the children with SLI or normal development and significantly lower proportions of assertions involving internal state and explanations than the children with Asperger syndrome. The children with autism used a higher proportion of assertions involving identifications than any other group. The assertions of the children with Asperger syndrome were generally not different than those of the children with SLI or normal development except for a higher proportion of assertions involving own internal state. Further analysis of the mental assertions revealed that the children with autism and Asperger syndrome predominantly referred to desire and made few references to thought and belief, whereas the children with SLI and those with normal development used a higher proportion of references to thought and belief.

  16. Developing a community-academic partnership to improve recognition and treatment of depression in underserved African American and white elders.

    Science.gov (United States)

    Dobransky-Fasiska, Deborah; Brown, Charlotte; Pincus, Harold A; Nowalk, Mary P; Wieland, Melissa; Parker, Lisa S; Cruz, Mario; McMurray, Michelle L; Mulsant, Benoit; Reynolds, Charles F

    2009-11-01

    Reducing mental health disparities among underserved populations, particularly African American elders, is an important public health priority. The authors describe the process and challenges of developing a community/academic research partnership to address these disparities. The authors are using a Community-Based Participatory Research approach to gain access to underserved populations in need of depression treatment. The authors identify six stages: 1) Collaborating to Secure Funding; 2) Building a Communications Platform and Research Infrastructure; 3) Fostering Enduring Relationships; 4) Assessing Needs/Educating about Research Process; 5) Initiating Specific Collaborative Projects (meeting mutual needs/interests); and 6) Maintaining a Sustainable and Productive Partnership. Data from a needs assessment developed collaboratively by researchers and community agencies facilitated agreement on mutual research goals, while strengthening the partnership. A community/academic-based partnership with a solid research infrastructure has been established and maintained for 3 years. Using the results of a needs assessment, the working partnership prioritized and launched several projects. Through interviews and questionnaires, community partners identified best practices for researchers working in the community. Future research and interventional projects have been developed, including plans for sustainability that will eventually shift more responsibility from the academic institution to the community agencies. To reach underserved populations by developing and implementing models of more effective mental health treatment, it is vital to engage community agencies offering services to this population. A successful partnership requires "cultural humility," collaborative efforts, and the development of flexible protocols to accommodate diverse communities.

  17. Microbial community structure of activated sludge in treatment plants with different wastewater compositions

    Directory of Open Access Journals (Sweden)

    Nataliya M. Shchegolkova

    2016-02-01

    Full Text Available Activated sludge (AS plays a crucial role in the treatment of domestic and industrial wastewater. AS is a biocenosis of microorganisms capable of degrading various pollutants, including organic compounds, toxicants and xenobiotics. We performed 16S rRNA gene sequencing of AS and incoming sewage in three wastewater treatment plants (WWTPs responsible for processing sewage with different origins: municipal wastewater, slaughterhouse wastewater, and refinery sewage. In contrast to incoming wastewater, the taxonomic structure of AS biocenosis was found to become stable in time, and each WWTP demonstrated a unique taxonomic pattern. Most pathogenic microorganisms (Streptococcus, Trichococcus, etc. and inductors of AS bulking and flocculation (Comamonadaceae, Flavobacteriaceae, etc., which are abundantly represented in incoming sewage, were significantly decreased in AS of all WWTPs, except for the slaughterhouse wastewater, which was rich in organic matter. Here we present a novel approach enabling the prediction of the metabolic potential of bacterial communities based on their taxonomic structures and MetaCyc database data. We developed a software application, XeDetect, to implement this approach. Using XeDetect, we found that the metabolic potential of the three bacterial communities clearly reflected the substrate composition. We revealed that the microorganisms responsible for AS flocculation and bulking (abundant in AS of slaughterhouse wastewater played a leading role in the degradation of substrates such as fatty acids, amino acids, and other bioorganic compounds. Moreover, we discovered that the chemical, rather than the bacterial composition of the incoming wastewater was the main factor in AS structure formation. XeDetect (freely available: https://sourceforge.net/projects/xedetect represents a novel powerful tool for the analysis of the metabolic capacity of bacterial communities. The tool will help to optimize bioreactor performance and

  18. [Site of care provision, etiology and treatment of community-acquired pneumonia in Palma de Mallorca].

    Science.gov (United States)

    Santos de Unamuno, C; Llorente San Martín, M A; Carandell Jäger, E; Gutiérrez García, M; Riera Jaume, M; Ramírez Rosales, A; Pareja Bezares, A; Corrales Nadal, A

    1998-03-07

    It is not common that community-acquired pneumonias studies include patients non treated in hospital. The objectives were: to determine the cases managed in the ambulatory setting; to describe the clinical features; to identify the aetiological agents, and to describe the treatment, comparing inpatients with outpatients. Observational prospective study. Population attended at three teaching primary care centers of Palma de Mallorca (60,450 habitants). Patients (> 14 years) were investigated when diagnosticated of community-acquired pneumoniae, from November 1992 to December 1994. Exclussions: HIV infection, patients living in a nursing home and tuberculosis. Data were collected in both Hospital and primary health care centers. Epidemiological, clinical, radiological and laboratory findings were recorded at the initial visit and 21 days after. 91 cases were investigated. 57% were managed at the primary care centers exclusively, 63.3% of the patients who went initially to the hospital were admitted in; but only 10.9% of those who went initially to the primary care centers (p < 0.005). 24 patients were hospitalized. 56 microbiological agents were identified in 48 patients (52.7%): Mycoplasma pneumoniae (10); Streptococcus pneumoniae (9); Influenza B (8); Chlamydia psittacci (7); Influenza A (7); Coxiella burnetii (5); Chlamydia pneumoniae (4); Legionella (3); Adenovirus (2); and Parainfluenza 3 (1). Mycoplasma was predominant in outpatients: 9 cases. S. pneumoniae in inpatients: 5 cases. Eritromycin was the most common treatment prescribed (76.9% of patients), alone or in combination with other antibiotics. Monotherapy was most common at primary care yield (96.7%) than at the hospital (45.2%) (p < 0.005). Most of the patients with community-acquired pneumonias are managed at primary health care centers. M. pneumoniae is the predominant microbiological agent in outpatients and S. pneumoniae in inpatients. Erithromycin is the most used antibiotic in both groups of

  19. Early intensive behavioral treatment: replication of the UCLA model in a community setting.

    Science.gov (United States)

    Cohen, Howard; Amerine-Dickens, Mila; Smith, Tristram

    2006-04-01

    Although previous studies have shown favorable results with early intensive behavioral treatment (EIBT) for children with autism, it remains important to replicate these findings, particularly in community settings. The authors conducted a 3-year prospective outcome study that compared 2 groups: (1) 21 children who received 35 to 40 hours per week of EIBT from a community agency that replicated Lovaas' model of EIBT and (2) 21 age- and IQ-matched children in special education classes at local public schools. A quasi-experimental design was used, with assignment to groups based on parental preference. Assessments were conducted by independent examiners for IQ (Bayley Scales of Infant Development or Wechsler Preschool and Primary Scales of Intelligence), language (Reynell Developmental Language Scales), nonverbal skill (Merrill-Palmer Scale of Mental Tests), and adaptive behavior (Vineland Adaptive Behavior Scales). Analyses of covariance, with baseline scores as covariates and Year 1-3 assessments as repeated measures, revealed that, with treatment, the EIBT group obtained significantly higher IQ (F = 5.21, p = .03) and adaptive behavior scores (F = 7.84, p = .01) than did the comparison group. No difference between groups was found in either language comprehension (F = 3.82, p = .06) or nonverbal skill. Six of the 21 EIBT children were fully included into regular education without assistance at Year 3, and 11 others were included with support; in contrast, only 1 comparison child was placed primarily in regular education. Although the study was limited by the nonrandom assignment to groups, it does provide evidence that EIBT can be successfully implemented in a community setting.

  20. Molecular analysis of bacterial isolates and total community DNA from kraft pulp mill effluent treatment systems.

    Science.gov (United States)

    Fortin, N; Fulthorpe, R R; Allen, D G; Greer, C W

    1998-06-01

    Chloroaliphatics are major components of bleached kraft mill effluents. Gene probes and oligonucleotide primers were developed to monitor kraft pulp mill effluent treatment systems for the presence of key genes (dehalogenases) responsible for the dehalogenation of chloroaliphatic organics. The primers were used for polymerase chain reaction (PCR) analysis of genomic DNA extracted from dehalogenating bacterial isolates and from total community DNA extracted from water and sediments of mill effluent treatment system. PCR amplification with oligonucleotide primers designed from dhlB, encoding the haloacid dehalogenase from Xanthobacter autotrophicus, revealed the presence of dehalogenase genes in both aerated lagoons and stabilization basins. Similarly, positive results were obtained with mmoX primers designed from the soluble methane monooxygenase gene of Methylococcus capsulatus Bath. The haloacetate dehalogenase encoding gene (dehH2) from Moraxella sp. was typically not detected in mill effluent treatment systems unless the biomass was selectively enriched. DNA sequence analysis of several PCR fragaments revealed significant similarity to known dehalogenase amd methane monooxygenase genes. The results indicated a broad distribution of known dehalogenation genes and bacteria with chloroorganic-degrading potential in the mill effluent treatment systems.

  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...... 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.......) 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...

  3. 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......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...

  4. Naturalistic outcomes of community treatment orders: antipsychotic long-acting injections versus oral medication.

    Science.gov (United States)

    Patel, Maxine X; Matonhodze, Jane; Baig, Mirza K; Taylor, David; Szmukler, George; David, Anthony S

    2013-07-01

    Community treatment orders (CTOs) are initiated to compel the patient in the community to take part in a management plan, of which medication is often a part. CTOs were introduced in 2008, in England and Wales. We evaluated naturalistic outcomes of CTOs, according to the antipsychotic formulation prescribed at CTO initiation. A cohort study with prospective consecutive sampling and 1-year follow-up was conducted in a large mental health trust in South London. Measures included: demographics, psychotropics and CTO outcomes. Comparison groups were long-acting injection (LAI) versus oral formulations only, for the primary outcomes of time to CTO cessation in days and time to first hospital admission in days, whilst the CTO remained active. For the 188 included patients, the CTO ceased within 1 year, either due to revocation (22.3%), discharge (28.1%) or lapse (19.7%). The CTO was renewed at 6 months for 92 (48.9%) patients, and then 56 (29.8%) were renewed again at 12 months. The antipsychotic formulation at CTO initiation was more likely to be LAI (60.6%) than oral (39.4%). Time to CTO cessation was longer for LAI than oral (median 251 versus 182 days, p = 0.030). A total of 54 patients experienced at least one admission; there was no difference between groups by drug formulation (oral 28.4% versus LAI 28.9%, p = 0.933). The mean time to first admission was 147.1 days and did not differ by formulation. CTO duration was longer for those prescribed an antipsychotic LAI at CTO initiation, although the time to first admission and number of admissions did not differ between groups. CTOs not only compel treatment, but bind services to the patient, resulting in more intensive follow up. Whether enhanced treatment, via oral or LAI and enabled by the CTO, translates into improved clinical outcomes is yet to be determined.

  5. Effects of harvesting treatments on the ant community in a Mississippi River bottomland hardwood forest in west-central Mississippi

    Science.gov (United States)

    Lynne C. Thompson; David M. General; Brian Roy Lockhart

    2010-01-01

    We assessed effects that harvesting treatments had on the ant community in a Mississippi River bottomland hardwood forest in west-central MS. Ants were collected on Pittman Island using pitfall traps from July to November in 1996, 1997, and 2000. The forest received three replicated harvesting treatments in 1995, including: 1) uncut controls (check), 2) selection...

  6. Community treatment orders: the experiences of Non-Maori and Maori within mainstream and Maori mental health services.

    Science.gov (United States)

    Newton-Howes, Giles; Lacey, Cameron J; Banks, Doug

    2014-02-01

    Community treatment orders (CTOs) are sometimes used to coerce patients into treatment on the basis that such treatment is in their best interest. The experiences of Maori, New Zealand's indigenous ethnic minority are less well known and this paper compares the views of Maori and non-Maori about CTOs. Patients with experience of CTOs for greater than 6 months participated. Self-report measures were used to identify patients' views of compulsory treatment. Demographic data, heath service characteristics, the experience of coercion, views of compulsory community treatment, satisfaction with care, social functioning, and psychopathology were assessed. There were few differences in demographic or clinical characteristics between Maori and non-Maori. There were no differences in the views of Maori compared to non-Maori patients with respect to compulsory community treatment. There were no differences in the views of Maori cared for by mainstream compared to culturally specialist Maori mental health service. In a well-established system of compulsory treatment, there is no evidence of greater negative impact of CTOs in an indigenous minority population. The opportunity for Maori to self-select between mainstream and specialist Maori mental health services may minimize the negative aspects of compulsory community treatment for Maori.

  7. Identifying the microbial communities and operational conditions for optimized wastewater treatment in microbial fuel cells.

    Science.gov (United States)

    Ishii, Shun'ichi; Suzuki, Shino; Norden-Krichmar, Trina M; Wu, Angela; Yamanaka, Yuko; Nealson, Kenneth H; Bretschger, Orianna

    2013-12-01

    Microbial fuel cells (MFCs) are devices that exploit microorganisms as "biocatalysts" to recover energy from organic matter in the form of electricity. MFCs have been explored as possible energy neutral wastewater treatment systems; however, fundamental knowledge is still required about how MFC-associated microbial communities are affected by different operational conditions and can be optimized for accelerated wastewater treatment rates. In this study, we explored how electricity-generating microbial biofilms were established at MFC anodes and responded to three different operational conditions during wastewater treatment: 1) MFC operation using a 750 Ω external resistor (0.3 mA current production); 2) set-potential (SP) operation with the anode electrode potentiostatically controlled to +100 mV vs SHE (4.0 mA current production); and 3) open circuit (OC) operation (zero current generation). For all reactors, primary clarifier effluent collected from a municipal wastewater plant was used as the sole carbon and microbial source. Batch operation demonstrated nearly complete organic matter consumption after a residence time of 8-12 days for the MFC condition, 4-6 days for the SP condition, and 15-20 days for the OC condition. These results indicate that higher current generation accelerates organic matter degradation during MFC wastewater treatment. The microbial community analysis was conducted for the three reactors using 16S rRNA gene sequencing. Although the inoculated wastewater was dominated by members of Epsilonproteobacteria, Gammaproteobacteria, and Bacteroidetes species, the electricity-generating biofilms in MFC and SP reactors were dominated by Deltaproteobacteria and Bacteroidetes. Within Deltaproteobacteria, phylotypes classified to family Desulfobulbaceae and Geobacteraceae increased significantly under the SP condition with higher current generation; however those phylotypes were not found in the OC reactor. These analyses suggest that species

  8. Community-based wastewater treatment systems and water quality of an Indonesian village.

    Science.gov (United States)

    Lim, H S; Lee, L Y; Bramono, S E

    2014-03-01

    This paper examines the impact of community-based water treatment systems on water quality in a peri-urban village in Yogyakarta, Indonesia. Water samples were taken from the wastewater treatment plants (WWTPs), irrigation canals, paddy fields and wells during the dry and wet seasons. The samples were tested for biological and chemical oxygen demand, nutrients (ammonia, nitrate, total nitrogen and total phosphorus) and Escherichia coli. Water quality in this village is affected by the presence of active septic tanks, WWTP effluent discharge, small-scale tempe industries and external sources. We found that the WWTPs remove oxygen-demanding wastes effectively but discharged nutrients, such as nitrate and ammonia, into irrigation canals. Irrigation canals had high levels of E. coli as well as oxygen-demanding wastes. Well samples had high E. coli, nitrate and total nitrogen levels. Rainfall tended to increase concentrations of biological and chemical oxygen demand and some nutrients. All our samples fell within the drinking water standards for nitrate but failed the international and Indonesian standards for E. coli. Water quality in this village can be improved by improving the WWTP treatment of nutrients, encouraging more villagers to be connected to WWTPs and controlling hotspot contamination areas in the village.

  9. Soil Microbial Community Structure and Target Organisms under Different Fumigation Treatments

    Directory of Open Access Journals (Sweden)

    Sadikshya R. Dangi

    2015-01-01

    Full Text Available Producers of several high-value crops in California rely heavily on soil fumigants to control key diseases, nematodes, and weeds. Fumigants with broad biocidal activity can affect both target and nontarget soil microorganisms. The ability of nontarget soil microorganisms to recover after fumigation treatment is critical because they play an important role in sustaining the health of agricultural and natural soil systems. Fumigation trial was conducted in Parlier, CA, and the study focuses on the effects of different rates of Telone C35 and also methyl bromide fumigation with polyethylene (PE and totally impermeable film (TIF tarps on target and nontarget soil microorganisms using field samples. Results indicated that the populations of target organisms, such as Fusarium oxysporum and Pythium spp., were reduced at all rates of fumigants. Phospholipid fatty acid (PLFA analysis indicated that all major nontarget soil microbial groups such as Gram positive bacteria, Gram negative bacteria, fungi, and arbuscular mycorrhizal fungi (AMF were affected by methyl bromide (MeBr fumigation treatment. In general, the effects of Telone C35 (299 L/ha under PE tarp had the least impact on microbial community structure and better effect on controlling target microorganisms and, therefore, indicated the better option among fumigation treatments.

  10. 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.

  11. A review of assertions about the processes and outcomes of social learning in natural resource management.

    Science.gov (United States)

    Cundill, G; Rodela, R

    2012-12-30

    Social learning has become a central theme in natural resource management. This growing interest is underpinned by a number of assertions about the outcomes of social learning, and about the processes that support these outcomes. Yet researchers and practitioners who seek to engage with social learning through the natural resource management literature often become disorientated by the myriad processes and outcomes that are identified. We trace the roots of current assertions about the processes and outcomes of social learning in natural resource management, and assess the extent to which there is an emerging consensus on these assertions. Results suggest that, on the one hand, social learning is described as taking place through deliberative interactions amongst multiple stakeholders. During these interactions, it is argued that participants learn to work together and build relationships that allow for collective action. On the other hand, social learning is described as occurring through deliberate experimentation and reflective practice. During these iterative cycles of action, monitoring and reflection, participants learn how to cope with uncertainty when managing complex systems. Both of these processes, and their associated outcomes, are referred to as social learning. Where, therefore, should researchers and practitioners focus their attention? Results suggest that there is an emerging consensus that processes that support social learning involve sustained interaction between stakeholders, on-going deliberation and the sharing of knowledge in a trusting environment. There is also an emerging consensus that the key outcome of such learning is improved decision making underpinned by a growing awareness of human-environment interactions, better relationships and improved problem-solving capacities for participants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Assertiveness, Self-Esteem and Academic Performance in Speech and Oral Communication of Filipino Junior Secondary Teacher Education Students

    National Research Council Canada - National Science Library

    Elma S. Pagaduan-Apostol

    2017-01-01

    This study explored the influence of assertiveness and self - esteem on the final grade in English III, Speech and Oral Communication, among the Bachelor of Secondary Education juniors at the Nueva...

  13. Community-based treatment of late life depression an expert panel-informed literature review.

    Science.gov (United States)

    Frederick, John T; Steinman, Lesley E; Prohaska, Thomas; Satariano, William A; Bruce, Martha; Bryant, Lucinda; Ciechanowski, Paul; Devellis, Brenda; Leith, Katherine; Leyden, Kevin M; Sharkey, Joseph; Simon, Gregory E; Wilson, Nancy; Unützer, Jurgen; Snowden, Mark

    2007-09-01

    To present findings from an expert panel-informed literature review on community-based treatment of late-life depression. A systematic literature review was conducted to appraise publications on community-based interventions for depression in older adults. The search was conducted between March and October 2005. An expert panel of mental health, aging, health services, and epidemiology researchers guided the review and voted on quality and effectiveness of these interventions. A total of 3,543 articles were found with publication dates from 1967 to October 2005; of these, 116 were eligible for inclusion. Adequate data existed to determine effectiveness for the following interventions: depression care management, group and individual psychotherapy for depression, psychotherapy targeting mental health, psychotherapy for caregivers, education and skills training (to manage health problems besides depression; and for caregivers), geriatric health evaluation and management, exercise, and physical rehabilitation and occupational therapy. After reviewing the data, panelists rated the depression care management interventions as effective. Education and skills training, geriatric health evaluation and management, and physical rehabilitation and occupational therapy received ineffective ratings. Other interventions received mixed effectiveness ratings. Insufficient data availability and poor study quality prevented the panelists from rating several reviewed interventions. While several well-described interventions were found to treat depression effectively in community-dwelling older adults, significant gaps still exist. Interventions that did not target depression specifically may be of benefit to older adults, but they should not be presumed to treat depression by themselves. Treating depressed elders may require a multifaceted approach to ensure effectiveness. More research in this area is needed.

  14. 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.

  15. The effect of recreational physical exercise on depression and assertiveness levels of university students

    OpenAIRE

    Gülcan Tekin; M. Tayfun Amman; Ali Tekin

    2009-01-01

     The aim of this study was to investigate the effects of the recreational physical exercise on depression and assertiveness levels of the university students who had never participated in regular physical exercise before. There were 15 male and 15 female totally 30 students in control group and 15 male and 15 female students in exercise group of research. The students in control group carried on their usual life during the research while the students in exercise group participated in a 8 week...

  16. Validación de la Sexual Assertiveness Scale en mujeres mexicanas

    OpenAIRE

    Reyna Torres-Obregon; Dora Julia Onofre-Rodríguez; Juan Carlos Sierra; Raquel Alicia Benavides-Torres; María Eugenia Garza-Elizondo

    2017-01-01

    La asertividad sexual constituye una dimensión fundamental de la sexualidad humana por su relación con distintos indicadores de la salud sexual. Es la capacidad de las personas para iniciar la actividad sexual, rechazar la actividad sexual no deseada y emplear métodos anticonceptivos y así desarrollar comportamientos saludables. Esta se mide a través de la Sexual Assertiveness Scale (SAS). Hasta la fecha, la SAS no se ha validado en población mexicana, por lo que se considera importante exami...

  17. Leaf treatments with a protein-based resistance inducer partially modify phyllosphere microbial communities of grapevine

    Directory of Open Access Journals (Sweden)

    Martina Cappelletti

    2016-07-01

    Full Text Available Protein derivatives and carbohydrates can stimulate plant growth, increase stress tolerance and activate plant defense mechanisms. However, these molecules can also act as a nutritional substrate for microbial communities living on the plant phyllosphere and possibly affect their biocontrol activity against pathogens. We investigated the mechanisms of action of a protein derivative (nutrient broth, NB against grapevine downy mildew, specifically focusing on the effects of foliar treatments on plant defense stimulation and on the composition and biocontrol features of the phyllosphere microbial populations. NB reduced downy mildew symptoms and induced the expression of defense-related genes in greenhouse- and in vitro-grown plants, indicating the activation of grapevine resistance mechanisms. Furthermore, NB increased the number of culturable phyllosphere bacteria and altered the composition of bacterial and fungal populations on leaves of greenhouse-grown plants. Although NB-induced changes on microbial populations were affected by the structure of indigenous communities originally residing on grapevine leaves, degrees of disease reduction and defense gene modulation were consistent among the experiments. Thus, modifications in the structure of phyllosphere populations caused by NB application could partially contribute to downy mildew control by competition for space or other biocontrol strategies. Particularly, changes in the abundance of phyllosphere microorganisms may provide a contribution to resistance induction, partially affecting the hormone-mediated signaling pathways involved. Modifying phyllosphere populations by increasing natural biocontrol agents with the application of selected nutritional factors can open new opportunities in terms of sustainable plant protection strategies.

  18. Leaf Treatments with a Protein-Based Resistance Inducer Partially Modify Phyllosphere Microbial Communities of Grapevine.

    Science.gov (United States)

    Cappelletti, Martina; Perazzolli, Michele; Antonielli, Livio; Nesler, Andrea; Torboli, Esmeralda; Bianchedi, Pier L; Pindo, Massimo; Puopolo, Gerardo; Pertot, Ilaria

    2016-01-01

    Protein derivatives and carbohydrates can stimulate plant growth, increase stress tolerance, and activate plant defense mechanisms. However, these molecules can also act as a nutritional substrate for microbial communities living on the plant phyllosphere and possibly affect their biocontrol activity against pathogens. We investigated the mechanisms of action of a protein derivative (nutrient broth, NB) against grapevine downy mildew, specifically focusing on the effects of foliar treatments on plant defense stimulation and on the composition and biocontrol features of the phyllosphere microbial populations. NB reduced downy mildew symptoms and induced the expression of defense-related genes in greenhouse- and in vitro-grown plants, indicating the activation of grapevine resistance mechanisms. Furthermore, NB increased the number of culturable phyllosphere bacteria and altered the composition of bacterial and fungal populations on leaves of greenhouse-grown plants. Although, NB-induced changes on microbial populations were affected by the structure of indigenous communities originally residing on grapevine leaves, degrees of disease reduction and defense gene modulation were consistent among the experiments. Thus, modifications in the structure of phyllosphere populations caused by NB application could partially contribute to downy mildew control by competition for space or other biocontrol strategies. Particularly, changes in the abundance of phyllosphere microorganisms may provide a contribution to resistance induction, partially affecting the hormone-mediated signaling pathways involved. Modifying phyllosphere populations by increasing natural biocontrol agents with the application of selected nutritional factors can open new opportunities in terms of sustainable plant protection strategies.

  19. Waterbird communities in rice fields subjected to different post-harvest treatments

    Science.gov (United States)

    Day, J.H.; Colwell, M.A.

    1998-01-01

    In California's Sacramento Valley, the potential value of rice fields as habitat for waterbirds may vary with harvest method, post-harvest treatment of rice straw (chopped, burned, plowed), and extent of flooding. Recent changes in rice harvesting methods (i.e., use of stripper-headers) and a legislative mandate to decrease burning of rice straw after harvest may alter habitat availability and use. Thus, we investigated species richness and community composition of nonbreeding waterbirds during October-March 1993-94 and 1994-95 in rice fields of the northern Sacramento Valley. Most (85-91% of land area) rice was conventionally harvested (i.e., cutter bar), and the remainder was stripped. Rice straw was left untreated in more than half of fields (52% in 1994 and 54% in 1995), especially in stripped fields (56-70%). In fields where farmers treated straw, the most common management methods were plowing (15-21%), burning (19-24%), and chopping (3-5%). Fields became increasingly wet from October through March as seasonal precipitation accumulated and farmers flooded fields to facilitate straw decomposition and provide habitat for ducks. Species richness of waterbirds was greater (P 0.23). Species richness in stripped fields probably was low because foraging opportunities were limited by tall dense straw, decreased grain density, and infrequent flooding. We recommend that land managers wishing to provide habitat for a diverse waterbird community harvest rice using conventional methods and flood fields shallowly.

  20. 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.

  1. 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.

  2. Annual Glyphosate Treatments Alter Growth of Unaffected Bentgrass (Agrostis) Weeds and Plant Community Composition

    Science.gov (United States)

    Ahrens, Collin W.; Auer, Carol A.

    2012-01-01

    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. PMID:23226530

  3. Leaf Treatments with a Protein-Based Resistance Inducer Partially Modify Phyllosphere Microbial Communities of Grapevine

    Science.gov (United States)

    Cappelletti, Martina; Perazzolli, Michele; Antonielli, Livio; Nesler, Andrea; Torboli, Esmeralda; Bianchedi, Pier L.; Pindo, Massimo; Puopolo, Gerardo; Pertot, Ilaria

    2016-01-01

    Protein derivatives and carbohydrates can stimulate plant growth, increase stress tolerance, and activate plant defense mechanisms. However, these molecules can also act as a nutritional substrate for microbial communities living on the plant phyllosphere and possibly affect their biocontrol activity against pathogens. We investigated the mechanisms of action of a protein derivative (nutrient broth, NB) against grapevine downy mildew, specifically focusing on the effects of foliar treatments on plant defense stimulation and on the composition and biocontrol features of the phyllosphere microbial populations. NB reduced downy mildew symptoms and induced the expression of defense-related genes in greenhouse- and in vitro-grown plants, indicating the activation of grapevine resistance mechanisms. Furthermore, NB increased the number of culturable phyllosphere bacteria and altered the composition of bacterial and fungal populations on leaves of greenhouse-grown plants. Although, NB-induced changes on microbial populations were affected by the structure of indigenous communities originally residing on grapevine leaves, degrees of disease reduction and defense gene modulation were consistent among the experiments. Thus, modifications in the structure of phyllosphere populations caused by NB application could partially contribute to downy mildew control by competition for space or other biocontrol strategies. Particularly, changes in the abundance of phyllosphere microorganisms may provide a contribution to resistance induction, partially affecting the hormone-mediated signaling pathways involved. Modifying phyllosphere populations by increasing natural biocontrol agents with the application of selected nutritional factors can open new opportunities in terms of sustainable plant protection strategies. PMID:27486468

  4. Factors associated with retention in alcohol and other drug treatment among disadvantaged communities in Cape Town, South Africa.

    Science.gov (United States)

    Pasche, Sonja; Myers, Bronwyn; Adam, Mohamed

    2010-05-01

    Retention in alcohol and other drug (AOD) treatment is strongly associated with positive outcomes. To design interventions to improve outcomes, it is therefore important to uncover the factors contributing to treatment retention. To date, South African AOD research has not examined the factors associated with retention among disadvantaged communities. This study aimed to address this gap by exploring client-level factors associated with retention in AOD treatment. Secondary data analysis was conducted on cross-sectional survey data collected from 434 persons residing in disadvantaged communities in the Cape Town metropolitan area who had accessed AOD treatment in 2006. Multiple regression analyses revealed that race, therapeutic alliance, abstinence-specific social support, and anxiety were significant partial predictors of treatment retention. Black African participants spent significantly fewer days in treatment than "Coloured" individuals. Findings point to the need to improve treatment retention among Black African clients specifically. For clients from poor South African communities, treatment retention rates can be improved by increasing abstinence-specific social support, improving perceptions of AOD treatment, and strengthening the counselor-client therapeutic alliance.

  5. China's Assertive Foreign Policy in South China Sea Under Xi Jinping: Its Impact on United States and Australian Foreign Policy

    OpenAIRE

    Sinaga, Lidya C.

    2015-01-01

    This essay examines the impact of the assertiveness of China's Foreign Policy in the South China Sea under Xi Jinping on United States and Australian foreign policy. The essay focuses on the Xi Jinping period from 2013 because Xi has a different approach in foreign policy making from that of his predecessors. His determination to defend and advance maritime claims and interests as well as the external developments, have made his foreign policy more assertive. This essay will argue that China...

  6. China's Assertive Foreign Policy in South China Sea Under XI Jinping: Its Impact on United States and Australian Foreign Policy

    OpenAIRE

    Sinaga, Lidya Christin

    2015-01-01

    This essay examines the impact of the assertiveness of China's Foreign Policy in the South China Sea under Xi Jinping on United States and Australian foreign policy. The essay focuses on the Xi Jinping period from 2013 because Xi has a different approach in foreign policy making from that of his predecessors. His determination to defend and advance maritime claims and interests as well as the external developments, have made his foreign policy more assertive. This essay will argue that Chin...

  7. Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia.

    Directory of Open Access Journals (Sweden)

    Armelle Forrer

    2016-08-01

    Full Text Available Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined.A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW. Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage.Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered without further delay.

  8. Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia.

    Science.gov (United States)

    Forrer, Armelle; Khieu, Virak; Schindler, Christian; Schär, Fabian; Marti, Hanspeter; Char, Meng Chuor; Muth, Sinuon; Odermatt, Peter

    2016-08-01

    Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined. A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW). Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered without further delay.

  9. Implementing tobacco use treatment guidelines in community health centers in Vietnam.

    Science.gov (United States)

    Shelley, Donna; VanDevanter, Nancy; Cleland, Charles C; Nguyen, Linh; Nguyen, Nam

    2015-10-09

    Vietnam has a smoking prevalence that is the second highest among Southeast Asian countries (SEACs). According to the World Health Organization (WHO), most reductions in mortality from tobacco use in the near future will be achieved through helping current users quit. Yet, largely due to a lack of research on strategies for implementing WHO-endorsed treatment guidelines in primary care settings, services to treat tobacco dependence are not readily available to smokers in low middle-income countries (LMICs) like Vietnam. The objective of this study is to conduct a cluster randomized controlled trial that compares the effectiveness of two system-level strategies for implementing evidence-based guidelines for the treatment of tobacco use in 26 public community health centers (CHCs) in Vietnam. The current study will use a cluster-randomized design and multiple data sources (patient exit interviews, provider and village health worker (VHW) surveys, and semi-structured provider/VHW interviews) to study the process of adapting and implementing clinical practice guidelines in Vietnam and theory-driven mechanisms hypothesized to explain the comparative effectiveness of the two strategies for implementation. CHCs will be randomly assigned to either of the following: (1) training plus clinical reminder system (TC) or (2) TC + referral to a VHW (TCR) for three in person counseling sessions. The primary outcome is provider adherence to tobacco use treatment guidelines. The secondary outcome is 6-month biochemically verified smoking abstinence. The proposed implementation strategies draw on evidence-based approaches and a growing literature that supports the effectiveness of integrating community health workers as members of the health care team to improve access to preventive services. We hypothesize that the value of these implementation strategies is additive and that incorporating a referral resource that allows providers to delegate the task of offering counseling (TCR

  10. The Relations h ip with Self Esteem Between Assertiveness Levels of Sub - Elite In - Door Soccer Players

    Directory of Open Access Journals (Sweden)

    Serdar SUCAN

    2015-07-01

    Full Text Available The aim of this study was investigated the relationship with self esteem between assertiveness levels of sub - elite in - door soccer players. For this aim, 18 – 28 aged, 86 male and 91 female athletes studying 7 universities which joined in - door soccer champio nship of Turkish University Sport Federation was participated to study volunteerly. Participants were performed socio - demographic data formi Rathus Assertiveness Schedule and Coopersmith Self - Esteem Inventory. Data were analyzed by using IBM SPSS (versi on 20.0. Spearman Correlation parameter calculated in order to comment the relationship with data, Multiple regretion analysis was performed for the predictive power of self - esteem for assertiveness levels of participants. According to analysis, a positi ve relationship was found between self esteem and assertivenes levels and it was found that self - esteem levels predictived assertiveness levels substantially. As a result of this study, high self - eseteemed athletes could transfer their feelings to others a nd could increase their assertiveness levels. It was known that highly self - esteemed athletes could increase their performance. Therefore, we could say that necessary studies about athletes’ gaining assertiveness behaviors, should take part of primary stud ies of trainers.

  11. Biological Treatment of Ammonia-Rich Wastewaters by Natural Microbial Communities in the ATOXIC/ASSET Purification System

    Energy Technology Data Exchange (ETDEWEB)

    Vishnivetskaya, Tatiana A [ORNL; Fisher, L. Suzanne [Tennessee Valley Authority (TVA); Brodie, Greg A [Tennessee Valley Authority (TVA); Phelps, Tommy Joe [ORNL

    2013-01-01

    Analyses of bacterial and archaeal 16S rRNA genes along with high throughput 454 pyrosequencing technology were used to identify microbial communities present at a novel passive wastewater treatment system designed to remove ammonium, nitrate, and heavy metals from fossil plant effluents. Seasonal changes in microbial community composition were observed, however significant (p=0.001) changes were detected in bacterial and archaeal communities consistent with ammonium removal throughout the treatment systems. Phylogenetic analysis of 16S rRNA gene sequences revealed presence of potential ammonium-oxidizing bacteria (AOB), Nitrosomonas, Nitrosococcus, Planctomycetes, and OD1. Other bacteria, such as Nitrospira, Nitrococcus, Nitrobacter, Thiobacillus, -Proteobacteria, Firmicutes, Acidobacteria, which play roles in nitrification and denitrification, were also detected. The relative abundance of the potential ammonium-oxidizing archaea (AOA) (Thermoprotei within the phylum Crenarchaeota) increased with ammonium availability at the splitter box and zero-valent iron extraction trenches even though AOB removed half of the ammonium in the trickling filters at the beginning of the treatment system. The microbial community removed the ammonium from the wastewater within both pilot-scale treatment systems, thus the treatment system components provided an effective environment for the treatment of ammonium enriched wastewater from coal burning power plants equipped with selective catalytic reducers for nitrogen oxide removal.

  12. Treatment of Diarrhoea in Rural African Communities: An Overview of Measures to Maximise the Medicinal Potentials of Indigenous Plants

    Directory of Open Access Journals (Sweden)

    Collise Njume

    2012-10-01

    Full Text Available Diarrhoea is a major cause of morbidity and mortality in rural communities in Africa, particularly in children under the age of five. This calls for the development of cost effective alternative strategies such as the use of herbal drugs in the treatment of diarrhoea in these communities. Expenses associated with the use of orthodox medicines have generated renewed interest and reliance on indigenous medicinal plants in the treatment and management of diarrhoeal infections in rural communities. The properties of many phenolic constituents of medicinal plants such as their ability to inhibit enteropooling and delay gastrointestinal transit are very useful in the control of diarrhoea, but problems such as scarcity of valuable medicinal plants, lack of standardization of methods of preparation, poor storage conditions and incertitude in some traditional health practitioners are issues that affect the efficacy and the practice of traditional medicine in rural African communities. This review appraises the current strategies used in the treatment of diarrhoea according to the Western orthodox and indigenous African health-care systems and points out major areas that could be targeted by health-promotion efforts as a means to improve management and alleviate suffering associated with diarrhoea in rural areas of the developing world. Community education and research with indigenous knowledge holders on ways to maximise the medicinal potentials in indigenous plants could improve diarrhoea management in African rural communities.

  13. Treatment of diarrhoea in rural African communities: an overview of measures to maximise the medicinal potentials of indigenous plants.

    Science.gov (United States)

    Njume, Collise; Goduka, Nomalungelo I

    2012-10-26

    Diarrhoea is a major cause of morbidity and mortality in rural communities in Africa, particularly in children under the age of five. This calls for the development of cost effective alternative strategies such as the use of herbal drugs in the treatment of diarrhoea in these communities. Expenses associated with the use of orthodox medicines have generated renewed interest and reliance on indigenous medicinal plants in the treatment and management of diarrhoeal infections in rural communities. The properties of many phenolic constituents of medicinal plants such as their ability to inhibit enteropooling and delay gastrointestinal transit are very useful in the control of diarrhoea, but problems such as scarcity of valuable medicinal plants, lack of standardization of methods of preparation, poor storage conditions and incertitude in some traditional health practitioners are issues that affect the efficacy and the practice of traditional medicine in rural African communities. This review appraises the current strategies used in the treatment of diarrhoea according to the Western orthodox and indigenous African health-care systems and points out major areas that could be targeted by health-promotion efforts as a means to improve management and alleviate suffering associated with diarrhoea in rural areas of the developing world. Community education and research with indigenous knowledge holders on ways to maximise the medicinal potentials in indigenous plants could improve diarrhoea management in African rural communities.

  14. 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

  15. Pengaruh Layanan Konseling Kelompok Teknik Assertive Training Terhadap Disiplin Belajar Siswa Kelas X

    Directory of Open Access Journals (Sweden)

    Tri Dewantari

    2017-06-01

    Full Text Available Learning discipline is a submission that requires students to follow the rules that apply to learning. However, in SMK Trisakti Bandar Lampung, there are X grade students who do not comply with the rules in a study. So it takes an effort to improve learning discipline by using group counseling services with assertive training techniques. The purpose of this study was to find out the picture of student learning discipline and to determine the effect of using group counseling services to improve learning discipline. The method used in this study is quasi-experimental research with the design of Non-equivalent Control Group Design. The technique of collecting data in this research use scale of study discipline scale, interview and documentation as supporting technique. The result of t-test score with df = 16 with significance level 0.05 equal to 2,145, and got count = 6,652. Since tcalculate> t table (6,652> 2,145 So, the conclusion of Ha is accepted and rejected by Ho said that assertive training can improve the discipline of X class students in SMK Trisakti Bandar Lampung accepted. The results of this study are expected to be an alternative solution for students experiencing a disciplinary problem so that counseling and counseling teachers can provide group counseling services to help develop students' learning discipline behavior

  16. Assertive Communication and Teamwork: Results of an Intervention Program to the Supervisors of a Company

    Directory of Open Access Journals (Sweden)

    Jesús H. Montes de Oca

    2014-11-01

    Full Text Available The study aimed to determine the effect of the implementation of the program "Manage your Talent" in competence assertive communication skills and teamwork. A quasi-experimental research design was used with pre-test - intervention - post-test with control group. The sample included 28 supervisors of a private company, 13 in the experimental group and 15 in the control group. A type of purposive sample was used. The results suggest a positive impact of the program to significantly increase competition achievement assertive communication (U = 3.5, Z = 4.58, *** P <.000, just as in effective dialogue dimensions (U = 8.0, feedback (U = 10.0, conflict resolution (U= 7.0 and non-verbal communication (U = 4.0, the skills of this competence in the highest increase was recorded were effective dialogue and nonverbal communication. In the other, the increase was lower. Regarding competition teamwork (U = 0.00, Z = 4.837, *** P <.000, just as in the dimensions (U = 9.0, Goal Achievement (U = 15.0, democratic environment (U= 12.0 and decision making (U = 7.0. The skills of this competence in the highest increase was recorded were the subject property, democratic environment and goal achievement. Minor increase in decision-making for managing consensus.

  17. Technical skills acquisition in surgery-bound senior medical students: an evaluation of student assertiveness.

    Science.gov (United States)

    Talbott, Vanessa A; Marks, Joshua A; Bodzin, Adam S; Comeau, Jason A; Maxwell, Pinckney J; Isenberg, Gerald A; Martin, Niels D

    2012-01-01

    To prepare students pursuing surgical careers, we devised a senior subinternship curriculum supplement that focused on the acquisition of technical skills required of surgical residents. We hypothesized that more assertive students, those that accomplished more of the curriculum, would perform better on a technical skills Objective Structured Clinical Examination (OSCE). Senior medical students rotating on their first general surgery subinternship were administered a 6-station OSCE on the first day of their subinternship and again during the final week of the month-long rotation. A self-directed, 38-task "scavenger hunt" representing common intern level clinical skills, procedures, and patient care activities was provided to each student. The study was performed at Jefferson Medical College, a large, private medical school in Philadelphia, PA. Forty-nine senior students completed surgical subinternships between July 2009 and September 2010, and participated both in the pre-/post-OSCEs and the scavenger hunt. Students performed significantly better on the post-rotation OSCE than on the pre-rotation OSCE; 70.2% ± 8.1% vs. 60.4% ± 12.0%, p technical skills. We feel assertiveness is overshadowed by other factors that may carry more weight in terms of technical skills acquisition. Further studies are required to delineate these factors and ultimately enhance technical skills acquisition during medical school. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Are gonadal steroids linked with orgasm perceptions and sexual assertiveness in women and men?

    Science.gov (United States)

    van Anders, Sari M; Dunn, Emily J

    2009-08-01

    Past findings suggest links between orgasms and testosterone (T), as well as sexuality and estradiol (E), and we examined hormone-orgasm links in this study via two hypotheses (below). Participants were 86 women and 91 men who provided a saliva sample and completed a demographics questionnaire, the Orgasm Checklist (Mah and Binik, 2002), the Hurlbert (1991) Index of Sexual Assertiveness, and the Sexual Desire Inventory (Spector and Fremeth, 1996). Results supported the first hypothesis of correlations between T and positive orgasm experience in women, specifically with the relaxation, soothing, and peaceful items in both partnered and solitary orgasm contexts. Results also indicated correlations between E and flooding and spreading items in a solitary orgasm context. There were no associations between hormones and men's perceptions of their orgasm experiences. There was no support for the second hypothesis of associations between higher T and more sexual assertiveness. Post hoc analyses showed associations between E and women's sexual desire, and T and men's sexual desire. We discuss implications of these findings including that solitary vs. partnered orgasm experiences may differ, and suggest that T might be associated with perceptions of psychological experiences of orgasms, and E might be associated with perceptions of physical experiences of orgasms.

  19. Alexithymia, Assertiveness and Psychosocial Functioning in HIV: Implications for Medication Adherence and Disease Severity.

    Science.gov (United States)

    McIntosh, Roger C; Ironson, Gail; Antoni, Michael; Fletcher, Mary Ann; Schneiderman, Neil

    2016-02-01

    Psychosocial function and adherence to antiretroviral regimen are key factors in human immunodeficiency virus (HIV) disease management. Alexithymia (AL) is a trait deficit in the ability to identify and describe feelings, emotions and bodily sensations. A structural equation model was used to test whether high levels of AL indirectly relate to greater non-adherent behavior and HIV disease severity via psychosocial dysfunction. Blood draws for HIV-1 viral load and CD4 T-lymphocyte, along with psychosocial surveys were collected from 439 HIV positive adults aged 18-73 years. The structural model supports significant paths from: (1) AL to non-active patient involvement, psychological distress, and lower social support, (2) psychological distress and non-active involvement to non-adherent behavior, and (3) non-adherence to greater HIV disease severity (CFI = .97, RMSEA = .04, SRMR = .05). A second model confirmed the intermediary effect of greater patient assertiveness on the path from AL to social support and non-active patient involvement (CFI = .94, RMSEA = .04, SRMR = .05). Altogether, AL is indirectly linked with HIV disease management through it's association with poor psychosocial function, however greater patient assertiveness buffers the negative impact of AL on relationship quality with healthcare providers and members of one's social support network.

  20. Nurse entrepreneurs' attitudes to management, their adoption of the manager's role and managerial assertiveness.

    Science.gov (United States)

    Sankelo, Merja; Akerblad, Leena

    2008-10-01

    This study explores the attitudes of Finnish nurse entrepreneurs to management, their adoption of the manager's role, managerial assertiveness, development and training needs in management and associated factors. The research was conducted as part of a questionnaire survey among 335 entrepreneurs with different educational backgrounds. The sample for the study reported here consisted of those respondents who had a registered nurse degree. The data were analysed using SPSS statistical software. Nurse entrepreneurs took a positive attitude towards management, but there were obvious shortcomings in their adoption of the manager's role. They also showed a lack of managerial assertiveness. Half of the respondents had development needs and one-third had training needs in relation to management. Nurses who are planning to start up in business should have earlier leadership experience and should attend some form of management training. The provision of care and nursing services is increasingly taking place in the private sector. This study contributes to our understanding of the managerial role of nurse entrepreneurs in this new environment.

  1. SystemVerilog assertions and functional coverage guide to language, methodology and applications

    CERN Document Server

    Mehta, Ashok B

    2016-01-01

    This book provides a hands-on, application-oriented guide to the language and methodology of both SystemVerilog Assertions and SystemVerilog Functional Coverage. Readers will benefit from the step-by-step approach to functional hardware verification using SystemVerilog Assertions and Functional Coverage, 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 ASIC/SoC/CPU and FPGA design and Verification, this book explains each concept with easy to understand examples, simulation logs and applications derived from real projects. Readers will be empowered to tackle the modeling of complex checkers for functional verification, thereby drastically reducing their time to design and debug. This updated second edition addresses the latest functional set released in IEEE-1800 (2012) L...

  2. Diasporic Authenticity Assertions: Analysis of Amy Tan’s The Bonesetter’s Daughter

    Directory of Open Access Journals (Sweden)

    Naeimeh Tabatabaei Lotfi

    2015-07-01

    Full Text Available This essay is an attempt to examine the active interaction of history and memory, in formulation of a diasporic authentic picture of past, in Amy Tan’s The Bonesetter’s Daughter (2001. Amongst discursive disciplines, memory and history perform vitally, in picturing past; both attempt to reproduce events, by emblematic narrative acts. However, their erratic quality endorses the existence of counter- stories that endangers displaying a homogeneous past. Among miscellaneous categories of memories, autobiographical memory asserts to obtain an authentic presentation, but as any other forms of accounts, it exhibits an imprecise fictional image. This psychological alleviation ensures the future mental integrity of trauma victims. In memory narratives, the contingent temperament of power network and continual formulation of resisting frameworks might be explored. Tan’s diasporic assertion of authenticity, as a migrant writer, amalgamated with employment of fantasy is to obtain a shared diasporic identity, among her characters, although personal accounts of characters undergo an extensive amount of contingency. The newly forged identity is collective in nature and defies the geographical and temporal borders and grants a humane picture rather than a diasporic one; an identity that is established to venerate the cardinal role of personal memory, in endowing legitimate truth.

  3. Co-occurring Disordered Gambling Among Treatment-Seekers at a Community Outpatient Addiction Clinic.

    Science.gov (United States)

    Elman, Igor; Borodovsky, Jacob; Howard, Margaret; Scoglio, Arielle; Steinkamp, Jackson; Sobieszczyk, Amy; Mysels, David; Albanese, Mark

    2016-01-01

    Parallel to the ongoing expansion of legalized gambling activities is a growing concern about rising occurrence of uncontrollable gambling. People with preexisting gambling and/or chemical addictions may be particularly vulnerable, but the extent of such co-occurring conditions and their demographic and clinical characteristics have not been sufficiently elucidated. To that end, the present study attempted to both, quantify the presence and to characterize co-occurring pathological or problem gambling (ie, respectively, at least 1- or at least 5 pathological gambling criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) among treatment-seeking patients at a community outpatient addiction program. The patients were assessed with the South Oaks Gambling Screen and their charts were reviewed for the extraction of demographic and clinical information according to a predetermined template. Data from 183 subjects withstood quality control procedures and were included. The prevalence rates of co-occurring problem- (18.6%) and pathological (10.9%) gambling were strikingly higher than those found in the general population (2% and 0.5%, respectively). No increase in the clinical severity indices was observed across the gambling groups. Our data replicate those of prior studies reporting heightened prevalence of problematic gambling in patients with substance use disorders and extend the prior findings by including a subject population of treatment-seekers. In the era of the gambling industry growth, these results call for creation and/or adjustment of clinical addiction services to meet emerging preventive and therapeutic needs.

  4. Assessment of periodontal status among dental fluorosis subjects using community periodontal index of treatment needs.

    Science.gov (United States)

    Kumar, Pradeep R; John, Joseph

    2011-01-01

    To determine the periodontal status and treatment needs among dental fluorosis subjects residing in Ennore, Chennai, using Community Periodontal Index of Treatment Needs (CPITN). All the subjects with dental fluorosis above 15 years of age, permanent residents of Ennore, were included in the study. Subjects with known systemic diseases and subjects with other intrinsic dental stains were excluded from the study. Periodontal status was estimated using CPITN and Dental fluorosis was recorded using Dean's Dental Fluorosis Index. The total number of study subjects was 1075, of which 489 were males and 586 were females. Males were predominantly affected with periodontal disease than females. This was found to be statistically significant (P=0.000). The association between Degree of Fluorosis and Periodontal Status is statistically significant (P=0.000). There was statistically significant difference in mean number of sextants between the degree of fluorosis in each of the periodontal status (P=0.000). The finding that the lower prevalence of shallow pockets in the study area, where the fluoride level in the drinking water ranges from 1.83 to 2.01 ppm, indicates that the use of fluoride in water is beneficial to the periodontal tissues.

  5. African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in Philadelphia, Pennsylvania.

    Science.gov (United States)

    Nunn, Amy; Sanders, Julia; Carson, Lee; Thomas, Gladys; Cornwall, Alexandra; Towey, Caitlin; Lee, Hwajin; Tasco, Marian; Shabazz-El, Waheedah; Yolken, Annajane; Smith, Tyrone; Bell, Gary; Feller, Sophie; Smith, Erin; James, George; Shelton Dunston, Brenda; Green, Derek

    2015-01-01

    African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change. © 2014 Society for Public Health Education.

  6. 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

  7. Biofilms in bioremediation and wastewater treatment: characterization of bacterial community structure and diversity during seasons in municipal wastewater treatment process.

    Science.gov (United States)

    Yousra Turki; Mehri, Ines; Lajnef, Rim; Rejab, Asma Ben; Khessairi, Amel; Cherif, Hanene; Ouzari, Hadda; Hassen, Abdennaceur

    2017-02-01

    The bacterial community structure and diversity were assessed at the scale of rotating biodisk procedure (RB) in a semi-industrial pilot plant. As well, the Salmonella community was particularly monitored, and the effects of ultraviolet (UV-C254) on the bacterial community were studied. The identification of dominant bacteria revealed the presence of beneficial and useful species that could play an important role in the process of wastewater purification. Several species as Enterobacter agglomerans, Cronobacter sakazakii, and Pantoea agglomerans known for their bioremediation activities were revealed in the majority of biofilm samples. Common detection of Salmonella community provides evidence that the RB system did not seriously affect Salmonella. Furthermore, the investigation on the (UV)-C254 inactivation of the whole bacterial community, in secondary treated wastewater, showed variable UV resistance results. No Salmonella detection was registered at a dose of around 1440 mW s cm-2 since a total disappearance of Salmonella was recorded.

  8. 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 (pwater 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 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.

  9. 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.

  10. Long term impact of large scale community-directed delivery of doxycycline for the treatment of onchocerciasis

    Directory of Open Access Journals (Sweden)

    Tamarozzi Francesca

    2012-03-01

    Full Text Available Abstract Background Anti-Wolbachia treatment with doxycycline is effective in sterilising and killing adult Onchocerca volvulus nematodes, proving superior to ivermectin and of great potential as an alternative approach for the treatment and control of onchocerciasis, particularly in areas of Loa loa co-endemicity. Nevertheless, the length of the required treatment poses potential logistical problems and risk of poor compliance, raising a barrier to the use of doxycycline in Mass Drug Administration (MDA strategies. In 2007 and 2008 a feasibility trial of community-directed treatment with doxycycline was carried out in two health districts in Cameroon, co-endemic for O. volvulus and L. loa. With 17,519 eligible subjects, the therapeutic coverage was 73.8% with 97.5% compliance, encouraging the feasibility of using doxycycline community-directed delivery in restricted populations of this size. The current study evaluated the effectiveness of this community-directed delivery of doxycycline four years after delivery. Findings Infection with O. volvulus was evaluated by skin biopsy and nodule palpation. Of the 507 subjects recruited, 375 had completed the treatment with doxycycline followed by one or two rounds of annual ivermectin MDA and 132 received one or two rounds of annual ivermectin MDA alone. Statistically significant lower microfilarial prevalence (17.0% [doxycycline plus ivermectin group], 27.0% [ivermectin only group], p = 0.014 and load (p = 0.012 were found in people that had received doxycycline followed by ivermectin compared to those who received ivermectin only. Conclusions This study demonstrates the long-term effectiveness of doxycycline treatment delivered with a community-directed strategy even when evaluated four years after delivery in an area of ongoing transmission. This finding shows that a multi-week course of treatment is not a barrier to community-delivery of MDA in restricted populations of this size and supports its

  11. Psychopathological symptoms of patients with heroin addiction entering opioid agonist or therapeutic community treatment.

    Science.gov (United States)

    Pani, Pier Paolo; Trogu, Emanuela; Vigna-Taglianti, Federica; Mathis, Federica; Diecidue, Roberto; Kirchmayer, Ursula; Amato, Laura; Davoli, Marina; Ghibaudi, Joli; Camposeragna, Antonella; Saponaro, Alessio; Faggiano, Fabrizio; Maremmani, Angelo Giovanni Icro; Maremmani, Icro

    2014-01-01

    The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychopathological profiles of patients entering a TC versus an OAT treatment and at the correlation between gender and the observed psychopathology. A confirmatory factor analysis was performed on the results of SCL-90 filled by 1,195 patients with heroin dependence entering TC treatment. It replicates the extraction method previously used on 1,055 OAT patients with heroin addiction by using a principal component factor analysis (PCA). The association between the kind of treatment received (TC or OAT), gender, and the psychopathological dimensions was assessed through logistic regression and general linear model (GLM) analysis. The PCA carried out on the SCL-90 results of patients entering a TC yielded a five-factor solution, confirming the same dimensions observed in patients entering an OAT: 'worthlessness and being trapped', 'somatization', 'sensitivity-psychoticism', 'panic anxiety', and 'violence-suicide'. The logistic regression analysis showed a statistically significant association between 'somatization' and 'violence-suicide' severity score and OAT. GLM analysis showed that psychopathological factorial scores for 'worthlessness-being trapped', 'somatic symptoms', and 'panic anxiety' dimensions were more severe in OAT vs TC male patients and in TC vs OAT female ones. 'Violence suicide' followed the same severity pattern for males, but did not differ in TC vs OAT females, while 'sensitivity-psychoticism' did not differ in OAT vs TC patients. The five dimensions did not differ in OAT

  12. Quality of life improves in children and adolescents during a community-based overweight and obesity treatment.

    Science.gov (United States)

    Mollerup, Pernille M; Nielsen, Tenna R H; Bøjsøe, Christine; Kloppenborg, Julie T; Baker, Jennifer L; Holm, Jens-Christian

    2017-06-01

    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. 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). Upon entry, 477 children (212 boys) completed a PedsQL, and 317 (143 boys) completed another PedsQL after a median of 13 months of treatment. Quality of life improved (p children and adolescents with low socioeconomic status or who increased their BMI SDS (p children and adolescents during a community-based overweight and obesity treatment, even in children and adolescents who increased their BMI SDS. Thus, improvements may be due to the treatment itself and not exclusively to reductions in BMI SDS. Clinicaltrials.gov, ID-no.: NCT02013843.

  13. Characterization of Microbial Communities in Coal Mine Drainage Treatment Systems With Elevated Manganese

    Science.gov (United States)

    Tan, H.; Zhang, G.; Burgos, W.

    2007-12-01

    Sediment samples were collected from two coal mine drainage treatment sites in western Pennsylvania. Both of the sites use constructed limestone beds to passively treat acidic coal mine drainage containing elevated manganese (Mn). Site #1 has influent manganese of 150 mg/L and effluent manganese between 40-100 mg/L. Site #2 has influent manganese of 20 mg/L and effluent manganese of less than 0.5 mg/L. Large quantities of black crusts were deposited throughout the beds at both sites. X-ray diffraction showed these crusts constituted of buserite, which is a layered structure manganese oxide mineral. Both culture-dependent and nucleic acid- based techniques were used to characterize the bacterial and fungal communities in these beds. 16S rRNA gene analysis showed that bacterial communities were very diverse and included Cyanobacter, Proteobacteria, Bacteroidete, Planctomyceta, Acidobacter, Actinobacter and Gemmatimonade taxa. The archaeal diversity was lower and most sequences were related to uncultivated species. Two Mn-oxidizing fungi strains were isolated from one of the sites. One of the fungi is capable of oxidizing Mn(II) at both low and netural pH (3-7) while the other fungi can only oxidze Mn(II) at circumneutral pH. 18S rRNA gene analysis showed the low pH Mn-oxidizing fungus was closely related to Menispora tortuosa, Chaetosphaeria curvispora and Kionochaeta spissa, and the circumneutral Mn-oxidizing fungus was closely related to Myrothecium verrucaria, Didymostilbe echinofibrosa and Myrothecium roridum.

  14. Adherence to treatment: practice, education and research in Danish community pharmacy

    Directory of Open Access Journals (Sweden)

    Herborg H

    2009-12-01

    Full Text Available Objective: To describe the practice, education and research concerning medication adherence in Danish community pharmacy. Methods: The authors supplemented their expertise in the area of medication adherence through their contacts with other educators and researchers as well as by conducting searches in the Danish Pharmacy Practice Evidence Database, which provides annually updated literature reviews on intervention research in Danish pharmacy practice.Results: Practice: Medication adherence is the focus of and/or is supported by a large number of services and initiatives used in pharmacy practice such as governmental funding, IT-supported medicine administration systems, dose-dispensing systems, theme years in pharmacies on adherence and concordance, standards for counselling at the counter, pharmacist counselling, medication reviews and inhaler technique assessment. Education: In Denmark, pharmacy and pharmaconomist students are extensively trained in the theory and practice of adherence to therapy.Pharmacy staff can choose from a variety of continuing education and post-graduate programmes which address patient adherence. Research: Nine ongoing and recently completed studies are described. Early research in Denmark comprised primarily smaller, qualitative studies centred on user perspectives, whereas later research has shifted the focus towards larger, quantitative, controlled studies and action-oriented studies focusing on patient groups with chronic diseases (such as diabetes, asthma, coronary vascular diseases.Conclusions: Our analysis has documented that Danish pharmaceutical education and research has focused strongly on adherence to treatment for more than three decades. Adherence initiatives in Danish community pharmacies have developed substantially in the past 5-10 years, and, as pharmacies have prioritised their role in health care and patient safety, this development can be expected to continue in future years.

  15. Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia

    DEFF Research Database (Denmark)

    Escribano Ferrer, Blanca; Hansen, Kristian Schultz; Gyapong, Margaret

    2017-01-01

    Background: Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study wa...

  16. 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...

  17. 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.

  18. 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.

  19. Characterization of wastewater treatment plant microbial communities and the effects of carbon sources on diversity in laboratory models.

    Directory of Open Access Journals (Sweden)

    Sangwon Lee

    Full Text Available We are developing a laboratory-scale model to improve our understanding and capacity to assess the biological risks of genetically engineered bacteria and their genetic elements in the natural environment. Our hypothetical scenario concerns an industrial bioreactor failure resulting in the introduction of genetically engineered bacteria to a downstream municipal wastewater treatment plant (MWWTP. As the first step towards developing a model for this scenario, we sampled microbial communities from the aeration basin of a MWWTP at three seasonal time points. Having established a baseline for community composition, we investigated how the community changed when propagated in the laboratory, including cell culture media conditions that could provide selective pressure in future studies. Specifically, using PhyloChip 16S-rRNA-gene targeting microarrays, we compared the compositions of sampled communities to those of inocula propagated in the laboratory in simulated wastewater conditionally amended with various carbon sources (glucose, chloroacetate, D-threonine or the ionic liquid 1-ethyl-3-methylimidazolium chloride ([C2mim]Cl. Proteobacteria, Bacteroidetes, and Actinobacteria were predominant in both aeration basin and laboratory-cultured communities. Laboratory-cultured communities were enriched in γ-Proteobacteria. Enterobacteriaceae, and Aeromonadaceae were enriched by glucose, Pseudomonadaceae by chloroacetate and D-threonine, and Burkholderiacea by high (50 mM concentrations of chloroacetate. Microbial communities cultured with chloroacetate and D-threonine were more similar to sampled field communities than those cultured with glucose or [C2mim]Cl. Although observed relative richness in operational taxonomic units (OTUs was lower for laboratory cultures than for field communities, both flask and reactor systems supported phylogenetically diverse communities. These results importantly provide a foundation for laboratory models of industrial

  20. Characterization of wastewater treatment plant microbial communities and the effects of carbon sources on diversity in laboratory models.

    Science.gov (United States)

    Lee, Sangwon; Geller, Jil T; Torok, Tamas; Wu, Cindy H; Singer, Mary; Reid, Francine C; Tarjan, Daniel R; Hazen, Terry C; Arkin, Adam P; Hillson, Nathan J

    2014-01-01

    We are developing a laboratory-scale model to improve our understanding and capacity to assess the biological risks of genetically engineered bacteria and their genetic elements in the natural environment. Our hypothetical scenario concerns an industrial bioreactor failure resulting in the introduction of genetically engineered bacteria to a downstream municipal wastewater treatment plant (MWWTP). As the first step towards developing a model for this scenario, we sampled microbial communities from the aeration basin of a MWWTP at three seasonal time points. Having established a baseline for community composition, we investigated how the community changed when propagated in the laboratory, including cell culture media conditions that could provide selective pressure in future studies. Specifically, using PhyloChip 16S-rRNA-gene targeting microarrays, we compared the compositions of sampled communities to those of inocula propagated in the laboratory in simulated wastewater conditionally amended with various carbon sources (glucose, chloroacetate, D-threonine) or the ionic liquid 1-ethyl-3-methylimidazolium chloride ([C2mim]Cl). Proteobacteria, Bacteroidetes, and Actinobacteria were predominant in both aeration basin and laboratory-cultured communities. Laboratory-cultured communities were enriched in γ-Proteobacteria. Enterobacteriaceae, and Aeromonadaceae were enriched by glucose, Pseudomonadaceae by chloroacetate and D-threonine, and Burkholderiacea by high (50 mM) concentrations of chloroacetate. Microbial communities cultured with chloroacetate and D-threonine were more similar to sampled field communities than those cultured with glucose or [C2mim]Cl. Although observed relative richness in operational taxonomic units (OTUs) was lower for laboratory cultures than for field communities, both flask and reactor systems supported phylogenetically diverse communities. These results importantly provide a foundation for laboratory models of industrial bioreactor

  1. Effect of cerium dioxide, titanium dioxide, silver, and gold nanoparticles on the activity of microbial communities intended in wastewater treatment

    OpenAIRE

    García, Ana

    2012-01-01

    Financial support was provided by the Spanish Ministerio de Medio Ambiente y Medio Rural y Marino (Project Exp. 007/RN08/03.1). Growth in production and use of nanoparticles (NPs) will result increased concentrations of these in industrial and urban wastewaters and, consequently, in wastewater-treatment facilities. The effect of this increase on the performance of the wastewater-treatment process has not been studied systematically and including all the microbial communities involved in wa...

  2. Spatiotemporal changes in bacterial community and microbial activity in a full-scale drinking water treatment plant.

    Science.gov (United States)

    Hou, Luanfeng; Zhou, Qin; Wu, Qingping; Gu, Qihui; Sun, Ming; Zhang, Jumei

    2017-12-29

    To gain insight into the bacterial dynamics present in drinking water treatment (DWT) systems, the microbial community and activity in a full-scale DWT plant (DWTP) in Guangzhou, South China, were investigated using Illumina Hiseq sequencing analyses combined with cultivation-based techniques during the wet and dry seasons. Illumina sequencing analysis of 16S rRNA genes revealed a large shift in the proportion of Actinobacteria, Proteobacteria and Firmicutes during the treatment process, with the proportion of Actinobacteria decreased sharply, whereas that of Proteobacteria and Firmicutes increased and predominated in treated water. Both microbial activity and bacterial diversity during the treatment process showed obvious spatial variation, with higher levels observed during the dry season and lower levels during the wet season. Clustering analysis and principal component analysis indicated dramatic shifts in the bacterial community after chlorination, suggesting that chlorination was highly effective at influencing the bacterial community. The bacterial community structure of finished water primarily comprised Pseudomonas, Citrobacter, and Acinetobacter, and interestingly showed high similarity to biofilms on granular activated carbon. Additionally, the abundance of bacterial communities was relatively stable in finished water and did not change with the season. A large number of unique operational taxonomic units were shared during treatment steps, indicating the presence of a diverse core microbiome throughout the treatment process. Opportunistic pathogens, including Pseudomonas, Acinetobacter, Citrobacter, Mycobacterium, Salmonella, Staphylococcus, Legionella, Streptococcus and Enterococcus, were detected in water including finished water, suggesting a potential threat to drinking-water safety. We also detected bacteria isolated from each treatment step using the pure-culture method. In particular, two isolates, identified as Mycobacterium sp. and Blastococcus

  3. 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.

  4. COMMUNITY IN SOUTH-EAST GHANA

    African Journals Online (AJOL)

    gest that there might be some sort of endemicity of cleft lip/palate in the community. A clue to this assertion is the regular night mar- ket within the cluster of villages which does not exist elsewhere in the region. There must there- fore be some special reason why this system of night business exists in this small community.

  5. Healthy Tribal Colleges Create Healthy Communities.

    Science.gov (United States)

    Demarest, Donna

    1999-01-01

    Asserts that tribal colleges play a pivotal role in both the cultural resilience and in addressing the health problems of a tribal community. Relates Oglala Lakota College (South Dakota) Department of Nursing's leadership role in the development of community resources and identification of private and federal sources of funding. (VWC)

  6. 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…

  7. Community-based facilities may be replacing hospitals for the treatment of alcoholism: the evidence from Ontario.

    Science.gov (United States)

    Adrian, M; Ogborne, A C; Rankin, J G; Ferguson, B S; Jull, P

    1994-11-01

    We examined hospital utilization and use of community facilities for the treatment of alcohol problems in Ontario using Statistics Canada, Hospital Medical Records Institute records, and other administrative records. Between 1974 and 1986 there was a large drop in utilization of hospital services for treatment of alcohol problems. Rates of alcohol inpatient cases in general hospitals dropped by 47% and in mental hospitals by 33%. At the same time, there was an increase in overall availability of hospital beds and bed-days of care for all medical conditions, and no change in the total number of hospital discharges (1.3 million) and occupancy rates (80-85%). Also at the same time, the number of community-based programs for the treatment of alcohol problems increased, as did the number of persons or cases treated by them. This was associated with a drop of inpatient cases treated for alcohol problems in 38 out of 48 counties in Ontario (P take into account the effect of the slight decline in overall alcohol consumption in this period. We found that after controlling for changes in alcohol consumption, the addition of one community-based alcohol treatment program was associated with a reduction in the number of cases treated on a hospital inpatient basis for alcohol-related problems, with a short-run drop of 27.1 hospital cases within 1 year of a community facility's availability and a long-run reduction of 52.2 cases. (P < .005).

  8. 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…

  9. Individualized treatment strategies in community-acquired pneumonia : from initial inflammatory response to long-term prognosis

    NARCIS (Netherlands)

    Bruns, A.H.W.

    2010-01-01

    Community-acquired pneumonia (CAP) is one of the most important causes of hospital admissions and together with influenza the third leading cause of death worldwide. Moreover, treatment of CAP largely contributes to the global burden of antibiotic resistance. In present thesis, we explored options

  10. Population dynamics of iron-oxidizing communities in pilot plants for the treatment of acid mine waters

    Energy Technology Data Exchange (ETDEWEB)

    Elke Heinzel; Eberhard Janneck; Franz Glombitza; Michael Schlmann; Jana Seifert [TU Bergakademie Freiberg, Freiberg (Germany). Interdisciplinary Ecological Center

    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. 32 refs., 4 figs. 1 tab.

  11. 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.

  12. 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 Fe3+ (5.6 mg L-1), iron powder (2.8 mg L-1), and CaCO3 powder (0.2 mg L-1) in influent as the adjusting agents, initial phosphorus source (PO43-) 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 CaCO3 promoted the physicochemical precipitation in contaminant removal. Meanwhile, Fe3+ and iron powder produced Fe2+, 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.

  13. 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

  14. Microfauna community during pulp and paper wastewater treatment in a UNOX system.

    Science.gov (United States)

    Bernat, Katarzyna; Kulikowska, Dorota; Drzewicki, Adam

    2017-04-01

    This study characterized the microfauna community during treatment of pulp and paper wastewater in a UNOX system aerated with pure oxygen, and with a high organic loading rate (0.4±0.06kg BOD/kg MLSSday), low sludge retention time (3.73±0.33 day), and high oxygen concentration (≤20mg O2/L) in comparison to municipal treatment systems. In the aeration tank, temperatures were high, averaging 35.7°C (March-May), then 38.9°C (June-August). Effluent quality was acceptable: 180±22mg COD/L, 7.2±2.1mg BOD5/L, and 33±5mg TSS/L. At 35.7°C, 5 taxa were identified in the activated sludge: small flagellates (flagellates <20μm), attached ciliates (Vorticella infusionum, Vorticella octava), crawling ciliates (Chilodonella uncinata) and free-swimming ciliates (Sathrophilus muscorum). During this period, the SBI (Sludge Biotic Index) was 6-7, corresponding to Quality Class II. At 38.9°C, two taxa co-dominated (Vorticella infusionum, Sathrophilus muscorum). When Vorticella infusionum dominated, the SBI was 5 or 7 (Quality Class III/II); when Sathrophilus muscorum dominated, the SBI was 0 (Quality Class IV). Slight changes in the abundance of two opposing Madoni keygroups impeded proper classification of activated sludge. However, effluent quality remained the same, showing that these indicators of activated sludge quality do not always reflect effluent quality. Copyright © 2017 Elsevier GmbH. All rights reserved.

  15. Evaluating the effect of self-awareness and communication techniques on nurses' assertiveness and self-esteem.

    Science.gov (United States)

    Unal, Sati

    2012-12-01

    The effect of a course on self-awareness and communication techniques on nursing students' assertiveness and self-esteem was examined. The Rathus Assertiveness Schedule and Coopersmith Self-Esteem Inventory were used to measure assertiveness and self-esteem in second-year students in an undergraduate nursing school. Seventy-nine students completed the course. The study was designed as a pre-test and post-test study. A significant difference between assertiveness and self-esteem scores of students in pre-test and post-test measurements was found. There was a positive relationship between assertiveness and self-esteem. The course lasted 14 weeks for a total of 3 h per week. The teaching methods focused mostly on active student participation, demonstration, role play, experience and experience sharing, homework, constructive feedback, and watching films. These educational approaches should be evaluated in future studies and adopted in the curriculum. This study provides a basis for the development of learner-centred teaching methods.

  16. Women’s Condom Use Assertiveness and Sexual Risk-Taking: Effects of Alcohol Intoxication and Adult Victimization

    Science.gov (United States)

    Norris, Jeanette; George, William H.; Morrison, Diane M.; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M.

    2008-01-01

    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. PMID:18556139

  17. Verification of Correspondence Assertions in a Calculus for Mobile Ad Hoc Networks

    DEFF Research Database (Denmark)

    Hüttel, Hans; Kühnrich, Morten; Godskesen, Jens Christian

    2009-01-01

    We introduce a novel process calculus called DBSPI (distributed broadcast SPI-calculus) which models mobile ad hoc networks (MANET). The calculus is a cryptographic broadcast calculus with locations and migration. Communication and migration are limited to neighborhoods. Neighborhood definitions...... are explicitly part of the syntax allowing dynamic extension using bound identifiers. In this semantic setting we study authentication of agents in MANET protocols. A safety property dealing with authentication correspondence assertions is defined. Later a dependent type and effect system is given...... and it is shown to be sound, i.e. protocols which are typeable are also safe. This result is lifted to open systems which involves Dolev-Yao attackers. Our Dolev-Yao attacker may use public keys for encryption and can attack any neighborhood it wishes. Our technique is applied to the Mobile IP registration...

  18. Einstein's Equations for Spin $2$ Mass $0$ from Noether's Converse Hilbertian Assertion

    CERN Document Server

    Pitts, J Brian

    2016-01-01

    An overlap between the general relativist and particle physicist views of Einstein gravity is uncovered. Noether's 1918 paper developed Hilbert's and Klein's reflections on the conservation laws. Energy-momentum is just a term proportional to the field equations and a 'curl' term with identically zero divergence. Noether proved a \\emph{converse} "Hilbertian assertion": such "improper" conservation laws imply a generally covariant action. Later and independently, particle physicists derived the nonlinear Einstein equations assuming the absence of negative-energy degrees of freedom ("ghosts") for stability, along with universal coupling: all energy-momentum including gravity's serves as a source for gravity. Those assumptions (all but) imply (for 0 graviton mass) that the energy-momentum is only a term proportional to the field equations and a symmetric "curl," which implies the coalescence of the flat background geometry and the gravitational potential into an effective curved geometry. The flat metric, though...

  19. [Assertiveness and peripheral intravenous catheters dwell time with ultrasonography-guided insertion in children and adolescents].

    Science.gov (United States)

    Avelar, Ariane Ferreira Machado; Peterlini, Maria Angélica Sorgini; da Pedreira, Mavilde Luz Gonçalves

    2013-06-01

    Randomized controlled trial which aimed to verify whether the use of vascular ultrasound (VUS) increases assertiveness in the use of peripheral venous catheter in children, and the catheter dwell time, when compared to traditional puncture. Data were collected after approval of theethical merit. Children and adolescents undergoing VUS-guided peripheral intravenous (GVUS) or puncture guided by clinical assessment of the venous conditions(CG) were included in the study. Significance level was set at pdwell time presented a median of less than one day in both groups (p=0.121), showing nostatistically significant difference. VUS did not significantly influence the results of the dependent variables investigated. ClinicalTrials.govNCT00930254.

  20. Pet ownership as a meaningful community occupation for people with serious mental illness.

    Science.gov (United States)

    Zimolag, Ulrike; Krupa, Terry

    2009-01-01

    We determined the proportion of pet owners and non-pet owners with serious mental illness, compared their characteristics and their motivations for owning or not owning a pet, and examined the relationship between pet ownership and engagement in meaningful activity and three dimensions of community integration. Three Assertive Community Treatment (ACT) teams reported on the pet ownership of all service recipients (N = 204). Of these recipients, 60 completed a survey. Nonparametric tests were selected for data analysis. Of 204 ACT clients, 38 (18.6%) were pet owners. Twenty-tour (63.2%) of 38 responding non-pet owners desired to live with a pet. There were significant differences between groups on diagnosis, gender, a global measure of function, meaningful activity, and psychological integration. The key finding supports the hypothesis that pet owners with serious mental illness living in the community demonstrate higher social community integration. Implications for future research and practice are discussed.

  1. 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.

  2. Interactive Effect of Parent and Adolescent Psychiatric Symptoms on Substance Use among Adolescents in Community Treatment.

    Science.gov (United States)

    Kelly, Lourah M; Becker, Sara J; Wolff, Jennifer C; Graves, Hannah; Spirito, Anthony

    2017-05-01

    Both adolescent and parent psychiatric symptoms are well-established risk factors for adolescent substance use (SU), but the ways that these symptoms interact are not well understood. This study examined the interactive effects of parent and adolescent psychiatric symptoms on adolescent frequency of alcohol and marijuana use, over and above the effects of parental SU. Seventy adolescents presenting to a community mental health center (CMHC) participated. Parent and adolescent psychiatric symptoms were measured with the brief symptom inventory (BSI) and child behavior checklist (CBCL), respectively. Hierarchical regressions revealed different patterns for adolescent alcohol and marijuana use. For alcohol, the BSI parent phobic anxiety subscale predicted increased adolescent use while the parent interpersonal sensitivity subscale predicted decreased use: the effects of these parental symptoms were strongest among adolescents with higher levels of externalizing problems on the CBCL. For marijuana, the BSI parent psychoticism subscale predicted increased adolescent use, whereas paranoid ideation predicted decreased use. Results suggest that adolescent SU treatment and assessment should attend to both adolescent and parent psychiatric symptoms.

  3. 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.

  4. Ageism, Aging and HIV: Community Responses to Prevention, Treatment, Care and Support.

    Science.gov (United States)

    DeMarco, Rosanna F; Brennan-Ing, Mark; Sprague, Courtenay; Brown, Shelley M

    Ageism, in the form of prejudice, stereotyping, and discrimination targeting older adults, represents a barrier to addressing the graying of the HIV epidemic. There is widespread misperception on the part of older adults themselves, as well as service providers and society in general that HIV risk is low as one ages. In addition, internalized ageism may play a role in poorer physical and mental health outcomes, as the negative stereotypes associated with aging become a self-fulfilling prophecy. A number of steps can be taken to address HIV and aging in the context of ageism with regard to: prevention, education, and outreach; treatment guidelines for older adults with HIV; funding to address the aging of the epidemic; engagement of communities, health and social service organizations, and other providers around mental health and social support, and addressing the needs of special populations. Caring for an aging population with HIV represents a challenge, which is exacerbated in low and/or middle-income countries that typically lack the infrastructure of high resource settings. How we address the aging-related issues of the HIV epidemic across regions and settings could serve as a model in dealing with aging in our society in general regardless of HIV status. © 2017 S. Karger AG, Basel.

  5. 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

  6. Bacterial community analysis of anoxic/aeration (A/O system in a combined process for gibberellin wastewater treatment.

    Directory of Open Access Journals (Sweden)

    Erming Ouyang

    Full Text Available Gibberellin wastewater cannot be directly discharged without treatment due to its high concentrations of sulfate and organic compounds and strong acidity. Therefore, multi-stage anaerobic bioreactor + micro-aerobic+ anoxic/aeration (A/O + biological contact oxidation combined processes are used to treat gibberellin wastewater. However, knowledge of the treatment effects of the A/O process and bacterial community structure in the aeration tank reactors of such systems is sparse. Therefore, this study was conducted to investigate the treatment effects and operation of the A/O process on gibberellin wastewater, as well as changes in the bacterial community structure of activated sludge in the aeration tank during treatment. Moreover, removal was examined based on evaluation of effluent after A/O treatment. Although influent chemical oxygen demand (COD, NH3-N and total phosphorus (TP fluctuated, effluent COD, NH3-N and TP remained stable. Moreover, average COD, NH3-N and TP removal efficiency were 68.41%, 93.67% and 45.82%, respectively, during the A/O process. At the phylum level, Proteobacteria was the dominant phylum in all samples, followed by Chloroflexi, Bacteroidetes and Actinobacteria. Proteobacteria played an important role in the removal of organic matter. Chloroflexi was found to be responsible for the degradation of carbohydrates and Bacteroidetes also had been found to be responsible for the degradation of complex organic matters. Actinobacteria are able to degrade a variety of environmental chemicals. Additionally, Anaerolineaceae_uncultured was the major genus in samples collected on May 25, 2015, while Novosphingobium and Nitrospira were dominant in most samples. Nitrosomonas are regarded as the dominant ammonia-oxidizing bacteria, while Nitrospira are the main nitrite-oxidizing bacteria. Bacterial community structure varied considerably with time, and a partial Mantel test showed a highly significant positive correlation between

  7. Bacterial community analysis of anoxic/aeration (A/O) system in a combined process for gibberellin wastewater treatment.

    Science.gov (United States)

    Ouyang, Erming; Lu, Yao; Ouyang, Jiating; Wang, Lele; Wang, Xiaohui

    2017-01-01

    Gibberellin wastewater cannot be directly discharged without treatment due to its high concentrations of sulfate and organic compounds and strong acidity. Therefore, multi-stage anaerobic bioreactor + micro-aerobic+ anoxic/aeration (A/O) + biological contact oxidation combined processes are used to treat gibberellin wastewater. However, knowledge of the treatment effects of the A/O process and bacterial community structure in the aeration tank reactors of such systems is sparse. Therefore, this study was conducted to investigate the treatment effects and operation of the A/O process on gibberellin wastewater, as well as changes in the bacterial community structure of activated sludge in the aeration tank during treatment. Moreover, removal was examined based on evaluation of effluent after A/O treatment. Although influent chemical oxygen demand (COD), NH3-N and total phosphorus (TP) fluctuated, effluent COD, NH3-N and TP remained stable. Moreover, average COD, NH3-N and TP removal efficiency were 68.41%, 93.67% and 45.82%, respectively, during the A/O process. At the phylum level, Proteobacteria was the dominant phylum in all samples, followed by Chloroflexi, Bacteroidetes and Actinobacteria. Proteobacteria played an important role in the removal of organic matter. Chloroflexi was found to be responsible for the degradation of carbohydrates and Bacteroidetes also had been found to be responsible for the degradation of complex organic matters. Actinobacteria are able to degrade a variety of environmental chemicals. Additionally, Anaerolineaceae_uncultured was the major genus in samples collected on May 25, 2015, while Novosphingobium and Nitrospira were dominant in most samples. Nitrosomonas are regarded as the dominant ammonia-oxidizing bacteria, while Nitrospira are the main nitrite-oxidizing bacteria. Bacterial community structure varied considerably with time, and a partial Mantel test showed a highly significant positive correlation between bacterial community

  8. 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

  9. A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.

    Science.gov (United States)

    Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

    2017-01-01

    Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. 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. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3-18), and the median BMI SDS was 2.85 (range: 1.26-8.96) in boys and 2.48 (range: 1.08-4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30-0.45, p0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7-4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0-6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. 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.

  10. Treatment of Individuals with Borderline Personality Disorder Using Dialectical Behavior Therapy in a Community Mental Health Setting: Clinical Application and a Preliminary Investigation

    Science.gov (United States)

    Ben-Porath, Denise D.; Peterson, Gregory A.; Smee, Jacqueline

    2004-01-01

    This article describes an effort to implement and examine dialectical behavior therapy's (DBT) effectiveness in a community mental health setting. Modifications made to address unique aspects of community mental health settings are described. Barriers encountered in implementation of DBT treatment in community mental health settings, such as staff…

  11. Microwave and ultrasound pre-treatments influence microbial community structure and digester performance in anaerobic digestion of waste activated sludge.

    Science.gov (United States)

    Westerholm, Maria; Crauwels, Sam; Van Geel, Maarten; Dewil, Raf; Lievens, Bart; Appels, Lise

    2016-06-01

    Comparative analyses of bacterial and archaeal community structures and dynamics in three biogas digesters during start-up and subsequent operation using microwaved, ultrasonicated or untreated waste activated sludge were performed based on 454 pyrosequencing datasets of part of 16S ribosomal RNA sequences and quantitative PCR. The pre-treatment increased the solubility, and thus the availability of the substrate for microbial degradation and significantly affected the succession of the anaerobic community structure over the course of the digestion. Bacteroidetes, Proteobacteria and Firmicutes were the dominant phyla in all digesters throughout operation. Proteobacteria decreased in relative abundance from 23-26 % to 11-13 % in association with enhanced substrate availability. Negative correlations between relative abundance of Alpha-, Beta- and Gammaproteobacteria and the substrate availability and/or biogas production were disclosed in statistical analyses. Clostridiales was the dominant order in Firmicutes, and Clostridiales, Clostridia and Firmicutes relative abundance and richness were shown to positively correlate with substrate availability and biogas generation. Methanogenic communities had a fairly restricted structure, highly dominated by Methanosaeta and Methanobrevibacter phylotypes. A gradual decline in Methanobrevibacter and increased representation of Methanosaeta concilii over time were particularly apparent in the digester receiving untreated waste activated sludge, whereas more diversified archaeal communities were maintained in the pre-treatment digesters. The quantitative PCR analyses revealed a methanogenic community distribution that coincided with the 454 pyrosequencing data.

  12. Association of race and age with treatment attendance and completion among adult marijuana users in community-based substance abuse treatment.

    Science.gov (United States)

    Peters, Erica N; Hendricks, Peter S; Clark, C Brendan; Vocci, Frank J; Cropsey, Karen L

    2014-01-01

    African American youth who use marijuana are less likely to attend and complete treatment than white youth. Limited information is available on racial and age variation in treatment attendance and completion among adults who use marijuana. The current research examined differences in community-based substance abuse treatment attendance and completion between adult African American and white marijuana users in 2 independent samples from the US southeastern (N = 160; 70.6% African American) and mid-Atlantic (N = 450; 34.7% African American) regions. Attended at least 3 treatment sessions, successful treatment completion, number of days in treatment, and percentage of positive urine drug screens. Adjusted regression models examined the association of race, age, and the interaction of race and age with treatment attendance and completion. In the southeastern sample, successful treatment completion was significantly associated with the interaction of race and age (adjusted odds ratio = 1.35, 95% confidence interval = 1.08-1.69); whereas younger African Americans were less likely to complete treatment than older African Americans, age was unrelated to treatment completion among whites. In the mid-Atlantic sample, African Americans were significantly less likely to attend at least 3 treatment sessions (adjusted odds ratio = 0.37, 95% confidence interval = 0.23-0.58), and younger adult marijuana users were retained for fewer days in treatment (adjusted β = 0.13, 95% confidence interval = 0.27-2.48). Among African Americans, 37.9% (SD = 38.0) of urine drug screens tested positive for at least 1 illicit drug, and among whites, 34.2% (SD = 37.8%) tested positive; the percentage of positive urine drug screens was not associated with race or age. Among marijuana-using adults, treatment attendance and completion differ by race and age, and improvements in treatment completion may occur as some African Americans mature out of young adulthood.

  13. Changes in the structure of the microbial community associated with Nannochloropsis salina following treatments with antibiotics and bioactive compounds

    Directory of Open Access Journals (Sweden)

    Haifeng Geng

    2016-07-01

    Full Text Available Open microalgae cultures host a myriad of bacteria, creating a complex system of interacting species that influence algal growth and health. Many algal microbiota studies have been conducted to determine the relative importance of bacterial taxa to algal culture health and physiological states, but these studies have not characterized the interspecies relationships in the microbial communities. We subjected Nanochroloropsis salina cultures to multiple chemical treatments (antibiotics and quorum sensing compounds and obtained dense time-series data on changes to the microbial community using 16S gene amplicon metagenomic sequencing (21,029,577 reads for 23 samples to measure microbial taxa-taxa abundance correlations. Short-term treatment with antibiotics resulted in substantially larger shifts in the microbiota structure compared to changes observed following treatment with signaling compounds and glucose. We also calculated operational taxonomic unit (OTU associations and generated OTU correlation networks to provide an overview of possible bacterial OTU interactions. This analysis identified five major cohesive modules of microbiota with similar co-abundance profiles across different chemical treatments. The Eigengenes of OTU modules were examined for correlation with different external treatment factors. This correlation-based analysis revealed that culture age (time and treatment types have primary effects on forming network modules and shaping the community structure. Additional network analysis detected Alteromonadeles and Alphaproteobacteria as having the highest centrality, suggesting these species are keystone OTUs in the microbial community. Furthermore, we illustrated that the chemical tropodithietic acid, which is secreted by several species in the Alphaproteobacteria taxon, is able to drastically change the structure of the microbiota within 3 hours. Taken together, these results provide valuable insights into the structure of the

  14. Obstacles to prompt and effective malaria treatment lead to low community-coverage in two rural districts of Tanzania

    Directory of Open Access Journals (Sweden)

    Dillip Angel

    2008-09-01

    Full Text Available Abstract Background Malaria is still a leading child killer in sub-Saharan Africa. Yet, access to prompt and effective malaria treatment, a mainstay of any malaria control strategy, is sub-optimal in many settings. Little is known about obstacles to treatment and community-effectiveness of case-management strategies. This research quantified treatment seeking behaviour and access to treatment in a highly endemic rural Tanzanian community. The aim was to provide a better understanding of obstacles to treatment access in order to develop practical and cost-effective interventions. Methods We conducted community-based treatment-seeking surveys including 226 recent fever episodes in 2004 and 2005. The local Demographic Surveillance System provided additional household information. A census of drug retailers and health facilities provided data on availability and location of treatment sources. Results After intensive health education, the biomedical concept of malaria has largely been adopted by the community. 87.5% (78.2–93.8 of the fever cases in children and 80.7% (68.1–90.0 in adults were treated with one of the recommended antimalarials (at the time SP, amodiaquine or quinine. However, only 22.5% (13.9–33.2 of the children and 10.5% (4.0–21.5 of the adults received prompt and appropriate antimalarial treatment. Health facility attendance increased the odds of receiving an antimalarial (OR = 7.7 but did not have an influence on correct dosage. The exemption system for under-fives in public health facilities was not functioning and drug expenditures for children were as high in health facilities as with private retailers. Conclusion A clear preference for modern medicine was reflected in the frequent use of antimalarials. Yet, quality of case-management was far from satisfactory as was the functioning of the exemption mechanism for the main risk group. Private drug retailers played a central role by complementing existing formal health

  15. Application of ion torrent sequencing to the assessment of the effect of alkali ballast water treatment on microbial community diversity.

    Directory of Open Access Journals (Sweden)

    Masanori Fujimoto

    Full Text Available 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 (p<0.001. UniFrac distance based 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 <0.5% of the total reads in intake samples but more than 50% of the reads in the treated discharge samples. The only apparent difference in 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

  16. Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program.

    Science.gov (United States)

    Kane, John M; Robinson, Delbert G; Schooler, Nina R; Mueser, Kim T; Penn, David L; Rosenheck, Robert A; Addington, Jean; Brunette, Mary F; Correll, Christoph U; Estroff, Sue E; Marcy, Patricia; Robinson, James; Meyer-Kalos, Piper S; Gottlieb, Jennifer D; Glynn, Shirley M; Lynde, David W; Pipes, Ronny; Kurian, Benji T; Miller, Alexander L; Azrin, Susan T; Goldstein, Amy B; Severe, Joanne B; Lin, Haiqun; Sint, Kyaw J; John, Majnu; Heinssen, Robert K

    2016-04-01

    The primary aim of this study was to compare the impact of NAVIGATE, a comprehensive, multidisciplinary, team-based treatment approach for first-episode psychosis designed for implementation in the U.S. health care system, with community care on quality of life. Thirty-four clinics in 21 states were randomly assigned to NAVIGATE or community care. Diagnosis, duration of untreated psychosis, and clinical outcomes were assessed via live, two-way video by remote, centralized raters masked to study design and treatment. Participants (mean age, 23) with schizophrenia and related disorders and ≤6 months of antipsychotic treatment (N=404) were enrolled and followed for ≥2 years. The primary outcome was the total score of the Heinrichs-Carpenter Quality of Life Scale, a measure that includes sense of purpose, motivation, emotional and social interactions, role functioning, and engagement in regular activities. The 223 recipients of NAVIGATE remained in treatment longer, experienced greater improvement in quality of life and psychopathology, and experienced greater involvement in work and school compared with 181 participants in community care. The median duration of untreated psychosis was 74 weeks. NAVIGATE participants with duration of untreated psychosis of quality of life and psychopathology compared with those with longer duration of untreated psychosis and those in community care. Rates of hospitalization were relatively low compared with other first-episode psychosis clinical trials and did not differ between groups. Comprehensive care for first-episode psychosis can be implemented in U.S. community clinics and improves functional and clinical outcomes. Effects are more pronounced for those with shorter duration of untreated psychosis.

  17. [Analysis of the efficiency of antimicrobial treatment for community-acquired pneumonia in clinical practice].

    Science.gov (United States)

    Zhukova, O V; Ruina, O V; Kononova, S V; Konyshkina, T M

    To analyze actual drug consumption based on the defined daily dose (DDD analysis) and to analyze the utilization of drugs based on their proportion of the total defined daily doses (DU90% analysis) for the antimicrobial therapy of community-acquired pneumonia (CAP) in clinical practice at a hospital in Russia. The investigation materials were the data of 117 case histories of male (51.3%) and female (48.7%) patients hospitalized with CAP at Nizhny Novgorod City Clinical Hospital Five in 2015. The investigation enrolled all the patients admitted to the hospital over the analyzed period. DDD analysis and DU90% analysis were used as study methods. DDD analysis and DU90% analysis of antimicrobial therapy for CAP were carried out at the hospital in clinical practice during a year. The annual number of defined daily doses (NDDD) for antimicrobial drugs, the number of defined daily doses per 100 bed-days (NDDD/100 bed-days), and a drug load (g) per 1000 CAP patients per day and per CAP patient per year were determined. The largest NDDD/year for CAP treatment with ceftriaxone was 376 g, or 43.43 NDDD/100 bed-days, which is much higher than that with other antimicrobial agents. The daily drug load of ceftriaxone per 1,000 CAP patients was 8.8 g, which exceeds that of moxifloxacin by 18.7 times, azithromycin and levofloxacin by 5 times, and ampicillin/sulbactam by 2.3 times. The daily drug load of ceftriaxone per CAP patient was 3.2 g, which exceeds that of of ampicillin/sulbactam by 2.3 times, levofloxacin and azithromycin by 5 times, and moxifloxacin by 19 times. It may be recommended that the proportion of cephalosporins as drugs that promote the rise of resistance in microbes and their production of extended-spectrum β-lactamases should be further limited, the proportion of penicillins be extended, and the administered ampicillin/sulbactam be added, for example, by amoxicillin/clavulanate. Penicillins contribute to the rise of resistance to a lesser degree, and the use

  18. Treatment rejecting and treatment seeking personality disorders: Type R and Type S.

    Science.gov (United States)

    Tyrer, Peter; Mitchard, Sarah; Methuen, Caroline; Ranger, Maja

    2003-06-01

    An important distinguishing feature of one group of personality disorders is the wish of the sufferer to seek treatment. For another group this wish is rarely entertained. Although there is some variation between different types of personality disorder the wish to change is not confined to any one diagnostic category. A useful subclassification of personality disorders is therefore into Type R (treatment rejecting) and Type S (treatment seeking) personality disorders, and these are defined operationally. The classification of 68 personality disordered patients on the caseload of an assertive community team using a simple scale showed a 3 to 1 ratio between Type R and Type S personality disorders with Cluster C personality disorders being significantly more likely to be Type S, and paranoid and schizoid (Cluster A) personality disorders significantly more likely to be Type R than others. It is suggested that this typology is useful for those contemplating treatment with those who have personality disorders.

  19. A Randomized Trial of a Multimodal Community-Based Prisoner Reentry Program Emphasizing Substance Abuse Treatment

    Science.gov (United States)

    Grommon, Eric; Davidson, William S., II; Bynum, Timothy S.

    2013-01-01

    Prisoner reentry programs continue to be developed and implemented to ease the process of transition into the community and to curtail fiscal pressures. This study describes and provides relapse and recidivism outcome findings related to a randomized trial evaluating a multimodal, community-based reentry program that prioritized substance abuse…

  20. Therapeutic Community in a California Prison: Treatment Outcomes after 5 Years

    Science.gov (United States)

    Zhang, Sheldon X.; Roberts, Robert E. L.; McCollister, Kathryn E.

    2011-01-01

    Therapeutic communities have become increasingly popular among correctional agencies with drug-involved offenders. This quasi-experimental study followed a group of inmates who participated in a prison-based therapeutic community in a California state prison, with a comparison group of matched offenders, for more than 5 years after their initial…

  1. The therapeutic community for addicts : intimacy, perent involvment and treatment outcome

    NARCIS (Netherlands)

    M. Kooyman (Martien)

    1992-01-01

    textabstractTherapeutic communities for addicts developed since the Sixties without a clear theory on what made them therapeutic. There have also been some doubts on their long term outcome results. Part I of this book describes how therapeutic communities for addicts have roots in the self-help

  2. Changes in determinants of compulsory community treatment over 11 years. A population-based analysis of linked mental health databases.

    Science.gov (United States)

    Kisely, Steve; Xiao, Jianguo; Jian, Le

    2015-12-15

    Differences in patient characteristics, legislation and service setting may explain variations in the reported efficacy of compulsory treatment orders (CTOs). Our objective was to investigate factors associated with CTO placement in Western Australia and see if there were any changes over the 11 years following their introduction. We used three linked Western Australian databases to compare 2958 patients on community treatment orders with an equal number of controls matched on age, sex and diagnosis, as well as 2832 consecutive controls selected on date of discharge from inpatient care or CTO placement. Multivariate analyses were used to further examine potential predictors of a CTO. The incidence of CTOs, and the characteristics of patients placed on these orders, showed little change over 11 years. They tended to be younger and male with schizophrenia or other non-affective psychotic disorders. Previous health service use as an inpatient or outpatient also predicted compulsory community treatment. Psychiatrists in Western Australia appear to be applying community treatment orders to similar types of patient as elsewhere, but unlike other jurisdictions, use has not increased. We need further research to establish the relative contribution of patient characteristics, legislation and service setting toward the use and outcome of CTOs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Probing community nurses' professional basis: a situational case study in diabetic foot ulcer treatment.

    Science.gov (United States)

    Schaarup, Clara; Pape-Haugaard, Louise; Jensen, Merete Hartun; Laursen, Anders Christian; Bermark, Susan; Hejlesen, Ole Kristian

    2017-03-01

    Complicated and long-lasting wound care of diabetic foot ulcers are moving from specialists in wound care at hospitals towards community nurses without specialist diabetic foot ulcer wound care knowledge. The aim of the study is to elucidate community nurses' professional basis for treating diabetic foot ulcers. A situational case study design was adopted in an archetypical Danish community nursing setting. Experience is a crucial component in the community nurses' professional basis for treating diabetic foot ulcers. Peer-to-peer training is the prevailing way to learn about diabetic foot ulcer, however, this contributes to the risk of low evidence-based practice. Finally, a frequent behaviour among the community nurses is to consult colleagues before treating the diabetic foot ulcers.

  4. [Efficacy of the therapeutic community model in the treatment of drug use-related problems: a systematic review].

    Science.gov (United States)

    Fiestas, Fabián; Ponce, Javier

    2012-03-01

    To summarize the scientific evidence about the efficacy of therapeutic communities (TC) to reduce substance use and related problems among people with substance use disorders. This systematic review builds from the work performed by Smith et al. (2006). We searched MEDLINE, EMBASE, Web of Science, Scielo, and LILACS for randomized trials that compare a TC with no treatment, a different type of treatment or another type of TC published from March 2004 to May 2011. 5 publications from 4 randomized trials were identified. All the studies had serious methodological limitations according to the CONSORT. The heterogeneity among studies did not allow for metaanalytic analysis to calculate pooled estimates. The primary analysis showed that, in prison, certain models of TC might be marginally superior to other types of treatments regarding levels of alcohol use, days in prison and re-incarceration rates. Also, evidence from a community setting (i.e., not in-prison) suggests that a community-based TC is not superior to an outpatient treatment model regarding levels of substance use, crime and unemployment at the 12-month follow-up. In general, there is no evidence to support superiority of TC over other more accessible and less costly types of treatment for drug use. However, in a prison context, TC might be of more benefit than other types of treatment. More research with solid experimental methodology is needed to add to the still weak body of evidence that supports the use of TC over other more affordable types of treatment for drug use disorders.

  5. Striking back: A case study in addressing a skeptic's public assertions about sea ice data

    Science.gov (United States)

    Meier, W. N.; Renfrow, S.; Serreze, M.

    2008-12-01

    The increasing visibility of climate change science-in international reports like the IPCC's, in day-to-day discussion on blogs like RealClimate.org, and in coverage by the mass media-has brought more exposure to the science behind the consensus. Some skeptics have become increasingly savvy about the availability of scientific information from public institutions like the National Snow and Ice Data Center (NSIDC). What happens when a smart but nonscientific skeptic skims scientific data and publishes his findings online, confusing the public and adding to the false "debate"? We present a case study of just such a scenario, which took place during the Arctic sea ice melt season in 2008. A skeptic discovered that NSIDC and the University of Illinois both offer near-real-time images showing sea ice conditions; to him, the images did not tell the same story. He thought he saw proof that NSIDC was tampering with the data to tell a false story of sea ice decline and climate change, and he took no time in publicizing his assertions online in a popular information technology magazine. What the skeptic in question didn't realize is the complexity of how science works. Hundreds of scientists at different institutions around the world may study the same data. With different processing, scientists may report different results. These differences are usually small, with trends and major findings generally in agreement and the kinks worked out through publication in peer-reviewed journals. But to the non-scientist, and especially to the skeptic, this "disagreement" may be a source of doubt and confusion about climate change. Our role in communicating and protecting the process of real science threatened to expand. Should we go with our first instinct and ignore his assertions as scientifically invalid, hunkering down in our traditional scientific role? Or further expose ourselves by contacting the author and attempting an exchange? In this presentation, we'll take you from our

  6. Using technology in the delivery of mental health and substance abuse treatment in rural communities: a review.

    Science.gov (United States)

    Benavides-Vaello, Sandra; Strode, Anne; Sheeran, Beth C

    2013-01-01

    Rural communities face tremendous challenges in accessing mental health and substance abuse treatment services. Some of the most promising advancements in the delivery of rural health care services have been in the area of telecommunication technology. These applications have the potential to reduce the disparities in the delivery of substance abuse and mental health services between urban and rural communities. The purpose of this inquiry was to explore the advances and uses of telecommunications technology, and related issues, in the delivery of mental health and substance abuse treatment services within rural areas. A review of the academic literature and other relevant works was conducted and the content was organized into four major themes: (a) advantages of telehealth and applications to rural practice, (b) barriers to implementation in rural practice, (c) utilization in rural areas, and (d) areas for further research.

  7. Field-scale electrolysis/ceramic membrane system for the treatment of sewage from decentralized small communities.

    Science.gov (United States)

    Son, Dong-Jin; Kim, Woo-Yeol; Yun, Chan-Young; Kim, Dae-Gun; Chang, Duk; Sunwoo, Young; Hong, Ki-Ho

    2017-07-05

    The electrolysis process adopting copper electrodes and ceramic membrane with pore sizes of 0.1-0.2 μm were consisted to a system for the treatment of sewage from decentralized small communities. The system was operated under an HRT of 0.1 hour, voltage of 24 V, and TMP of 0.05 MPa. The system showed average removals of organics, nitrogen, phosphorus, and solids of up to 80%, 52%, 92%, and 100%, respectively. Removal of organics and nitrogen dramatically increased in proportion to increment of influent loading. Phosphorus and solids were remarkably eliminated by both electro-coagulation and membrane filtration. The residual particulate constituents could also be removed successfully through membrane process. A system composed of electrolysis process with ceramic membrane would be a compact, reliable, and flexible option for the treatment of sewage from decentralized small communities.

  8. Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda

    DEFF Research Database (Denmark)

    Hansen, Kristian S; Ndyomugyenyi, Richard; Magnussen, Pascal

    2017-01-01

    In Sub-Saharan Africa, malaria remains a major cause of morbidity and mortality among children under 5, due to lack of access to prompt and appropriate diagnosis and treatment. Many countries have scaled-up community health workers (CHWs) as a strategy towards improving access. The present study...... was a cost-effectiveness analysis of the introduction of malaria rapid diagnostic tests (mRDTs) performed by CHWs in two areas of moderate-to-high and low malaria transmission in rural Uganda. CHWs were trained to perform mRDTs and treat children with artemisinin-based combination therapy (ACT......) in the intervention arm while CHWs offered treatment based on presumptive diagnosis in the control arm. Data on the proportion of children with fever 'appropriately treated for malaria with ACT' were captured from a randomised trial. Health sector costs included: training of CHWs, community sensitisation, supervision...

  9. Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students

    Science.gov (United States)

    Hijazi, Alaa M.; Tavakoli, Shedeh; Slavin-Spenny, Olga M.; Lumley, Mark A.

    2011-01-01

    Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study (Tavakoli "et al. Journal of Counseling Psychology 56":590-596, "2009"), the authors reported that two stress reduction interventions--expressive writing (EW) and assertiveness training (AT)--had…

  10. Self-Consciousness and Assertiveness as Explanatory Variables of L2 Oral Ability: A Latent Variable Approach

    Science.gov (United States)

    Ockey, Gary

    2011-01-01

    Drawing on current theories in personality, second-language (L2) oral ability, and psychometrics, this study investigates the extent to which self-consciousness and assertiveness are explanatory variables of L2 oral ability. Three hundred sixty first-year Japanese university students who were studying English as a foreign language participated in…

  11. The Effects of Contingent Teacher Praise, as Specified by Canter's Assertive Discipline Programme, on Children's On-Task Behaviour.

    Science.gov (United States)

    Ferguson, Elizabeth; Houghton, Stephen

    1992-01-01

    Presents study results examining the effectiveness of teacher praise on children's on-task behavior. Describes Canter's Assertive Discipline, its use in Australia, and the basics of a study of the technique. Reports that all teacher subjects increased rates of praising following training, and all but one student improved levels of behavior.…

  12. Community-based physical activity interventions for treatment of type 2 diabetes: A systematic review with meta-analysis

    Directory of Open Access Journals (Sweden)

    Ronald C Plotnikoff

    2013-01-01

    Full Text Available Evidence suggests engaging in regular physical activity (PA can have beneficial outcomes for adults with type 2 diabetes (TD2, including weight loss, reduction of medication usage and improvements in hemoglobin A1c (HbA1c/fasting glucose. While a number of clinical-based physical activity interventions exist, community-based approaches are limited. The objective of this study is to conduct a systematic review with meta-analysis to assess the effectiveness of community-based PA interventions for the treatment of TD2 in adult populations. A search of peer-reviewed publications from 2002 to June 2012 was conducted across several electronic databases to identify interventions evaluated in community settings. Twenty-two studies were identified, and 11 studies reporting HbA1c as an outcome measure were pooled in the meta-analysis. Risk of bias assessment was also conducted. The findings demonstrate community-based PA interventions can be effective in producing increases in PA. Meta-analysis revealed a lowering of HbA1c levels by -0.32% [95% CI -0.65, 0.01], which approached statistical significance (p < 0.06. Our findings can guide future PA community based interventions in adult populations diagnosed with TD2.

  13. Microbial community dynamics of an urban drinking water distribution system subjected to phases of chloramination and chlorination treatments.

    Science.gov (United States)

    Hwang, Chiachi; Ling, Fangqiong; Andersen, Gary L; LeChevallier, Mark W; Liu, Wen-Tso

    2012-11-01

    Water utilities in parts of the U.S. control microbial regrowth in drinking water distribution systems (DWDS) by alternating postdisinfection methods between chlorination and chloramination. To examine how this strategy influences drinking water microbial communities, an urban DWDS (population ≅ 40,000) with groundwater as the source water was studied for approximately 2 years. Water samples were collected at five locations in the network at different seasons and analyzed for their chemical and physical characteristics and for their microbial community composition and structure by examining the 16S rRNA gene via terminal restriction fragment length polymorphism and DNA pyrosequencing technology. Nonmetric multidimension scaling and canonical correspondence analysis of microbial community profiles could explain >57% of the variation. Clustering of samples based on disinfection types (free chlorine versus combined chlorine) and sampling time was observed to correlate to the shifts in microbial communities. Sampling location and water age (water, and Methylophilaceae, Methylococcaceae, and Pseudomonadaceae were more abundant in chloraminated water. No correlation was observed with minor populations that were detected frequently (water and survived through the treatment process. Transient microbial populations including Flavobacteriaceae and Clostridiaceae were also observed. Overall, reversible shifts in microbial communities were especially pronounced with chloramination, suggesting stronger selection of microbial populations from chloramines than chlorine.

  14. The Acceptability of Treatments for Depression to a Community Sample of Adolescent Girls

    Science.gov (United States)

    Caporino, Nicole E.; Karver, Marc S.

    2012-01-01

    An efficacious treatment is diminished in value if consumers do not seek it out and adhere to it, making treatment acceptability an important predictor of the effectiveness of treatment. This study examined the acceptability of treatments for depression to 67 female high school students. All participants read a vignette describing a depressed…

  15. Pre-fire fuel reduction treatments influence plant communities and exotic species 9 years after a large wildfire

    Science.gov (United States)

    Kristen L. Shive; Amanda M. Kuenzi; Carolyn H. Sieg; Peter Z. Fule

    2013-01-01

    We used a multi-year data set from the 2002 Rodeo-Chediski Fire to detect post-fire trends in plant community response in burned ponderosa pine forests. Within the burn perimeter, we examined the effects of pre-fire fuels treatments on post-fire vegetation by comparing paired treated and untreated sites on the Apache-Sitgreaves National Forest.We sampled these paired...

  16. Nitrifying Community Analysis in a Single Submerged Attached-Growth Bioreactor for Treatment of High-Ammonia Waste Stream

    DEFF Research Database (Denmark)

    Gu, April Z.; Pedros, Philip B; Kristiansen, Anja

    2007-01-01

    addition (methanol). With influent ammonia and total Kjeldahl nitrogen ranging from 537 to 968 mg/L and 643 to1510 mg/L, respectively, 85% nitrogen removal was obtained, and effluent was dominated by nitrite (NO2 −/NOx >0.95). Nitrifying community analysis using fluorescence in situ hybridization (FISH...... in this study is applicable for high-ammonia-strength wastewater treatment, such as centrate or industrial wastes. Udgivelsesdato: December 2007...

  17. Bacterial communities in different sections of a municipal wastewater treatment plant revealed by 16S rDNA 454 pyrosequencing

    OpenAIRE

    Ye, Lin; Zhang, Tong

    2012-01-01

    In this study, we successfully demonstrated that 454 pyrosequencing was a powerful approach for investigating the bacterial communities in the activated sludge, digestion sludge, influent, and effluent samples of a full scale wastewater treatment plant treating saline sewage. For each sample, 18,808 effective sequences were selected and utilized to do the bacterial diversity and abundance analysis. In total, 2,455, 794, 1,667, and 1,932 operational taxonomic units were obtained at 3?% distanc...

  18. Management by assertion: beavers and songbirds at Lake Skinner (Riverside County, California).

    Science.gov (United States)

    Longcore, Travis; Rich, Catherine; Müller-Schwarze, Dietland

    2007-04-01

    Management of ecological reserve lands should rely on the best available science to achieve the goal of biodiversity conservation. "Adaptive Resource Management" is the current template to ensure that management decisions are reasoned and that decisions increase understanding of the system being managed. In systems with little human disturbance, certain management decisions are clear; steps to protect native species usually include the removal of invasive species. In highly modified systems, however, appropriate management steps to conserve biodiversity are not as readily evident. Managers must, more than ever, rely upon the development and testing of hypotheses to make rational management decisions. We present a case study of modern reserve management wherein beavers (Castor canadensis) were suspected of destroying habitat for endangered songbirds (least Bell's vireo, Vireo bellii pusillus, and southwestern willow flycatcher, Empidonax traillii extimus) and for promoting the invasion of an exotic plant (tamarisk, Tamarix spp.) at an artificial reservoir in southern California. This case study documents the consequences of failing to follow the process of Adaptive Resource Management. Managers made decisions that were unsupported by the scientific literature, and actions taken were likely counterproductive. The opportunity to increase knowledge of the ecosystem was lost. Uninformed management decisions, essentially "management by assertion," undermine the long-term prospects for biodiversity conservation.

  19. Validación de la Sexual Assertiveness Scale en mujeres mexicanas

    Directory of Open Access Journals (Sweden)

    Reyna Torres-Obregon

    2017-01-01

    Full Text Available La asertividad sexual constituye una dimensión fundamental de la sexualidad humana por su relación con distintos indicadores de la salud sexual. Es la capacidad de las personas para iniciar la actividad sexual, rechazar la actividad sexual no deseada y emplear métodos anticonceptivos y así desarrollar comportamientos saludables. Esta se mide a través de la Sexual Assertiveness Scale (SAS. Hasta la fecha, la SAS no se ha validado en población mexicana, por lo que se considera importante examinar sus propiedades psicométricas en esta población. Por lo tanto, este estudio tuvo como objetivo validar la SAS en una muestra de 202 mujeres mexicanas. Mediante un análisis factorial confirmatorio, se confirmó la estructura trifactorial del SAS: inicio, rechazo y embarazo-enfermedades de transmisión sexual (CFI = .953; TLI = .927. Asimismo, se obtuvo una confiabilidad adecuada en las tres subescalas y, de forma global (ω = .85, sus puntuaciones correlacionaron significativamente en la dirección esperada con autoestima sexual y depresión rasgo. Se concluye que la SAS presenta buenas propiedades psicométricas en población femenina mexicana.

  20. Is Mandarin Chinese a Truth-Based Language? Rejecting Responses to Negative Assertions and Questions

    Science.gov (United States)

    Li, Feifei; González-Fuente, Santiago; Prieto, Pilar; Espinal, M.Teresa

    2016-01-01

    This paper addresses the central question of whether Mandarin Chinese (MC) is a canonical truth-based language, a language that is expected to express the speaker's disagreement to a negative proposition by means of a negative particle followed by a positive sentence. Eight native speakers of MC participated in an oral Discourse Completion Task that elicited rejecting responses to negative assertions/questions and broad focus statements (control condition). Results show that MC speakers convey reject by relying on a combination of lexico-syntactic strategies (e.g., negative particles such as bù, méi(yǒu), and positive sentences) together with prosodic (e.g., mean pitch) and gestural strategies (mainly, the use of head nods). Importantly, the use of a negative particle, which was the expected outcome in truth-based languages, only appeared in 52% of the rejecting answers. This system puts into question the macroparametric division between truth-based and polarity-based languages and calls for a more general view of the instantiation of a reject speech act that integrates lexical and syntactic strategies with prosodic and gestural strategies. PMID:28066292

  1. Improving outcomes for persons with aphasia in advanced community-based treatment programs

    National Research Council Canada - National Science Library

    Aftonomos, L B; Appelbaum, J S; Steele, R D

    1999-01-01

    .... We explore this issue here in an outcome study of individuals with aphasia enrolled in 2 community-based, comparably managed and equipped therapy programs, which use a specially designed computer...

  2. Loss to follow-up and mortality amongst pregnant women referred to a community clinic for antiretroviral treatment

    Science.gov (United States)

    Orrell, Catherine; Zwane, Eugene; Bekker, Linda-Gail; Wood, Robin

    2009-01-01

    Summary In a retrospective cohort analysis, loss to follow-up (LTFU) and mortality rates were compared between pregnant and non-pregnant women referred to a community-based antiretroviral treatment (ART) program in South Africa. While there was no significant difference in adjusted mortality rates between the two groups, the pregnant women had a substantially higher risk of LTFU both pre and on-treatment. This finding highlights the need for programmatic interventions to address retention in care for this patient population. PMID:18670232

  3. Role of moxifloxacin for the treatment of community-acquired [corrected] complicated intra-abdominal infections in Taiwan.

    Science.gov (United States)

    Lau, Yeu-Jun; Chen, Yen-Hsu; Huang, Ching-Tai; Lee, Wen-Sen; Liu, Cheng-Yi; Liu, Jien-Wei; Liu, Hsiao-Dong; Lee, Yuarn-Jang; Chen, Chao-Wen; Ko, Wen-Chien; Hsueh, Po-Ren

    2012-02-01

    Complicated intra-abdominal infections (cIAIs) are common yet serious infections that can potentially lead to substantial morbidity and morbidity. As an essential adjunct to source control, the goals of antimicrobial therapy are to promote patient recovery, reduce recurrence risk, and prevent antimicrobial resistance. The current international guidelines on the empirical treatment of community-acquired complicated IAIs were published by the Infectious Diseases Society of America (IDSA) and Surgical Infections Society (SIS) in 2010. These guidelines all recommend the use of a fluoroquinolone (ciprofloxacin or levofloxacin) plus metronidazole for mild-to-moderate- and high-severity cases. Moxifloxacin monotherapy is recommended by the current IDSA/SIS guidelines for the treatment of mild-to-moderate complicated IAIs. Moxifloxacin has demonstrated a broad spectrum coverage of both aerobic and anaerobic pathogens, good tissue penetration into the gastrointestinal tract, and a good tolerability profile. Clinical data have demonstrated that moxifloxacin is at least as effective as other standard therapeutic regimens recommended by current clinical guidelines. Due to the high rates of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and fluoroquinolone-resistant Enterobacteriaceae among isolates causing community-acquired IAIs in Asia, any fluoroquinolones (including moxifloxacin) are not recommended as drugs of choice for the empirical treatment of community-acquired IAIs, particularly in countries (China, India, Thailand, and Vietnam) with fluoroquinolone resistance rates among Escherichia coli isolates of >20%. Given the low rates of fluoroquinolone-resistant (country. Copyright © 2011. Published by Elsevier B.V.

  4. Treatment for hepatitis C virus infection among people who inject drugs attending opioid substitution treatment and community health clinics: the ETHOS Study.

    Science.gov (United States)

    Grebely, Jason; Alavi, Maryam; Micallef, Michelle; Dunlop, Adrian J; Balcomb, Anne C; Phung, Nghi; Weltman, Martin D; Day, Carolyn A; Treloar, Carla; Bath, Nicky; Haber, Paul S; Dore, Gregory J

    2016-02-01

    To estimate adherence and response to therapy for chronic hepatitis C virus (HCV) infection among people with a history of injecting drug use. A secondary aim was to identify predictors of HCV treatment response. Prospective cohort recruited between 2009 and 2012. Participants were treated with peg-interferon alfa-2a/ribavirin for 24 (genotypes 2/3, G2/3) or 48 weeks (genotype 1, G1). Six opioid substitution treatment (OST) clinics, two community health centres and one Aboriginal community-controlled health organization providing drug treatment services in New South Wales, Australia. Among 415 people with a history of injecting drug use and chronic HCV assessed by a nurse, 101 were assessed for treatment outcomes (21% female). Study outcomes were treatment adherence and sustained virological response (SVR, undetectable HCV RNA >24 weeks post-treatment). Among 101 treated, 37% (n = 37) had recently injected drugs (past 6 months) and 62% (n = 63) were receiving OST. Adherence ≥ 80% was 86% (n = 87). SVR was 74% (75 of 101), with no difference observed by sex (males: 76%, females: 67%, P = 0.662). In adjusted analysis, age < 35 (versus ≥ 45 years) [adjusted odds ratio (aOR) = 5.06, 95% confidence interval (CI) = 1.47, 17.40] and on-treatment adherence ≥ 80% independently predicted SVR (aOR = 19.41, 95% CI = 3.61, 104.26]. Recent injecting drug use at baseline was not associated with SVR. People with a history of injecting drug use and chronic hepatitis C virus attending opioid substitution treatment and community health clinics can achieve adherence and responses to interferon-based therapy similar to other populations, despite injecting drugs at baseline. Younger age and adherence are predictive of improved response to hepatitis C virus therapy. © 2015 Society for the Study of Addiction.

  5. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  6. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

  7. Effect of heterogeneous Fenton-like pre-treatment on anaerobic granular sludge performance and microbial community for the treatment of traditional Chinese medicine wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Su, Chengyuan, E-mail: suchengyuan2008@126.com [School of Environment and Resources, Guangxi Normal University, 15 Yucai Road, Guilin 541004 (China); School of Municipal and Environmental Engineering, Harbin Institute of Technology, 73 Huanghe Road, Harbin 150090 (China); Li, Weiguang [School of Municipal and Environmental Engineering, Harbin Institute of Technology, 73 Huanghe Road, Harbin 150090 (China); Lu, Yuxiang; Chen, Menglin; Huang, Zhi [School of Environment and Resources, Guangxi Normal University, 15 Yucai Road, Guilin 541004 (China)

    2016-08-15

    Highlights: • Rhein has metabolic or physiological toxicity on methanogens in anaerobic granular sludge. • TCM wastewater containing rhein can be successfully treated by the combined treatment. • The productions of the EPS of granular sludge increased after pre-treatment. • Methanoregula, Methanobacterium, Methanosphaerula were predominant in the DC reactor after pre-treatment. - Abstract: The effect of a heterogeneous Fenton-like pre-treatment on the anaerobic processes, characteristics and microbial community of sludge was investigated for traditional Chinese medicine (TCM) wastewater containing rhein. When the concentrations of rhein were 50 mg/L and 100 mg/L, the toxic effect was physiological toxicity for anaerobic granular sludge. Using a single double circle (DC) reactor for the treatment of TCM wastewater containing rhein at concentrations of 15–20 mg/L, the chemical oxygen demand (COD) removal rate was 69%, and coenzyme F{sub 420} was nearly undetectable in the 3D-excitation-emission matrix (EEM) spectra of soluble microbial products (SMP). The abundances of Methanoregula, Methanobacterium, Methanosphaerula were only 5.57%, 2.39% and 1.08% in the DC reactor, respectively. TCM wastewater containing rhein could be successfully treated by the combination of the heterogeneous Fenton-like pre-treatment and the DC reactor processes, and the COD removal rate reached 95%. Meanwhile, the abundances of Methanoregula, Methanobacterium, Methanosphaerula increased to 22.5%, 18.5%, and 13.87%, respectively. For the bacterial community, the abundance of Acidobacteria-Gp6 decreased from 6.99% to 1.07%, while the abundances of Acidobacteria-Gp1 and Acidobacteria-Gp2 increased from 1.61% to 6.55% and from 1.28% to 5.87%, respectively.

  8. Warfarin Treatment and All-Cause Mortality in Community-Dwelling Older Adults with Atrial Fibrillation: A Retrospective Observational Study.

    Science.gov (United States)

    Pilotto, Alberto; Gallina, Pietro; Copetti, Massimiliano; Pilotto, Andrea; Marcato, Francesco; Mello, Anna M; Simonato, Matteo; Logroscino, Giancarlo; Padovani, Alessandro; Ferrucci, Luigi; Panza, Francesco

    2016-07-01

    To investigate the relationship between warfarin treatment and different strata of all-cause mortality risk assessed using the Multidimensional Prognostic Index (MPI) based on information collected using the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA) in community-dwelling older adults with atrial fibrillation (AF). Retrospective observational study. Older community-dwelling adults who underwent a SVaMA evaluation establishing accessibility to homecare services and nursing home admission from 2005 to 2013 in the Padova Health District, Italy. Community-dwelling individuals with AF aged 65 and older (N = 1,827). Participants were classified as being at mild (MPI-SVaMA-1), moderate (MPI-SVaMA-2), or severe (MPI-SVaMA-3) risk of mortality using the MPI-SVaMA, a validated prognostic tool based on age, sex, comorbidity, cognitive status, mobility and functional disability, pressure sore risk, and social support. The association between warfarin treatment and mortality was tested using multivariate- and propensity score-adjusted Cox regression models, controlling for age, sex, all SVaMA domains, concomitant diseases, and drug treatments. Higher MPI-SVaMA scores were associated with lower rates of warfarin treatment and higher 3-year mortality. After adjustment for propensity score quintiles, warfarin treatment was significantly associated with lower 2-year mortality in individuals with MPI-SVaMA-1 (hazard ratio (HR) = 0.64, 95% confidence interval (CI) = 0.50-0.82), MPI-SVaMA-2 (HR = 0.68, 95% CI = 0.55-0.85), and MPI-SVaMA-3 (HR = 0.55, 95% CI = 0.44-0.67). Heterogeneity analyses confirmed that the effect of warfarin treatment was not different between MPI-SVaMA groups (P for heterogeneity = .48). Community-dwelling older adults with AF benefitted from anticoagulation in terms of lower all-cause mortality over a mean follow-up of 2 years, regardless of poor health and functional condition. Although this benefit can be ascribed

  9. Effect of cerium dioxide, titanium dioxide, silver, and gold nanoparticles on the activity of microbial communities intended in wastewater treatment

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Ana; Delgado, Lucia; Tora, Josep A. [Department of Chemical Engineering, Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra (Spain); Casals, Eudald; Gonzalez, Edgar [Institut Catala de Nanotecnologia, Campus de la Universitat Autonoma de Barcelona, 08193 Bellaterra (Spain); Puntes, Victor [Institut Catala de Nanotecnologia, Campus de la Universitat Autonoma de Barcelona, 08193 Bellaterra (Spain); Institut Catala de Recerca i Estudis Avancats, Passeig Lluis Companys, 23, 08010 Barcelona (Spain); Font, Xavier; Carrera, Julian [Department of Chemical Engineering, Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra (Spain); Sanchez, Antoni, E-mail: antoni.sanchez@uab.cat [Department of Chemical Engineering, Escola d' Enginyeria, Universitat Autonoma de Barcelona, 08193 Bellaterra (Spain)

    2012-01-15

    Highlights: Black-Right-Pointing-Pointer Toxicity of TiO{sub 2}, CeO{sub 2}, Ag and Au nanoparticles (NP) has been studied. Black-Right-Pointing-Pointer NP were synthesized in the lab and stabilized to prevent agglomeration. Black-Right-Pointing-Pointer Toxicity was studied in all the communities used for the wastewater treatment. Black-Right-Pointing-Pointer Heterotrophic, nitrifying and anaerobic organisms were studied for nanotoxicology. Black-Right-Pointing-Pointer Au and TiO{sub 2} NP were not toxic, but Ag and CeO{sub 2} NP were inhibitory. - Abstract: Growth in production and use of nanoparticles (NPs) will result increased concentrations of these in industrial and urban wastewaters and, consequently, in wastewater-treatment facilities. The effect of this increase on the performance of the wastewater-treatment process has not been studied systematically and including all the microbial communities involved in wastewater treatment. The present work investigates, by using respiration tests and biogas-production analysis, the inhibitory effect of four different commonly used metal oxide (CeO{sub 2} and TiO{sub 2}) and zero-valent metal (Ag and Au) nanoparticles on the activity of the most important microbial communities present in a modern wastewater-treatment plant. Specifically, the actions of ordinary heterotrophic organisms, ammonia oxidizing bacteria, and thermophilic and mesophilic anaerobic bacteria were tested in the presence and absence of the nanoparticles. In general, CeO{sub 2} nanoparticles caused the greatest inhibition in biogas production (nearly 100%) and a strong inhibitory action of other biomasses; Ag nanoparticles caused an intermediate inhibition in biogas production (within 33-50%) and a slight inhibition in the action of other biomasses, and Au and TiO{sub 2} nanoparticles caused only slight or no inhibition for all tested biomasses.

  10. Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment: a comparison of three models.

    Science.gov (United States)

    Yan, Liping; Liu, Enwu; McGoogan, Jennifer M; Duan, Song; Wu, Li-Tzy; Comulada, Scott; Wu, Zunyou

    2013-08-13

    Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China. Using a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics. Of the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral. Findings suggest that providing MMT within detoxification centers promotes successful

  11. Adverse reactions from community directed treatment with ivermectin (CDTI for onchocerciasis and loiasis in Ondo State, Nigeria

    Directory of Open Access Journals (Sweden)

    O.A Otubanjo

    2008-12-01

    Full Text Available Onchocerciasis is an endemic disease in Ondo state, Nigeria. Community directed distribution of ivermectin is currently on-going in some local government areas of the state. Randomly selected persons (2 331 males and 2 469 females were interviewed using a modified rapid assessment procedure for Loa loa (RAPLOA to assess community directed treatment with ivermectin. The retrospective study evaluated the coverage, impacts and adverse reactions to the drug treatment. A questionnaire was administered by house-to-house visit in six local government areas, implementing community directed treatment with ivermectin (CDTI in this bioclimatic zone. A total of 2,398 respondents were reported to have participated in the treatment. The overall ivermectin coverage of 49.96% was recorded (range 0 - 52% in different communities. Adverse reactions from ivermectin administration were experienced in 38% of individuals. Diverse adverse reactions experienced included predominantly itching (18.50%; oedema, especially of the face and the limbs (8.2%; rashes (3.4% and body weakness (2.4%. Expulsion of intestinal worms occurred in 0.96% of the respondents. The occurrence of adverse reactions in relation to age categories was statistically significant. Neither fatal nor severe adverse reactions were reported by respondents. Significantly, despite experienced adverse reactions, continued participation, acceptability and compliance to ivermectin treatment was expressed by the various communities. This attitude is in consonance with the African Programme for Onchocerciasis Control (APOC objectives. Rev. Biol. Trop. 56 (4: 1635-1643. Epub 2008 December 12.La oncocercosis es endémica en el estado Ondo, Nigeria. Se seleccionaron 4 800 personas al azar para evaluar con encuesta retrospectiva la cobertura, efectos y reacciones al tratamiento farmacológico con ivermectina administrado por la misma comunidad. La cobertura global de ivermectina fue 50 % con reacciones adversas en

  12. Prevalence, Patterns, and Predictors of Depression Treatment among Community-Dwelling Elderly Individuals with Dementia in the United States.

    Science.gov (United States)

    Bhattacharjee, Sandipan; Oh, Yeum Mok; Reiman, Eric M; Burke, William J

    2017-07-01

    Co-occurring dementia and depression exerts a substantial burden on the elderly. This study utilizes data from a nationally representative cohort of community-dwelling individuals 65 years and older to examine the prevalence, patterns, and predictors of depression treatment among elderly individuals with co-occurring dementia and depression. Retrospective, cross-sectional study. Multiple years of Medical Expenditure Panel Survey (2002, 2004, 2006, 2008, 2010, and 2012) data. The study sample consisted of elderly (age ≥65 years) individuals who 1) had dementia, 2) were alive during the calendar year, and 3) had co-occurring depression. The dependent variable of this study was depression treatment, identified by antidepressant medication with or without psychotherapy use. Individual level factors associated with depression treatment among elderly individuals with dementia and co-occurring depression were evaluated by conducting multinomial logistic regression. Co-occurring depression prevalence among community-dwelling elderly individuals with dementia was approximately 22%. An overwhelming majority (nearly 88%) of the study sample reported receipt of depression treatment. Antidepressants only and combination therapy (antidepressant with psychotherapy) was reported by 75% and 13%, respectively, of the study sample. Age, race/ethnicity, marital status, limitations of instrumental activities of daily living, perceived mental health status, and pain were significantly associated with the reporting of receipt of depression treatment. An overwhelming majority of the study sample received depression treatment and several subgroup differences (such as in terms of age) existed in terms of reporting the use of depression treatment was observed. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. Mulching fuels treatments promote understory plant communities in three Colorado, USA, coniferous forest types

    Science.gov (United States)

    Paula J. Fornwalt; Monique E. Rocca; Michael Battaglia; Charles C. Rhoades; Michael G. Ryan

    2017-01-01

    Mulching fuels treatments have been increasingly implemented by forest managers in the western USA to reduce crown fire hazard. These treatments use heavy machinery to masticate or chip unwanted shrubs and small-diameter trees and broadcast the mulched material on the ground. Because mulching treatments are relatively novel and have no natural analog, their ecological...

  14. Impact of titanium dioxide nanoparticles on the bacterial communities of biological activated carbon filter intended for drinking water treatment.

    Science.gov (United States)

    Zhiyuan, Liu; Shuili, Yu; Heedeung, Park; Qingbin, Yuan; Guicai, Liu; Qi, Li

    2016-08-01

    Titanium dioxide nanoparticles (TiO2 NPs) are inevitably present in the aquatic environment owing to their increasing production and use. However, knowledge of the potential effects of TiO2 NPs on the treatment of drinking water is scarce. Herein, the effects of two types of anatase TiO2 NPs (TP1, 25 nm; TP2, 100 nm) on the bacterial community in a biological activated carbon (BAC) filter were investigated via quantitative polymerase chain reaction (Q-PCR) analysis, ATP quantification, and 454 pyrosequencing analysis. Both TP1 and TP2 significantly inhibited the bacterial ATP level (p treatment, whereas those of Bacilli class and Gammaproteobacteria class increased. TiO2 NP size showed a greater effect on the bacterial composition than did the dose based on Bray-Curtis distances. These findings identified negative effects of TiO2 NPs on the bacterial community in the BAC filter. Given the fact that BAC filters are used widely in drinking water treatment plants, these results suggested a potential threat by TiO2 NP to drinking water treatment system.

  15. Imidacloprid seed treatments affect individual ant behavior and community structure but not egg predation, pest abundance or soybean yield.

    Science.gov (United States)

    Penn, Hannah J; Dale, Andrew M

    2017-08-01

    Neonicotinoid seed treatments are under scrutiny because of their variable efficacy against crop pests and for their potential negative impacts on non-target organisms. Ants provide important biocontrol services in agroecosystems and can be indicators of ecosystem health. This study tested for effects of exposure to imidacloprid plus fungicide or fungicide-treated seeds on individual ant survival, locomotion and foraging capabilities and on field ant community structure, pest abundance, ant predation and yield. Cohorts of ants exposed to either type of treated seed had impaired locomotion and a higher incidence of morbidity and mortality but no loss of foraging capacity. In the field, we saw no difference in ant species richness, regardless of seed treatment. Blocks with imidacloprid did have higher species evenness and diversity, probably owing to variable effects of the insecticide on different ant species, particularly Tetramorium caespitum. Ant predation on sentinel eggs, pest abundance and soybean growth and yield were similar in the two treatments. Both seed treatments had lethal and sublethal effects on ant individuals, and the influence of imidacloprid seed coating in the field was manifested in altered ant community composition. Those effects, however, were not strong enough to affect egg predation, pest abundance or soybean yield in field blocks. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  16. Facial width-to-height ratio relates to alpha status and assertive personality in capuchin monkeys.

    Science.gov (United States)

    Lefevre, Carmen Emilia; Wilson, Vanessa A D; Morton, F Blake; Brosnan, Sarah F; Paukner, Annika; Bates, Timothy C

    2014-01-01

    Social dominance hierarchies play a pivotal role in shaping the behaviour of many species, and sex differences within these hierarchies often exist. To date, however, few physical markers of dominance have been identified. Such markers would be valuable in terms of understanding the etiology of dominant behaviour and changes in social hierarchies over time. Animals may also use such traits to evaluate the potential dominance of others relative to themselves (i.e. a physical "cue"). Facial width-to-height ratio (fWHR), for example, has been suggested as a cue to dominance in humans, with links to both dominant behaviour and the perception of dominance in other individuals. Whether this association is present in non-human animals is currently not known. Therefore, here we examine within-species links between fWHR and dominant behaviour in 64 brown capuchin monkeys (Sapajus spp.) aged between 2 and 40 years. fWHR was positively associated with alpha status and with a dimensional rating of assertive personality in both males and females. Moreover, fWHR showed significant sexual dimorphism in adults but not juveniles, suggesting a developmental change may occur during puberty. In a sub-sample, sex differences were mediated by weight, suggesting fWHR dimorphism does not exceed what would be expected by differences in body weight. This is the first report of an association between face shape and behaviour in a non-human species. Results are discussed in terms of the role that face-behaviour associations might play within capuchin societies, and the possible selective forces that might have led to the evolution of fWHR-dominance associations in humans.

  17. Community reinforcement training for family and significant others of drug abusers: a unilateral intervention to increase treatment entry of drug users.

    Science.gov (United States)

    Kirby, K C; Marlowe, D B; Festinger, D S; Garvey, K A; La Monaca, V

    1999-08-02

    We randomly assigned 32 concerned family members and significant others (FSOs) of drug users (DUs) to a community reinforcement training intervention or a popular 12-step self-help group. We measured problems arising from the DU's behavior, social functioning of the DU and FSO, and mood of the FSO at baseline and 10 weeks later. We also monitored the FSOs' treatment attendance and treatment entry of the DUs. The treatment groups showed equal reductions from baseline to follow-up in problems and improvements in social functioning and mood of the FSO. However the community reinforcement intervention was significantly better at retaining FSOs in treatment and inducing treatment entry of the DUs.

  18. Competency of psychiatric residents in the treatment of people with severe mental illness before and after a community psychiatry rotation.

    Science.gov (United States)

    Randall, Melinda; Romero-Gonzalez, Mauricio; Gonzalez, Gerardo; Klee, Anne; Kirwin, Paul

    2011-01-01

    psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents' 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. a 3-month rotation in psychiatric rehabilitation significantly improved residents' competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.

  19. Initiation and adherence to TB treatment in a Pakistani community influenced more by perceptions than by knowledge of tuberculosis

    Directory of Open Access Journals (Sweden)

    Mubashir Zafar

    2013-01-01

    Full Text Available Background: The tuberculosis (TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. Aims: To investigate knowledge about TB, perceptions of (access to TB treatment, and adherence to treatment among a Pakistani population. Setting and Design: Descriptive cross-sectional study. Materials and Methods: A total of 175 participants were selected nonrandomly, 100 were TB patient and 75 were non-TB patient in proportion to the total number of participants in each ward of hospital. Statistical Analysis: Analysis of attitudes and perceptions toward TB, adherence to TB treatment, health seeking behavior, and TB treatment types done by frequency counts and percentages. Regression analysis and logistic regression analysis were performed to test whether differences in age, gender, and education level led to different knowledge scores and different attitudes and preferences toward TB, adherence to TB treatment, health seeking behavior, and TB treatment types. All statistical analyses were performed using Statistical Package for Social Sciences (SPSS 16.0. Result: TB knowledge can be considered fairly well among this community. Respondents′ perceptions suggest that stigma may influence TB patients′ decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Conclusion: Most of the subjects were unaware of TB that seems to be due to their illiteracy and those who knew had got the knowledge from media, but the majority of the patients who were on directly observed treatment, short-course (DOTS were found to be satisfied.

  20. Effectiveness of Provider and Community Interventions to Improve Treatment of Uncomplicated Malaria in Nigeria: A Cluster Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Obinna Onwujekwe

    Full Text Available The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT. Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs with basic instruction (control; RDTs with provider training (provider arm; and RDTs with provider training plus a school-based community intervention (provider-school arm. The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93% of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36: stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26 in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19 in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47. Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.ClinicalTrials.gov NCT01350752.

  1. Utility of repeated praziquantel dosing in the treatment of schistosomiasis in high-risk communities in Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Charles H King

    2011-09-01

    Full Text Available Controversy persists about the optimal approach to drug-based control of schistosomiasis in high-risk communities. In a systematic review of published studies, we examined evidence for incremental benefits from repeated praziquantel dosing, given 2 to 8 weeks after an initial dose, in Schistosoma-endemic areas of Africa.We performed systematic searches of electronic databases PubMed and EMBASE for relevant data using search terms 'schistosomiasis', 'dosing' and 'praziquantel' and hand searches of personal collections and bibliographies of recovered articles. In 10 reports meeting study criteria, improvements in parasitological treatment outcomes after two doses of praziquantel were greater for S. mansoni infection than for S. haematobium infection. Observed cure rates (positive to negative conversion in egg detection assays were, for S. mansoni, 69-91% cure after two doses vs. 42-79% after one dose and, for S. haematobium, 46-99% cure after two doses vs. 37-93% after a single dose. Treatment benefits in terms of reduction in intensity (mean egg count were also different for the two species-for S. mansoni, the 2-dose regimen yielded an weighted average 89% reduction in standardized egg counts compared to a 83% reduction after one dose; for S. haematobium, two doses gave a 93% reduction compared to a 94% reduction with a single dose. Cost-effectiveness analysis was performed based on Markov life path modeling.Although schedules for repeated treatment with praziquantel require greater inputs in terms of direct costs and community participation, there are incremental benefits to this approach at an estimated cost of $153 (S. mansoni-$211 (S. haematobium per additional lifetime QALY gained by double treatment in school-based programs. More rapid reduction of infection-related disease may improve program adherence, and if, as an externality of the program, transmission can be reduced through more effective coverage, significant additional benefits are

  2. Pilot Experimentation with Complete Mixing Anoxic Reactors to Improve Sewage Denitrification in Treatment Plants in Small Communities

    Directory of Open Access Journals (Sweden)

    Massimo Raboni

    2013-12-01

    Full Text Available This paper reports the results of two sewage treatment tests in a community of 15,000 inhabitants. The sewage treatment plant is subject to strong fluctuations in load (BOD5, COD, TKN, and in particular in the BOD5/TKN ratio. These fluctuations adversely affect the biological denitrification, as demonstrated by many pilot and real-scale plants. The plants we tested were subjected to two treatment types: anoxic-aerobic and simultaneous denitrification. Both processes are designed for complete mixing conditions in the reactors in order to level the fluctuations in the load and thus improve the denitrification efficiency. The results prove that an average denitrification efficiency of up to 80% can be achieved with the sludge loading close to 0.1 kg BOD5 (d∙kgMLVSS−1. The effect of the sludge loading and dissolved oxygen on the denitrification efficiency is highlighted.

  3. Reduction of Severe Behavior Problems in the Community Using a Multicomponent Treatment Approach.

    Science.gov (United States)

    Carr, Edward G.; Carlson, Jane I.

    1993-01-01

    A multicomponent intervention to change problem behavior, which prevented community integration of three adolescents with autism, was evaluated. The intervention (implemented in a supermarket setting) included choice making, embedding, functional communication training, building tolerance for delay of reinforcement, and presenting discriminative…

  4. BEHAVIORAL ASPECTS IN COMMUNITY ORAL HEALTH PROBLEMS: A STUDY ON DENTAL TREATMENT DISCONTINUATION

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    Felix Aryadi Joelimar

    2015-08-01

    Full Text Available The low value of F/DMF-T ration on Performed Treatment Index in Indoneisa gives an indication of great problems in dental treatment utilization. Dental treatment utilization is affected by several obstacles, the greatest among which is psychosocial obstacles. In this study the psychosocial obstacles were detected through Intrinsic Obstacles, Obstacles in Transportation, and Obstacles in Dental Clinic related to their effects on their discontinuation of dental treatments at Balkesmas Kiara, Kecamatan Senen, Jakarta Pusat. The discontinuation of dental treatments was mostly affected by Intrinsic Obstacles, through its components as Types of Cases, Dental Anxiety Scale, and Intrinsic Motivation. Generally Obstacles in Transportation had no effects, excpet its components of Travel Time and Tiredness. Obstacles in Dental Clinic had a significant effect on the discontinuation of dental treatments through the unpleasant manner of the druggist, the hot waiting room, and the high expense on drugs.

  5. Post-treatment follow-up study of abdominal cystic echinococcosis in tibetan communities of northwest Sichuan Province, China.

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    Tiaoying Li

    2011-10-01

    Full Text Available Human cystic echinococcosis (CE, caused by the larval stage of Echinococcus granulosus, with the liver as the most frequently affected organ, is known to be highly endemic in Tibetan communities of northwest Sichuan Province. Antiparasitic treatment with albendazole remains the primary choice for the great majority of patients in this resource-poor remote area, though surgery is the most common approach for CE therapy that has the potential to remove cysts and lead to complete cure. The current prospective study aimed to assess the effectiveness of community based use of cyclic albendazole treatment in Tibetan CE cases, and concurrently monitor the changes of serum specific antibody levels during treatment.Ultrasonography was applied for diagnosis and follow-up of CE cases after cyclic albendazole treatment in Tibetan communities of Sichuan Province during 2006 to 2008, and serum specific IgG antibody levels against Echinococcus granulosus recombinant antigen B in ELISA was concurrently monitored in these cases. A total of 196 CE cases were identified by ultrasound, of which 37 (18.9% showed evidence of spontaneous healing/involution of hepatic cyst(s with CE4 or CE5 presentations. Of 49 enrolled CE cases for treatment follow-up, 32.7% (16 were considered to be cured based on B-ultrasound after 6 months to 30 months regular albendazole treatment, 49.0% (24 were improved, 14.3% (7 remained unchanged, and 4.1% (2 became aggravated. In general, patients with CE2 type cysts (daughter cysts present needed a longer treatment course for cure (26.4 months, compared to cases with CE1 (univesicular cysts (20.4 months or CE3 type (detached cyst membrane or partial degeneration of daughter cysts (9 months. In addition, the curative duration was longer in patients with large (>10 cm cysts (22.3 months, compared to cases with medium (5-10 cm cysts (17.3 months or patients with small (<5 cm cysts (6 months. At diagnosis, seven (53.8% of 13 cases with CE1 type

  6. Analysis of denitrifier community in a bioaugmented sequencing batch reactor for the treatment of coking wastewater containing pyridine and quinoline

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Yaohui; Xing, Rui; Wen, Donghui; Tang, Xiaoyan [Peking Univ., Beijing (CN). Key Lab. of Water and Sediment Sciences (Ministry of Education); Sun, Qinghua [Peking Univ., Beijing (CN). Key Lab. of Water and Sediment Sciences (Ministry of Education); Chinese Center for Disease Control and Prevention, Beijing (China). Inst. of Environmental Health and Related Product Safety

    2011-05-15

    The denitrifier community and associated nitrate and nitrite reduction in the bioaugmented and general sequencing batch reactors (SBRs) during the treatment of coking wastewater containing pyridine and quinoline were investigated. The efficiency and stability of nitrate and nitrite reduction in SBR was considerably improved after inoculation with four pyridine- or quinoline-degrading bacterial strains (including three denitrifying strains). Terminal restriction fragment length polymorphism (T-RFLP) based on the nosZ gene revealed that the structures of the denitrifier communities in bioaugmented and non-bioaugmented reactors were distinct and varied during the course of the experiment. Bioaugmentation protected indigenous denitrifiers from disruptions caused by pyridine and quinoline. Clone library analysis showed that one of the added denitrifiers comprised approximately 6% of the denitrifier population in the bioaugmented sludge. (orig.)

  7. Smoking and tobacco-free policies in women's residential substance use disorder treatment facilities: A community engaged approach.

    Science.gov (United States)

    Fallin-Bennett, Amanda; Parker, Kimberly A; Miller, Alana; Ashford, Kristin; Hahn, Ellen J

    2017-09-19

    The purpose of this study was to: (1) describe the role of smoking in the lives of women in residential SUD treatment; (2) explore perceptions of the facilitators and barriers to tobacco-free policy among women in residential SUD treatment. This was a community engaged study using qualitative descriptive methods. We first recruited women in a residential SUD treatment facility to participate on a community research team. Interviews with staff (N=10) and focus groups with clients (N=42) were conducted using guides informed by the community research team. Interviews and focus groups were analyzed using content analysis. There were two themes related to the role of smoking in the women's lives: (1) smoking facilitates socialization; and (2) smoking as a coping mechanism. There were three themes related to the benefits of tobacco-free policy: (1) improved health; (2) support for continued abstinence from a previous tobacco-free placement (e.g, prison); and (3) less grounds up-keep. Barriers to tobacco-free policy included: (1) lack of an alternative coping mechanism to smoking; (2) fear that a tobacco-free policy would drive clients away; and (3) anticipation of implementation challenges. Many women in residential SUD treatment smoke, which they attribute to the fact that smoking is used to facilitate socialization and cope with stress. Future research is needed to develop and test messages to counter the misperception that smoking is an effective method to cope with stress. Ultimately, evidence based tobacco-free policies are needed to reduce tobacco-related disease among women with SUDs. To promote smoking cessation among women with substance use disorders through evidence based tobacco policy, it is necessary to first understand the role of smoking in their lives as well as facilitators and barriers to tobacco-free policy in residential treatment facilities. Participants reported that smoking facilitated socialization and served as a coping mechanism. Tobacco

  8. Adaptation of the Patient Feedback Survey at a Community Treatment Setting

    OpenAIRE

    Kolodziej, Monika E.; Muchowski, Patrice M.; Hamdi, Nayla R.; Morrissette, Paula; Psy.D.,; McGowan, Alicen J.; Weiss, Roger D.

    2011-01-01

    The Patient Feedback Survey is a performance improvement measure designed to assess the quality of outpatient substance abuse treatment. We modified and administered this measure to 500 individuals at a multi-site treatment provider. Although the feedback scores were high in general, analyses of variance showed score variability in relation to type and length of treatment. Moreover, respondents who reported any use of marijuana, cravings for substances, or mutual-support group attendance (i.e...

  9. Adaptation of the patient feedback survey at a community treatment setting.

    Science.gov (United States)

    Kolodziej, Monika E; Muchowski, Patrice M; Hamdi, Nayla R; Morrissette, Paula; McGowan, Alicen J; Weiss, Roger D

    2012-01-01

    The Patient Feedback Survey is a performance improvement measure designed to assess the quality of outpatient substance abuse treatment. We modified and administered this measure to 500 individuals at a multisite treatment provider. Although the feedback scores were high in general, analyses of variance showed score variability in relation to type and length of treatment. Moreover, respondents who reported any use of marijuana, cravings for substances, or mutual-support group attendance (ie, Alcoholics Anonymous or Narcotics Anonymous) had lower feedback scores than respondents without these experiences. We highlight the importance of investigating treatment evaluations in the context of other recovery experiences.  Copyright © American Academy of Addiction Psychiatry.

  10. A randomized controlled evaluation of a spiritually integrated treatment for subclinical anxiety in the Jewish community, delivered via the Internet.

    Science.gov (United States)

    Rosmarin, David H; Pargament, Kenneth I; Pirutinsky, Steven; Mahoney, Annette

    2010-10-01

    This study evaluated the efficacy of a spiritually integrated treatment (SIT) for subclinical anxiety in the Jewish community. One hundred and twenty-five self-reported religious Jewish individuals with elevated levels of stress and worry received SIT (n=36), progressive muscle relaxation (PMR, n=42), or a waitlist control condition (WLC, n=47). SIT and PMR participants accessed Internet-based treatment on a daily basis for a period of 2 weeks. All participants completed self-report assessments at pre-treatment (T1), post-treatment (T2), and 6-8-week follow-up (T3). SIT participants reported large improvements in primary (stress and worry) and secondary (depression and intolerance of uncertainty) outcomes, and moderate improvements in spiritual outcomes (positive/negative religious coping; trust/mistrust in God). SIT participants reported greater belief in treatment credibility, greater expectancies from treatment and greater treatment satisfaction than PMR participants. SIT participants also reported better improvements in both primary outcomes (stress and worry), one of two secondary outcomes (intolerance of uncertainty), and two of four spiritual outcomes (positive religious coping and mistrust in God) compared to the WLC group, whereas PMR and WLC participants did not differ on most outcomes. Results of this investigation offer initial support for the efficacy of SIT for the treatment of subclinical anxiety symptoms among religious Jews. Results further suggest that it is important to incorporate spiritual content into treatment to help facilitate the delivery of psychotherapy to religious individuals. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. Performance and microbial community dynamics of electricity-assisted sequencing batch reactor (SBR) for treatment of saline petrochemical wastewater.

    Science.gov (United States)

    Liu, Jiaxin; Shi, Shengnan; Ji, Xiangyu; Jiang, Bei; Xue, Lanlan; Li, Meidi; Tan, Liang

    2017-07-01

    High-salinity wastewater is often difficult to treat by common biological technologies due to salinity stress on the bacterial community. Electricity-assisted anaerobic technologies have significantly enhanced the treatment performance by alleviating the impact of salinity stress on the bacterial community, but electricity-assisted aerobic technologies have less been reported. Herein, a novel bio-electrochemistry system has been designed and operated in which a pair of stainless iron mesh-graphite plate electrodes were installed into a sequencing batch reactor (SBR, designated as S1) to strengthen the performance of saline petrochemical wastewater under aerobic conditions. The removal efficiency of phenol and chemical oxygen demand (COD) in S1 were 94.1 and 91.2%, respectively, on day 45, which was clearly higher than the removal efficiency of a single SBR (S2) and an electrochemical reactor (S3), indicating that a coupling effect existed between the electrochemical process and biodegradation. A certain amount of salinity (≤8000 mg/L) could enhance the treatment performance in S1 but weaken that in S2. Illumina sequencing revealed that microbial communities in S1 on days 45 and 91 were richer and more diverse than in S2, which suggests that electrical stimulation could enhance the diversity and richness of the microbial community, and reduce the negative effect of salinity on the microorganisms and enrich some salt-adapted microorganisms, thus improve the ability of S1 to respond to salinity stress. This novel bio-electrochemistry system was shown to be an alternative technology for the high saline petrochemical wastewater.

  12. Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial.

    Science.gov (United States)

    Cohen, Judith A; Mannarino, Anthony P; Iyengar, Satish

    2011-01-01

    To evaluate community-provided trauma-focused cognitive behavior therapy (TF-CBT) compared with usual community treatment for children with intimate partner violence (IPV)-related posttraumatic stress disorder (PTSD) symptoms. Randomized controlled trial conducted using blinded evaluators. Recruitment, screening, and treatment were conducted at a community IPV center between September 1, 2004, and June 30, 2009. Of 140 consecutively referred 7- to 14-year-old children, 124 participated. Children and mothers were randomly assigned to receive 8 sessions of TF-CBT or usual care (child-centered therapy). Total child PTSD symptoms assessed using child and parent structured interview (Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version [K-SADS-PL]) and self-report (University of California at Los Angeles PTSD Reaction Index [RI]). Secondary child outcomes were scores on the K-SADS-PL (PTSD symptom clusters), Screen for Child Anxiety Related Emotional Disorders (SCARED) (anxiety), Children's Depression Inventory (depression), Kaufman Brief Intelligence Test (cognitive functioning), and Child Behavior Checklist (total behavior problems). Intent-to-treat analysis using last observation carried forward showed superior outcomes for TF-CBT on the total K-SADS-PL (mean difference, 1.63; 95% confidence interval [CI], 0.44-2.82), RI (mean difference, 5.5; 95% CI, 1.37-9.63), K-SADS-PL hyperarousal (mean difference, 0.71; 95% CI, 0.22-1.20), K-SADS-PL avoidance (0.55; 0.07-1.03), and SCARED (mean difference, 5.13; 95% CI, 1.31-8.96). Multiple imputation analyses confirmed most of these findings. The TF-CBT completers experienced significantly greater PTSD diagnostic remission (χ(2) = 4.67, P = .03) and had significantly fewer serious adverse events. Community TF-CBT effectively improves children's IPV-related PTSD and anxiety. clinicaltrials.gov Identifier: NCT00183326.

  13. Investigating Impacts of Incorporating an Adjuvant Mind–Body Intervention Method Into Treatment as Usual at a Community-Based Substance Abuse Treatment Facility

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    Yoshio Nakamura

    2015-02-01

    Full Text Available Treatment of substance use/misuse (SUM continues to pose a difficult challenge. This exploratory pilot study evaluated whether a novel mind–body intervention program called “Mind–Body Bridging” (MBB could be an effective short-term adjuvant intervention for managing SUM and coexisting symptoms in women undergoing residential and outpatient substance use treatment in a community setting. Thirty-eight women attending a local substance abuse (SA facility were recruited and randomly assigned to either (a treatment as usual (TAU or (b MBB and TAU. The MBB program consisted of 20 sessions and lasted for 10 weeks. Participants were asked to complete a set of self-report questionnaires designed to assess drug/alcohol cravings, impact of past trauma, depression, sleep disturbance, mindfulness, self-compassion, and well-being. They completed the questionnaires at three time points: preintervention, midintervention (after the fifth week, and postintervention. MBB + TAU significantly reduced drug/alcohol cravings, trauma-related thinking, and disturbed sleep in comparison with TAU. Furthermore, MBB + TAU significantly increased mindfulness, self-compassion, and well-being in comparison with TAU. MBB for SUM appears promising as a complementary adjuvant intervention, warranting future larger scale randomized controlled trials of MBB for SUM populations. SUM is a difficult condition to treat and manage clinically, especially given the multiple comorbid conditions that frequently affect those with SUM. In the search to develop effective adjuvant interventions for SUM, the present pilot study suggested that adding MBB to standard SUM treatment in community-based settings could enhance therapeutic efficacy and quality of care.

  14. Association of biodiversity with the rates of micropollutant biotransformations among full-scale wastewater treatment plant communities.

    Science.gov (United States)

    Johnson, David R; Helbling, Damian E; Lee, Tae Kwon; Park, Joonhong; Fenner, Kathrin; Kohler, Hans-Peter E; Ackermann, Martin

    2015-01-01

    Biodiversities can differ substantially among different wastewater treatment plant (WWTP) communities. Whether differences in biodiversity translate into differences in the provision of particular ecosystem services, however, is under active debate. Theoretical considerations predict that WWTP communities with more biodiversity are more likely to contain strains that have positive effects on the rates of particular ecosystem functions, thus resulting in positive associations between those two variables. However, if WWTP communities were sufficiently biodiverse to nearly saturate the set of possible positive effects, then positive associations would not occur between biodiversity and the rates of particular ecosystem functions. To test these expectations, we measured the taxonomic biodiversity, functional biodiversity, and rates of 10 different micropollutant biotransformations for 10 full-scale WWTP communities. We have demonstrated that biodiversity is positively associated with the rates of specific, but not all, micropollutant biotransformations. Thus, one cannot assume whether or how biodiversity will associate with the rate of any particular micropollutant biotransformation. We have further demonstrated that the strongest positive association is between biodiversity and the collective rate of multiple micropollutant biotransformations. Thus, more biodiversity is likely required to maximize the collective rates of multiple micropollutant biotransformations than is required to maximize the rate of any individual micropollutant biotransformation. We finally provide evidence that the positive associations are stronger for rare micropollutant biotransformations than for common micropollutant biotransformations. Together, our results are consistent with the hypothesis that differences in biodiversity can indeed translate into differences in the provision of particular ecosystem services by full-scale WWTP communities. Copyright © 2015, American Society for

  15. [The relationship between four components of assertiveness and interpersonal behaviors, interpersonal adjustment in high school students' friendship].

    Science.gov (United States)

    Watanabe, Asami

    2010-04-01

    This study examines the relationship between four components of assertiveness ("open expression", "control of emotion", "consideration for others" and "self-direction") and interpersonal behaviors on friends, interpersonal stress events, social anxiety. A questionnaire which included scales to measure the four components of assertiveness, activities with friend, considerate behavior for friends, interpersonal stress events and social anxiety was completed by 177 high school students. The results showed that "self-direction" had curvilinear relations with considerate behavior for friends, interpersonal stress events. An excessively high score for "self-direction" was associated with fewer considerate behavior and interpersonal stress events. An optimum score for "self-direction" was associated with more considerate behavior and interpersonal stress events.

  16. Documentation of Herbal Medicines Used for the Treatment and Management of Human Diseases by Some Communities in Southern Ghana

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    Augustine A. Boadu

    2017-01-01

    Full Text Available Traditional medicine is an important component of the health care system of most developing countries. However, indigenous knowledge about herbal medicines of many Ghanaian cultures has not yet been investigated. The aim of the present study was to document herbal medicines used by traditional healers to treat and manage human diseases and ailments by some communities living in Ghana. The study was conducted in eight communities in southern Ghana. Data were collected from 45 healers using ethnobotanical questionnaire and voucher specimens were collected. A total of 52 species of plants belonging to 28 plant families were reportedly used for treatment and management of 42 diseases and ailments. Medicinal plants were commonly harvested from the wild and degraded lowland areas in the morning from loamy soil. Herbal medicines were prepared in the form of decoctions (67% and infusions (33%. Oral administration of the herbals was most (77% common route of administration whereas the least used routes were nasal (1% and rectal (2%. The results of the study show that herbal medicines are used for treatment and management of both common and specialized human diseases and that factors of place and time are considered important during harvesting of plants for treatments.

  17. A comparative assessment of intensive and extensive wastewater treatment technologies for removing emerging contaminants in small communities.

    Science.gov (United States)

    Matamoros, Víctor; Rodríguez, Yolanda; Albaigés, Joan

    2016-01-01

    Ecosystem pollution due to the lack of or inefficient wastewater treatment coverage in small communities is still a matter of great concern, even in developed countries. This study assesses the seasonal performance of 4 different full-scale wastewater technologies that have been used in small communities (treatment systems (an extended aeration system (AS) and a rotating biological contactor (RBC)) and two extensive treatment systems (a constructed wetland (CW) and a waste stabilization pond (WSP)), all located in north-eastern Spain. The studied compounds belonged to the groups of pharmaceuticals, sunscreen compounds, fragrances, antiseptics, flame retardants, surfactants, pesticides and plasticizers. The 25 ECs occurred in wastewater at concentrations ranging from undetectable to 80 μg L(-1). The average removal efficiency was 42% for the CW, 62% for the AS, 63% for the RBC and 82% for the WSP. All the technologies except the WSP system showed seasonal variability in the removal of ECs. The ecotoxicological assessment study revealed that, whilst all the technologies were capable of decreasing the aquatic risk, only the WSP yielded no risk in both seasons. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Community risk factors for ocular Chlamydia infection in Niger: pre-treatment results from a cluster-randomized trachoma trial.

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    Abdou Amza

    Full Text Available Trachoma control programs utilize mass azithromycin distributions to treat ocular Chlamydia trachomatis as part of an effort to eliminate this disease world-wide. But it remains unclear what the community-level risk factors are for infection.This cluster-randomized, controlled trial entered 48 randomly selected communities in a 2×2 factorial design evaluating the effect of different treatment frequencies and treatment coverage levels. A pretreatment census and examination established the prevalence of risk factors for clinical trachoma and ocular chlamydia infection including years of education of household head, distance to primary water source, presence of household latrine, and facial cleanliness (ocular discharge, nasal discharge, and presence of facial flies. Univariate and multivariate associations were tested using linear regression and Bayes model averaging.There were a total of 24,536 participants (4,484 children aged 0-5 years in 6,235 households in the study. Before treatment in May to July 2010, the community-level prevalence of active trachoma (TF or TI utilizing the World Health Organization [WHO] grading system was 26.0% (95% CI: 21.9% to 30.0% and the mean community-level prevalence of chlamydia infection by Amplicor PCR was 20.7% (95% CI: 16.5% to 24.9% in children aged 0-5 years. Univariate analysis showed that nasal discharge (0.29, 95% CI: 0.04 to 0.54; P = 0.03, presence of flies on the face (0.40, 95% CI: 0.17 to 0.64; P = 0.001, and years of formal education completed by the head of household (0.07, 95% CI: 0.07 to 0.13; P = 0.03 were independent risk factors for chlamydia infection. In multivariate analysis, facial flies (0.26, 95% CI: 0.02 to 0.49; P = 0.03 and years of formal education completed by the head of household (0.06, 95% CI: 0.008 to 0.11; P = 0.02 were associated risk factors for ocular chlamydial infection.We have found that the presence of facial flies and years of education of the head

  19. Cost and cost-effectiveness of community based and health facility based directly observed treatment of tuberculosis in Dar es Salaam, Tanzania

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    Robberstad Bjarne

    2005-07-01

    Full Text Available Abstract Background Identifying new approaches to tuberculosis treatment that are effective and put less demand to meagre health resources is important. One such approach is community based direct observed treatment (DOT. The purpose of the study was to determine the cost and cost effectiveness of health facility and community based directly observed treatment of tuberculosis in an urban setting in Tanzania. Methods Two alternative strategies were compared: health facility based directly observed treatment by health personnel and community based directly observed treatment by treatment supervisors. Costs were analysed from the perspective of health services, patients and community in the year 2002 in US $ using standard methods. Treatment outcomes were obtained from a randomised-controlled trial which was conducted alongside the cost study. Smear positive, smear negative and extra-pulmonary TB patients were included. Cost-effectiveness was calculated as the cost per patient successfully treated. Results The total cost of treating a patient with conventional health facility based DOT and community based DOT were $ 145 and $ 94 respectively. Community based DOT reduced cost by 35%. Cost fell by 27% for health services and 72% for patients. When smear positive and smear negative patients were considered separately, community DOT was associated with 45% and 19% reduction of the costs respectively. Patients used about $ 43 to follow their medication to health facility which is equivalent to their monthly income. Indirect costs were as important as direct costs, contributing to about 49% of the total patient's cost. The main reason for reduced cost was fewer number of visits to the TB clinic. Community based DOT was more cost-effective at $ 128 per patient successfully treated compared to $ 203 for a patient successfully treated with health facility based DOT. Conclusion Community based DOT presents an economically attractive option to complement

  20. Test Anxiety: Theory, Assessment, and Treatment. The Series in Clinical and Community Psychology.

    Science.gov (United States)

    Spielberger, Charles D., Ed.; Vagg, Peter R., Ed.

    It is not surprising that a broad array of treatment programs have been developed to reduce test anxiety, since the consequences can be serious. The contributions in this volume review and evaluate the theory of test anxiety, its measurement, its manifestations, and possible treatments and their outcomes. The following chapters are included: (1)…