Sample records for diverse client group

  1. Group Work with Transgender Clients (United States)

    Dickey, Lore M.; Loewy, Michael I.


    Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…

  2. Clinical use of the Kessler psychological distress scales with culturally diverse groups. (United States)

    Stolk, Yvonne; Kaplan, Ida; Szwarc, Josef


    The Kessler 10 (K10) and embedded Kessler 6 (K6) was developed to screen for non-specific psychological distress and serious mental illness in mental health surveys of English-speaking populations, but has been adopted in Western and non-Western countries as a screening and outcome measure in primary care and mental health settings. This review examines whether the original K6/K10's validity for culturally diverse populations was established, and whether the cultural equivalence, and sensitivity to change of translated or culturally adapted K6/K10s, has been demonstrated with culturally diverse client groups. Evidence for the original K6/K10's validity for culturally diverse populations is limited. Questions about the conceptual and linguistic equivalence of translated/adapted K6/K10s arise from reports of changes in item connotation and differential item functioning. Evidence for structural equivalence is inconsistent, as is support for criterion equivalence, with the majority of studies compromising on accuracy in case prediction. Research demonstrating sensitivity to change with culturally diverse groups is lacking. Inconsistent evidence for the K6/K10's cultural appropriateness in clinical settings, and a lack of clinical norms for either majority or culturally diverse groups, indicate the importance of further research into the psychological distress construct with culturally diverse clients, and the need for caution in interpreting K6/K10 scores. Copyright © 2014 John Wiley & Sons, Ltd.

  3. 75 FR 66796 - Pricewaterhousecoopers LLP (“PwC”), Internal Firm Services Client Account Administrators Group... (United States)


    ... LLP (``PwC''), Internal Firm Services Client Account Administrators Group Atlanta, GA; Amended...''), Internal Firm Services Client Account Administrators Group. Accordingly, the Department is amending this... Firm Services Client Account Administrators Group. The amended notice applicable to TA-W-73,630 is...

  4. 75 FR 66797 - PricewaterhouseCoopers LLP (“PwC”) Internal Firm Services Client Account Administrators Group... (United States)


    ... LLP (``PwC'') Internal Firm Services Client Account Administrators Group, Charlotte, NC; Amended... Firm Services Client Account Administrators Group. Accordingly, the Department is amending this... Firm Services Client Account Administrators Group. The amended notice applicable to TA-W-73,608 is...

  5. 77 FR 24685 - Proposed Information Collection; Comment Request; Client Focus Groups and Qualitative Interviews (United States)


    ... Request; Client Focus Groups and Qualitative Interviews AGENCY: International Trade Administration (ITA... ``Quality Assurance Surveys'' to collect feedback from the U.S. business clients it serves. These surveys ask the client to evaluate the U.S. Commercial Service on its customer service provision. Results from...

  6. Individualistic and Collective Group Counseling: Effects with Korean Clients. (United States)

    Lee, In-Ja; Kelly, Eugene W., Jr.


    In a study of 20 female and 21 male Korean clients with three group counseling approaches (individualistic, collective, and combination of both), no treatment effects were found for social commitment or perceptions of counselor effectiveness. Significant changes were seen in individualism-collectivism congruent with different treatments. (Author)

  7. Working with Clients Who Engage in Self-Harming Behaviour: Experiences of a Group of Counsellors (United States)

    Fox, Claudine


    This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed…

  8. Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia. (United States)

    Smith, Cynthia; McNaughton, Darlene A; Meyer, Samantha


    Type 2 diabetes mellitus (T2DM) is a progressive chronic disease that requires significant self-surveillance and adherence to the treatment protocols for successful management and future health. There is a growing body of evidence suggesting that diabetes education is beneficial for patient outcomes. However, there is some debate about how best to deliver diabetes education, whether individually or in groups. Although several studies have investigated the role of group education in improving the management of T2DM, few studies have examined this issue from the client's perspective. It is here that this study makes a contribution to understanding diabetes management. Drawing on systematic observation of group education sessions provided by diabetic resource nurses and in-depth interviews with clients, this paper describes the experiences, perspectives and significance of these sessions to clients. Our results suggest that group education sessions were seen as valuable to the clients for: the opportunity they provided to meet others living with diabetes; to improve motivation for managing the disease; and to enhance knowledge of diabetes, its management and long-term implications. In short, this study demonstrates that the clients value group education sessions for the social contact, increasing knowledge about the disease for self-management and support they provide; factors recognised as important to maintaining health. In addition, group education sessions appear to be a cost-effective method for diabetes self-management that funders need to consider.


    Directory of Open Access Journals (Sweden)

    Ângela Cristina Bueno Vieira


    Full Text Available ABSTRACT: In our experience and work in the Medical Clinic at the Federal University of Goiás Clinical Hospital (HC/UFG, we observe that in despite of the most patients get orientations about their pathology by the health team, they don’t accomplish these orientations. For the continuous self-care promotion was implanted project "Citizen Client", with intention to contribute to patient citizenship rescue, guiding and strengthening its rights and duties while carrying on pathology. This article is an experience related by a qualitative approach with a group of patients interned in the Medical Clinic of the HC/UFG that rambles, their familiars and that ones who participates in the project Citizen Client during their internment in the year of 2003. On the meeting we work with lectures, workshops and groups by the multi-professional team and coordinated by a Nurse. The subjects had been diverse, approaching some pathology and its cares, social and spiritual assistance. The client participation in its recovery has extreme importance and, so that this occurs, it is necessary health education understood in its extended form, recognizing the client’s life reality, their day-by-day, providing mechanisms for them to become an asset subject with autonomy to act in favor of own health. KEYWORDS: Health Education; Self Care; Quality of Life.

  10. Cultural humility: measuring openness to culturally diverse clients. (United States)

    Hook, Joshua N; Davis, Don E; Owen, Jesse; Worthington, Everett L; Utsey, Shawn O


    Building on recent theory stressing multicultural orientation, as well as the development of virtues and dispositions associated with multicultural values, we introduce the construct of cultural humility, defined as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individual's cultural background and experience. In 4 studies, we provide evidence for the estimated reliability and construct validity of a client-rated measure of a therapist's cultural humility, and we demonstrate that client perceptions of their therapist's cultural humility are positively associated with developing a strong working alliance. Furthermore, client perceptions of their therapist's cultural humility were positively associated with improvement in therapy, and this relationship was mediated by a strong working alliance. We consider implications for research, practice, and training. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  11. Diversity within African American, female therapists: variability in clients' expectations and assumptions about the therapist. (United States)

    Kelly, Jennifer F; Greene, Beverly


    Despite the presence of some literature that has addressed the characteristics of the African American female therapist, most psychotherapy training proceeds with the assumption that therapists are members of dominant groups, and most of the psychological and psychotherapy literature has been written by therapists and psychologists who come from dominant cultural perspectives. Not as much has been written about psychological paradigms or the process of psychotherapy from the perspective of the therapist who is not a dominant group member. This article explores both the common and divergent experiences that we, the authors, share as African American female therapists and the different reactions we frequently elicit in clients. We also explore how individual differences in our physical appearances, personal backgrounds, and different characteristics of our respective practices elicit distinct responses from clients that we believe are based on differences between us, despite the fact that we are both African American women. We believe that many of the stereotypes that affect perceptions of African American female clients also exist for African American female therapists. We will address how the intersection of gender, race, and sexual orientation of the client highlights the complexity of culturally competent practice. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  12. Examining the Effectiveness of Functional Family Therapy across Diverse Client Ethnic Groups (United States)

    Dunham, Jessica Barfield


    Treatment for adolescent problem behavior has been given extensive attention in the literature due to the serious nature of the problem and the potential risk to others and the community. As the needs of an increasingly diverse juvenile population intensify and mounting evidence suggests ethnic minority youth receive disparate treatment across…

  13. Social networks and links to isolation and loneliness among elderly HCBS clients. (United States)

    Medvene, Louis J; Nilsen, Kari M; Smith, Rachel; Ofei-Dodoo, Samuel; DiLollo, Anthony; Webster, Noah; Graham, Annette; Nance, Anita


    The purpose of this study was to explore the network types of HCBS clients based on the structural characteristics of their social networks. We also examined how the network types were associated with social isolation, relationship quality and loneliness. Forty personal interviews were carried out with HCBS clients to assess the structure of their social networks as indicated by frequency of contact with children, friends, family and participation in religious and community organizations. Hierarchical cluster analysis was conducted to identify network types. Four network types were found including: family (n = 16), diverse (n = 8), restricted (n = 8) and religious (n = 7). Family members comprised almost half of participants' social networks, and friends comprised less than one-third. Clients embedded in family, diverse and religious networks had significantly more positive relationships than clients embedded in restricted networks. Clients embedded in restricted networks had significantly higher social isolation scores and were lonelier than clients in diverse and family networks. The findings suggest that HCBS clients' isolation and loneliness are linked to the types of social networks in which they are embedded. The findings also suggest that clients embedded in restricted networks are at high risk for negative outcomes.

  14. Massage therapy services for healthcare: a telephone focus group study of drivers for clients' continued use of services. (United States)

    Smith, Joanna M; Sullivan, S John; Baxter, G David


    To explore opinions of why clients use, value and continue to seek massage therapy as a healthcare option. Telephone focus group methodology was used. Current and repeat users (n = 19) of either relaxation, remedial or sports massage therapy services participated in three telephone focus groups. Audiotaped semi-structured interviews were conducted. Telephone focus group with massage clients from provincial and urban localities in New Zealand. Summary of reported themes of the massage experience and suggested drivers for return to, or continuing with massage therapy. Data were transcribed, categorised (NVivo7) and thematically analysed using the general inductive approach. Key drivers for return to, or continuing with, massage therapy were: positive outcomes, expectations of goals being met, a regular appointment and the massage therapy culture. Massage therapy is perceived and valued as a personalised, holistic and hands-on approach to health management, which focuses on enhancing relaxation in conjunction with effective touch, within a positive client-therapist relationship and a pleasant non-rushed environment. Massage therapy as a health service is result and client driven but is reinforced by the culture of the experience.

  15. Do client attributes moderate the effectiveness of a group cognitive behavioral therapy for depression in addiction treatment? (United States)

    Hunter, Sarah B; Paddock, Susan M; Zhou, Annie; Watkins, Katherine E; Hepner, Kimberly A


    The study goal was to determine whether client attributes were associated with outcomes from group cognitive behavioral therapy for depression (GCBT-D) as delivered in community-based addiction treatment settings. Data from 299 depressed residential clients assigned to receive either usual care (N = 159) or usual care plus GCBT-D (N = 140) were examined. Potential moderators included gender, race/ethnicity, education, referral status, and problem substance use. Study outcomes at 6 months post-baseline included changes in depressive symptoms, mental health functioning, negative consequences from substance use, and percentage of days abstinent. Initial examination indicated that non-Hispanic Whites had significantly better outcomes than other racial/ethnic groups on two of the four outcomes. After correcting for multiple testing, none of the examined client attributes moderated the treatment effect. GCBT-D appears effective; however, the magnitude and consistency of treatment effects indicate that it may be less helpful among members of racial/ethnic minority groups and is worthy of future study.

  16. Some common indices of group diversity: upper boundaries. (United States)

    Solanas, Antonio; Selvam, Rejina M; Navarro, José; Leiva, David


    Workgroup diversity can be conceptualized as variety, separation, or disparity. Thus, the proper operationalization of diversity depends on how a diversity dimension has been defined. Analytically, the minimal diversity must be obtained when there are no differences on an attribute among the members of a group, however maximal diversity has a different shape for each conceptualization of diversity. Previous work on diversity indexes indicated maximum values for variety (e.g., Blau's index and Teachman's index), separation (e.g., standard deviation and mean Euclidean distance), and disparity (e.g., coefficient of variation and the Gini coefficient of concentration), although these maximum values are not valid for all group characteristics (i.e., group size and group size parity) and attribute scales (i.e., number of categories). We demonstrate analytically appropriate upper boundaries for conditional diversity determined by some specific group characteristics, avoiding the bias related to absolute diversity. This will allow applied researchers to make better interpretations regarding the relationship between group diversity and group outcomes.

  17. Provision of care to clients of migrant origin: the experiences of maternity care providers.

    NARCIS (Netherlands)

    Boerleider, A.W.; Francke, A.L.; Wiegers, T.A.; Manniën, J.; Devillé, W.L.J.M.


    Background: Women of non-western migrant origin comprise a substantial part of the client population in maternity care. According to Statistics Netherlands, mothers of non-western migrant origin contribute to 17% of all live births. This group is very diverse in origin which implies a variety in

  18. Relating Therapist Characteristics to Client Engagement and the Therapeutic Alliance in an Adolescent Custodial Group Substance Misuse Treatment Program. (United States)

    Daniels, Rachael Anne; Holdsworth, Emma; Tramontano, Carlo


    Client engagement in substance misuse treatment programs is directly associated with positive treatment outcomes. The nature of these programs means there are often difficulties engaging and retaining clients, but authors have consistently found a strong therapeutic alliance is associated with client engagement. While research has focused on the association between the alliance and engagement, the factors that influence the therapeutic alliance have received less attention. To examine therapists' characteristics, namely therapists' stress and empathy levels, as potential predictors of client engagement and the therapeutic alliance, within an adolescent substance misuse group treatment program. The sample included 84 adolescent clients and 14 therapists from a Secure Training Centre in England. Client engagement in the treatment program was observed, while self-reporting measures assessed the therapeutic alliance (client and therapist-rated), and therapists' stress and empathy levels. Multiple regression analysis revealed that therapists' stress levels negatively influenced the therapeutic alliance and had a curvilinear relationship with client engagement, indicating that stress is not exclusively negatively related to engagement. Although stress was found to negatively impact both cognitive and affective empathy, neither cognitive nor affective empathy were significantly related to client engagement or the therapeutic alliance. This study demonstrates the importance of therapist characteristics on client engagement and the therapeutic alliance. Within practice stress can have a positive impact on clients' engagement. Nevertheless, therapists may need additional support to deal with stress effectively. Therapists' empathy may too be fundamental to client engagement, but only it if is perceived by clients.

  19. Three Levels of Diversity: An Examination of the Complex Relationship Between Diversity, Group Cohesiveness, Sexual Harassment, Group Performance, and Time

    National Research Council Canada - National Science Library

    Whaley, Gary


    ...: surface, working, and deep level diversity. The author explains the nature of the relationship between the three levels of diversity and posits a general model of organizational behavior including diversity, group cohesiveness, group...

  20. Do client fees help or hurt? (United States)

    Barnett, B


    This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

  1. Developing a cultural context for conducting a neuropsychological evaluation with a culturally diverse client: the ECLECTIC framework. (United States)

    Fujii, Daryl E M


    With the increasing diversification of the American population, the discipline of neuropsychology is challenged to develop appropriate tools and conceptual models to meet its evolving client base. Thus far, the focus has been on developing appropriate tests and norms to obtain accurate testing data. By contrast, far less attention has been paid to the contextual impact of culture on an evaluation. This paper attempts to address this shortcoming. This manuscript introduces the ECLECTIC framework for conceptualizing different facets of culture pertinent for understanding a culturally diverse client when conducting a neuropsychological evaluation. Individual components of the framework (E: education and literacy; C: culture and acculturation; L: language; E: economics; C: communication; T: testing situation: comfort and motivation; I: intelligence conceptualization; and C: context of immigration) are introduced and potential biases to fairness in testing are described. In this manner, the framework specifies how individual facets of culture can impact neuropsychological test performance. Clinical implementation of the framework will be illustrated with a case sample. Strengths and weaknesses of the framework are discussed as well as recommendations for implementation.

  2. Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion. (United States)


    In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

  3. Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients (United States)

    American Psychologist, 2012


    The "Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients" provide psychologists with (a) a frame of reference for the treatment of lesbian, gay, and bisexual clients and (b) basic information and further references in the areas of assessment, intervention, identity, relationships, diversity, education, training, and…

  4. The impact of group composition and attitudes towards diversity on anticipated outcomes of diversity in groups

    NARCIS (Netherlands)

    van Oudenhoven-van der Zee, Karen; Paulus, Paul; Vos, Menno; Parthasarathy, Niveditha

    In two studies, students evaluated group pictures of workgroups of varying ethnic and gender composition with respect to anticipated affective and productive outcomes. The impact of level of diversity, faultlines and individual differences in diversity attitudes on anticipated outcomes were

  5. Psychosocial stressors contributing to emergency psychiatric service utilization in a sample of ethno-culturally diverse clients with psychosis in Toronto. (United States)

    Rotenberg, Martin; Tuck, Andrew; McKenzie, Kwame


    Understanding the psychosocial stressors of people with psychoses from minority ethnic groups may help in the development of culturally appropriate services. This study aimed to compare psychosocial factors associated with attendance at an emergency department (ED) for six ethnic groups. Preventing crises or supporting people better in the community may decrease hospitalization and improve outcomes. A cohort was created by retrospective case note analysis of people of East-Asian, South-Asian, Black-African, Black-Caribbean, White-North American and White-European origin groups attending a specialized psychiatric ED in Toronto with a diagnosis of psychosis between 2009 and 2011. The psychological or social stressors which were linked to the presentation at the ED that were documented by the attending physicians were collected for this study. Logistic regression models were constructed to analyze the odds of presenting with specific stressors. Seven hundred sixty-five clients were included in this study. Forty-four percent of the sample did not have a psychiatrist, and 53% did not have a primary care provider. Social environmental stressors were the most frequent psychosocial stressor across all six groups, followed by issues in the primary support group, occupational and housing stressors. When compared to White-North American clients, East-Asian and White-European origin clients were less likely to present with a housing stressor, while Black-African clients had decreased odds of presenting with primary support group stressor. Having a primary care provider or psychiatrist were predominantly protective factors. In Toronto, moving people with chronic mental health conditions out of poverty, increasing the social safety net and improving access to primary care and community based mental health services may decrease many of the stressors which contribute to ED attendance.

  6. Cultural diversity and patient teaching. (United States)

    Price, J L; Cordell, B


    Cultural diversity challenges health care providers to facilitate bridging cross-cultural gaps with clients. It is through providing culturally relevant care that health care practitioners truly serve the needs of all clients in our diverse society. A theory of Cultural Care Diversity and Universality offers a framework for building linkages of clinical knowledge to cultural care. A four-step approach to providing culturally sensitive patient teaching is described: (1) health care providers should assess their own cultural beliefs and be aware of general ethnic, regional, and religious beliefs and practices in their area; (2) develop a teaching plan; (3) implement the plan; (4) evaluate the success of the teaching-learning process and make alterations based on evaluation. When providers assess clients' beliefs and practices and incorporate them into the teaching plan design, teaching becomes more relevant and clients become more successful at learning.

  7. Maximising health literacy and client recall of clinical information: An exploratory study of clients and speech-language pathologists

    Directory of Open Access Journals (Sweden)

    Friderike Schmidt von Wûhlisch


    Full Text Available Limited research has been carried out in the field of speech-language pathology with regard to ways of maximising health literacy and client recall. However, speech-language pathologists (SLPs frequently provide vast amounts of information that clients need to understand, apply and review in order to manage their (or their child’s health. This exploratory study aimed to contribute information about ways in which SLPs can overcome low health literacy and poor client recall so that treatment effectiveness is improved. A case-study design was used with specific focus on four clients receiving treatment for dysphagia, voice disorders (including laryngectomies and cleft lip and/or palate management in Cape Town. Strategies which may be able to maximise health literacy and client recall of clinical information were trialled and evaluated by clients and their SLPs, using semi-structured interviews. The researchers proposed a combination of high-tech strategies which assisted in all the cases. No single solution or universal tool was found that would be appropriate for all. There is a need to evaluate the long-term effectiveness of the combined strategies across a wider population, at different stages of rehabilitation and in diverse contexts. Implications and suggestions for future related research are presented.

  8. New way of working: Professionals' expectations and experiences of the Culture and Health Project for clients with psychiatric disabilities: A focus group study. (United States)

    Wästberg, Birgitta A; Sandström, Boel; Gunnarsson, Anna Birgitta


    There is a need for various types of interventions when meeting needs of clients with psychiatric disabilities and complementary interventions may also influence their well-being. The Culture and Health project, based on complementary interventions with 270 clients, was created in a county in Sweden for clients with psychiatric disabilities and for professionals to carry out the interventions. The aim of this study was to investigate the professionals' expectations regarding the project and their clients' possibilities for participating, and to investigate the professionals' experiences of the project after its completion. Focus group data with a total of 30 professionals participating were collected. A qualitative content analysis revealed four categories of the professionals' expectations before entering the project: "Clients' own possibilities and limitations for their development and independence", "Professionals' possibilities for supporting the clients", "Societal prerequisites", and "Expectations of a new way of working". Furthermore, the analysis regarding professionals' experiences after working with the project revealed three categories: "Adopting the challenges", "Having ways of working that function - prerequisites and possibilities", and "Meeting the future - an ambition to continue". Working in the Culture and Health project together with the clients in group-based activities was perceived as beneficial, although challenges arose. When implementing cultural activities, support from stakeholder organisations is needed. © 2017 Australian College of Mental Health Nurses Inc.

  9. Fostering group identification and creativity in diverse groups: the role of individuation and self-verification. (United States)

    Swann, William B; Kwan, Virginia S Y; Polzer, Jeffrey T; Milton, Laurie P


    A longitudinal study examined the interplay of identity negotiation processes and diversity in small groups of master's of business administration (MBA) students. When perceivers formed relatively positive impressions of other group members, higher diversity predicted more individuation of targets. When perceivers formed relatively neutral impressions of other group members, however, higher diversity predicted less individuation of targets. Individuation at the outset of the semester predicted self-verification effects several weeks later, and self-verification, in turn, predicted group identification and creative task performance. The authors conclude that contrary to self-categorization theory, fostering individuation and self-verification in diverse groups may maximize group identification and productivity.

  10. Client Predictors of Short-term Psychotherapy Outcomes among Asian and White American Outpatients (United States)

    Kim, Jin E.; Zane, Nolan W.; Blozis, Shelley A.


    Purpose To examine predictors of psychotherapy outcomes, focusing on client characteristics that are especially salient for culturally diverse clients. Method Sixty clients (31 women; 27 White Americans, 33 Asian Americans) participated in this treatment study. Client characteristics were measured at pre-treatment, and outcomes were measured post-fourth session via therapist ratings of functioning and symptomatology. Regression analyses were utilized to test for predictors of outcomes, and bootstrap analyses were utilized to test for mediators. Results Higher levels of somatic symptoms predicted lower psychosocial functioning at post-treatment. Avoidant coping style predicted more negative symptoms and more psychological discomfort. Non-English language preference predicted worse outcomes; this effect was mediated by an avoidant coping style. Conclusions Language preference, avoidant coping style, and somatic symptoms predicted treatment outcome in a culturally diverse sample. Findings suggest that race/ethnicity-related variables may function through mediating proximal variables to affect outcomes. PMID:22836681

  11. Demographic diversity, communication and learning behaviour in healthcare groups

    NARCIS (Netherlands)

    Curseu, P.L.


    An integrative model of group learning was tested in a sample of 40 healthcare groups (434 respondents), and the results show that age diversity reduces the frequency of face-to-face communication whereas educational diversity reduces the frequency of virtual communication in healthcare groups.

  12. Connaissances, attitudes et pratiques en focus group des clients ...

    African Journals Online (AJOL)

    According to the transmission's fashion of the illness, the clients' majority cited sexual rout and cutting stained objects. Only a ... woman would be able to decide not to be pregnant are: the afraid to have a seropositive new-born baby, to transmit the sickness to his husband, stigmatization particularly in the child nutrition.

  13. Practitioner and client explanations for disparities in health care use between migrant and non-migrant groups in Sweden: a qualitative study. (United States)

    Akhavan, Sharareh; Karlsen, Saffron


    To investigate variations in explanations given for disparities in health care use between migrant and non-migrant groups, by clients and care providers in Sweden. Qualitative evidence collected during in-depth interviews with five 'migrant' health service clients and five physicians. The interview data generated three categories which were perceived by respondents to produce ethnic differences in health service use: "Communication issues", "Cultural differences in approaches to medical consultations" and "Effects of perceptions of inequalities in care quality and discrimination". Explanations for disparities in health care use in Sweden can be categorized into those reflecting social/structural conditions and the presence/absence of power and those using cultural/behavioural explanations. The negative perceptions of 'migrant' clients held by some Swedish physicians place the onus for addressing their poor health with the clients themselves and risks perpetuating their health disadvantage. The power disparity between doctors and 'migrant' patients encourages a sense of powerlessness and mistreatment among patients.

  14. An integrative approach to threat assessment and management: security and mental health response to a threatening client. (United States)

    Farkas, Gary M; Tsukayama, John K


    Workplace violence threat assessment and management practices represent an interdisciplinary approach to the diversion of potentially dangerous employees and clients. This case study illustrates such an intervention in a complex situation involving a social service agency and its client. Following a curtailment of services and an arrest, the client developed an escalating homicidal anger toward the agency administrator. Once a Tarasoff warning was received, the agency contacted a security company who organized a threat assessment and management plan involving interdisciplinary collaboration. Information developed in the course of the assessment was presented to prosecutors, who facilitated the client's arrest and involuntary psychiatric commitment until he was judged to be no longer dangerous. This case ultimately involved an integration of the services of security, law enforcement, mental health professionals, prosecutors, the courts and the state mental health system in leading to a successful diversion of the client from a path of intended violence.

  15. Counseling and Psychotherapy with Clients of Middle Eastern Descent: A Qualitative Inquiry


    Boghosian, Sara


    It is becoming increasingly important for clinical and counseling psychologists to have multicultural competence skills for treating an increasingly diverse client population. The psychology literature related to culturally competent treatment with persons of Middle Eastern descent is currently limited. In this study, qualitative methodology was utilized to explore the mental health attitudes and psychotherapy experiences of clients of Middle Eastern descent. Participants described culturally...

  16. 中国政企客户移动信息化现状及策略研究%Study on the Status and Strategy of China Group Clients' Mobile Informationization

    Institute of Scientific and Technical Information of China (English)



    With the development of mobile communication technology in 4G era , China group clients' mobile informationization becomes the important development of telecom operators. This paper analyzes on the status of group clients and the short board of the mobile informationalization and builds the indicator system which affect group clients' mobile informationalization through the Delphi Method. And then this paper puts forward group clients' mobile informationization can be affected by seven key factors-market environment, product value, cooperative guarantee, employees' ability, clients' willingness, team construction, innovation capacity. Telecom operators should implement the corresponding strategies to enhance the market competitiveness and the group clients' satisfaction and then promote China group clients' mobile informationization.%随着4G时代移动通信技术的发展,政企客户移动信息化市场成为中国电信运营企业发展战略中的重要战场。文章通过分析政企客户市场现状、移动信息化短板,采用德尔菲法构建影响政企客户移动信息化的指标体系,提出电信运营企业应在市场环境、产品价值、协同保障、员工能力、团队建设、创新投入、用户需求这七方面实施发展策略,从而提升电信运营企业的市场竞争力和客户感知度,促进中国政企客户移动信息化发展。

  17. Institutional policy changes aimed at addressing obesity among mental health clients. (United States)

    Knol, Linda L; Pritchett, Kelly; Dunkin, Jeri


    People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. This intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients' weight at 3 and 6 months after policy implementation. At the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. Institutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients.

  18. Diversity attitudes and group knowledge processing in multicultural organizations

    DEFF Research Database (Denmark)

    Lauring, Jakob; Selmer, Jan


    The ability to locate, share, and use knowledge is vital for effective functioning of organizations. However, such knowledge processing can be complicated by increasing cultural diversity. Recent studies have suggested that a group’s diversity attitudes may increase group outcomes. In this study...... diversity only had a positive effect on personal knowledge....

  19. Xerostomia among older home care clients. (United States)

    Viljakainen, Sari; Nykänen, Irma; Ahonen, Riitta; Komulainen, Kaija; Suominen, Anna Liisa; Hartikainen, Sirpa; Tiihonen, Miia


    The purpose of this study was to examine drug use and other factors associated with xerostomia in home care clients aged 75 years or older. The study sample included 270 home care clients aged ≥75 years living in Eastern and Central Finland. The home care clients underwent in-home interviews carried out by trained home care nurses, nutritionists, dental hygienists and pharmacists. The collected data contained information on sociodemographic factors, health and oral health status, drug use, depressive symptoms (GDS-15), cognitive functioning (MMSE), functional ability (Barthel Index, IADL) and nutrition (MNA). The primary outcome was xerostomia status (never, occasionally or continuously). Among the home care clients, 56% (n = 150) suffered from xerostomia. Persons with continuous xerostomia used more drugs and had more depressive symptoms and a higher number of comorbidities than other home care clients. In multivariate analyses, excessive polypharmacy (OR = 1.83, 95% Cl 1.08-3.10) and depressive symptoms (OR = 1.12, 95% Cl 1.03-1.22) were associated with xerostomia. Xerostomia is a common problem among old home care clients. Excessive polypharmacy, use of particular drug groups and depressive symptoms were associated with xerostomia. The findings support the importance of a multidisciplinary approach in the care of older home care clients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Employment-related information for clients receiving mental health services and clinicians. (United States)

    King, Joanne; Cleary, Catherine; Harris, Meredith G; Lloyd, Chris; Waghorn, Geoff


    Clients receiving public mental health services and clinicians require information to facilitate client access to suitable employment services. However, little is known about the specific employment-related information needs of these groups. This study aimed to identify employment-related information needs among clients, clinicians and employment specialists, with a view to developing a new vocational information resource. Employment-related information needs were identified via a series of focus group consultations with clients, clinicians, and employment specialists (n=23). Focus group discussions were guided by a common semi-structured interview schedule. Several categories of information need were identified: countering incorrect beliefs about work; benefits of work; disclosure and managing personal information; impact of earnings on welfare entitlements; employment service pathways; job preparation, planning and selection; and managing illness once working. Clear preferences were expressed about effective means of communicating the key messages in written material. This investigation confirmed the need for information tailored to clients and clinicians in order to activate clients' employment journey and to help them make informed decisions about vocational assistance.

  1. Concordance between botanical groups and genetic diversity in peanut

    Directory of Open Access Journals (Sweden)

    Ingrid Pinheiro Machado

    Full Text Available ABSTRACT The aims of this study were to characterize peanut accessions of germplasm collection of the CCA/UFC and check consistency between the pre-existing botanical groups to estimates of genetic diversity. For this were conducted a trial with 43 accessions of peanut in a randomized block design with three replications. To characterization were used 21 morphological descriptors, where revealed large genetic variation. The mass hundred grains trait showed the main discriminating factors, with relative percentage of 22.1%. The cluster obtained with the linkage complete method, it was possible to view the dendrogram the formation of seven groups based on the Mahalanobis distance. By principal components analysis was identified phenotypic diversity among genotypes. The first three components explained 81% of the total variation. Subsequently, built a three-dimensional scatter chart for access of visualization, eight groups being formed. There was medium magnitude of agreement between the botanical groups and genetic diversity, both by the dendrogram and graphic dispersion proving the dissimilarity between genotypes of different botanic groups. Therefore, crossings between group access botanical Spanish or Valencia with those belonging to the Virginia group should generate segregating populations with high genetic potential.

  2. Demographic diversity, communication and learning behaviour in healthcare groups. (United States)

    Curşeu, Petru Lucian


    An integrative model of group learning was tested in a sample of 40 healthcare groups (434 respondents), and the results show that age diversity reduces the frequency of face-to-face communication whereas educational diversity reduces the frequency of virtual communication in healthcare groups. Frequency of communication (both face-to-face and virtual), in turn, positively impacts on the emergence of trust and psychological safety, which are essential drivers of learning behaviours in healthcare groups. Additional results show that average educational achievement within groups is conducive for communication frequency (both face-to-face and virtual), whereas mean age within groups has a negative association with the use of virtual communication in healthcare groups. Copyright © 2012 John Wiley & Sons, Ltd.

  3. Encounters with unemployment in occupational health care: Nurses' constructions of clients without work. (United States)

    Romppainen, Katri; Jähi, Rita; Saloniemi, Antti; Virtanen, Pekka


    This study explores occupational health nurses' encounters with unemployed clients in Finland. It involved setting up and evaluating a new service, Career Health Care, that resembled occupational health care, except that clients were recruited from among job seekers who were participating in one of three active labour market policy measures: vocational training, subsidised employment in the public sector, or participatory training for entering the labour market. Our main interest focused on nurses' perceptions of the unemployed and their professional practices in the context of Career Health Care. The analysis revealed four overlapping discourses with regard to clients: the client as a casualty of unemployment, the client as unemployed but active, the client as a deviant in the labour market, and the client as a skilled user of the system. Each discourse had implications for professional practice. The risk of negative stereotyping and consequent exclusion from services is discussed here. In conclusion, we stress the complexity of providing health services that can match the increasing diversity of contemporary labour market trajectories. Copyright 2009 Elsevier Ltd. All rights reserved.

  4. Globalisation in the Lecture Room? Gender and Cultural Diversity in Work Groups (United States)

    Umans, Timurs


    This paper empirically investigates the relationship between cultural and gender diversity and performance in groups of business students working on complex assignments. The study finds that gender diversity in student groups has a positive influence on group outcomes, while cultural diversity, irrespective of its conceptualisation, leads to…

  5. A RAD approach to client/server system development

    International Nuclear Information System (INIS)

    Brule, M.; Fair, W.; Jiang, J.; Sanvido, R.


    The capability, richness, and leverage of inexpensive commercial operating systems, off-the-shelf applications, and powerful developing tools have made building feature-rich client/server systems possible in rapid time and at low cost--ushering in a new level of systems integration not before possible. The authors achieve rapid application development (RAD) by using a flexible and extendible client/service integration framework. The framework provides the means to integrate in-house and third-party software applications with databases and expert-system knowledge bases and, where appropriate, provides communication links among the applications. The authors discuss the integration framework's capabilities, explain its underlying system architecture, and outline the methods and tools used to customize and integrate many diverse applications

  6. 76 FR 5840 - Supermedia LLC, Formerly Known as Idearc Media LLC, Supermedia Information Services LLC, Client... (United States)


    ... Known as Idearc Media LLC, Supermedia Information Services LLC, Client Care Group and Publishing... known as Idearc Media LLC, Client Care Group and Publishing Operations Group, Middleton, Massachusetts... Information Services LLC, Client Care Group and Publishing Operations Group, including on-site leased workers...

  7. Clinical educators' experiences of facilitating learning when speaking a different language from both the student and client. (United States)

    Keeton, Nicola; Kathard, Harsha; Singh, Shajila


    Worldwide there is an increasing responsibility for clinical educators to help students from different language backgrounds to develop the necessary skills to provide health care services to a linguistically diverse client base. This study describes the experiences of clinical educators who facilitate learning in contexts where they are not familiar with the language spoken between students and their clients. A part of the qualitative component of a larger mixed methods study is the focus of this paper. Semi-structured interviews were conducted with eight participants recruited from all audiology university programmes in South Africa. Thematic analysis allowed for an in depth exploration of the research question. Member checking was used to enhance credibility. It is hoped that the findings will inform training programmes and in so doing, optimize the learning of diverse students who may better be able to provide appropriate services to the linguistically diverse population they serve. Participants experienced challenges with fair assessment of students and with ensuring appropriate client care when they were unable to speak the language shared between the client and the student. In the absence of formal guidelines, clinical educators developed unique coping strategies that they used on a case-by-case basis to assess students and ensure adequate client management when they experienced such language barriers while supervising. Coping strategies included engaging other students as interpreters, having students role-play parts of a session in English in advance and requesting real-time translations from the student during the session. They expressed concern about the fairness and efficacy of the coping strategies used. While clinical educators use unique strategies to assess students and to ensure suitable client care, dilemmas remain regarding the fairness of assessment and the ability to ensure the quality of client care.

  8. How clients influence building projects - a comparison of the construction industry and the petroleum industry in Norway


    Evju, Mads; Mai, Nam Bao Nguyen


    Master's thesis in Industrial economics Several studies indicate the need for competence and quality improvement in the Norwegian construction industry. Findings show that diversity in client groups can lead to different levels of competence. This poses many challenges to the industry and those involved, all of which will be highlighted in this thesis. The objective of this thesis is to provide an understanding of how clients’ levels of competence and focus can influence the final resu...

  9. Ma(r)king Differences in Dutch Social Work : Professional Discourse and Ways of Relating to Clients in Context

    NARCIS (Netherlands)

    Haar, M. van der


    This study investigates the ways social workers in the Netherlands deal with a diversity of clients, particularly focussing on allochtonous clients. The study is motivated by the current hegemonic tendency to problematise allochtonous Dutch, often explained along the lines of culture. It was assumed

  10. Client Views of TESOL Service: Expectations and Perceptions. (United States)

    Walker, John


    Used focus groups to explore TESOL (teaching of English to speakers of other languages) client expectations and perceptions of the service they received in New Zealand English language schools. Findings confirmed the key role of the teacher and the importance of the school's milieu and home stay, quality of client feedback systems, servicescape,…

  11. Neurobiological response to EMDR therapy in clients with different psychological traumas

    Directory of Open Access Journals (Sweden)



    Full Text Available We assessed cortical activation differences in real-time upon exposure to traumatic memory between two distinct groups of psychologically traumatised clients also in comparison with healthy controls. We used electroencephalography (EEG to compare neuronal activation throughout the bilateral stimulation phase of Eye Movement Desensitization and Reprocessing (EMDR sessions. We compared activation between the first (T0 and the last (T1 session, the latter performed after processing the index trauma. The group including all clients showed significantly higher cortical activity in orbito-frontal cortex at T0 shifting at T1 towards posterior associative regions. However the subgroup of clients with chronic exposure to the traumatic event showed a cortical firing at both stages which was closer to that of controls. For the first time EEG monitoring enabled to disclose neurobiological differences between groups of clients with different trauma histories during the reliving of the traumatic event. Cortical activations in clients chronically exposed to traumatic memories were moderate, suggesting an association between social and environmental contexts with the neurobiological response to trauma exposure and psychotherapy.

  12. Client Perspective

    International Nuclear Information System (INIS)

    Cohen, M.; Oleksiak, T.A.


    Training Sections can best serve the needs of their clients by encouraging them to recognize that self-determination and overall training program ownership are the key ingredients of a successful program. In a support role, Training Sections should provide excellent lesson plans and instructors, good record keeping, and feedback vehicles. Most importantly, Training Sections should communicate closely with their clients and provide maximum flexibility to support overall client responsibilities

  13. How do Student Clients of a University-based Food Bank Cope with Food Insecurity? (United States)

    Farahbakhsh, Jasmine; Ball, Geoff D C; Farmer, Anna P; Maximova, Katerina; Hanbazaza, Mahitab; Willows, Noreen D


    To describe the food security status, food insecurity coping strategies, characteristics, and experiences of student clients of the Campus Food Bank (CFB) at the University of Alberta in Edmonton, Alberta, Canada. A convenience sample of 58 students completed a survey from April 2013 to April 2014. Food security status was determined using the "Adult Food Security Survey Module". Ninety percent of CFB student clients who participated in this study were food insecure, which included both moderately and severely food insecure groups. The most prevalent coping strategies for food insecurity included applying for a loan or bursary (86.2%), seeking employment or working more hours (84.5%), and purchasing food using a credit card (77.6%). Participants were a diverse mix of students, including graduate students (50.0%), international students (46.6%), and caregivers of children (24.1%). The most common primary sources of income were government student loans (29.3%) and research assistantships (20.7%). Most participants (82.8%) liked the food they received from the food bank. Food insecurity is highly prevalent among student clients of this university-based food bank. Students used a variety of coping strategies to increase their disposable income, highlighting the need for additional strategies to alleviate food insecurity among vulnerable students.

  14. Evaluating the Influence of the Client Behavior in Cloud Computing. (United States)

    Souza Pardo, Mário Henrique; Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José


    This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system.

  15. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin


    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  16. Medicaid care management: description of high-cost addictions treatment clients. (United States)

    Neighbors, Charles J; Sun, Yi; Yerneni, Rajeev; Tesiny, Ed; Burke, Constance; Bardsley, Leland; McDonald, Rebecca; Morgenstern, Jon


    High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Case management in early psychosis intervention programme: Perspectives of clients and caregivers. (United States)

    Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily


    This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

  18. Client retention and health among sex workers in Nairobi, Kenya. (United States)

    Izugbara, Chimaraoke O


    It is still a small body of research that directly addresses female sex workers' relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi's FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers' practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer.

  19. Cultural diversity and work-group performance : Detecting the rules

    NARCIS (Netherlands)

    Girndt, T.


    With greater levels of international cooperation, work-groups are increasingly composed of members from different cultures. These groups often suffer from communication problems; however, research suggests that they also benefit from their members cultural diversity and generate higher ranges of

  20. Predicting treatment noncompliance among criminal justice-mandated clients: a theoretical and empirical exploration. (United States)

    Sung, Hung-En; Belenko, Steven; Feng, Li; Tabachnick, Carrie


    Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.

  1. Atheism and Nonspirituality as Diversity Issues in Counseling (United States)

    D'Andrea, Livia M.; Sprenger, Johann


    Counseling professionals have begun to realize that, in order to be as effective as possible, counselors must explore and understand the spiritual and religious beliefs of their clients. The literature on client belief systems and diversity, however, does not include discussion of individuals without religious or spiritual beliefs. The purpose of…

  2. The Challenge of Prejudice: Counsellors' Talk about Challenging Clients' Prejudices (United States)

    Spong, Sheila J.


    This paper considers the implications for training and practice of counsellors' responses to the notion of challenging clients' prejudices. It explores tensions in counselling discourse between social responsibility, responsibility to the client and responsibility for one's self as counsellor. Three focus groups of counsellors were asked whether a…

  3. Supporting Workplace Diversity: Emerging Roles for Employment Counselors (United States)

    Neault, Roberta A.; Mondair, Suneet


    Employment counselors generally understand the benefits of workplace diversity; most are actively engaged in supporting diverse clients to attach to the workforce. However, they are less likely to be involved in supporting organizations to create workplaces where diverse workers are welcomed, appreciated, and fully engaged. In this article,…

  4. Effects of EAP follow-up on prevention of relapse among substance abuse clients. (United States)

    Foote, A; Erfurt, J C


    Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

  5. Client-Oriented Approach: Forming the System of Management of the Bank Relations with Clients

    Directory of Open Access Journals (Sweden)

    Zavadska Diana V.


    Full Text Available The aim of the article is to develop the theoretical principles of forming the bank relations with clients as part of the client-oriented strategy implementation. As a result of the conducted research there has been presented the definition of client-orientation, mechanism and system of management. The system of management of the bank relations with clients, the purpose and objectives of its formation have been substantiated. The hierarchy of subjects of forming and managing the process of the bank relations with client has been presented. The ways of implementing in practice the functions of the mechanism of managing relations with clients have been revealed. It has been proved that for implementation of the client-oriented approach the banking institution should have a comprehensive view of its clients’ behavior, which detailed understanding will allow for a more accurate segmentation and building individualized partnership relations. Implementing the principle of totality of client relationships level and comprehensive knowledge, development of employee behavior techniques and special techniques for working with the most valuable clients, the use of analytics and forecasting tools will provide targeting of marketing campaigns and lead to minimization of additional costs, satisfaction of every client, loyalty, increase in the market share, growth of sales volume, increase in profits of the banking institution.

  6. La contrainte client

    Directory of Open Access Journals (Sweden)

    Guillaume Tiffon


    Full Text Available Cet article montre que le contact client a beau être ambivalent, dans la mesure où il est à la fois source de contrainte et de reconnaissance, dans certains cas, comme celui des caissières, il constitue avant tout une contrainte, en ce que les clients contrôlent le travail qui s’opère « sous leurs yeux », tandis que, dans d’autres cas, comme celui des kinésithérapeutes, il contribue avant tout à donner du sens au travail et, par là, à susciter l’engagement des travailleurs. L’article souligne ainsi combien la contrainte client revêt des modalités différentes selon la configuration, spatiale et temporelle, dans laquelle se déroule la relation de service, et le différentiel de compétences entre les protagonistes engagés dans cette relation.The client constraint. A comparative analysis of cashiers and physiotherapistsThis article shows that despite the ambivalence of client contact, insofar as it is both a source of constraint and recognition, in some cases, as the ones of cashiers, it isprimarily a constraint: clients control the work that takes place “before their eyes”, whereas in other cases – as in the ones of physiotherapists – it contributes to give meaning to work and, thereby, to arouse the commitment of workers. The article highlights how the client constraint takes on different forms depending on thespatial and temporal configuration where the service relation runs, and the skills differential between the protagonists involved in this relation.El apremio de los clientes. Análisis comparativo entre las cajeras de supermercado y los kinesiterapeutasEn este artículo se demuestra que aunque el contacto con los clientes puede ser percibido como agradable, en realidad en la mayoría de los casos el cliente es percibido como un peso puesto que estos « controlan » visualmente el trabajo de las cajeras mientras que en otras profesiones como es el caso de los kinesiterapeutas la presencia del paciente

  7. Being trusted: How team generational age diversity promotes and undermines trust in cross-boundary relationships. (United States)

    Williams, Michele


    We examine how demographic context influences the trust that boundary spanners experience in their dyadic relationships with clients. Because of the salience of age as a demographic characteristic as well as the increasing prevalence of age diversity and intergenerational conflict in the workplace, we focus on team age diversity as a demographic social context that affects trust between boundary spanners and their clients. Using social categorization theory and theories of social capital, we develop and test our contextual argument that a boundary spanner's experience of being trusted is influenced by the social categorization processes that occur in dyadic interactions with a specific client and, simultaneously, by similar social categorization processes that influence the degree to which the client team as a whole serves as a cooperative resource for demographically similar versus dissimilar boundary spanner-client dyads. Using a sample of 168 senior boundary spanners from the consulting industry, we find that generational diversity among client team members from a client organization undermines the perception of being trusted within homogeneous boundary spanner-client dyads while it enhances the perception of being trusted within heterogeneous dyads. The perception of being trusted is an important aspect of cross-boundary relationships because it influences coordination and the costs associated with coordination. © 2015 The Author Journal of Organizational Behavior Published by John Wiley & Sons Ltd.

  8. Gender diversity and motivation in collaborative learning groups : the mediating role of group discussion quality

    NARCIS (Netherlands)

    Curseu, P.L.; Chappin, M.M.H.|info:eu-repo/dai/nl/304835056; Jansen, Rob J. G.

    Collaborative learning is often used in higher education to help students develop their teamwork skills and acquire curricular knowledge. In this paper we test a mediation model in which the quality of group discussions mediates the impact of gender diversity and group motivation on collaborative

  9. Gender diversity and motivation in collaborative learning groups : The mediating role of group discussion quality

    NARCIS (Netherlands)

    Curseu, Petre; Chappin, M.M.H.; Jansen, R.J.G.


    Collaborative learning is often used in higher education to help students develop their teamwork skills and acquire curricular knowledge. In this paper we test a mediation model in which the quality of group discussions mediates the impact of gender diversity and group motivation on collaborative

  10. Managing diversity : How leaders' multiculturalism and colorblindness affect work group functioning

    NARCIS (Netherlands)

    Meeussen, Loes; Otten, Sabine; Phalet, Karen

    Workforces are becoming increasingly diverse and leaders face the challenge of managing their groups to minimize costs and maximize benefits of diversity. This paper investigates how leaders' multiculturalism and colorblindness affect cultural minority and majority members' experiences of

  11. Meaning of dancing therapy in therapy of clients with psychological diseases


    NĚMCOVÁ, Barbora


    Bachelor thesis deals with meaning and effects of Dance therapy in frame of medical therapy of clients with psychical disease. Theoretical part defines words like dance, movement and Dance therapy. This part also describes history of dance, meaning and aims of Dance therapy, its school, aims and divisions. Mensioned are person of dance therapist, personalities connected with dance and Dance therapy, target groups of clients suitable for Dance therapy, importance of Dance therapy for clients w...

  12. Consumer-providers of care for adult clients of statutory mental health services. (United States)

    Pitt, Veronica; Lowe, Dianne; Hill, Sophie; Prictor, Megan; Hetrick, Sarah E; Ryan, Rebecca; Berends, Lynda


    the same outcome to provide a summary estimate of the effect across studies. We describe findings for each outcome in the text of the review with considerations of the potential impact of bias and the clinical importance of results, with input from a clinical expert. We included 11 randomised controlled trials involving 2796 people. The quality of these studies was moderate to low, with most of the studies at unclear risk of bias in terms of random sequence generation and allocation concealment, and high risk of bias for blinded outcome assessment and selective outcome reporting.Five trials involving 581 people compared consumer-providers to professionals in similar roles within mental health services (case management roles (4 trials), facilitating group therapy (1 trial)). There were no significant differences in client quality of life (mean difference (MD) -0.30, 95% confidence interval (CI) -0.80 to 0.20); depression (data not pooled), general mental health symptoms (standardised mean difference (SMD) -0.24, 95% CI -0.52 to 0.05); client satisfaction with treatment (SMD -0.22, 95% CI -0.69 to 0.25), client or professional ratings of client-manager relationship; use of mental health services, hospital admissions and length of stay; or attrition (risk ratio 0.80, 95% CI 0.58 to 1.09) between mental health teams involving consumer-providers or professional staff in similar roles.There was a small reduction in crisis and emergency service use for clients receiving care involving consumer-providers (SMD -0.34 (95%CI -0.60 to -0.07). Past or present consumers who provided mental health services did so differently than professionals; they spent more time face-to-face with clients, and less time in the office, on the telephone, with clients' friends and family, or at provider agencies.Six trials involving 2215 people compared mental health services with or without the addition of consumer-providers. There were no significant differences in psychosocial outcomes (quality of

  13. Workforce Diversity in Outpatient Substance Abuse Treatment: The Role of Leaders’ Characteristics (United States)

    Guerrero, Erick G.


    Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers’ tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. PMID:22658932

  14. Workforce diversity in outpatient substance abuse treatment: the role of leaders' characteristics. (United States)

    Guerrero, Erick G


    Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers' tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Gardening with Huntington's disease clients--creating a programme of winter activities. (United States)

    Spring, Josephine Anne; Baker, Mark; Dauya, Loreane; Ewemade, Ivie; Marsh, Nicola; Patel, Prina; Scott, Adrienne; Stoy, Nicholas; Turner, Hannah; Viera, Marc; Will, Diana


    A programme of garden-related indoor activities was developed to sustain a gardening group for people with mid to late stage Huntington's disease during the winter. The activities were devised by the horticulturist, working empirically, involving the services occupational therapist, physiotherapist, occupational therapy art technician, computer room, recreation and leisure staff. The programme was strongly supported by the nursing and care staff. Feedback on the effectiveness of the activities was sought from the clients, team members and unit staff. The clients' interest in gardening was sustained by a multidisciplinary programme of indoor growing and using plant products in creative activities, computing and group projects. The clients enjoyed all activities except one that they said lacked contact with plants. The inexpensive programme of activities enabled creativity and self-expression, stimulated social contact and helped with therapeutic goals of the clients. In addition, it engaged the multi-disciplinary team and the unit staff, was practical and enhanced the environment.

  16. Developing Pluralistic Practice in Counselling and Psychotherapy: Using What the Client Knows

    Directory of Open Access Journals (Sweden)

    John McLeod


    Full Text Available The concept of pluralism is increasingly used to indicate the rich diversity of theory and practice in the field of counselling and psychotherapy. A version of pluralism is described that takes account of the range of ideas about health and healing that exist within contemporary culture, and the expression of these positions in the personal knowledge and preferences held by clients in respect of different therapy formats and techniques. A review of recent research is used to provide a basis for discussion of some of the practical manifestations of client knowledge, and the ways in which practitioners can work with these factors.

  17. Diversion and injection of buprenorphine-naloxone film two years post-introduction in Australia. (United States)

    Larance, Briony; Mattick, Richard; Ali, Robert; Lintzeris, Nicholas; Jenkinson, Rebecca; White, Nancy; Kihas, Ivana; Cassidy, Rosemary; Degenhardt, Louisa


    We report 2 years of post-marketing surveillance of the diversion and injection of buprenorphine-naloxone (BNX) film following its introduction in 2011. Interviews were conducted with people who inject drugs regularly (PWID) (2004-2013), opioid substitution therapy clients (2013, n = 492) and key experts (n = 44). Key outcomes were unsanctioned removal of supervised doses, diversion, injection and street price. Prevalence of past 6-month injection among PWID was adjusted for background availability of opioid substitution therapy medications using sales data. Among out-of-treatment PWID, the levels of regular (weekly+) BNX film injection were comparable to methadone and BNX tablets, and lower than mono-buprenorphine, adjusting for background availability. Fewer BNX film clients [3%; 95% (CI) 1-5] regularly injected their medication than mono-buprenorphine clients (25%; 95% CI 11-39), but at levels equivalent to those among methadone (3%; 95% CI 1-6) and BNX tablet clients (2%; 95% CI 0-6). Key experts perceived BNX film needed less supervised dosing time as it dissolved rapidly and was harder to remove from the mouth than sublingual tablets; however, removal of supervised doses was higher among BNX film clients (15%; 95% CI: 10-20) than methadone clients (3%; 95% CI 1-6), and not significantly different from BNX tablet (11%; 95% CI 2-21) and mono-buprenorphine clients (31%; 95% CI 16-46). Two years post-introduction, levels of BNX film diversion and injection remained comparable with those for methadone and BNX tablets, and lower than mono-buprenorphine. We found no evidence that BNX film has lower non-adherence and diversion than the tablet formulation. [Larance B, Mattick R, Ali R, Lintzeris N, Jenkinson R, White N, Kihas I, Cassidy R, Degenhardt L. Diversion and injection of buprenorphine-naloxone film two years post-introduction in Australia. Drug Alcohol Rev 2015]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  18. Counselor Responsiveness to Client Religiousness. (United States)

    Kelly, Eugene W., Jr.


    Presents eight categories of client attitudes toward religion and suggests opportunities for religiously oriented counselor responses. Uses four categories to describes how religion may be associated with specific client issues. Contends that an informed appreciation of clients' religiousness and the religious dimensions of many client issues can…

  19. The Impact of Client Expertise, Client Gender and Auditor Gender on Auditors' Judgments

    NARCIS (Netherlands)

    A.H. Gold-Nöteberg (Anna); J.E. Hunton (James); M.I. Gomaa (Mohamed)


    textabstractThe purpose of the current study is to assess the extent to which auditors’ judgments are affected by client expertise, client gender and auditor gender. Prior audit research suggests that auditors place more weight on evidence received from clients who possess higher, relative to

  20. Do inclusive leaders help to reduce turnover in diverse groups? The moderating role of leader-member exchange in the diversity to turnover relationship. (United States)

    Nishii, Lisa H; Mayer, David M


    This research examines leader-member exchange (LMX) at the group level as a moderator of the relationships between demographic (i.e., race, age, gender) and tenure diversity and group turnover. Drawing primarily from LMX, social categorization, and expectation states theories, we hypothesized that through the pattern of LMX relationships that they develop with followers, group managers influence inclusion and status differentials within groups such that the positive relationship between diversity and group turnover will be weaker when the group mean on LMX is high or when group differentiation on LMX is low. Results from a sample of supermarket departments (N = 348) yielded general support for the study hypotheses. We also found evidence for a 3-way interaction involving demographic diversity, LMX mean, and LMX differentiation such that the interaction between demographic diversity and LMX differentiation was only significant when LMX mean was high. These findings highlight the important role that leaders play in influencing the relationship between diversity and turnover through the patterns of inclusion that they create in their units.

  1. Perceiving groups: The people perception of diversity and hierarchy. (United States)

    Phillips, L Taylor; Slepian, Michael L; Hughes, Brent L


    The visual perception of individuals has received considerable attention (visual person perception), but little social psychological work has examined the processes underlying the visual perception of groups of people (visual people perception). Ensemble-coding is a visual mechanism that automatically extracts summary statistics (e.g., average size) of lower-level sets of stimuli (e.g., geometric figures), and also extends to the visual perception of groups of faces. Here, we consider whether ensemble-coding supports people perception, allowing individuals to form rapid, accurate impressions about groups of people. Across nine studies, we demonstrate that people visually extract high-level properties (e.g., diversity, hierarchy) that are unique to social groups, as opposed to individual persons. Observers rapidly and accurately perceived group diversity and hierarchy, or variance across race, gender, and dominance (Studies 1-3). Further, results persist when observers are given very short display times, backward pattern masks, color- and contrast-controlled stimuli, and absolute versus relative response options (Studies 4a-7b), suggesting robust effects supported specifically by ensemble-coding mechanisms. Together, we show that humans can rapidly and accurately perceive not only individual persons, but also emergent social information unique to groups of people. These people perception findings demonstrate the importance of visual processes for enabling people to perceive social groups and behave effectively in group-based social interactions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  2. Pseudomonas aeruginosa diversity in distinct paediatric patient groups

    DEFF Research Database (Denmark)

    Tramper-Stranders, G.A.; Ent, C.K. van der; Wolfs, T.F.


    the other groups. A group of clonal isolates was observed among patients from the CF-chronic and CF-1 groups. These or different clonal isolates were not encountered among the three other patient groups. No characteristic resistance pattern could be identified among isolates from the distinct patient groups......Pseudomonas aeruginosa is a pathogen that often infects patients who are either immunocompromised or have local defects in host defences. It is known that cystic fibrosis (CF) patients are sometimes infected with certain clonal isolates. It is not clear whether these clonal isolates also infect non......-CF patients and whether clonality of isolates occurs in other patient groups. The aim of this study was to investigate P. aeruginosa diversity and the occurrence of clones within five distinct paediatric patient groups susceptible to P. aeruginosa infection. P. aeruginosa isolates were cultured from 157...

  3. Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic. (United States)

    Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Mayhew, Susannah H


    To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  4. Distributed Information and Group Decision-Making: Effects of Diversity and Affect

    NARCIS (Netherlands)

    J.M. Kooij-de Bode (Hanneke)


    textabstractOrganizations tend to rely on small groups rather than individuals when important decision have to be made, based on the assumption that groups possess a broader range of informational resources and more diversity of insights than individuals. However, research on group decision-making

  5. Distributed information and group decision-making : Effects of diversity and affect

    NARCIS (Netherlands)

    Kooij-de Bode, H.


    Organizations tend to rely on small groups rather than individuals when important decision have to be made, based on the assumption that groups possess a broader range of informational resources and more diversity of insights than individuals. However, research on group decision-making shows that

  6. Client-Oriented Approach: Forming the System of Management of the Bank Relations with Clients


    Zavadska Diana V.


    The aim of the article is to develop the theoretical principles of forming the bank relations with clients as part of the client-oriented strategy implementation. As a result of the conducted research there has been presented the definition of client-orientation, mechanism and system of management. The system of management of the bank relations with clients, the purpose and objectives of its formation have been substantiated. The hierarchy of subjects of forming and managing the process...

  7. Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness. (United States)

    Browne, Julia; Mihas, Paul; Penn, David L


    The health benefits of exercise are well established, yet individuals with serious mental illness (SMI) have a shorter life expectancy due in large part to physical health complications associated with poor diet and lack of exercise. There is a paucity of research examining exercise in this population with the majority of studies having examined interventions with limited feasibility and sustainability. Before developing an intervention, a thorough exploration of client and clinician perspectives on exercise and its associated barriers is warranted. Twelve clients and fourteen clinicians participated in focus groups aimed at examining exercise, barriers, incentives, and attitudes about walking groups. Results indicated that clients and clinicians identified walking as the primary form of exercise, yet barriers impeded consistent participation. Distinct themes arose between groups; however, both clients and clinicians reported interest in a combination group/pedometer based walking program for individuals with SMI. Future research should consider examining walking programs for this population.

  8. A Group Counseling Approach for Persons Who Work With Sickle Cell Anemia Clients. (United States)

    Calvin, Richmond

    Although many workshops on sickle cell anemia have been held, it is still difficult to implement a comprehensive training program for sickle cell anemia clients in many communities. Research data on the topic are somewhat nebulous and insufficient political and social pressure have been exerted to change attitudes and take action towards the…

  9. Open client/server computing and middleware

    CERN Document Server

    Simon, Alan R


    Open Client/Server Computing and Middleware provides a tutorial-oriented overview of open client/server development environments and how client/server computing is being done.This book analyzes an in-depth set of case studies about two different open client/server development environments-Microsoft Windows and UNIX, describing the architectures, various product components, and how these environments interrelate. Topics include the open systems and client/server computing, next-generation client/server architectures, principles of middleware, and overview of ProtoGen+. The ViewPaint environment

  10. Surface-Level Diversity and Decision-Making in Groups: When Does Deep-Level Similarity Help?



    Abstract We examined how surface-level diversity (based on race) and deep-level similarities influenced three-person decision-making groups on a hidden-profile task. Surface-level homogeneous groups perceived their information to be less unique and spent less time on the task than surface-level diverse groups. When the groups were given the opportunity to learn about their deep-level similarities prior to t...

  11. A qualitative analysis of staff-client interactions within a breast cancer assessment clinic

    International Nuclear Information System (INIS)

    Nightingale, J.M.; Murphy, F.; Eaton, C.; Borgen, R.


    Objectives: Breast screening clients recalled to an assessment clinic experience high levels of anxiety. The culture of the assessment clinic may impact upon client experience, which may influence their future re-engagement in screening. This study aimed to explore the culture of staff-client interactions within a breast cancer assessment clinic. Materials and methods: Following an ethnographic approach, twenty-three client journeys were observed, followed by semi-structured interviews with the clients. The observation and interview data were analysed to produce research themes, which were then explored within two focus groups to add a practitioner perspective. Results: Multiple staff-client interaction events were observed over a period of several weeks. Client interview feedback was overwhelmingly positive. Three recurrent and sequential themes emerged: breaking down barriers, preparing the ground and sign-posting. These themes outline the changing focus of staff-client interactions during the client's clinic journey, encompassing how anxieties were expressed by clients, and responded to by practitioners. Conclusion: This study was the first to explore in depth the staff-client interaction culture within a breast assessment clinic using an ethnographic approach. A new perspective on professional values and behaviours has been demonstrated via a model of staff-client interaction. The model documents the process of guiding the client from initial confusion and distress to an enhanced clarity of understanding. A recommendation most likely to have a positive impact on the client experience is the introduction of a client navigator role to guide the clients through what is often a lengthy, stressful and confusing process. - Highlights: • This study was the first to explore staff-client interaction within breast assessment clinics. • Assessment clinic culture may affect client perceptions and future re-engagement in screening. • An ethnographic approach

  12. GenExp: an interactive web-based genomic DAS client with client-side data rendering.

    Directory of Open Access Journals (Sweden)

    Bernat Gel Moreno

    Full Text Available BACKGROUND: The Distributed Annotation System (DAS offers a standard protocol for sharing and integrating annotations on biological sequences. There are more than 1000 DAS sources available and the number is steadily increasing. Clients are an essential part of the DAS system and integrate data from several independent sources in order to create a useful representation to the user. While web-based DAS clients exist, most of them do not have direct interaction capabilities such as dragging and zooming with the mouse. RESULTS: Here we present GenExp, a web based and fully interactive visual DAS client. GenExp is a genome oriented DAS client capable of creating informative representations of genomic data zooming out from base level to complete chromosomes. It proposes a novel approach to genomic data rendering and uses the latest HTML5 web technologies to create the data representation inside the client browser. Thanks to client-side rendering most position changes do not need a network request to the server and so responses to zooming and panning are almost immediate. In GenExp it is possible to explore the genome intuitively moving it with the mouse just like geographical map applications. Additionally, in GenExp it is possible to have more than one data viewer at the same time and to save the current state of the application to revisit it later on. CONCLUSIONS: GenExp is a new interactive web-based client for DAS and addresses some of the short-comings of the existing clients. It uses client-side data rendering techniques resulting in easier genome browsing and exploration. GenExp is open source under the GPL license and it is freely available at

  13. The Competitive Advantage: Client Service. (United States)

    Leffel, Linda G.; DeBord, Karen B.

    The adult education literature contains a considerable amount of research on and discussion of client service in the marketing process, management and staff roles in service- and product-oriented businesses, and the importance of client service and service quality to survival in the marketplace. By applying the principles of client-oriented…

  14. Chaperone-client complexes: A dynamic liaison (United States)

    Hiller, Sebastian; Burmann, Björn M.


    Living cells contain molecular chaperones that are organized in intricate networks to surveil protein homeostasis by avoiding polypeptide misfolding, aggregation, and the generation of toxic species. In addition, cellular chaperones also fulfill a multitude of alternative functionalities: transport of clients towards a target location, help them fold, unfold misfolded species, resolve aggregates, or deliver clients towards proteolysis machineries. Until recently, the only available source of atomic resolution information for virtually all chaperones were crystal structures of their client-free, apo-forms. These structures were unable to explain details of the functional mechanisms underlying chaperone-client interactions. The difficulties to crystallize chaperones in complexes with clients arise from their highly dynamic nature, making solution NMR spectroscopy the method of choice for their study. With the advent of advanced solution NMR techniques, in the past few years a substantial number of structural and functional studies on chaperone-client complexes have been resolved, allowing unique insight into the chaperone-client interaction. This review summarizes the recent insights provided by advanced high-resolution NMR-spectroscopy to understand chaperone-client interaction mechanisms at the atomic scale.

  15. Working with Difficult Group Members. (United States)

    Kottler, Jeffrey A.


    Describes types of group members who are challenging in group settings including entitled, manipulative, and character-disordered clients. Provides suggestions for working with these group members, either as isolated cases or as homogenous populations, emphasizing the protection of other clients' rights. Includes 31 references. (Author/CRR)

  16. Ethnic and Gender Diversity, Process and Performance in Groups of Business Students in Sweden (United States)

    Umans, Timurs; Collin, Sven-Olof; Tagesson, Torbjorn


    This article investigates the complex interrelation between ethnic and gender diversity, process and performance among groups of business students. The article is based on an empirical survey of business students working on a complex assignment in groups of two to five in a small Swedish university. The results indicate that gender diversity leads…

  17. Team-client Relationships And Extreme Programming

    Directory of Open Access Journals (Sweden)

    John Karn


    Full Text Available This paper describes a study that examined the relationship between software engineering teams who adhered to the extreme programming (XP methodology and their project clients. The study involved observing teams working on projects for clients who had commissioned a piece of software to be used in the real world. Interviews were conducted during and at the end of the project to get client opinion on how the project had progressed. Of interest to the researchers were opinions on frequency of feedback, how the team captured requirements, whether or not the iterative approach of XP proved to be helpful, and the level of contextual and software engineering knowledge the client had at the start of the project. In theory, fidelity to XP should result in enhanced communication, reduce expectation gaps, and lead to greater client satisfaction. Our results suggest that this depends heavily on the communication skills of the team and of the client, the expectations of the client, and the nature of the project.

  18. Using CBPR to Assess Client Needs at a Social Service Agency. (United States)

    Amendola, Mary Grace; Nazario, Noelia; Sanchez, Veronica


    Community-based participatory research (CBPR) has become an important research approach for universities to partner with social service agencies by uniting them in project design, planning, implementation, and evaluation. This study involved FOCUS, an urban social service agency, and Rutgers College of Nursing (RUCON) collaboratively conducting a needs assessment to compare the health needs of its clients and their employees' perception of their clients health needs, utilizing CBPR. Qualitative data was collected using the focus group method, field notes, photographs, and observation. The employees of FOCUS facilitated focus groups, participant recruitment, and transcribed and translated data. Three themes emerged: Health Education, Cost of Health Care, and Barriers to Health Care. This study contributes to the growing body of knowledge of integrating the CBPR approach when conducting a community needs assessment with a social service agency. The CBPR approach closely reflects the identified health needs of its clients resulting in interventions that will meet their specific health needs. © 2015 Wiley Periodicals, Inc.

  19. Client-oriented Building Mass Customization (CoBMC) (United States)

    Lee, Xia Sheng; Faris Khamidi, Mohd; Kuppusamy, Sivaraman; Tuck Heng, Chin


    Although much later compared to other industries including aerospace, automobile, oil and gas etc., digital technology development has been cresting towards an exponential curve in the construction industry. Technological diversity and abundance change the game from “what you can” to “what you want”. Society is changing at an unprecedented rate. Consequently adaptability will be crucial. This research paper explores the integration of digital adaptive technologies that transform the construction industry from the mass production to that of a possible client-oriented mass customization. The focus on the design, construction and performance stages of a building project, currently undergoing major overhaul faces a paradigm shift globally that will impact and compel attention for the next three decades with viable solutions such as Building Information Modelling (BIM) to manage massive data cum information. Customization maximizes clients’ participation during the design process thereby achieving greater effective value and higher satisfaction. A study between customized and standardized examples will investigate how adaptive customization will shift the design paradigm from cost to value centric. This action research will explore different aspects of emerging innovative systems already in place pushing the edge of frontiers, and transforming the building industry landscape whether micro or giga, to compliment new technologies to create an unprecedented exhilaration of freshness over the mundane, routine and mediocrity. Three identified fundamental aspects that are instrumental to Client-oriented Building Mass Customization (CoBMC) are design option visualization, parametric product information and n-dimensional modelling. The study concluded that a paradigm shift is therefore inevitable for every stakeholder including clients who will need to re-examine their roles, capabilities, and competencies in preparation towards challenging future.

  20. Preventative health, diversity, and inclusion: a qualitative study of client experience aboard a mobile health clinic in Boston, Massachusetts. (United States)

    Bouchelle, Zoe; Rawlins, Yasmin; Hill, Caterina; Bennet, Jennifer; Perez, Leonor Xochitl; Oriol, Nancy


    There are approximately 2000 mobile health clinics operating in the United States. While researchers have established that mobile health clinics can be cost effective and improve outcomes, there is scant research examining the healthcare experience on a mobile health clinic from patients' perspectives. Data were gathered from interviews with 25 clients receiving care on a Boston-based mobile health clinic and analyzed using grounded theory methodology. Emerging patterns in the data revealed three relational and three structural factors most significant to participants' experience of care on The Family Van. Relational factors include providers who 1) Communicate understandably, 2) Create a culture of respect and inclusivity, and 3) Are diverse with knowledge of the community. Structural factors include 1) A focus on preventative health and managing chronic disease, 2) Expeditious, free, and multiple services, and 3) Location. The participant accounts in this report serve to expand on prior research exploring mobile health clinics' role in patients' healthcare, to more clearly define the most salient aspects of the mobile health clinic model for the patients they serve, and to give voice to patients too seldom heard in the academic literature.

  1. Anxiety in mammography: mammographers' and clients' perspectives

    International Nuclear Information System (INIS)

    Galletta, S.; Joel, N.; Maguire, R.; Weaver, K.; Poulos, A.


    The aim of this study was to identify causes of anxiety experienced by mammographers and clients during mammography and strategies to decrease the anxiety generated by the mammographic procedure. Two questionnaires were distributed: one to mammographers in public and private centres within NSW, the other to women (clients) who have experienced mammography. Mammographers' and clients' rankings of causes of clients' anxiety demonstrated many similarities indicating the mammographers' acknowledgement of factors contributing to client anxiety. Thematic analysis provided important qualitative data concerning anxiety experienced by both mammographers and clients and the influence of mammographer and client behaviour on that anxiety. The results of this study have provided important new knowledge for mammographic practice and mammography education. By understanding the causes of anxiety experienced by clients, mammographers can provide an informed, empathetic approach to the mammographic process. By acknowledging factors which increase their own anxiety mammographers can reduce the impact of this on themselves and on their clients. Copyright (2003) Australian Institute of Radiography

  2. Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists' Observable Behaviors. (United States)

    Sotero, Luciana; Cunha, Diana; da Silva, José Tomás; Escudero, Valentín; Relvas, Ana Paula


    This study aimed to compare therapists' observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists' contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients' engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists' alliance-building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research. © 2016 Family Process Institute.

  3. Call center. Centrados en el cliente


    Leal-Alonso-de-Castañeda, José Enrique


    La empresa actual ha de estar preparada para responder al Cliente tal y como éste espera, porque no se busca un cliente puntual, sino un cliente fiel. La globalización de la economía y del acceso a los mercados exige que la empresa sea capaz de atraer al cliente no sólo con un servicio de calidad, sino además con una atención de calidad. La implantación de un Call Center (Centro de Atención al Cliente, Centro de Atención de Llamadas) constituye por todo ello una estrategia de negocio qu...

  4. African-American women: considering diverse identities and societal barriers in psychotherapy. (United States)

    Greene, B


    Effective psychotherapy with African-American women explicitly requires cultural literacy and competence of its practitioners. Cultural literacy includes understanding the collective social plight of African-American women and the individual client in the context of the prevailing reality of race, gender, and sexual orientation bias and the interpersonal and institutional barriers that result from that bias. Cultural literacy presumes a willingness on the part of the therapist to educate himself or herself about the clients cultural background and milieu and validate the client's accurate perceptions of discrimination and bias and their impact on the client's life. Cultural competence may be seen as the appropriate level of technical skill in applying those concepts to the understanding of the client and the conduct of the psychotherapeutic inquiry. The culturally literate practitioner will acknowledge and appreciate the wide range of diversity within African-American women as a group. The individual client's intrapsychic and familial endowments and personal relationship history as they are embedded in the aforementioned context should be carefully explored and understood as well as are all relevant social factors. Finally, therapists must be willing to scrutinize their own feelings and motivations for working with African-American women. What should follow is a careful analysis of the developmental interactions of these variables, how they promote an individual's view of the world, her perceptions of her options, her strategies for negotiating institutional barriers, her relationships with other persons, as well as any contributions she makes, consciously or unconsciously, to her own dilemma. A culturally literate and antiracist therapist must begin with an understanding of the role of multiple identities and oppressions in client's lives and must have or be willing to acquire a familiarity with the clients' cultural and ethnic heritage and the role of

  5. Morphological and functional diversity of primary producers group in savannas

    International Nuclear Information System (INIS)

    Medina, E.


    The meaning of biological diversity for the operation and stability of natural ecosystems is matter of great theoretical and practical interest. The appearance and permanency of species in a given atmosphere indicates its capacity to compete with other species with similar habit and requirements, and to accumulate the resources that allow its reproduction. On the other hand, the coexistence of similar species in the same ecosystem allows to wonder if ever biological redundancy exists, that is to say, if several species coexist with the same function inside the ecosystem, so that the disappearance of one of them would not have biological significant consequences. A strategy to simplify the analysis of relationships between biodiversity and ecosystems operation is by grouping species with similar function, called functional groups. In this work the the primary producers functional group is analyzed, essentially superiors plants, in a savannas ecosystems. The analysis establishes that the gives the primary producers group is heterogeneous and complex, so much morphological as functionally: 1) the structural complexity and diversity forms of life in an savannas ecosystem are associated with the stratified exploitation of resources over (light) and under the floor (nourishment and water). Changes in diversity that affect the system structure will probably also affect its operations. 2 )Very similar morphological species can differ physiologically up to constitute production units with contrasting nutritional requirements. The echo-physiologic analysis of this differentiation can explain the habitat preferences that are naturally observed. 3) The long-time permanency of rare species, of low frequency, show the inability of dominant species to capture all the available resources. 4) The primary producers and the floor microorganisms have strong interactions. Changes in the community composition can generate significant changes in other community. These biotic interactions

  6. WORKING WITH HOMOSEXUAL CLIENTS: Application of Solution-Focused Therapy

    Directory of Open Access Journals (Sweden)

    Husmiati Husmiati


    Full Text Available This article discusses the psychosocial problems dealt by gay, lesbian, and bisexual clients. Gay is an individual who has sex orientation to male, whereas lesbian is to female. Bisexual has both sex orientation towards male and female. This article also points out one approach called Solution-Focused Therapy (SFT which can be applied in clinical practice. Working with SFT technique to homoerotic individual or group is significantly different to common people. Mental health experts such as social workers and clinical psychologists should have this understanding. Keywords: Homosexuality, client, clinical practice, therapy, solution focused



    Mohammad Hefni


    Abstrac This article traces patron-client relationship of Madurese both from socio-historical point of view and its contemporary progress. As an imbalance social-exchange relationship, in terms of patron-client relationship, second side (client) much highly depends upon the first side (patron). This had been experienced in Madurese social history during the native governmental period of time. The government was classified into two major classes; ruler class (patron) and farmer class (client)....

  8. Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro

    Directory of Open Access Journals (Sweden)

    Laušević Dragan


    Full Text Available Introduction. Female sex workers (FSWs are a group at increased risk for human immunodeficiency virus (HIV infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0% of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR = 22.7, 95% confidence interval (CI = 2.3-228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4-118.9 towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0, and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5. Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.

  9. A comparison of fusion breeder/fission client and fission breeder/fission client systems for electrical energy production

    International Nuclear Information System (INIS)

    Land, R.J.; Parish, T.A.


    A parametric study that evaluated the economic performance of breeder/client systems is described. The linkage of the breeders to the clients was modelled using the stockpile approach to determine the system doubling time. Since the actual capital costs of the breeders are uncertain, a precise prediction of the cost of a breeder was not attempted. Instead, the breakeven capital cost of a breeder relative to the capital cost of a client reactor was established by equating the cost of electricity from the breeder/client system to the cost of a system consisting of clients alone. Specific results are presented for two breeder/client systems. The first consisted of an LMFBR with LWR clients. The second consisted of a DT fusion reactor (with a 238 U fission suppressed blanket) with LWR clients. The economics of each system was studied as a function of the cost of fissile fuel from a conventional source. Generally, the LMFBR/LWR system achieved relatively small breakeven capital cost ratios; the maximum ratio computed was 2.2 (achieved at approximately triple current conventional fissile material cost). The DTFR/LWR system attained a maximum breakeven capital cost ratio of 4.5 (achieved at the highest plasma quality (ignited device) and triple conventional fissile cost)

  10. Negotiating the Client-Based Capstone Experience (United States)

    Reifenberg, Steve; Long, Sean


    Many graduate programs for professionals (public policy, public administration, business, international affairs, and others) use client-based experiential learning projects, often termed "capstones," in which students combine theory and practice to benefit an outside client. Increasingly, undergraduate programs use client-based capstones…

  11. The Impact of internet use on the Client-professional relationship: A comparative analysis

    DEFF Research Database (Denmark)

    Johnsen, Helle


    use the internet to prepare for the client-professional meeting and to seek second opinions. Professionals reported more limitations than benefits in relation to internet use. Limitations were linked to doubts of reliability of internet information and information overload. Midwifery clients were......This study explores how internet use impacts the client–professional relationship among midwives compared to related professions. Thirty health professionals in Denmark and Norway took part in nine focus group interviews. A template approach was used to analyse data. Findings indicate that clients...... reported to use internet chatrooms as an information source. However, these were often perceived as interfering with midwifery work. Although midwifery clients were frequent users of internet information, they also turned to midwives for verification of the information they found. Seeking reassurance...

  12. The Effects of Psychotherapist's and Clients' Interpersonal Behaviors during a First Simulated Session: A Lab Study Investigating Client Satisfaction

    Directory of Open Access Journals (Sweden)

    François Moors


    Full Text Available The purpose of this study was to examine the effects of psychotherapists' behaviors during a first simulated therapy session on clients' satisfaction, including their intention to pursue or drop out from therapy. The importance of psychotherapists' warmth on clients' satisfaction was examined to check previous findings stressing this determining factor. Examining the role of warm behaviors is however insufficient according to the interpersonal perspective. We therefore tested the role of the psychotherapist's agentic behaviors since only a few studies provide contradictory results about the role of this interpersonal dimension on clients' satisfaction and how it is influenced by matching up client and therapist's profiles. To test our hypotheses and control for alternative therapy-related explanatory variables, we used different videos as experimental conditions manipulating the therapist's behaviors. Seventy-five participants had to imagine themselves as potential clients arriving for a first therapy session. They successively watched a role-playing therapist behaving according to five randomized interpersonal profiles. Results confirmed that warmth was a major dimension predicting client satisfaction. They revealed that agency was also a determinant of client satisfaction and that its effects depended on the client's own interpersonal agentic profile. Dominant clients were found to be more satisfied with the dominant psychotherapist than the submissive one while submissive clients preferred only the warm psychotherapist. These findings are discussed and suggest that therapists may need to be flexible and adapt their behaviors according to their client's interpersonal profile to increase their client satisfaction and decrease drop outs.

  13. Design considerations for a transparent mode group diversity multiplexing link

    NARCIS (Netherlands)

    Tsekrekos, C.; Martinez, A.; Huijskens, Frans; Koonen, A.M.J.


    Mode group diversity multiplexing (MGDM) is an optical multiple-input-multiple-output technique that aims at creating independent communication channels over a multimode fiber, using subsets of propagating modes. This letter deals with the analysis of an MGDM point-to-point link, transparent to the

  14. Women-focused treatment agencies and process improvement: Strategies to increase client engagement (United States)

    Wisdom, Jennifer P.; Hoffman, Kim; Rechberger, Elke; Seim, Kay; Owens, Betta


    Behavioral health treatment agencies often struggle to keep clients engaged in treatment. Women clients often have additional factors such as family responsibilities, financial difficulties, or abuse histories that provide extra challenges to remaining in care. As part of a national initiative, four women-focused drug treatment agencies used process improvement to address treatment engagement. Interviews and focus groups with staff assessed the nature and extent of interventions. Women-focused drug treatment agencies selected relational-based interventions to engage clients in treatment and improved four-week treatment retention from 66% to 76%. Process improvement interventions in women-focused treatment may be useful to improve engagement. PMID:20046914

  15. The ICF as a common language for rehabilitation goal-setting: comparing client and professional priorities

    Directory of Open Access Journals (Sweden)

    van der Merwe Aletia


    Full Text Available Abstract Background Joint rehabilitation goals are an important component for effective teamwork in the rehabilitation field. The activities and participation domain of the ICF provides a common language for professionals when setting these goals. Involving clients in the formulation of rehabilitation goals is gaining momentum as part of a person-centred approach to rehabilitation. However, this is particularly difficult when clients have an acquired communication disability. The expressive communication difficulties negatively affect the consensus building process. As a result, obtaining information regarding rehabilitation goals from professionals and their clients warrants further investigation for this particular population. Methods This comparative study investigated clients and their assigned rehabilitation professionals' perception of the importance of ICF activities and participation domains for inclusion in their rehabilitation program. Twelve clients in an acute rehabilitation centre and twenty of their corresponding rehabilitation professionals participated in an activity using the Talking Mats™ visual framework for goal setting. Each participant rated the importance of the nine activities and participation domains of the ICF for inclusion in their current rehabilitation program. Results The ICF domains which consistently appear as very important across these groups are mobility, self-care and communication. Domains which consistently appear in the lower third of the rankings include spare time, learning and thinking and domestic life. Results indicate however that no statistical significant differences exist in terms of the individual domains across each of the participant groups. Within group differences however indicated that amongst the speech-language therapists and physiotherapists there was a statistical significant difference between spare time activities and communication and mobility. Conclusions Findings indicate that

  16. 14 CFR 1261.317 - Attorney-client privilege. (United States)


    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Attorney-client privilege. 1261.317 Section... Injury or Death-Accruing On or After January 18, 1967 § 1261.317 Attorney-client privilege. (a) Attorneys... traditional attorney-client relationship with the employee with respect to application of the attorney-client...

  17. HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry. (United States)

    Mwanri, Lillian; Fauk, Nelsensius Klau; Kustanti, Christina Yeni; Ambarwati, Atik; Merry, Maria Silvia


    Background: The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.

  18. Cognitive Behavioural Therapy from the Perspective of Clients with Mild Intellectual Disabilities: A Qualitative Investigation of Process Issues (United States)

    Pert, C.; Jahoda, A.; Stenfert Kroese, B.; Trower, P.; Dagnan, D.; Selkirk, M.


    Background: Clinicians working with clients who have mild intellectual disabilities (IDs) have shown growing enthusiasm for using a cognitive behavioural approach, amid increasing evidence of good treatment outcomes for this client group. However, very little is known about the views and experiences of clients with IDs who have undergone cognitive…

  19. [Grouping of nurses: gender diversity or the neutralization of gender?]. (United States)

    Divay, Sophie


    Professional nurses' group: towards gender diversity or the neutralisation of gender? The nursing profession is essentially feminine. It is interesting to listen to what professionals, and particularly women, have to say about the question. Different opinions emerge and conclusions are established. The first step is awareness.

  20. 32 CFR 776.4 - Attorney-client relationships. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Attorney-client relationships. 776.4 Section 776... General § 776.4 Attorney-client relationships. (a) The executive agency to which assigned (DON in most cases) is the client served by each covered USG attorney unless detailed to represent another client by...

  1. β-Diversity of functional groups of woody plants in a tropical dry forest in Yucatan.

    Directory of Open Access Journals (Sweden)

    Jorge Omar López-Martínez

    Full Text Available Two main theories have attempted to explain variation in plant species composition (β-diversity. Niche theory proposes that most of the variation is related to environment (environmental filtering, whereas neutral theory posits that dispersal limitation is the main driver of β-diversity. In this study, we first explored how α- and β-diversity of plant functional groups defined by growth form (trees, shrubs and lianas, which represent different strategies of resource partitioning, and dispersal syndrome (autochory, anemochory and zoochory, which represent differences in dispersal limitation vary with successional age and topographic position in a tropical dry forest. Second, we examined the effects of environmental, spatial, and spatially-structured environmental factors on β-diversity of functional groups; we used the spatial structure of sampling sites as a proxy for dispersal limitation, and elevation, soil properties and forest stand age as indicators of environmental filtering. We recorded 200 species and 22,245 individuals in 276 plots; 120 species were trees, 41 shrubs and 39 lianas. We found that β-diversity was highest for shrubs, intermediate for lianas and lowest for trees, and was slightly higher for zoochorous than for autochorous and anemochorous species. All three dispersal syndromes, trees and shrubs varied in composition among vegetation classes (successional age and topographic position, whilst lianas did not. β-diversity was influenced mostly by proxies of environmental filtering, except for shrubs, for which the influence of dispersal limitation was more important. Stand age and topography significantly influenced α-diversity across functional groups, but showed a low influence on β-diversity -possibly due to the counterbalancing effect of resprouting on plant distribution and composition. Our results show that considering different plant functional groups reveals important differences in both α- and β-diversity

  2. 49 CFR 1103.23 - Confidences of a client. (United States)


    ... 49 Transportation 8 2010-10-01 2010-10-01 false Confidences of a client. 1103.23 Section 1103.23... Responsibilities Toward A Client § 1103.23 Confidences of a client. (a) The practitioner's duty to preserve his client's confidence outlasts the practitioner's employment by the client, and this duty extends to the...

  3. Characterizing fentanyl use in methadone-maintained clients. (United States)

    Arfken, Cynthia L; Suchanek, Jessica; Greenwald, Mark K


    Deaths attributed to fentanyl have increased in the United States. However, little is known about fentanyl use among substance abuse treatment clients. To fill this gap, we assessed prevalence of fentanyl exposure, characteristics of clients testing positive for fentanyl, other substances detected concurrently or simultaneously with fentanyl, and clients' perception of how many people are actively seeking to use fentanyl. A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan. Urine drug screens (UDS) including fentanyl (and its metabolite norfentanyl) were conducted clinically. To obtain additional data, 113 clients in this clinic subsequently completed an anonymous survey. Of 368 unique clients with UDS, 38.0% had at least one and 26.1% had ≥2 fentanyl-positive UDS results. None had a fentanyl prescription. Clients ever testing positive for fentanyl were significantly (pFentanyl-positive UDS results coincided most commonly with metabolites of cocaine- and heroin-positive UDS results. Of the anonymously surveyed clients, most (67.3%) reported they did not know anyone seeking fentanyl, a proportion significantly higher than for heroin, cocaine, alprazolam, hydrocodone and morphine. Fentanyl was commonly detected during this period with some clients having multiple fentanyl-positive UDS. Most clients did not know anyone seeking to obtain fentanyl. Regardless, the high exposure underscores that naloxone training and distribution is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The Views of Clients with Mild Intellectual Disabilities regarding Their Working Relationships with Caregivers (United States)

    Roeden, John M.; Maaskant, Marian A.; Curfs, Leopold M. G.


    Background: Research studies into the effect of therapies have shown that a good relationship between the client and his caregiver is a key factor in a positive treatment outcome. Methods: The nominal group technique (NGT) has been used in this study to discover what clients with intellectual disabilities feel contributes to a successful working…

  5. Interactive Effects of Counselor-Client Similarity and Client Self-Esteem on Termination Type and Number of Sessions. (United States)

    Berry, G. William; Sipps, Gary J.


    Examined effects of client self-esteem as measured by Rosenberg Self-Esteem Scale and client-counselor similarity as determined by Myers-Briggs Type Indicator (MBTI) on number of sessions and type of termination (unilateral or mutual) for 55 clients and 9 counselors at university counseling center. Self-esteem interacted significantly with…

  6. Client Involvement in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Henriksen, Nina; Kjær, Lone


    Client involvement’ has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how ‘client involvement’ is practised in home-care services. The aim of this article is to analyse ‘client involvement’ in practise seen fr...... in public home-care practice remains limited...

  7. Comparison of communication skills between trained and untrained students using a culturally sensitive nurse-client communication guideline in Indonesia. (United States)

    Claramita, Mora; Tuah, Rodianson; Riskione, Patricia; Prabandari, Yayi Suryo; Effendy, Christantie


    A communication guideline that is sensitive to the local culture is influential in the process of nursing care. The Gadjah Mada nurse-client communication guideline, the "Ready-Greet-Invite-Discuss," was meant (1) to strengthen the relationship between the nurse and the client despite of socio-culturally hierarchical gap between health providers and clients in Indonesian context, (2) to provide attention to the unspoken concerns especially in the context of indirect communication which mostly using non-verbal signs and politeness etiquettes, and (3) to initiate dialog in the society which hold a more community-oriented decision making. Our aim is to compare the communication skills of nursing students who had and had not received a training using a culture-sensitive Gadjah Mada nurse-client communication guideline. This was a quasi experimental randomized control study to the fifth semester students of a nursing school at Yogyakarta, Indonesia. The intervention group was trained by the Gadjah Mada nurse-client communication guideline. Both intervention and the control group had learned general nurse-client communication guidelines. The training was 4h with role-plays, supportive information and feedback sessions. An objective-structured clinical examination (OSCE) was conducted 1week after the training, in seven stations, with seven simulated clients. Observers judged the communication skills of the students using a checklist of 5-point Likert scale, whereas simulated clients judged their satisfaction using 4-point Likert scale represented in colorful ribbons. There were significant mean differences in each domain of communication guideline observed between the trained and the control groups as judged by the teachers (p≤0.05) and simulated clients. Training using a culture-sensitive communication skills guideline could improve the communication skills of the nursing students and may increase satisfaction of the clients. Copyright © 2015 Elsevier Ltd. All rights

  8. 31 CFR 10.28 - Return of client's records. (United States)


    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Return of client's records. 10.28... § 10.28 Return of client's records. (a) In general, a practitioner must, at the request of a client, promptly return any and all records of the client that are necessary for the client to comply with his or...

  9. Development of a Nutrition Education Intervention for Food Bank Clients. (United States)

    Dave, Jayna M; Thompson, Deborah I; Svendsen-Sanchez, Ann; McNeill, Lorna Haughton; Jibaja-Weiss, Maria


    The focus of this article is the development of a nutrition education intervention for food bank clients. Formative research using mixed-methods (qualitative and quantitative) and community-based participatory research principles was conducted to assess the nutrition education needs of clients obtaining service from the Houston Food Bank (HFB). Participants were HFB and pantry staff and clients. Interview data were coded and analyzed using grounded theory approach. Themes were then identified. Quantitative data were analyzed for frequencies and descriptives. Data were used to tailor the curriculum to the target population. Six HFB staff, 49 pantry staff from 17 pantries, and 54 clients from 10 pantries participated in interviews and focus groups and completed questionnaires. The participants provided opinion on the current nutrition education provided via the food bank and made suggestions on strategies for development of an intervention. Their feedback was used to develop the six-session intervention curriculum to be delivered over 6 months. This research provides evidence that it is critical for members of the target audience be included in formative research to develop behavior change programs that are relevant and appealing and target their needs and interests.

  10. Podemos fidelizar clientes inicialmente insatisfechos

    Directory of Open Access Journals (Sweden)

    Jesús Cambra-Fierro


    Full Text Available El paradigma relacional, dominante en el ámbito de la mercadotecnia, aboga por establecer y desarrollar relaciones duraderas con los clientes. Para ello es preciso conocer cuáles son sus necesidades y esforzarse por satisfacerlas. Los clientes quieren sentirse importantes y, por tanto, las empresas deberían preocuparse no sólo por vender, sino también por conocer su índice real de satisfacción/ insatisfacción. Por tanto, desde un punto de vista lógico este debería ser el patrón de comportamiento empresarial, los trabajos de Barroso (2008 y Coca (2008 así lo indican. Pero la realidad demuestra que esto no siempre es así. A pesar de que los clientes siempre desean sentirse atendidos, existen empresas que parecen olvidarse de esta premisa básica y, sin embargo, obtienen resultados positivos. Este trabajo tiene el objetivo de analizar la posible contribución de los procesos de recuperación de servicios en la fidelización de clientes/usuarios. Para ello tomamos como referencia el concepto de procesos de recuperación de servicio y estudiamos el contexto del sector de telefonía móvil en España.Através de un análisis de estadísticos descriptivos y de la técnica Partial Least Squares (PLS, concluimos que las empresas se comportan de manera opuesta a lo que esperan los clientes y no se preocupan realmente por reconquistar su satisfacción. Sin embargo, la opinión de los usuarios resulta muy reveladora y sugiere que es posible convertir un cliente inicialmente insatisfecho en un cliente fiel.

  11. Assessing group differences in biodiversity by simultaneously testing a user-defined selection of diversity indices. (United States)

    Pallmann, Philip; Schaarschmidt, Frank; Hothorn, Ludwig A; Fischer, Christiane; Nacke, Heiko; Priesnitz, Kai U; Schork, Nicholas J


    Comparing diversities between groups is a task biologists are frequently faced with, for example in ecological field trials or when dealing with metagenomics data. However, researchers often waver about which measure of diversity to choose as there is a multitude of approaches available. As Jost (2008, Molecular Ecology, 17, 4015) has pointed out, widely used measures such as the Shannon or Simpson index have undesirable properties which make them hard to compare and interpret. Many of the problems associated with the use of these 'raw' indices can be corrected by transforming them into 'true' diversity measures. We introduce a technique that allows the comparison of two or more groups of observations and simultaneously tests a user-defined selection of a number of 'true' diversity measures. This procedure yields multiplicity-adjusted P-values according to the method of Westfall and Young (1993, Resampling-Based Multiple Testing: Examples and Methods for p-Value Adjustment, 49, 941), which ensures that the rate of false positives (type I error) does not rise when the number of groups and/or diversity indices is extended. Software is available in the R package 'simboot'. © 2012 Blackwell Publishing Ltd.

  12. Perceptions towards IT Security in Online Banking: Croatian Clients vs. Clients of Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Nedim Makarevic


    Full Text Available This study has been completed with a purpose to analyze and compare perceptions of clients of Bosnia and Herzegovina and those of Croatian clients about IT security in online banking, to provide insight into similarities and differences of their view points and to create important set of information for all subjects active in banking industry. Once the survey based on six variables and specific questions assigned to each one of those variables was prepared, results regarding both countries were collected and concluded. Survey was completed in both Bosnia and Herzegovina and Croatia at high response rates. Even 207 respondents replied from Bosnia and Herzegovina, while 203 respondents completed survey from Croatia. Results were analyzed and presented using descriptive statistics. Results indicated that Croatian e-banking users trust to banks when it comes to IT security of online banking much more compared to clients of Bosnia and Herzegovina. It is important to mention that clients of Croatia perceive tangible features as highly significant while Bosnian clients do not perceive tangible features that much important. This proved that Croatian clients are aware of potential security threats and they know their part of responsibility when it comes to handling money online. On the other hand, results from Bosnia and Herzegovina indicated that Bosnian clients have lack of trust in online banking, and lack of awareness about personal tangible aspects that can improve security of personal online banking experience. The main limitation of this study is relatively small sample and too generic approach. Therefore, this study may be perceived as a pilot study for future researchers. The study’s results may be of interest to marketers and managers of banks operating in Bosnia and Herzegovina and Croatia to learn more about their clients’ perceptions towards their e-banking services.

  13. Clients' and therapists' stories about psychotherapy. (United States)

    Adler, Jonathan M


    This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.

  14. The Client's Perspective on Voluntary Stuttering. (United States)

    Byrd, Courtney T; Gkalitsiou, Zoi; Donaher, Joe; Stergiou, Erin


    Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering. The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use. A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment. To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.

  15. [On the clients of public health organizations]. (United States)

    Duran, Júlia; Villalbí, Joan R; Guix, Joan


    Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.

  16. Group Process in a Women's Career Intervention. (United States)

    Mawson, Diana L.; Kahn, Sharon E.


    Explored women's experiences of group process in career planning interventions and relationship of those experiences to vocational maturity. Results from 99 career-undecided women revealed that female clients, similar to other counseling clients, highly valued both cognitive and affective components of group process in career counseling groups.…

  17. Client Intimacy & Performance Advice: Determinants of Trust in the Public Accountant - SME Client Relationship

    Directory of Open Access Journals (Sweden)

    Dianne McGrath


    Full Text Available This multi-discipline research investigated the determinants of trust in the relationship between Australia’s public accountants and their small and medium-sized (SME clients. In excess of four hundred SME owners, across Australia, were surveyed to test a proposed model and client intimacy variables were found to be the most significant predictors of trust in this important relationship. Offer-related variables, primarily the provision of advisory or performance-related services (rather than conformance-related services, were also found to be significant, however, at a lesser level than client intimacy and relationship variables. The multi-dimensionality of the trust construct was also highlighted.

  18. User rights management of the CSNS control system client

    International Nuclear Information System (INIS)

    Zhang Zhuoyu; Liu Minqian; Chu Yuanping; Zhuang Jian; Hu Lei; Jin Dapeng


    The China Spallation Neutron Source (CSNS) will become the first pulsed spallation neutron source owned by China, CSS (Control System Studio), used as the the target station and spectrometer control system client, is mainly responsible for equipment controlling and parameter monitoring. In order to ensure the safety of the control system, the advanced GUI and important operating parameters must be restricted to ordinary users, only senior experts have the rights to view and modify them, so we must divide CSS users into different groups and give different rights to different groups. Based on user roles, CSS can implicit workbench contents and widgets, to ensure that users can seamlessly log into different clients. This article mainly talk about the JAAS authentication and authorization services in CSS, and deploy user information and master-slave synchronization information on the LDAP server, and use the Eclipse activity extension points to accomplish GUI explicit-implicit control according to the logged in user. (authors)

  19. Exploring the Black Box in Brazilian Work Groups: a Study of Diversity, Conflict and Performance

    Directory of Open Access Journals (Sweden)

    Filipe Sobral


    Full Text Available Over the last few decades, several studies have been conducted to examine the complex relationships betweenteam diversity and individual and organizational outcomes. Although, in theory, team diversity can fosterpositive organizational synergies by increasing the variance of perspectives and approaches to work differentmembers can bring, the same idiosyncratic characteristics can also engender significant difficulties resultingfrom problems in coordination, communication and conflict. This study used a sample of 44 work groups toexamine the influence of five types of diversity on team outcomes and the mediating role of task and relationalconflict on this relationship. A survey of 279 team members and interviews with the 44 team managers wereused to examine these relationships. Findings suggest that different forms of diversity impact task conflict indifferent ways, which in turn is negatively associated with job satisfaction and team performance. Results furthershow that diversity is unrelated to relational conflict; however, this type of conflict seems to hinder both jobsatisfaction and team performance. Overall, these patterns suggest a complex link between team diversity andhow work groups function.

  20. 49 CFR 1103.22 - Restraining clients from improprieties. (United States)


    ... 49 Transportation 8 2010-10-01 2010-10-01 false Restraining clients from improprieties. 1103.22... Practitioner's Duties and Responsibilities Toward A Client § 1103.22 Restraining clients from improprieties. A practitioner should see that his clients act with the same restraint that the practitioner himself uses...

  1. Acerca de los clientes de las organizaciones de salud pública On the clients of public health organizations

    Directory of Open Access Journals (Sweden)

    Júlia Duran


    Full Text Available Los servicios públicos han de responder y satisfacer a una diversidad de agentes: sus usuarios, los ciudadanos que pagan impuestos que los financian, los políticos, y el personal que trabaja en ellos. Para conseguir unos servicios públicos que pongan al ciudadano-usuario en el vértice de su funcionamiento habrá que conocer al cliente, sus expectativas, preferencias, quejas y satisfacción. Este manuscrito presenta el proceso de reflexión interna realizado en nuestra organización acerca de sus clientes, cuya naturaleza es muy distinta de los de una empresa industrial o comercial. Se plantea una tipología y el proceso que ha llevado a confeccionar un listado de clientes, y se plantean acciones que hay que realizar para mejorar los servicios desde su perspectiva.Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.


    Directory of Open Access Journals (Sweden)

    Isa Nagib edrus


    Full Text Available Infrastructure development in the particular sites of  Seribu Islands as well as those in main land of Jakarta City increased with coastal population this phenomenon is likely to increase the effects to the adjacent coral waters of Seribu Islands.  Chemical pollutants, sedimentation, and domestic wastes are the common impact and threatening, the survival of coral reef ecosystem. Coral reef resiliences naturaly remained on their processes under many influences of supporting factors. One of the major factor is the role of reef fish functional groups on controling algae growth to recolonize coral juveniles. The  aim of this study to obtain data of a herbivory and other fish functional groups of reef fishes in the Pari Islands that are resilience indicators, or that may indicate the effectiveness of management actions. A conventional scientific approach on fish diversity and abundance data gathering was conducted by the underwater visual cencus. Diversity values of the reef fish functional groups, such as the abundance of individual fish including species, were collected and tabulated by classes and weighted as a baseline to understand the resilience of coral reed based on Obura and Grimsditch (2009 techniques. The results succesfully identified several fish functional groups such as harbivores (21 species, carnivores (13 species and fish indicator (5 species occurred in the area. Regarding the aspects of fish density and its diversity, especially herbivorous fish functional group, were presumably in the state of rarely available to support the coral reef resiliences. Resilience indices ranged from 1 (low level to 3 (moderate level and averages of the quality levels ranged from 227 to 674. These levels were inadequate to support coral reef recolonization.

  3. 29 CFR 402.11 - Attorney-client communications exempted. (United States)


    ... 29 Labor 2 2010-07-01 2010-07-01 false Attorney-client communications exempted. 402.11 Section 402... LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION INFORMATION REPORTS § 402.11 Attorney-client... communicated to such attorney by any of his clients in the course of a legitimate attorney-client relationship. ...

  4. 29 CFR 403.9 - Attorney-client communications exempted. (United States)


    ... 29 Labor 2 2010-07-01 2010-07-01 false Attorney-client communications exempted. 403.9 Section 403... LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION ANNUAL FINANCIAL REPORTS § 403.9 Attorney-client... communicated to such attorney by any of his clients in the course of a legitimate attorney-client relationship. ...

  5. Phylogenetic diversity in the core group of Peziza inferred from ITS sequences and morphology

    DEFF Research Database (Denmark)

    Hansen, K.; Læssøe, Thomas; Pfister, D.H.


    Species delimitation within the core group of Peziza is highly controversial. The group, typified by P. vesiculosa, is morphologically coherent and in previous analyses of LSU rDNA sequences it formed a highly supported clade. Phylogenetic diversity and species limits were investigated within......), shallowly cup- to disc-shaped apothecia (A) and large (up to 15 cm), deeply cup-shaped to expanded apothecia (B). The overall exciple structure (a stratified or non-stratified medullary layer) and to some degree spore surface relief, likewise support the groupings. Clade A contains taxa with smooth...... that populations on a diverse array of substrates may be closely related, or indeed, conspecific....

  6. Diversity in peer groups - the benefits and tensions it may entail

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.; Madsen, Henning

    One of the aspects of English Medium Instruction (EMI) and Internationalisation at Home (IaH) is that students are expected to work together in peer groups across linguistic and cultural barriers, e.g. to complete mandatory assignments in small groups. However, students’ attitude and response...... to this form of cooperation differ widely. This paper discusses the benefits and tensions of work in diverse peer groups exemplified by the findings of a study of student responses to intercultural collaboration in a master of business programme. One conclusion is that the international students are more...

  7. 32 CFR 776.33 - Client under a disability. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Client under a disability. 776.33 Section 776.33... of Professional Conduct § 776.33 Client under a disability. (a) Client under a disability: (1) When a client's ability to make adequately considered decisions in connection with the representation is...

  8. 29 CFR 404.5 - Attorney-client communications exempted. (United States)


    ... 29 Labor 2 2010-07-01 2010-07-01 false Attorney-client communications exempted. 404.5 Section 404... LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION OFFICER AND EMPLOYEE REPORTS § 404.5 Attorney-client... communicated to such attorney by any of his clients in the course of a legitimate attorney-client relationship. ...

  9. 42 CFR 483.420 - Condition of participation: Client protections. (United States)


    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Client protections. 483... Condition of participation: Client protections. (a) Standard: Protection of clients' rights. The facility must ensure the rights of all clients. Therefore, the facility must— (1) Inform each client, parent (if...

  10. Authoritarianism, conservatism, racial diversity threat, and the state distribution of hate groups. (United States)

    McCann, Stewart J H


    On the basis of K. Stenner's (2005) authoritarian dynamic theory, the author hypothesized that there is an interaction between U.S. state conservatism-liberalism and state racial heterogeneity threat, such that greater diversity threat tends to be associated with more hate groups in more conservative states and fewer hate groups in more liberal states. State aggregates of the conservative-liberal ideological preferences of 141,798 participants from 122 CBS News/New York Times national telephone polls conducted between 1976 and 1988 (R. S. Erikson, G. C. Wright, & J. P. McIver, 1993) served as proxies for authoritarian-nonauthoritarian dispositions. For the 47 states with complete data, the hypothesized interaction was tested for 2000, 2005, and 2006 with hierarchical multiple regression strategies and supported. The author's hypothesis was also affirmed with SES and the interaction of SES and diversity threat controlled for. In contrast, SES entirely accounted for simple relationships between threat and hate group frequency.

  11. 31 CFR 10.21 - Knowledge of client's omission. (United States)


    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Knowledge of client's omission. 10.21... § 10.21 Knowledge of client's omission. A practitioner who, having been retained by a client with respect to a matter administered by the Internal Revenue Service, knows that the client has not complied...

  12. The effect of Bandura's social cognitive theory implementation on addiction quitting of clients referred to addiction quitting clinics. (United States)

    Heydari, Abbas; Dashtgard, Ali; Moghadam, Zahra Emami


    Addiction, especially addiction quitting, has been the main problem of health systems of many countries in recent years. High percentage of addiction recurrence (more than 80%) indicates that the nature and therapeutic method of addiction have not been recognized and it demands more efforts in this field. Thus, the present study was conducted with an aim to examine the effect of Bandura's social cognitive theory implementation on addiction quitting of clients referred to Imam Reza Hospital addiction quitting clinic. This two-group experimental study was conducted on 60 clients (30 clients in test group and 30 in control group) referred to Imam Reza Hospital addiction quitting clinic. The study tools were demographic and addiction-quitting self-efficacy questionnaires. After gathering demographic data and conducting pretest, the intervention was carried out based on Bandura's social cognitive theory for the test group and post-test was taken 1 month after the intervention. Data were analyzed by SPSS using related tests. According to the results, test group was more successful than the control group in addiction quitting. There was a significant difference between the two groups in terms of recurrence; it was less in the test group. A significant difference was also found between self-efficacy scores before and after the intervention in the test group. Using Bandura's social cognitive theory was effective on addiction quitting. So, it is recommended to apply it for clients referring to addiction quitting clinics.

  13. Uncovering client retention antecedents in service organizations

    Directory of Open Access Journals (Sweden)

    Mari Jansen van Rensburg


    Full Text Available This paper develops a multi-dimensional model of retention to provide a more complete and integrated view of client retention and its determinants in service contexts. To uncover the antecedents of client retention, social and economic exchanges were reviewed under the fundamental ideas of the Social Exchange Theory. Findings from a survey of senior South African advertising executives suggest that client retention is the result of evaluative as well as relational factors that can influence client responses. Despite contractual obligations, advertisers are willing to pay the costs and make the sacrifices of switching should their expectations be unmet. An important contribution of this study is the use of multi-item scales to measure retention. The model developed provides valuable insight to agencies on client retention management and the optimal allocation of resources for maximum customer equity. This model may also be applied to other service organisations to provide insight to client retention.

  14. Client Contacts Improve Quality of Copywriting. (United States)

    McCann, Guy


    Discusses the advantages of using real-life clients for class assignments in copywriting courses. Presents suggestions for client sources and identifies possible problems which may be encountered. (MM)

  15. Making participation accessible for vulnerable clients

    Directory of Open Access Journals (Sweden)

    Louis Anthony Iaquinto


    Full Text Available Despite forty years of research, community sector service providers still find operationalising participation in their practice confusing and difficult.  This paper presents the results of a preliminary study that begins to question why this is so and what can be done about it?  The study examines the meaning and importance of participation determined by a review of the academic literature, by soliciting feedback from a range of stakeholders in community sector organisations, including service users with complex barriers to participation, staff, and board members.  The participants’ perspectives, views and experience of participation were obtained through the use of semi-structured interviews.  The data generated a number of telling examples of the impact organisational culture has on service delivery and how the values of the leadership shape the organization, as well as illustrations of the principles that underpin participation expressed from the standpoints of the three participant groups.  Study findings underscore the critical importance for service providers to consider their culture and its influences.   Keywords: organisational culture, vulnerable clients, client participation

  16. Payeeship, financial leverage, and the client-provider relationship. (United States)

    Angell, Beth; Martinez, Noriko I; Mahoney, Colleen A; Corrigan, Patrick W


    Although representative payeeship provided within clinical settings is believed to have therapeutic benefits, its potential negative impact on the therapeutic alliance or client-provider relationship is of concern. This study examined the effects of payeeship and perceived financial leverage on positive and negative dimensions of the client-provider relationship. The sample consisted of 205 adults ages 18 to 65 with axis I disorders who were receiving mental health services from a large urban community mental health clinic. Information about money management characteristics and ratings of the client-provider relationship were collected via face-to-face interview. Fifty-three percent of the sample had a payee or money manager, and 79% of this group had a clinician payee. Respondents with co-occurring psychotic and substance use disorders, lower functioning, and lower insight about their illness were more likely to have a clinician payee. Forty percent of those with a clinician payee reported perceived financial leverage. Having a clinician payee was also associated with perceived financial leverage and with higher levels of conflict in the case management relationship. When examined in combination, financial leverage was found to mediate the effects of payeeship on conflict in the case management relationship (mean+/-SE=2.37+/-1.33, 95% confidence interval=16-5.52, pconflict in the therapeutic alliance when used as a source of treatment leverage. Although payeeship provides important support and may enhance functional outcomes for the patient, decisions about using the mechanism for promoting treatment adherence should take into account the potential disruption to the client-provider relationship.

  17. Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions. (United States)

    Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F


    Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. There was a significant difference in the mean ratings for clients and clinicians for

  18. Implementing groupwork in primary care to meet client need. (United States)

    Newcombe, Teresa; Gledstone, Pam

    Hertsmere health visitors are successfully using groupwork to target patient groups who may not traditionally access services. This includes working with clients in environments such as a homeless family hostel and an English as a second language group. The health visitors have incorporated national service framework targets and important health promotion advice into sessions, and work with a range of other professionals. The result is a modernised, family-centred public health role.

  19. Functional group diversity is key to Southern Ocean benthic carbon pathways.

    Directory of Open Access Journals (Sweden)

    David K A Barnes

    Full Text Available High latitude benthos are globally important in terms of accumulation and storage of ocean carbon, and the feedback this is likely to have on regional warming. Understanding this ecosystem service is important but difficult because of complex taxonomic diversity, history and geography of benthic biomass. Using South Georgia as a model location (where the history and geography of benthic biology is relatively well studied we investigated whether the composition of functional groups were critical to benthic accumulation, immobilization and burial pathway to sequestration-and also aid their study through simplification of identification. We reclassified [1], [2] morphotype and carbon mass data to 13 functional groups, for each sample of 32 sites around the South Georgia continental shelf. We investigated the influence on carbon accumulation, immobilization and sequestration estimate by multiple factors including the compositions of functional groups. Functional groups showed high diversity within and between sites, and within and between habitat types. Carbon storage was not linked to a functional group in particular but accumulation and immobilization increased with the number of functional groups present and the presence of hard substrata. Functional groups were also important to carbon burial rate, which increased with the presence of mixed (hard and soft substrata. Functional groups showed high surrogacy for taxonomic composition and were useful for examining contrasting habitat categorization. Functional groups not only aid marine carbon storage investigation by reducing time and the need for team size and speciality, but also important to benthic carbon pathways per se. There is a distinct geography to seabed carbon storage; seabed boulder-fields are hotspots of carbon accumulation and immobilization, whilst the interface between such boulder-fields and sediments are key places for burial and sequestration.

  20. 45 CFR 1608.7 - Attorney-client relationship. (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Attorney-client relationship. 1608.7 Section 1608... PROHIBITED POLITICAL ACTIVITIES § 1608.7 Attorney-client relationship. Nothing in this part is intended to prohibit an attorney or staff attorney from providing any form of legal assistance to an eligible client...

  1. Can retail banking clients' attrition be managed?

    Directory of Open Access Journals (Sweden)

    Agaliotis Konstantinos


    Full Text Available The rurrο_e of all banks across the universe is to satisfy their clients' necessities. One of the predominant impacts of the last few years' financial crisis in Europe was the way in which customers interact with their banks. The theory of 'main bank' is not any more the case as clients' trust toward banks fades away together with their loyalty. Nowadays, it is necessary for banks to segment their clientele data base, and target the most profitable clients. The retention strategy of each financial institution becomes more and more important as the value of each retained customer is disproportional to the cost of acquiring a new one. The main findings of the subject retail banking clients' retention policy analysis prove that clients of different lifetime value have different propensity to defect. At the same time, the ability of a bank to retain a potential defector does not depend directly on satisfying the defection reason. Many of the various bank counter offers which do not directly satisfy the reason that a client refers to as the 'defection' one, are enough in order to retain a client. Equally important to the identification of clients' behavioural patterns is the use of the subject findings on behalf of the retail oriented banks in order to predict accurately the cost of future defection, as well as, to incorporate one more measurable parameter in their credit risk scorecards i.e. the intention to increase credit exposure.

  2. A physician role typology: colleague and client dependence in an HMO. (United States)

    Barr, J K; Steinberg, M K


    This paper reports on physicians' role definitions in one prepaid group practice, a health maintenance organization (HMO). Colleague and client dependence are reviewed and analyzed as separable dimensions of physician role definitions. Data are derived from documents, interviews, and staff questionnaires collected in 1979-1980. The evidence reported suggests widespread colleague dependence in the HMO. Physicians consulted with one another about patient care and engaged in informal referral and review, developing practice standards; and some of these physicians relied on colleagues for handling their patient visits when needed. In relation to their patients, some physicians viewed themselves as bureaucratic officials relatively dependent on client approval in carrying out their health care activities, while others saw themselves as trusted medical experts in a setting free of nonmedical constraints in patient care. The relationship of organizational structure to these different role definitions is discussed. Classifying these HMO physicians according to a fourfold typology of professional dependence shows that most are Organizational Physicians (Type I), who are both colleague and client dependent. Collegial Physicians (Type II) are colleague dependent and, at the same time, do not perceive clients as demanding. Implications for quality of care and physician satisfaction and turnover are considered.

  3. The genetic diversity of commensal Escherichia coli strains isolated from nonantimicrobial treated pigs varies according to age group

    DEFF Research Database (Denmark)

    Ahmed, Shahana; Olsen, John E.; Herrero-Fresno, Ana


    This is the first report on the genetic diversity of commensal E. coli from pigs reared in an antibiotic free production system and belonging to different age groups. The study investigated the genetic diversity and relationship of 900 randomly collected commensal E. coli strains from non......-antimicrobial treated pigs assigned to five different age groups in a Danish farm. Fifty-two unique REP profiles were detected suggesting a high degree of diversity. The number of strains per pig ranged from two to 13. The highest and the lowest degree of diversity were found in the early weaners group (Shannon...... diversity index, H' of 2.22) and piglets (H' of 1.46) respectively. The REP profiles, R1, R7 and R28, were the most frequently observed in all age groups. E. coli strains representing each REP profile and additional strains associated with the dominant profiles were subjected to PFGE and were assigned to 67...

  4. 17 CFR 205.3 - Issuer as client. (United States)


    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Issuer as client. 205.3... ISSUER § 205.3 Issuer as client. (a) Representing an issuer. An attorney appearing and practicing before...'s clients. (b) Duty to report evidence of a material violation. (1) If an attorney, appearing and...

  5. 19 CFR 111.39 - Advice to client. (United States)


    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Advice to client. 111.39 Section 111.39 Customs... CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.39 Advice to client. (a) Withheld or false information. A broker must not withhold information relative to any customs business from a client...

  6. The impact of a reproductive health franchise on client satisfaction in rural Nepal. (United States)

    Agha, Sohail; Karim, Ali Mehryar; Balal, Asma; Sosler, Steve


    This study evaluates the impact of a nurse and paramedic reproductive health franchise in rural Nepal on client satisfaction and utilization of services. A quasi-experimental study design, with baseline and follow-up measurements on nonequivalent control groups, was used to assess the effects of the intervention. The study collected data from exit interviews with male and female clients at clinics and from household interviews with married women. Our assessment covers the project's performance for about a year of actual implementation. Client satisfaction with the quality of services increased across a range of indicators at intervention clinics but not at control clinics. Overall satisfaction with services also increased only at intervention clinics but not at control clinics. Consistent with these changes, loyalty increased among clients of franchised clinics. The analysis showed a positive relationship between client satisfaction and loyalty. Although the project's implementation was examined over a relatively short period of time, there appears to have been a net positive effect of the intervention on obtaining family planning products from medical stores/pharmacies. The study shows that franchising reproductive health services increases a provider's interest in delivering better quality services in rural areas of a developing country.

  7. Análise da lucratividade dos clientes


    Madeira, Paulo


    Um bom sistema de Análise da lucratividade de Clientes pode ajudar a melhorar a rendibilidade global do negócio, selecionando os clientes de qualidade, e a indicar o principal caminho a segui rpara atingir uma maior lucartividade, indicando o impacto financeiro actual e potencial dos movimentos estratégicos dos clientes.

  8. Lack of congruence in species diversity indices and community structures of planktonic groups based on local environmental factors. (United States)

    Doi, Hideyuki; Chang, Kwang-Hyeon; Nishibe, Yuichiro; Imai, Hiroyuki; Nakano, Shin-ichi


    The importance of analyzing the determinants of biodiversity and community composition by using multiple trophic levels is well recognized; however, relevant data are lacking. In the present study, we investigated variations in species diversity indices and community structures of the plankton taxonomic groups-zooplankton, rotifers, ciliates, and phytoplankton-under a range of local environmental factors in pond ecosystems. For each planktonic group, we estimated the species diversity index by using linear models and analyzed the community structure by using canonical correspondence analysis. We showed that the species diversity indices and community structures varied among the planktonic groups and according to local environmental factors. The observed lack of congruence among the planktonic groups may have been caused by niche competition between groups with similar trophic guilds or by weak trophic interactions. Our findings highlight the difficulty of predicting total biodiversity within a system, based upon a single taxonomic group. Thus, to conserve the biodiversity of an ecosystem, it is crucial to consider variations in species diversity indices and community structures of different taxonomic groups, under a range of local conditions.

  9. [Catering for client groups during the XXII Olympic winter games and XI Paralympic winter games of 2014 in Sochi]. (United States)

    Popova, A Yu; Gus'kov, A S; Ivanov, G E; Chikina, L V; Klindukhov, V P; Nikolaevich, P N; Grechanaya, T V; Balaeva, M I; Vechernyaya, L S; Vechernyaya, E A; Bozhko, I I; Parkhomenko, V V; Kulichenko, O A; Tushina, O V; Manin, E A; Taran, T V


    The problems of catering control various client groups during the XXII Olympic Winter Games and XI Paralympic Winter Games of 2014 in Sochi is one of the priorities of the sanitary and epidemiological welfare of the population during mass events. The data on the order of nutrition of guests and participants of the games, control of food items, sanitary and microbiological monitoring of drinking water, food raw materials and products are presented. It is noted that the ongoing supervisory activities contributed to the sanitary and epidemiological well-being during the Games. The purpose of this study was to lighting modern achievements in the field of nutrition and food microbiology in the period of the Olympic Games and the determination of their value to the further improvement and use at when conducting mass gatherings.

  10. ‘Would you like to talk about that?’ How and when group emotional awareness enhances effectiveness of gender diverse teams

    Directory of Open Access Journals (Sweden)

    Smaranda Boros


    Full Text Available The aim of this paper is to explore the moderating role of group emotional awareness and diversity beliefs inthe relationship between gender diversity and group effectiveness. In study 1 (cross-sectional survey in 31organizational teams, the interaction effect between diversity and awareness suggests that awareness contributes toa larger extent to team effectiveness in gender homogenous rather than heterogeneous teams. Considering themoderating role of diversity beliefs for the outcomes of diversity, in study 2 (an experimental study on 21 studentproject teams we look at the interaction of diversity beliefs and group emotional awareness. Results suggest that apositive framing of diversity has the strongest positive impact on effectiveness. However, group emotionalawareness cancels the negative framing effect of diversity on effectiveness. Our data gives evidence for theexistence of an affective, rather than cognitive path to reaping the benefits of gender diversity without paying theprice elicited by categorization.

  11. Unexpected pattern of pearl millet genetic diversity among ethno-linguistic groups in the Lake Chad Basin. (United States)

    Naino Jika, A K; Dussert, Y; Raimond, C; Garine, E; Luxereau, A; Takvorian, N; Djermakoye, R S; Adam, T; Robert, T


    Despite of a growing interest in considering the role of sociological factors in seed exchanges and their consequences on the evolutionary dynamics of agro-biodiversity, very few studies assessed the link between ethno-linguistic diversity and genetic diversity patterns in small-holder farming systems. This is key for optimal improvement and conservation of crop genetic resources. Here, we investigated genetic diversity at 17 SSR markers of pearl millet landraces (varieties named by farmers) in the Lake Chad Basin. 69 pearl millet populations, representing 27 landraces collected in eight ethno-linguistic farmer groups, were analyzed. We found that the farmers' local taxonomy was not a good proxy for population's genetic differentiation as previously shown at smaller scales. Our results show the existence of a genetic structure of pearl millet mainly associated with ethno-linguistic diversity in the western side of the lake Chad. It suggests there is a limit to gene flow between landraces grown by different ethno-linguistic groups. This result was rather unexpected, because of the highly outcrossing mating system of pearl millet, the high density of pearl millet fields all along the green belt of this Sahelian area and the fact that seed exchanges among ethno-linguistic groups are known to occur. In the eastern side of the Lake, the pattern of genetic diversity suggests a larger efficient circulation of pearl millet genes between ethno-linguistic groups that are less numerous, spatially intermixed and, for some of them, more prone to exogamy. Finally, other historical and environmental factors which may contribute to the observed diversity patterns are discussed.

  12. Legibility of USP pictograms by clients of community pharmacies in Portugal. (United States)

    Soares, Maria Augusta


    Effective and safe use of medicines depends on patients' good understanding of the pharmacotherapy. Pictograms are a communication tool, as complement of verbal/written information, to facilitate drug use and, avoiding errors, being useful for drug effectiveness and safety. To assess the ability of pharmacy's clients, in understanding USP pictograms, establishing the relationship with their socio demographic profiles. The study was developed in community pharmacies, in Lisbon region. Cross sectional study, carried out in pharmacies in Lisbon. A structured questionnaire was used in pharmacies clients of 18 years old and above. Legibility of fifteen USP pictograms was studied using ISO and ANSI criteria. Correlation between the legibility of pictograms and pharmacies clients' demographic profile (age, gender, scholarship, frequency of medicines use) was evaluated. SPSS data base version 18 was used for descriptive analysis. Legibility of fifteen United States Pharmacopeia (USP) pictograms and, its relationship with clients' demographic data (scholarship degree, age, frequency of medicines use and, gender) was studied. From 751 responders, ten pictograms were legible by ISO and seven by ANSI. More than 30 % of the responders weren't able to understand five of the pictograms. It was found statistically significant relationships between some the understanding of some pictograms and clients' scholarships degree, age and frequency of medicines use. It was found that not all the fifteen tested USP pictograms were correctly comprehended by Portuguese pharmacies' clients, having found correlations with scholarship degree, daily use of medicines and age group, for some pictograms. To ensure the effectiveness of USP pictograms it is advisable to test patients' comprehension, before their use in general practice.

  13. Improving UK client-contractor relations

    International Nuclear Information System (INIS)

    Brant, A.W.


    The client's aim in any decommissioning project is that the originally intended end point is achieved, within budget and on time. The contractor's aim is to have a satisfied client, so that both are happy to work together again, and to have a reasonable return for his efforts. How can these - not incompatible - aims best be achieved? (UK)

  14. The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition. (United States)

    Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia


    Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

  15. A Meta-Analysis of Skills Training Programs for Rehabilitation Clients. (United States)

    Bolton, Brian; Akridge, Robert L.


    Summarized the results of 15 experimental studies of 10 small-group skills training interventions developed for use with vocational rehabilitation clients. Concluded that the typical participant in skills training interventions received substantial benefit from the activity. Skills training programs should be implemented more widely with clients…

  16. Competent Counseling for Middle Eastern American Clients: Implications for Trainees (United States)

    Soheilian, Sepideh S.; Inman, Arpana G.


    The authors used a factorial multivariate analysis of variance (MANOVA) to determine whether counselor trainees' group differences on measures of multicultural competence, empathy, and multicultural counseling self-efficacy (CSE) when working with Middle Eastern American (MEA) clients were moderated by trainee race. Two hundred and fifty-six…

  17. Agreement between clients with schizophrenia and mental health workers on clients' social quality of life: The role of social cognition and symptoms. (United States)

    Ofir-Eyal, Shani; Hasson-Ohayon, Ilanit; Bar-Kalifa, Eran; Kravetz, Shlomo; Lysaker, Paul H


    Studies have showed that therapists and mental health workers of persons with schizophrenia tend to estimate their patients' social quality of life (SQoL) as poorer than the clients' own estimation. This study explores the hypothesis that this discrepancy is related to clients' social cognition and symptomatology. Cross-sectional assessment of both clients and their mental health workers. Ninety persons with schizophrenia and 12 persons who were formal care providers participated in the study. All responded to a parallel version (client and clinician) of social quality-of-life scales. Clients' emotion identification, theory of mind and symptoms were also assessed. Low social cognitive abilities of persons with schizophrenia, as well as negative symptomatology and having children, may be related to the negative bias of mental health workers, with regard to their client's SQoL. While more severe levels of negative symptoms and more deficits of social cognition were related to reduced levels of agreement, paradoxically, a relatively normative family life that includes parenting was also related to lower levels of agreement. Attention should be given to low agreement between clients with schizophrenia and clinicians with regard to the client's quality of life, as it is central to alliance and outcome. Clinicians tend to estimate clients' social quality of life as poorer than the clients' own estimation when those clients have low social cognition, high negative symptomatology and children. There is a need to identify additional factors that contribute to agreement and alliance in therapy. Longitudinal assessment during therapy can trace the process of construction of agreement. © 2016 The British Psychological Society.

  18. Managing Client Values in Construction Design

    DEFF Research Database (Denmark)

    Thyssen, Mikael Hygum; Emmitt, Stephen; Bonke, Sten


    In construction projects the client will comprise both owner, end-users, and the wider society, representatives of which may have conflicting goals and values; and these may not be fully realized by the stakeholders themselves. Therefore it is a great challenge to capture and manage the values...... for capturing and managing client values within a lean framework. This paper describes the initial findings of a joint research project between academia and industry practitioners that seeks to develop the workshop method to create a state of the art approach in construction design management. This includes...... of the multiple stakeholders that constitutes the “client”. However, seeing client satisfaction as the end-goal of construction it is imperative to make client values explicit in the early project phase and make sure that these values are reflected in all subsequent phases of design and construction...

  19. Client Involvement in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Henriksen, Nina; Kjær, Lone


    , political and administrative frames that rule home- care practice. Client involvement is shown within four constructed analytical categories: ‘Structural conditions of providing and receiving home care’; ‘Client involvement inside the home: performing a professional task and living an everyday life......’; ‘Client involvement outside the home: liberal business and mutual goal setting’; and ‘Converting a home to a working place: refurnishing a life’. The meaning of involvement is depending on which position it is viewed from. On the basis of this analysis, we raise the question of the extent to which...

  20. Homebased rehabilitation: Physiotherapy student and client perspectives

    Directory of Open Access Journals (Sweden)

    Dianne Parris


    Full Text Available Background. Home-based rehabilitation (HBR in under-resourced areas in a primary healthcare (PHC context exposes students to the real-life situations of their clients. There is a scarcity of literature on student and client experiences of HBR in the physiotherapy context. Increased knowledge of HBR could result in an enhanced experience for both student and client. This study sought to discover the perceptions of final-year physiotherapy students and their clients relating to their experiences of HBR during a PHC placement in a resource-constrained setting. Objectives. To explore the experiences and perceptions of physiotherapy students and their clients regarding HBR as part of clinical training in resource-constrained settings. To discover the barriers to and facilitators of effective HBR. Methods. An exploratory case study was performed. A qualitative phenomenological research design in the interpretivist paradigm was used. Semistructured interviews were conducted with clients (n=7 living in an under-resourced setting, who had received HBR from physiotherapy students. Paired interviews were conducted with final-year physiotherapy students (n=6 after their HBR placement. Results. Clients appreciated the students’ services; however, data revealed communication barriers and unmet expectations. Students reported struggling to adapt to the context, resulting in interventions not being sufficiently client-centred. They voiced a need for language competency and earlier exposure to such contexts. Conclusion. Exposure to real-life situations in under-resourced settings in HBR provides valuable situated and authentic learning opportunities for physiotherapy students. The experience can be useful in preparing graduates to address the needs of the populations they serve during community service.

  1. Coordination of services for dual diagnosis clients in the interface between specialist and community care

    Directory of Open Access Journals (Sweden)

    Bjørkquist C


    Full Text Available Catharina Bjørkquist, Gunnar Vold Hansen Faculty of Health and Welfare, Østfold University College, Halden, Norway Purpose: The aim of this article is to study the coordination of comprehensive services for clients with concurrent substance abuse and mental health disorders (dual diagnosis, which is a very complex client group. In order to achieve comprehensive care and treatment, the service providers need to cooperate and coordinate, but the questions here, are how this is done and how appropriate the coordination is. Data and methods: Data were collected from group interviews during a 1-day workshop with clients, relatives, and employees from the various services involved. Results: Information exchange between the services was generally in writing. Coordination between substance abuse and mental health services was experienced as fragmented. ­Employees had an unclear perception of the work and expertise of the other service providers involved. There were examples of disparity between the services a municipality could offer and client needs. A coordinator, if available, was emphasized by both clients and service providers as serving an important function in coordination and relationship building. Conclusion: Predominantly written communication and unclear division of responsibilities and duties resulted in employees creating stereotypes of each other, both within specialist health services and between specialist and municipal health services. A coordinator was able to coordinate various inputs, often through informal contact, with a view to establishing appropriate services for individual clients. Coordination in interagency meeting points, such as “responsibility teams”, was the most successful solution, but this will involve a greater degree of networking than is common today. Keywords: addiction and mental health issues, collaboration, coordination, specialist health services, primary care

  2. Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment. (United States)

    Kaufman, Bridget P; Guttman-Yassky, Emma; Alexis, Andrew F


    Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects diverse ethnic groups with varying prevalence. Despite a predominance of studies in individuals of European ancestry, AD has been found to occur more frequently in Asian and Black individuals than Whites. Therefore, an understanding of the unique clinical features of AD in diverse ethnic groups, as well as the differences in genetic polymorphisms that influence susceptibility to AD and response to current therapies, is paramount for management of an increasingly diverse patient population. In this article, we review key nuances in the epidemiology, pathophysiology, clinical presentation and treatment of AD in non-White ethnic groups, which are largely underappreciated in the literature. We highlight the need for studies evaluating the tissue molecular and cellular phenotypes of AD in non-White patients, as well as greater inclusion of minority groups in clinical trials, to develop targeted treatments for a multi-ethnic population. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Factors limiting deceased organ donation: focus groups' perspective from culturally diverse community. (United States)

    Wong, L P


    In-depth understanding of cultural and religious factors limiting organ donation of three ethnic populations (Malay, Chinese, and Indian) in Southeast Asia is lacking. Identification of factors limiting organ donation among these three ethnic groups will provide insights into culturally appropriate strategies to promote acceptance of organ donation in a multiethnic Asian community. A total of 17 focus group discussions (105 participants) were conducted between September and December 2008. Participants were members of the general public aged 18 to 60 years, recruited through convenient sampling around the Klang Valley area of Malaysia. Although the majority had favorable attitudes toward deceased organ donation and transplantation, a diversity of myths and misinformation were unearthed from the discussions across the ethnic groups. These include perceived religious prohibition, cultural myths and misperceptions, fear of disfigurement, fear of surgery, distrust of the medical system, and family disapproval. Culture and religious beliefs played important prohibitive roles among those opposed to organ donations. There were distinctive ethnic differences in cultural and religious concerns regarding organ donation. Less-educated and rural groups appeared to have more misconceptions than the well-educated and the urban groups. Our findings may assist organ donation and transplantation organizations to reach diverse sociodemographic and ethnic communities with culture-specific information about organ donation. The involvement of community and religious leaders is critical in organ donation requests.

  4. Does taxonomic diversity in indicator groups influence their effectiveness in identifying priority areas for species conservation?

    DEFF Research Database (Denmark)

    Bladt, Jesper Stentoft; Larsen, Frank Wugt; Rahbek, Carsten


    The identification of priority areas for biodiversity conservation is a cornerstone of systematic conservation planning. However, biodiversity, or even the distribution of all species, cannot be directly quantified, due to the inherent complexity of natural systems. Species indicator groups may...... serve as important tools for the identification of priority areas for conservation. Yet, it is unclear which factors make certain indicator groups perform better than others. In this study, using data on the Danish distribution of 847 species of plants, vertebrates and insects, we assessed whether...... the taxonomic diversity in species indicator groups influence their effectiveness in the identification of priority areas for species conservation. We tested whether indicator groups comprising a higher taxonomic diversity (i.e. indicator groups consisting of species from many different taxonomic groups...

  5. 32 CFR 776.28 - Conflict of interest: Former client. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Conflict of interest: Former client. 776.28... ADVOCATE GENERAL Rules of Professional Conduct § 776.28 Conflict of interest: Former client. (a) Conflict of interest: Former client. A covered attorney who has represented a client in a matter shall not...

  6. Plant diversity surpasses plant functional groups and plant productivity as driver of soil biota in the long term.

    Directory of Open Access Journals (Sweden)

    Nico Eisenhauer


    Full Text Available One of the most significant consequences of contemporary global change is the rapid decline of biodiversity in many ecosystems. Knowledge of the consequences of biodiversity loss in terrestrial ecosystems is largely restricted to single ecosystem functions. Impacts of key plant functional groups on soil biota are considered to be more important than those of plant diversity; however, current knowledge mainly relies on short-term experiments.We studied changes in the impacts of plant diversity and presence of key functional groups on soil biota by investigating the performance of soil microorganisms and soil fauna two, four and six years after the establishment of model grasslands. The results indicate that temporal changes of plant community effects depend on the trophic affiliation of soil animals: plant diversity effects on decomposers only occurred after six years, changed little in herbivores, but occurred in predators after two years. The results suggest that plant diversity, in terms of species and functional group richness, is the most important plant community property affecting soil biota, exceeding the relevance of plant above- and belowground productivity and the presence of key plant functional groups, i.e. grasses and legumes, with the relevance of the latter decreasing in time.Plant diversity effects on biota are not only due to the presence of key plant functional groups or plant productivity highlighting the importance of diverse and high-quality plant derived resources, and supporting the validity of the singular hypothesis for soil biota. Our results demonstrate that in the long term plant diversity essentially drives the performance of soil biota questioning the paradigm that belowground communities are not affected by plant diversity and reinforcing the importance of biodiversity for ecosystem functioning.

  7. Involvement of the Client in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Kjær, Lone; Præstegaard, Jeanette

    Background: Through the last 35 years, ‘client involvement’ has been a mantra within health policies, education curriculums and health care institutions, yet very little is known about how ‘client involvement’ is practiced in the meetings with clients and health professionals. Aim: To analyse...

  8. Ethnic Diversity, Inter-group Attitudes and Countervailing Pathways of Positive and Negative Inter-group Contact: An Analysis Across Workplaces and Neighbourhoods. (United States)

    Laurence, James; Schmid, Katharina; Hewstone, Miles


    This study advances the current literature investigating the relationship between contextual out-group exposure, inter-group attitudes and the role of inter-group contact. Firstly, it introduces the concept of contact-valence into this relationship; that is, whether contact is experienced positively or negatively. Secondly, it presents a comparative analysis of how processes of out-group exposure and frequency of (valenced) contact affect prejudice across both neighbourhoods and workplaces. Applying path analysis modelling to a nationally-representative sample of white British individuals in England, we demonstrate, across both contexts, that increasing out-group exposure is associated with higher rates of both positively- and negatively-valenced contact. This results in exposure exhibiting both positive and negative indirect associations with prejudice via more frequent inter-group mixing. These countervailing contact-pathways help explain how out-group exposure is associated with inter-group attitudes. In neighbourhoods, increasing numbers of individuals experiencing positive-contact suppress an otherwise negative effect of neighbourhood diversity (driven partly by increasing numbers of individuals reporting negative contact). Across workplaces the effect differs such that increasing numbers of individuals experiencing negative-contact suppress an otherwise positive effect of workplace diversity (driven largely by increasing numbers of individuals experiencing positive contact).

  9. Acceptance and commitment therapy and family psycho education for clients with schizophrenia. (United States)

    Ema Komala, Encik Putri; Anna Keliat, Budi; Yulia Wardani, Ice


    This study aims to determine the effectiveness of combining acceptance and commitment therapy with family psycho education on increased insight, diminished symptoms, and the client's improved ability to control violent behavior. The design of this study was a quasi-experimental pretest-posttest utilizing intervention and control groups. The intervention group consisted of 33 people, and the control group was composed of 33 people. Data was collected before and after respondents received both acceptance and commitment therapy and family psycho education. The study showed that patient insight improved significantly, the signs and symptoms of violent behavior decreased, and the client's ability to control such behavior improved with a p value psycho education. In the control group, patient insight did not improved significantly, showing a p value > 0.05. Therefore, our study recommends that acceptance and commitment therapy and family psycho education should be given to patients with schizophrenia to improve insight into their disease, decrease signs and symptoms of violent behavior and improve their ability to control violent behavior. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  10. On Being "Attractive" With Resistant Clients. (United States)

    Miller, Mark J.; Wells, Don


    Calls client resistance a frequent occurrence within the helping profession. Defines client resistance, provides a brief review of related literature, and offers counselor attractiveness as one way of addressing the issue. Identifies attractive counselor behaviors and attitudes and presents case study illustrating specific attractive counselor…

  11. 37 CFR 10.84 - Representing a client zealously. (United States)


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client... Office Code of Professional Responsibility § 10.84 Representing a client zealously. (a) A practitioner shall not intentionally: (1) Fail to seek the lawful objectives of a client through reasonably available...

  12. A theory led narrative review of one-to-one health interventions: the influence of attachment style and client-provider relationship on client adherence. (United States)

    Nanjappa, S; Chambers, S; Marcenes, W; Richards, D; Freeman, R


    A theory-led narrative approach was used to unpack the complexities of the factors that enable successful client adherence following one-to-one health interventions. Understanding this could prepare the provider to anticipate different adherence behaviours by clients, allowing them to tailor their interventions to increase the likelihood of adherence. The review was done in two stages. A theoretical formulation was proposed to explore factors which influence the effectiveness of one-to-one interventions to result in client adherence. The second stage tested this theory using a narrative synthesis approach. Eleven studies across the health care arena were included in the synthesis and explored the interplay between client attachment style, client-provider interaction and client adherence with health interventions. It emerged that adherence results substantially because of the relationship that the client has with the provider, which is amplified or diminished by the client's own attachment style. This occurs because the client's attachment style shapes how they perceive and behave in relationships with the health-care providers, who become the 'secure base' from which the client accepts, assimilates and adheres with the recommended health intervention. The pathway from one-to-one interventions to adherence is explained using moderated mediation and mediated moderation models. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email:

  13. Are we bridging the gap? A review of cultural diversity within stoma care. (United States)

    Cooper-Gamson, Louise


    The aim of this article is to highlight the aspects of how religion, ethnic grouping, age, gender, and learning disabilities affect how stoma care is approached and supported. It will try to highlight the positive and negative approaches documented so far and how this has affected the quality of stoma care given. By following guidelines set out by the Nursing and Midwifery Council (NMC) (2015) and the Association of Stoma Care Nurses (ASCN) (2015) the aim of the article will be to expand cultural awareness in stoma care nursing. By learning about the multifaceted aspects of culture as it applies to stoma care and then being able to apply that knowledge, usefully and skilfully, expands the SCN's ability to provide services for any cultural diverse client group.

  14. Clients' knowledge, perception and satisfaction with quality of ...

    African Journals Online (AJOL)

    Clients' knowledge, perception and satisfaction with quality of maternal health care services at the primary health care level in Nnewi, Nigeria. ... Furthermore cost, local language used, staff attitude and interaction with clients was acceptable and may be the reason for high level of satisfaction reported. Key words: Clients' ...

  15. Key Mechanisms for Employee-Driven Innovation in Governmental Client Organisations

    DEFF Research Database (Denmark)

    Sørensen, Henrik; Faber, Lene; Wandahl, Søren


    the mechanisms of organisational trust, innovation safety, organisational practices, cultural settings and the recognition and rewards structure to motivate employees. The decision-making procedures should be transparent especially to the idea-owner and the employees involved, and the implementation and putting......In order to ensure that knowledge and ideas are transformed into innovative contributions, a systematic approach is important. The aim of this research was to identify the specific mechanisms that are key to implementing an innovation process model when conducting Employee-driven Innovation...... in a governmental client organisation. The methodological approach was an exploratory case study of a governmental client organisation within the Danish construction industry. The units of analysis were groups of employees and managers within the case organisation. The primary mechanisms identified were...

  16. A "client perspective" helps improve services. (United States)


    Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.

  17. Deciding about Design Quality : Value judgements and decision making in the selection of architects by public clients under European tendering regulations

    NARCIS (Netherlands)

    Volker, L.


    In the past few years the image of tender procedures in which Dutch public clients selected an architect has been dominated by distressing newspaper headlines. Architects fear that the current tender culture will harm the quality of our built environment due to a potential lack of diversity,

  18. Client/server approach to image capturing (United States)

    Tuijn, Chris; Stokes, Earle


    The diversity of the digital image capturing devices on the market today is quite astonishing and ranges from low-cost CCD scanners to digital cameras (for both action and stand-still scenes), mid-end CCD scanners for desktop publishing and pre- press applications and high-end CCD flatbed scanners and drum- scanners with photo multiplier technology. Each device and market segment has its own specific needs which explains the diversity of the associated scanner applications. What all those applications have in common is the need to communicate with a particular device to import the digital images; after the import, additional image processing might be needed as well as color management operations. Although the specific requirements for all of these applications might differ considerably, a number of image capturing and color management facilities as well as other services are needed which can be shared. In this paper, we propose a client/server architecture for scanning and image editing applications which can be used as a common component for all these applications. One of the principal components of the scan server is the input capturing module. The specification of the input jobs is based on a generic input device model. Through this model we make abstraction of the specific scanner parameters and define the scan job definitions by a number of absolute parameters. As a result, scan job definitions will be less dependent on a particular scanner and have a more universal meaning. In this context, we also elaborate on the interaction of the generic parameters and the color characterization (i.e., the ICC profile). Other topics that are covered are the scheduling and parallel processing capabilities of the server, the image processing facilities, the interaction with the ICC engine, the communication facilities (both in-memory and over the network) and the different client architectures (stand-alone applications, TWAIN servers, plug-ins, OLE or Apple-event driven

  19. 31 CFR 8.34 - Knowledge of client's omission. (United States)


    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Knowledge of client's omission. 8.34... client's omission. Each attorney, certified public accountant, or enrolled practitioner who knows that a client has not complied with applicable law, or has made an error in or omission from any document...

  20. Successful Vocational Rehabilitation of Clients with Retinitis Pigmentosa. (United States)

    Taheri-Araghi, M.; Hendren, G.


    Statistical analysis of 10 personal (client) variables and four program variables related to 76 people who became blind from retinitis pigmentosa revealed that 6 variables predicted clients' rehabilitation outcomes: age, gender, race, work status, amount of case-service money spent on the client's behalf, and number of changes in career objectives…

  1. Social Justice at the Microlevel: Working with Clients' Prejudices (United States)

    MacLeod, Bailey P.


    Social justice is considered the 5th force in counseling and has largely been aimed toward advocating for oppressed individuals and groups by creating change in the societal structures that maintain oppression. However, there is a lack of information for counselors who work with clients who oppress others. This article addresses assessment,…

  2. Mutual powerlessness in client participation practices in mental health care (United States)

    Broer, Tineke; Nieboer, Anna P.; Bal, Roland


    Abstract Background  Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation process. Many articles have concluded that client participation is limited; professionals often still control the participation process and outcomes. Objective  The objective of this study is to gain insight into (i) the practice of client participation within a quality improvement collaborative in mental health care and (ii) the consequences of a Foucauldian conceptualization of power in analysing practices of client participation. Design  We used an ethnographic design consisting of observations of national events and improvement team meetings and interviews with the collaborative’s team members and programme managers. Results  Contrary to many studies on client participation, we found both clients and service providers frequently felt powerless in its practice. Professionals and clients alike struggled with the contributions clients could make to the improvement processes and what functions they should fulfil. Moreover, professionals did not want to exert power upon clients, but ironically just for that reason sometimes struggled with shaping practices of client participation. This mutual powerlessness (partly) disappeared when clients helped to determine and execute specific improvement actions instead of participating in improvement teams. Conclusion  Recognizing that power is inescapable might allow for a more substantive discussion concerning the consequences that power arrangements produce, rather than looking at who is exerting how much power. PMID:22390793

  3. Feline immunodeficiency virus testing in stray, feral, and client-owned cats of Ottawa


    Little, Susan E.


    Feline immunodeficiency virus (FIV) seroprevalence is evaluated in 3 groups of cats. Seventy-four unowned urban strays were tested, as well as 20 cats from a small feral cat colony, and 152 client-owned cats. Of the 246 cats tested, 161 (65%) were male and 85 (35%) were female. Seroprevalence for FIV was 23% in the urban strays, 5% in the feral cat colony, and 5.9% in the client-owned cats. Ten cats (4%) were also positive for Feline leukemia virus (FeLV) antigen, including 2 cats coinfected ...

  4. Asymmetry of Responsiveness in Client-Centered Therapy (United States)

    Shapiro, David A.


    Each utterance of a psychotherapy session conducted by Carl Rogers was transcribed on a separate card. Fifteen undergraduate subjects reconstituted client-therapist sequences more accurately than therapist-client sequences. (Author)

  5. Experimental Blind Quantum Computing for a Classical Client (United States)

    Huang, He-Liang; Zhao, Qi; Ma, Xiongfeng; Liu, Chang; Su, Zu-En; Wang, Xi-Lin; Li, Li; Liu, Nai-Le; Sanders, Barry C.; Lu, Chao-Yang; Pan, Jian-Wei


    To date, blind quantum computing demonstrations require clients to have weak quantum devices. Here we implement a proof-of-principle experiment for completely classical clients. Via classically interacting with two quantum servers that share entanglement, the client accomplishes the task of having the number 15 factorized by servers who are denied information about the computation itself. This concealment is accompanied by a verification protocol that tests servers' honesty and correctness. Our demonstration shows the feasibility of completely classical clients and thus is a key milestone towards secure cloud quantum computing.

  6. Experimental Blind Quantum Computing for a Classical Client. (United States)

    Huang, He-Liang; Zhao, Qi; Ma, Xiongfeng; Liu, Chang; Su, Zu-En; Wang, Xi-Lin; Li, Li; Liu, Nai-Le; Sanders, Barry C; Lu, Chao-Yang; Pan, Jian-Wei


    To date, blind quantum computing demonstrations require clients to have weak quantum devices. Here we implement a proof-of-principle experiment for completely classical clients. Via classically interacting with two quantum servers that share entanglement, the client accomplishes the task of having the number 15 factorized by servers who are denied information about the computation itself. This concealment is accompanied by a verification protocol that tests servers' honesty and correctness. Our demonstration shows the feasibility of completely classical clients and thus is a key milestone towards secure cloud quantum computing.

  7. Status of Syndromic Management of Clients and their Partners at STI Clinic in a Suburban Area of Mumbai, India

    Directory of Open Access Journals (Sweden)

    Dilip Kadam


    Full Text Available Introduction: Sexually transmitted infections (STI are major public health problem of economically productive age group. Worldwide more cases of STI are seen among reproductive age group i.e., 15 to 49 years. World Health Organization estimates 340 million curable STIs each year. In India, 6% to 15% population is infected with one or more STIs. Hence, present study was conducted at STI clinic in suburban area. The objectives were to assess the socio-demographic factors, syndromes suffered and factors influencing treatment outcome among clients attending STI OPD. Methodology: 274 clients participated in the longitudinal study over a period of 6 months. Results: 232 female clients (84.7% proved female preponderance at STI clinic. Around 194 cases (70.8% belonged to the age group 25 to 44 years which is economically productive age group. Married females (92.24% and unmarried males (59.5% presented with STI syndromes. Among males, urethral discharge (66.67% and among females, vaginal discharge (82.76% were the predominating symptoms. The clients studied up to 10th standard, constituted 48.54% of the study sample. 53.28% of the clients belonged to upper lower socio-economic status. About 211 (90.9% women were housewives. About 31 (73.8% males were semi-skilled and skilled laborers. Conclusion: This study highlighted the vulnerability of females to STIs. The reproductive and economically productive age group forms major part of the affected population. The gap between the knowledge and application of correct and consistent use of condom needs to be reduced. Special emphasis on partner notification and their management will have an impact on prevention of STIs.

  8. 37 CFR 10.78 - Limiting liability to client. (United States)


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Limiting liability to client... Office Code of Professional Responsibility § 10.78 Limiting liability to client. A practitioner shall not attempt to exonerate himself or herself from, or limit his or her liability to, a client for his or her...

  9. Who cares for involuntary clients? (United States)

    Soliman, Soheil; Pollack, Harold A; Alexander, Jeffrey A


    The objectives of this study were to compare characteristics of outpatient substance abuse treatment (OSAT) units that serve high proportions of involuntary clients (ICs) with those that serve a low percentage of such clients. The authors analyze unit-level 1995-2005 data from the National Drug Abuse Treatment System Survey (NDATSS). Approximately 1/6 of OSAT units draw the dominant majority of their clients from involuntary referrals. OSAT units that treat a high proportion of ICs are less likely to be accredited by professional organizations, have fewer treatment staff with advanced degrees, and have shorter average treatment duration than do OSAT units that serve few ICs. OSAT units that serve ICs are more likely to offer legal and domestic violence services but are less likely to offer mental health services or aftercare. OSAT units that serve ICs are less likely to be hospital-affiliated than are other units. Clients at such facilities are more likely to be convicted of driving while intoxicated (DWI), are younger, are less likely to have received prior treatment, are more likely to remain abstinent after treatment, but are more likely to be remanded back to courts. The authors conclude that ICs are an important market niche in OSAT care. DWI is by far the most common offense reported in units that specialize in ICs. Aside from legal and domestic violence services, units with a high proportion of ICs appear to offer somewhat less intensive and professionalized services than do other facilities; however, clients at these units are more likely to be abstinent at the end of treatment and but more likely to be remanded back to the courts.

  10. Diversity and evolution of Lactobacillus casei group isolated from fermented dairy products in Tibet. (United States)

    Feng, Jing; Jiang, Yujun; Li, Mingyu; Zhao, Siyu; Zhang, Yanming; Li, Xuesong; Wang, Hui; Lin, Guangen; Wang, Hao; Li, Tiejing; Man, Chaoxin


    Bacteria in Lactobacillus casei group, including Lactobacillus casei (L. casei), Lactobacillus paracasei (L. paracasei), and Lactobacillus rhamnosus (L. rhamnosus) are important lactic acid bacteria in the production of fermented dairy products and are faced with the controversial nomenclatural status due to their close phylogenetic similarity. To probe the evolution and phylogeny of L. casei group, 100 isolates of lactic acid bacteria originated from naturally fermented dairy products in Tibet of China were subjected to multilocus sequence typing (MLST). The MLST scheme, based on analysis of the housekeeping genes fusA, ileS, lepA, leuS, pyrG, recA and recG, revealed that all the isolates belonged to a group containing the L. paracasei reference strains and were clearly different from the strains of L. casei and L. rhamnosus. Although nucleotide diversity (π) was low for the seven genes (ranging from 0.00341 for fusA to 0.01307 for recG), high genetic diversity represented by 83 sequence types (STs) with a discriminatory index of 0.98 was detected. A network-like structure based on split decomposition analysis, and the high values of the relative effect of recombination and mutation in the diversification of the lineages (r/m = 4.76) and the relative frequency of occurrence of recombination and mutation (ρ/θ = 2.62) indicated that intra-species recombination occurred frequently and homologous recombination played a key role in generating genotypic diversity amongst L. paracasei strains in Tibet. The discovery of 51 new STs and the results of STRUCTURE analysis suggested that the L. casei group in Tibet had an individual and particular population structure in comparison to European isolates. Overall, this research might be the first report about genetic diversity and population structure of Lactobacillus populations isolated from naturally fermented dairy products in Tibet based on MLST scheme.

  11. Client capital as a source of enterprise cost

    Directory of Open Access Journals (Sweden)

    Verba Veronika A.


    Full Text Available The article presents the authors’ vision of the essence of the client capital and its influence upon the enterprise cost. The goal of the article is explanation of the role of the client capital in the process of enterprise capitalisation with the help of the business cost capitalisation model: investments into assets – cash flow generation – enterprise capitalisation. The result of the study is the authors’ position regarding the essence and structuring the client capital, which gives a possibility to detect financial and managerial instruments of capitalisation of the client capital. The conducted analysis of dynamics of financial parameters of the world leaders of IT industry, car building, clothes manufacture and beverages production allows detection of interconnection of the enterprise cost with the volume of assets and profit and identification of influence of the client capital upon capitalisation of enterprises of various spheres of activity. The article develops a model of capitalisation of the client capital on the basis of detection of cash flows, caused by formation of enterprises of B2C and B2B types.

  12. Client Motivation for Therapy Scale Adaptation to Turkish: Reliability and Validity Study

    Directory of Open Access Journals (Sweden)

    Omer Ozer


    Full Text Available The purpose of this study is to adapt Client Motivation for Therapy Scale to the Turkish. Study group of the research consisted of 109 undergraduate students studying in Anadolu and Gaziosmanpasa Universities, in academic year 2014-2015. After establishing language, the validity and reliability of the scale of analysis was examined. Item-factor structure has been tested for compliance with a model by confirmatory factor analysis (CFA. Based on this, five-factor structure of Motivation for Counseling/Therapy Scale has been validated. The coefficient of the total internal consistency is found .79. As a result of the analysis for adaptation of Client Motivation for Therapy Scale to Turkish, it can be said that the scale is a reliable and valid measurement tool. It is suggested that studies on reliability and validity of Client Motivation for Therapy Scale on other samples can be made in future researches. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(1.000: 13-30

  13. Gas and electricity markets have been open to all professional clients since July 1, 2004? how is it working

    International Nuclear Information System (INIS)

    Carbonnier, R.


    The gas and electricity markets have been open to competition for all professional clients since July 1, 2004. In order to achieve proper market operation, measures have been developed by players in the gas and electricity sectors (network managers, suppliers, authorities and clients) within working groups, GTGs and GTEs 2004, under the aegis of the Commission de Regulation de l'Energie (CRE); the measures prepared by those working groups aim at ensuring the simplicity of contractual relationships between users, suppliers and network managers, to implement high performance management tools and to inform market players. Now, the feedback from those measures helps initiate the preparation of the next step, i.e. the opening of energy markets to competition for all clients, including households, on July 1, 2007. On players' request, the CRE is preparing this new term through other working groups, the 2007 Gas Working Group and the 2007 Electricity Working Group, enlarged to user association representatives. The first results are expected in early 2006, for the most structuring aspects, in order to enable players to initiate organisation changes in due time. (author)

  14. Mutual construction and reconstruction in client-consultant interaction

    DEFF Research Database (Denmark)

    Smith, Irene Skovgaard

    Based on preliminary interviews with client representatives and a pilot case study, the pa-per explores collaboration and mutual construction in client-consultant relationships. Both consultants and client actors take part in an active construction and reconstruction of knowledge that involve...... struggles over position, power and control. In the context of client-consultant interaction, it is thus not only ideas and solutions that are contested but also the power to define. Attention is paid to how ideas are brought into play and negotiated in the interaction between actors. The empirical material...... presented in the paper illustrates how consultancy projects evolve through processes of negotiation over whose interpretation should count and who should be in control. In the process, client actors with different posi-tions and interests play an active role in creating what become valid and what ideas...

  15. Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships. (United States)

    MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve


    Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

  16. Prenatal screening for congenital anomalies: exploring midwives' perceptions of counseling clients with religious backgrounds. (United States)

    Gitsels-van der Wal, Janneke T; Manniën, Judith; Gitsels, Lisanne A; Reinders, Hans S; Verhoeven, Pieternel S; Ghaly, Mohammed M; Klomp, Trudy; Hutton, Eileen K


    In the Netherlands, prenatal screening follows an opting in system and comprises two non-invasive tests: the combined test to screen for trisomy 21 at 12 weeks of gestation and the fetal anomaly scan to detect structural anomalies at 20 weeks. Midwives counsel about prenatal screening tests for congenital anomalies and they are increasingly having to counsel women from religious backgrounds beyond their experience. This study assessed midwives' perceptions and practices regarding taking client's religious backgrounds into account during counseling. As Islam is the commonest non-western religion, we were particularly interested in midwives' knowledge of whether pregnancy termination is allowed in Islam. This exploratory study is part of the DELIVER study, which evaluated primary care midwifery in The Netherlands between September 2009 and January 2011. A questionnaire was sent to all 108 midwives of the twenty practices participating in the study. Of 98 respondents (response rate 92%), 68 (69%) said they took account of the client's religion. The two main reasons for not doing so were that religion was considered irrelevant in the decision-making process and that it should be up to clients to initiate such discussions. Midwives' own religious backgrounds were independent of whether they paid attention to the clients' religious backgrounds. Eighty midwives (82%) said they did not counsel Muslim women differently from other women. Although midwives with relatively many Muslim clients had more knowledge of Islamic attitudes to terminating pregnancy in general than midwives with relatively fewer Muslim clients, the specific knowledge of termination regarding trisomy 21 and other congenital anomalies was limited in both groups. While many midwives took client's religion into account, few knew much about Islamic beliefs on prenatal screening for congenital anomalies. Midwives identified a need for additional education. To meet the needs of the changing client population

  17. Impact of Psychoeducation on Knowledge of and Attitude Toward Medications in Clients With Schizophrenia and Schizoaffective Disorders. (United States)

    Choe, Kwisoon; Sung, Byung-Ju; Kang, Youngmi; Yoo, So Yeon


    To examine a psychoeducational intervention's effects on knowledge and attitudes toward antipsychotic medication in clients with schizophrenia and schizoaffective disorders. A one-group pretest-posttest design was employed. A convenience sample (61 psychiatric clients aged 20 or above) was recruited from a Korean mental health center. At baseline, participants had limited knowledge (M = 50.89, range: 27-77, SD = 12.05) of and negative feelings toward antipsychotic medications (M = -.89, range: -8 to 8, SD = 4.27). Both measures significantly improved post-intervention. A psychoeducational intervention improved clients' knowledge of and attitudes toward antipsychotic medications. © 2015 Wiley Periodicals, Inc.

  18. Multi-client quantum key distribution using wavelength division multiplexing

    International Nuclear Information System (INIS)

    Grice, Warren P.; Bennink, Ryan S.; Earl, Dennis Duncan; Evans, Philip G.; Humble, Travis S.; Pooser, Raphael C.; Schaake, Jason; Williams, Brian P.


    Quantum Key Distribution (QKD) exploits the rules of quantum mechanics to generate and securely distribute a random sequence of bits to two spatially separated clients. Typically a QKD system can support only a single pair of clients at a time, and so a separate quantum link is required for every pair of users. We overcome this limitation with the design and characterization of a multi-client entangled-photon QKD system with the capacity for up to 100 clients simultaneously. The time-bin entangled QKD system includes a broadband down-conversion source with two unique features that enable the multi-user capability. First, the photons are emitted across a very large portion of the telecom spectrum. Second, and more importantly, the photons are strongly correlated in their energy degree of freedom. Using standard wavelength division multiplexing (WDM) hardware, the photons can be routed to different parties on a quantum communication network, while the strong spectral correlations ensure that each client is linked only to the client receiving the conjugate wavelength. In this way, a single down-conversion source can support dozens of channels simultaneously--and to the extent that the WDM hardware can send different spectral channels to different clients, the system can support multiple client pairings. We will describe the design and characterization of the down-conversion source, as well as the client stations, which must be tunable across the emission spectrum.

  19. 37 CFR 10.65 - Limiting business relations with a client. (United States)


    ... with a client. 10.65 Section 10.65 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... a client. A practitioner shall not enter into a business transaction with a client if they have differing interests therein and if the client expects the practitioner to exercise professional judgment...

  20. Empathy from the client's perspective: A grounded theory analysis. (United States)

    MacFarlane, Peter; Anderson, Timothy; McClintock, Andrew S


    Although empathy is one of most robust predictors of client outcome, there is little consensus about how best to conceptualize this construct. The aim of the present research was to investigate clients' perceptions and in-session experiences of empathy. Semi-structured, video-assisted interpersonal process recall interviews were used to collect data from nine clients receiving individual psychotherapy at a university psychology clinic. Grounded theory analysis yielded a model consisting of three clusters: (1) relational context of empathy (i.e., personal relationship and professional relationship), (2) types of empathy (i.e., psychotherapists' cognitive empathy, psychotherapists' emotional empathy, and client attunement to psychotherapist), and (3) utility of empathy (i.e., process-related benefits and client-related benefits). These results suggest that empathy is a multi-dimensional, interactional process that affects-and is affected by-the broader relationship between client and psychotherapist.

  1. Evaluating healing for cancer in a community setting from the perspective of clients and healers: a pilot study. (United States)

    Vaghela, C; Robinson, N; Gore, J; Peace, B; Lorenc, A


    The real-life practice of 'healing' for cancer in the community as perceived by clients and healers was investigated in a multi-method pilot study. Fifteen clients received six weekly healing sessions. Pre- and post-changes in perception towards well-being and client experience were assessed by EuroQol (EQ-5D), measure yourself concerns and well-being (MYCaW) and a client satisfaction tool. Qualitative methods, including focus groups, explored the perceived effects of healing in more depth and the participants' experience of taking part in research. The study was not designed to test the effect of healing on disease. Quantitative data showed perceived significant improvements in 'concerns/problems' for which clients wanted help (pquantitative improvements to healing itself. Despite some concerns, healers and clients engaged fully with the research process, and were enthusiastic about the importance of research into healing. Our study suggests that, while there are some confounding issues and study limitations to address, clients and healers perceive healing to have a range of benefits, particularly in terms of coping with cancer, and regard it as a useful approach that can be applied in a community setting alongside conventional medicine.

  2. Social work - client relationship practice: exploring social worker perspectives




    This thesis explores, using qualitative methodology, the significance of social worker – client relationships for achieving client outcomes in the field of child and family welfare. The study found that social worker – client relationships are critical for achieving outcomes. It is a distinct practice method, informed by relational views about ‘the self’, human development and healing. The social worker, as Relationship Building Agent, is heavily focused on client engagement and building t...

  3. Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers. (United States)

    Suryawanshi, Dipak; Bhatnagar, Tarun; Deshpande, Sucheta; Zhou, Weiwei; Singh, Pankaj; Collumbien, Martine


    It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients' consistent condom use with FSW. Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks.

  4. Theoretical Explanations of Environmental Motivations and Expectations of Clients on Green Building Demand and Investment

    International Nuclear Information System (INIS)

    Joachim, Onuoha Iheanyichukwu; Kamarudin, Norhaya; Aliagha, Godwin Uche; Ufere, Kalu Joseph


    In building industry, green demand and investment creates a positive footprint on the environment. However, these environmental opportunities have not been adequately harnessed and explored by Clients of green building apparently because of poor understanding of the motivating drivers and benefits accruing from green building demand and investment. The decision to demand for or invest in green building is influenced by certain environmental motivating drivers and expectations which have not been fully examined by researchers and not well understood by stakeholders. Based on the Theory of Planned Behaviour (TPB) and Theory of Value Belief Norm (VBN) explanations, this study focused on the Clients, purchasers and users' motivations and intentions to go for green building. Based on the reviewed theories, we hypothesized that environmental motivations and expectations for green building demand and investment are embedded in the environmental quest for protection of eco-system and bio-diversity, improvement of water and air quality, reduction of solid waste, conservation of natural resources, reduction of societal costs of landfill creation and maintenance, minimization of site impact and reduction emission to air and enhanced energy efficiency. However, the predictive validity of these propositions depends on the client's beliefs, values, social pressure, and perceived behavioural control

  5. 49 CFR 1103.15 - The practitioner's duty to clients, generally. (United States)


    ... 49 Transportation 8 2010-10-01 2010-10-01 false The practitioner's duty to clients, generally... Practitioner's Duties and Responsibilities Toward A Client § 1103.15 The practitioner's duty to clients... all clients to observe the statutory law to the best of his knowledge or as interpreted by competent...

  6. Assessment of ART centres in India: client perspectives. (United States)

    Sogarwal, Ruchi; Bachani, Damodar


    Drug adherence and quality of antiretroviral therapy (ART) services are the keys for the successful ART programme. Hence, an attempt has been made to assess ART centres in India from client perspectives that are receiving services from the centres. Data were gathered through exit interviews with 1366 clients from 27 ART centres that were selected on the basis of drug adherence and client load. Analyses revealed that more than 80 per cent of the clients reported overall satisfaction with the services availed from the centre and 60 per cent reported that the quality of life has improved to a great extent after getting ART. Most of the clients strongly demanded to open ART centre in each district for better access as that will increase drug adherence and eventually control the HIV progression. It has been found that as many as 14% of respondents, ever been on ART, reported non-adherence and 70% of them cited distance and economic factors as the reasons for non-adherence. Study concludes that while majority of the clients were satisfied with ART services, shortage of staff, high level of non-drug adherence, long distances and poor referring system are the weak areas requiring attention.

  7. An Action Learning Project on Diversity: Pitfalls and Possibilities. (United States)

    Hite, Linda M.


    In a college course on diversity in the workplace, students' experiences with conducting a cultural audit of the university as a workplace illustrate the dilemmas that can arise when students conduct action research in a real client system. Despite the inherent problems, the project resulted in significant student learning about the subject and…

  8. Automated Detection of Client-State Manipulation Vulnerabilities

    DEFF Research Database (Denmark)

    Møller, Anders; Schwarz, Mathias


    automated tools that can assist the programmers in the application development process by detecting weaknesses. Many vulnerabilities are related to web application code that stores references to application state in the generated HTML documents to work around the statelessness of the HTTP protocol....... In this paper, we show that such client-state manipulation vulnerabilities are amenable to tool supported detection. We present a static analysis for the widely used frameworks Java Servlets, JSP, and Struts. Given a web application archive as input, the analysis identifies occurrences of client state...... and infers the information flow between the client state and the shared application state on the server. This makes it possible to check how client-state manipulation performed by malicious users may affect the shared application state and cause leakage or modifications of sensitive information. The warnings...

  9. Servidor de claves públicas pgp, cliente administrador y cliente para ciframiento y desciframiento de correo electrónico


    Redrovan Castillo, Fabian; Ruiz Ampuero, Luis M.; Vaca Ruiz, Carmen K.; Yanez Godoy, Ricardo E.; Caicedo Rossi, Guido Alfredo


    Basándose en el paradigma Cliente-Servidor bajo la arquitectura TCP/IP, se implementaran tres aplicaciones. Cada aplicación tiene un nombre que refleja su propósito: el Cliente Administrador, el Cliente de Correo Electrónico y finalmente el servidor PGP. Este último ofrece varios servicios, sobresaliendo por su importancia, el proporcionar a quien lo necesite, la clave pública de encriptación PGP (Pretty Good Privacy) de una persona determinada. Para que esto sea posible, dicha persona deb...


    Directory of Open Access Journals (Sweden)

    Mohammad Hefni


    Full Text Available Abstrac This article traces patron-client relationship of Madurese both from socio-historical point of view and its contemporary progress. As an imbalance social-exchange relationship, in terms of patron-client relationship, second side (client much highly depends upon the first side (patron. This had been experienced in Madurese social history during the native governmental period of time. The government was classified into two major classes; ruler class (patron and farmer class (client. The former is fully in authority to take control either economic or politic potencies, however, the later transacts labors to the first side. Both side is connected by a bribe (upeti systems—percaton, apanage and daleman. In current progress this relationship becomes more acquaintance, it covers economic and politic relationship. The success of Trunojoyo, the king of Sumenep's inherit, against the Mataram domination had been supported by Madurese people that had previously tightened to the system. Today,  patron-client relationship in Madura is reflected in the relationship between the head of village, as the owner of percaton,  and the staff as well as people, as the percaton manager. The other is well-described in the relationship of ship owner and pandega (fisher in fishing. Once the relationship is set up, it directs to diadik relation, a two in one relation which is more personal and long lasting one. Kata-kata kunci Patron-klien, percaton, apanage, panembahan, rakyat, daleman, kepala desa, juragan, pandega, dan diadik.

  11. Laser Surgeon, Client Education, and Satisfaction with Tattoo Removal

    DEFF Research Database (Denmark)

    Hutton Carlsen, Katrina; Esmann, Jørgen; Serup, Jørgen


    Studies of satisfaction with tattoo removal outcomes by laser, rated by clients themselves, including qualitative aspects, are sparse. We studied long-term results and client satisfaction with tattoo removal by Q-switched YAG laser. Client satisfaction is influenced by numerous factors: pretreatm...

  12. ["... so that Theo knows what he should do better". Client orientation in social-therapeutic child group work--an experiential report of quality management at a child guidance clinic]. (United States)

    Bobzien, Monika; Hausmann, Verena; Kornder, Theo; Manz-Gill, Brigitte


    Within the framework of internal evaluation and self-evaluation activities in a child guidance clinic, measures of success have to date been based primarily on the degree to which the delegating organisations are satisfied with the results of the counselling. The orientation of the success of counselling towards the results stems from the fact that the process of helping is not generally manifest to parents, schools, and education staff. It takes place in the context of direct contact between therapists and children, the immediate addresses of help, and therefore often remains "hidden". Since the children's perspective--their impressions and appraisals--has often been neglected in past assessment methods, it hardly plays any role at all in the discussion of quality at counselling centres. This made it all the more stimulating for all those involved to initiate improvement measures within the framework of quality management on the basis of a client survey and in this way to launch a shared learning process as to how client orientation can flow directly into everyday practice. This is certainly the first attempt of its kind in the work of child guidance clinics to develop an understanding of client orientation in line with the expectations of parents and children and to link this to the quality development of the service. In the first part of this experiential report, the external process coach provides a brief summary of the assessment method employed in connection with the introduction of internal quality management at the counselling centre. This is followed by the centre's own description of the concrete performance of the client survey with children using the example of social-therapeutic child group work. The study concludes with a discussion of the benefit drawn from this process for the improvement of this pedagogical project.

  13. Using spiritually modified cognitive-behavioral therapy in substance dependence treatment: therapists' and clients' perceptions of the presumed benefits and limitations. (United States)

    Hodge, David R; Lietz, Cynthia A


    Cognitive-behavioral therapy (CBT) that has been modified to incorporate clients' spiritual beliefs and practices has been used to treat a variety of problems. This study examines the utility of this modality with the treatment of alcohol dependence and other forms of substance abuse. Toward this end, six focus groups (three therapist groups and three client groups) were conducted to identify the presumed benefits and limitations of using spiritually modified CBT in substance dependence treatment. In terms of benefits, spiritually modified CBT was perceived to enhance outcomes through operationalizing horizontal and vertical sources of social support, divine coping resources, and spiritual motivation. Potential challenges include the risk of therapists inadvertently imposing their own beliefs during the modification process and the possibility of offending clients when conflicts in belief systems emerge, particularly in group setting. The article concludes by providing suggestions for incorporating spiritually modified CBT into treatment and develops a number of illustrative examples of spiritually modified CBT self-statements.

  14. Prospective comparative effectiveness cohort study comparing two models of advance care planning provision for Australian community aged care clients. (United States)

    Detering, Karen Margaret; Carter, Rachel Zoe; Sellars, Marcus William; Lewis, Virginia; Sutton, Elizabeth Anne


    Conduct a prospective comparative effectiveness cohort study comparing two models of advance care planning (ACP) provision in community aged care: ACP conducted by the client's case manager (CM) ('Facilitator') and ACP conducted by an external ACP service ('Referral') over a 6-month period. This Australian study involved CMs and their clients. Eligible CM were English speaking, ≥18 years, had expected availability for the trial and worked ≥3 days per week. CMs were recruited via their organisations, sequentially allocated to a group and received education based on the group allocation. They were expected to initiate ACP with all clients and to facilitate ACP or refer for ACP. Outcomes were quantity of new ACP conversations and quantity and quality of new advance care directives (ACDs). 30 CMs (16 Facilitator, 14 Referral) completed the study; all 784 client's files (427 Facilitator, 357 Referral) were audited. ACP was initiated with 508 (65%) clients (293 Facilitator, 215 Referral; p<0.05); 89 (18%) of these (53 Facilitator, 36 Referral) and 41 (46%) (13 Facilitator, 28 Referral; p<0.005) completed ACDs. Most ACDs (71%) were of poor quality/not valid. A further 167 clients (facilitator 124; referral 43; p<0.005) reported ACP was in progress at study completion. While there were some differences, overall, models achieved similar outcomes. ACP was initiated with 65% of clients. However, fewer clients completed ACP, there was low numbers of ACDs and document quality was generally poor. The findings raise questions for future implementation and research into community ACP provision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Family Group Conferencing: A Theoretical Underpinning

    NARCIS (Netherlands)

    Metze, R.N.; Abma, T.A.; Kwekkeboom, R.H.


    In the last decade, Family Group Conferences (FGCs) have increasingly been used to help people and their networks deal with their problems. The FGC fits well with the call for equal rights and self-management coming from clients and client movements, as well as the economy-driven pressure towards

  16. 32 CFR 776.32 - Department of the Navy as client. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Department of the Navy as client. 776.32 Section... Rules of Professional Conduct § 776.32 Department of the Navy as client. (a) Department of Navy as client: (1) Except when representing an individual client pursuant to paragraph (a)(6) of this section, a...

  17. Client experiences with perinatal healthcare for high-risk and low-risk women

    NARCIS (Netherlands)

    van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana


    Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

  18. 45 CFR 1639.4 - Permissible representation of eligible clients. (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Permissible representation of eligible clients... CORPORATION WELFARE REFORM § 1639.4 Permissible representation of eligible clients. Recipients may represent an individual eligible client who is seeking specific relief from a welfare agency. [62 FR 30766...

  19. 37 CFR 10.33 - Direct contact with prospective clients. (United States)


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Direct contact with prospective clients. 10.33 Section 10.33 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... clients. A practitioner may not solicit professional employment from a prospective client with whom the...

  20. Home-based rehabilitation: Physiotherapy student and client ...

    African Journals Online (AJOL)

    Results. Clients appreciated the students' services; however, data revealed communication barriers and unmet expectations. Students reported struggling to adapt to the context, resulting in interventions not being sufficiently client-centred. They voiced a need for language competency and earlier exposure to such contexts.

  1. Caring for Clients and Families With Anxiety

    Directory of Open Access Journals (Sweden)

    Noriko Yamamoto-Mitani


    Full Text Available This study elucidated Japanese home care nurses’ experiences of supporting clients and families with anxiety. We interviewed 10 registered nurses working in home care agencies and analyzed the data using grounded theory to derive categories pertaining to the nurses’ experiences of providing care. We conceptualized nurses’ approaches to caring for anxiety into three categories: First, they attempted to reach out for anxiety even when the client/family did not make it explicit; second, they tried to alter the outlook of the situation; and third, they created comfort in the lives of the client/family. The conceptualizations of nurses’ strategies to alleviate client/family anxiety may reflect Japanese/Eastern cultural characteristics in communication and their view of the person and social care system, but these conceptualizations may also inform the practice of Western nurses by increasing awareness of skills they may also have and use.

  2. Analysis Using Popularity Awareness Index, Recency Index and Purchase Diversity in Group Buying


    Shirai, Yasuyuki; Morita, Hiroyuki; Nakamoto, Masakazu; Oyama, Satoshi


    We propose new metrics for customers’ purchasing behaviors in a group buying coupon website, based on HITS algorithms and information entropy: that is, popularity awareness index, recency index, and purchase diversity. These indices are used to classify customers and predict future behaviors. This paper includes definitions of these new indices to be used in real group buying websites. In these websites, adequate characteristics for customers are strongly required and are critical for marketi...

  3. Client reflections on confirmation and disconfirmation of expectations in cognitive behavioral therapy for generalized anxiety disorder with and without motivational interviewing. (United States)

    Button, Melissa L; Norouzian, Nikoo; Westra, Henny A; Constantino, Michael J; Antony, Martin M


    Addressing methodological shortcomings of prior work on process expectations, this study examined client process expectations both prospectively and retrospectively following treatment. Differences between clients receiving cognitive behavioral therapy (CBT) versus motivational interviewing integrated with CBT (MI-CBT) were also examined. Grounded theory analysis was used to study narratives of 10 participants (N = 5 CBT, 5 MI-CBT) who completed treatment for severe generalized anxiety disorder as part of a larger randomized controlled trial. Clients in both groups reported and elaborated expectancy disconfirmations more than expectancy confirmations. Compared to CBT clients, MI-CBT clients reported experiencing greater agency in the treatment process than expected (e.g., that they did most of the work) and that therapy provided a corrective experience. Despite nearly all clients achieving recovery status, CBT clients described therapy as not working in some ways (i.e., tasks did not fit, lack of improvement) and that they overcame initial skepticism regarding treatment. Largely converging with MI theory, findings highlight the role of key therapist behaviors (e.g., encouraging client autonomy, validating) in facilitating client experiences of the self as an agentic individual who is actively engaged in the therapy process and capable of effecting change.

  4. 75 FR 82236 - Principal Trades with Certain Advisory Clients (United States)


    ... 3235-AJ96 Principal Trades with Certain Advisory Clients AGENCY: Securities and Exchange Commission... certain of their advisory clients. The amendment extends the date on which rule 206(3)- 3T will sunset... a principal capacity in transactions with certain of their advisory clients.\\1\\ In December 2009, we...

  5. Diversity and Abundance of Beetle (Coleoptera Functional Groups in a Range of Land Use System in Jambi, Sumatra

    Directory of Open Access Journals (Sweden)



    Full Text Available Degradation of tropical rain forest might exert impacts on biodiversity loss and affect the function and stability of the related ecosystems. The objective of this study was to study the impact of land use systems (LUS on the diversity and abundance of beetle functional groups in Jambi area, Sumatra. This research was carried out during the rainy season (May-June of 2004. Inventory and collection of beetles have been conducted using winkler method across six land use systems, i.e. primary forest, secondary forest, Imperata grassland, rubber plantation, oilpalm plantation, and cassava garden. The result showed that a total of 47 families and subfamilies of beetles was found in the study area, and they were classified into four major functional groups, i.e. herbivore, predator, scavenger, and fungivore. There were apparent changes in proportion, diversity, and abundance of beetle functional groups from forests to other land use systems. The bulk of beetle diversity and abundance appeared to converge in primary forest and secondary forest and predatory beetles were the most diverse and the most abundant of the four major functional groups.

  6. Genetic Diversity of Globally Dispersed Lacustrine Group I Haptophytes: Implications for Quantitative Temperature Reconstructions (United States)

    Richter, N.; Longo, W. M.; Amaral-Zettler, L. A.; Huang, Y.


    There are significant uncertainties surrounding the forcings that drive terrestrial temperature changes on local and regional scales. Quantitative temperature reconstructions from terrestrial sites, such as lakes, help to unravel the fundamental processes that drive changes in temperature on different temporal and spatial scales. Recent studies at Brown University show that distinct alkenones, long chain ketones produced by haptophytes, are found in many freshwater, alkaline lakes in the Northern Hemisphere, highlighting these systems as targets for quantitative continental temperature reconstructions. These freshwater alkenones are produced by the Group I haptophyte phylotype and are characterized by a distinct signature: the presence of isomeric tri-unsaturated ketones and absence of alkenoates. There are currently no cultured representatives of the "Group I" haptophytes, hence they are only known based on their rRNA gene signatures. Here we present robust evidence that Northern Hemispheric freshwater, alkaline lakes with the characteristic "Group I" alkenone signature all host the same clade of Isochrysidales haptophytes. We employed next generation DNA amplicon sequencing to target haptophyte specific hypervariable regions of the large and small-subunit ribosomal RNA gene from 13 different lakes from three continents (i.e., North America, Europe, and Asia). Combined with previously published sequences, our genetic data show that the Group I haptophyte is genetically diverse on a regional and global scale, and even within the same lake. We present two case studies from a suite of five lakes in Alaska and three in Iceland to assess the impact of various environmental factors affecting Group I diversity and alkenone production. Despite the genetic diversity in this group, the overall ketone signature is conserved. Based on global surface sediment samples and in situ Alaskan lake calibrations, alkenones produced by different operational taxonomic units of the Group

  7. HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers. (United States)

    Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin


    Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs

  8. Serving up the self: Role identity and burnout in client service environments

    Directory of Open Access Journals (Sweden)

    Carly Steyn


    Full Text Available Orientation: Whilst the limited investigations into the relationship between identity and burnout have made an important contribution to our understanding of the development of burnout, further research is required to gain a deeper understanding of how the processes associated with the construction and enactment of a specific identity could contribute to burnout amongst client service employees. Research purpose: The purpose of this research was to explore whether levels of burnout amongst client service employees are associated with the manner in which they define and enact the client service role identity. Motivation for the study: The negative effects of burnout amongst client service employees can be particularly devastating for client service organisations. A deeper understanding of the causes of burnout amongst client service employees is therefore essential if we wish to reduce the significant costs associated with burnout in this environment. Research approach, design and method: The research strategy comprised a qualitative design consisting of semi-structured interviews. Main findings: The results of the study indicate that the role identities of higher burnout client service employees differ from the role identities of lower burnout client service employees. Lower burnout employees view the client relationship as a partnership and experience a high level of self-verification when dealing with their clients. Higher burnout employees, on the other hand, describe themselves as subordinate to the client and exhibit strong feelings of defeat and failure when interacting with their clients. Practical implications/managerial implications: The study shows that if client service organisations wish to reduce the detrimental effects of burnout in the workplace, they need to pay careful attention to the way in which their client service employees perceive themselves in relation to the client. Since client service employees construct role

  9. Organizational and Client Commitment among Contracted Employees (United States)

    Coyle-Shapiro, Jacqueline A-M.; Morrow, Paula C.


    This study examines affective commitment to employing and client organizations among long-term contracted employees, a new and growing employment classification. Drawing on organizational commitment and social exchange literatures, we propose two categories of antecedents of employee commitment to client organizations. We tested our hypotheses…

  10. Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers.

    Directory of Open Access Journals (Sweden)

    Dipak Suryawanshi

    Full Text Available BACKGROUND: It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. METHODS: The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040. The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM to estimate the average treatment effect on treated (ATT of intervention messages on clients' consistent condom use with FSW. RESULTS: Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%. Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%, and highest among men soliciting less visible sex workers (70%. Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001 and among men soliciting other more hidden FSW (ATT 17%; p=0.001. In Tamil Nadu no impact could be demonstrated. CONCLUSION: Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks.

  11. Proceedings of the Working Group Session on Fertility Preservation for Individuals with Gender and Sex Diversity. (United States)

    Finlayson, Courtney; Johnson, Emilie K; Chen, Diane; Dabrowski, Elizabeth; Gosiengfiao, Yasmin; Campo-Engelstein, Lisa; Rosoklija, Ilina; Jacobson, Jill; Shnorhavorian, Margarett; Pavone, Mary Ellen; Moravek, Molly B; Bonifacio, Herbert J; Simons, Lisa; Hudson, Janella; Fechner, Patricia Y; Gomez-Lobo, Veronica; Kadakia, Rachel; Shurba, Angela; Rowell, Erin; Woodruff, Teresa K


    Children and adolescents with gender and sex diversity include (1) gender-nonconforming and transgender individuals for whom gender identity or expression are incongruent with birth-assigned sex (heretofore, transgender) and (2) individuals who have differences in sex development (DSD). Although these are largely disparate groups, there is overlap in the medical expertise necessary to care for individuals with both gender and sex diversity. In addition, both groups face potential infertility or sterility as a result of desired medical and surgical therapies. The Ann & Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) gender and sex development program (GSDP) provides specialized multidisciplinary care for both transgender and DSD patients. In response to patient concerns that recommended medical treatments have the potential to affect fertility, the Lurie Children's GSDP team partnered with experts from the Oncofertility Consortium at Northwestern University to expand fertility preservation options to gender and sex diverse youth. This article summarizes the results of a meeting of experts across this field at the annual Oncofertility Consortium conference with thoughts on next steps toward a unified protocol for this patient group.

  12. Discrimination against Obese Exercise Clients: An Experimental Study of Personal Trainers. (United States)

    Fontana, Fabio; Bopes, Jonathan; Bendixen, Seth; Speed, Tyler; George, Megan; Mack, Mick


    The aim of the study was to compare exercise recommendations, attitudes, and behaviors of personal trainers toward clients of different weight statuses. Fifty-two personal trainers participated in the study. The data collection was organized into two phases. In phase one, trainers read a profile and watched the video displaying an interview of either an obese or an average-weight client. Profiles and video interviews were identical except for weight status. Then, trainers provided exercise recommendations and rated their attitude toward the client. In phase two, trainers personally met an obese or an average-weight mock client. Measures were duration and number of advices provided by the trainer to a question posed by the client and sitting distance between trainer and client. There were no significant differences in exercise intensity ( p = .94), duration of first session ( p = .65), and total exercise duration of first week ( p = .76) prescribed to the obese and average-weight clients. The attitude of the personal trainers toward the obese client were not significantly different from the attitude of personal trainers toward the average-weight client ( p = .58). The number of advices provided ( p = .49), the duration of the answer ( p = .55), and the distance personal trainers sat from the obese client ( p = .68) were not significantly different from the behaviors displayed toward the average-weight client. Personal trainers did not discriminate against obese clients in professional settings.

  13. clientes surdos

    Directory of Open Access Journals (Sweden)

    Wiliam César Alves Machado


    Full Text Available Objetivo: identificar cómo profesionales de la unidad municipal de rehabilitación física se comunican con personas sordas que buscan atención especializada. Métodos: estudio exploratorio, descriptivo, de enfoque cualitativo, realizado con 32 profesionales que trabajan en rehabilitación física a través de instrumento auto aplicable. Resultados: del análisis de datos, surgieron dos categorías temáticas: Usando el Lenguaje Brasileño de Signos; Improvisación de Estrategias de comunicación para interactuar con clientes sordos. Improvisación de estrategias utilizadas por los profesionales para comunicarse con personas sordas pueden causar barreras que inciden negativamente en la calidad de los servicios prestados a esta población. Conclusión: la comunicación es deficiente, e iniciativas eficaces centradas en la cualificación de los profesionales que trabajan en el ámbito de la rehabilitación, pueden contribuir para que puedan dominar el Lenguaje Brasileño de Signos, garantizándose a los clientes sordos la atención adecuada, conforme a lo dispuestos para personas sin discapacidad auditiva.

  14. 37 CFR 10.67 - Settling similar claims of clients. (United States)


    ... clients. 10.67 Section 10.67 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE... Office Code of Professional Responsibility § 10.67 Settling similar claims of clients. A practitioner who represents two or more clients shall not make or participate in the making of an aggregate settlement of the...

  15. Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico. (United States)

    Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Earnshaw, Valerie A; Patterson, Thomas L


    HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino versus non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed.

  16. Psychometrics of the Personal Questionnaire: A client-generated outcome measure. (United States)

    Elliott, Robert; Wagner, John; Sales, Célia M D; Rodgers, Brian; Alves, Paula; Café, Maria J


    We present a range of evidence for the reliability and validity of data generated by the Personal Questionnaire (PQ), a client-generated individualized outcome measure, using 5 data sets from 3 countries. Overall pretherapy mean internal consistency (alpha) across clients was .80, and within-client alphas averaged .77; clients typically had 1 or 2 items that did not vary with the other items. Analyses of temporal structure indicated high levels of between-clients variance (58%), moderate pretherapy test-retest correlation (r = .57), and high session-to-session Lag-1 autocorrelation (.82). Scores on the PQ provided clear evidence of convergence with a range of outcome measures (within-client r = .41). Mean pre-post effects were large (d = 1.25). The results support a revised caseness cutoff of 3.25 and a reliable change index interval of 1.67. We conclude that PQ data meet criteria for evidence-based, norm-referenced measurement of client psychological distress for supporting psychotherapy practice and research. (c) 2016 APA, all rights reserved).

  17. Group anxiety management: effectiveness, perceived helpfulness and follow-up. (United States)

    Cadbury, S; Childs-Clark, A; Sandhu, S


    An evaluation was conducted on out-patient cognitive-behavioural anxiety management groups. Twenty-nine clients assessed before and after the group and at three-month follow-up showed significant improvement on self-report measures. A further follow-up on 21 clients, conducted by an independent assessor at an average of 11 months, showed greater improvement with time. Clients also rated how helpful they had found non-specific therapeutic factors, and specific anxiety management techniques. 'Universality' was the most helpful non-specific factor, and 'the explanation of anxiety' was the most helpful technique.

  18. Client contribution in negotiations on employability – categories revised?

    DEFF Research Database (Denmark)

    Eskelinen, L.; Olesen, Søren Peter; Caswell, D.


    worker–client talk: how the category unemployed is shaped and ‘translated’ when the client negotiates her situation with the social worker. Two types of category revisions are identified. First, the employability of the client, rather than her unemployment situation, is the issue under negotiation......In this article, we explore how the institutional category ‘unemployed’ is specified in everyday practice when implementing an active employment policy. We illustrate the process of categorisation as an aspect of the in situ positioning and self-representation of the client by examining one social...

  19. Research Study on the Migration of Clients on Banking Market

    Directory of Open Access Journals (Sweden)

    Cornelia Tureac


    Full Text Available In this paper we present the relevancy and importance of knowing the reasons on clients’migration to competitive banking institutions. The main reason of being the client of several banks isdue to the fierce competition between credit institutions,thusthe banking market has changed. Basedon a case study within the Raiffeisen Bank we researched and presented the reasons fordiscontinuation of banking tiesand the migration of clients to other banks. The used researchmethodology consisted of the application of analysis point of contact by sending a questionnairethrough which there could have been identified 105 migrating clients, out of which 89 were formerclients of Raiffeisen Bank. Since both in the specialized literatureand in practice there is very littleinformation about migration behavior of banking clients-especially in the category of small andmedium enterprises-the present research was not limited to the Raiffeisen Bank clients, but to all 105respondents whodiscontinued totally or partially their connection with the bank. It can be concludedthat the attitude of the bank clients has a considerable influence on the migration behavior. The most“infidel” banking clients are considered in the category of “clients oriented towards the conditions.”

  20. Writing about Clients: Ethical Considerations and Options (United States)

    Sperry, Len; Pies, Ronald


    Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case…

  1. Experiential Interventions for Clients with Genital Herpes. (United States)

    Cummings, Anne L.


    Explores potential benefits of incorporating concepts and interventions from experimental therapy to help clients with psychosocial difficulties in learning to live with genital herpes. Recommends experimental counseling of two-chair dialog, empty chair, and metaphor for helping clients with emotional sequelae of genital herpes. Presents case…

  2. Can Knowledge of Client Birth Order Bias Clinical Judgment? (United States)

    Stewart, Allan E.


    Clinicians (N = 308) responded to identical counseling vignettes of a male client that differed only in the client's stated birth order. Clinicians developed different impressions about the client and his family experiences that corresponded with the prototypical descriptions of persons from 1 of 4 birth orders (i.e., first, middle, youngest, and…

  3. E-mail security: mail clients must use encrypted protocols

    CERN Multimedia


    In the coming weeks, users of mail clients other than Outlook (e.g. Pine, Mozilla, Mac Mail, etc.) may receive an e-mail from with instructions to update the security settings of their mail client. The aim of this campaign is to enforce the use of encrypted and authenticated mail protocols in order to prevent the propagation of viruses and protect passwords from theft. As a first step, from 6 June 2006 onwards, access to mail servers from outside CERN will require a securely configured mail client as described in the help page On this page most users will also find tools that will update their mail client settings automatically. Note that Outlook clients and WebMail access are not affected. The Mail Team

  4. Client and parent feedback on a Youth Mental Health Service: The importance of family inclusive practice and working with client preferences. (United States)

    Coates, Dominiek


    In mental health settings, feedback from clients and carers is central to service evaluation, development and delivery. Increasingly, client and carer feedback is considered an integral part of service planning, and recognized as a critical element of the provision of recovery oriented service. This paper outlines the findings of a qualitative evaluation of a Youth Mental Health (YMH) service from the perspective of discharged clients and their parents. The service researcher conducted telephone interviews with 39 parents of discharged clients, and 17 young people themselves. Participants reported positive or mixed experiences with the service. In addition to more generic positive statements about the service, analysis identified two key themes: the importance of 'family inclusive practice' and the importance of 'working with client preferences'. Young people and their parents want to be actively engaged in treatment and have their treatment preferences considered in treatment planning. Participants expressed the importance of "a good fit" between the client and the worker in terms of the clinician's gender, personality and treatment style/modality. While for some participants these themes were raised in the context of service strengths, others identified them as limitations or opportunities for service improvement. The extent to which clients and their parents felt engaged and heard by their allocated clinician is critical to their satisfaction or dissatisfaction with the service, depending on their unique experience. As an outcome of this evaluation, a range of service improvement strategies have been recommended. © 2016 Australian College of Mental Health Nurses Inc.

  5. Communication Management Guidelines for Software Organizations in Pakistan with clients from Afghanistan (United States)

    Arif Shah, Muhammad; Hashim, Rathiah; Shah, Adil Ali; Farooq Khattak, Umar


    Developing software through Global Software Development (GSD) became very common now days in the software industry. Pakistan is one of the countries where projects are taken and designed from different countries including Afghanistan. The purpose of this paper is to identify and provide an analysis on several communication barriers that can have a negative impact on the project and to provide management guidelines for medium size software organizations working in Pakistan with clients from Afghanistan and to overcome these communication barriers and challenges organizations face when coordinating with client. Initially we performed a literature review to identify different communication barriers and to check if there are any standardized communications management guidelines for medium size software houses provided in the past. The second stage of the research paper involves guidelines with vendor's perspective that include interviews and focus group discussions with different stakeholders and employees of software houses with clients from Afghanistan. Based on those interviews and discussions we established communication management guidelines in order to overcome the communication problems and barriers working with clients from Afghanistan. As a result of the literature review, we have identified that barriers such as cultural barriers and language barrier were one of the main reasons behind the project failure and suggested that software organizations working in Pakistan should follow certain defined communication guidelines in order to overcome communication barriers that affect the project directly.

  6. Hydrological-niche models predict water plant functional group distributions in diverse wetland types. (United States)

    Deane, David C; Nicol, Jason M; Gehrig, Susan L; Harding, Claire; Aldridge, Kane T; Goodman, Abigail M; Brookes, Justin D


    Human use of water resources threatens environmental water supplies. If resource managers are to develop policies that avoid unacceptable ecological impacts, some means to predict ecosystem response to changes in water availability is necessary. This is difficult to achieve at spatial scales relevant for water resource management because of the high natural variability in ecosystem hydrology and ecology. Water plant functional groups classify species with similar hydrological niche preferences together, allowing a qualitative means to generalize community responses to changes in hydrology. We tested the potential for functional groups in making quantitative prediction of water plant functional group distributions across diverse wetland types over a large geographical extent. We sampled wetlands covering a broad range of hydrogeomorphic and salinity conditions in South Australia, collecting both hydrological and floristic data from 687 quadrats across 28 wetland hydrological gradients. We built hydrological-niche models for eight water plant functional groups using a range of candidate models combining different surface inundation metrics. We then tested the predictive performance of top-ranked individual and averaged models for each functional group. Cross validation showed that models achieved acceptable predictive performance, with correct classification rates in the range 0.68-0.95. Model predictions can be made at any spatial scale that hydrological data are available and could be implemented in a geographical information system. We show the response of water plant functional groups to inundation is consistent enough across diverse wetland types to quantify the probability of hydrological impacts over regional spatial scales. © 2017 by the Ecological Society of America.

  7. The ARAC client system: network-based access to ARAC

    International Nuclear Information System (INIS)

    Leach, M J; Sumikawa, D; Webster, C


    The ARAC Client System allows users (such as emergency managers and first responders) with commonly available desktop and laptop computers to utilize the central ARAC system over the Internet or any other communications link using Internet protocols. Providing cost-effective fast access to the central ARAC system greatly expands the availability of the ARAC capability. The ARAC Client system consists of (1) local client applications running on the remote user's computer, and (2) ''site servers'' that provide secure access to selected central ARAC system capabilities and run on a scalable number of dedicated workstations residing at the central facility. The remote client applications allow users to describe a real or potential them-bio event, electronically sends this information to the central ARAC system which performs model calculations, and quickly receive and visualize the resulting graphical products. The site servers will support simultaneous access to ARAC capabilities by multiple users. The ARAC Client system is based on object-oriented client/server and distributed computing technologies using CORBA and Java, and consists of a large number of interacting components

  8. Health education for microcredit clients in Peru: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fernald Lia CH


    Full Text Available Abstract Background Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to receive a health education module based on the World Health Organization's Integrated Management of Childhood Illness (IMCI community intervention. Methods Baseline data were collected in February 2007 from clients of a microcredit organization in Pucallpa, Peru (n = 1,855 and their children (n = 598. Loan groups, consisting of 15 to 20 clients, were then randomly assigned to receive a health education intervention involving eight monthly 30-minute sessions given by the organization's loan officers at monthly loan group meetings. In February 2008, follow-up data were collected, and included assessments of sociodemographic information, knowledge of child health issues, and child health status (including child height, weight, and blood hemoglobin levels. To explore the effects of treatment (i.e., participation in the health education sessions on the key outcome variables, multivariate regressions were implemented using ordinary least squares. Results Individuals in the IMCI treatment arm demonstrated more knowledge about a variety of issues related to child health, but there were no changes in anthropometric measures or reported child health status. Conclusions Microcredit clients randomized to an IMCI educational intervention showed greater knowledge about child health, but no differences in child health outcomes compared to controls. These results imply

  9. Health education for microcredit clients in Peru: a randomized controlled trial. (United States)

    Hamad, Rita; Fernald, Lia Ch; Karlan, Dean S


    Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to receive a health education module based on the World Health Organization's Integrated Management of Childhood Illness (IMCI) community intervention. Baseline data were collected in February 2007 from clients of a microcredit organization in Pucallpa, Peru (n = 1,855) and their children (n = 598). Loan groups, consisting of 15 to 20 clients, were then randomly assigned to receive a health education intervention involving eight monthly 30-minute sessions given by the organization's loan officers at monthly loan group meetings. In February 2008, follow-up data were collected, and included assessments of sociodemographic information, knowledge of child health issues, and child health status (including child height, weight, and blood hemoglobin levels). To explore the effects of treatment (i.e., participation in the health education sessions) on the key outcome variables, multivariate regressions were implemented using ordinary least squares. Individuals in the IMCI treatment arm demonstrated more knowledge about a variety of issues related to child health, but there were no changes in anthropometric measures or reported child health status. Microcredit clients randomized to an IMCI educational intervention showed greater knowledge about child health, but no differences in child health outcomes compared to controls. These results imply that the intervention did not have sufficient intensity to change

  10. Client/server models for transparent, distributed computational resources

    International Nuclear Information System (INIS)

    Hammer, K.E.; Gilman, T.L.


    Client/server models are proposed to address issues of shared resources in a distributed, heterogeneous UNIX environment. Recent development of automated Remote Procedure Call (RPC) interface generator has simplified the development of client/server models. Previously, implementation of the models was only possible at the UNIX socket level. An overview of RPCs and the interface generator will be presented and will include a discussion of generation and installation of remote services, the RPC paradigm, and the three levels of RPC programming. Two applications, the Nuclear Plant Analyzer (NPA) and a fluids simulation using molecular modelling, will be presented to demonstrate how client/server models using RPCs and External Data Representations (XDR) have been used production/computation situations. The NPA incorporates a client/server interface for transferring/translation of TRAC or RELAP results from the UNICOS Cray to a UNIX workstation. The fluids simulation program utilizes the client/server model to access the Cray via a single function allowing it to become a shared co-processor to the workstation application. 5 refs., 6 figs

  11. A comparative study on managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. (United States)

    Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaz


    Organizational and structural obstacles are a group of major obstacles in achievement of appropriate family planning counseling. Detection of these obstacles from the viewpoint of managers, staffs and clients who are key members in health services providing system is a major step toward appropriate planning to modify or delete this group of obstacles. The present study was conducted with the goal of comparing managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 staffs and 126 clients in medical health-care centers in Isfahan in 2012. Managers and the staffs were selected by census sampling and the clients were recruited through convenient random sampling. The date collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. The obtained results showed no significant difference between mean scores of viewpoints in three groups of managers, staffs and clients concerning organizational and structural obstacles in family planning counseling (P = 0.677). In addition, most of the managers, staffs and clients reported organizational and structural obstacles as the obstacles in the process of family planning in moderate level. The results showed the necessity of health services managers' planning to modify or delete organizational and structural obstacles especially the agreed obstacles from the viewpoint of managers, staffs and clients.

  12. 75 FR 65515 - Supermedia LLC, Formerally Known as IDEARC Media LLC, Supermedia Information Services LLC, Client... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,290] Supermedia LLC, Formerally Known as IDEARC Media LLC, Supermedia Information Services LLC, Client Care Group and Publishing Operations Group, Including On-Site Leased Workers of Advavtage (TAC), RESPRCCONN, TATACONSSV, MODIS, AMDOCS...

  13. What Business Students Should Know about Attorney-Client Privilege (United States)

    Draba, Robert; Marshall, Brent


    The case law on attorney-client privilege is extensive and can be somewhat complex. Over seven hundred articles in Westlaw, for example, have the phrase "attorney-client privilege" in the title; in the last three years alone, there have been over 3700 federal cases in which the phrase "attorney-client privilege" appears at least once. However,…

  14. Enhancing Clients' Communication Regarding Goals for Using Psychiatric Medications. (United States)

    Deegan, Patricia E; Carpenter-Song, Elizabeth; Drake, Robert E; Naslund, John A; Luciano, Alison; Hutchison, Shari L


    Discordance between psychiatric care providers' and clients' goals for medication treatment is prevalent and is a barrier to person-centered care. Power statements-short self-advocacy statements prepared by clients in response to a two-part template-offer a novel approach to help clients clarify and communicate their personal goals for using psychiatric medications. This study described the power statement method and examined a sample of power statements to understand clients' goals for medication treatment. More than 17,000 adults with serious mental illness at 69 public mental health clinics had the option to develop power statements by using a Web application located in the clinic waiting areas. A database query determined the percentage of clients who entered power statements into the Web application. The authors examined textual data from a random sample of 300 power statements by using content analysis. Nearly 14,000 (79%) clients developed power statements. Of the 277 statements in the sample deemed appropriate for content analysis, 272 statements had responses to the first part of the template and 230 had responses to the second part. Clients wanted psychiatric medications to help control symptoms in the service of improving functioning. Common goals for taking psychiatric medications (N=230 statements) were to enhance relationships (51%), well-being (32%), self-sufficiency (23%), employment (19%), hobbies (15%), and self-improvement (10%). People with serious mental illness typically viewed medications as a means to pursue meaningful life goals. Power statements appear to be a simple and scalable technique to enhance clients' communication of their goals for psychiatric medication treatment.

  15. 37 CFR 10.68 - Avoiding influence by others than the client. (United States)


    ... than the client. 10.68 Section 10.68 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... the client. (a) Except with the consent of the practitioner's client after full disclosure, a practitioner shall not: (1) Accept compensation from one other than the practitioner's client for the...

  16. Client's constraining factors to construction project management ...

    African Journals Online (AJOL)

    This study analyzed client's related factors that constrain project management success of public and private sector construction in Nigeria. Issues that concern clients in any project can not be undermined as they are the owners and the initiators of project proposals. It is assumed that success, failure or abandonment of ...

  17. Training Therapists about Client Expectations of Psychotherapy. (United States)

    Soley, Georgia; Marshall, Renee; Chambliss, Catherine

    Research has indicated that premature termination of therapy is sometimes due to a conflict in goal and outcome expectations between therapists and family members of clients. The present study requested both therapists and parents of child clients to complete questionnaires to determine if there is congruence between therapist and parental…

  18. Experience of Client-centered Practice amongst Danish Occupational Therapists

    DEFF Research Database (Denmark)

    Larsen, Anette Enemark

    A client-centered approach is on the health care agenda in many European countries (1), and amongst these Denmark (2). It is described as the foundation for Occupational Therapy (OT) (3), a code of professional conduct (4,5), and defined as a partnership between client and therapist (3). The goal...... is to empower a client to fulfil his/her occupational roles in a variety of environments, leading to an increase in intervention efficacy and client perception of intervention quality (3). However, it is known to be challenging (1,3). Given the importance of this approach, there has been limited exploration...

  19. Client experiences of motivational interviewing: An interpersonal process recall study. (United States)

    Jones, Sarah A; Latchford, Gary; Tober, Gillian


    To explore clients' experience of the therapy process in motivational interviewing (MI) for alcohol abuse. A qualitative study using grounded theory. Interviews with nine clients were conducted using interpersonal process recall (IPR), a methodology which utilizes a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe the important moments in the therapy session. The transcribed interviews were then analysed using grounded theory. A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. The themes which emerged partly confirm processes of MI previously hypothesized to be important, but also highlight the importance of factors common to all therapeutic approaches. The aspects of therapy which clients in this study felt were important are similar to those hypothesized to underlie the effectiveness of MI, including a non-confrontational approach, affirmation, and developing discrepancies between beliefs and behaviour. These were embedded in aspects common to all therapies, including the qualities of the therapist and the therapeutic relationship. Client's perspectives on therapeutic processes are an important area of research, and IPR is a particularly suitable method. © 2015 The British Psychological Society.

  20. Client capital as a source of enterprise cost


    Verba Veronika A.; Tyshchenko Oleksandr O.


    The article presents the authors’ vision of the essence of the client capital and its influence upon the enterprise cost. The goal of the article is explanation of the role of the client capital in the process of enterprise capitalisation with the help of the business cost capitalisation model: investments into assets – cash flow generation – enterprise capitalisation. The result of the study is the authors’ position regarding the essence and structuring the client capital, which gives a poss...

  1. Characteristics of clients accessing HIV counseling and testing ...

    African Journals Online (AJOL)

    Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in ... Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. ... AJOL African Journals Online.

  2. The Contribution of the Counselor-Client Working Alliance to Career Exploration (United States)

    Elad-Strenger, Julia; Littman-Ovadia, Hadassah


    This longitudinal study examines the effects of Israeli counselors' and clients' ratings of their working alliance on clients' career exploration (CE), using a sample of 94 three-session career counseling processes. Results reveal that both clients' and counselors' working alliance ratings increased over time; yet, clients' ratings remained…

  3. Emotional congruence between clients and therapists and its effect on treatment outcome. (United States)

    Atzil-Slonim, Dana; Bar-Kalifa, Eran; Fisher, Hadar; Peri, Tuvia; Lutz, Wolfgang; Rubel, Julian; Rafaeli, Eshkol


    The present study aimed to (a) explore 2 indices of emotional congruence-temporal similarity and directional discrepancy-between clients' and therapists' ratings of their emotions as they cofluctuate session-by-session; and (b) examine whether client/therapist emotional congruence predicts clients' symptom relief and improved functioning. The sample comprised 109 clients treated by 62 therapists in a university setting. Clients and therapists self-reported their negative (NE) and positive emotions (PE) after each session. Symptom severity and functioning level were assessed at the beginning of each session using the clients' self-reports. To assess emotional congruence, an adaptation of West and Kenny's (2011) Truth and Bias model was applied. To examine the consequences of emotional congruence, polynomial regression, and response surface analyses were conducted (Edwards & Parry, 1993). Clients and therapists were temporally similar in both PE and NE. Therapists experienced less intense PE on average, but did not experience more or less intense NE than their clients. Those therapists who experienced more intense NE than their clients were more temporally similar in their emotions to their clients. Therapist/client incongruence in both PE and NE predicted poorer next-session symptomatology; incongruence in PE was also associated with lower client next-session functioning. Session-level symptoms were better when therapists experienced more intense emotions (both PE and NE) than their clients. The findings highlight the importance of recognizing the dynamic nature of emotions in client-therapist interactions and the contribution of session-by-session emotional dynamics to outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  4. HIV-1 group O infection in Cameroon from 2006 to 2013: Prevalence, genetic diversity, evolution and public health challenges (United States)

    Villabona-Arenas, Christian Julian; Domyeum, Jenny; Mouacha, Fatima; Butel, Christelle; Delaporte, Eric; Peeters, Martine; Mpoudi-Ngole, Eitel; Aghokeng, Avelin Fobang


    The human immunodeficiency virus, HIV, is characterized by a tremendously high genetic diversity, leading to the currently known circulating HIV types, groups, subtypes, and recombinant forms. HIV-1 group O is one of the most diverse forms of HIV-1 and has been so far related to Cameroon or individuals originating from Cameroon. In this study, we investigated in Cameroon, the evolution of this viral group from 2006 to 2013, in terms of prevalence, genetic diversity and public health implications. Our results confirmed the predominance of HIV-1 group M (98.5%), a very low prevalence (O was found at around 0.6% (95% confidence interval: 0.4–0.8%), indicating that the frequency of this virus in Cameroon has remained stable over the last decades. However, we found an extensive high genetic diversity within this HIV-1 group, that resulted from previous steady increase on the effective number of HIV-1 group O infections through time, and the current distribution of the circulating viral strains still does not allow classification as subtypes. The frequency of dual infections with HIV-1 group M and group O was 0.8% (95% confidence interval: 0.6–1.0%), but we found no recombinant forms in co-infected patients. Natural resistance to integrase inhibitors was not identified, although we found several mutations considered as natural polymorphisms. Our study shows that infections with HIV-1 group O can be adequately managed in countries where the virus circulates, but this complex virus still represents a challenge for diagnostics and monitoring strategies. PMID:26371064

  5. Understanding the innovation adoption process of construction clients, Clients driving Innovation

    NARCIS (Netherlands)

    Hartmann, Andreas; Dewulf, Geert P.M.R.; Reymen, Isabelle; Adams, L.; Guest, K.


    Although the role of clients in stimulating construction innovation seems to be controversial, little has been known about their innovation adoption behaviour. This paper presents first results of an ongoing research project the aim of which is to shed more light on the adoption processes of

  6. 77 FR 17367 - Permissible Sharing of Client Records by Customs Brokers (United States)


    ...-0038] RIN 1651-AA80 Permissible Sharing of Client Records by Customs Brokers AGENCY: U.S. Customs and... would allow brokers, upon the client's consent in a written authorization, to share client information... services to the broker's clients. Although the proposed rule was prepared in response to a request from a...

  7. Dreaming of you: client and therapist dreams about each other during psychodynamic psychotherapy. (United States)

    Hill, Clara E; Knox, Sarah; Crook-Lyon, Rachel E; Hess, Shirley A; Miles, Joe; Spangler, Patricia T; Pudasaini, Sakar


    Our objectives were to describe the frequency of therapists' dreams about their clients and clients' dreams about their therapists, to determine how therapists and clients who had such dreams differed from those who did not have such dreams, whether therapy process and outcome differed for those who had and did not have such dreams, and to describe the content and consequences of these dreams. Thirteen doctoral student therapists conducted psychodynamic psychotherapy with 63 clients in a community clinic. Therapists who had dreams about clients had higher estimated and actual dream recall than did therapists who did not dream about clients. Qualitative analyses indicated that therapists' dreams yielded insights about the therapist, clients, and therapy; therapists used insights in their work with the clients. Among the clients, only two (who were particularly high in attachment anxiety and who feared abandonment from their therapists) reported dreams that were manifestly about their therapists. Therapists-in-training dreamed more about their clients than their clients dreamed about them. Dreams about clients can be used by therapists to understand themselves, clients, and the dynamics of the therapy relationship.

  8. Examining challenging behaviors of clients with borderline personality disorder. (United States)

    Chalker, Samantha A; Carmel, Adam; Atkins, David C; Landes, Sara J; Kerbrat, Amanda H; Comtois, Katherine Anne


    Few studies have examined effects of challenging behaviors of clients with borderline personality disorder (BPD) on psychotherapy outcomes. Dialectical behavior therapy (DBT) is an evidence-based treatment designed to treat chronic suicidality, self-directed violence (SDV), and emotion dysregulation, while targeting challenging behaviors. DBT has been shown to be effective with clients with BPD. We evaluated whether therapist reported challenging behaviors, such as high volume phone contacts or violating the therapist's limits, during DBT would be associated with dropping out of DBT, severity and frequency of SDV, emotion regulation deficits, psychological symptom severity and client's and therapist's satisfaction of treatment. The current study examined challenging behaviors reported by therapists in a sample of 63 psychiatrically disabled outpatient DBT clients diagnosed with BPD (73% women, average age 37 years). More frequent phone contacts were associated with a decrease in dropout and psychological symptoms, and an increase in client and therapist satisfaction. More avoidance/disengagement behavior was associated with more than twice the risk of SDV and a decrease in therapist satisfaction. Findings suggest that the phone coaching might serve to maximize client satisfaction and reduce the likelihood of dropout. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Sociocultural Attitudes and Symptoms of Bulimia: Evaluating the SATAQ with Diverse College Groups (United States)

    Cashel, Mary Louise; Cunningham, Dana; Landeros, Clarinda; Cokley, Kevin O.; Muhammad, Grace


    This study evaluated the utility of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ; L. J. Heinberg, J. K. Thompson, & S. Stormer, 1995) for the assessment of diverse college groups, including men, women, minorities, and sorority members. Scores from the SATAQ were compared with the Eating Disorder Inventory-2 (EDI-2; D. M.…

  10. Restating a Client-Centered Approach to Career Counseling. (United States)

    Miller, Mark J.


    Asserts career counseling too often is associated with objective test scores and rational decision making. Reiterates the importance of considering the client's developing self-concept in career counseling. Provides sample client centered career counseling session. (Author/ABL)

  11. Posttraumatic stress disorder: An exploratory study examining rates of trauma and PTSD and its effect on client outcomes in community mental health

    Directory of Open Access Journals (Sweden)

    Yellowlees Peter


    Full Text Available Abstract Background Rates of trauma and Posttraumatic Stress Disorder (PTSD were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored. Methods A convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data. Results High levels of undocumented trauma and PTSD were found. Twenty clients, (74% reported exposure to multiple traumatic events; 33.3% (9 met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments. Conclusion A similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have

  12. 34 CFR 370.1 - What is the Client Assistance Program (CAP)? (United States)


    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Client Assistance Program (CAP)? 370.1... § 370.1 What is the Client Assistance Program (CAP)? The purpose of this program is to establish and carry out CAPs that— (a) Advise and inform clients and client applicants of all services and benefits...

  13. Clients' outcomes of home health nursing in Taiwan. (United States)

    Yeh, L; Wen, M J


    The home health nursing movement is expanding rapidly. Home health nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from home health nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity-number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping home health nursing services in Taiwan.

  14. 13 CFR 113.3-3 - Structural accommodations for handicapped clients. (United States)


    ... handicapped clients. 113.3-3 Section 113.3-3 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... ADMINISTRATOR General Provisions § 113.3-3 Structural accommodations for handicapped clients. (a) Existing... by handicapped clients. Where structural changes are necessary to make the recipient's goods or...

  15. Trust and Professional Skepticism in the Relationship between auditors and Clients

    DEFF Research Database (Denmark)

    Aschauer, Ewald; Fink, Matthias; Moro, Andrea


    This study empirically investigates the relationship between auditors' identification-based trust in client firm's managers and their perceptions of auditors' professional skepticism. We employ a multimethod approach broken Down into two studies. First, in study 1, we approached auditors...... collected from 233 real auditor-client dyads in Germany reveals that auditors' identification-based trust is positively Associated with their clients' perception of the auditors' professional skepticism. The identified coexistence of trust and professional skepticism in auditor-client dyads implies...... that regulatory measures that impede the evolution of trust between auditors and their clients will fail to enhance professional skepticism. instead, regulations should give auditors and their clients sufficient leeway to establish identification-based trust....

  16. Diverse Effects of a Seven-Year Experimental Grassland Fragmentation on Major Invertebrate Groups. (United States)

    Braschler, Brigitte; Baur, Bruno


    Habitat fragmentation is a major driver of biodiversity loss, but observed effects vary and may depend on the group examined. Time since fragmentation may explain some differences between taxonomical groups, as some species and thus species composition respond with a delay to changes in their environment. Impacts of drivers of global change may thus be underestimated in short-term studies. In our study we experimentally fragmented nutrient-poor dry calcareous grasslands and studied the response of species richness, individual density and species composition of various groups of invertebrates (gastropods, ants, ground beetles, rove beetles, orthoptera, spiders, woodlice) in 12 small (1.5 m * 1.5 m) and 12 large (4.5 m * 4.5 m) fragments and their corresponding control plots after 7 years. We further examined responses to fragmentation in relation to body size and habitat preferences. Responses to fragmentation varied between taxonomical groups. While spider species richness and individual density were lower in fragments, the opposite was true for an orthopteran species and woodlice. Species composition and β-diversity differed between fragments and control plots for some groups. However, the interaction treatment*plot size was rarely significant. Species with high occupancy rates in undisturbed control plots responded more negatively to the fragmentation, while species with large body size were relatively more abundant in fragments in some groups. No effect of the fragmentation was found for ants, which may have the longest lag times because of long-lived colonies. However, relationships between abundance and the species' preferences for environmental factors affected by edge effects indicate that ant diversity too may be affected in the longer-term. Our results show the importance of considering different groups in conservation management in times of widespread fragmentation of landscapes. While species richness may respond slowly, changes in abundance related to

  17. Among Friends: The Role of Academic-Preparedness Diversity in Individual Performance within a Small-Group STEM Learning Environment (United States)

    Micari, Marina; Van Winkle, Zachary; Pazos, Pilar


    In this study, we investigate the relationship between academic-preparedness diversity within small learning groups and individual academic performance in science, technology, engineering, and mathematics (STEM) university courses. We further examine whether academic-preparedness diversity impacts academically more- and less-prepared students…

  18. Mutual powerlessness in client participation practices in mental health care

    NARCIS (Netherlands)

    T. Broer (Tineke); A.P. Nieboer (Anna); R.A. Bal (Roland)


    textabstractBackground Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation

  19. Structure of Vocational Interests for Diverse Groups on the 2005 Strong Interest Inventory (United States)

    Kantamneni, Neeta; Fouad, Nadya


    This study was designed to examine the structure of vocational interests in a diverse sample of individuals who completed the 2005 revision of the Strong Interest Inventory. We examined the fit of three racial/ethnic groups (African American, Caucasian, and Latino/a), both genders, and three levels of professional status (GRS participant, student,…

  20. Romancing the boundary: client masculinities in the Chinese sex industry. (United States)

    Kong, Travis S K


    This paper draws on 24 in-depth interviews and 2 focus-group discussions conducted since 2012 with Hong Kong heterosexual men who buy sex in order to examine men's level of physical and emotional engagement with sex workers under two dominant sexual scripts in contemporary Hong Kong. Torn between companionate sexuality, with its companionate model of relationships, and recreational sexuality, with its promiscuous model of sexual pleasure, Hong Kong male clients seek to satisfy their sexual and affective needs through commercial sexual relationships. The term (meaning 'chicken worm', connoting a 'McSex' form of masculinity) refers to those men who seek impersonal sexual release with as many women as they wish, while the term (meaning 'sunken boat' and connoting a 'Titanic' form of masculinity) refers to those men who seek an intense level of emotional intimacy with sex workers. Between these two contrasting types, the majority of respondents fall into a form of 'bounded' masculinity characteristic of men who emphasise control and balance by seeking emotionally responsive women in a time-bound romance. By comparing clients' variations in the level of physical and emotional engagement with sex workers, this paper seeks to understand individual differences in client types and offers a new understanding of Chinese male sexuality and relationship formation, and the corresponding health risks (e.g., sexual, emotional) associated with each type.

  1. Qualidade de vida de clientes pós-infarto agudo do miocárdio Calidad de vida de los clientes pós-infarto agudo del miocardio Client's quality of life after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Joselany Afio Caetano


    Full Text Available Objetivou-se neste estudo avaliar a qualidade de vida de clientes que sofreram infarto agudo do miocárdio. A amostra constou de 30 clientes selecionados pela busca em prontuários de uma unidade cardiológica, que nos permitiu a identificação e localização desses clientes, internados no ano de 2004. Para coleta de dados utilizamos a Escala de Qualidade de Vida de Flanagan e o tratamento estatístico com desvio-padrão. Os resultados mostraram maior índice de respostas nos níveis "indiferentes" a "pouco satisfeitos" em suas qualidades de vida. A relação interpessoal apresentou o mais alto índice de satisfação, contrariando o bem-estar físico e material, com o mais baixo índice de satisfação. Concluiu-se que a avaliação da qualidade de vida de clientes que sofreram infarto agudo do miocárdio se mostra comprometida, o que vem corroborar outros estudos anteriormente realizados.El objetivo del estudio fue evaluar la calidad de vida de los clientes que han sufrido infarto agudo del miocardio. La muestra ha consistido de 30 pacientes escogidos por la búsqueda en historias clínicas de una unidad cardiológica, que nos permitió la identificación y localización de estos clientes, internados en el año 2004. Para la colecta de los datos utilizamos la Escala de Calidad de Vida de Flanagan y el tratamiento estadístico con desvío medio. Los resultados muestran mayor índice de respuestas en los niveles "indiferentes" a "poco satisfechos" en sus calidades de vida. La relación interpersonal presentó el más alto índice de satisfacción, contrariando el bienestar físico y material, con el más bajo índice de satisfacción. Ha concluído que la evaluación de la calidad de vida de clientes que sufrieron infarto agudo del miocardio muéstrase comprometida, lo que viene a confirmar otros estudios anteriormente realizados.This study evaluates the quality of life of clients who suffered myocardial infarction. The sample consisted of 30

  2. A study on client needs regarding FDG-PET for cancer screening

    International Nuclear Information System (INIS)

    Yamane, Tomohiko; Yoshiya, Kazuhiko; Nagata, Takeshi; Ito, Shinichi; Ito, Satoshi; Mezaki, Yukio; Uchida, Hideo


    We researched client needs regarding FDG-PET for cancer screening. The study included 1,527 individuals who underwent FDG-PET for cancer screening at our hospital. An interview sheet was distributed after injecting FDG. Clients listed the organs that required examination and the symptoms causing them anxiety. Results indicated that 9.8% of the clients listed organs for which FDG-PET would not be useful in detecting cancer. This study suggested that there exists a gap between client needs and FDG-PET utility; hence we need improved methods of providing correct information to clients. (author)

  3. Counselling and Psychological Services for Clients at the Shelter Home

    Directory of Open Access Journals (Sweden)

    Ľudmila Fonferová


    target group, which is described with the use of demographic and social characteristics, and the position of psychotherapy in social services. The differences, conditions and limitations of various approaches of assisting professions in the shelter home are organised into a three-dimensional model with interlinked variables where the socio-therapeutic environment of the shelter home represents the width, the social work represents the height and the psychological counselling represents the depth. This paper presents the results of the functioning concept of psychological work with all clients and its typical results. It describes and analyses some of the variables which generally work in psychotherapy and which are specific factors in this environment: relationship between a therapeutist and a client, variables on the side of a client, used techniques and non-therapeutical factors. Discussion and assessment of results: The final part evaluates the work of psychologist and psychotherapist in the context of the socio-therapeutic environment which by its nature calls for changes. It points out various views of social workers and psychologists or psychotherapists in their evaluation of co-operation with individual clients and shows a different conception of relationship between an evaluator and a person being evaluated which makes those two approaches different yet complementary in the complex of services. Conclusion: The conclusion brings an assessment of the importance of psychotherapy in social services as an activity determined by the concept of social work and psychotherapy and their historical continuity in individual countries.

  4. Relative efficacy of cash versus vouchers in engaging opioid substitution treatment clients in survey-based research. (United States)

    Topp, Libby; Islam, M Mofizul; Day, Carolyn Ann


    Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20-30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); χ(2)=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; ppayment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use.

  5. Feline immunodeficiency virus testing in stray, feral, and client-owned cats of Ottawa. (United States)

    Little, Susan E


    Feline immunodeficiency virus (FIV) seroprevalence is evaluated in 3 groups of cats. Seventy-four unowned urban strays were tested, as well as 20 cats from a small feral cat colony, and 152 client-owned cats. Of the 246 cats tested, 161 (65%) were male and 85 (35%) were female. Seroprevalence for FIV was 23% in the urban strays, 5% in the feral cat colony, and 5.9% in the client-owned cats. Ten cats (4%) were also positive for Feline leukemia virus (FeLV) antigen, including 2 cats coinfected with FeLV and FIV. Seroprevalence for FIV in cats from Ottawa is similar to that found in other nonrandom studies of cats in North America.

  6. A clinical reasoning model focused on clients' behaviour change with reference to physiotherapists: its multiphase development and validation. (United States)

    Elvén, Maria; Hochwälder, Jacek; Dean, Elizabeth; Söderlund, Anne


    A biopsychosocial approach and behaviour change strategies have long been proposed to serve as a basis for addressing current multifaceted health problems. This emphasis has implications for clinical reasoning of health professionals. This study's aim was to develop and validate a conceptual model to guide physiotherapists' clinical reasoning focused on clients' behaviour change. Phase 1 consisted of the exploration of existing research and the research team's experiences and knowledge. Phases 2a and 2b consisted of validation and refinement of the model based on input from physiotherapy students in two focus groups (n = 5 per group) and from experts in behavioural medicine (n = 9). Phase 1 generated theoretical and evidence bases for the first version of a model. Phases 2a and 2b established the validity and value of the model. The final model described clinical reasoning focused on clients' behaviour change as a cognitive, reflective, collaborative and iterative process with multiple interrelated levels that included input from the client and physiotherapist, a functional behavioural analysis of the activity-related target behaviour and the selection of strategies for behaviour change. This unique model, theory- and evidence-informed, has been developed to help physiotherapists to apply clinical reasoning systematically in the process of behaviour change with their clients.

  7. Electric organ discharge diversity in the genus Gymnotus: anatomo-functional groups and electrogenic mechanisms. (United States)

    Rodríguez-Cattáneo, A; Aguilera, P; Cilleruelo, E; Crampton, W G R; Caputi, A A


    Previous studies describe six factors accounting for interspecific diversity of electric organ discharge (EOD) waveforms in Gymnotus. At the cellular level, three factors determine the locally generated waveforms: (1) electrocyte geometry and channel repertoire; (2) the localization of synaptic contacts on electrocyte surfaces; and (3) electric activity of electromotor axons preceding the discharge of electrocytes. At the organismic level, three factors determine the integration of the EOD as a behavioral unit: (4) the distribution of different types of electrocytes and specialized passive tissue forming the electric organ (EO); (5) the neural mechanisms of electrocyte discharge coordination; and (6) post-effector mechanisms. Here, we reconfirm the importance of the first five of these factors based on comparative studies of a wider diversity of Gymnotus than previously investigated. Additionally, we report a hitherto unseen aspect of EOD diversity in Gymnotus. The central region of the EO (which has the largest weight on the conspecific-received field) usually exhibits a negative-positive-negative pattern where the delay between the early negative and positive peaks (determined by neural coordination mechanisms) matches the delay between the positive and late negative peaks (determined by electrocyte responsiveness). Because delays between peaks typically determine the peak power frequency, this matching implies a co-evolution of neural and myogenic coordination mechanisms in determining the spectral specificity of the intraspecific communication channel. Finally, we define four functional species groups based on EO/EOD structure. The first three exhibit a heterogeneous EO in which doubly innervated electrocytes are responsible for a main triphasic complex. Group I species exhibit a characteristic cephalic extension of the EO. Group II species exhibit an early positive component of putative neural origin, and strong EO auto-excitability. Group III species exhibit

  8. Comparison and selection of client computer in nuclear instrument

    International Nuclear Information System (INIS)

    Ma Guizhen; Xie Yanhui; Peng Jing; Xu Feiyan


    The function of modern new nuclear instrument is very much. And the information degree is high requested. Through close matching for host computer and client computer, the data processing function can be carried out. This article puts forward a few of projects for the client computer of general nuclear instrument. The function and features of several common client computers, such as FPGA, ARM and DSP, are analyzed and compared. The applied scope is discussed also. At the same time, using a practical design as an example, the selection ideas of client computer are described. This article can be used for reference for the hardware design of data acquisition processing unit in nuclear instrument. (authors)

  9. Perceptions of problem-based learning (PBL) group effectiveness in a socially-culturally diverse medical student population. (United States)

    Singaram, V S; Dolmans, D H J M; Lachman, N; van der Vleuten, C P M


    A key aspect of the success of a PBL curriculum is the effective implementation of its small group tutorials. Diversity among students participating in tutorials may affect the effectiveness of the tutorials and may require different implementation strategies. To determine how students from diverse backgrounds perceive the effectiveness of the processes and content of the PBL tutorials. This study also aims to explore the relationship between students' perceptions of their PBL tutorials and their gender, age, language, prior educational training, and secondary schooling. Data were survey results from 244 first-year student-respondents at the Nelson Mandela School of Medicine at the University of KwaZulu-Natal in South Africa. Exploratory factor analysis was conducted to verify scale constructs in the questionnaire. Relationships between independent and dependent variables were investigated in an analysis of variance. The average scores for the items measured varied between 3.3 and 3.8 (scale value 1 indicated negative regard and 5 indicated positive regard). Among process measures, approximately two-thirds of students felt that learning in a group was neither frustrating nor stressful and that they enjoyed learning how to work with students from different social and cultural backgrounds. Among content measures, 80% of the students felt that they learned to work successfully with students from different social and cultural groups and 77% felt that they benefited from the input of other group members. Mean ratings on these measures did not vary with students' gender, age, first language, prior educational training, and the types of schools they had previously attended. Medical students of the University of KwaZulu-Natal, regardless of their backgrounds, generally have positive perceptions of small group learning. These findings support previous studies in highlighting the role that small group tutorials can play in overcoming cultural barriers and promoting unity and

  10. Communication management between architects and clients (United States)

    Taleb, Hala; Ismail, Syuhaida; Wahab, Mohammad Hussaini; Rani, Wan Nurul Mardiah Wan Mohd.


    Architectural projects are initiated with the designing phase, that tends to translate and materialize the client's requirements and needs. This phase is highly and directly affected by the exchanged information and communication between architects with their clients. Nevertheless, despite of its importance, studies have proven that communication management, being a significant field of project management, is distinctly overlooked by architects in the architectural industry. Thus, this paper highlights the current practices and attributes of communication management in the context of architectural design phase. It outlines the different aspects' definitions of communication, as well as communication management standards and practices. By the end of this paper, the findings are expected to increase the communication management knowledge amongst architects to achieve success in projects by promoting the relationships between them and their clients. Finally, this paper uncover the architects' need for significant improvement of communication management as an insistent matter to ultimately fulfill project success.

  11. [Intercultural health care policy from the perspective of health care providers and Mapuche clients]. (United States)

    Alarcón, Ana María; Astudillo, Paula; Barrios, Sara; Rivas, Edith


    Intercultural health is becoming an emergent topic in the design of health care programs for Mapuche people of Chile. This process faces important challenges such as the scarce theoretical support about the meaning of intercultural health and their practical consequences for providers and clients. To explore the perception in providers and Mapuche clients about intercultural health. A survey performed in 11 counties with the highest concentration of Mapuche people, of the IX region of Chile. The perception about the development of a new health policy specially designed for Mapuche patients was surveyed in 399 Mapuche patients and 64 providers of primary health care centers. Mapuche clients considered, as the main regional challenges, the indifference and discrimination of health care teams towards Mapuche patients, aggravated by the indifference of authorities. Providers considered that the main problem was a lack of knowledge about Mapuche culture and skills to deal with this ethnic group. Patients and providers agreed on the need to use Mapuche dialect in health care attentions, to coordinate actions with traditional healers and to accept ethnical therapeutic practices. There is scarce agreement between providers and Mapuche clients about the need for an special intercultural health policy, its contents, and the regional conditions for its implementation and development.

  12. Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency. (United States)

    von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger


    Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

  13. Evaluation of a liaison librarian program: client and liaison perspectives. (United States)

    Tennant, Michele R; Cataldo, Tara Tobin; Sherwill-Navarro, Pamela; Jesano, Rae


    This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.

  14. 45 CFR 1609.5 - Acceptance of reimbursement from a client. (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Acceptance of reimbursement from a client. 1609.5... CORPORATION FEE-GENERATING CASES § 1609.5 Acceptance of reimbursement from a client. (a) When a case results in recovery of damages or statutory benefits, a recipient may accept reimbursement from the client...

  15. Corruption of Client Advocacy in a Community Mental Health System. (United States)

    Denner, Bruce

    This speech discusses client advocacy, a paraprofessional service offered in many community mental health centers to help bridge the gap between therapist and client. While having an advocate on the mental health team is an attractive idea, these client advocates are quite susceptible to "corruption." The author discusses two major causes of this…

  16. Volunteering and Organizational Diversity

    DEFF Research Database (Denmark)

    Henriksen, Lars Skov; Rosdahl, David


    volunteering within the three major welfare fields: social service, health, and education. It could be argued that this is a more heterogeneous type of volunteering, because some volunteers work in ‘service organizations' aiming at particular client groups (battered women, homeless, elderly people etc.) while...

  17. Inventory, differentiation, and proportional diversity: a consistent terminology for quantifying species diversity. (United States)

    Jurasinski, Gerald; Retzer, Vroni; Beierkuhnlein, Carl


    Almost half a century after Whittaker (Ecol Monogr 30:279-338, 1960) proposed his influential diversity concept, it is time for a critical reappraisal. Although the terms alpha, beta and gamma diversity introduced by Whittaker have become general textbook knowledge, the concept suffers from several drawbacks. First, alpha and gamma diversity share the same characteristics and are differentiated only by the scale at which they are applied. However, as scale is relative--depending on the organism(s) or ecosystems investigated--this is not a meaningful ecological criterion. Alpha and gamma diversity can instead be grouped together under the term "inventory diversity." Out of the three levels proposed by Whittaker, beta diversity is the one which receives the most contradictory comments regarding its usefulness ("key concept" vs. "abstruse concept"). Obviously beta diversity means different things to different people. Apart from the large variety of methods used to investigate it, the main reason for this may be different underlying data characteristics. A literature review reveals that the multitude of measures used to assess beta diversity can be sorted into two conceptually different groups. The first group directly takes species distinction into account and compares the similarity of sites (similarity indices, slope of the distance decay relationship, length of the ordination axis, and sum of squares of a species matrix). The second group relates species richness (or other summary diversity measures) of two (or more) different scales to each other (additive and multiplicative partitioning). Due to that important distinction, we suggest that beta diversity should be split into two levels, "differentiation diversity" (first group) and "proportional diversity" (second group). Thus, we propose to use the terms "inventory diversity" for within-sample diversity, "differentiation diversity" for compositional similarity between samples, and "proportional diversity" for the

  18. Understanding the usage of the Helioviewer Project clients and services (United States)

    Ireland, J.; Zahniy, S.; Mueller, D.; Nicula, B.; Verstringe, F.; Bourgoignie, B.; Buchlin, E.; Alingery, P.


    The Helioviewer Project enables visual exploration of the Sun and the inner heliosphere for everyone, everywhere via intuitive interfaces and novel technology. The project mainly develops two clients, and JHelioviewer, and the server-side capabilities accessed via those clients. Images from many different ground and space-based sources are currently available from multiple servers. Solar and heliospheric feature and event information, magnetic field extrapolations and important time-series can also be browsed and visualized using Helioviewer Project clients. Users of the Helioviewer Project have made over two million movies and many millions of screenshots since detailed (and anonymous) logging of Helioviewer Project usage was implemented in February 2011. These usage logs are analyzed to give a detailed breakdown on user interaction with solar and heliospheric data via Helioviewer Project clients and services. We present summary statistics on how our users are using our clients and services, which data they are interested in, and how they choose to interact with different data sources. At the poster presentation we will also be soliciting ideas from the community to improve our clients and services.

  19. Directive approach for Chinese clients receiving psychotherapy: Is that really a priority?

    Directory of Open Access Journals (Sweden)

    Chi Ting Connie eNg


    Full Text Available The academic literature often suggests that Chinese people prefer directive approaches in therapy. However, studies on this topic are often based on therapists’ self-reports: clients’ perceptions are rarely considered. What does directive approach mean? Is it what clients prefer? Using cultural psychology and medical anthropology as a theoretical framework, the ethnography explored the experience of psychotherapy from Chinese clients’ perspectives. Specifically, using ethnographic interview, eight informants, two male and six female, ranging in age from 40 to 55, were interviewed twice in-depth about their experiences of seeing Chinese therapists. All informants are Chinese immigrants who reside in a major Canadian city and saw at least one Chinese therapist in a community counselling agency within one year prior to the interview. In the first interview, informants created groups of cards describing a list of hypothesized cultural knowledge regarding psychotherapy. After initial data analysis, the cards were presented to the informants in the second interviews, in which they confirmed and/or rejected the hypotheses by grouping, reorganizing, and ranking the cards. In the end each informant created a number of mind-maps with the cards, which served as a representation of informants’ psychological reality of psychotherapy based on their ordinary language. The maps were then further analysed for themes among informants. Results suggest that clients appreciate therapists who give homework, analyse their problems, talk about strategies that other clients have found useful, chat, and provide resources. Results also highlight informants’ understanding of their own responsibility for the therapeutic relationship which has never been documented before and has important clinical implications.

  20. Psychotherapy for Suicidal Clients. (United States)

    Lester, David


    Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

  1. 17 CFR 275.206(3)-2 - Agency cross transactions for advisory clients. (United States)


    ... advisory clients. 275.206(3)-2 Section 275.206(3)-2 Commodity and Securities Exchanges SECURITIES AND... Agency cross transactions for advisory clients. (a) An investment adviser, or a person registered as a... advisory client, if: (1) The advisory client has executed a written consent prospectively authorizing the...

  2. Male nurses' experiences of providing intimate care for women clients. (United States)

    Inoue, Madoka; Chapman, Rose; Wynaden, Dianne


    This paper reports a study of male nurses' experiences of providing intimate care for women clients. The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded. Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004. Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery. Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

  3. Therapist's interpersonal style and therapy benefit as the determinants of personality self-reports in clients. (United States)

    Hadziahmetović, Nina; Alispahić, Sabina; Tuce, Đenita; Hasanbegović-Anić, Enedina


    BACKGROUND/AIM. In (counter)transference relationship therapist's interpersonal style, implying the perceived relation of therapist to a client (patient) in terms of control, autonomy, care and positive feedback, has been shown to be important. The aim of our study was to assess the relationship between therapist's interpersonal style and clients' personality self-reports. Within therapist's interpersonal style, preliminary validation of the Therapist's Interpersonal Style Scale has been conducted, which included double translation method, exploratory factor analysis, confirmatory factor analysis, as well as the reliability tests of the derived components. This research was conducted on a group of 206 clients, attending one of the four psychotherapy modalities: psychoanalysis, gestalt therapy, cognitive-behavioral and systemic family therapy. Beside Therapist's Interpersonal Style Scale, Big Five Questionnaire and Therapy Benefit Scale were administered, showing good internal consistency. Principal component analysis of therapist's interpersonal style singled out two components Supportive Autonomy and Ignoring Control, explaining 42% of variance. Two-factor model of the therapist's styles was better fitted in confirmatory factor analysis than the original 4-factor model. Structural model showing indirect and direct effects of therapist's interpersonal styles on self-reports in clients indicates good fitness (χ²(12) = 8.932, p = 0.709; goodness-of-fit index = 0.989), with Ignoring Control having direct effect on Stability, Supportive Autonomy on Therapy Benefit, and Therapy Benefit on Plasticity. The results of this study indicate the importance of further research on therapist's interpersonal style, as well as further validation of the instrument that measures this construct. Besides, a client's perception that the therapy is being helpful could instigate more explorative and approach-oriented behavior, what indirectly might contribute to a client's stability.

  4. Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site. (United States)

    Higashi, Robin T; Craddock Lee, Simon J; Leonard, Tammy; Cuate, Erica L; Cole, Jay; Pruitt, Sandi L


    Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population. © 2015 Wiley Periodicals, Inc.

  5. 37 CFR 10.57 - Preservation of confidences and secrets of a client. (United States)


    ... and secrets of a client. 10.57 Section 10.57 Patents, Trademarks, and Copyrights UNITED STATES PATENT... confidences and secrets of a client. (a) “Confidence” refers to information protected by the attorney-client or agent-client privilege under applicable law. “Secret” refers to other information gained in the...

  6. Weight and body mass index among female contraceptive clients. (United States)

    Kohn, Julia E; Lopez, Priscilla M; Simons, Hannah R


    As obesity may affect the efficacy of some contraceptives, we examined weight, body mass index (BMI) and prevalence of obesity among female contraceptive clients at 231 U.S. health centers. A secondary aim was to analyze differences in contraceptive method use by obesity status. Cross-sectional study using de-identified electronic health record data from family planning centers. We analyzed contraceptive visits made by 147,336 females aged 15-44 years in 2013. A total of 46.1% of clients had BMI ≥25. Mean body weight was 154.4 lb (S.D.=41.9); mean BMI was 26.1 (S.D.=6.6). A total of 40% had BMI ≥26, when levonorgestrel emergency contraception may become less effective. Obese clients had higher odds of using a tier 1 or tier 3 contraceptive method and had lower odds of using a tier 2 or hormonal method than non-obese clients. About half of contraceptive clients would be categorized as overweight or obese. Contraceptive method choices differed by obesity status. About half of contraceptive clients in this study population were overweight or obese. Contraceptive method choices differed by obesity status. All women - regardless of body size - should receive unbiased, evidence-based counseling on the full range of contraceptive options so that they can make informed choices. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Ten-year audit of clients presenting to a specialised service for young people experiencing or at increased risk for psychosis. (United States)

    Conrad, Agatha M; Lewin, Terry J; Sly, Ketrina A; Schall, Ulrich; Halpin, Sean A; Hunter, Mick; Carr, Vaughan J


    Despite strong research interest in psychosis risk identification and the potential for early intervention, few papers have sought to document the implementation and evaluation of specialised psychosis related services. Assessment of Ultra High Risk (UHR) has been given priority, but it is equally as important to identify appropriate comparison groups and other baseline differences. This largely descriptive service evaluation paper focuses on the 'baseline characteristics' of referred clients (i.e., previously assessed characteristics or those identified within the first two months following service presentation). Data are reported from a 10-year layered service audit of all presentations to a 'Psychological Assistance Service' for young people (PAS, Newcastle, Australia). Baseline socio-demographic and clinical characteristics (N =1,997) are described (including clients' psychosis and UHR status, previous service contacts, hospitalisation rates, and diagnostic and comorbidity profiles). Key groups are identified and comparisons made between clients who received ongoing treatment and those who were primarily assessed and referred elsewhere. Clients averaged 19.2 (SD =4.5) years of age and 59% were male. One-tenth of clients (9.6%) were categorised as UHR, among whom there were relatively high rates of attenuated psychotic symptoms (69.1%), comorbid depression (62.3%), anxiety (42.9%), and attentional and related problems (67.5%). Overall, one-fifth (19.8%) experienced a recent psychotic episode, while a further 14.5% were categorised as having an existing psychosis (46.7% with a schizophrenia diagnosis), amongst whom there were relatively high rates of comorbid substance misuse (52.9%), psychosocial (70.2%) and physical health (37.7%) problems. The largest group presenting to PAS were those with non-psychotic disorders (43.7%), who provide a valuable comparison group against which to contrast the health trajectories of those with UHR and recent psychosis. Ongoing

  8. An experimental study of client-side Spotify peering behaviour


    Ellis, M.; Strowes, S.; Perkins, C.


    Spotify is a popular music-streaming service which has seen widespread use across Europe. While Spotify’s server-side behaviour has previously been studied, little is known about the client-side behaviour. In this paper, we describe an experimental study where we collect packet headers for Spotify traffic over multiple 24-hour time frames at a client host. Two distinct types of behaviour are observed, when tracks are being downloaded, and when the client is only serving requests from other pe...

  9. 37 CFR 10.112 - Preserving identity of funds and property of client. (United States)


    ... and property of client. 10.112 Section 10.112 Patents, Trademarks, and Copyrights UNITED STATES PATENT... funds and property of client. (a) All funds of clients paid to a practitioner or a practitioner's firm... therein. (2) Funds belonging in part to a client and in part presently or potentially to the practitioner...

  10. 49 CFR 1103.19 - Advising upon the merits of a client's cause. (United States)


    ... 49 Transportation 8 2010-10-01 2010-10-01 false Advising upon the merits of a client's cause. 1103... Practitioner's Duties and Responsibilities Toward A Client § 1103.19 Advising upon the merits of a client's cause. A practitioner shall try to obtain full knowledge of his client's cause before advising thereon...

  11. Human methanogen diversity and incidence in healthy and diseased colonic groups using mcrA gene analysis

    Directory of Open Access Journals (Sweden)

    Scanlan Pauline D


    Full Text Available Abstract Background The incidence and diversity of human methanogens are insufficiently characterised in the gastrointestinal tract of both health and disease. A PCR and clone library methodology targeting the mcrA gene was adopted to facilitate the two-fold aim of surveying the relative incidence of methanogens in health and disease groups and also to provide an overview of methanogen diversity in the human gastrointestinal tract. Results DNA faecal extracts (207 in total from a group of healthy controls and five gastrointestinal disease groups were investigated. Colorectal cancer, polypectomised, irritable bowel syndrome and the control group had largely equivalent numbers of individuals positive for methanogens (range 45–50%. Methanogen incidence in the inflammatory bowel disease groups was reduced, 24% for ulcerative colitis and 30% for Crohn's disease. Four unique mcrA gene restriction fragment length polymorphism profiles were identified and bioinformatic analyses revealed that the majority of all sequences (94% retrieved from libraries were 100% identical to Methanobrevibacter smithii mcrA gene. In addition, mcrA gene sequences most closely related to Methanobrevibacter oralis and members of the order Methanosarcinales were also recovered. Conclusion The mcrA gene serves as a useful biomarker for methanogen detection in the human gut and the varying trends of methanogen incidence in the human gut could serve as important indicators of intestinal function. Although Methanobrevibacter smithii is the dominant methanogen in both the distal colon of individuals in health and disease, the diversity of methanogens is greater than previously reported. In conclusion, the low incidence of methanogens in Inflammatory Bowel Disease, the functionality of the methanogens and impact of methane production in addition to competitive interactions between methanogens and other microbial groups in the human gastrointestinal tract warrants further

  12. Sexually transmitted infections among heterosexual male clients of female sex workers in China: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Megan M McLaughlin

    Full Text Available Female sex workers have been the target of numerous sexually transmitted infection (STI prevention strategies in China, but their male clients have attracted considerably less public health attention and resources. We sought to systematically assess the prevalence of HIV, syphilis, gonorrhea, and chlamydia among heterosexual male clients of female sex workers in China.Original research manuscripts were identified by searching Chinese and English language databases, and 37 studies analyzing 26,552 male clients were included in the review. Client STI prevalence across studies was heterogeneous. Pooled prevalence estimates and 95% confidence intervals were 0.68% (0.36-1.28% for HIV, 2.91% (2.17-3.89% for syphilis, 2.16% (1.46-3.17% for gonorrhea, and 8.01% (4.94-12.72% for chlamydia.The pooled prevalence estimates of HIV, syphilis, gonorrhea, and chlamydia among clients in this review exceed the prevalences previously reported among population-representative samples and low-risk groups in China. However, heterogeneity across studies and sampling limitations prevent definitive conclusions about how the prevalence of STIs in this population compares to the general population. These findings suggest a need for greater attention to clients' sexual risk and disease prevalence in China's STI research agenda in order to inform effective prevention policies.

  13. Meeting the Needs of Clients with Dissociative Identity Disorder: Considerations for Psychotherapy (United States)

    Ringrose, Jo L.


    Psychotherapy for clients with Dissociative Identity Disorder (DID) is different to therapy with most clients because these clients are multiple, comprising one or more host, and one or more alter personalities. The necessary components to be addressed in order that clients can live successfully either as a multiple or as an integrated person are…

  14. Diverse Effects of a Seven-Year Experimental Grassland Fragmentation on Major Invertebrate Groups.

    Directory of Open Access Journals (Sweden)

    Brigitte Braschler

    Full Text Available Habitat fragmentation is a major driver of biodiversity loss, but observed effects vary and may depend on the group examined. Time since fragmentation may explain some differences between taxonomical groups, as some species and thus species composition respond with a delay to changes in their environment. Impacts of drivers of global change may thus be underestimated in short-term studies. In our study we experimentally fragmented nutrient-poor dry calcareous grasslands and studied the response of species richness, individual density and species composition of various groups of invertebrates (gastropods, ants, ground beetles, rove beetles, orthoptera, spiders, woodlice in 12 small (1.5 m * 1.5 m and 12 large (4.5 m * 4.5 m fragments and their corresponding control plots after 7 years. We further examined responses to fragmentation in relation to body size and habitat preferences. Responses to fragmentation varied between taxonomical groups. While spider species richness and individual density were lower in fragments, the opposite was true for an orthopteran species and woodlice. Species composition and β-diversity differed between fragments and control plots for some groups. However, the interaction treatment*plot size was rarely significant. Species with high occupancy rates in undisturbed control plots responded more negatively to the fragmentation, while species with large body size were relatively more abundant in fragments in some groups. No effect of the fragmentation was found for ants, which may have the longest lag times because of long-lived colonies. However, relationships between abundance and the species' preferences for environmental factors affected by edge effects indicate that ant diversity too may be affected in the longer-term. Our results show the importance of considering different groups in conservation management in times of widespread fragmentation of landscapes. While species richness may respond slowly, changes in

  15. Fidelização de clientes na web: como conhecer e fidelizar clientes por meio da internet


    Benossi, Claudio


    A dissertação intitulada Fidelização de Clientes na WEB: Como conhecer e fidelizar clientes através da Internet do Mestrado em Tecnologias da Inteligência e Design Digital (TIDD) tem como objetivo analisar a contribuição da tecnologia da informação para o marketing de relacionamento, incrementando a competitividade empresarial. O atual ambiente globalizado implica numa era de concorrência e competição, resultado da desintegração de fronteiras e da abertura de mercados anteriormente protegidos...

  16. De Novo Advanced Adult-Onset Offending: New Evidence from a Population of Federal Correctional Clients. (United States)

    DeLisi, Matt; Tahja, Katherine N; Drury, Alan J; Elbert, Michael J; Caropreso, Daniel E; Heinrichs, Timothy


    Adult antisocial behavior is almost always predated by delinquency during childhood or adolescence; however, there is also evidence of adult-onset criminal offending. This study examined this controversial subgroup of offenders using self-reported and official data from a total population of federal correctional clients selected from the Midwestern United States. Difference of means t-tests, chi-square tests, and logistic regression models found that 11.7% of clients had an adult onset of offending and 2.7% of clients (n = 23) had an onset occurring at age 60 years or older. This group-introduced as de novo advanced adult-onset offenders-had high socioeconomic status, mixed evidence of adverse childhood experiences, and virtually no usage of drugs with the exception of alcohol. These offenders were primarily convicted of social security and white-collar crimes and evinced remarkably low psychopathology and criminal risk. More research is needed to replicate the phenomenon of de novo advanced adult-onset offending. © 2017 American Academy of Forensic Sciences.

  17. Healing Relationships: A Qualitative Study of Healers and Their Clients in Germany

    Directory of Open Access Journals (Sweden)

    B. M. H. Stöckigt


    Full Text Available Background. The aim of this study was to investigate the nature of the relationships between healers and their clients in Germany. Methods. An interdisciplinary research team performed semistructured interviews with healers and clients and participatory observation of healing sessions. All interviews were digitally recorded, transcribed, and analyzed using content analysis. Results. Fifteen healers and sixteen clients were included. The healer-client relationship was described as a profound and unique experience, which brought forth interpersonal and spiritual connections. The healers were seen as role models for healing to occur and support for being connected spiritually. The clients had to be open-minded and responsible. The importance of the healers’ empathy was emphasized. Discussion. The relationship between healer and client can be seen as a triangular connection between client, healer, and a transcendent source which is not the case in typical patient-doctor relationships. The spiritual connection is also said to enhance the empathetic understanding of the healer. The personality and a partner-like attitude of the healer supported the client in giving a more positive meaning to his life, in reconnecting to his spirituality, and in taking responsibility. Future studies should address the role of spirituality in health care and the development of enduring healer-client relationships.

  18. Cleaner shrimp use a rocking dance to advertise cleaning service to clients. (United States)

    Becker, Justine H A; Curtis, Lynda M; Grutter, Alexandra S


    Signals transmit information to receivers about sender attributes, increase the fitness of both parties, and are selected for in cooperative interactions between species to reduce conflict [1, 2]. Marine cleaning interactions are known for stereotyped behaviors [3-6] that likely serve as signals. For example, "dancing" and "tactile dancing" in cleaner fish may serve to advertise cleaning services to client fish [7] and manipulate client behavior [8], respectively. Cleaner shrimp clean fish [9], yet are cryptic in comparison to cleaner fish. Signals, therefore, are likely essential for cleaner shrimp to attract clients. Here, we show that the yellow-beaked cleaner shrimp [10] Urocaridella sp. c [11] uses a stereotypical side-to-side movement, or "rocking dance," while approaching potential client fish in the water column. This dance was followed by a cleaning interaction with the client 100% of the time. Hungry cleaner shrimp, which are more willing to clean than satiated ones [12], spent more time rocking and in closer proximity to clients Cephalopholis cyanostigma than satiated ones, and when given a choice, clients preferred hungry, rocking shrimp. The rocking dance therefore influenced client behavior and, thus, appears to function as a signal to advertise the presence of cleaner shrimp to potential clients.

  19. The Impact of Organizational Stress and Burnout on Client Engagement (United States)

    Landrum, Brittany; Knight, Danica K.; Flynn, Patrick M.


    This paper explores the impact of organizational attributes on client engagement within substance abuse treatment. Previous research has identified organizational features, including small size, accreditation, and workplace practices that impact client engagement (Broome, Flynn, Knight, & Simpson, 2007). The current study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the U.S. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, while engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress, but was not related to participation. Two additional organizational measures – workload and influence – moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are discussed. PMID:22154029

  20. Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy. (United States)

    Sivec, Harry J; Montesano, Vicki L; Skubby, David; Knepp, Kristen A; Munetz, Mark R


    This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

  1. Efficient Mobile Client Caching Supporting Transaction Semantics

    Directory of Open Access Journals (Sweden)

    IlYoung Chung


    Full Text Available In mobile client-server database systems, caching of frequently accessed data is an important technique that will reduce the contention on the narrow bandwidth wireless channel. As the server in mobile environments may not have any information about the state of its clients' cache(stateless server, using broadcasting approach to transmit the updated data lists to numerous concurrent mobile clients is an attractive approach. In this paper, a caching policy is proposed to maintain cache consistency for mobile computers. The proposed protocol adopts asynchronous(non-periodic broadcasting as the cache invalidation scheme, and supports transaction semantics in mobile environments. With the asynchronous broadcasting approach, the proposed protocol can improve the throughput by reducing the abortion of transactions with low communication costs. We study the performance of the protocol by means of simulation experiments.

  2. Task Force on Culture and Ethnic Diversity

    DEFF Research Database (Denmark)

    Singla, Rashmi

    differences. Key words: work motivation, (sub) cultural differences, meta-representation. Email: 3.Abstract for presentation in Symposium Case conceptualization, relationship building and intervention challenges with culturally diverse clients among clinical psychologists: a case...... of knowledge originating from different geographical contexts. The initiative taken by the psychology students in Århus University, the specific course dynamic developed and the evaluation is to be delineated in the paper. In addition, both pedagogical psychological aspects and long term consequences...

  3. Counseling Older Japanese American Clients: An Overview and Observations. (United States)

    Itai, Goro; McRae, Cynthia


    Discusses important aspects of providing counseling to older Japanese American clients, including ethical issues based on cultural differences and nontraditional approaches to counseling. Examines unique historical and cultural characteristics of these clients. Includes 26 citations. (Author/CRR)

  4. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    Directory of Open Access Journals (Sweden)

    Mark Brennan-Ing

    Full Text Available In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM, for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment. Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500. When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of

  5. Visualization Software for VisIT Java Client

    Energy Technology Data Exchange (ETDEWEB)


    The VisIT Java Client (JVC) library is a lightweight thin client that is designed and written purely in the native language of Java (the Python & JavaScript versions of the library use the same concept) and communicates with any new unmodified standalone version of VisIT, a high performance computing parallel visualization toolkit, over traditional or web sockets and dynamically determines capabilities of the running VisIT instance whether local or remote.

  6. 75 FR 66050 - Permissible Sharing of Client Records by Customs Brokers (United States)


    .... USCBP-2010-0038] RIN 1651-AA80 Permissible Sharing of Client Records by Customs Brokers AGENCIES... the Code of Federal Regulations (CFR) pertaining to the obligations of customs brokers to keep clients' information confidential. The proposed amendment would allow brokers, upon the client's consent in a written...

  7. Difficult Clients: Who Are They and How Do We Help Them? (United States)

    Seligman, Linda; Gaaserud, Lynn


    Reviewed literature on dealing with resistant clients and, based on review, developed survey to elicit counselors' reactions to and experiences with resistant clients. Responses from 215 American Mental Health Counselors Association members suggest that nearly all counselors have encountered resistant clients, but counselors' reactions to and…

  8. A Client-Centered Review of Rogers with Gloria (United States)

    Moon, Kathryn A.


    Carl Rogers's nondirective theory and his response style with Gloria (E. L. Shostrom, 1965) are discussed in reply to S. A. Wickman and C. Campbell's (2003) "An Analysis of How Carl Rogers Enacted Client-Centered Conversation With Gloria." Client-centered studies of C. Rogers's transcripts give context for reformulating S. A. Wickman and C.…

  9. Propuesta metodológica para la gestión del cliente

    Directory of Open Access Journals (Sweden)

    Luis Ignacio López Villegas


    Full Text Available La investigación tuvo como objetivo diseñar una propuesta metodológica para la fidelización del cliente bancario. Situando al cliente como la razón de ser de su negocio, aportando a dicha entidad bancaria una visión más amplia del valor de sus clientes y un punto de partida para el diseño de acciones o estrategias realmente efectivas a la hora de gestionar en torno a éstos. La metodología se aplicó considerando clientes externos; mediante técnicas estadísticas aleatorias se les aplicó un instrumento —encuesta— validada previamente mediante prueba piloto, y a los clientes internos —funcionarios del banco— se les aplicó una entrevista, dando como resultado una propuesta metodológica de intervención hacia el cumplimiento del objetivo: incrementar la rentabilidad mediante la fidelización de clientes.

  10. assessment of clients' satisfaction with health service deliveries at ...

    African Journals Online (AJOL)


    Hence, the objective of this study was to assess the perceived levels of clients' ... doctor. Furthermore, satisfaction with the health care was found to have a significant association with the age ... those client values and expectations, which are.

  11. Individual- and contextual-level factors associated with client-initiated HIV testing

    Directory of Open Access Journals (Sweden)

    Claudia Renata dos Santos Barros

    Full Text Available ABSTRACT: Background: Knowing the reasons for seeking HIV testing is central for HIV prevention. Despite the availability of free HIV counseling and testing in Brazil, coverage remains lacking. Methods: Survey of 4,760 respondents from urban areas was analyzed. Individual-level variables included sociodemographic characteristics; sexual and reproductive health; HIV/AIDS treatment knowledge and beliefs; being personally acquainted with a person with HIV/AIDS; and holding discriminatory ideas about people living with HIV. Contextual-level variables included the Human Development Index (HDI of the municipality; prevalence of HIV/AIDS; and availability of local HIV counseling and testing (CT services. The dependent variable was client-initiated testing. Multilevel Poisson regression models with random intercepts were used to assess associated factors. Results: Common individual-level variables among men and women included being personally acquainted with a person with HIV/AIDS and age; whereas discordant variables included those related to sexual and reproductive health and experiencing sexual violence. Among contextual-level factors, availability of CT services was variable associated with client-initiated testing among women only. The contextual-level variable “HDI of the municipality” was associated with client-initiated testing among women. Conclusion: Thus, marked gender differences in HIV testing were found, with a lack of HIV testing among married women and heterosexual men, groups that do not spontaneously seek testing.

  12. Clients' experiences of a community based lifestyle modification program: a qualitative study. (United States)

    Chan, Ruth S M; Lok, Kris Y W; Sea, Mandy M M; Woo, Jean


    There is little information about how clients attending lifestyle modification programs view the outcomes. This qualitative study examined the clients' experience of a community based lifestyle modification program in Hong Kong. Semi-structured interviews were conducted with 25 clients attending the program. Clients perceived the program had positive impacts on their health and nutrition knowledge. They experienced frustration, negative emotion, lack of motivation, and pressure from others during the program. Working environment and lack of healthy food choices in restaurants were the major perceived environmental barriers for lifestyle modification. Clients valued nutritionists' capability of providing professional information and psychological support in the program. Our results suggest that nutritionist's capability of providing quality consultations and patient-centered care are important for empowering clients achieve lifestyle modification.

  13. A Pilot Evaluation of a Tutorial to Teach Clients and Clinicians About Gambling Game Design. (United States)

    Turner, Nigel E; Robinson, Janine; Harrigan, Kevin; Ferentzy, Peter; Jindani, Farah


    This paper describes the pilot evaluation of an Internet-based intervention, designed to teach counselors and problem gamblers about how electronic gambling machines (EGMs) work. This study evaluated the tutorial using assessment tools, such as rating scales and test of knowledge about EGMs and random chance. The study results are based on a number of samples, including problem gambling counselors ( n  = 25) and problem gamblers ( n  = 26). The interactive tutorial was positively rated by both clients and counselors. In addition, we found a significant improvement in scores on a content test about EGM games for both clients and counselors. An analysis of the specific items suggests that the effects of the tutorial were mainly on those items that were most directly related to the content of the tutorial and did not always generalize to other items. This tutorial is available for use with clients and for education counselors. The data also suggest that the tutorial is equally effective in group settings and in individual settings. These results are promising and illustrate that the tool can be used to teach counselors and clients about game design. Furthermore, research is needed to evaluate its impact on gambling behavior.

  14. Assessment of genetic diversity within the Merodon ruficornis species group (Diptera: Syrphidae by RAPD analysis

    Directory of Open Access Journals (Sweden)

    Andrić Andrijana


    Full Text Available As one of the most distinct groups in the hoverfly genus Merodon, the monophyletic ruficornis species group has been the focus of several studies using different approaches. Molecular methods have shown incongruences between morphological and molecular data. In the present study, we investigated four species of the Merodon ruficornis group (i.e. M. loewi, M. armipes, M. papillus and M. hoplitis with the aim of detecting intra- and interspecific genetic diversity, and we examined the usefulness of random amplified polymorphic DNA (RAPD in an integrative taxonomic approach to species delimitation. Analysis of Nei’s genetic variation over all loci showed that genetic diversity for the analyzed Merodon species was h=0.24. Based on UPGMA, PCoA and Bayesian clustering analyses, our results clearly differentiated four groups that correspond to the four morphologically-defined Merodon species. Among the analyzed species, M. armipes and M. hoplitis showed the lowest level of genetic divergence; M. loewi was clearly separated from both M. armipes and M. papillus. Based on our data, we propose the use of RAPD-PCR as an additional tool for resolving taxonomic problems within Merodon. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.173002

  15. Physical Attractiveness: Interactive Effects of Counselor and Client on Counseling Processes. (United States)

    Vargas, Alice M.; Borkowski, John G.


    Assessed how the physical attractiveness of counselors and clients interacted to build rapport in two experiments involving college students (N=128 and N=64). Results showed the counselor's physical attractiveness had a major impact on her perceived effectiveness and the client's expectation of success irrespective of the client's attractiveness…

  16. Clients' perception of service quality of care in health facilities in ...

    African Journals Online (AJOL)

    Introduction: Clients perception of service quality is important for utilization of health services. Clients with positive perception are more likely to comply with treatment and to continue to use health care services. Assessing clients' perception of services offered is crucial for improving delivery and organization of the services.

  17. 17 CFR 275.206(4)-3 - Cash payments for client solicitations. (United States)


    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Cash payments for client... for client solicitations. (a) It shall be unlawful for any investment adviser required to be... client at the time of the solicitation or referral; or (iii) Other than a solicitor specified in...

  18. Performance of the logistics service to the client. StudyCase No farming Cooperative Atelier "La Moda"

    Directory of Open Access Journals (Sweden)

    Liana Padrón Carmona


    Full Text Available Services have become a highly dominant economic force where the main value of logistics has been to meet the client's requirements, at the same time, which maintains its efficiency in costs. Any strategy of service to be successful must have an adequate design of the logistic system, which is the one that guarantees the materialization of the acquisition of the product or service by the client, in the place and at the moment that needs it. When having to adapt to a highly changing economic environment, the non-state sector also competes to endorse the feasibility of its implementation based on the socioeconomic development of the nation, which is why this work is intended to show the main results in the no farming Cooperative Atelier "La Moda" from the application of a group of actions that contribute to improve the performance of the logistics service to the client.

  19. Home care clients in the last year of life: is material deprivation associated with service characteristics? (United States)

    Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve


    To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

  20. Speaking for the Client

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna; Silverman, D.

    . Nonetheless staff often assume that their clients were at the centre of the encounter, even when there is little indication that they understand the Danish language spoken. In order to analyze and explain dilemmas like these, we draw on symbolic interactionism and conversation analysis, placing linguistic...

  1. Subjective Experiences of Clients in a Voluntary Money Management Program. (United States)

    Serowik, Kristin L; Bellamy, Chyrell D; Rowe, Michael; Rosen, Marc I


    A large proportion of people diagnosed with mental illnesses have difficulty managing their money, and therefore many psychiatric treatments involve providing money management assistance. However, little is known about the subjective experience of having a money manager, and extant literature is restricted to people forced to work with a representative payee or conservator. In this study, fifteen people were interviewed about their experience receiving a voluntary money management intervention designed to minimize substance use. Clients emphasized the importance of trusting the money manager, financial mindfulness (an enhanced awareness of the financial transactions in clients' day-to-day lives), agency over their own affairs, and addiction. In contrast to evaluations of people assigned representative payees and/or conservators, there was little mention of feeling coerced. These findings suggest that money management programs can address client concerns by building trust, relating budgeting to clients' day-to-day lives, and encouraging clients' control over their own affairs.

  2. Patient-Therapist Value Congruence and Ratings of Client Improvement (United States)

    Martini, Janie L.


    It can be concluded from the results of the two studies described here that value similarity between client and therapist is related to therapists' ratings of client improvement. This phenomenon can be expected in therapies irrespective of theoretical orientation. (Author)

  3. Procedimentos estéticos: percepção do cliente quanto ao esclarecimento para a tomada de decisão Procedimientos estéticos: percepción del cliente en cuanto a la explicacion para la toma de decisión A esthetic procedures: client's perception regarding the information given for the decision making process

    Directory of Open Access Journals (Sweden)

    Ana Maria Auricchio


    escalas referentes a la percepción de los clientes, se concluye, en general, que se percibieron informados y libres para la toma de decisión.This research verified client's perception regarding the infor-mation given and freedom of choice for the decision making process related to aesthetic procedures. It was carried out with a sample of 44 clients of the clinic where the study was conducted. Data collection was based on 28 propositions classified in three categories: Information, Competence and Freedom, and two scales to measure client's perception concerning the elucidation of the information provided and freedom of choice. Most clients were married women, with a University degree, professional background classified in levels III, IV and V, monthly income above 30 minimum wages, and in the age group from 41 to 50 years old. There was a predominance of clinical treatment compared to surgical ones, and superiority on the average score given to Competence compared to Information provided and Freedom. Based on the scales concerning client's perception, we concluded that in general clients felt they were fully informed and were free to choose the procedures that suited them best.

  4. Seeking what matters: determinants of clients' satisfaction in obstetric care services in Pakistan. (United States)

    Ali, Moazzam; Qazi, Muhammad Suleman; Seuc, Armando


    Aim of this study was to determine the dimensions of the service quality in the public hospitals and evaluate the determinants of client satisfaction in obstetric health in the context of Pakistan. The present research evaluates the application of an integrated client satisfaction model that draws mainly from the original SERVQUAL framework in obstetric health services. We conducted a cross-sectional study, in four public district hospitals in Pakistan, enrolling 1101 clients attending obstetric health care services. Measures of service quality and determinants of client satisfaction were factor-analysed and multiple regression analysis was used to test the hypothesis. The client satisfaction increased significantly with increases in respondent's age, number of children, number of visits and with decrease in educational status. Factor analysis revealed five service quality dimensions; and multiple regression analysis showed that all five dimensions of service quality in obstetric care were significant in explaining client satisfaction. The most powerful predictor for client satisfaction was provider communication with clients, followed by responsiveness and discipline. Interventions aimed at improving client provider interaction would not only advance the clinical provision of services, butwould also result in greater patient satisfaction with the services provided, leading to higher levels of facility utilization and continuity of care. Better client provider interaction can be accomplished at hospital's level through focused training of all cadre of service providers sensitizing them on clients' needs. Results also showed that the proposed framework is a valid and flexible instrument in assessing and monitoring service quality and enabling staff to identify where improvements are needed, from the clients' perspective.

  5. What client?

    DEFF Research Database (Denmark)

    Unterrainer, Walter


    rising pressure for new approaches towards space, urbanization, environmental challenges, technological inventions, transformation of cities and buildings on one hand and the decline in impact, reputation, self-esteem and economy of ´conventional´architectural profession on the other hand. In Asia like...... engage architects, no matter how urgent the problems are. It is the architects who must reverse their understanding of ´clients´, for the sake of these challenges as well as for their own professional future. This started happen very much in contrast to predominant architectural education models: Young...

  6. Client Centeredness and Health Reform: Key Issues for Occupational Therapy (United States)

    Pitonyak, Jennifer S.; Fogelberg, Donald; Leland, Natalie E.


    Health reform promotes the delivery of patient-centered care. Occupational therapy’s rich history of client-centered theory and practice provides an opportunity for the profession to participate in the evolving discussion about how best to provide care that is truly patient centered. However, the growing emphasis on patient-centered care also poses challenges to occupational therapy’s perspectives on client-centered care. We compare the conceptualizations of client-centered and patient-centered care and describe the current state of measurement of client-centered and patient-centered care. We then discuss implications for occupational therapy’s research agenda, practice, and education within the context of patient-centered care, and propose next steps for the profession. PMID:26356651

  7. Diastereoisomeric diversity dictates reactivity of epoxy groups in limonene dioxide polymerization

    Directory of Open Access Journals (Sweden)

    M. Soto


    Full Text Available Limonene dioxide (LDO has the potential to find a wide application as a bio-based epoxy resin. Its polymerizations by catalyzed ring-opening, and by polyaddition with diamines were compared with the polymerizations of the commercial epoxy resins bisphenol-A diglycidyl ether (BADGE, and 3,4-epoxycyclohexylmethyl-3′,4′-epoxycyclohexane carboxylate (ECC. Differential scanning calorimetry (DSC studies showed that LDO polymerizations suffer in all cases studied from incomplete conversions. Nuclear magnetic resonance (NMR studies revealed that in cis-isomers of LDO the internal epoxide rings were not reacting. The low reactivity of this epoxide group was explained by mechanistic considerations making use of the Fürst-Plattner rule, or trans-diaxial effect. Due to diastereomeric diversity approximately one-fourth of epoxide groups present in LDO could not react. Therefore, a diastereoselective epoxidation of limonene could provide a fully reactive bio-based epoxy resin.

  8. El servicio al cliente: una necesidad imperante en la calidad de la industria. // The client service: a prevailing necessity in the quality of the industry.

    Directory of Open Access Journals (Sweden)

    E. Martínez Delgado


    Full Text Available A través de todos los sectores industriales la investigación por la excelencia en el servicio se ha convertido en unapreocupación creciente y los gerentes han reconocido que la ventaja sustancial competitiva puede ganarse a través de unservicio superior al cliente, e igualmente importante, el servicio al cliente se convierte en un medio poderoso de diferenciarlas compañías desde la competencia. La calidad equivale entonces no sólo al producto en sí mismo, sino combinado éstecon lo que le rodea; de hecho, en las normas ISO 9000: 2000 se define al producto como el resultado de un proceso,siendo los servicios una de las cuatro categorías genéricas de éste. Cada vez más se demanda la garantía de la capacidad deproducir establemente una calidad superior y de innovación del producto acorde con los deseos de los clientes; pasándosede la certificación del producto a la certificación de toda la cadena logística, debiendo brindarse servicios de alto valoragregado a los clientes en forma diferenciada. Así, en el mercado globalizado donde sólo es posible ubicar productos dealta calidad para satisfacer a los clientes y al mercado, lo primero que debe hacer el gerente de servicios es comprender lascalidades demandadas por los clientes, así como la información relacionada con la importancia relativa de lascaracterísticas de calidad.El presente trabajo expone los resultados favorables obtenidos en el sistema de producción-distribución a través de unmodelo conformado para la evaluación integral del desempeño de la organización. Éste considera al cliente, con suscriterios y preferencias, como un elemento clave en la planeación de la producción y en la proyección de las capacidadesproductivas, incorporándolo con su oferta de valor.Palabras claves: Calidad industrial, producción-distribución, ISO 9000, cliente._______________________________________________________________________________Abstract.The investigation for the

  9. On the Use of Client-Driven Projects in the Mathematics Classroom (United States)

    Maki, Dan; Winston, Wayne; Shafii-Mousavi, Morteza; Kochanowski, Paul; Lang, Chris; Ernstberger, Kathy; Hodgson, Ted


    In this article, we discuss the use of client-driven projects--projects that are posed by business, government, and non-profit organizations and based upon real problems facing the organization. Although client-driven projects have long been used in business and engineering education, their use in the mathematics classroom is rare. Client-driven…

  10. Client Mobile Software Design Principles for Mobile Learning Systems

    Directory of Open Access Journals (Sweden)

    Qing Tan


    Full Text Available In a client-server mobile learning system, client mobile software must run on the mobile phone to acquire, package, and send student’s interaction data via the mobile communications network to the connected mobile application server. The server will receive and process the client data in order to offer appropriate content and learning activities. To develop the mobile learning systems there are a number of very important issues that must be addressed. Mobile phones have scarce computing resources. They consist of heterogeneous devices and use various mobile operating systems, they have limitations with their user/device interaction capabilities, high data communications cost, and must provide for device mobility and portability. In this paper we propose five principles for designing Client mobile learning software. A location-based adaptive mobile learning system is presented as a proof of concept to demonstrate the applicability of these design principles.

  11. Encouraging smoking cessation among disadvantaged groups: a qualitative study of the financial aspects of cessation. (United States)

    Bonevski, Billie; Bryant, Jamie; Paul, Christine


    This study aimed to explore perceptions about financial aspects of smoking cessation among a group of disadvantaged welfare agency clients and their carers. Qualitative focus groups and in-depth interviews were supplemented with participant exit surveys about preferred smoking cessation strategies. Each discussion was audiotaped, transcribed and analysed using a thematic analysis. The setting was six non-government community welfare service organisations operating in New South Wales, Australia. Eleven social services offered by these organisations participated. Thirty two clients participated in six client focus groups, 35 staff participated in six staff focus groups and eight manager telephone interviews were conducted. Clients indicated that the cost of nicotine replacement therapy was a barrier to its use and that financial incentives were acceptable. Of the 16 possible strategies listed in the exit survey, the three selected as the most preferred by clients incorporated financial or non-financial assistance. By contrast, staff and managers selected financial and non-financial incentives as the least preferred and least feasible strategies. The study found high acceptance of incentives as a smoking cessation strategy among a disadvantaged group of non-government welfare service clients. The comparatively low level of desirability and feasibility from the perspective of service staff and managers suggests implementation of such an approach within the community service setting requires careful further testing. © 2010 Australasian Professional Society on Alcohol and other Drugs.

  12. Tattoo removal by Q-switched yttrium aluminium garnet laser: client satisfaction. (United States)

    Hutton Carlsen, K; Esmann, J; Serup, J


    Tattoo removal by Q-switched yttrium aluminium garnet (YAG) lasers is golden standard; however, clients' satisfaction with treatment is little known. To determine clients' satisfaction with tattoo removal. One hundred and fifty-four tattoo removal clients who had attended the private clinic 'Centre for Laser Surgery', Hellerup, Denmark, from 2001 to 2013 completed a questionnaire concerning outcome expectations, level of pain experiences and satisfaction with tattoo removal. The laser surgeon and his team were blinded from data handling. The study design included a minimum 2-year postlaser treatment observation period from 2013 to 2015. Overall, clients were satisfied with their laser treatment; 85% assessed their treatment and results to be acceptable to superb, while 15% assessed their treatment and results to be inferior to unacceptable. Effectiveness relative to colour of tattoo on a scale from 0 (no effect) to 10 (complete removal) scored a mean of blue 9.5, black 9.4, yellow 8.9, red 8.8 and green 6.5. Clients were dissatisfied with green pigment remnants, which could mimic bruising. One hundred and twenty-nine clients (84%) experienced moderate to extreme pain during treatment. Twenty-eight (20%) developed minor scarring. There were many reasons for tattoo removal; e.g. stigmatisation (33%), conspicuousness (29%) and poor artistic quality (22%). One hundred and two clients had expected complete removal of tattoos without a blemish, expectations that were only partly fulfilled. During the treatment period, clients adjusted expectations and adapted more realistic views of outcomes. The majority of clients were satisfied with Q-switched YAG laser removal of tattoos despite high pretreatment expectations which were only partly met. The study supports YAG lasers for tattoo removal as acceptable therapy of today, with room for new approaches. © 2017 European Academy of Dermatology and Venereology.

  13. Supporting transvisibility and gender diversity in nursing practice and education: embracing cultural safety. (United States)

    Kellett, Peter; Fitton, Chantelle


    Many nursing education programs deserve a failing grade with respect to supporting gender diversity in their interactions with their students and in terms of the curricular content directed toward engaging in the safe and supportive nursing care of transgender clients. This situation contributes to transinvisibility in the nursing profession and lays a foundation for nursing practice that does not recognize the role that gender identity plays in the health and well-being of trans-clients and trans-nurses. This article seeks to raise readers' awareness about the problems inherent to transinvisibility and to propose several curricular and structural-level interventions that may serve to gradually increase the recognition of gender diversity in the planning and delivery of nursing education and practice. Contextualized in gender and intersectionality theory, cultural safety is presented as a viable and appropriate framework for engaging in these upstream approaches to addressing gender diversity in nursing education and practice. Among the structural interventions proposed are as follows: inclusive information systems, creation of gender neutral and safe spaces, lobbying for inclusion of competencies that address care of trans-persons in accreditation standards and licensure examinations and engaging in nursing research in this area. © 2016 John Wiley & Sons Ltd.

  14. Workplace Responses and Psychologists' Needs Following Client Suicide. (United States)

    Finlayson, Melissa; Simmonds, Janette


    This research aimed to explore the role of workplace responses in psychologists' adaptation to client suicides. Participants were 178 psychologists who completed an online self-report questionnaire which included both open and closed questions yielding qualitative and quantitative data. Fifty-six (31.5%) participants reported one or more client suicides. Mixed results were found in terms of perceived support from the workplace following a client suicide. Psychologists reported a need for more open communication in the workplace, peer supports, space to grieve, as well as opportunities to engage in a learning process. The findings have important implications for research and for understanding the role of the workplace postvention. It also raises the need for external support to be accessible for psychologists working in private practice.

  15. Addressing clients' racism and racial prejudice in individual psychotherapy: Therapeutic considerations. (United States)

    Bartoli, Eleonora; Pyati, Aarti


    Psychotherapists lack clear guidelines regarding how to address clients' racist and prejudicial comments in clinical work. The authors explore the contributions of multicultural, social justice, feminist, and ethical theories to the field of psychotherapy and apply these theories to 2 clinical vignettes in which clients made racially charged statements. These clinical examples highlight the importance of using racial, in addition to traditional, theories to decipher the clinical meanings of racial comments and dynamics in clinical work. The article provides therapeutic conceptualizations regarding how to address clients' racist and prejudicial comments in psychotherapy and elaborates on the complex meanings that might arise from engaging in racially charged discussions with clients depending on the racial composition of the therapeutic dyad. In addition to highlighting how social justice, multicultural, and feminist lenses are necessary to fully understand the meaning of clients' comments, the argument is made that addressing clients' racist and prejudicial comments is at once a clinical and a social justice issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  16. Performance of Distributed Query Optimization in Client/Server Systems

    NARCIS (Netherlands)

    Skowronek, J.; Blanken, Henk; Wilschut, A.N.

    The design, implementation and performance of an optimizer for a nested query language is considered. The optimizer operates in a client/server environment, in particular an Intranet setting. The paper deals with the scalability challenge by tackling the load of many clients by allocating optimizer

  17. Innovaciones tecnológicas en la atención al cliente: Ushuaïa Ibiza Beach Hotel y Hard Rock Hotel Ibiza


    Ramón Cardona, José; Jiménez Caballero, José Luis (Coordinador)


    Palladium Hotel Group es la octava cadena hotelera de España y ha centrado sus objetivos en generar valor añadido para los clientes, siendo la experiencia emocional la línea central de su producto. El Ushuaïa Ibiza Beach Hotel y el Hard Rock Hotel Ibiza han sido el campo de pruebas de varias innovaciones tecnológicas para la atención al cliente: integración de las redes sociales en la experiencia del cliente (Social Presence); implantación de tecnología biométrica; uso de ...

  18. Retención de clientes en agencias de eventos

    Directory of Open Access Journals (Sweden)

    Claudia Gómez-Ramírez


    Full Text Available Como componente de la mezcla de comunicación efectiva para las marcas se encuentran los "Eventos", que hoy en día exigen una gestión estratégica. Resulta clave, para las organizaciones especializadas en la prestación de este servicio, aplicar herramientas que les permitan ser competitivas a largo plazo gracias a la diferenciación. Para ello, el CESA ha estudiado la relación cliente-agencia de comunicación de marketing, fundamentalmente respecto a la importancia de la retención de clientes en relaciones B2B, como las que se llevan a cabo entre agencias de eventos y sus clientes. En el presente artículo se exponen los principales hallazgos de una investigación de tipo exploratorio acerca del tema de retención de clientes, que incluye perfiles, elementos claves para la satisfacción y factores relevantes de la relación clienteagencia de eventos como elementos fundamentales de la gestión empresarial. Al tener un mayor conocimiento del perfil de los clientes, las agencias podrán ser más productivas y competitivas, pues estarán en capacidad de ofrecer iniciativas de servicios con características particulares.

  19. 34 CFR 377.31 - What information must a grantee provide to eligible clients? (United States)


    ... clients? 377.31 Section 377.31 Education Regulations of the Offices of the Department of Education... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM What Post-Award Conditions Must Be Met by a Grantee? § 377.31 What information must a grantee provide to eligible clients? Each grantee shall advise all clients and...

  20. Report on Provider-Client Interaction From 68 Methadone Maintenance Clinics in China. (United States)

    Li, Li; Comulada, W Scott; Lin, Chunqing; Lan, Chiao-Wen; Cao, Xiaobin; Wu, Zunyou


    Provider-client interaction is an integral of clinical practice and central to the delivery of high-quality medical care. This article examines factors related to the provider-client interaction in the context of methadone maintenance treatment (MMT). Data were collected from 68 MMT clinics in China. In total, 418 service providers participated in the survey. Linear mixed effects regression models were performed to identify factors associated with provider-client interaction. It was observed that negative attitude toward drug users was associated with lower level of provider-client interaction and less time spent with each client. Other factors associated with lower level of interaction included being female, being younger, being a nurse, and fewer years in medical field. Higher provider-client interaction was associated with provider reported job satisfaction. The findings of this study call for a need to address provider negative attitudes that can impact provider-client interaction and the effectiveness of MMT. Future intervention efforts targeting MMT providers should be tailored by gender, provider type, and medical experiences.

  1. Interactional patterns between staff and clients with borderline to mild intellectual disabilities

    NARCIS (Netherlands)

    Reuzel, E.; Embregts, P.J.C.M.; Bosman, A.M.T.; van Nieuwenhuizen, A.; Jahoda, A.


    Background Client-centred models of care imply that clients should have a collaborative relationship with staff providing support. This study investigates whether dialogues between staff and clients in naturally occurring contexts reflect this collaborative ideal. Methods Nineteen staff members

  2. Speech Mannerisms: Games Clients Play (United States)

    Morgan, Lewis B.


    This article focuses on speech mannerisms often employed by clients in a helping relationship. Eight mannerisms are presented and discussed, as well as possible interpretations. Suggestions are given to help counselors respond to them. (Author)

  3. Diálise peritoneal: a percepção tátil do cliente na convivência com o cateter Diálisis peritoneal: la percepción táctil del cliente en la convivencia con el catéter Peritoneal dialysis: the tactile perception of clients that live with the catheter

    Directory of Open Access Journals (Sweden)

    Doris de Oliveira Araújo Cruz


    Full Text Available OBJETIVO: Este estudo objetivou investigar a percepção tátil do cliente na convivência com o cateter de diálise peritoneal indicadora de necessidades de cuidado. MÉTODOS: Estudo de abordagem qualitativa baseado nos princípios da sociopoética e no dispositivo do grupo pesquisador. Realizado no período de março a maio de 2006, empregou dinâmica de criação artística com sete clientes, em um hospital universitário. RESULTADOS: As análises apontaram para a adaptação, a negação, o cuidado, a indiferença, o mal-estar, que revelaram as categorias auto-estima e auto-imagem. CONCLUSÕES: O grupo como sujeito ativo da pesquisa evidenciou experiências através do diálogo. Emergiram através da criatividade os saberes inconscientes, desconhecidos e inesperados.OBJETIVO: En este estudio se tuvo como objetivo investigar la percepción táctil del cliente en la convivencia con el catéter de diálisis peritoneal indicador de necesidades de cuidado. MÉTODOS: Se trata de un estudio con abordaje cualitativo basado en los principios de la sociopoética y en el dispositivo del grupo investigador. Se llevó a cabo en el período de marzo a mayo del 2006, empleándose la dinámica de creación artística con siete clientes, en un hospital universitario. RESULTADOS: Los análisis señalaron la adaptación, la negación, el cuidado, la indiferencia, el malestar, reveladas en las categorías auto-estima y autoimagem. CONCLUSIONES: El grupo como sujeto activo de la investigación evidenció experiencias a través del diálogo. Emergieron por medio de la creatividad los saberes inconscientes, desconocidos e inesperados.OBJECTIVE: The purpose of this study was to investigate the clients' tactile perception toward living with a peritoneal dialysis catheter indicating their care needs. METHODS: This qualitative study was based on the principles of social poetics and according to the research group. It was carried out in the period from March to May

  4. Feminist Therapy: A Comparative Study of Therapists and Clients. (United States)

    Curtin, Catherine A.

    Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical…

  5. Highly task-related diversity vs. less task-related diversity among university staff

    DEFF Research Database (Denmark)

    Lauring, Jakob; Selmer, Jan


    from 489 university staff members showed that age diversity and cultural diversity, representing highly task-related diversity, were positively associated with most of the variables depicting group cohesiveness. On the other hand, gender diversity, illustrating less task-related diversity, seemed......As only very few large-scale studies have investigated multi-cultural university staff and as none of these studies have dealt with diversity and group processes, this survey was directed toward staffs in 16 science departments from three large universities in Denmark. Results based on the response...

  6. Approaches to culture and diversity: A critical synthesis of occupational therapy literature. (United States)

    Beagan, Brenda L


    The 2007 position statement on diversity for the Canadian occupational therapy profession argued discussion was needed to determine the implications of approaches to working with cultural differences and other forms of diversity. In 2014, a new position statement on diversity was published, emphasizing the importance of social power relations and power relations between client and therapist, and supporting two particular approaches: cultural safety and cultural humility with critical reflexivity This paper reviews and critically synthesizes the literature concerning culture and diversity published in occupational therapy between 2007 and 2014, tracing the major discourses and mapping the implications of four differing approaches: cultural competence, cultural relevance, cultural safety, and cultural humility. Approaches differ in where they situate the "problem," how they envision change, the end goal, and the application to a range of types of diversity. The latter two are preferred approaches for their attention to power relations and potential to encompass a range of types of social and cultural diversity. © CAOT 2015.

  7. Comparison of the perspectives of managers, employees and clients regarding the individual barriers of family planning counseling in healthcare centers of isfahan in 2012. (United States)

    Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaze; Farzi, Saba; Jaafarpour, Molouk; Direkvand-Moghaddam, Ashraf


    Family planning is a lifestyle that is selected voluntarily and is based on the knowledge, attitude and responsible decision making by couples in order to promote the health and welfare of the family and the advancement of the society. In this regard, family planning counseling plays an important role in making informed decisions if used properly and in a responsible way. Detection of individual barriers in family planning counseling based on the viewpoints of managers, employees and clients who are key participants in the healthcare service provision is a major step towards appropriate planning to modify or eliminate such barriers. The present study was conducted with the goal of comparing managers', employees' and clients' viewpoints about individual barriers in family planning counseling in health care centers in Isfahan in 2012. This was a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 employees and 126 clients in medical health care centers in Isfahan in 2012. The managers and employees were selected by census sampling, and the clients were recruited through convenient random sampling. The data collection tool was a researcher-designed questionnaire, which was designed in two sections of fertility and personal characteristics, and viewpoint measurement. Descriptive and inferential statistical tests were used to analyze the data. The obtained results showed significant differences between mean scores of viewpoints in three groups of managers, employees and clients concerning individual barriers in family planning counseling. In addition, most of the managers, employees and clients reported individual barriers as an intermediate level barrier in the process of family planning counseling. Results indicate that subjects in three studied groups hold different views regarding the individual barriers in family planning counseling. This difference in the perspectives may be a factor that affects

  8. Evaluation of the Technology Acceptance of a Collaborative Documentation System for Addiction Therapists and Clients. (United States)

    Perlich, Anja; Meinel, Christoph; Zeis, Daniel


    Addiction treatment outcomes are strongly determined by relational factors. We present the interactive documentation system Tele-Board MED (TBM) developed as an adjunct to therapy sessions aimed at enhancing the therapeutic alliance and patient empowerment. The objective of this work is to find factors that predict the acceptance of TBM in face-to-face addiction treatment sessions. We combined the methodologies of survey and focus group and based the data collection and analysis on the Unified Theory of Acceptance and Use of Technology. The studies, which involved therapists (n=13) and clients (n=33), were conducted in an addiction counselling center in Germany. Therapists see a flexible, context-dependent usage as a basic condition for TBM acceptance and its greatest benefit in providing a discussion framework and quick access to worksheets-in both individual and group sessions. Clients are inclined to use the system with the expectation of improved communication and better recall of the discussed topics based on a personal copy of the session notes.

  9. Alienation: A Concept for Understanding Low-Income, Urban Clients (United States)

    Holcomb-McCoy, Cheryl


    The author examines the concept of alienation and how it can be used to understand low-income, urban clients. A description is presented of 4 dimensions of alienation: powerlessness, meaninglessness, normlessness, and social isolation. Case illustrations are provided, and recommendations are made for counseling alienated clients. This article…

  10. Development and psychometric properties of the client's assessment of treatment scale for supported accommodation (CAT-SA). (United States)

    Sandhu, Sima; Killaspy, Helen; Krotofil, Joanna; McPherson, Peter; Harrison, Isobel; Dowling, Sarah; Arbuthnott, Maurice; Curtis, Sarah; King, Michael; Leavey, Gerard; Shepherd, Geoff; Priebe, Stefan


    Patient-Reported Outcome Measures (PROMs) are important for evaluating mental health services. Yet, no specific PROM exists for the large and diverse mental health supported accommodation sector. We aimed to produce and validate a PROM specifically for supported accommodation services, by adapting the Client's Assessment of Treatment Scale (CAT) and assessing its psychometric properties in a large sample. Focus groups with service users in the three main types of mental health supported accommodation services in the United Kingdom (residential care, supported housing and floating outreach) were conducted to adapt the contents of the original CAT items and assess the acceptability of the modified scale (CAT-SA). The CAT-SA was then administered in a survey to service users across England. Internal consistency was assessed using Cronbach's alpha. Convergent validity was tested through correlations with subjective quality of life and satisfaction with accommodation, as measured by the Manchester Short Assessment of Quality of Life (MANSA). All seven original items of the CAT were regarded as relevant to appraisals of mental health supported accommodation services, with only slight modifications to the wording required. In the survey, data were obtained from 618 clients. The internal consistency of the CAT-SA items was 0.89. Mean CAT-SA scores were correlated with the specific accommodation item on the MANSA (r s  = 0.37, p ˂ .001). The content of the CAT-SA has relevance to service users living in mental health supported accommodation. The findings from our large survey show that the CAT-SA is acceptable across different types of supported accommodation and suggest good psychometric properties. The CAT-SA appears a valid and easy to use PROM for service users in mental health supported accommodation services.

  11. A macro perspective for client-centred practice in curricula: Critique and teaching methods. (United States)

    Fleming-Castaldy, Rita P


    Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients' goal attainment. The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students' abilities to address the complexities of client-centred practice. This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography. Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students' competencies for empowered client-centred practice are required. Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.

  12. Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran. (United States)

    Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E


    We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

  13. Exploring the field of public construction clients by a graphical network analysis

    NARCIS (Netherlands)

    Eisma, P.R.; Volker, L.


    Because public construction clients form the majority of construction clients and procure over 40% of the construction output in most countries, they are important actors in the construction industry. Yet, the field of research on clients is still underdeveloped. In order to identify the research

  14. Client-Controlled Case Information: A General System Theory Perspective (United States)

    Fitch, Dale


    The author proposes a model for client control of case information via the World Wide Web built on principles of general system theory. It incorporates the client into the design, resulting in an information structure that differs from traditional human services information-sharing practices. Referencing general system theory, the concepts of…

  15. A Call for Feminist Research: A Limited Client Perspective (United States)

    Murray, Kirsten


    Feminist approaches embrace a counselor stance that is both collaborative and supportive, seeking client empowerment. On review of feminist family and couple counseling literature of the past 20 years using several academic databases, no research was found that explored a clients experience of feminist-informed family and couple counseling. The…

  16. Knowledge, Practices and Education of Clients on Cervical Cancer ...

    African Journals Online (AJOL)

    Background: Most patients with cancer of the cervix present late with poor prognosis. Health workers' knowledge and utilization of the screening services might influence their clients. The aim of this study was to determine the knowledge, practice and education of clients on cervical cancer and its screening among female ...

  17. Clients' experiences of HIV positive status disclosure to sexual ...

    African Journals Online (AJOL)

    The purpose of the study was to describe the experiences of HIV positive clients as they disclose their HIV positive status to their sexual partners. A qualitative descriptive and phenomenological design was used. Purposive sampling was used to select 15 HIV positive clients to participate in the study. Semi-structured ...

  18. Short Essay on Managing Multicultural Students Groups within Diversity Context

    Directory of Open Access Journals (Sweden)

    Cătălin Ploae


    Full Text Available The present essay focuses on summarizing the key elements that should be considered wheneducators are in a position to manage and interact with a group of students from different culturesor social environments. In this respect, we consider that the challenge educators’ face inconnecting with students of diverse backgrounds is to develop a critical consciousness of the waysin which these larger discourses operate in their classrooms and to care enough to question them,to challenge them and to advocate for their students. To care for students who come fromhistorically marginalized populations educators need to remember that schooling can serve eithera liberating or marginalizing function. They can empower students to identify structures in societythat have contributed to marginalizing their perspective and seek to maintain inequitable structuresin society or even narrow communities.

  19. Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

    Directory of Open Access Journals (Sweden)



    Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

  20. 77 FR 62185 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients (United States)


    ... 3235-AJ96 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... principal capacity in transactions with certain of their advisory clients. The amendment would extend the... Advisers Act when they act in a principal capacity in transactions with certain of their advisory clients...

  1. 75 FR 75650 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients (United States)


    ... 3235-AJ96 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... principal capacity in transactions with certain of their advisory clients. The amendment would extend the... Advisers Act when they act in a principal capacity in transactions with certain of their advisory clients...

  2. 42 CFR 483.450 - Condition of participation: Client behavior and facility practices. (United States)


    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Client behavior and... Retarded § 483.450 Condition of participation: Client behavior and facility practices. (a) Standard: Facility practices—Conduct toward clients. (1) The facility must develop and implement written policies and...

  3. Client Server design and implementation issues in the Accelerator Control System environment

    International Nuclear Information System (INIS)

    Sathe, S.; Hoff, L.; Clifford, T.


    In distributed system communication software design, the Client Server model has been widely used. This paper addresses the design and implementation issues of such a model, particularly when used in Accelerator Control Systems. in designing the Client Server model one needs to decide how the services will be defined for a server, what types of messages the server will respond to, which data formats will be used for the network transactions and how the server will be located by the client. Special consideration needs to be given to error handling both on the server and client side. Since the server usually is located on a machine other than the client, easy and informative server diagnostic capability is required. The higher level abstraction provided by the Client Server model simplifies the application writing, however fine control over network parameters is essential to improve the performance. Above mentioned design issues and implementation trade-offs are discussed in this paper

  4. A brain-computer interface controlled mail client. (United States)

    Yu, Tianyou; Li, Yuanqing; Long, Jinyi; Wang, Cong


    In this paper, we propose a brain-computer interface (BCI) based mail client. This system is controlled by hybrid features extracted from scalp-recorded electroencephalographic (EEG). We emulate the computer mouse by the motor imagery-based mu rhythm and the P300 potential. Furthermore, an adaptive P300 speller is included to provide text input function. With this BCI mail client, users can receive, read, write mails, as well as attach files in mail writing. The system has been tested on 3 subjects. Experimental results show that mail communication with this system is feasible.

  5. Request queues for interactive clients in a shared file system of a parallel computing system (United States)

    Bent, John M.; Faibish, Sorin


    Interactive requests are processed from users of log-in nodes. A metadata server node is provided for use in a file system shared by one or more interactive nodes and one or more batch nodes. The interactive nodes comprise interactive clients to execute interactive tasks and the batch nodes execute batch jobs for one or more batch clients. The metadata server node comprises a virtual machine monitor; an interactive client proxy to store metadata requests from the interactive clients in an interactive client queue; a batch client proxy to store metadata requests from the batch clients in a batch client queue; and a metadata server to store the metadata requests from the interactive client queue and the batch client queue in a metadata queue based on an allocation of resources by the virtual machine monitor. The metadata requests can be prioritized, for example, based on one or more of a predefined policy and predefined rules.

  6. Suicidal behavior among delinquent former child welfare clients. (United States)

    Björkenstam, C; Björkenstam, E; Ljung, R; Vinnerljung, B; Tuvblad, C


    Child welfare clients represent a high-risk group for delinquency and adult criminality, but also for future suicidal behavior. We examine associations between delinquency and suicidal behavior in a national child welfare population. This register-based cohort study is based on data for all Swedish former child welfare clients born between 1972 and 1981 that experienced interventions before their adolescent years. We followed 27,228 individuals from age 20 years until 31 December 2006. Juvenile delinquency was defined as being convicted of at least one crime between age 15 and 19. The risk of suicidal behavior was calculated as incidence rate ratios (IRRs). Fifteen percent of the women and 40% of the men had at least one conviction between the age 15 and 19. The adjusted risk of suicidal behavior among women with five or more convictions was 3.5 (95% CI 2.0-6.2); corresponding IRR for men was 3.9 (95% CI 3.1-4.9). Child welfare experience-specifically of out-of-home care-in combination with delinquency is a potent risk factor for suicidal behavior among young adults. However, we cannot exclude that some of this association is an epiphenomenon of uncontrolled confounders, such as impulsivity or severity of psychiatric disease. Despite this caveat, results should be disseminated to practitioners in the health and correction services.

  7. 77 FR 76854 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients (United States)


    ... 3235-AL28 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... transactions with certain of their advisory clients. The amendment extends the date on which rule 206(3)- 3T... releases used RIN 3235-AJ96. (See Temporary Rule Regarding Principal Trades with Certain Advisory Clients...

  8. Prevalence and Risk Factors of HIV Infection among Clients Attending ICTCs in Six Districts of Tamilnadu, South India

    Directory of Open Access Journals (Sweden)

    Rajeswari Ramachandran


    Full Text Available Objective. To assess the HIV serostatus of clients attending integrated counseling and testing centres (ICTCs in Tamilnadu, south India (excluding antenatal women and children, and to study its association with demographic, socioeconomic, and behavioral risk factors. Design. In a prospective observational study, we interviewed clients attending 170 ICTCs from six districts of Tamilnadu during 2007 utilizing a standard pretest assessment questionnaire. All the clients were tested for HIV with rapid test kits. Multiple logistic regression analysis was used to identify determinants of HIV infection. Results. Of 18329 clients counseled, 17958 (98% were tested for HIV and 732 (4.1%; range 2.6 to 6.2% were tested positive for HIV. Median age of clients was 30 years; 89% had never used condoms in their lives and 2% gave history of having received blood transfusion. In multivariate analysis HIV seropositivity was associated with HIV in the family (adjusted odds ratio (AOR 11.6, history of having sex with sex workers (AOR 2.9, age ≥31 years (AOR 2.8; being married (AOR 2.5, previously tested for HIV (AOR 1.9, illiteracy (AOR 1.7, unemployment (AOR 1.5, and alcoholism (AOR 1.5. Conclusion. HIV seroprevalence being high in ICTC clients (varied from 2.6 to 6.2%, this group should also be included in routine programme monitoring of sero-positivity and risk factors for better understanding of the impact of the National AIDS Control Programme. This would help in evolving appropriate policies and strategies to reduce the spread of HIV infection.

  9. Prevalence and risk factors of frailty among home care clients. (United States)

    Miettinen, Minna; Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma


    Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. NCT02214758 .

  10. Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening. (United States)

    Martin, Linda; Gitsels-van der Wal, Janneke T; Pereboom, Monique T R; Spelten, Evelien R; Hutton, Eileen K; van Dulmen, Sandra


    This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; pcommunication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  11. Genetic diversity within lichen photobionts of the Lecanora varia group (Lichenes, Ascomycota)

    DEFF Research Database (Denmark)

    Pérez-Ortega, S.; Søchting, Ulrik; Printzen, C.

    partner of the symbiosis. Meanwhile, knowledge about photobiont diversity and the degree of photobiont selectivity of the fungus have been lacking behind. The Lecanora varia group is a set of species within the genus Lecanora defined by the presence of an amphitecial cortex along with the presence...... of usnic acid as secondary metabolite. We have focused on a small group of three species, namely L. varia, L. burgaziae, and L. densa which share very similar anatomical and morphological characters and an identical chemistry, with psoromic and 2-O-demethylpsoromic acids in addition to usnic acid. We have...... collected populations of these three species from various localities within their distributional range: L varia (Spain, Austria, Sweden, Czech Republic, western Siberia); L. burgaziae (Spain) and L. densa (North America and Spain). Subsequently, we sequenced the internal transcribed spacer (ITS) region...

  12. The measurement of emotional reactions of bank clients

    Directory of Open Access Journals (Sweden)

    Marinković Veljko


    Full Text Available Focus on customers is an important factor in gaining sustainable competitive advantage of retail banks. Modern marketing-oriented banks have to be focused towards understanding and meeting the financial requirements of their clients. Attention of bank management should also be directed towards the study of quality of relationships between a bank and its clients. In this context, it is important to measure emotional reactions of clients. The aim of this paper is to identify the key drivers of emotional reactions. Specifically, two emotional reactions are observed in the paper: satisfaction and affective commitment. In the conducted study, two research models that include four independent variables (service quality, bank image, trust and social bonds are designed, wherein satisfaction is regarded as dependent variable in the first model, while affective commitment is given the role of dependent variable in the second model. The results indicate a moderate degree of satisfaction, but also a low level of affective commitment of the respondents. In addition, trust is stressed as the most important factor of emotional reactions. On the other hand, clients believe that banks provide a good quality service, where the quality stands out as an important driver of satisfaction, but not as a driver of affective commitment.

  13. 17 CFR 4.31 - Required delivery of Disclosure Document to prospective clients. (United States)


    ... Disclosure Document to prospective clients. 4.31 Section 4.31 Commodity and Securities Exchanges COMMODITY... Advisors § 4.31 Required delivery of Disclosure Document to prospective clients. (a) Each commodity trading... prospective client a Disclosure Document containing the information set forth in §§ 4.34 and 4.35 for the...


    Directory of Open Access Journals (Sweden)

    Gary D. Holt


    Full Text Available Due to the significant impact of client performance on overall project performance and the interdependence of participant%5C%27s performance in the construction project coalition %28i.e. clients%2C designers and constructors%29%2C there is a need to establish client performance measures. Based on data collected from in-depth interviews with nineteen UK architects and nine UK contractors%2C a generic tool for the on-going formal assessment of client performance is presented. It was found that this approach to performance assessment %28i.e. from the view point of other%2C non-client coalition participants%29 should lead to improved project relationships. Data analysis showed that in addition to %5C%27harder%5C%27 measures such as understanding of project requirements and finance%2C other%2C %5C%27softer%5C%27 measures of client performance %28e.g. attitude%29 were worthy of consideration since they determine the quality of participant relationships. It is recommended that the tool be used to promote more effective client performance and thus enhance coalition relationships%2C enabling continuous improvement. The ultimate aim is to develop similar tools for the assessment of all coalition participants based on a culture of openness and trust. Abstract in Bahasa Indonesia : assessment+tool%2C+coalition+participants%2C+client+performance%2C+perceptions%2C+performance+measures%2C+satisfaction.

  15. Análise de Clientes de uma Distribuidora de Medicamentos


    Sidney Lino Oliveira; Josmária Lima Ribeiro Oliveira


    Este artigo trata da análise de clientes por meio de uma pesquisa quantitativa para uma distribuidora farmacêutica. O interesse desta análise foi de identificar os principais clientes para estabelecer um relacionamento mais efetivo, e promo- ver a implantação de um sistema logístico que possibilite uma abordagem voltada para o cliente. O estudo de caso foi desenvolvido em uma distribuidora farmacêutica situada em Juiz de Fora/MG que atende à região da Zona da Mata/MG e o estado do Rio de Jane...

  16. Community ambulation: influences on therapists and clients reasoning and decision making. (United States)

    Corrigan, Rosemary; McBurney, Helen


    Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

  17. Improving Readability of an Evaluation Tool for Low-Income Clients Using Visual Information Processing Theories (United States)

    Townsend, Marilyn S.; Sylva, Kathryn; Martin, Anna; Metz, Diane; Wooten-Swanson, Patti


    Literacy is an issue for many low-income audiences. Using visual information processing theories, the goal was improving readability of a food behavior checklist and ultimately improving its ability to accurately capture existing changes in dietary behaviors. Using group interviews, low-income clients (n = 18) evaluated 4 visual styles. The text…

  18. Montessori-based training makes a difference for home health workers & their clients. (United States)

    Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J


    Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.

  19. Designing e-learning solutions with a client centred approach

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin


      This paper claims that the strategies applied in designing e-learning solutions tend to focus on how to proceed after the precondition, e.g., learners requirements, pedagogical choice, etc., have been decided upon. Investigating the HCI research field, we find that the methodological approaches...... as the organisation that has initiated the e-learning project and needs to manage the e-learning system after its development. Through the Client Centred Design and in close collaboration with the client, three strategic issues are uncovered and strategic models are presented for each. These models are complementary...... perspectives in a Client Centred framework that is useable as the starting point for others in developing large scale e-learning projects....

  20. Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women. (United States)

    Molewyk Doornbos, Mary; Zandee, Gail Landheer; DeGroot, Joleen


    The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care. © The Author(s) 2014.

  1. 34 CFR 377.1 - What is the Demonstration Projects to Increase Client Choice Program? (United States)


    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Demonstration Projects to Increase Client... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM General § 377.1 What is the Demonstration Projects to Increase Client Choice Program? The Demonstration Projects to Increase Client Choice Program is designed to...

  2. Diversity management


    Knákalová, Lucie


    The key topic of the work is diversity management, i.e. management of em-ployees" diversity within organization. Opening part of the work identifies the position of diversity within society and related phenomena such as stereotypes, biases and various forms of discrimination. Then the work discusses the role of diversity management in organizations, its principles and basic areas of focus. Attention is paid to certain social groups that the diversity management concept should especially deal ...

  3. Experiences of working from a freestanding position as a case manager when supporting clients in the Swedish welfare system. (United States)

    Klockmo, Carolina; Marnetoft, Sven-Uno


    The Swedish state uses a case management function known as Personligt Ombud (PO). The role as PO differs from the traditional professional roles. It has a freestanding position in the welfare system. The aim of this study was to investigate POs' experiences of working from a freestanding position when supporting clients. Telephone interviews were conducted with 22 POs across Sweden. The interviews were recorded, transcribed, and analyzed by latent qualitative content analysis. The findings were reflected in three categories - freedom-promoted flexibility, surfing through a complex welfare system, and working for legitimacy. POs developed a holistic view to both the client as well as to the welfare system. POs experienced solely representing the client, which is a positive feature because part of the POs' role is advocating for the clients rights. The PO service differs from the PO service from other existing case management models and may need to develop strategies for decision-making and support in their own role. For example, they may use group supervision teams or 'reflective teams'. The freestanding position may also entail problems in terms of lack of legitimacy. It is important for POs to develop good platforms with the surrounding actors among others things to improve the co-ordination process. It could be interesting if the PO model would be tested in other countries that have a fragmented welfare system. The PO model may also be useful to other 'target groups' who are in need of co-ordinated rehabilitation services.

  4. Letter Writing as a Tool To Increase Client Motivation To Change: Application to an Inpatient Crisis Unit. (United States)

    Tubman, Jonathan G.; Montgomery, Marilyn J.; Wagner, Eric F.


    Describes the application of a letter writing exercise as a motivational technique for group counseling in contemporary crisis unit settings. Discusses guidelines and implications for clinical practice with clients with multiple, chronic problems. (Contains 37 references and 1 table.) (GCP)

  5. Integrating Social and Traditional Media in the Client Project (United States)

    Melton, James; Hicks, Nancy


    Based on a client project assigned to students in two undergraduate business classes, this article argues that social media learning is best done in a context that mixes social media with more traditional kinds of media. Ideally, this approach will involve teams of students who are working on different aspects of a larger client project. This…

  6. Prostitución en Galicia: clientes e imaginarios femeninos Prostitution in Galicia: clients and feminine imaginary

    Directory of Open Access Journals (Sweden)

    Agueda Gómez Suárez


    Full Text Available Hoy, la prostitución en nuestra sociedad resulta un indicador de la "cultura sexual" dominante en las sociedades patriarcales y capitalistas. Este artículo pretende aportar otro enfoque al análisis de la industria sexual en nuestro país, ajustándose, principalmente, a las experiencias de los hombres implicados en el fenómeno de la prostitución en Galicia. El dramatismo con que las mujeres en prostitución viven su realidad y la frivolidad y ociosidad en la que se recrean los clientes, muestra el controvertido e inquietante semblante de esta realidad. El análisis del discurso de los clientes a través del "Frame Analysis", y el estudio de los imaginarios femeninos dominantes entre ellos son retratados en este texto, junto con el discurso de las mujeres en prostitución y el de los hombres que ocupan espacios masculinizados. Este artículo pretende ser una contribución más al complejo estudio del fenómeno de la prostitución en nuestro país.Today, the prostitution in our society turns out to be an indicator of the dominant "sexual culture" in the patriarchal and capitalist societies. This article tries to contribute with another approach to the analysis of the sexual industry in our country, adjusting, principally, to the experiences of the men involved in the phenomenon of the prostitution in Galicia. The dramatic quality in which the women in prostitution live their reality and the levity and idleness, in which the clients enjoy themselves, show the controversial and worrying face of this reality. The analysis of the clients' speech across the "Frame Analysis", and the study of the feminine dominant imaginary among them are portrayed in this text, together with the speech of the women in prostitution and of the men who occupy masculinized spaces. This article tries to be a contribution to the complex study of the phenomenon of the prostitution in our country.

  7. Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

    Directory of Open Access Journals (Sweden)

    Rachel E. Maddux


    Full Text Available The present study assessed the rate of depressive personality (DP, as measured by the self-report instrument depressive personality disorder inventory (DPDI, among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

  8. Working in clients' homes: the impact on the mental health and well-being of visiting home care workers. (United States)

    Denton, Margaret A; Zeytinoğlu, Işk Urla; Davies, Sharon


    The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.

  9. Telephone-administered cognitive-behavioral therapy for clients with depressive symptoms in an employee assistance program: a pilot study. (United States)

    Lam, Raymond W; Lutz, Kevin; Preece, Melady; Cayley, Paula M; Bowen Walker, Anne


    To assess the clinical and work productivity effects of a brief intervention using telephone-administered cognitive-behavioral therapy (CBT) for clients with depressive symptoms attending an employee assistance program (EAP). Self-referred clients attending the PPC Canada EAP with clinically relevant depressive symptoms at initial assessment were offered an 8-session telephone-administered CBT program. Outcomes before and after intervention were assessed with the 9-item Personal Health Questionnaire (PHQ-9), Global Assessment of Functioning (GAF), and clinician ratings of work absence and performance impairment. Fifty clients were referred to the pilot program; 39 participated and 31 completed the telephone CBT program. Among program participants, there was significant improvement in PHQ-9 and GAF scores. There was also a significant reduction in performance impairment but not work absence. Anecdotal reports indicated high satisfaction ratings among participants. The results of this pilot study, although limited by the absence of a comparison or control group, suggest that a brief telephone-administered CBT program can improve depressive symptomatology, work productivity, and general function in depressed clients attending an EAP. Further controlled studies are needed to confirm these preliminary findings.

  10. 45 CFR 1621.4 - Complaints by clients about manner or quality of legal assistance. (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Complaints by clients about manner or quality of...) LEGAL SERVICES CORPORATION CLIENT GRIEVANCE PROCEDURES § 1621.4 Complaints by clients about manner or... clients about the manner or quality of legal assistance that has been rendered by the recipient to the...

  11. Bringing the client back in

    DEFF Research Database (Denmark)

    Danneris, Sophie; Nielsen, Mathias Herup


    Categorizing the job readiness of unemployed clients is a task of the utmost importance for active labor market policies. Scholarly attention on the topic has mostly focused either on questions of political legitimacy or on how categories are practically negotiated in meetings between the welfare...

  12. Ulysses directives in The Netherlands: opinions of psychiatrists and clients

    NARCIS (Netherlands)

    Varekamp, I.


    In this article we present a study on the opinions of Dutch psychiatrists and clients on Ulysses directives. In-depth interviews were conducted with 18 clients and 17 psychiatrists. Most respondents were proponents of Ulysses directives. The most frequently mentioned objective of these directives

  13. Client participation in moral case deliberation: a precarious relational balance

    NARCIS (Netherlands)

    Weidema, F.C.; Abma, T.A.; Widdershoven, G.A.M.; Molewijk, A.C.


    Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client

  14. Toward Healthy Family Breathing: client survey

    National Research Council Canada - National Science Library

    Kaloti, Jiti; Naylor, P.J


    .... A secondary purpose was to measure clients behaviours and attitudes to add to the knowledge about how different types of perinatal workers can best assist pregnant and parenting women who smoke...

  15. Antecedent control in the treatment of brain-injured clients. (United States)

    Zencius, A H; Wesolowski, M D; Burke, W H; McQuade, P


    Three brain-injured clients failed to respond significantly to consequence management programmes designed to increase attendance, use of a cane, and to reduce unauthorized breaks. When antecedent stimulus control procedures were applied, attendance and use of a cane increased and unauthorized breaks decreased. The study shows that antecedent control may be the treatment of choice when treating brain-injured clients with memory loss.

  16. Transoceanic dispersal and subsequent diversification on separate continents shaped diversity of the Xanthoparmelia pulla group (Ascomycota.

    Directory of Open Access Journals (Sweden)

    Guillermo Amo de Paz

    Full Text Available In traditional morphology-based concepts many species of lichenized fungi have world-wide distributions. Molecular data have revolutionized the species delimitation in lichens and have demonstrated that we underestimated the diversity of these organisms. The aim of this study is to explore the phylogeography and the evolutionary patterns of the Xanthoparmelia pulla group, a widespread group of one of largest genera of macrolichens. We used a dated phylogeny based on nuITS and nuLSU rDNA sequences and performed an ancestral range reconstruction to understand the processes and explain their current distribution, dating the divergence of the major lineages in the group. An inferred age of radiation of parmelioid lichens and the age of a Parmelia fossil were used as the calibration points for the phylogeny. The results show that many species of the X. pulla group as currently delimited are polyphyletic and five major lineages correlate with their geographical distribution and the biosynthetic pathways of secondary metabolites. South Africa is the area where the X. pulla group radiated during the Miocene times, and currently is the region with the highest genetic, morphological and chemical diversity. From this center of radiation the different lineages migrated by long-distance dispersal to others areas, where secondary radiations developed. The ancestral range reconstruction also detected that a secondary lineage migrated from Australia to South America via long-distance dispersal and subsequent continental radiation.


    Directory of Open Access Journals (Sweden)

    afdal afdal


    Full Text Available The practice of counseling by counselor not only need the skills to understand what is expressed by the client, but were further able to understand and have skills in giving meaning to the nonverbal communication, demonstrated by the behavior of a counseling session. During this time many of counselors who focus only on what is revealed by the client and using verbal techniques alone without seeing what goes on inside the client more deeply to understand the communication indicated by nonverbal behavior. The techniques used in the discussion of this article provides the inspiration that counseling is an art, not superficial, not skeptical and just focus on one technique alone, but many of the techniques that can be used to explore client issues. Furthermore, this paper supports the philosophical theory of Gestalt who believe that the client can feel the direct presence in the counseling sessions through the practices of the techniques used, to interpret the expression of various communications made, stationing themselves and find their own meaning.

  18. BAG3 induces the sequestration of proteasomal clients into cytoplasmic puncta (United States)

    Minoia, Melania; Boncoraglio, Alessandra; Vinet, Jonathan; Morelli, Federica F; Brunsting, Jeanette F; Poletti, Angelo; Krom, Sabine; Reits, Eric; Kampinga, Harm H; Carra, Serena


    Eukaryotic cells use autophagy and the ubiquitin–proteasome system as their major protein degradation pathways. Upon proteasomal impairment, cells switch to autophagy to ensure proper clearance of clients (the proteasome-to-autophagy switch). The HSPA8 and HSPA1A cochaperone BAG3 has been suggested to be involved in this switch. However, at present it is still unknown whether and to what extent BAG3 can indeed reroute proteasomal clients to the autophagosomal pathway. Here, we show that BAG3 induces the sequestration of ubiquitinated clients into cytoplasmic puncta colabeled with canonical autophagy linkers and markers. Following proteasome inhibition, BAG3 upregulation significantly contributes to the compensatory activation of autophagy and to the degradation of the (poly)ubiquitinated proteins. BAG3 binding to the ubiquitinated clients occurs through the BAG domain, in competition with BAG1, another BAG family member, that normally directs ubiquitinated clients to the proteasome. Therefore, we propose that following proteasome impairment, increasing the BAG3/BAG1 ratio ensures the “BAG-instructed proteasomal to autophagosomal switch and sorting” (BIPASS). PMID:25046115

  19. Qualidade de vida de clientes em hemodiálise e necessidades de orientação de enfermagem para o autocuidado Calidad de vida de clientes en hemodiálisis y necesidades de orientación de enfermería para el autocuidado Quality of life of clients on hemodialisys and needs of nursing guidance for self-care

    Directory of Open Access Journals (Sweden)

    Iraci dos Santos


    se encuentran en el Sistema de Autocuidado con total compensación de la enfermera. Se sugiere el desarrollo de la orientación de enfermería para el autocuidado, en consulta de enfermería, para promoción de la calidad de vida de los clientes.This work relates the needs of nursing guidance with quality of life of patients with chronic kidney disease on hemodialysis, considering conceptions of the Self-care of Orem. Descriptive search, through the interview held with 43 clients of the University Hospital of Rio de Janeiro, from 2008 to 2009. The Clients has arterial hypertension, being 83.72% on this treatment for less than a year. Applying the Kidney Disease Quality of Life Short Form obtained the lowest scores in the dimensions: physical emotional, work conditions, functional capacity. These results were related to the ones obtained with the needs of a guidance of nursing for nutrition, fluid intake, hemodialysis complications, anticoagulation, physical and leisure activities with membership associated groups. It was concluded that these clients are in this Totally Compensatory System of Self- care. Then It is suggested the development of the nursing guidance for the self-care through nursing consult, in order to promote the quality of life of the clients.

  20. Global Population Structure of a Worldwide Pest and Virus Vector: Genetic Diversity and Population History of the Bemisia tabaci Sibling Species Group (United States)


    The whitefly Bemisia tabaci sibling species (sibsp.) group comprises morphologically indiscernible lineages of well-known exemplars referred to as biotypes. It is distributed throughout tropical and subtropical latitudes and includes the contemporary invasive haplotypes, termed B and Q. Several well-studied B. tabaci biotypes exhibit ecological and biological diversity, however, most members are poorly studied or completely uncharacterized. Genetic studies have revealed substantial diversity within the group based on a fragment of the mitochondrial cytochrome oxidase I (mtCOI) sequence (haplotypes), with other tested markers being less useful for deep phylogenetic comparisons. The view of global relationships within the B. tabaci sibsp. group is largely derived from this single marker, making assessment of gene flow and genetic structure difficult at the population level. Here, the population structure was explored for B. tabaci in a global context using nuclear data from variable microsatellite markers. Worldwide collections were examined representing most of the available diversity, including known monophagous, polyphagous, invasive, and indigenous haplotypes. Well-characterized biotypes and other related geographic lineages discovered represented highly differentiated genetic clusters with little or no evidence of gene flow. The invasive B and Q biotypes exhibited moderate to high levels of genetic diversity, suggesting that they stemmed from large founding populations that have maintained ancestral variation, despite homogenizing effects, possibly due to human-mediated among-population gene flow. Results of the microsatellite analyses are in general agreement with published mtCOI phylogenies; however, notable conflicts exist between the nuclear and mitochondrial relationships, highlighting the need for a multifaceted approach to delineate the evolutionary history of the group. This study supports the hypothesis that the extant B. tabaci sibsp. group contains

  1. An Exploration of Supervisory and Therapeutic Relationships and Client Outcomes (United States)

    Bell, Hope; Hagedorn, W. Bryce; Robinson, E. H. Mike


    The authors explored the connection between the facilitative conditions present within the supervisory relationship, the therapeutic relationship, and client outcomes. A correlational research design was used with a sample of 55 counselors-in-training and 88 clients. Results indicated a significant positive relationship between the therapeutic…

  2. Ulysses directives in The Netherlands: opinions of psychiatrists and clients. (United States)

    Varekamp, I


    In this article we present a study on the opinions of Dutch psychiatrists and clients on Ulysses directives. In-depth interviews were conducted with 18 clients and 17 psychiatrists. Most respondents were proponents of Ulysses directives. The most frequently mentioned objective of these directives was to secure timely admission to hospital, although a large minority was mainly interested in giving patients influence on treatment decisions. Psychiatrists differed on how much autonomy they preferred with regard to decisions about the moment of admission and kind of treatment. Clients also differed in this respect. Pressure from others to execute a Ulysses directive, and premature admission to the hospital were mentioned as risks of Ulysses directives. Crisis cards were seen as an alternative by many psychiatrists and some clients. Recommendations are made for a good functioning of Ulysses directives, and the appropriateness of crisis cards as an alternative for a number of patients is discussed.

  3. Challenging the Courtesy Bias Interpretation of Favorable Clients' Perceptions of Family Planning Delivery (United States)

    Len, Federico R.; Lundgren, Rebecka; Huapaya, Ana; Sinai, Irit; Jennings, Victoria


    Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three…

  4. Round-Trip Delay Estimation in OPC UA Server-Client Communication Channel


    Nakutis, Zilvinas; Deksnys, Vytautas; Jarusevicius, Ignas; Dambrauskas, Vilius; Cincikas, Gediminas; Kriauceliunas, Alenas


    In this paper an estimation of round-trip delay (RTD) in OPC UA server-client channel was investigated in various data communication networks including Ethernet, WiFi, and 3G. Testing was carried out using the developed IoT gateway device running OPC UA server and remote computer running OPC UA client. The server and the client machines were configured to operate in Virtual Private Network powered by OpenVPN. Experimental analysis revealed that RTD values are distributed in the wide range exh...

  5. Communicative principles among corporate clients and regional branches of commercial banks




    The aim of this article is to discuss the share of consumption taken by the corporate clients in the autonomous republic of Adjara. It is remarkable that the most of the share of banks’ total incomes are formed exactly on the base of accumulated resource accounts of corporate clients. So in order to attract corporate clients in the region, there is a great and strong competition among the banks. According to the above mentioned information, we are discussing several principles concerning to t...

  6. The nutritional status and energy and protein intakes of MOW clients and the need for further targeted strategies to enhance intakes. (United States)

    Walton, Karen; Charlton, Karen E; Manning, Fiona; McMahon, Anne T; Galea, Sarah; Evans, Kaitlyn


    There is a paucity of literature about the nutritional status and energy and protein intakes of Meals on Wheels (MOW) clients. The current study aimed to determine the nutritional status and the adequacy of energy and protein intakes of MOW clients. Forty-two clients were recruited from two MOW services in the Illawarra region of Australia for assessment of their nutritional status, using the Mini Nutritional Assessment (MNA(®)). Estimated energy and protein intakes for a MOW day were compared to a non-MOW day and average daily energy and protein intakes were assessed against estimated daily requirements. A single dietitian performed all assessments and home based interviews to explore the client's perception of the service. Mean daily energy intake (7593 (±2012) kJ) was not significantly different to estimated requirements (7720 (±975) kJ) (P = 0.480), while mean daily protein intake was higher (78.7 (±23.4) g) than calculated requirements (68.4 (±10.8) g; P = 0.009). However 16 clients were identified as at risk of malnutrition and 2 were malnourished; consuming 2072 kJ (P = 0.000) less energy and 20.4 g less protein (P = 0.004) per day compared to well-nourished clients. MOW clients are at risk of being poorly nourished and meals delivered by the service provide an important contribution to overall intakes. These findings support the need for regular nutrition screening and dietary monitoring in this high risk group, to identify those for whom additional strategies may be indicated. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Patterns of functional diversity of two trophic groups after canopy thinning in an abandoned coppice

    Czech Academy of Sciences Publication Activity Database

    Šipoš, Jan; Hédl, Radim; Hula, V.; Chudomelová, Markéta; Košulič, O.; Niedobová, J.; Riedl, Vladan


    Roč. 52, č. 1 (2017), s. 45-58 ISSN 1211-9520 R&D Projects: GA AV ČR IAA600050812; GA MŠk(CZ) EE2.3.20.0267 EU Projects: European Commission(XE) 278065 - LONGWOOD Institutional support: RVO:67985939 Keywords : coppice restoration * functional diversity * trophic groups Subject RIV: EH - Ecology, Behaviour OBOR OECD: Ecology Impact factor: 1.017, year: 2016

  8. How to reach clients of female sex workers: a survey by surprise in brothels in Dakar, Senegal. (United States)

    Espirito Santo, M. E. Gomes do; Etheredge, G. D.


    OBJECTIVE: To describe the sampling techniques and survey procedures used in identifying male clients who frequent brothels to buy sexual services from female sex workers in Dakar, Senegal, with the aim of measuring the prevalence of human immunodeficiency virus (HIV) infection and investigating related risk behaviours. METHODS: Surveys were conducted in seven brothels in Dakar, Senegal. Clients were identified "by surprise" and interviewed and requested to donate saliva for HIV testing. RESULTS: Of the 1450 clients of prostitutes who were solicited to enter the study, 1140 (79.8%) agreed to be interviewed; 1083 (95%) of these clients provided saliva samples for testing. Of the samples tested, 47 were positive for HIV-1 or HIV-2, giving an HIV prevalence of 4.4%. CONCLUSION: The procedures adopted were successful in reaching the target population. Men present in the brothels could not deny being there, and it proved possible to explain the purpose of the study and to gain their confidence. Collection of saliva samples was shown to be an excellent method for performing HIV testing in difficult field conditions where it is hard to gain access to the population under study. The surveying of prostitution sites is recommended as a means of identifying core groups for HIV infection with a view to targeting education programmes more effectively. In countries such as Senegal, where the prevalence of HIV infection is still low, interventions among commercial sex workers and their clients may substantially delay the onset of a larger epidemic in the general population. PMID:12378288

  9. Prevention of involuntary admission through Family Group Conferencing: a qualitative case study in community mental health nursing

    NARCIS (Netherlands)

    de Jong, G.; Schout, G.; Abma, T.


    To understand whether and how Family Group Conferencing might contribute to the social embedding of clients with mental illness. Background: Ensuring the social integration of psychiatric clients is a key aspect of community mental health nursing. Family Group Conferencing has potency to create

  10. Improving the efficiency of cognitive-behavioural therapy by using formal client feedback. (United States)

    Janse, Pauline D; De Jong, Kim; Van Dijk, Maarten K; Hutschemaekers, Giel J M; Verbraak, Marc J P M


    Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback. Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer. Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.

  11. Nonromantic/Nonsexual Relationships with Former Clients: Implications for Psychologists' Training. (United States)

    Anderson, Sharon K.

    The ethical principles and code of conduct of the American Psychological Association are clear: psychologists are to avoid sexual relationships with former clients. But guidelines offer scant guidance on nonromantic and nonsexual relationships with former clients; the ethical risks of such relationships are explored in this paper. The information…

  12. Patent Medicine VendorsAND#8217; Clients: Medicine Use Behaviour

    Directory of Open Access Journals (Sweden)

    Asa Auta


    Full Text Available AIM: To investigate some medicine use behaviour of Patent Medicine Vendors’ (PMVs clients including self medication practice and medication sharing behaviour. METHOD: A descriptive, cross-sectional survey was conducted in July 2011, on 361 undergraduate students of the University of Jos, Nigeria who visited PMVs within a month preceding the study. A pretested questionnaire was administered to participating students. Participants responded to questions on demography, and medicine use behaviour. Data were entered into the Statistical Package for Social Sciences (SPSS version 16 to generate descriptive statistics which were represented in percentages. RESULTS: The results showed that majority of the respondents (91.7% visited the PMVs for self-medication with the common classes of medicines procured by PMVs clients including analgesics (38.4%, antimalarials (22.2% and nutrition/blood preparations (14.1%. About 78.5% of the medicines sold to PMVs clients were in their original package and only 45.9% of clients reported checking the expiry date of their procured medicine prior to use. Medication sharing behaviour was common (60.2% among respondents. Although most respondents (70.2% said they had read a medicine information leaflet in the past, majority of them depended on unreliable sources such as friends/relatives (23.2%, media (10.8% and the internet (9.9% for medicine information. CONCLUSION: The study therefore demonstrated that PMV clients are those on self-medication practices and medication sharing behaviour is high among them. [TAF Prev Med Bull 2012; 11(6.000: 681-686

  13. Experiences in occupational therapy with Afghan clients in Australia. (United States)

    Maroney, Pamela; Potter, Marianne; Thacore, Vinod Rai


    With a steady increase of refugees arriving in Australia from Afghanistan coupled with reports that prevalence of mental illness amongst Afghan refugees in South-East Melbourne is particularly high, mental health providers will need to acquire cultural competence to provide effective treatment. There is a dearth of literature on the subject of rehabilitation of Afghan psychiatric clients in the Australian context, providing the impetus for this article. To illustrate the impact of Afghan socio-cultural beliefs and attitudes on the implementation of occupational therapy and rehabilitation programmes in a mental health facility and adaptations to accommodate the needs of the clients and their families. Two case vignettes of Afghan clients are presented to illustrate the variance in goals and expectations of the clients and their families to that of the occupational therapy and rehabilitation programmes offered. Family expectations and involvement, culture-specific factors and religion play significant roles in the presentation and treatment of clients from the Muslim culture and require modification in implementation of rehabilitation programmes. A need for developing family or community-based services is proposed coupled with culturally responsive practices. Culture sensitive models of occupational therapy will need to be developed as younger generations of refugee families acculturate and need psychological help to deal with conflicts with parents and elders who hold values different from those adopted by their children born and brought up in the Australian socio-cultural environment. These and other issues mentioned above provide fertile fields for research in this evolving area of occupational therapy. © 2014 Occupational Therapy Australia.

  14. The insecure psychotherapy base: Using client and therapist attachment styles to understand the early alliance. (United States)

    Marmarosh, Cheri L; Kivlighan, Dennis M; Bieri, Kathryn; LaFauci Schutt, Jean M; Barone, Carrie; Choi, Jaehwa


    The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  15. Effectiveness of Client-centered Play Therapy on Fear and Anxiety in Preschool Children

    Directory of Open Access Journals (Sweden)

    Hoda Sadat Mosavi


    Full Text Available Background and Objective: Preschool period is playing main role in development and adjustment of children. Fear and anxiety are of externalizing disorders, providing untreated it leads to negative effects on individual and social relationship specially in adulthood therefore, this research investigates the influence of client-centered play therapy on fear and anxiety among preschool children (5-6 aged.Materials and Methods: This study is a quasi-experimental study with pre and post- tests. 14 male and female preschool children (5-6 aged who were obtaining scores higher than cut-off in Spence anxiety scale (SAS and fear survey schedule for children-revised (FSSC-R parents’ form questionnaires were selected, and then they were assigned randomly to the control and experimental groups. The experimental group received techniques of client-centered play therapy for six treatment sessions (45minutes for each session. The fear and anxiety were measured at the beginning and at end of therapeutic session, utilizing the Spence Children's Anxiety Scale and fear survey schedule for children-revised (FSSC-R parents’ form. Statistical analysis conducted by analysis of covariance (ANCOVA.Results: There is significantly difference in Mean (SD scores of pretest 130.4 (3.3 and posttest 127.1 (4.6 fear (P<0.001, F= 24.6 and in scores of pretest 58.6 (2.6 and post-test 48.28 (3.6 anxiety (P<0.001, F=19.5 between preschool children in pre and post-test.Conclusion: Findings indicated that client-centered play therapy has effective in reducing behavioral problem such as fear and anxiety disorders in preschool children. Therefore, it can be useful and applicable as the psychological therapeutic interventions for decreasing behavioral distress in children.

  16. Client-Centered Employee Assistance Services. (United States)

    Bayer, Darryl Lee

    This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

  17. The Influence of Climatic Seasonality on the Diversity of Different Tropical Pollinator Groups (United States)

    Abrahamczyk, Stefan; Kluge, Jürgen; Gareca, Yuvinka; Reichle, Steffen; Kessler, Michael


    Tropical South America is rich in different groups of pollinators, but the biotic and abiotic factors determining the geographical distribution of their species richness are poorly understood. We analyzed the species richness of three groups of pollinators (bees and wasps, butterflies, hummingbirds) in six tropical forests in the Bolivian lowlands along a gradient of climatic seasonality and precipitation ranging from 410 mm to 6250 mm. At each site, we sampled the three pollinator groups and their food plants twice for 16 days in both the dry and rainy seasons. The richness of the pollinator groups was related to climatic factors by linear regressions. Differences in species numbers between pollinator groups were analyzed by Wilcoxon tests for matched pairs and the proportion in species numbers between pollinator groups by correlation analyses. Species richness of hummingbirds was most closely correlated to the continuous availability of food, that of bees and wasps to the number of food plant species and flowers, and that of butterflies to air temperature. Only the species number of butterflies differed significantly between seasons. We were not able to find shifts in the proportion of species numbers of the different groups of pollinators along the study gradient. Thus, we conclude that the diversity of pollinator guilds is determined by group-specific factors and that the constant proportions in species numbers of the different pollinator groups constitute a general pattern. PMID:22073268

  18. The influence of climatic seasonality on the diversity of different tropical pollinator groups.

    Directory of Open Access Journals (Sweden)

    Stefan Abrahamczyk

    Full Text Available Tropical South America is rich in different groups of pollinators, but the biotic and abiotic factors determining the geographical distribution of their species richness are poorly understood. We analyzed the species richness of three groups of pollinators (bees and wasps, butterflies, hummingbirds in six tropical forests in the Bolivian lowlands along a gradient of climatic seasonality and precipitation ranging from 410 mm to 6250 mm. At each site, we sampled the three pollinator groups and their food plants twice for 16 days in both the dry and rainy seasons. The richness of the pollinator groups was related to climatic factors by linear regressions. Differences in species numbers between pollinator groups were analyzed by Wilcoxon tests for matched pairs and the proportion in species numbers between pollinator groups by correlation analyses. Species richness of hummingbirds was most closely correlated to the continuous availability of food, that of bees and wasps to the number of food plant species and flowers, and that of butterflies to air temperature. Only the species number of butterflies differed significantly between seasons. We were not able to find shifts in the proportion of species numbers of the different groups of pollinators along the study gradient. Thus, we conclude that the diversity of pollinator guilds is determined by group-specific factors and that the constant proportions in species numbers of the different pollinator groups constitute a general pattern.

  19. Hsp90: Friends, clients and natural foes. (United States)

    Verma, Sharad; Goyal, Sukriti; Jamal, Salma; Singh, Aditi; Grover, Abhinav


    Hsp90, a homodimeric ATPase, is responsible for the correct folding of a number of newly synthesized polypeptides in addition to the correct folding of denatured/misfolded client proteins. It requires several co-chaperones and other partner proteins for chaperone activity. Due to the involvement of Hsp90-dependent client proteins in a variety of oncogenic signaling pathways, Hsp90 inhibition has emerged as one of the leading strategies for anticancer chemotherapeutics. Most of Hsp90 inhibitors blocks the N terminal ATP binding pocket and prevents the conformational changes which are essential for the loading of co-chaperones and client proteins. Several other inhibitors have also been reported which disrupt chaperone cycle in ways other than binding to N terminal ATP binding pocket. The Hsp90 inhibition is associated with heat shock response, mediated by HSF-1, to overcome the loss of Hsp90 and sustain cell survival. This review is an attempt to give an over view of all the important players of chaperone cycle. Copyright © 2016 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  20. A real time multi-server multi-client coherent database for a new high voltage system

    International Nuclear Information System (INIS)

    Gorbics, M.; Green, M.


    A high voltage system has been designed to allow multiple users (clients) access to the database of measured values and settings. This database is actively maintained in real time for a given mainframe containing multiple modules each having their own database. With limited CPU nd memory resources the mainframe system provides a data coherency scheme for multiple clients which (1) allows the client to determine when and what values need to be updated, (2) allows for changes from one client to be detected by another client, and (3) does not depend on the mainframe system tracking client accesses

  1. Dinheiro, afeto, sexualidade: a relação de prostitutas com seus clientes Dinero, afecto y sexualidad: la relación de prostitutas com sus clientes Money, affection and sexuality: the prostitutes' relationship with clients

    Directory of Open Access Journals (Sweden)

    Fernanda Burbulhan


    Full Text Available A prostituição é alvo constante de diferentes olhares, e para desvelar alguns de seus significados, resolvemos estudar a relação estabelecida entre a prostituta e o seu cliente. Para tanto, elegemos a abordagem qualitativa de pesquisa, com informações obtidas através de entrevista semiestruturada. Nosso estudo contou com sete participantes mulheres, com idade mínima de dezoito anos e envolvimento com a prática da prostituição há pelo menos um ano. As participantes responderam um questionário socioeconômico e foram entrevistadas, sendo as entrevistas posteriormente submetidas à análise de conteúdo. Com base nas informações obtidas, concluímos que a relação estabelecida entre prostitutas e seus clientes fundamenta-se no dinheiro, tanto em relação ao que o cliente paga quanto em relação àquilo que ele não pode pagar, porque "não tem preço". Essa negociação serve de alicerce para o estabelecimento de condições de ser-estar dessas mulheres profissionais do sexo dentro e fora da prostituição.La prostitución es objetivo constante de diferentes puntos de vista y a fin de aclarar algunos de sus significados, se optó por estudiar la relación establecida entre la prostituta y su cliente. Así, elegimos un enfoque cualitativo de la investigación, con la información obtenida a través de entrevista semiestructurada. Nuestro estudio contó con la presencia de siete participantes del sexo femenino, con edad mínima de 18 años y su participación en el ejercicio de la prostitución en al menos un año. Las participantes respondieron a un cuestionario socioeconómico y fueron entrevistadas, y las entrevistas posteriormente objeto de análisis de contenido. Podemos concluir que la relación establecida entre las prostitutas y sus clientes se basa en el dinero, tanto en relación a lo que el cliente paga, así como en lo que respecta a lo que él no puede pagar porque "no tiene un precio". Este acuerdo sirve como base

  2. Valuing gender diversity in teams

    DEFF Research Database (Denmark)

    Lauring, Jakob; Villeseche, Florence


    Team gender diversity has been much debated in many different contexts – not least since the search for a main effect of diversity on performance was launched. However, results have so far been inconclusive, and a number of scholars suggest that more attention should be directed at contextual...... factors which could influence the effect of gender diversity on team performance. In this study, we explore the effect of positive diversity attitudes and assess the degree of gender diversity where such group attitudes have greater impact. This is done by using a sample of 1085 leaders of academic...... research teams. Findings show that positive diversity attitude in the form of group openness to diversity is strongly associated with team performance. We also find a moderating effect of gender diversity meaning that the effect of openness to diversity is stronger when gender groups are more balanced...

  3. The Performance and Compatibility of Thin Client Computing with Fleet Operations

    National Research Council Canada - National Science Library

    Landry, Kenneth J


    ...) with a thin client/server-based computing (TCSBC) architecture. After becoming nearly extinct in the early 1990s, thin clients are emerging on the forefront of technology with numerous bandwidth improvements and cost reduction benefits...

  4. Paying by the hour: The least appealing option for clients of lawyers


    Seldeslachts, Jo


    In this study, we analyze a client's choice of contract in auctions where Dutch law firms compete for cases. The distinguishing feature is that lawyers may submit bids with any fee arrangement they wish. We find robust evidence that bids offering hourly rates are less attractive to clients. Our findings tentatively contradict lawyers' often-made argument that hourly rates are in a client's best interest.

  5. Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective


    Jati Utomo Dwi Hatmoko; Riqi Radian Khasania


    By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respo...

  6. Channel Access Client Toolbox for Matlab

    International Nuclear Information System (INIS)


    This paper reports on MATLAB Channel Access (MCA) Toolbox--MATLAB [1] interface to EPICS Channel Access (CA) client library. We are developing the toolbox for SPEAR3 accelerator controls, but it is of general use for accelerator and experimental physics applications programming. It is packaged as a MATLAB toolbox to allow easy development of complex CA client applications entirely in MATLAB. The benefits include: the ability to calculate and display parameters that use EPICS process variables as inputs, availability of MATLAB graphics tools for user interface design, and integration with the MATLABbased accelerator modeling software - Accelerator Toolbox [2-4]. Another purpose of this paper is to propose a feasible path to a synergy between accelerator control systems and accelerator simulation codes, the idea known as on-line accelerator model

  7. Distribución comercial: Tema 14. El servicio al cliente en el comercio minorista


    Juan Vigaray, María Dolores de


    El servicio al cliente tiene una importancia trascendente a la hora de mantener y recuperar clientes. Un mal servicio al cliente puede anular completamente un producto fantástico. Se debe de recordar al cliente la posibilidad y el interés de la empresa en que reclame y diga cualquier cosa que no le haya satisfecho, para que la empresa pueda corregir el error y compensarle.

  8. Lightweight Tactical Client: A Capability-Based Approach to Command Post Computing (United States)


    bundles these capabilities together is proposed: a lightweight tactical client. In order to avoid miscommunication in the future, it is... solutions and almost definitely rules out most terminal-based thin clients. UNCLASSIFIED Approved for public release

  9. The influence of clients' leadership in relation to construction health ...

    African Journals Online (AJOL)

    The South African Construction Regulations realise the contributions by each member of a project team to health and safety (H&S) improvement. These Regulations amplify the roles and contributions of clients to project realisation. The tenets of the Regulations conform with the observation that clients' H&S leadership and ...

  10. Exploring Psychotherapy Clients' Independent Strategies for Change While in Therapy (United States)

    Mackrill, Thomas


    Psychotherapy research usually describes how client change is caused by therapist interventions. This article describes how clients change by continuing to use and revising the strategies for change that they bring with them when they first enter therapy. This article presents data from a qualitative diary study of psychotherapy. Three cases…

  11. Do Organizational Culture and Climate Matter for Successful Client Outcomes? (United States)

    Silver Wolf, David A. Patterson; Dulmus, Catherine N.; Maguin, Eugene; Cristalli, Maria


    Objectives: The existing literature on the impact of workplace conditions on client care suggests that good cultures and climates provide the best outcomes for clients. The primary purpose of this study was to investigate the relationship between organizational culture and climate and the proportion of children and youth successfully discharged…

  12. Client Participation in Managing Social Work Service--An Unfinished Quest (United States)

    Leung, Terry T. F.


    "Client participation" is a popular ideal and object of rhetorical commitment in social work service. But the much-touted potential of this concept requires careful and critical scrutiny. This article reports on a study of client-participation initiatives in the Hong Kong welfare sector. The study identified significant differences in…

  13. Parallel Journeys: How a Music Therapist Can Travel with his Client


    Henry Dunn


    This paper explores the nature of the client-therapist relationship through the presentation of a case study. In this case study I aim to show how our processes within the therapy had strong parallels and how through being personally affected by my client this enabled me to work therapeutically more effectively and help him on his journey. The case study demonstrates how I was prepared to try new techniques at the same time as my client became more experimental, and also reveals how the clien...

  14. Prevalence of syphilis among female sex workers and their clients in Togo in 2011

    Directory of Open Access Journals (Sweden)

    Wemboo Afiwa Halatoko


    Full Text Available Abstract Background During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs, from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs and their clients in Togo. Methods We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing. Results In total, 1,836 participants (1,106 FSWs and 730 clients were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82. This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR =5.03; 95% CI [1.95-13.49]. Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]. Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]. Out of the 1,836 participants of the survey, 165 (8.9% were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]. Conclusion This study showed that: i the prevalence of syphilis among FSWs and their clients was high; ii syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.

  15. Prevalence of syphilis among female sex workers and their clients in Togo in 2011. (United States)

    Halatoko, Wemboo Afiwa; Landoh, Dadja Essoya; Saka, Bayaki; Akolly, Koffi; Layibo, Yao; Yaya, Issifou; Gbetoglo, Dodji; Banla, Abiba Kere; Pitché, Palokinam


    During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs), from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs) and their clients in Togo. We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing. In total, 1,836 participants (1,106 FSWs and 730 clients) were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82). This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR) =5.03; 95% CI [1.95-13.49]). Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]). Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]). Out of the 1,836 participants of the survey, 165 (8.9%) were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]). This study showed that: i) the prevalence of syphilis among FSWs and their clients was high; ii) syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.

  16. Multi-way multi-group segregation and diversity indices. (United States)

    Gorelick, Root; Bertram, Susan M


    How can we compute a segregation or diversity index from a three-way or multi-way contingency table, where each variable can take on an arbitrary finite number of values and where the index takes values between zero and one? Previous methods only exist for two-way contingency tables or dichotomous variables. A prototypical three-way case is the segregation index of a set of industries or departments given multiple explanatory variables of both sex and race. This can be further extended to other variables, such as disability, number of years of education, and former military service. We extend existing segregation indices based on Euclidean distance (square of coefficient of variation) and Boltzmann/Shannon/Theil index from two-way to multi-way contingency tables by including multiple summations. We provide several biological applications, such as indices for age polyethism and linkage disequilibrium. We also provide a new heuristic conceptualization of entropy-based indices. Higher order association measures are often independent of lower order ones, hence an overall segregation or diversity index should be the arithmetic mean of the normalized association measures at all orders. These methods are applicable when individuals self-identify as multiple races or even multiple sexes and when individuals work part-time in multiple industries. The policy implications of this work are enormous, allowing people to rigorously test whether employment or biological diversity has changed.

  17. Blood Groups Distribution and Gene Diversity of the ABO and Rh (D Loci in the Mexican Population

    Directory of Open Access Journals (Sweden)

    Adrián Canizalez-Román


    Full Text Available Objective. To determine the frequency and distribution of ABO and Rh (D antigens and, additionally, investigate gene diversity and the structure of Mexican populations. Materials and Methods. Blood groups were tested in 271,164 subjects from 2014 to 2016. The ABO blood group was determined by agglutination using the antibodies anti-A, Anti-B, and Anti-D for the Rh factor, respectively. Results. The overall distribution of ABO and Rh (D groups in the population studied was as follows: O: 61.82%; A: 27.44%; B: 8.93%; and AB: 1.81%. For the Rh group, 95.58% of people were Rh (D, and 4.42% were Rh (d. Different distributions of blood groups across regions were found; additionally, genetic analysis revealed that the IO and ID allele showed an increasing trend from the north to the center, while the IA and Id allele tended to increase from the center to the north. Also, we found more gene diversity in both loci in the north compared with the center, suggesting population structure in Mexico. Conclusion. This work could help health institutions to identify where they can obtain blood products necessary for medical interventions. Moreover, this piece of information contributes to the knowledge of the genetic structure of the Mexican populations which could have significant implications in different fields of biomedicine.

  18. A genomic insight into diversity among tribal and nontribal population groups of Manipur, India. (United States)

    Saraswathy, K N; Kiranmala, Naorem; Murry, Benrithung; Sinha, Ekata; Saksena, Deepti; Kaur, Harpreet; Sachdeva, M P; Kalla, A K


    Twenty autosomal markers, including linked markers at two gene markers, are used to understand the genomic similarity and diversity among three tribal (Paite, Thadou, and Kom) and one nontribal communities of Manipur (Northeast India). Two of the markers (CD4 and HB9) are monomorphic in Paite and one (the CD4 marker) in Kom. Data suggest the Meitei (nontribal groups) stand apart from the three tribal groups with respect to higher heterozygosity (0.366) and presence of the highest ancestor haplotypes of DRD2 markers (0.228); this is also supported by principal co-ordinate analysis. These populations are found to be genomically closer to the Chinese population than to other Indian populations.

  19. A corporalidade do cliente segundo representações de estudantes de enfermagem La corporalidad del cliente según representaciones de estudiantes de enfermería The corporality of the client according to nursing students representations

    Directory of Open Access Journals (Sweden)

    Renata Campos de Lima


    Full Text Available É um estudo fundamentado na teoria da Representação Social que subsidiou a apreensão e análise de como as estudantes de enfermagem perceberam e representaram o corpo de seus clientes e as subjetividades emergentes do contato da relação do cuidar. Foi realizado junto a 20 estudantes do sexo feminino das quatro séries de graduação em Enfermagem da UNIFESP. Os dados foram obtidos utilizando a entrevista aberta e analisados pelo método Análise de Conteúdo (Análise Categorial, o qual desvelou as seguintes categorias: corpo objeto, estigmatização, relação estudante-cliente, comunicação corporal, invasão de privacidade e constrangimento.Es un estudio basado en la teoría de la Representación Social que subsidió la incautación y análisis de como las estudiantes de enfermería percibieron y representaron el cuerpo de sus clientes y las subjetividades emergentes del contacto de la relación del cuidar. Fue realizado junto la 20 estudiantes del sexo femenino de las cuatro series de graduación en Enfermería de la UNIFESP. Los datos fueron obtenidos utilizando la entrevista abierta y analizados por el método Análisis de Contenido (Análisis Categorial, lo cual desveló las siguientes categorías: cuerpo objeto, estigmatizacion, relación estudiante-cliente, comunicación corporal, invasión de privacidad y constreñimiento.This study based on the theory of the Social Representation that subsidized the apprehension and analysis of how nursing students had perceived and represented the body of their clients and the emergent subjectives of contact and relation of taking care. It was carried with 20 female students of four grades of the nursing faculty of the UNIFESP. The data were obtained using interview and analysed by content analysis method (Categorial Analysis that showed the following categories: body object, stigmatisation, student-client relationship, body communication, privacy's intrusion and embarrassing.

  20. Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana

    Directory of Open Access Journals (Sweden)

    Jessica D. Rothstein


    Full Text Available Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources.

  1. 37 CFR 10.85 - Representing a client within the bounds of the law. (United States)


    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client within... OFFICE Patent and Trademark Office Code of Professional Responsibility § 10.85 Representing a client within the bounds of the law. (a) In representation of a client, a practitioner shall not: (1) Initiate...

  2. Effects of Counselor Gender and Gender-Role Orientation on Client Career Choice Traditionality. (United States)

    Barak, Azy; And Others


    Male (N=120) and female (N=120) clients were counseled by male or female counselor classified as masculine, feminine, or androgynous in sex-role orientation. Clients' career choice traditionality was measured during counseling, following counseling, and with respect to clients' career six months later. Counselor gender and gender-role orientation…

  3. Counselors' attachment anxiety and avoidance and the congruence in clients' and therapists' working alliance ratings. (United States)

    Kivlighan, Dennis M; Marmarosh, Cheri L


    To determine how counselors' attachment anxiety and avoidance related to congruence between counselors' and clients' Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients' WA ratings predicting counselors' WA ratings. Directional bias was defined as the difference in level between counselors' and clients' WA ratings. Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. As hypothesized counselors' WA ratings were significantly and positively related to clients' WA ratings. Also as hypothesized, counselors' WA ratings were significantly lower than their clients' WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors' attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Counselors' attachment anxiety is realted to their ability to accurately percieve their clients' WA.

  4. Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective

    Directory of Open Access Journals (Sweden)

    Jati Utomo Dwi Hatmoko


    Full Text Available By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respondents. The results show that there is a significant difference between both types of client performance. Three variables related to financial indicators, i.e. timely payment, owner value estimate, and payment approval, rank in the bottom three of the government client performance, but in contrast rank in the top three of the private ones. These results suggest that the government clients’ performance is perceived inferior to the private ones. Establishing a clients’ forum for sharing knowledge and best practices would be a strategic solution to enhance clients’ capacities.

  5. The Effects of Client-Counselor Racial Matching on Therapeutic Outcome (United States)

    Kim, Eunha; Kang, Minchul


    This study explored the effects of ethnic/racial matching on psychotherapy outcomes via the number of counseling sessions attended by clients, using clinical data collected from a university's counseling center. A total sample of 644 clients (193 men, 448 women) was selected and the ethnic/racial distribution of the sample comprised 499…

  6. An Empirical Research on Bank Client Credit Assessments

    Directory of Open Access Journals (Sweden)

    Quan Chen


    Full Text Available Individual microcredit loans involve large quantities and small amounts and necessitate rapid approval, therefore making simple and fast application approvals rather critical. Creditors must evaluate clients’ credit status and default risk within the shortest time when determining whether to approve or decline their applications, preventing overdue responses that negatively impact bank profits and management practices, and could trigger domestic financial crises. This study investigates client credit quality criteria, focusing on the expert opinions of bank managers. The decision-making trial and evaluation laboratory method is adopted to enable a comparison and analysis of the similarities and differences in how banks evaluate their clients’ character, ability, financial capability, and collateral. Based on causality and correlations among the criteria, we also identify the core problems and key improvement criteria in the evaluation system. Through survey results of professional managers from Taiwanese banks, this study uses the DEMATEL method to compare the differences in bank evaluation methods based on the four dimensions of clients’ character, ability, pockets, and collateral, as well as the corresponding 14 criteria. In order to improve the reliability and usefulness in bank client credit risk assessment, the assessment dimensions and indicators of bank client credit risk assessment are first discussed; second, the causal relationship and degree of mutual influence between different dimensions and criteria are researched and assessed; in the end, the paper discusses how to improve the function and the benefits of bank client credit risk assessment.

  7. Therapists' causal attributions of clients' problems and selection of intervention strategies. (United States)

    Royce, W S; Muehlke, C V


    Therapists' choices of intervention strategies are influenced by many factors, including judgments about the bases of clients' problems. To assess the relationships between such causal attributions and the selection of intervention strategies, 196 counselors, psychologists, and social workers responded to the written transcript of a client's interview by answering two questionnaires, a 1982 scale (Causal Dimension Scale by Russell) which measured causal attribution of the client's problem, and another which measured preference for emotional, rational, and active intervention strategies in dealing with the client, based on the 1979 E-R-A taxonomy of Frey and Raming. A significant relationship was found between the two sets of variables, with internal attributions linked to rational intervention strategies and stable attributions linked to active strategies. The results support Halleck's 1978 hypothesis that theories of psychotherapy tie interventions to etiological considerations.

  8. Should Family and Friends Be Involved in Group-Based Rehabilitation Programs for Adults with Low Vision? (United States)

    Rees, G.; Saw, C.; Larizza, M.; Lamoureux, E.; Keeffe, J.


    This qualitative study investigates the views of clients with low vision and vision rehabilitation professionals on the involvement of family and friends in group-based rehabilitation programs. Both groups outlined advantages and disadvantages to involving significant others, and it is essential that clients are given the choice. Future work is…

  9. 45 CFR 2551.81 - What type of clients are eligible to be served? (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false What type of clients are eligible to be served... FOR NATIONAL AND COMMUNITY SERVICE SENIOR COMPANION PROGRAM Clients Served § 2551.81 What type of clients are eligible to be served? Senior Companions serve only adults, primarily older adults, who have...

  10. Development and construct validation of the Client-Centredness of Goal Setting (C-COGS) scale. (United States)

    Doig, Emmah; Prescott, Sarah; Fleming, Jennifer; Cornwell, Petrea; Kuipers, Pim


    Client-centred philosophy is integral to occupational therapy practice and client-centred goal planning is considered fundamental to rehabilitation. Evaluation of whether goal-planning practices are client-centred requires an understanding of the client's perspective about goal-planning processes and practices. The Client-Centredness of Goal Setting (C-COGS) was developed for use by practitioners who seek to be more client-centred and who require a scale to guide and evaluate individually orientated practice, especially with adults with cognitive impairment related to acquired brain injury. To describe development of the C-COGS scale and examine its construct validity. The C-COGS was administered to 42 participants with acquired brain injury after multidisciplinary goal planning. C-COGS scores were correlated with the Canadian Occupational Performance Measure (COPM) importance scores, and measures of therapeutic alliance, motivation, and global functioning to establish construct validity. The C-COGS scale has three subscales evaluating goal alignment, goal planning participation, and client-centredness of goals. The C-COGS subscale items demonstrated moderately significant correlations with scales measuring similar constructs. Findings provide preliminary evidence to support the construct validity of the C-COGS scale, which is intended to be used to evaluate and reflect on client-centred goal planning in clinical practice, and to highlight factors contributing to best practice rehabilitation.

  11. Students: Customers, Clients or Pawns? (United States)

    Tight, Malcolm


    The metaphor of the student as a consumer or customer is widely used within contemporary higher education, and impacts on the ways in which students, academics and institutions behave. These, and a number of alternative metaphors for the student, are critically reviewed. The alternatives considered include both contemporary (student as client or…

  12. Usage of Thin-Client/Server Architecture in Computer Aided Education (United States)

    Cimen, Caghan; Kavurucu, Yusuf; Aydin, Halit


    With the advances of technology, thin-client/server architecture has become popular in multi-user/single network environments. Thin-client is a user terminal in which the user can login to a domain and run programs by connecting to a remote server. Recent developments in network and hardware technologies (cloud computing, virtualization, etc.)…

  13. Client and family engagement in rehabilitation research: a framework for health care organizations. (United States)

    Anderson, James; Williams, Laura; Karmali, Amir; Beesley, Lori; Tanel, Nadia; Doyle-Thomas, Krissy; Sheps, Gideon; Chau, Tom


    To describe the development and implementation of an organizational framework for client and family-centered research. Case report. While patient-centered care is now well established, patient-centered research remains underdeveloped. This is particularly true at the organizational level (e.g., hospital based research institutes). In this paper we describe the development of an organizational framework for client and family centered research at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada. It is our hope that, by sharing our framework other research institutions can learn from our experience and develop their own research patient/client/family engagement programs. Implications for rehabilitation Family engagement in rehabilitation research •Rehabilitation research is crucial to the development and improvement of rehabilitative care. •The relevance, appropriateness, and accountability of research to patients, clients and families could be improved. •Engaging clients and families as partners in all aspects of the research process is one way to address this problem. •In this paper, we describe a framework for engaging clients and families in research at the organizational level.

  14. Care farms in the Netherlands: attractive empowerment-oriented and strengths-based practices in the community. (United States)

    Hassink, Jan; Elings, Marjolein; Zweekhorst, Marjolein; van den Nieuwenhuizen, Noor; Smit, Annet


    Empowerment-oriented and strengths-based practices focusing on community integration have gained recognition for various client groups in recent decades. This paper discusses whether care farms in the Netherlands are relevant examples of such practices. We identify characteristics associated with care farms that are relevant for three different client groups: clients with severe mental health problems, clients from youth care backgrounds, and frail elderly clients. We interviewed 41 clients, 33 care farmers, and 27 health professionals. The study shows that care farms are experienced as unique services because of a combination of different types of characteristic qualities: the personal and involved attitude of the farmer, a safe community, useful and diverse activities, and a green environment. This leads to an informal context that is close to normal life. We found no essential differences in the assessment of characteristics between different client groups and between clients, farmers, and health professionals. Care farms can be considered as an innovative example of community-based services that can improve the quality of life of clients. Copyright 2009 Elsevier Ltd. All rights reserved.

  15. An Evaluation of Treatment Outcomes in a Cohort of Clients on the DOTS Strategy, 2012-2016. (United States)

    Tetteh, Ato Kwamena; Agyarko, Edward; Otchere, Joseph; Bimi, Langbong; Ayi, Irene


    We present, for the first time, an evaluation of treatment outcomes in a cohort at a TB referral centre in the Central Region of Ghana. Of the 213 clients placed on DOTS, 59.2% (126/213) were sputum smear-positive. An overall cure rate of 90.2% (51.6% cured + 37.6% completed) and a death rate of 8.5% (18/213) were estimated. Of the number of clients who died, 5.7% (12/213) were males ( χ 2 = 2.891, p = 0.699; LR = 3.004, p = 0.699). Deaths were only recorded among clients who were > 19 years old ( χ 2 = 40.319, p = 0.099; LR = 41.244, p = 0.083). Also, 0.9% (2/213) was lost to follow-up, while 1.4% (3/213) had treatment failure. In total, 13.6% (7.0%, 15/213 males, and 6.6%, 14/213 females) of clients who were placed on DOTS were HIV seropositive. Ages of 40-49 years had the highest number, 13/213 (6.1%), infected with HIV, though the difference among the remaining age groups was not statistically significant ( χ 2 = 9.621, p = 0.142). Furthermore, 7.0% (15/213) had TB/HIV coinfection. Out of them, 9 were cured and 5 died at home, while 1 had treatment failure. Tuberculosis/HIV infection prevention advocacy and interventions that address sociodemographic determinants of unfavourable treatment outcomes are urgently required to augment national efforts towards control.

  16. mtDNA sequence diversity of Hazara ethnic group from Pakistan. (United States)

    Rakha, Allah; Fatima; Peng, Min-Sheng; Adan, Atif; Bi, Rui; Yasmin, Memona; Yao, Yong-Gang


    The present study was undertaken to investigate mitochondrial DNA (mtDNA) control region sequences of Hazaras from Pakistan, so as to generate mtDNA reference database for forensic casework in Pakistan and to analyze phylogenetic relationship of this particular ethnic group with geographically proximal populations. Complete mtDNA control region (nt 16024-576) sequences were generated through Sanger Sequencing for 319 Hazara individuals from Quetta, Baluchistan. The population sample set showed a total of 189 distinct haplotypes, belonging mainly to West Eurasian (51.72%), East & Southeast Asian (29.78%) and South Asian (18.50%) haplogroups. Compared with other populations from Pakistan, the Hazara population had a relatively high haplotype diversity (0.9945) and a lower random match probability (0.0085). The dataset has been incorporated into EMPOP database under accession number EMP00680. The data herein comprises the largest, and likely most thoroughly examined, control region mtDNA dataset from Hazaras of Pakistan. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Integrative analysis of multiple diverse omics datasets by sparse group multitask regression

    Directory of Open Access Journals (Sweden)

    Dongdong eLin


    Full Text Available A variety of high throughput genome-wide assays enable the exploration of genetic risk factors underlying complex traits. Although these studies have remarkable impact on identifying susceptible biomarkers, they suffer from issues such as limited sample size and low reproducibility. Combining individual studies of different genetic levels/platforms has the promise to improve the power and consistency of biomarker identification. In this paper, we propose a novel integrative method, namely sparse group multitask regression, for integrating diverse omics datasets, platforms and populations to identify risk genes/factors of complex diseases. This method combines multitask learning with sparse group regularization, which will: 1 treat the biomarker identification in each single study as a task and then combine them by multitask learning; 2 group variables from all studies for identifying significant genes; 3 enforce sparse constraint on groups of variables to overcome the ‘small sample, but large variables’ problem. We introduce two sparse group penalties: sparse group lasso and sparse group ridge in our multitask model, and provide an effective algorithm for each model. In addition, we propose a significance test for the identification of potential risk genes. Two simulation studies are performed to evaluate the performance of our integrative method by comparing it with conventional meta-analysis method. The results show that our sparse group multitask method outperforms meta-analysis method significantly. In an application to our osteoporosis studies, 7 genes are identified as significant genes by our method and are found to have significant effects in other three independent studies for validation. The most significant gene SOD2 has been identified in our previous osteoporosis study involving the same expression dataset. Several other genes such as TREML2, HTR1E and GLO1 are shown to be novel susceptible genes for osteoporosis, as confirmed

  18. Certification. Tool for quality? Market and client for radiation experts

    International Nuclear Information System (INIS)

    Zwaard, W.


    The role and impact of certification in the advisory work of radiation experts is briefly outlined. Certification is a guarantee for quality of the advice or a product in case there is a client and a market. In cases where there is not a client or a market certification will lead to 'window-dressing and a bureaucratic system

  19. Construction of group exercise sessions in geriatric inpatient rehabilitation. (United States)

    Wallin, Marjo; Talvitie, Ulla; Cattan, Mima; Karppi, Sirkka-Liisa


    There is little knowledge about the ways geriatric physiotherapy is being carried out in practice and about the situational construction of formal policies for promoting physical activity. This article examines how professional physiotherapists and frail community-dwelling older adults as their clients use talk and action to construct a group exercise session in an inpatient rehabilitation setting in Finland. The analysis of 7 group exercise sessions with a total of 52 clients and 9 professional physiotherapists revealed 3 different practitioner approaches, which served different functions in older adults' empowerment and lifestyle activity change. The highly structured approach favored taciturn physical performances completed independently and successfully by frail older adults. The guided exercise approach with individualized guidance encouraged occasional coconstruction of shared understanding of learning the exercises. The circuit training approach facilitated occasional self-regulation by the clients. The results of this study indicate that a combination of different approaches is required to address the multifaceted needs of heterogeneous frail older adults.

  20. 77 FR 38766 - Proposed Information Collection; Comment Request; International Client Life-Cycle Multi-Purpose... (United States)


    ... Request; International Client Life-Cycle Multi-Purpose Forms AGENCY: International Trade Administration...-0151, 0625-0215, 0625-0220, 0625-0228, and 0625- 0238. These collections include all client intake... trade events to U.S. organizations. The International Client Life-cycle Multi-Purpose Forms, previously...