... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...
Pomeroy House, a long-term residential treatment program in San Francisco, California, was created to help recovering alcoholic mothers and their children. Eight to 10 families stay at Pomeroy House for a minimum period of 6 months with extensions of up to 9 or 12 months, and the alcoholic mothers care for their children while recovering from…
Kasprow, W J; Rosenheck, R; Frisman, L; DiLella, D
This study compared two types of residential programs that treat dually diagnosed homeless veterans. Programs specializing in the treatment of substance abuse disorders (SA) and those programs addressing both psychiatric disorders and substance abuse problems within the same setting (DDX) were compared on (1) program characteristics, (2) clients' perceived environment, and (3) outcomes of treatment. The study was based on surveys and discharge reports from residential treatment facilities that were under contract to the Department of Veterans Affairs Health Care for Homeless Veterans program, a national outreach and case management program operating at 71 sites across the nation. Program characteristics surveys were completed by program administrators, perceived environment surveys were completed by veterans in treatment, and discharge reports were completed by VA case managers. DDX programs were characterized by lower expectations for functioning, more acceptance of problem behavior, and more accommodation for choice and privacy, relative to SA programs after adjusting for baseline differences. Dually diagnosed veterans in DDX programs perceived these programs as less controlling than SA programs, but also as having lower involvement and less practical and personal problem orientations. At discharge, a lower percentage of veterans from DDX than SA programs left without staff consultation. A higher percentage of veterans from DDX than SA programs were discharged to community housing rather than to further institutional treatment. Program effects were not different for psychotic and non-psychotic veterans. Although differences were modest, integration of substance abuse and psychiatric treatment may promote a faster return to community living for dually diagnosed homeless veterans. Such integration did not differentially benefit dually diagnosed veterans whose psychiatric problems included a psychotic disorder.
Suter, Marius; Strik, Werner; Moggi, Franz
Alcohol use disorder (AUD) and depressive disorders often co-occur. Findings on the effects of major depressive disorder (MDD) or depressive symptoms on posttreatment alcohol relapse are controversial. The study's aim is to examine the association of MDD and depressive symptoms with treatment outcomes after residential AUD programs. In a naturalistic-prospective, multisite study with 12 residential AUD treatment programs in the German-speaking part of Switzerland, 64 patients with AUD with MDD, 283 patients with AUD with clinically significant depressive symptoms at admission, and 81 patients with AUD with such problems at discharge were compared with patients with AUD only on alcohol use, depressive symptoms, and treatment service utilization. MDD was provisionally identified at admission and definitively defined at discharge. Whereas patients with MDD did not differ from patients with AUD only at 1-year follow-up, patients with AUD with clinically significant depressive symptoms had significantly shorter time-to-first-drink and a lower abstinence rate. These patients also had elevated AUD indices and treatment service utilization for psychiatric disorders. Our results suggest that clinically significant depressive symptoms are a substantial risk factor for relapse so that it may be important to treat them during and after residential AUD treatment programs. Copyright © 2011 Elsevier Inc. All rights reserved.
Gaddy, Melinda A
A 4-week interdisciplinary integrative medicine program was recently added to the core treatment offerings for veterans participating in the Mental Health Residential Rehabilitation Program at the Dwight D. Eisenhower Veterans Affairs Medical Center. The new integrative medicine program teaches veterans about using meditative practices, nutrition, creative expression, tai chi, hatha yoga, sensory and breathing techniques, and lifestyle changes to enhance well-being. The groups are run by professionals from a variety of disciplines including recreation therapy, art therapy, occupational therapy, psychology, and nutrition. For the first 42 veterans to complete the program, the Short Form 12-item Health Survey was administered before and after participation in the integrative medicine program to assess the potential effectiveness of the program in enhancing physical and psychological well-being. In addition, a brief semistructured interview was used to assess veteran opinions about the program. Results suggest that the program was well received and that both physical and mental health scores improved from before to after treatment in this sample of veterans with complex behavioral health concerns. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Raney, Valerie K.; Magaletta, Philip; Hubbert, Timothy A.
The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates' perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were…
Thompson-Brenner, Heather; Boswell, James F; Espel-Huynh, Hallie; Brooks, Gayle; Lowe, Michael R
Data are lacking from empirically supported therapies implemented in residential programs for eating disorders (EDs). Common elements treatments may be well-suited to address the complex implementation and treatment challenges that characterize these settings. This study assessed the preliminary effect of implementing a common elements therapy on clinician treatment delivery and patient (N = 616) symptom outcomes in two residential ED programs. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders was adapted to address ED and co-occurring psychopathology and implemented across sites. Therapists' treatment fidelity was rated independently to assess implementation success. Additionally, longitudinal (pre-post) design compared treatment outcomes among patients treated before and after implementation. Patient outcomes included ED and depressive symptoms, experiential avoidance, anxiety sensitivity, and mindfulness. Following training and implementation, clinicians demonstrated adequate to good fidelity. Relative to pre-implementation, post-implementation patients showed significantly greater improvements in experiential avoidance, anxiety sensitivity, and mindfulness at discharge (ps ≤ .04) and more favorable outcomes on ED symptom severity, depression, and experiential avoidance at 6-month follow up (ps ≤ .0001). Preliminary pilot data support the feasibility of implementing transdiagnostic common elements therapy in residential ED treatment, and suggest that implementation may benefit transdiagnostic outcomes for patients.
Berlin, Lisa J; Shanahan, Meghan; Appleyard Carmody, Karen
This pilot randomized trial tested the feasibility and efficacy of supplementing residential substance-abuse treatment for new mothers with a brief, yet rigorous, attachment-based parenting program. Twenty-one predominantly (86%) White mothers and their infants living together in residential substance-abuse treatment were randomly assigned to the program (n = 11) or control (n = 10) group. Program mothers received 10 home-based sessions of Dozier's Attachment and Biobehavioral Catch-up (ABC) intervention. Postintervention observations revealed more supportive parenting behaviors among the randomly assigned ABC mothers. © 2013 Michigan Association for Infant Mental Health.
Yung, Kathryn; Eickhoff, Erin; Davis, Diane L; Klam, Warren P; Doan, Andrew P
Internet addiction disorder (IAD) is characterized by the problematic use of online video games, computer use, and mobile handheld devices. While not officially a clinical diagnosis according to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), individuals with IAD manifest severe emotional, social, and mental dysfunction in multiple areas of daily activities due to their problematic use of technology and the internet. We report a 31year-old man who exhibited problematic use of Google Glass™. The patient has a history of a mood disorder most consistent with a substance induced hypomania overlaying a depressive disorder, anxiety disorder with characteristics of social phobia and obsessive compulsive disorder, and severe alcohol and tobacco use disorders. During his residential treatment program at the Navy's Substance Abuse and Recovery Program (SARP) for alcohol use disorder, it was noted that the patient exhibited significant frustration and irritability related to not being able to use his Google Glass™. The patient exhibited a notable, nearly involuntary movement of the right hand up to his temple area and tapping it with his forefinger. He reported that if he had been prevented from wearing the device while at work, he would become extremely irritable and argumentative. Over the course of his 35-day residential treatment, the patient noted a reduction in irritability, reduction in motor movements to his temple to turn on the device, and improvements in his short-term memory and clarity of thought processes. He continued to intermittently experience dreams as if looking through the device. To our knowledge, this is the first reported case of IAD involving problematic use of Google Glass™. Published by Elsevier Ltd.
Weis, Robert; Crockett, Thomas E.; Vieth, Sasha
Military-style residential treatment for adolescents with academic and conduct problems is an increasingly popular alternative to traditional school-based services. However, dropout from "boot camp" programs is a primary reason for their high cost. Social-emotional functioning before referral may differentiate adolescents who…
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...
Kasprow, W J; Frisman, L; Rosenheck, R A
Because little is known about homeless individuals' satisfaction with mental health services or the association between satisfaction and measures of treatment outcome, the study examined those issues in a group of homeless veterans. Demographic and clinical data were obtained from intake assessments conducted before veterans' admission to residential treatment facilities under contract with the Department of Veterans Affairs Health Care for Homeless Veterans program, a national outreach and case management program. Clients completed a satisfaction survey and the Community-Oriented Programs Environment Scale, which asks them to rate dimensions of the treatment environment. Outcome data came from discharge outcome summaries completed by VA case managers. Overall satisfaction with residential treatment services was high among the 1,048 veterans surveyed. Greater satisfaction was associated with more days of drug abuse and more days spent institutionalized in the month before intake and with an intake diagnosis of drug abuse. Regression analyses indicated that satisfaction was most strongly related to clients' perceptions of several factors in the treatment environment. Policy clarity, clients' involvement in the program, an emphasis on order, a practical orientation, and peer support were positively related to satisfaction; staff control and clients' expression of anger were negatively related. Satisfaction was significantly associated with case managers' discharge ratings of clinical improvement of drug problems and psychiatric problems. Homeless veterans are more satisfied in environments they perceive to be supportive, orderly, and focused on practical solutions. The results indicate that client satisfaction is not related to treatment outcomes strongly enough to serve as a substitute for other outcome measures.
Kaskutas, Lee Ann; Zavala, Silvana K; Parthasarathy, Sujaya; Witbrodt, Jane
Patient placement criteria developed by the American Society of Addiction Medicine (ASAM) have identified a need for low-intensity residential treatment as an alternative to day hospital for patients with higher levels of severity. A recent clinical trial found similar outcomes at social model residential treatment and clinically-oriented day hospital programs, but did not report on costs. This paper addresses whether the similar outcomes in the recent trial were delivered with comparable costs, overall and within gender and ethnicity stratum. This paper reports on clients not at environmental risk who participated in a randomized trial conducted in three metropolitan areas served by a large pre-paid health plan. Cost data were collected using the Drug Abuse Treatment Cost Analysis Program (DATCAP). Costs per episode were calculated by multiplying DATCAP-derived program-specific costs by each client's length of stay. Differences in length of stay, and in per-episode costs, were compared between residential and day hospital subjects. Lengths of stay at residential treatment were significantly longer than at day hospital, in the sample overall and in disaggregated analyses. This difference was especially marked among non-Whites. The average cost per week was USD 575 per week at day hospital, versus USD 370 per week at the residential programs. However, because of the longer stays in residential, per-episode costs were significantly higher in the sample overall and among non-Whites (and marginally higher for men). These cost results must be considered in light of the null findings comparing outcomes between subjects randomized to residential versus day hospital programs. The longer stays in the sample overall and for non-White clients at residential programs came at higher costs but did not lead to better rates of abstinence. The short stays in day hospital among non-Whites call into question the attractiveness of day hospital for minority clients. Outcomes and costs
Presnell, Katherine; Pells, Jennifer; Stout, Anna; Musante, Gerard
The aim of the current study was to examine whether weight loss self-efficacy, binge eating, and depressive symptoms predicted weight loss during treatment, and whether gender moderates these associations with prospective data from 297 participants (223 women and 74 men) enrolled in a residential obesity treatment program. Men reported higher initial levels of self-efficacy than women, whereas women reported greater pre-treatment levels of binge eating and depressive symptoms. Higher pre-treatment levels of weight control self-efficacy, binge eating, and depressive symptoms predicted greater weight loss in men, but not in women. Results suggest that certain psychological and behavioral factors should be considered when implementing weight loss interventions, and indicate a need to consider gender differences in predictors of weight loss treatment. Future research should seek to identify predictors of weight loss among women.
Smith, Kirsten Elin; Lawson, Thomas
Kratom use in the West has increased recently, yet the prevalence and motives for use among individuals with a history of substance use disorder (SUD) have not been fully examined. Kratom has been documented as a means of treating chronic pain, mitigating drug dependence, and easing withdrawal symptoms, yet it is unclear if substance users are utilizing kratom as a self-medication. Abuse liability, side effects, and overall appeal of kratom remain uncertain. In April 2017, an anonymous survey regarding kratom use and motivations was completed by clients enrolled in a 12-Step-oriented residential program. 500 respondents with a self-reported history of SUD completed the survey. 20.8% of respondents endorsed lifetime kratom use and 10.2% reported past-12-month use. Kratom-users were younger (=32.1 vs. 35.9, pkratom-users reported having used the drug as a means of reducing or abstaining from non-prescription opioids (NPO) and/or heroin, and 64.1% reported using kratom as a substitute for NPO/heroin. 18.4% of kratom-users reported using the drug due to a disability or chronic pain. One-third of kratom-users stated that kratom was a helpful substance and that they would try it again. However, kratom was not preferred and was indicated as having less appeal than NPO, heroin, amphetamines, and Suboxone. Among substance users, kratom use may be initiated for a variety of reasons, including as a novel form of harm-reduction or drug substitution, particularly in the context of dependence and withdrawal from other substances. Copyright © 2017 Elsevier B.V. All rights reserved.
Bittman, Barry; Dickson, Larry; Coddington, Kim
Obstacles to effectively rehabilitate inner-city adolescents in staff-secure residential treatment centers should not be underestimated. Effective evidence-based protocols are lacking to help juveniles who are often angry, detached, frustrated, and in direct conflict with their peers. Facing a myriad of issues ranging from youth delinquency offenses to trauma, abuse, drug/alcohol use, peer pressure/gang-related activities, lack of structure in home environments, mental health diagnoses, and cognitive functioning difficulties, these adolescents present extraordinary challenges to an over-stressed juvenile justice system. A randomized controlled crossover study is utilized to comprehensively evaluate the effectiveness of a novel creative musical expression protocol as a catalyst for nonverbal and verbal disclosure leading to improvements in quality of life for inner-city youth in a court-referred residential treatment program. A total of 52 (30 females and 22 males) African-American, Asian, Caucasian, and Puerto Rican subjects ranging in age from 12 to 18 (mean age 14.5) completed the study. Dependent variable measures included the Child and Adolescent Functional Assessment Scale (CAFAS), the Adolescent Psychopathology Scale (APS), the Adolescent Anger Rating Scale (AARS), the Reynolds Adolescent Depression Scale, 2nd edition (RADS 2), and the Adolescent Visual-Analog Recreational Music Making Assessment (A-VARMMA). Statistically significant (experimental vs control) improvements in multiple parameters include school/work role performance, total depression, anhedonia/negative affect, negative self-evaluation, and instrumental anger. In addition, extended impact (experimental vs control) is characterized by statistically significant improvements 6 weeks after completion of the protocol, for school/work role performance, behavior toward others, anhedonia/negative affect, total anger, instrumental anger, anger, and interpersonal problems. The primary limitations of this
Dell, Debra; Hopkins, Carol
The Youth Solvent Addiction Program (YSAP) was established in 1996 in response to the misuse of volatile substances among First Nations and Inuit youth in Canada. This article outlines the role of Indigenous culture and its intersection with Western approaches to recovery in YSAP's operation of nine residential treatment centers for youth. Treatment practices and client outcome data are used to illustrate YSAP's approach. Limitations of the article are noted.
Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Holt, Edward [Ed Holt & Associates, Inc., Harpswell, ME (United States)
High up-front costs and a lack of financing options have historically been the primary barriers to the adoption of photovoltaics (PV) in the residential sector. State clean energy funds, which emerged in a number of states from the restructuring of the electricity industry in the mid-to-late 1990s, have for many years attempted to overcome these barriers through PV rebate and, in some cases, loan programs. While these programs (rebate programs in particular) have been popular, the residential PV market in the United States only started to achieve significant scale in the last five years – driven in large part by an initial wave of financial innovation that led to the rise of third-party ownership.
Jacobson, Bonnie B.; Lundien, Barbara; Kaufman, Jeffrey; Kreczko, Adam; Ferrey, Steven; Morgan, Stephen
The Weatherization Residential Assistance Partnership,'' or WRAP program, is a fuel-blind conservation program designed to assist Northeast Utilities' low-income customers to use energy safely and efficiently. Innovative with respect to its collaborative approach and its focus on utilizing and strengthening the existing low-income weatherization service delivery network, the WRAP program offers an interesting model to other utilities which traditionally have relied on for-profit energy service contractors and highly centralized program implementation structures. This report presents appendices with surveys, participant list, and computers program to examine and predict potential energy savings.
Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.
Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…
Jordan, Neil; Leon, Scott C.; Epstein, Richard A.; Durkin, Elizabeth; Helgerson, Jena; Lakin-Starr, Brittany L.
This study examined the association between organizational climate and changes in internalizing and externalizing behavior for youth in residential treatment centers (RTCs). The sample included 407 youth and 349 front-line residential treatment staff from 17 RTCs in Illinois. Youth behavior was measured using the Child Functional Assessment Rating…
Shabat, Julia Cathcart; Lyons, John S.; Martinovich, Zoran
We examined the differential outcomes in residential treatment for youths with conduct disorder (CD)--with special attention paid to interactions with age and gender--in a sample of children and adolescents in 50 residential treatment centers and group homes across Illinois. Multi-disciplinary teams rated youths ages 6-20 (N = 457) on measures of…
Schoenthaler, Stephen J; Blum, Kenneth; Fried, Lyle; Oscar-Berman, Marlene; Giordano, John; Modestino, Edward J.; Badgaiyan, Rajendra
This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p treatment of both disorders and explained their effectiveness. Co-occurring DSM IV mood disorders such as anxiety and depression as well as drug abuse involving opioids or cocaine fell between 66 and 95% at months one, six, and twelve. PMID:28868159
Siefert, K; Pimlott, S
The female prison population has increased dramatically in recent years. Most women prisoners are involved with drugs, and as many as 25 percent are pregnant or have delivered within the past year. Reproductive health and drug treatment services for women in prison are inadequate, if they are available at all, and although illicit drugs are readily available in prison, drug-involved pregnant women often are incarcerated to protect fetal health. Studies of pregnancy outcome among women prisoners have demonstrated high rates of perinatal mortality and morbidity. This article examines issues related to pregnancy among women prisoners and describes an innovative residential program designed for pregnant, drug-dependent women in a state adult corrections system. Social workers can play an important role in promoting policy reform and improved services for this underserved population.
Griffith, Annette K.; Ingram, Stephanie D.; Barth, Richard P.; Trout, Alexandra L.; Hurley, Kristin Duppong; Thompson, Ronald W.; Epstein, Michael H.
Although much is known about the mental health and behavioral functioning of youth who enter residential care programs, very little research has focused on examining the family characteristics of this population. Knowledge about family characteristics is important, however, as it can aid in tailoring programs to meet the needs of families who are…
Neale, Joanne; Tompkins, Charlotte N E; Strang, John
Relationships between peers are often considered central to the therapeutic process, yet there is relatively little empirical research either on the nature of peer-to-peer relationships within residential treatment or on how those relationships generate positive behaviour change or facilitate recovery. In this paper, we explore relationships between peers in residential addiction treatment, drawing upon the concept of social capital to frame our analyses. Our study was undertaken during 2015 and 2016 in two English residential treatment services using the same therapeutic community-informed model of treatment. We conducted 22 in-depth interviews with 13 current and 9 former service residents. All interviews were audio-recorded, transcribed verbatim, coded in MAXQDA, and analysed using Iterative Categorisation. Residents reported difficult relationship histories and limited social networks on entry into treatment. Once in treatment, few residents described bonding with their peers on the basis of shared experiences and lifestyles. Instead, interpersonal differences polarised residents in ways that undermined their social capital further. Some senior peers who had been in residential treatment longer acted as positive role models, but many modelled negative behaviours that undermined others' commitment to treatment. Relationships between peers could generate feelings of comfort and connectedness, and friendships developed when residents found things in common with each other. However, residents more often reported isolation, loneliness, wariness, bullying, manipulation, intimidation, social distancing, tensions and conflict. Overall, relationships between peers within residential treatment seemed to generate some positive but more negative social capital; undermining the notion of the community as a method of positive behaviour change. With the caveat that our data have limitations and further research is needed, we suggest that residential treatment providers should
Staiger, Petra K; Kyrios, Michael; Williams, James S; Kambouropoulos, Nicolas; Howard, Alexandra; Gruenert, Stefan
Residential drug rehabilitation is often seen as a treatment of last resort for people with severe substance abuse issues. These clients present with more severe symptoms, and frequent psychiatric comorbidities relative to outpatients. Given the complex nature of this client group, a high proportion of clients seeking treatment often do not enter treatment, and of those who do, many exit prematurely. Given the highly social nature of residential drug rehabilitation services, it has been argued that social anxieties might decrease the likelihood of an individual entering treatment, or increase the likelihood of them prematurely exiting treatment. The current paper reports on the protocol of a Randomised Control Trial which examined whether treatment of social anxiety prior to entry to treatment improves entry rates and retention in residential drug rehabilitation. A Randomised Control Trial comparing a social skills treatment with a treatment as usual control group was employed. The social skills training program was based on the principles of Cognitive Behaviour Therapy, and was adapted from Ron Rapee's social skills training program. A permutated block randomisation procedure was utilised. Participants are followed up at the completion of the program (or baseline plus six weeks for controls) and at three months following entry into residential rehabilitation (or six months post-baseline for participants who do not enter treatment). The current study could potentially have implications for addressing social anxiety within residential drug treatment services in order to improve entry and retention in treatment. The results might suggest that the use of additional screening tools in intake assessments, a focus on coping with social anxieties in support groups for clients waiting to enter treatment, and greater awareness of social anxiety issues is warranted. Australian New Zealand Clinical Trials Registry (ACTRN) registration number: ACTRN12611000579998.
Swain, Caroline H.
The paper describes the residential treatment program at Daniel Memorial, a private agency for 24 emotionally troubled adolescents. Students are said to live on campus for 5 days and return home on weekends. The role of the teacher is focused on, and the Getzels-Guba model is used to picture the organizational areas of conflict or congruence for…
Doerfler, Leonard A.; Toscano, Peter F., Jr.; Connor, Daniel F.
We examined the relationship of gender and different forms of abuse experience on internalizing symptoms, externalizing symptoms, and IQ in a sample of 397 youngsters who were admitted to a residential treatment program. Three types of abuse experience were examined in this study: sexual abuse only, physical abuse only, and "both" sexual and…
Kruzich, Jean M.; Friesen, Barbara J.; Williams-Murphy, Tracy; Longley, M. J.
Examines families' perceptions about involvement in residential treatment from the viewpoints of African American and non-African American family members. Focus group interviews found that all family members shared some common positive and negative experiences. However, unique issues remained for African American caregivers. Implications for…
Branson, Christopher E.; Clemmey, Philip; Harrell, Paul; Subramaniam, Geetha; Fishman, Marc
This study examined posttreatment patterns of polysubstance use and heroin relapse in a sample of 43 adolescents (ages 14-20) entering short-term residential treatment for primary heroin use. At 12-month follow-up, youths that achieved heroin abstinence (N = 19) were significantly less likely than youths that relapsed to heroin (N = 24) to endorse…
Laquatra, J.; Chi, P.S.K.
Recognizing the importance of energy conservation, under sponsorship of the US Department of Energy, Cornell University conducted a research and demonstration project entitled An Innovative Educational Program for Residential Energy Efficiency. The research project examined the amount of residential energy that can be saved through changes in behavior and practices of household members. To encourage these changes, a workshop was offered to randomly-selected households in New York State. Two surveys were administered to household participants (Survey 1 and Survey 2, Appendix A) and a control group; and a manual was developed to convey many easy but effective ways to make a house more energy efficient (see Residential Manual, Appendix B). Implementing methods of energy efficiency will help reduce this country`s dependence on foreign energy sources and will also reduce the amount of money that is lost on inefficient energy use. Because Cornell Cooperative Extension operates as a component of the land-grant university system throughout the US, the results of this research project have been used to develop a program that can be implemented by the Cooperative Extension Service nationwide. The specific goals and objectives for this project will be outlined, the population and sample for the research will be described, and the instruments utilized for the survey will be explained. A description of the workshop and manual will also be discussed. This report will end with a summary of the results from this project and any observed changes and/or recommendations for future surveys pertaining to energy efficiency.
Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.
Fox, Robert A.; Burke, Amie M.; Fung, Michael P.
We studied the effectiveness of an individually-tailored leisure program implemented by direct care staff in a residential program for 28 adults with severe to profound intellectual disability using a multiple baseline design across two homes over a 1.5 year baseline and treatment period followed by another nearly 1.5 year maintenance phase. The…
Morse, Siobhan; MacMaster, Samuel
Opiate use patterns, user characteristics, and treatment response among young adults are of interest due to current high use prevalence and historical low levels of treatment engagement relative to older populations. Prior research in this population suggests that overall, young adults present at treatment with different issues. In this study the authors investigated potential differences between young adult (18-25 years of age) and older adult (26 and older) opiate users and the impact of differences relative to treatment motivation, length and outcomes. Data for this study was drawn from 760 individuals who entered voluntary, private, residential treatment. Study measures included the Addiction Severity Index (ASI), the Treatment Service Review (TSR), and University of Rhode Island Change Assessment (URICA). Interviews were conducted at program intake and 6-month post-discharge. Results indicate that older adults with a history of opiate use present at treatment with higher levels of severity for alcohol, medical, and psychological problems and young adults present at treatment with greater drug use and more legal issues. Significant improvement for both groups was noted at 6 months post treatment; there were also fewer differences between the two age groups of opiate users. Results suggest different strategies within treatment programs may provide benefit in targeting the disparate needs of younger opiate users. Overall, however, results suggest that individualized treatment within a standard, abstinence-based, residential treatment model can be effective across opiate users at different ages and with different issues, levels of severity, and impairment at intake.
Choi, Sam; Adams, Susie M; MacMaster, Samuel A; Seiters, John
A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders. The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA. Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days. The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change. These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.
Edwards, Rachel; Beech, Anthony; Bishopp, Daz; Erikson, Matt; Friendship, Caroline; Charlesworth, Lucy
This study addresses the prediction that dropout from a UK specialized residential treatment program for adolescent sexual abusers can be determined from pre-treatment variables. Participants were 49 adolescents aged 12-16 years, who had sexually abused children, peers/adults or both. Of the variables examined, 25 showed a significant association…
Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz
There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley
Miller, Merlene; Chen, Amanda LC; Stokes, Stan D.; Silverman, Susan; Bowirrat, Abdalla; Manka, Matthew; Manka, Debra; Miller, David K.; Perrine, Kenneth; Chen, Thomas JH; Bailey, John A.; Downs, William; Waite, Roger L.; Madigan, Margaret A.; Braverman, Eric R.; Damle, Uma; Kerner, Mallory; Giordano, John; Morse, Siobhan; Oscar-Berman, Marlene; Barh, Debmalya; Blum, Kenneth
Substance use disorders (SUD) are inheritable and the culprit is hypodopaminergic function regulated by reward genes. We evaluated a natural dopaminergic agonist; KB220 intravenous (IV) and oral variants, to improve dopaminergic function in SUD. Our pilot experiment found a significant reduction of chronic symptoms, measured by the Chronic Abstinence Symptom Severity (CASS) Scale. The combined group (IV and oral) did significantly better than the oral-only group over the first week and 30-day follow-up period. Next, the combination was given to129 subjects and three factors; Emotion, Somatic, and Impaired Cognition, with eigenvalues greater than one were extracted for baseline CASS-Revised (CASS-R) variables. Paired sample t-tests for pre and post-treatment scales showed significant declines (p = .00001) from pre- to post-treatment: t = 19.1 for Emotion, t = 16.1 for Somatic, and t = 14.9 for Impaired Cognition. In a two-year follow-up of 23 subjects who underwent KB220IV therapy (at least five IV treatments over seven days) plus orals for 30+ days: 21 (91%) were sober at six months, 19 (82%) having no relapse; 19 (82%) were sober at one year, 18 (78%) having no relapse; and 21 (91%) were sober two-years post-treatment, 16 (70%) having no relapse. We await additional research and advise caution in interpreting these encouraging results. PMID:23457891
Cullum, Jodi Leigh
The present study aimed to examine the relationship between maladaptive schemas and treatment outcomes of adolescent and adult women with an eating disorder receiving residential treatment. Existing data were obtained from 67 females aged 11 to 47 years (m =18.61) that had entered residential treatment for anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) at a Western United States residential eating disorder treatment facility. Pre- and posttreat...
Lyons, Tara; Shannon, Kate; Pierre, Leslie; Small, Will; Krüsi, Andrea; Kerr, Thomas
While considerable research has been undertaken on addiction treatment, the experiences of transgender individuals who use drugs are rarely explored in such research, as too often transgender individuals are excluded entirely or grouped with those of sexual minority groups. Consequently, little is known about the treatment experiences in this population. Thus, we sought to qualitatively investigate the residential addiction treatment experiences of transgender individuals who use illicit drugs in a Canadian setting. In-depth semi-structured interviews were conducted with 34 transgender individuals in Vancouver, Canada between June 2012 and May 2013. Participants were recruited from three open prospective cohorts of individuals who use drugs and an open prospective cohort of sex workers. Theory-driven and data-driven approaches were used to analyze the data and two transgender researcher assistants aided with the coding and the interpretation of data in a process called participatory analysis. Fourteen participants had previous experience of addiction treatment and their experiences varied according to whether their gender identity was accepted in the treatment programs. Three themes emerged from the data that characterized individuals' experiences in treatment settings: (1) enacted stigma in the forms of social rejection and violence, (2) transphobia and felt stigma, and (3) "trans friendly" and inclusive treatment. Participants who reported felt and enacted stigma, including violence, left treatment prematurely after isolation and conflicts. In contrast, participants who felt included and respected in treatment settings reported positive treatment experiences. The study findings demonstrate the importance of fostering respect and inclusivity of gender diverse individuals in residential treatment settings. These findings illustrate the need for gender-based, anti-stigma policies and programs to be established within existing addiction treatment programs
... multipliers based on climate, consumer behavior assumptions, and product characteristics (e.g., multi-stage or... Conservation Program for Consumer Products: Test Procedures for Residential Furnace Fans; Proposed Rule #0;#0... Conservation Program for Consumer Products: Test Procedures for Residential Furnace Fans AGENCY: Office of...
Koontz, M.D.; Lee, S.M.; Spears, J.W.; Kesselring, J.P.
Energy recovery ventilators offer the prospect of tighter control over residential ventilation rates than manual methods, such as opening windows, with a lesser energy penalty. However, the appropriate size of such a ventilator is not readily apparent in most situations. Sizing of energy recovery ventilation software was developed to calculate the size of ventilator necessary to satisfy ASHRAE Standard 62-1989, Ventilation for Acceptable Air Quality, or a user-specified air exchange rate. Inputs to the software include house location, structural characteristics, house operations and energy costs, ventilation characteristics, and HVAC system COP/efficiency. Based on these inputs, the program estimates the existing air exchange rate for the house, the ventilation rate required to meet the ASHRAE standard or user-specified air exchange rate, the size of the ventilator needed to meet the requirement, and the expected changes in indoor air quality and energy consumption. In this paper an illustrative application of the software is provided
Frensch, Karen; Cameron, Gary; Preyde, Michele
Caregivers of 210 youth receiving residential treatment (RT) or intensive family services (IFS) in Ontario were interviewed about the long term community adaptation of youth after leaving these programs. School attendance and academic functioning data at admission, discharge, and 12-18 months post-discharge were analyzed to explore predictors of…
Ward, Ronald J.
Rhode Islanders Saving Energy (RISE) is a non-profit corporation founded in 1977 to provide Rhode Island residents with a variety of energy conservation services. Since January of 1981, it has been performing energy audits in compliance with the Department of Energy's (DOE) Residential Conservation Service Program (RCS). One aspect of the RCS program is the performance of inspections on energy conservation activities completed according to RCS installation guidelines. This paper will describe both the use and results of thermographic inspections within the RISE program. The primary objective of these inspections has been to assure the quality of the building envelope after completion of retrofit measures. Thermal anamolies have been detected that vary in size, location and probable cause. Approximately 37% of all jobs performed through RISE in conjunction with the RCS program have required remedial work as a result of problems that were identi-fied during the thermographic inspection. This percentage was much higher when infra-red inspections were conducted on "Non-RCS" retrofits. Statistics will be presented that provide an interesting insight on the quality of retrofit work when performed in associa-tion with a constant inspection process.
Adams, Jonathan; Eveland, Vicki
A total of 150 university Web sites were segregated into one of three groups: accredited residential, regionally accredited online, and nonaccredited online institutions. The promotional imagery, marketing messages and marketing themes found on the landing pages of each university program Web sites were analyzed for similarities and differences. A…
Taylor, Nicholas Wade
Electric utilities, government agencies, and private interests in the U.S. have committed and continue to invest substantial resources in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. Program investments, and the demand for impact evaluations that accompany them, are projected to grow in coming years due to increased pressure from state-level energy regulation, costs and challenges of building additional production capacity, fuel costs and potential carbon or renewable energy regulation. This dissertation provides detailed analyses of ex-post energy savings from energy efficiency programs in three key sectors of residential buildings: new, single-family, detached homes; retrofits to existing single-family, detached homes; and retrofits to existing multifamily housing units. Each of the energy efficiency programs analyzed resulted in statistically significant energy savings at the full program group level, yet savings for individual participants and participant subgroups were highly variable. Even though savings estimates were statistically greater than zero, those energy savings did not always meet expectations. Results also show that high variability in energy savings among participant groups or subgroups can negatively impact overall program performance and can undermine marketing efforts for future participation. Design, implementation, and continued support of conservation programs based solely on deemed or projected savings is inherently counter to the pursuit of meaningful energy conservation and reductions in greenhouse gas emissions. To fully understand and optimize program impacts, consistent and robust measurement and verification protocols must be instituted in the design phase and maintained over time. Furthermore, marketing for program participation must target those who have the greatest opportunity for savings. In most utility territories it is not possible to gain access to the type of large scale
Embregts, Petri J. C. M.
In this study, the question was explored whether children with a mild intellectual disability (MID) who were placed in residential treatment following outpatient treatment differ significantly on child and family characteristics from children with MID and not placed in residential treatment following outpatient treatment. The records of the…
Khalsa, Sat Bir S; Khalsa, Gurucharan S; Khalsa, Hargopal K; Khalsa, Mukta K
Previously reported substance abuse interventions incorporating meditation and spiritual approaches are believed to provide their benefit through modulation of both psychological and pyschosocial factors. A 90-day residential group pilot treatment program for substance abuse that incorporated a comprehensive array of yoga, meditation, spiritual and mind-body techniques was conducted in Amritsar, India. Subjects showed improvements on a number of psychological self-report questionnaires including the Behavior and Symptom Identification Scale and the Quality of Recovery Index. Application of comprehensive spiritual lifestyle interventions may prove effective in treating substance abuse, particularly in populations receptive to such approaches.
Collier, Scott; Gavriel, Mardell
A nonprofit primary care, substance abuse and mental health treatment provider that operates nine separate residential treatment facilities in both northern and southern California began allowing clients to keep their mobile phones while in treatment. From the advent of mobile phone technology and its widespread adoption through early 2013, the organization prohibited clients from having phones while in treatment. Calls to and from clients needed to be made and received at the house phone. After years of enforcing the policy with diminished success as phones became cheaper, smaller, and more prevalent, agency leadership decided to experiment with allowing the clients to keep their phones while in treatment. Elopement data as they relate to the policy are examined along with data from staff interviews about its implementation and impact. Results show that elopements resulting from being caught with a mobile phone were eliminated and some clients were able to be returned to treatment using the devices. All seven (100%) of the interviewees were supportive of the new policy and thought it should be continued. The impact of the policy on clinical disruptions, lost/stolen property liability, and confidentiality issues are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.
Shapiro, Cory Adam
The purpose for this doctoral action research study was to discover if and how an updated training and development curriculum benefited residential student organization advisers at Arizona State University (ASU). Eleven advisers of residential student organizations completed a pilot training and development program and agreed to participate in a…
... Efficiency Program: Test Procedures for Residential Water Heaters, Direct Heating Equipment, and Pool Heaters... residential water heaters, direct heating equipment, and pool heaters. This rulemaking is intended to fulfill... water heaters, possible clarifications and improvement of the direct heating equipment test procedures...
... for Residential Water Heaters, Direct Heating Equipment, and Pool Heaters AGENCY: Office of Energy... ``Energy Conservation Program for Consumer Products Other Than Automobiles,'' including residential water... energy consumption, and because off mode is not applicable to water heaters, no amendment is required...
... procedure for residential water heaters fully addresses standby mode and off mode energy consumption, this... DEPARTMENT OF ENERGY 10 CFR Part 430 [Docket No. EERE-2009-BT-TP-0013] RIN 1904-AB95 Energy Conservation Program for Consumer Products: Test Procedures for Residential Water Heaters, Direct Heating...
Giorgi, Ines; Ottonello, Marcella; Vittadini, Giovanni; Bertolotti, Giorgio
Alcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive-affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse. The sample included 560 subjects (mean age 46.91±10.2 years) who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment - Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome evaluation of the residential intervention. Moreover, differences in the psychological functioning between patients with different characteristics were investigated. The score measured by the Cognitive Behavioral Assessment - Outcome Evaluation showed significant improvements in all the psychological characteristics assessed, and the profile at discharge was within the normal scores. Some significant differences were found in relation to specific characteristics of the sample, such as age, sex, level of education, type of intervention, and polysubstance use. This study shows the changes in psychological profile in subjects undergoing residential rehabilitation from alcohol and how this profile may permit identification of subjects requiring more
Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen
This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…
Noftle, J. W.; Cook, S.; Leschied, A.; St. Pierre, J.; Stewart, S. L.; Johnson, A. M.
This study examined the symptom response trajectories for 225 children and youth throughout a period of residential treatment. With the 10-item "Conners' Global Index" ("CGI") as the primary outcome measure, assessments were completed on a bi-weekly basis during the average 4 month stay within the youth's residential treatment. Clients…
This report provides an overview of issues involved in residential ventilation; provides an overview of the various ventilation strategies being evaluated by the five teams, or consortia, currently involved in the Building America Program; and identifies unresolved technical issues.
Oostermeijer, S.; van Nieuwenhuijzen, M.; van de Ven, P.M.; Popma, A.; Jansen, L.M.C.
Adolescents in residential treatment predominantly show externalizing problems. To provide more tailored treatments, gaining knowledge on underlying processes is important. Aggression is often subdivided in defensive/reactive, and instrumental/proactive aggression. The social information processing
Lipscomb, Jane A; London, M; Chen, Y M; Flannery, K; Watt, M; Geiger-Brown, J; Johnson, J V; McPhaul, K
To examine the association between violence prevention safety climate measures and self reported violence toward staff in state-run residential addiction treatment centers. In mid-2006, 409 staff from an Eastern United States state agency that oversees a system of thirteen residential addiction treatment centers (ATCs) completed a self-administered survey as part of a comprehensive risk assessment. The survey was undertaken to identify and measure facility-level risk factors for violence, including staff perceptions of the quality of existing US Occupational Safety and Health Administration (OSHA) program elements, and ultimately to guide violence prevention programming. Key informant interviews and staff focus groups provided researchers with qualitative data with which to understand safety climate and violence prevention efforts within these work settings. The frequency with which staff reported experiencing violent behavior ranged from 37% for "clients raised their voices in a threatening way to you" to 1% for "clients pushed, hit, kicked, or struck you". Findings from the staff survey included the following significant predictors of violence: "client actively resisting program" (OR=2.34, 95% CI=1.35, 4.05), "working with clients for whom the history of violence is unknown" (OR=1.91, 95% CI=1.18, 3.09) and "management commitment to violence prevention" reported as "never/hardly ever" and "seldom or sometimes" (OR=4.30 and OR=2.31 respectively), while controlling for other covariates. We utilized a combination of qualitative and quantitative research methods to begin to describe the risk and potential for violence prevention in this setting. The prevalence of staff physical violence within the agency's treatment facilities was lower than would be predicted. Possible explanations include the voluntary nature of treatment programs; strong policies and consequences for resident behavior and ongoing quality improvement efforts. Quantitative data identified low
Dickens, Yani L; Haynos, Ann F; Nunnemaker, Shannon; Platka-Bird, Lorraine; Dolores, John
Research on treatment for diabetes and co-occurring eating disorders is sparse. We examined outcomes from multidisciplinary residential treatment for women with type 1 diabetes and eating disorders and the impact of treatment duration on outcomes. Participants were 29 women with type 1 diabetes and eating disorders receiving residential treatment. Repeated measures analyses of variance examined changes in blood glucose and psychological symptoms over treatment. Analyses were repeated to include treatment by duration interactions. Treatment produced significant reductions in blood glucose, eating disorder symptoms, and psychological concerns. Longer treatment duration was associated with greater improvements in psychological symptoms.
Bride, Brian E; Macmaster, Samuel A; Morse, Siobhan A; Watson, Cayce M; Choi, Sam; Seiters, John
The past decade has seen a marked increase in the illicit use of opioids, as well as a doubling of the percentage of individuals seeking treatment for opioid use disorders. However, little is known about the differences between opioid users and nonopioid users in residential treatment. Further, no studies have been published that compare opioid users and nonopioid users in treatment for co-occurring substance use and mental disorders. To address this gap, this study examined differences between opioid and nonopioid substance users in residential treatment for co-occurring disorders. Data was drawn from 1,972 individuals treated between 2009 and 2011 at one of three private residential treatment centers that provide integrated treatment for co-occurring substance use and mental disorders. Data was collected at program intake, and 1- and 6-month postdischarge using the Addiction Severity Index and the University of Rhode Island Change Assessment. To examine within-group changes in substance use, addiction severity, and mental health across time, linear mixed-model analyses were conducted with facility, year, age, gender, and race included as covariates. The authors found more similarities than differences between the two groups on baseline characteristics, treatment motivation, length of stay, and outcomes on measures of substance use, addiction severity, and mental health. The results demonstrate that though opioid users entered treatment with higher levels of substance use-related impairment, they were just as successful in treatment outcomes as their non-opioid-using peers.
Adolescence is a period during human development characterized by a variety of biological, psychological, and social changes. Navigating these changes can be a stressful experience for both adolescents and their families. To complicate matters further, the Internet has altered the landscape of human interaction in a way that may accentuate deficits in the capacity for self-sustaining, reciprocal peer relationships. Adolescents suffering from emotional and behavioral disorders may be especially prone to this influence, as evidenced by our observation of the growing clinical trend of adolescents admitted to inpatient and residential psychiatric units who present with a history of risky cyber-behaviors. Within these settings, education for adolescents and their families around appropriate use of the Internet, as well as social training for the online management of the impulsivity and poor judgment that is so often characteristic of adolescence, is vital. Milieu models employed in the treatment of emotionally troubled adolescents must adapt so as to incorporate the identification of problematic attachment behaviors not only in real-time relationships, but also as those behaviors inevitably occur in more troubling and potentially destructive ways over the Internet. The article addresses this need by offering recommendations for the creation of a skills-based, Internet-focused curriculum for inpatient and residential programs targeting at-risk adolescents. Evaluating the association between online communication habits and the evolution of disturbances in attachment systems is an important future direction for research aimed at safeguarding the emotional and physical well-being of all adolescents.
Berry, L.; Hubbard, M.; White, D.
This report describes thirty-nine utility-sponsored residential conservation programs for four types of markets. The program types considered are: (1) financial incentive programs for the general residential market, (2) programs for low-income households, (3) programs for the elderly, and (4) programs for the multifamily market. Each program description contains information on incentive terms, eligibility, conservation measures, program history, design and marketing, and the utility/agency motivation for operating the program. The names, addresses and phone numbers of contact persons also are included. Two methods were used to select the programs to be described. First, nominations of successful programs of each type were solicited from experts on residential energy conservation. Second, managers of the programs on this initial list were asked to describe their programs and to suggest other successful programs that should be included in the sample. Because of the selection process used, this report covers mainly the best known and most frequently studied programs that are aimed at the four market types.
Guydish, Joseph; Ziedonis, Douglas; Tajima, Barbara; Seward, Greg; Passalacqua, Emma; Chan, Mable; Delucchi, Kevin; Zammarelli, Lucy; Levy, Michael; Kolodziej, Monika; Brigham, Greg
Smoking prevalence among persons in addiction treatment is 3-4 times higher than in the general population. However, treatment programs often report organizational barriers to providing tobacco-related services. This study assessed the effectiveness of a six month organizational change intervention, Addressing Tobacco Through Organizational Change (ATTOC), to improve how programs address tobacco dependence. The ATTOC intervention, implemented in three residential treatment programs, included consultation, staff training, policy development, leadership support and access to nicotine replacement therapy (NRT) medication. Program staff and clients were surveyed at pre- and post-intervention, and at 6 month follow-up. The staff survey measured knowledge of the hazards of smoking, attitudes about and barriers to treating smoking, counselor self-efficacy in providing such services, and practices used to address tobacco. The client survey measured knowledge, attitudes, and tobacco-related services received. NRT use was tracked. From pre- to post-intervention, staff beliefs became more favorable toward treating tobacco dependence (F(1, 163)=7.15, p=0.008), NRT use increased, and tobacco-related practices increased in a non-significant trend (F(1, 123)=3.66, p=0.058). Client attitudes toward treating tobacco dependence became more favorable (F(1, 235)=10.58, p=0.0013) and clients received more tobacco-related services from their program (F(1, 235)=92.86, p<0.0001) and from their counselors (F(1, 235)=61.59, p<0.0001). Most changes remained at follow-up. The ATTOC intervention can help shift the treatment system culture and increase tobacco services in addiction treatment programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Cook, Emily C.
This qualitative study explores the aspects of a residential wilderness experience that informed self-evaluations in male adolescents, ages 12-16. To assess change in self-evaluations and program factors associated with change, qualitative interviews were conducted with adolescents upon entry to the program and four months later. Participants'…
Matthews, Geraldine M.
The directory lists approximately 120 library information service programs in residential facilities for the mentally retarded. Each program is described in terms of its collection (journals, books, films, and tapes), space, services (story hours, reference questions, bibliographies, and translation services), budget, clientele, and program…
Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.
This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…
Kerr, R.; Tondro, M.
Behavior-based approaches have been a growing interest in the energy efficiency field over recent years and the use of residential energy feedback has garnered particular interest. By providing an increased level of detail, feedback can greatly increase a consumer's understanding of how energy is used in their home. This project reviewed the existing body of research on electricity feedback to identify parallel lessons for gas, discussed the benefits and challenges of different types of feedback, and identifying three feedback options that show strong potential for natural gas savings.
Kerr, R. [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Tondro, M. [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States)
Behavior-based approaches have been a growing interest in the energy efficiency field over recent years and the use of residential energy feedback has garnered particular interest. By providing an increased level of detail, feedback can greatly increase a consumer’s understanding of how energy is used in their home. This project reviewed the existing body of research on electricity feedback to identify parallel lessons for gas, discussed the benefits and challenges of different types of feedback, and identifying three feedback options that show strong potential for natural gas savings.
Lejuez, C W; Simmons, Burnetta L; Aklin, Will M; Daughters, Stacey B; Dvir, Sharone
In the current study, a battery of self-report measures of impulsivity, self-esteem, and depressive symptoms, as well as a behavioral measure of risk-taking propensity, was administered to 76 residents of two inner-city substance use residential treatment programs to determine the unique relationship between risk-taking propensity and risky sexual behavior (RSB). Results indicated that impulsivity, self-esteem, and risk-taking propensity were independently related to RSB. In a subsequent regression analysis, risk-taking propensity evidenced incremental validity, suggesting a relationship between risk-taking propensity and RSB, above and beyond that provided with the other relevant variables. The potential importance of risk-taking propensity the better understanding HIV risk through engagement in RSB is discussed.
Chun, JongSerl; Guydish, Joseph; Chan, Ya-Fen
The study was designed to: (1) identify smoking policies and interventions in adolescent residential treatment settings; (2) examine the prevalence of smoking among adolescents in these settings; and (3) assess relationships between program-level smoking policies and client-level smoking. The Center for Substance Abuse Treatment funded 17 sites to evaluate the effectiveness of Adolescent Residential Treatment (ART) programs for substance abuse. To describe program smoking policies and interve...
DBT and EMDR as primary treatment methods provide effective treatment for adolescents in the setting of group residential facilities. Regardless of the intensity of the pathology or the length of stay, these compatible treatment methods provide adolescents with significant decreases in the impact of traumatic memories and increased emotional…
Manuel, Jennifer I; Yuan, Yeqing; Herman, Daniel B; Svikis, Dace S; Nichols, Obie; Palmer, Erin; Deren, Sherry
Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals' basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment. Copyright © 2016 Elsevier Inc. All rights reserved.
Adelman, Robert; McGee, Patricia; Power, Robert; Hanson, Cathy
Sundown Ranch, a residential behavioral health care treatment facility for adolescents, tracked the progress and results of treatment by selecting performance measures from a psychosocial screening inventory. The temper scale was one of the two highest scales at admission and the highest scale at discharge. A clinical performance improvement (PI) project was conducted to assess improvements in clients' ability to manage anger after the incorporation of Rational Emotive Behavior Therapy (REBT) into treatment. Eighteen months of baseline data (July 1, 1999 - February 1, 2001) were collected, and 20 months of data (May 1, 2001 - December 31, 2002) were collected after the introduction of the PI activity. In all, data were collected for 541 consecutive admissions. A comparison of five successive quarterly reviews indicated average scores of 1.4 standard deviations (SDs) above the mean on the temper scale before the PI activity and .45 SD above the mean after. The performance threshold of reduction of the average temper scale score to REBT with the treatment population. After the project was completed, REBT was promoted as an additional therapeutic modality within the treatment program.
Morse, Siobhan A; Watson, Cayce; MacMaster, Samuel A; Bride, Brian E
The purpose of this study was to examine differences between older and younger adults who received integrated treatment for co-occurring substance use and mental disorders, including differences on demographic and baseline characteristics (e.g., substance use, readiness for change, mental health symptoms, and severity of problems associated with substance use), as well as predictors of retention in treatment. This study included 1400 adults who received integrated substance abuse and mental health treatment services at one of two private residential facilities offering residential and outpatient services. Initial analyses consisted of basic descriptive and bivariate analyses to examine differences between older (≥ 50 years old) and younger (co-occurring substance use and mental health disorders by documenting that age-based differences exist in general and in the factors that are associated with the length of stay in residential treatment.
Based on an evaluation of 10 residential new construction programs, primarily sponsored by investor-owned utilities in the United States, we find that many of these programs are in dire straits and are in danger of being discontinued because current inclusion of only direct program effects leads to the conclusion that they are not cost-effective. We believe that the cost-effectiveness of residential new construction programs can be improved by: (1) promoting technologies and advanced building design practices that significantly exceed state and federal standards; (2) reducing program marketing costs and developing more effective marketing strategies; (3) recognizing the role of these programs in increasing compliance with existing state building codes; and (4) allowing utilities to obtain an ``energy-savings credit`` from utility regulators for program spillover (market transformation) impacts. Utilities can also leverage their resources in seizing these opportunities by forming strong and trusting partnerships with the building community and with local and state government.
Callaway, J.W.; Lee, A.D.
In July 1986, the US Department of Energy (DOE) awarded competitive grants to five states to conduct pilot projects to establish partnerships and use resource leveraging to stimulate support for low-income residential energy retrofits. The projects were conducted under DOE's Partnerships in Low-Income Residential Retrofit (PILIRR) Program. These projects have been monitored and analyzed through a concurrent process evaluation conducted by the Pacific Northwest Laboratory (PNL). This study reports the findings of that evaluation. The overriding goal of the PILIRR Program was to determine whether the states could stimulate support for low-income residential energy improvements from non-federal sources. The goal for the process evaluation was to conduct an assessment of the processes used by the states and the extent to which they successfully established partnerships and leveraged resources. Five states were selected to participate in the program: Florida, Iowa, Kentucky, Oklahoma and Washington. Each state proposed a different approach to promote non-federal support for low-income residential weatherization. Three of the five states--Florida, Iowa, and Washington--established partnerships that led to retrofits during the monitoring period (October 1986--October 1988). Kentucky established its partnership during the monitoring period, but did not accomplish its retrofits until after monitoring was complete. Oklahoma completed development of its marketing program and had begun marketing efforts by the end of the monitoring period. 16 refs., 7 figs., 1 tab.
Progress in the effort to develop a residential solar-powered air conditioning system is reported. The topics covered include the objectives, scope and status of the program. The results of state-of-art, design, and economic studies and component and system data are also presented.
... DEPARTMENT OF ENERGY 10 CFR Part 430 [Docket Number EE-2006-BT-STD-0129] RIN 1904-AA90 Energy Conservation Program: Energy Conservation Standards for Residential Water Heaters, Direct Heating Equipment, and Pool Heaters Correction In rule document 2010-7611 beginning on page 20112 in the issue of Friday...
Building Technologies Office
This case study describes how the Midwest Energy Efficiency Alliance (MEEA) partnered with gas and electric utilities in Iowa to establish the Iowa residential heating, ventilation, and air conditioning System Adjustment and Verified Efficiency (HVAC SAVE) program, taking it to scale improving the performance and energy efficiency of HVAC systems, growing businesses, and gaining consumer trust.
Seidner, Andrea L.; And Others
Gathered descriptive data on 163 telephone applicants to residential rehabilitation program for homeless veterans and compared data with general veteran and homeless populations. Found subjects to be young, educated group of homeless men with histories of relatively high, stable functioning and high rates of medical, substance abuse, psychiatric,…
Brauers, Malou; Kroneman, Leoniek; Otten, Rene; Lindauer, Ramon; Popma, Arne
Youths in compulsory residential care show a high prevalence of various mental health problems but often lack motivation to engage in therapeutic treatment. Although the self-determination-theory (SDT) and the transtheoretical model of change (TTM) offer a useful framework for treatment motivation,
Preyde, Michele; Watkins, Hanna; Ashbourne, Graham; Lazure, Kelly; Carter, Jeff; Penney, Randy; White, Sara; Frensch, Karen; Cameron, Gary
The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental…
Lozano-Verduzco, Ignacio; Romero-Mendoza, Martha; Marín-Navarrete, Rodrigo
Violence against women is a social and public health issue in Mexico. The aim of this article is to explore violence among an understudied group of women, who attended Mutual-Aid Residential Centers for Addiction Treatment and experienced stigma both as women and addicts. These centers are particular kind of addiction treatment services that stem from 12-step philosophy, but that have been found to manipulate said philosophy and exercise extreme forms of psychological and physical violence. Thirteen semi-structured interviews were carried in 2014 and 2015 out with women who resided in at least one of these centers to understand their experiences of violence prior and during their rehabilitation process. The interview guide covered questions regarding substance use initiations, family violence and dynamics, and rehabilitation experiences. Qualitative data was analyzed using interpretative-phenomenological analysis. Two categories emerged: violence and substance use and abuse, and violence against women in recovery. Results show that all participants experienced violence in their family since childhood, particularly sexual and physical violence. As a result, participants experienced guilt, sadness and shame, which led them to contexts of consumption. Violence continued as they explored alcohol and drug use, even though women felt empowered. Treatment reproduced masculine violence constantly, but women felt that they were in a context that helped them understand their addiction. Even though women felt these centers played a crucial role in their recovery, women's particular needs and experiences are not considered in the treatment program.
Grevatt, Jim [Energy Futures Group (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffmeyer, Dale [US Department of Energy, Washington, DC (United States)
After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residential savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in
Department of Homeland Security — The National Flood Insurance Program (NFIP) aims to reduce the impact of flooding—a burden not covered by homeowner’s insurance—by providing insurance to homeowners,...
The ``Weatherization Residential Assistance Partnership,`` or WRAP program, is a fuel-blind conservation program designed to assist Northeast Utilities` low-income customers to use energy safely and efficiently. Innovative with respect to its collaborative approach and its focus on utilizing and strengthening the existing low-income weatherization service delivery network, the WRAP program offers an interesting model to other utilities which traditionally have relied on for-profit energy service contractors and highly centralized program implementation structures. This report presents appendices with surveys, participant list, and computers program to examine and predict potential energy savings.
Lyons, Tara; Shannon, Kate; Pierre, Leslie; Small, Will; Kr?si, Andrea; Kerr, Thomas
Background While considerable research has been undertaken on addiction treatment, the experiences of transgender individuals who use drugs are rarely explored in such research, as too often transgender individuals are excluded entirely or grouped with those of sexual minority groups. Consequently, little is known about the treatment experiences in this population. Thus, we sought to qualitatively investigate the residential addiction treatment experiences of transgender individuals who us...
Brown, Danice L.; Jewell, Jeremy D.; Stevens, Amy L.; Crawford, Jessica D.; Thompson, Ronald
We investigated the relationship between gender and clinician diagnosis of a depressive disorder at intake on variables reflecting depression among adolescents in residential treatment. It was hypothesized that females diagnosed with a depressive disorder would have the highest scores on measures of suicide risk, the number of symptoms of a major…
Coll, Kenneth M.; Powell, Stephanie; Thobro, Patti; Haas, Robin
This study examined relations between family cohesion and adaptability (as measured by the Family Adaptability and Cohesion Scales-III) and the formation of trust and intimacy (assessed with the Measure of Psychosocial Development) among adolescents in residential treatment. Bivariate correlation revealed a significant association between family…
Nelson, Timothy D.; Smith, Tori R.; Duppong Hurley, Kristin; Epstein, Michael H.; Thompson, Ronald W.; Tonniges, Thomas F.
Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to…
Kelly Peter J
Full Text Available Abstract Background A large proportion of people attending residential alcohol and other substance abuse treatment have a co-occurring mental illness. Empirical evidence suggests that it is important to treat both the substance abuse problem and co-occurring mental illness concurrently and in an integrated fashion. However, the majority of residential alcohol and other substance abuse services do not address mental illness in a systematic way. It is likely that computer delivered interventions could improve the ability of substance abuse services to address co-occurring mental illness. This protocol describes a study in which we will assess the effectiveness of adding a computer delivered depression and substance abuse intervention for people who are attending residential alcohol and other substance abuse treatment. Methods/Design Participants will be recruited from residential rehabilitation programs operated by the Australian Salvation Army. All participants who satisfy the diagnostic criteria for an alcohol or other substance dependence disorder will be asked to participate in the study. After completion of a baseline assessment, participants will be randomly assigned to either a computer delivered substance abuse and depression intervention (treatment condition or to a computer-delivered typing tutorial (active control condition. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based treatment facility. Randomisation will be stratified by gender (Male, Female, length of time the participant has been in the program at the commencement of the study (4 weeks or less, 4 weeks or more, and use of anti-depressant medication (currently prescribed medication, not prescribed medication. Participants in both conditions will complete computer sessions twice per week, over a five-week period. Research staff blind to treatment allocation will complete the assessments at baseline, and then 3, 6, 9
Bergeron, C.; Bernard, J.-T.
Higher than expected electricity consumption in recent years and increasing objections to capacity expansion on environmental grounds have led Quebec's government-owned electric utility, Hydro-Quebec, to launch an innovative program to reduce peak period residential electric heating demand. When the outside temperature drops below -12 degree C, customers who have opted for the program are charged 10 cents/kWh for their electricity (substantially above the 4.46 cents/kWh paid by normal residential customers) and they are automatically switched to a non-electric heating source, whereas above -12 degree C they pay 2.75 cents/kWh for all uses. A cost benefit analysis of this dual energy program finds that if, as Hydro-Quebec forecasts, 150,000 residential customers were to opt for this program, they would benefit by $19.0 million per year, while the utility and the government would lose $21.6 million and $1.6 million respectively, with a total net loss to Quebec society of $4.25 million a year. 12 refs., 4 figs., 6 tabs
Ardoin, Nicole M.; DiGiano, Maria L.; O'Connor, Kathleen; Podkul, Timothy E.
Trust, a relational phenomenon that is an important building block of interpersonal relationships and within society, can also be an intermediary outcome of field-based environmental education programs. Trust creates a foundation for collaboration and decision-making, which are core to many ultimate outcomes of environmental education. Yet,…
. Analysis of the questionnaires revealed that compared to non-completers, completers had fewer psychiatric symptoms, higher levels of introverted behavior in stressful situations, a better sense of coherence, and less ability to share emotions. No significant differences were found with regard to demographic and substance use factors. All 19 women who completed treatment and the follow-up questionnaire remained abstinent from illicit drugs for 18 months following the end of treatment.Conclusion: Results indicate that women see the women-only treatment setting as extremely significant. Also, there is a profile of psychiatric co-morbidity, extrapunitiveness, and fewer personal resources that predict a risk for attrition. Thus, women at risk for attrition may be identified early and treatment staff can utilize the results to assist clients in achieving their treatment goals. Results can inform policymakers in making decisions regarding the allocation of resources, by pointing to the importance of long-term women-only residential treatment in increasing positive treatment outcomes.Keywords: gender, drug abuse, therapeutic community, mixed methods, program evaluation
Landon, Adam C.; Kyle, Gerard T.; Kaiser, Ronald A.
Residential water conservation initiatives often involve some form of education or persuasion intended to change the attitudes and behaviors of residential consumers. However, the ability of these instruments to change attitudes toward conservation and their efficacy in affecting water use remains poorly understood. In this investigation the authors examine consumer attitudes toward complying with a persuasive water conservation program, the extent to which those attitudes predict compliance, and the influence of environmental contextual factors on outdoor water use. Results indicate that the persuasive program was successful in developing positive attitudes toward compliance, and that those attitudes predict water use. However, attitudinal variables explain a relatively small proportion of the variance in objectively measured water use behavior. Recommendations for policy are made stressing the importance of understanding both the effects of attitudes and environmental contextual factors in behavior change initiatives in the municipal water sector.
Rawson, Richard A; Chudzynski, Joy; Gonzales, Rachel; Mooney, Larissa; Dickerson, Daniel; Ang, Alfonso; Dolezal, Brett; Cooper, Christopher B
This paper reports data from a study designed to determine the impact of an 8-week exercise program on depression and anxiety symptoms among newly abstinent methamphetamine (MA)-dependent individuals in residential treatment. One hundred thirty-five MA-dependent individuals, newly enrolled in residential treatment, were randomly assigned to receive either a 3-times-per-week, 60-minute structured exercise program for 8 weeks (24 sessions) or an equivalent number of health education sessions. Using mixed-modeling repeated-measures regression, we examined changes in weekly total depression and anxiety scores as measured by the Beck Depression Inventory and Beck Anxiety Inventory over the 8-week study period. Mean age of participants was 31.7 (SD = 6.9); 70.4% were male and 48% Latino. Analyses indicate a significant effect of exercise on reducing depression (β = -0.63, P = 0.001) and anxiety (β = -0.95, P=0.001) symptoms (total scores) over the 8-week period compared to a health education control group. A significant dose interaction effect between session attendance and exercise was found as well on reducing depression (β = -0.61, P < 0.001) and anxiety symptoms (β = -0.22, P=0.009) over time compared to the control group. Results support the role of a structured exercise program as an effective intervention for improving symptoms of depression and anxiety associated with MA abstinence. Copyright © 2015 Elsevier Inc. All rights reserved.
Alternative regulatory provisions are considered which might permit achievement of the building energy conservation regulatory goals at a lower cost. Major issues, regulatory and legislative options, and cost-benefit analyses are discussed for multi-family and commercial buildings. The following are presented: related government programs, urban and community impact analysis, institutional impacts, energy cost, Residential Conservation Service coverage, methods of analysis, and regional studies. (MHR)
Geurtsen, G.J.; Heugten, C.M. van; Martina, J.D.; Rietveld, A.C.; Meijer, R.; Geurts, A.C.H.
OBJECTIVE: To examine the effects of a residential community reintegration program on independent living, societal participation, emotional well-being, and quality of life in patients with chronic acquired brain injury and psychosocial problems hampering societal participation. DESIGN: A prospective
Full Text Available One of hot topics for ecological management is sewage treatment today in places where there is no sewerage. The volume of country construction in territories, which are not connected to the public sewage system increasing nowadays. Therefore, problem of wastewater treatment take place. Currently, there are a lot of different designs of local waste treatment plants is offered to consumers. However, a large number of negative reviews indicate serious shortcomings in most of the local plants offered in the market. The purpose of this paper is the proposal of improvement of the most common local treatment plants in Russia.
Lozano-Verduzco, Ignacio; Romero-Mendoza, Martha; Mar?n-Navarrete, Rodrigo
Background Violence against women is a social and public health issue in Mexico. The aim of this article is to explore violence among an understudied group of women, who attended Mutual-Aid Residential Centers for Addiction Treatment and experienced stigma both as women and addicts. These centers are particular kind of addiction treatment services that stem from 12-step philosophy, but that have been found to manipulate said philosophy and exercise extreme forms of psychological and physical ...
Cohler, Bertram J; Friedman, Daniel H
family scapegoat. Within these families, therapeutic efforts directed either at the troubled child or the whole family often fail to resolve conflict. Among these families, placement of a child in a therapeutic milieu provides refuge for children and permits parents to marshal their own resources in an effort to restore their own lives. Although many young persons with severe personality disorders meet the criteria formerly acceptable for residential care, such treatment facilities have proved particularly vulnerable to the effects of funding declines and increasing regulatory demands. Increasing visibility of pediatric pharmacology has lessened the impact of a child's disruptive behavior and may have facilitated decreased length of treatment. If, as Bettelheim maintained, psychological symptoms are a response to a world felt as overwhelming, early return to community in the absence of a young person's enhanced awareness of his or her own situation and impact on others may exacerbate return to care. As Rinsley observed, the pathologic family organization that led to the need for residential treatment is not likely to be significantly ameliorated by short-term, system-focused programs. Traditionally, the efforts of the long-term milieu settings have been aimed at restructuring complex and ingrained pathologic influences that have become embedded in family dynamics and have led to maladaptive behaviors in youngsters. The psychodynamic milieu approach emphasized the nuances of relation-ships and meanings ascertained from every interaction with other young people and with adults. This enhanced awareness of a child's impact on others through the marginal life-space interview, together with enhanced awareness of one's own wishes and thoughts as provided by the milieu and individual therapy, may offer the best means for helping a young person return successfully to the community. Although it is increasingly difficult to support young people in long-term milieu therapy, the
Ingram, Isabella; Kelly, Peter J; Deane, Frank P; Baker, Amanda L; Lyons, Geoff; Blackman, Russell
Smoking continues to be a major health concern for people with a history of alcohol or other substance use problems. The current research is aimed to (1) describe the prevalence of smoking in residential addictions treatment services and (2) compare characteristics of people who had or had not quit smoking. Participants were attending residential substance abuse treatment provided by the Australian Salvation Army. These programs are up to 10 months in length and offer a range of low-intensity smoking cessation supports. Measures of smoking, substance use, and clinical characteristics were collected from 2008 to 2015 at baseline and three months post-discharge from treatment (N = 702). At baseline, 86% of people were smokers (n = 606). At follow-up, only 48 participants who were smokers at baseline (7%) had quit smoking. Participants who had quit smoking at follow-up also reported higher rates of abstinence from alcohol or other substances at follow-up (72%) than people who had not quit smoking (46%; OR = 2.95, 95% CI [1.52, 5.74]). There is potential for smoking cessation to be better addressed as part of routine care in substance abuse treatment settings. Future research should evaluate the provision of more systematic smoking cessation interventions within these settings.
Kim, HyunSoo; Tracy, Elizabeth; Brown, Suzanne; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung; McCarty, Chris
This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t -tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.
Smith, Kathryn E; Mason, Tyler B; Leonard, Rachel C; Wetterneck, Chad T; Smith, Brad E R; Farrell, Nicholas R; Riemann, Brad C
Despite evidence documenting relationships between eating disorder (ED) psychopathology, depression, and anxiety, little is known regarding how social anxiety is related to ED symptoms in treatment. Therefore this study examined associations between depression, general anxiety, social anxiety, and ED psychopathology at the beginning and end of treatment (EOT) among patients (N = 380) treated in a residential ED program. Participants completed measures of ED psychopathology and affective variables. Higher depression and general anxiety, but not social anxiety, were related to higher ED psychopathology at baseline. However, social anxiety emerged as a unique predictor of ED psychopathology at EOT such that participants with higher social anxiety evidenced less improvement in ED psychopathology. Findings suggest that social anxiety has specific relevance to treatment in EDs, which may reflect shared mechanisms and underlying deficits in emotion regulation.
Amodeo, Maryann; Chassler, Deborah; Oettinger, Catherine; Labiosa, Wilfred; Lundgren, Lena M.
Client drop out from treatment is of great concern to the substance abuse field. Completion rates across modalities vary from low to moderate, not ideal since length of stay has been positively and consistently associated with better client outcomes. The study explored whether client characteristics shown to be related to retention were associated…
Prabucki, K; Wootton, E; McCormick, R; Washam, T
This study sought to evaluate the effects of a residential rehabilitation program for homeless mentally ill veterans on several measures of subjects' community adjustment. Subjects' housing status, financial and vocational status, psychological stability, utilization of coping resources, and extent of social contacts were measured at entry into the program and at follow-up six months after discharge. Data were available for 58 subjects at follow-up. Outcomes for subjects who successfully completed the program were compared with outcomes for those who did not. As a group, subjects assessed at follow-up showed significant improvement in housing, financial, and vocational status, in severity of several symptoms of psychological and emotional distress, in utilization of some types of coping resources, and in measures of social contacts and satisfaction. However, subjects who completed the program were more likely to have improved their housing, financial, and vocational situations. Comprehensive residential rehabilitation programs can help homeless veterans improve several aspects of their lives and maintain stability in those areas after discharge.
Dahne, Jennifer; Lejuez, Carl W
Following completion of substance use treatment, it is crucial for patients to continue to utilize skills learned in treatment for optimal treatment outcomes. Mobile applications (apps) on smartphones offer a unique platform to promote utilization of evidence-based skills following completion of substance use treatment. Despite the promise of mobile apps and smartphones for treatment delivery, it remains unknown whether patients in substance use treatment in the United States have access to smartphones and utilize mobile apps on smartphones. The present study sought to determine smartphone utilization among individuals enrolled in one residential substance use treatment center in the U.S. catering specifically to low-income adults. Participants included 251 individuals at a residential substance use treatment center in Washington DC admitted to the center between March, 2014 and January, 2015. During the intake process, participants completed interviewer-administered demographics and psychiatric questionnaires as well as a self-report of technology utilization. Results indicated that the majority of patients in this residential substance use treatment center owned mobile phones prior to treatment entry (86.9%) and expected to own mobile phones after leaving treatment (92.6%). Moreover, the majority of these phones were (68.5%) or will be smartphones (72.4%) on which patients reported utilizing mobile applications (prior to treatment: 61.3%; post treatment: 64.3%) and accessing the Internet (prior to treatment: 61.3%; post treatment: 65.9%). Mobile phone and smartphone ownership among this sample were comparable to ownership among U.S. adults broadly. Findings suggest that smartphones and mobile apps may hold clinical utility for fostering continued use of treatment skills following substance use treatment completion. Copyright © 2015 Elsevier Inc. All rights reserved.
Hoicka, Christina E.; Parker, Paul; Andrey, Jean
Better methods of characterizing and addressing heterogeneity in preferences and decision making are needed to stimulate reductions in household greenhouse gas emissions. Four residential energy efficiency programs were delivered consecutively in the Region of Waterloo, Canada, between 1999 and 2011, and each offered a unique combination of information, financial reward structure, and price. A natural quasi-experimental intervention design was employed to assess differences in outcomes across these program structures. Participation at the initial (evaluation by an energy advisor) and follow-up (verification of retrofit) stages, and the material characteristics (e.g., energy performance) were measured and compared between the groups of houses included in each program at each stage. The programs appealed to people with different types of material concerns; each phase of the program was associated with houses with a different mix of material characteristics and depths of recommended and achieved changes. While a performance-based reward attracted fewer houses at each stage than a larger list-based reward, older houses with poorer energy performance were included at each stage. The findings support experimentation with program designs to target sub-populations of housing stock; future program designs should experiment more carefully and with larger performance-based rewards and test parallels with potential carbon market structures. - Highlights: • Multi-program data over 12 years detailing residential energy retrofits. • Natural experimental intervention research design for program evaluation. • Number and attributes of participating households differed by program design. • Financial rewards attracted more participants to the verification stage. • Performance-based incentives have the largest potential for energy savings
Smith, E M; North, C S; Fox, L W
In response to the dearth of data on substance abuse treatment among homeless mothers, this study breaks new ground in presenting 18-month follow-up data on 149 homeless mothers with young children enlisted in a substance abuse treatment program. The effects of residential compared to nonresidential services were evaluated over the follow-up period. Although dropout rates were high, predictors of dropout were identified, and the residential had a lower dropout rate compared to the nonresidential comparison group. Members of both residential and nonresidential groups evidenced improvement in alcohol and drug problems and in housing stability, regardless of the amount of time they spent in the program. This project demonstrated that homeless mothers can be more successfully engaged in substance abuse programs with provisions of residential placement in addition to participation in a therapeutic community. Future interventions can take advantage of this knowledge in designing more effective programs.
Narendorf, Sarah Carter; Fedoravicius, Nicole; McMillen, J. Curtis; McNelly, David; Robinson, Debra R.
Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth’s perspective on making this transition. This study utilized qualitative intervi...
Rigby, Mary E.; Woodcock, Charles C.
To design a residential school program for multiply handicapped blind children and to develop identifying procedures for prospects for this type of program, 15 children (ages 5 to 13, legally blind, educationally retarded, multiply handicapped) of both sexes were enrolled in a 12 month program. The curriculum was based on a systematic presentation…
Chemical dependency, commonly known as substance abuse and use disorders, continues to plague residents of the United States. Because treatment has expanded beyond the walls of the acute care hospital, advanced practice nurses play a pivotal role in caring for clients addicted to various substances. This article describes how an advanced practice nurse in collaboration with the medical director and a director of nursing at a residential treatment center in southern New Jersey oversaw the development of an evidence-based detoxification treatment protocol for alcohol dependency, emphasizing the critical role of nurses in assuring that clinical practice is rooted in current evidence. Copyright © 2013 Elsevier Inc. All rights reserved.
Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio
Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs). CRAMAAs are a culturally specific form of substance abuse treatment in Mexico that are characterized by control and violence. Fifteen interviews were carried out with men of varied sociodemographic characteristics, and who resided in at least two of these centers. Results identify that power is expressed through drug abuse and leads them to subsequent biopsychosocial degradation. Residency in CRAMAAs is motivated by women, but men do not seek the residency and are usually admitted unwillingly. Power through violence is carried out inside CRAMAAs where men are victims of abuse. From a 12-step philosophy, this violence is believed to lead them to a path of recovery but instead produces feelings of anger and frustration. The implications of these centers on Mexican public health are discussed. © The Author(s) 2015.
Cowan, Jennifer A; Devine, Carol M
To evaluate the implementation of a controlled, 6-week, environmental and educational intervention to improve dietary intake and body composition, and to study the association of implementation fidelity with diet and body composition outcomes. A process evaluation documented participation, dose of nutrition education delivered, participant satisfaction, fidelity and completeness of the food environment intervention implementation, and context through observations and interviews with staff and residents. Intervention sites were scored and categorized as high or low participation and implementation and compared on essential elements of the food environment and on diet and body composition outcomes. Six urban residential drug-treatment facilities in Upstate New York. Fifty-five primarily black and white men in residential drug-treatment programmes. Participants were exposed to 94 % and 69 % of the educational and environmental elements, respectively. High implementation sites were significantly more likely to provide water and 100 % juice, offer fruit or vegetable salad, offer choices of fruits and vegetables, and limit fried foods. Mixed-model analysis of covariance revealed that participants in the high participation and implementation sites reported greater reductions in total energy, percentage of energy from sweets, daily servings of fats, oils and sweets, and BMI over the intervention period. Participants in low participation and implementation sites reported greater reductions in percentage of energy from fat. Differential implementation of environmental elements limited the intervention impact. These findings document the contribution of changes in eating environments to facilitate dietary behaviour change in community residential substance-abuse settings.
Caulfield, T.O.; Shepherd, M.A.
Citizens Utilities Company, Arizona Electric Division (CUC/AED) fielded a Residential New Construction Program (RNC) in the forth quarter of 1994 that had been designed from conception as a market transformation program. The CUC RNC Program encouraged builders to adopt energy efficient building practices for new homes by supplying builders estimates of energy savings, supplying inspections services to assist builders in applying energy efficient building practices while verifying compliance, and posting and promoting the home as energy efficient during the sales period. Measures generally required to qualify for the program were R-38 ceiling insulation, R-21 wall insulation, polysealing of all infiltration gaps during construction, well sealed air-conditioning ducts, and an air conditioner Seasonal Energy Efficiency Rating (SEER) of 11.0 or greater. In less than two years the program achieved over 17% market penetration without offering rebates to builders. This paper reviews the design of the program, including a discussion of the features felt to be primarily responsible for its success. It reviews the levels of penetration achieved, free-ridership, spillover, and market barriers encountered. Finally it proposes improvements to the program designed to carry it the next step toward a self-sustaining market transformation program.
Cunningham, Mary; Harwood, Robin; Hall, Sam
As homelessness increased among families and children during the 1980s and 1990s, policymakers created, and strengthened, the McKinney-Vento Education for Homeless Children and Youth (EHCY) program. The McKinney-Vento EHCY program aims to mitigate the effects of residential instability through the identification of homeless children in schools and…
Energy Research and Development Administration, Washington, DC. Div. of Solar Energy.
Three volumes present brief abstracts of projects funded by the Energy Research and Development Administration (ERDA) and conducted under the National Program for Solar Heating and Cooling of Buildings through July 1976. The overall federal program includes demonstrations of heating and/or combined cooling for residential and commercial buildings…
Narendorf, Sarah Carter; Fedoravicius, Nicole; McMillen, J Curtis; McNelly, David; Robinson, Debra R
Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth's perspective on making this transition. This study utilized qualitative interviews with youths who were participating in a treatment foster care intervention study (n=8) to gain their perspectives on the process of transitioning from residential care. Youths were interviewed right before they exited residential care and two months after placement in the new foster home. Youths reported hopes for gaining family in the new home as well as fears of placement disruption. Findings point to the need to enlist youths in discussion and problem solving about difficulties they anticipate in the new home and expectations for their relationship with the new foster parents. In addition, the struggles described after two months in the home point to the need for youths to build specific skills to better manage ongoing relationships with foster parents and for foster parent training on how to help build these skills.
Smith, Phillip N; Currier, Joseph; Drescher, Kent
This study aimed to describe the frequency of firearm ownership in veterans entering residential treatment for posttraumatic stress disorder (PTSD) and examine the association of firearm ownership with suicide ideation and suicide attempt history, combat exposure, and PTSD symptom severity. Two samples of veterans entering residential PTSD treatment were assessed at intake using self-report measures. Approximately one third of participants endorsed firearm ownership across the two samples. Analyses with a sample predominantly comprised of Vietnam Veterans found that those who endorsed both suicide ideation and prior suicide attempts were less likely to own a firearm compared to suicide ideators and non-suicidal participants. In addition, more frequent combat exposure, but not PTSD symptom severity, was associated with firearm ownership in both samples and most participants endorsed using safe storage practices. These lower rates of firearm ownership generally, and in those with suicide ideation and prior attempts in particular, may reflect an increased focused on means restriction in treatment for combat-related PTSD. Means restriction counseling among PTSD treatment seeking veterans should target those with combat exposure. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
During the deinstitutionalisation of psychiatric care in Germany, new psychiatric care approaches have been developed, which have been rarely scientifically evaluated. This study aims at evaluating the residential care and supported housing program of a public service in Westphalia, Northwestern Germany. Data on 1486 clients about sociodemographics, individual biographies, housing, social integration and perspective of care were collected by staff. Individual interviews on the clients' quality of life were conducted with 941 subjects. The residential care and supported housing program clients are chronically mentally ill and disabled. Clients from the supported housing sector have a much more favorable biographical and social background compared to those from residential care. Integration into the regular workforce does usually not happen. Clients from the residential care sector have only few social contacts outside their institution. The quality of life assessment revealed no differences between the settings. More external social contacts should be provided especially for the residential care clients. Motivational interventions might enhance the clients' social inclusion further. Copyright Georg Thieme Verlag KG Stuttgart . New York.
Voluse, Andrew C; Gioia, Christopher J; Sobell, Linda Carter; Dum, Mariam; Sobell, Mark B; Simco, Edward R
The psychometric properties of the Drug Use Disorders Identification Test (DUDIT), an 11-item self-report questionnaire developed to screen individuals for drug problems, are evaluated. The measure, developed in Sweden and evaluated there with individuals with severe drug problems, has not been evaluated with less severe substance abusers or with clinical populations in the United States. Participants included 35 drug abusers in an outpatient substance abuse treatment program, 79 drug abusers in a residential substance abuse treatment program, and 39 alcohol abusers from both treatment settings who did not report a drug abuse problem. The DUDIT was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=.85) when compared with the Drug Abuse Screening Test (DAST-10), and to have a Cronbach's alpha of .94. In addition, a single component accounted for 64.91% of total variance, and the DUDIT had sensitivity and specificity scores of .90 and .85, respectively, when using the optimal cut-off score of 8. Additionally, the DUDIT showed good discriminant validity as it significantly differentiated drug from alcohol abusers. These findings support the DUDIT as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations. Copyright © 2011 Elsevier Ltd. All rights reserved.
Walter, Kristen H; Barnes, Sean M; Chard, Kathleen M
Among military personnel, posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and a history of traumatic brain injury (TBI) are frequently reported, highlighting the need for treatment outcome research with this population. This study examined the influence of the presence or absence of comorbid MDD on the outcome of a residential treatment program at the midpoint and end of the program for 47 male veterans with PTSD and a history of TBI. Results demonstrated significant decreases of self-reported symptoms on the PTSD Checklist-Stressor Specific Version (PCL-S; MDD, d = 1.19; No MDD, d = 1.17) and the Beck Depression Inventory-II (BDI-II; MDD, d = 0.98; No MDD, d = 1.09) following treatment for both groups. There were no differences in the rate of symptom reduction between groups. Individuals who also met criteria for MDD at pretreatment, however, evidenced higher scores on symptom measures at all assessment time points (ds = 0.60-1.25). Copyright © 2012 International Society for Traumatic Stress Studies.
Rohsenow, Damaris J; Martin, Rosemarie A; Monti, Peter M; Colby, Suzanne M; Day, Anne M; Abrams, David B; Sirota, Alan D; Swift, Robert M
Residential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) motivational interviewing (MI) to brief advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1 month, and 2% at 3, 6 and 12 months. However, patients with more drug use pretreatment (>22 days in 6 months) given BA had more abstinence at 12 months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation. © 2014.
This report was prepared for the Office of Conservation, Bonneville Power Administration. The report will be used by the Office as background information to support future analysis and implementation of electricity conservation programs for owners of residential rental housing in the Northwest. The principal objective of the study was to review market research information relating to attitudes and actions of Northwest rental housing owners and, to a lesser extent, tenants toward energy conservation and energy-efficiency improvements. Available market research data on these subjects were found to be quite limited. The most useful data were two surveys of Seattle rental housing owners conducted in late 1984 for Seattle City Light. Several other surveys provided supplemental market research information in selected areas. In addition to market research information, the report also includes background information on rental housing characteristics in the Northwest.
Broadbear, Jillian H; Nesci, Julian; Thomas, Rosemary; Thompson, Katherine; Beatson, Josephine; Rao, Sathya
Residential patients diagnosed with borderline personality disorder were evaluated to determine whether borderline personality disorder-focused psychotherapy reduced prescribing, personality disorder and co-morbid symptom severity. Psychotropic prescriptions were measured at admission, discharge and 1 year later in 74 female participants with one or more personality disorder diagnosis and co-morbid mood disorders. Changes in pharmacotherapy were examined in the context of improvements in borderline personality disorder and/or co-morbid disorder symptom severity. Residential treatment included individual and group psychotherapy for borderline personality disorder. The Structured Clinical Interview for DSM-IV was used to confirm the borderline personality disorder diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point. A significant reduction in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including borderline personality disorder, was accompanied by a reduction in prescription of psychoactive medications. Three to six months of intensive borderline personality disorder-specific psychotherapy showed lasting benefit with regard to symptom severity of personality disorders (borderline personality disorder in particular) as well as depressive symptoms. This improvement corresponded with a reduction in prescriptions for psychoactive medications, which is consistent with current thinking regarding treatment for borderline personality disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Geurtsen, Gert J.; van Heugten, Caroline M.; Martina, Juan D.; Rietveld, Antonius C.; Meijer, Ron; Geurts, Alexander C.
To examine the effects of a residential community reintegration program on independent living, societal participation, emotional well-being, and quality of life in patients with chronic acquired brain injury and psychosocial problems hampering societal participation. A prospective cohort study with
... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section 17.81... Federal Agencies § 17.81 Contracts for residential treatment services for veterans with alcohol or drug... “Confidentiality of Alcohol and Drug Abuse Patient Records” (42 CFR part II) and the “Confidentiality of Certain...
Rohsenow, Damaris J; Tidey, Jennifer W; Martin, Rosemarie A; Colby, Suzanne M; Sirota, Alan D; Swift, Robert M; Monti, Peter M
Residential drug treatment provides an opportunity to intervene with smokers with substance use disorders (SUD). A randomized controlled clinical trial compared: (1) contingent vouchers (CV) for smoking abstinence to noncontingent vouchers (NCV), crossed with (2) motivational interviewing (MI) or brief advice (BA), for 184 smokers in SUD treatment. During the voucher period, 36% of carbon monoxide readings indicated smoking abstinence for those receiving CV versus 13% with NCV (p drug use or motivation to quit smoking occurred. Thus, CV had limited effects on long-term smoking abstinence in this population but effects were improved when CV was combined with MI. More effective methods are needed to increase motivation to quit smoking and quit rates in this high-risk population. Published by Elsevier Inc.
Butryn, Meghan L; Juarascio, Adrienne; Shaw, Jena; Kerrigan, Stephanie G; Clark, Vicki; O'Planick, Antonia; Forman, Evan M
Mindfulness and its related constructs (e.g., awareness and acceptance) are increasingly being recognized as relevant to understanding eating disorders and improving treatment. The purpose of this study was to (1) examine the relationship between mindfulness and ED symptomatology at baseline and (2) examine how changes in mindfulness relate to change in ED symptomatology. Measures of mindfulness and ED symptomatology were administered to 88 patients upon admission to residential ED treatment and at discharge. Baseline ED symptomatology was associated with lower awareness, acceptance, and cognitive defusion, and higher emotional avoidance. Improvements in these variables were related to improvement in ED symptomatology. Interventions targeting mindfulness could be beneficial for patients with EDs. Copyright © 2012 Elsevier Ltd. All rights reserved.
Antonio Galán Rodríguez
Full Text Available Residential treatment for minors with severe conduct problems has been questioned from a social and institutional point of view, but little attention has been paid from academic contexts. Difficulties in definition, implementation and management are analyzed, including problems caused by clinical-based definitions. Management by the Healthcare System is considered the best choice in most cases; nevertheless, Child Protection Services could run these centers for children in foster care. If so, a number of concepts and models different from clinical ones should be used: deficits in self-regulation as the core problem, and psycho-educational intervention as the axis of the treatment. Other controversial topics are analyzed, such as restraint methods, intervention models, or the relationship with the Juvenile Justice System. Finally, some recommendations related to the definition and functioning of these facilities are provided.
Deason, Jeff; Murphy, Sean
A new study by Berkeley Lab found that residential Property Assessed Clean Energy (R-PACE) programs increased deployment of residential solar photovoltaic (PV) systems in California, raising it by about 7-12% in cities that adopt these programs. R-PACE is a financing mechanism that uses a voluntary property tax assessment, paid off over time, to facilitate energy improvements and, in some jurisdictions, water and resilience measures. While previous studies demonstrated that early, regional R-PACE programs increased solar PV deployment, this new analysis is the first to demonstrate these impacts from the large, statewide R-PACE programs dominating the California market today, which use private capital to fund the upfront costs of the improvements. Berkeley Lab estimated the impacts using econometric techniques on two samples: -Large cities only, allowing annual demographic and economic data as control variables -All California cities, without these annual data Analysis of both samples controls for several factors other than R-PACE that would be expected to drive solar PV deployment. We infer that on average, cities with R-PACE programs were associated with greater solar PV deployment in our study period (2010-2015). In the large cities sample, solar PV deployment in jurisdictions with R-PACE programs was higher by 1.1 watts per owner-occupied household per month, or 12%. Across all cities, solar PV deployment in jurisdictions with R-PACE programs was higher by 0.6 watts per owner-occupied household per month, or 7%. The large cities results are statistically significant at conventional levels; the all-cities results are not. The estimates imply that the majority of solar PV deployment financed by R-PACE programs would likely not have occurred in their absence. Results suggest that R-PACE programs have increased PV deployment in California even in relatively recent years, as R-PACE programs have grown in market share and as alternate approaches for financing solar PV
... (NRDC), Alliance to Save Energy (ASE), Alliance for Water Efficiency (AWE), Northwest Power and... in the docket of the residential dishwasher, dehumidifier, and conventional cooking products test...
Full Text Available This paper aims to analyze the possible effects of the housing program “Mi Casa, Mi Vida” in socioeconomic residential segregation in the city of Córdoba (Argentina. These effects are estimated from the study of the socioeconomic residential composition (before and after the implementation of the program, the mapping of residential movements generated by the program and the application of bivariate autocorrelation techniques. Among the key findings, most of the program beneficiaries are concentrated in poor areas surrounded by others in similar conditions. This fact favors the existence of a large cluster of poverty in the peripheries of the city and promotes marginalization and social exclusion.
Rawson, Richard A; Chudzynski, Joy; Mooney, Larissa; Gonzales, Rachel; Ang, Alfonso; Dickerson, Daniel; Penate, Jose; Salem, Bilal A; Dolezal, Brett; Cooper, Christopher B
We examined the efficacy of an 8-week exercise intervention on posttreatment methamphetamine (MA) use among MA-dependent individuals following residential treatment. 135 individuals newly enrolled in treatment were randomly assigned to a structured 8-week exercise intervention or health education control group. Approximately 1 week after completion of the intervention, participants were discharged to the community. Interview data and urine samples were collected at 1-, 3-, and 6-months post-residential care. Of the sample, 54.8% were classified as higher severity users (using MA more than 18 days in the month before admission) and 45.2% as lower severity users (using MA for up to 18 days in the month before admission). Group differences in MA use outcomes were examined over the 3 timepoints using mixed-multivariate modeling. While fewer exercise participants returned to MA use compared to education participants at 1-, 3- and 6-months post-discharge, differences were not statistically significant. A significant interaction for self-reported MA use and MA urine drug test results by condition and MA severity was found: lower severity users in the exercise group reported using MA significantly fewer days at the three post-discharge timepoints than lower severity users in the education group. Lower severity users in the exercise group also had a lower percentage of positive urine results at the three timepoints than lower severity users in the education group. These relationships were not present in the comparison of the higher severity conditions. Results support the value of exercise as a treatment component for individuals using MA 18 or fewer days/month. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Krebs, Christopher P.; Strom, Kevin J.; Koetse, Willem H.; Lattimore, Pamela K.
A variety of approaches for addressing drug use and drug-related crime among the nearly 5 million offenders on community supervision in the United States has been tried and evaluated, but questions remain about which policies or programs are most effective. The authors use a large data set to assess the impact of residential and nonresidential…
Full Text Available Background: The treatment of cocaine-dependent individuals (CDI is substantially challenged by high drop-out rates, raising questions regarding contributing factors. Recently, a number of studies have highlighted the potential of greater focus on the clinical significance of neurocognitive impairments in treatment-seeking cocaine users. In the present study, we hypothesized that disadvantageous decision-making would be one such factor placing CDI at greater risk for treatment drop-out. Methods: In order to explore this hypothesis, the present study contrasted baseline performance (at treatment onset on two validated tasks of decision-making, the Iowa Gambling Task (IGT and the Cambridge Gamble Task (CGT in CDI who completed treatment in a residential Therapeutic Community (TC (N=66 and those who dropped out of TC prematurely (N=84. Results: Compared to treatment completers, CDI who dropped out of TC prematurely did not establish a consistent and advantageous response pattern as the IGT progressed and exhibited a poorer ability to choose the most likely outcome on the CGT. There were no group differences in betting behavior.Conclusions: Our findings suggest that neurocognitive rehabilitation of disadvantageous decision-making may have clinical benefits in CDI admitted to long-term residential treatment programs.
Kuhn, Eric; Drescher, Kent; Ruzek, Josef; Rosen, Craig
Aggressive and unsafe driving was examined in 474 male veterans receiving Veterans Affairs residential treatment for posttraumatic stress disorder (PTSD). Specifically, the authors evaluated if PTSD was associated with aggressive and unsafe driving and if Iraq and Afghanistan War veterans were at higher risk than other war veterans. Approximately two thirds of the sample reported lifetime aggressive driving and one third reported current aggressive driving. Posttraumatic stress disorder severity was associated with aggressive driving, but not other forms of unsafe driving. Iraq and Afghanistan veterans endorsed higher rates of and more frequent aggressive driving than did other veterans. After accounting for PTSD severity, age, income, and marital status being an Iraq and Afghanistan War veteran predicted aggressive driving frequency and infrequent seatbelt use.
... Energy (DOE) is amending its test procedures for residential water heaters, direct heating equipment (DHE... procedures for residential water heaters include a full- year accounting of energy use, both electricity and... water heaters already account for standby mode and off mode energy consumption. III. Discussion In the...
Brem, Meagan J; Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L
Approximately 31% of men in treatment for a substance use disorders (SUD) engage in compulsive sexual behavior (CSB). Shame, a well-documented consequence of CSB, increases the likelihood of relapse following treatment for SUDs. Despite the risk of relapse, prior research has not investigated factors that may attenuate the relation between CSB and shame. Dispositional mindfulness is one such factor known to mitigate shame. However, researchers have yet to examine dispositional mindfulness as a moderator of the relationship between CSB and shame among a sample of men in treatment for SUDs. In an effort to inform intervention efforts, the present study aimed to investigate the hypothesis that CSB would not relate to shame among men with high, as opposed to low, levels of dispositional mindfulness. The present study reviewed medical records of 184 men in residential treatment for SUDs who completed cross-sectional measures of shame, CSB, dispositional mindfulness, and substance use problems. Results demonstrated a significant interaction between CSB and dispositional mindfulness such that CSB positively related to shame at low, but not mean or high, levels of dispositional mindfulness. These results support and extend previous mindfulness and CSB treatment research. Findings suggested that intervention efforts for CSB may benefit from increasing dispositional mindfulness in an effort to reduce shame-related cognitions.
Kearney, Kathleen A.; McEwen, Erwin; Bloom-Ellis, Brice; Jordan, Neil
The National Quality Improvement Center on the Privatization of Child Welfare Services selected Illinois as a demonstration site in 2007 to evaluate performance-based contracting in residential treatment services. This article discusses the first two years of project implementation including developing residential treatment performance indicators,…
Acevedo, Andrea; Lee, Margaret T; Garnick, Deborah W; Horgan, Constance M; Ritter, Grant A; Panas, Lee; Campbell, Kevin; Bean-Mortinson, Jason
Despite the importance of continuity of care after detoxification and residential treatment, many clients do not receive further treatment services after discharged. This study examined whether offering financial incentives and providing client-specific electronic reminders to treatment agencies lead to improved continuity of care after detoxification or residential treatment. Residential (N = 33) and detoxification agencies (N = 12) receiving public funding in Washington State were randomized into receiving one, both, or none (control group) of the interventions. Agencies assigned to incentives arms could earn financial rewards based on their continuity of care rates relative to a benchmark or based on improvement. Agencies assigned to electronic reminders arms received weekly information on recently discharged clients who had not yet received follow-up treatment. Difference-in-difference regressions controlling for client and agency characteristics tested the effectiveness of these interventions on continuity of care. During the intervention period, 24,347 clients received detoxification services and 20,685 received residential treatment. Overall, neither financial incentives nor electronic reminders had an effect on the likelihood of continuity of care. The interventions did have an effect among residential treatment agencies which had higher continuity of care rates at baseline. Implementation of agency-level financial incentives and electronic reminders did not result in improvements in continuity of care, except among higher performing agencies. Alternative strategies at the facility and systems levels should be explored to identify ways to increase continuity of care rates in specialty settings, especially for low performing agencies. Copyright © 2017 Elsevier B.V. All rights reserved.
Byrne, Andrew M.; Sias, Shari M.
This article applies the tenets of Bernard's in "Counselor Edu Supervision" 19:60-68, (1979) discrimination model of clinical supervision to the supervision needs of those who provide direct care to adolescents in residential treatment due to abuse, neglect, behavioral, or emotional problems. The article focuses on three areas…
Lipschitz-Elhawi, Racheli; Itzhaky, Haya; Michal, Hefetz
The article deals with the contribution of background variables (gender, years of residence in a treatment center, and family status), internal resource (self-esteem), and external resources (peer, family and significant other support, sense of belonging to the community) to life satisfaction among adolescents living in residential treatment…
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Alcohol and drug... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...
Beker, Jerome, Ed.; Magnuson, Douglas, Ed.
Residential treatment centers have always steered a course between bureaucracy and anarchy. The conventional professional wisdom in the United States holds that residential group care programs for children and youth are intrinsically flawed. This volume seeks to remedy this perception by making a case for the adoption of Israeli and European…
Full Text Available Research has demonstrated that individuals with substance use disorders (SUDs and comorbid mental health problems evidence heightened negative consequences, including poorer treatment outcomes, a higher risk for relapse, and mortality compared to individuals with a single disorder. In this study, we focus on the comorbidity between SUDs and eating disorder (ED symptomatology, as EDs are similarly associated with high rates of relapse, morbidity, and mortality. Of particular importance is research examining treatment rejection among individuals in treatment for SUDs with cooccurring ED symptomatology. This study seeks to add to the literature by examining treatment rejection among young adult men in residential treatment for SUDs ( N = 68 with cooccurring ED symptomatology. Results from hierarchical regression analyses indicated that ED symptoms were significantly associated with treatment rejection after controlling for alcohol and drug use and problems and depression symptoms. Although this is a preliminary study, the results add to a growing body of research examining the comorbidity between SUDs and ED symptomatology. Future research examining this relationship is needed to further elucidate the treatment patterns among individuals with comorbid ED symptoms and substance use diagnoses.
The methodology used to perform the ''Parametric Study'' to define a recommended demonstration program involved a decision making process. In this approach, selective solar buying factors were quantitatively evaluated for influencing key decision makers to install solar HVAC equipment. The selection of the recommended demo level also considered the probability of a decision maker actually seeing a demonstration as a function of how far he is located from a demo and how far he is willing to travel to see one. Demonstration levels of 200, 400, 800, 1600 and 3200 were assumed to determine the effects on Solar HVAC market penetration. The 800 demo level program is recommended to effectively stimulate the private sector to install solar HVAC systems. (WDM)
The objective of this study was to provide a resource document for the Northeastern states when pursuing the analysis of localized problems resulting from residential wood combustion. Specific tasks performed include assigning emission rates for total suspended particulates (TSP) and benzo(a)pyrene (BaP) from wood burning stoves, estimating the impact on ambient air quality from residential wood combustion and elucidating the policy options available to Northeastern states in their effort to limit any detrimental effects resulting from residential wood combustion. Ancillary tasks included providing a comprehensive review on the relevant health effects, indoor air pollution and toxic air pollutant studies. 77 refs., 11 figs., 25 tabs.
Morse, Siobhan; Bride, Brian E
Opioid use results in higher healthcare utilization and costs, particularly among those with co-occurring mental health disorders. Presumably, effective treatment would result in a reduction in healthcare utilization and costs. To date, research has not examined this question. As such, the purpose of this study was to estimate and compare pre- and post-treatment healthcare utilization and costs for individuals receiving residential integrated treatment for co-occurring mental health and opioid use disorders. A single-group, repeated measures design was used to examine changes in pre- and post-treatment healthcare utilization and costs among a sample of individuals with co-occurring mental health and opioid use disorders who received residential, integrated treatment. Significant reductions in emergency rooms visits, inpatient admissions, and resulting costs were observed in the six months following treatment. Residential, integrated treatment of co-occurring mental health and opioid use disorders can significantly decrease both utilization and cost of healthcare among opioid users with co-occurring mental health disorders.
...-Conditioning and Warm Air Heating Equipment and Commercial and Industrial Refrigeration Equipment Manufacturing... Refrigeration Institute (AHRI) recommended that to avoid unnecessary burden, the existing test procedure..., and Refrigeration Institute's Directory of Certified Product Performance for Residential Furnaces and...
Shorey, Ryan C; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L
Social-cognitive theories of aggression postulate that individuals who perpetrate aggression are likely to have high levels of maladaptive cognitive schemas that increase risk for aggression. Indeed, recent research has begun to examine whether early maladaptive schemas may increase the risk for aggression. However, no known research has examined this among individuals in substance use treatment, despite aggression and early maladaptive schemas being more prevalent among individuals with a substance use disorder than the general population. Toward this end, we examined the relationship between early maladaptive schemas and aggression in men in a residential substance use treatment facility ( N = 106). Utilizing pre-existing patient records, results demonstrated unique associations between early maladaptive schema domains and aggression depending on the type of aggression and schema domain examined, even after controlling for substance use, antisocial personality, age, and education. The Impaired Limits domain was positively associated with verbal aggression, aggressive attitude, and overall aggression, whereas the Disconnection and Rejection domain was positively associated with physical aggression. These findings are consistent with social-cognitive models of aggression and advance our understanding of how early maladaptive schemas may influence aggression. The implications of these findings for future research are discussed.
Pope, Leah Gogel
Based on 11 months of ethnographic fieldwork at a residential treatment center in the United States, this article explores the varied meanings that female youth attribute to behavior and the strategic (mis)use of knowledge about psychiatric diagnosis and medication at a time when the scope of behaviors pathologized in young people continues to expand. Drawing upon psychological and critically applied medical anthropology, as well as contributions from philosophy on how classifications of people come into being and circulate, attention is paid to the multiple contradictions at work in diagnosing young people with mental disorders. A detailed examination of an exchange that occurred during one particular group therapy session is presented to demonstrate how psychiatric selves emerge in this environment when conventional labeling practices no longer suffice as an explanation of behavior. This turn to psychiatry reveals both the salience of and confusion around mental health treatment and diagnosis among adolescents, opens up the distinctions young people make between "real selves" and "medicated selves," and invokes the possibility of psychiatric disorder as a means to both forgive and discredit.
Shorey, Ryan C; Brasfield, Hope; Anderson, Scott; Stuart, Gregory L
Recent research has begun to examine the early maladaptive schemas of substance abusers, as it is believed that targeting these core beliefs in treatment may result in improved substance use outcomes. One special population that has received scant attention in the research literature, despite high levels of substance use, is airline pilots. The current study examined the early maladaptive schemas of a sample of airline pilots ( n = 64) who were seeking residential treatment for alcohol dependence and whether they differed in early maladaptive schemas from non-pilot substance abusers who were also seeking residential treatment for alcohol dependence ( n = 45). Pre-existing medical records from patients of a residential substance abuse treatment facility were reviewed for the current study. Of the 18 early maladaptive schemas, results demonstrated that pilots scored higher than non-pilots on the early maladaptive schema of unrelenting standards (high internalized standards of behavior), whereas non-pilots scored higher on insufficient self-control (low frustration tolerance and self-control). Early maladaptive schemas may be a relevant treatment target for substance abuse treatment seeking pilots and non-pilots.
Lee A. Underwood
Full Text Available The purpose of this study was to offer preliminary support for the Louisiana Sex Offender Treatment Program (LSOTP in addressing the needs of juvenile sex offenders. Research objectives were (1 to offer statistical evidence for reductions in anxiety, depression, cognitive distortion and negative attitudes towards women comparing a group of 21 adolescents, 12 of whom received services as usual and nine of whom participated in the LSOTP. A controlled experimental evaluation design was utilized. The juvenile sex offenders were randomly assigned to the experimental group for 12 weeks receiving treatment services and a control group receiving care “as usual” in a residential group care program. Participants in the experimental group experienced statistically significant decreases in cognitive distortions related specifically to rape and molestation.The results of this study offer preliminary support of the LSOTP as a best practices alternative to other treatment modalities.
Lee, A James
This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families) was too small to be economical. Although the sample size (just nine programs) was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's) Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW) Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.
Lee A James
Full Text Available Abstract This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families was too small to be economical. Although the sample size (just nine programs was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.
Souverein, F.A.; van der Helm, G.H.P.; Stams, G.J.J.M.
A debate about the effectiveness of secure residential youth care is currently going on. While some continue to support secure residential youth care, others conclude that ‘nothing works’ in secure residential youth care, and argue that non-residential treatment is superior to secure residential
Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cappers, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
The U.S. Department of Energy’s (DOE’s) Smart Grid Investment Grant (SGIG) program is working with a subset of the 99 SGIG projects undertaking Consumer Behavior Studies (CBS), which examine the response of mass market consumers (i.e., residential and small commercial customers) to time-varying electricity prices (referred to herein as time-based rate programs) in conjunction with the deployment of advanced metering infrastructure (AMI) and associated technologies. The effort presents an opportunity to advance the electric industry’s understanding of consumer behavior.
Conrow, Douglas C.
Old style and new style mental hospitals are criticized for not dealing directly with a person's inability to live within his community and relate effectively with significant people. The comprehensive mental health programs, which arose in reaction to the deficits of previous facilities and treatment, are viewed as frequently following a similar,…
Bluett, E J; Lee, E B; Simone, M; Lockhart, G; Twohig, M P; Lensegrav-Benson, Tera; Quakenbush-Roberts, Benita
The purpose of this study was to test whether pre-treatment levels of psychological flexibility would longitudinally predict quality of life and eating disorder risk in patients at a residential treatment facility for eating disorders. Data on body image psychological flexibility, quality of life, and eating disorder risk were collected from 63 adolescent and 50 adult, female, residential patients (N=113) diagnosed with an eating disorder. These same measures were again collected at post-treatment. Sequential multiple regression analyses were performed to test whether pre-treatment levels of psychological flexibility longitudinally predicted quality of life and eating disorder risk after controlling for age and baseline effects. Pre-treatment psychological flexibility significantly predicted post-treatment quality of life with approximately 19% of the variation being attributable to age and pre-treatment psychological flexibility. Pre-treatment psychological flexibility also significantly predicted post-treatment eating disorder risk with nearly 30% of the variation attributed to age and pre-treatment psychological flexibility. This study suggests that levels of psychological flexibility upon entering treatment for an eating disorder longitudinally predict eating disorder outcome and quality of life. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
Shorey, Ryan C; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L
Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, few studies have examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N=122). The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD, even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes.
John A. A. Geddes
Full Text Available Introduction. Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts. Aims. To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers. Methods. We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required. Results. Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty. Discussion. A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.
... Procedures for Residential Furnace Fans AGENCY: Office of Energy Efficiency and Renewable Energy, Department... referred to as ``furnace fans.'' DOE proposes a test procedure that would be applicable to furnace fans..., even though DOE interprets its authority as encompassing more than just circulation fans used in...
... systems are relatively high due to the price of electricity, so using an electric system in a cold climate... marginal residential and commercial electricity prices in its life-cycle-cost analysis; (4) technical...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0...
... designed to improve energy efficiency. (All references to EPCA refer to the statute as amended through the... cooking products,'' as used in this notice, refers to residential electric and gas kitchen ovens, ranges... section shall be reasonably designed to produce test results which measure energy efficiency, energy use...
Bryson, Stephanie A; Gauvin, Emma; Jamieson, Ally; Rathgeber, Melanie; Faulkner-Gibson, Lorelei; Bell, Sarah; Davidson, Jana; Russel, Jennifer; Burke, Sharlynne
Many young people who receive psychiatric care in inpatient or residential settings in North America have experienced various forms of emotional trauma. Moreover, these settings can exacerbate trauma sequelae. Common practices, such as seclusion and restraint, put young people at risk of retraumatization, development of comorbid psychopathology, injury, and even death. In response, psychiatric and residential facilities have embraced trauma-informed care (TIC), an organizational change strategy which aligns service delivery with treatment principles and discrete interventions designed to reduce rates of retraumatization through responsive and non-coercive staff-client interactions. After more than two decades, a number of TIC frameworks and approaches have shown favorable results. Largely unexamined, however, are the features that lead to successful implementation of TIC, especially in child and adolescent inpatient psychiatric and residential settings. Using methods proposed by Pawson et al. (J Health Serv Res Policy 10:21-34, 2005), we conducted a modified five-stage realist systematic review of peer-reviewed TIC literature. We rigorously searched ten electronic databases for peer reviewed publications appearing between 2000 and 2015 linking terms "trauma-informed" and "child*" or "youth," plus "inpatient" or "residential" plus "psych*" or "mental." After screening 693 unique abstracts, we selected 13 articles which described TIC interventions in youth psychiatric or residential settings. We designed a theoretically-based evaluative framework using the active implementation cycles of the National Implementation Research Network (NIRN) to discern which foci were associated with effective TIC implementation. Excluded were statewide mental health initiatives and TIC implementations in outpatient mental health, child welfare, and education settings. Interventions examined included: Attachment, Self-Regulation, and Competency Framework; Six Core Strategies
Thomas, Jennifer J; Eddy, Kamryn T; Murray, Helen B; Tromp, Marilou D P; Hartmann, Andrea S; Stone, Melissa T; Levendusky, Philip G; Becker, Anne E
This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (κ=.48) and DSM-5 (κ=.57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (κ=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Workowski, Eric J.
This study examined the relationship between criminal violence and type of substance abuse among 184 current and former residents of an inpatient non-hospital drug and alcohol treatment facility. The criminal justice system functioned as the source of referral into the program for 89% of the subjects studied while only 11% came to treatment…
Gately, Paul J; Cooke, Carlton B; Barth, Julian H; Bewick, Bridgette M; Radley, Duncan; Hill, Andrew J
The evidence base for child obesity treatment is weak. Children's weight-loss camps, despite their popularity, have not been properly evaluated. This study evaluated the effectiveness of a residential weight-loss camp program for overweight and obese children. A total of 185 overweight children (mean age: 13.9 years) enrolled in 1 of 4 consecutive programs between 1999 and 2002 (intervention group) were compared with 94 children of similar ages who were not camp attendees, ie, 38 overweight children and 56 normal-weight children. The intervention group attended a 6-week (maximum) summer residential weight-loss camp. The program included a daily schedule of six 1-hour, skill-based, fun, physical activity sessions, moderate dietary restriction, and group-based educational sessions. All children were assessed for body weight, height, and other anthropometric measures, blood pressure, aerobic fitness, self-esteem, and selected sports skills. Campers, who stayed for a mean of 29 days, lost 6.0 kg, reduced their BMI by 2.4 units, and reduced their BMI SD scores by 0.28. Fat mass decreased significantly (from 42.7 to 37.1 kg), whereas fat-free mass did not change. In contrast, both comparison groups gained weight during this period. Camp attendees also showed significant improvements in blood pressure, aerobic fitness, and self-esteem. Longer durations of stay were associated with greater improvements in outcomes. In the short term at least, this weight-loss program was effective across a range of health outcomes. Ongoing research is examining the maintenance of these improvements. Future research should investigate whether benefits can be generalized across weight-loss camps and how the intervention can be adapted to nonresidential, term-time settings.
Ji, L.; Niu, D.X.; Huang, G.H.
In this paper a stochastic robust optimization problem of residential micro-grid energy management is presented. Combined cooling, heating and electricity technology (CCHP) is introduced to satisfy various energy demands. Two-stage programming is utilized to find the optimal installed capacity investment and operation control of CCHP (combined cooling heating and power). Moreover, interval programming and robust stochastic optimization methods are exploited to gain interval robust solutions under different robustness levels which are feasible for uncertain data. The obtained results can help micro-grid managers minimizing the investment and operation cost with lower system failure risk when facing fluctuant energy market and uncertain technology parameters. The different robustness levels reflect the risk preference of micro-grid manager. The proposed approach is applied to residential area energy management in North China. Detailed computational results under different robustness level are presented and analyzed for providing investment decision and operation strategies. - Highlights: • An inexact two-stage stochastic robust programming model for CCHP management. • The energy market and technical parameters uncertainties were considered. • Investment decision, operation cost, and system safety were analyzed. • Uncertainties expressed as discrete intervals and probability distributions
... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Treatment program. 264.271 Section 264... Treatment § 264.271 Treatment program. (a) An owner or operator subject to this subpart must establish a land treatment program that is designed to ensure that hazardous constituents placed in or on the...
Scott, Michael J; Dirks, James A; Cort, Katherine A
U.S. residential and commercial buildings currently use about 39 quadrillion Btu (quads) of energy per year and account for 0.6 gigatonnes (GT) of carbon emitted to the atmosphere (38% of U.S. total emissions of 1.6 GT and approximately 9% of the world fossil-fuel related anthropogenic emissions of 6.7 GT). U.S. government buildings-related energy efficiency research and implementation programs are expected to reduce energy consumption in buildings. This has value both in reducing carbon emissions that result in global warming and adapting the U.S. residential and commercial building stock to a potentially warmer world. Analyses conducted by the Intergovernmental Panel on Climate Change (IPCC) show that the world’s climate could warm relative to 1990 by 0.4ºC to 1.2°C by the year 2030 and by 1.4°C to 5.8°C by the end of the 21st century. This paper shows that the effect of the regional projected warming on energy consumption in U.S. residential and commercial buildings is a net decrease ranging from about 5% in 2020 to as much as 20% in 2080, but with an increase of as much as 25% in space cooling. Buildings-related energy efficiency programs should reduce energy consumption in buildings by more than 2 quads in 2020, which would more than offset the growth in space cooling due to climate and growth in building stock combined, and would be worth between $28 and $33 billion.
Kenaszchuk, Chris; Wild, T Cameron; Rush, Brian R; Urbanoski, Karen
The GAIN Substance Problem Scale (SPS) measures alcohol and drug problem severity within a DSM-IV-TR framework. This study builds on prior psychometric evaluation of the SPS by using Rasch analysis to assess scale unidimensionality, item severity, and differential item functioning (DIF). Participants were attending residential or outpatient treatment in Alberta and Ontario, Canada, respectively (n=372). Rasch analyses modeled a latent problem severity continuum using SPS scores at treatment admission and 6-week follow-up. We examined DIF by gender, treatment modality (outpatient vs. residential), and assessment timing (baseline vs. follow-up). Model fit was good overall, supporting unidimensionality and a single underlying continuum of substance problem severity. Relative to person severity, however, the range of item severities was narrow. Items were too severe for many clients to endorse, particularly at follow-up. Overall, the rank order of item severities was stable across gender, treatment modality, and time point. Although traditional Rasch criteria indicated a number of statistically significant and substantive DIF estimates across modality and time points, effect size indices did not suggest a net effect on total scale scores. The analysis broadly supports use of the SPS as an additive measure of global substance severity in men and women and both residential and outpatient settings. Although DIF was not a major concern, there was evidence of item redundancy and suboptimal matching between items and persons. Findings highlight potential opportunities for further improving this scale in future research and clinical applications of the GAIN. Copyright © 2013 Elsevier Ltd. All rights reserved.
Gerassi, Lara B
More than 50% of women entering substance use treatment in the U.S. reported having traded sex for money or drugs. Women's participation in addiction treatment and related services is essential to their recovery and increased safety, stabilization, and quality of life. This paper's aim is to explore the barriers related to accessing detox facilities and essential services including substance use treatment and residential services for women impacted by commercial sexual exploitation (CSE). Data are drawn from a larger, community-based, grounded theory study. In-depth interview data were collected from 30 adult women who traded sex as adults (through maximum variation and snowball sampling), as well as 20 service providers who come into contact with adult women who trade sex (through nominations and purposive sampling). Finding suggest that women often encountered sobriety requirements, which created barriers to accessing addiction treatment or residential services. Some organizations' policies required evicting women if they were caught using, which created additional challenges for women who relapsed. Women wanted to avoid becoming "dopesick" on the streets or at home, which partially contributed to them needing to maintain their addiction. Consequently, some returned to sex trading, thus increasing their risk of trafficking. Some women engaged in creative strategies, such as claiming they were suicidal, in order to access the detox facilities in hospitals. Some women indicated they were only able to detox when they were forced to do so in jail or prison, often without medical assistance. Implications to improve health care delivery for this population are discussed.
Elmquist, JoAnna; Shorey, Ryan C; Anderson, Scott E; Stuart, Gregory L
The comorbidity between eating disorders (EDs) and substance use disorders (SUDs) is of particular concern given the high rates of mortality, relapse and poor treatment outcomes associated with both disorders. As a result, there has been a growing impetus within the field to elucidate factors that might influence and aid treatment for this comorbidity. One such factor is dispositional mindfulness, as past literature has demonstrated a significant relationship between mindfulness and both EDs and SUDs. However, we are unaware of any research that has examined the relationship between dispositional mindfulness and ED symptoms in a sample of men in residential treatment for SUDs. Medical records from 152 men were included in the current study. Alcohol and drug use and problems, ED symptoms, and dispositional mindfulness were assessed with self-report measures. Hierarchical regression analysis indicated that dispositional mindfulness was inversely related to ED symptoms after controlling for alcohol use, drug use, and age. Although results are preliminary and continued research in this area is needed, our findings suggest that there may be potential usefulness in targeting and enhancing mindfulness among patients in residential treatment for SUDs with co-occurring psychiatric symptoms (e.g., EDs).
In 1982, the North Carolina State University (NCSU) Department of Nuclear Engineering (NE Department) established a 2-week residential summer program on nuclear science and technology for high school rising seniors to stimulate their interest in nuclear engineering as a career. The program was designed with the following goals in mind: (1) to expose the students to mathematics and science fundamentals, which are essential for a career in science or engineering; (2) to demonstrate the use of nuclear energy and nuclear techniques in areas that affect the well being, technical progress, and the shape of our society; (3) to acquaint the students with the resources of NCSU when contemplating a career in science of engineering; and (4) to provide a relaxed setting for student-faculty interaction, which can provide motivation and guidance toward a career in science or engineering and ease the transition from high school to college
Full Text Available Nonresident African American (AA fathers sometimes face challenges to achieving satisfaction with their parenting skills, which may inhibit their motivations for parenting. Studies have found that residential history of fathers is associated with parental involvement; however, current fatherhood programs rarely consider the influence of different residential history on fathering. In the current study, we examined whether nonresident AA fathers’ residential history with their sons moderated their parenting skills satisfaction after participating in the Fathers and Sons Program. Our results indicated that after controlling for fathers’ pretest parenting skills satisfaction, age, education, marital status, employment, and ever lived with their son’s mother; there was a moderating effect of residential history on the intervention’s effects on posttest parenting skills satisfaction. The regression analyses showed that fathers in the intervention group who had lived with their son increased their parenting skills satisfaction more at posttest compared with fathers who had never lived with their sons. However, fathers in the comparison group who had lived with their sons had lower posttest parenting skills satisfaction. Future fatherhood programs for nonresident AA fathers should develop more nuanced group-specific interventions that consider residential history as a critical factor to enhance their parenting skills satisfaction as a strategy for improving father involvement.
Qian, Yiqing; De Loney, E Hill; Caldwell, Cleopatra Howard
Nonresident African American (AA) fathers sometimes face challenges to achieving satisfaction with their parenting skills, which may inhibit their motivations for parenting. Studies have found that residential history of fathers is associated with parental involvement; however, current fatherhood programs rarely consider the influence of different residential history on fathering. In the current study, we examined whether nonresident AA fathers' residential history with their sons moderated their parenting skills satisfaction after participating in the Fathers and Sons Program. Our results indicated that after controlling for fathers' pretest parenting skills satisfaction, age, education, marital status, employment, and ever lived with their son's mother; there was a moderating effect of residential history on the intervention's effects on posttest parenting skills satisfaction. The regression analyses showed that fathers in the intervention group who had lived with their son increased their parenting skills satisfaction more at posttest compared with fathers who had never lived with their sons. However, fathers in the comparison group who had lived with their sons had lower posttest parenting skills satisfaction. Future fatherhood programs for nonresident AA fathers should develop more nuanced group-specific interventions that consider residential history as a critical factor to enhance their parenting skills satisfaction as a strategy for improving father involvement.
Ojinnaka, Chinedum O; Luo, Wen; Ory, Marcia G; McMaughan, Darcy; Bolin, Jane N
Early-stage breast cancer can be surgically treated by using mastectomy or breast-conserving surgery and adjuvant radiotherapy, also known as breast-conserving therapy (BCT). Little is known about the association between racial residential segregation, year of diagnosis, and surgical treatment of early-stage breast cancer, and whether racial residential segregation influences the association between other demographic characteristics and disparities in surgical treatment. This was a retrospective study using data from the Texas Cancer Registry composed of individuals diagnosed with breast cancer between 1995 and 2012. The dependent variable was treatment using mastectomy or BCT (M/BCT) and the independent variables of interest (IVs) were racial residential segregation and year of diagnosis. The covariates were race, residence, ethnicity, tumor grade, census tract (CT) poverty level, age at diagnosis, stage at diagnosis, and year of diagnosis. Bivariate and multivariable multilevel logistic regression models were estimated. The final sample size was 69,824 individuals nested within 4335 CTs. Adjusting for the IVs and all covariates, there were significantly decreased odds of treatment using M/BCT, as racial residential segregation increased from 0 to 1 (odds ratio [OR] 0.47; 95% confidence interval [CI], 0.41-0.54). There was also an increased likelihood of treatment using M/BCT with increasing year of diagnosis (OR 1.14; 95% CI, 1.13-1.16). A positive interaction effect between racial residential segregation and race was observed (OR 0.56; 95% CI, 0.36-0.88). Residents of areas with high indices of racial residential segregation were less likely to be treated with M/BCT. Racial disparities in treatment using M/BCT increased with increasing racial residential segregation. Copyright © 2016 Elsevier Inc. All rights reserved.
Lujano-Rojas, Juan M.; Monteiro, Cláudio; Dufo-López, Rodolfo; Bernal-Agustín, José L.
This paper presents an optimal load management strategy for residential consumers that utilizes the communication infrastructure of the future smart grid. The strategy considers predictions of electricity prices, energy demand, renewable power production, and power-purchase of energy of the consumer in determining the optimal relationship between hourly electricity prices and the use of different household appliances and electric vehicles in a typical smart house. The proposed strategy is illustrated using two study cases corresponding to a house located in Zaragoza (Spain) for a typical day in summer. Results show that the proposed model allows users to control their diary energy consumption and adapt their electricity bills to their actual economical situation. - Highlights: ► This work shows an optimal load management strategy for residential consumers. ► It has been considered the communication infrastructure of the future smart grid. ► A study case shows the optimal utilization of some appliances and electric vehicles. ► Results showed that the proposed model allows users to reduce their electricity bill.
The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Records for maintenance treatment programs and detoxification treatment programs. 1304.24 Section 1304.24 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION... treatment programs and detoxification treatment programs. (a) Each person registered or authorized (by...
Harris, Patricia M.; And Others
Considers challenge programs as treatment for adult offenders, focusing on APPEL (Adult Probation Positive Experiential Learning) program. Describes development of such offender programs, discusses how particular activities might be used to increase probationers' receptivity to traditional treatment services, examines reasons for apparent success…
Depla, Marja F. I. A.; Pols, Jeannette; de Lange, Jacomine; Smits, Carolien H. M.; de Graaf, Ron; Heeren, Thea J.
Integrating mental health care into residential homes for the elderly is a potentially effective model to address the complex care needs of older chronically mentally ill people. Because no research was available on the implementation of such integrated care in practice, six programs already
van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C
Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of sexual harassment. However, in general, there are very few interventions targeting this at-risk group, and no such programs exist in the Netherlands. To this end, a group intervention program-Make a Move-targeting determinants of sexual harassment was developed. This program was implemented and evaluated among boys (N = 177) in Dutch residential youth care (20 institutions). A pre-test, post-test, and 6-month follow-up design including an intervention and a waiting list control group with randomized assignment of institutions (cluster randomized trial) was used to measure the effects of the intervention on determinants of sexual harassment. Multilevel (mixed) regression analysis with Bonferroni correction for multiple testing (α = .005) showed no significant effects of Make a Move on determinants of sexual harassment (ps > .03, Cohen's ds < .44). Results are discussed in light of a three-way explanatory model focusing on intervention content, evaluation, and implementation as potential explanations for not finding any measurable intervention effects. © The Author(s) 2016.
Maremmani, Angelo G I; Pani, Pier Paolo; Trogu, Emanuela; Vigna-Taglianti, Federica; Mathis, Federica; Diecidue, Roberto; Kirchmayer, Ursula; Amato, Laura; Ghibaudi, Joli; Camposeragna, Antonella; Saponaro, Alessio; Davoli, Marina; Faggiano, Fabrizio; Maremmani, Icro
multivariate level, age, detoxified status and total number of psychopathological symptoms proved to influence outcome negatively, especially in CUD. Somatic symptoms and violence-suicide symptoms turned out to correlate with dropout from residential treatment. The SCL-90 5-factor dimensions can be appropriately used as a prognostic tool for drug-dependent subjects entering a residential treatment.
... Program for Consumer Products Other Than Automobiles,\\1\\ a program covering most major household... reflect a declining trend using the default product price trend in the Primary Estimate and High Benefits.... Although the price trends in the Primary Estimate and the High Benefits Estimate are the same, the...
... technologies not covered by the current procedure; (2) more accurately reflect current consumer behavior and... Part II Department of Energy 10 CFR Part 430 Energy Conservation Program for Consumer Products... [Docket No. EERE-2010-BT-TP-0021] RIN 1904-AC08 Energy Conservation Program for Consumer Products: Test...
... technologies not covered by the current procedure; (2) more accurately reflect current consumer behavior and... Part II Department of Energy 10 CFR Part 430 Energy Conservation Program for Consumer Products... [Docket No. EERE-2010-BT-TP-0021] RIN 1904-AC08 Energy Conservation Program for Consumer Products: Test...
Tims, Frank M.; And Others
Data about outpatient treatment unit follow-up evaluations drawn from selected evaluation items in the recent National Drug Abuse Treatment Survey are reported. Directors and supervisors of 670 units completed surveys describing the follow-up studies. The majority of programs collecting follow-up data used the information for program change. (SLD)
Keller, Robert A.; And Others
This article presents the findings from a nationwide survey of 553 child sexual abuse treatment programs. The survey focused on program context, client, and service characteristics. Most programs were affiliated with a larger agency, focused on treating victims, and relied on a combination of individual, family, dyad, and group therapy approaches.…
Berry, L.; Schweitzer, M.; Freeman, E.
This report describes barriers to energy conservation by the elderly. Because of these barriers, they have a greater need for programs that assist with the installation of energy-efficiency improvements. In response to this need, a number of specialized programs are operated for the elderly. This report contains descriptions of 39 energy conservation programs for the elderly. Telephone interviews were conducted with the managers of these programs to identify marketing techniques and organizational structures. Interagency networking, presentations and referrals are the most common methods of recruiting clients. Other marketing techniques in order of the frequency of use are: direct mail, bill inserts, television, radio, printed materials, and telemarketing. Many managers consider word-of-mouth advertising from satisfied clients the most effective form of marketing. Interagency networking and support (financial, structural and in-kind) can offer real advantages in the operation of conservation programs for the elderly. The use of specific marketing techniques is probably less important to success in recruiting clients than the degree of trust potential clients have in the sponsoring organization(s). 4 figs., 10 tabs.
McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis
Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.
Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing the barrier of initial capital cost. The majority of the PACE programs in the market today include PV as an eligible measure. PV appeals to homeowners as a way to reduce utility bills, self-generate sustainable power, increase energy independence and demonstrate a commitment to the environment. If substantial state incentives for PV exist, PV projects can be economic under PACE, especially when partnered with good net metering policies. At the same time, PV is expensive relative to other eligible measures with a return on investment horizon that might exceed program targets. This fact sheet reviews the benefits and potential challenges of including PV in PACE programs.
Wouters, Carmen; Fraga, Eric S.; James, Adrian M.
The integration of distributed generation units and microgrids in the current grid infrastructure requires an efficient and cost effective local energy system design. A mixed-integer linear programming model is presented to identify such optimal design. The electricity as well as the space heating and cooling demands of a small residential neighbourhood are satisfied through the consideration and combined use of distributed generation technologies, thermal units and energy storage with an optional interconnection with the central grid. Moreover, energy integration is allowed in the form of both optimised pipeline networks and microgrid operation. The objective is to minimise the total annualised cost of the system to meet its yearly energy demand. The model integrates the operational characteristics and constraints of the different technologies for several scenarios in a South Australian setting and is implemented in GAMS. The impact of energy integration is analysed, leading to the identification of key components for residential energy systems. Additionally, a multi-microgrid concept is introduced to allow for local clustering of households within neighbourhoods. The robustness of the model is shown through sensitivity analysis, up-scaling and an effort to address the variability of solar irradiation. - Highlights: • Distributed energy system planning is employed on a small residential scale. • Full energy integration is employed based on microgrid operation and tri-generation. • An MILP for local clustering of households in multi-microgrids is developed. • Micro combined heat and power units are key components for residential microgrids
Duong, K.; Grant, S. B.; Rippy, M.; Feldman, D.
From 2011 to 2017, the combination of record low precipitation and extreme warm temperatures resulted in the most severe drought in California's written history. In April 2015, Governor Jerry Brown issued an executive order mandating a statewide 25% reduction in potable urban water usage. Under such circumstances, outdoor watering is an obvious target for restriction, because it can account for a large fraction of total domestic water usage, up to 50% in the arid southwest [Syme et. al 2004, Cameron et. al 2012]. In this study we analyzed one such effort, in which the Irvine Ranch Water District (IRWD) in Orange County (California) offered a financial incentive through a turf rebate program to encourage Irvine residents to replace turf grass with drought tolerant landscaping. We focused specifically on the number of residents who applied to the turf rebate program. Our hypothesis was that the observed application rate (number of applicants per month) is influenced by a combination of (a) financial incentives issued by IRWD, (b) drought awareness, and (c) the fraction of neighbors that have already applied to the program (a phenomenon that can be described quantitatively through models of social contagion or social diffusion [Karsai et. al 2014]). Our preliminary results indicate that applications to the program occurred in geographic "hot spots", consistent with the idea that early adopters may have influenced neighbors to retrofit their lawns. We are currently evaluating the geographic, demographic, and temporal drivers that influence the rate of spontaneous adoption, the rate of adoption under influence, and the total size of the susceptible population. Overall, our goal is to identify the key factors that contribute to early rapid uptake of conservation behavior, and the rapid diffusion of that behavior through the community.
Arentsen, S K
The DOE-1 computer program is used to examine energy consumption in a typical middle-class household in Cincinnati, Ohio. The program is used to compare energy consumption under different structural and environmental conditions, including various levels of insulation in the walls and ceiling, double and single glazing of windows, and thermostat setback schedules. In addition, the DOE-1 program is used to model the house under three energy distribution systems: a unit heater, a single-zone fan system with optional subzone reheat; and a unitary heat pump. A plant equipment simulation is performed to model the heating and cooling plant currently installed in the house. A simple economic analysis of life-cycle costs for the house is done utilizing the economic simulation portion of DOE-1. Utility bills over the past six years are analyzed to gain an actual energy-use profile for the house to compare with computer results. Results indicate that a 35% savings in heating load may be obtained with addition of proper amounts of insulation as compared with the house with no insulation. The installation of double glazing on windows may save close to 6% on heating load. Thermostat setbacks may result in savings of around 25% on energy consumed for heating. Similar results are achieved with regard to cooling load. Comparison of actual energy consumed by the household (from utility bills) with the computer results shows a 4.25% difference in values between the two. This small percent difference certainly strengthens the case for future use of computer programs in comparing construction alternatives and predicting building energy consumption.
Shin, Juh Hyun
The aim of this study was to examine the effectiveness of an older adult exercise program in a senior-living complex campus. A longitudinal one-group design was used. To supply residents with tools to maintain or improve general quality of life, balance, endurance, depression, and functional mobility, the Wellness and Fitness Center at the research setting provided a wide assortment of user-friendly equipment with many options. One fitness director in the selected setting evaluated participants every 6 months with 33 participants using the Senior Fitness Test (SFT). Repeated ANOVAs identified factors impacting the effects of the exercise program using PROC MIXED SAS 9.0. The improvement or deterioration rate of SFT scores was tested as a time effect in balance, upper body strength, and lower body flexibility. A statistically significant gender effect emerged on the 6-minute walk, which measured aerobic endurance and the chair sit-and-reach test, which measured lower body flexibility. The 8-foot up-and-go, arm curl, chair stand, and chair sit-and-reach tests showed statistically significant improvement over time, which means balance, upper body strength, lower body strength, and lower body flexibility improved. Developing customized exercise protocols and using standardized measurement tools should be encouraged to enhance effective research and consistent measurement of exercise programs.
also be necessary. Water treatment systems are presented which can be developed to yield potable water from these sources. The proposed systems can be designed to meet the requirements of the Bare Base Mobility Program. (Author)
White, Melissa K; Holcomb, Franklin H; Josefik, Nicholas M; Lux, Scott M; Binder, Michael J
...) fuel cells at military facilities. The objective of the program was to assess PEM fuel cells in supporting sustainability in military installations, increasing efficiency in installation, operation, and maintenance of fuel cells...
Zhao, Xue; Zhang, Zi-Feng; Xu, Lei; Liu, Li-Yan; Song, Wei-Wei; Zhu, Fu-Jie; Li, Yi-Fan; Ma, Wan-Li
Benzotriazoles (BTs) UV filters are widely used as ultraviolet absorbents for our daily products, which received increasing attention in the past decades. Residential wastewater treatment plant (WWTP) is both an important sink for wastewater and a key pollution source for receiving water for these chemicals. In this study, pretreatment and gas chromatography-tandem mass spectrometry analysis method were developed to determine the occurrence and fate of 9 BTs UV filters in wastewater and sludge from the WWTP with anaerobic-oxic treatment process (A/O) and biological aerated filter treatment process (BAF). Totally, 81 wastewater samples and 11 sludge samples were collected in four seasons. In wastewater, UV-326 and UV-329 were frequently detected, while the highest mean concentrations were detected for UV-234 and UV-329. The concentrations were in the range of UV filters was >85% in A/O process and 60-77% in BAF process except for UV-350, which was more difficult to remove with lower removal efficiencies of 33.3% for both A/O and BAF. All the target chemicals except for UV-320 were detected in sludge samples with the mean concentration ranging from 0.90 ng/g to 303.39 ng/g. There was no significant difference with concentrations and removal efficiency among different seasons. Higher detection frequency and concentration of BTs UV filters in downstream of the receiving water system indicated the contribution of effluent of the WWTP. Compared with other rivers, the lower concentrations in surface water in the Songhua River indicated light pollution status with of BTs UV filters. Copyright © 2017 Elsevier Ltd. All rights reserved.
Roderick A. Rose
Full Text Available The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children in out-of-home care, research is needed to examine the factors that predict entry in PRTFs among children investigated for maltreatment. This exploratory study used cross-sector administrative records linked across multiple systems, including child welfare records and Medicaid claims, from a single state over a five-year period (n = 105,982. Cox proportional hazards modeling was used to predict entry into a PRTF. After controlling for many factors, PRTF entry was predicted by diagnosis code indicating a trauma-related condition, antipsychotic medication prescriptions, and entry into lower levels of out-of-home care, supporting the view that youth are admitted to PRTFs largely due to clinical need. However, PRTF admission is also associated with characteristics of their experiences with the social service system, primarily foster care placement stability and permanency. Implications for practice and research are discussed.
Capron, Daniel W; Bujarski, Sarah J; Gratz, Kim L; Anestis, Michael D; Fairholme, Christopher P; Tull, Matthew T
Suicide is a leading cause of death and is significantly elevated among those with substance use disorders (SUDs). However, specific mechanisms of suicide in this population have been relatively understudied. The depression-distress amplification model posits that one pathway to increased suicide risk is through the intensification of depressive symptoms by anxiety sensitivity cognitive concerns. However, this model has not been tested in populations with SUDs. The current study tested the depression-distress amplification model of suicide risk and examined the relation of anxiety sensitivity to suicide risk in a sample of men in residential SUD treatment. Consistent with prior work, anxiety sensitivity cognitive concerns were significantly associated with suicide risk. Moreover, and consistent with the depression-distress amplification model, anxiety sensitivity cognitive concerns related to elevated suicide risk among those with a current major depressive episode specifically, above and beyond insomnia (another risk factor for suicide) and relevant covariates. The results of this study corroborate the relevance of anxiety sensitivity cognitive concerns and the depression-distress amplification model to suicide risk in an at-risk clinical sample of SUD patients. Findings suggest the importance of assessing anxiety sensitivity cognitive concerns and targeting this vulnerability through brief interventions to reduce suicide risk. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Rainwater harvesting (RWH) is an alternative method of providing water for indoor domestic use, but the water quality after treatment and distribution at individual residences is not well documented. In this study, water quality parameters were measured at the cistern and indoor ...
Christensen, Thomas Højlund; Fruergaard, Thilde; Matsufuji, Y.
are discussed in this chapter. Characterizing residential waste is faced with the problem that many residences already divert some waste away from the official collection systems, for example performing home composting of vegetable waste and garden waste, having their bundled newspaper picked up by the scouts...... twice a year or bringing their used furniture to the flea markets organized by charity clubs. Thus, much of the data available on residential waste represents collected waste and not necessarily all generated waste. The latter can only be characterized by careful studies directly at the source...
Shorey, Ryan C.; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L.
Social-cognitive theories of aggression postulate that individuals who perpetrate aggression are likely to have high levels of maladaptive cognitive schemas that increase risk for aggression. Indeed, recent research has begun to examine whether early maladaptive schemas may increase the risk for aggression. However, no known research has examined this among individuals in substance use treatment, despite aggression and early maladaptive schemas being more prevalent among individuals with a su...
Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L
Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment.
Stinchfield, R; Winters, K C
This study measured the outcome of four state-supported outpatient gambling treatment programs in Minnesota. The programs were developed specifically for the treatment of pathological gamblers and offered multiple modalities of treatment including individual, group, education, twelve-step work, family groups, and financial counseling. The therapeutic orientation was eclectic with an emphasis on the twelve steps of Gamblers Anonymous (GA) and a treatment goal of abstinence. The sample included 348 men and 220 women treated between January 1992 and January 1995. A pretest-posttest design was utilized with multidimensional assessments obtained at intake, discharge, six-months, and twelve-months post-discharge. Variables assessed included a range of clinical and outcome variables. At six month follow-up, 28% reported that they had abstained from gambling during the six months following discharge and an additional 20% had gambled less than once per month. Almost half of the sample (48%) showed clinically significant improvement in gambling frequency at six month follow-up. Outcome variables of gambling frequency, SOGS scores, amount of money gambled, number of friends who gamble, psychosocial problems, and number of financial problems, all showed statistically significant improvements from pretreatment to follow-up. The treatment programs yielded outcome results similar to those reported for alcohol and drug abuse treatment programs.
Vahedipour-Dahraie, Mostafa; Najafi, Hamid Reza; Anvari-Moghaddam, Amjad
In recent deregulated power systems, demand response (DR) has become one of the most cost-effective and efficient solutions for smoothing the load profile when the system is under stress. By participating in DR programs, customers are able to change their energy consumption habits in response...... to energy price changes and get incentives in return. In this paper, we study the effect of various time-based rate (TBR) programs on the stochastic day-ahead energy and reserve scheduling in residential islanded microgrids (MGs). An effective approach is presented to schedule both energy and reserve...... in presence of renewable energy resources (RESs) and electric vehicles (EVs). An economic model of responsive load is also proposed on the basis of elasticity factor to model the behavior of customers participating in various DR programs. A two-stage stochastic programming model is developed accordingly...
McPherson, Amy C; Rudzik, Alanna; Kingsnorth, Shauna; King, Gillian; Gorter, Jan Willem; Morrison, Andrea
Life skills programs aim to equip youth with physical disabilities with the foundational skills required for adulthood. This study explored the perceived impact of residential immersive life skills (RILS) programs on the lives of participants. Qualitative interviews were conducted with alumni of three RILS programs. Data were thematically analyzed using a phenomenological approach. Themes identified from fourteen interviews were: (1) enhancing higher-order skills; (2) new notions of independence; and (3) identity change, empowerment, and advocacy. Opportunities to learn and practise a variety of skills in a structured, facilitative environment led to increased competence and motivation to engage in independent activities. Engaging with peers undergoing similar experiences also helped some youth integrate disability into their identity. Providing youth with physical disabilities opportunities to engage with others sharing similar experiences and challenges is essential. The study contributes toward the development of evidence-based best practices for life skills programs.
Hummer, Victoria Latham; Dollard, Norin; Robst, John; Armstrong, Mary I.
Children in the child welfare system frequently experience trauma within the caregiving relationship. These traumatic experiences may be compounded by system trauma and place these children at high risk of emotional disorders and placement in out-of-home (OOH) mental health treatment programs. This article reviews the literature on trauma and…
Comparison of Test Procedures and Energy Efficiency Criteria in Selected International Standards & Labeling Programs for Copy Machines, External Power Supplies, LED Displays, Residential Gas Cooktops and Televisions
Zheng, Nina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fridley, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
This report presents a technical review of international minimum energy performance standards (MEPS), voluntary and mandatory energy efficiency labels and test procedures for five products being considered for new or revised MEPS in China: copy machines, external power supply, LED displays, residential gas cooktops and flat-screen televisions. For each product, an overview of the scope of existing international standards and labeling programs, energy values and energy performance metrics and description and detailed summary table of criteria and procedures in major test standards are presented.
Hwang, Stephen W; Gogosis, Evie; Chambers, Catharine; Dunn, James R; Hoch, Jeffrey S; Aubry, Tim
Supportive housing, defined as subsidized housing in conjunction with site-based social services, may help improve the health and residential stability of highly disadvantaged individuals. This study examined changes in health status, quality of life, substance use, health care utilization, and residential stability among 112 homeless and vulnerably housed individuals who applied to a supportive housing program in Toronto, Canada, from December 2005 to June 2007. Follow-up interviews were conducted every 6 months for 18 months. Comparisons were made between individuals who were accepted into the program (intervention) and those who were wait-listed (usual care) using repeated-measures analyses. Individuals who were accepted into the housing program experienced significantly greater improvements in satisfaction with living situation compared with individuals in the usual care group (time, F(3,3,261) = 47.68, p homeless individuals was limited by the small number of participants who were literally homeless at baseline and by the large number of participants who gained stable housing during the study period regardless of their assigned housing status. Nonetheless, this study shows that highly disadvantaged individuals with a high prevalence of poor physical and mental health and substance use can achieve stable housing.
Is residential treatment effective for opioid use disorders? A longitudinal comparison of treatment outcomes among opioid dependent, opioid misusing, and non-opioid using emerging adults with substance use disorder.
Schuman-Olivier, Zev; Claire Greene, M; Bergman, Brandon G; Kelly, John F
Opioid misuse and dependence rates among emerging adults have increased substantially. While office-based opioid treatments (e.g., buprenorphine/naloxone) have shown overall efficacy, discontinuation rates among emerging adults are high. Abstinence-based residential treatment may serve as a viable alternative, but has seldom been investigated in this age group. Emerging adults attending 12-step-oriented residential treatment (N=292; 18-24 years, 74% male, 95% White) were classified into opioid dependent (OD; 25%), opioid misuse (OM; 20%), and no opiate use (NO; 55%) groups. Paired t-tests and ANOVAs tested baseline differences and whether groups differed in their during-treatment response. Longitudinal multilevel models tested whether groups differed on substance use outcomes and treatment utilization during the year following the index treatment episode. Despite a more severe clinical profile at baseline among OD, all groups experienced similar during-treatment increases on therapeutic targets (e.g., abstinence self-efficacy), while OD showed a greater decline in psychiatric symptoms. During follow-up relative to OM, both NO and OD had significantly greater Percent Days Abstinent, and significantly less cannabis use. OD attended significantly more outpatient treatment sessions than OM or NO; 29% of OD was completely abstinent at 12-month follow-up. Findings here suggest that residential treatment may be helpful for emerging adults with opioid dependence. This benefit may be less prominent, though, among non-dependent opioid misusers. Randomized trials are needed to compare more directly the relative benefits of outpatient agonist-based treatment to abstinence-based, residential care in this vulnerable age-group, and to examine the feasibility of an integrated model. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
DTA) experiments, five heat treatment programs were developed. All programs lead to single phase perovskite KNN films with random crystal orientation, but only the programs that included a treatment after each single spin-coating step ...
Cunningham, C E; Davis, J R; Bremner, R; Dunn, K W; Rzasa, T
This trial compared two approaches used to introduce parenting skills in a residential staff training program. Fifty staff were randomly assigned to: mastery modelling in which videotaped models demonstrated new skills, coping modelling problem solving (CMPS) in which participants formulated their own solutions to the errors depicted by videotaped models, or a waiting-list control group. In both, leaders used modelling, role playing, and homework projects to promote mastery and transfer of new skills. The skills of all groups improved, but CMPS participants attended more sessions, were late to fewer sessions, completed more homework, engaged in more cooperative in-session interaction, rated the program more positively, and reported higher job accomplishment scores. These data suggest that CMPS allowing participants to formulate their own solutions may enhance adherence and reduce the resistance observed in more didactic programs.
Newsham, Guy R., E-mail: firstname.lastname@example.org [National Research Council Canada-Institute for Research in Construction, Building M24, 1200 Montreal Road, Ottawa, Ontario, K1A 0R6 (Canada); Birt, Benjamin J. [National Research Council Canada-Institute for Research in Construction, Building M24, 1200 Montreal Road, Ottawa, Ontario, K1A 0R6 (Canada); Rowlands, Ian H. [University of Waterloo, Ontario (Canada)
We analyzed the peak load reductions due to a residential direct load control program for air-conditioners in southern Ontario in 2008. In this program, participant thermostats were increased by 2 deg. C for four hours on five event days. We used hourly, whole-house data for 195 participant households and 268 non-participant households, and four different methods of analysis ranging from simple spreadsheet-based comparisons of average loads on event days, to complex time-series regression. Average peak load reductions were 0.2-0.9 kWh/h per household, or 10-35%. However, there were large differences between event days and across event hours, and in results for the same event day/hour, with different analysis methods. There was also a wide range of load reductions between individual households, and only a minority of households contributed to any given event. Policy makers should be aware of how the choice of an analysis method may affect decisions regarding which demand-side management programs to support, and how they might be incentivized. We recommend greater use of time-series methods, although it might take time to become comfortable with their complexity. Further investigation of what type of households contribute most to aggregate load reductions would also help policy makers better target programs. - Highlights: > We analyzed peak load reductions due to residential a/c load control. > We used four methods, ranging from simple comparisons to time-series regression. > Average peak load reductions were 0.2-0.9 kW per household, varying by method. > We recommend a move towards time-series regression for future studies. > A minority of participant households contributed to a given load control event.
Hirst, E.; White, D.
This report discusses changes in indoor temperatures in response to retrofit improvements. The data on which this analysis is based are from an evaluation of the Bonneville Power Administration (BPA) interim Residential Weatherization Program. The BPA program, operated through participating private and public utilities throughout the Pacific Northwest, offered financial assistance (generally a cash rebate) to encourage installation of energy-efficiency improvements to existing homes in the region. These retrofits included attic, wall, floor and heating duct insulation; storm windows and doors; clock thermostats; and caulking and weatherstripping. This program, which operated during 1982 and 1983, weatherized 104 thousand homes at a total cost to BPA of $157 million. In mid-1983, staff at Oak Ridge National Laboratory and Evaluation Research Corporation began an evaluation of the BPA program. The primary focus of this evaluation was assessment of the actual electricity saving that can be attributed to the program (Hirst, et al., 1985). These savings estimates were used to help assess the economic attractiveness of the program to participants, the BPA power system, and the Pacific Northwest region as a whole.
Yount, Rick A; Olmert, Meg D; Lee, Mary R
In July 2008, social worker and certified service dog trainer Rick Yount created the first Warrior dog-training program designed to be a safe, effective, nonpharmaceutical intervention to treat the symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury in Veterans and service members undergoing treatment at a large Veterans Administration residential treatment facility. In 2009, Yount was asked to establish the program at a prominent Department of Defense medical center. In October 2010, Yount was invited to create a service dog training program to support the research and treatment mission at the new National Intrepid Center of Excellence (NICoE), in Bethesda, Maryland. This program, now being offered through the nonprofit foundation Warrior Canine Connection, continues to produce anecdotal evidence that training service dogs reduces the PTSD symptoms of Warrior-trainers and that the presence of the dogs enhances the sense of wellness in the NICoE staff and the families of our Wounded Warriors. Under the research leadership of the NICoE, the Warrior Canine Connection research team plans to systematically investigate the physiological, psychological, and behavioral benefits of this program.
Wray, Craig P.; Walker, Iain S.; Sherman, Max H.
Currently, houses do not perform optimally or even as many codes and forecasts predict, largely because they are field assembled and there is no consistent process to identify problems or to correct them. Residential commissioning is a solution to this problem. This guide is the culmination of a 30-month project that began in September 1999. The ultimate objective of the project is to increase the number of houses that undergo commissioning, which will improve the quality, comfort, and safety of homes for California citizens. The project goal is to lay the groundwork for a residential commissioning industry in California focused on end-use energy and non-energy issues. As such, we intend this guide to be a beginning and not an end. Our intent is that the guide will lead to the programmatic integration of commissioning with other building industry processes, which in turn will provide more value to a single site visit for people such as home energy auditors and raters, home inspectors, and building performance contractors. Project work to support the development of this guide includes: a literature review and annotated bibliography, which facilitates access to 469 documents related to residential commissioning published over the past 20 years (Wray et al. 2000), an analysis of the potential benefits one can realistically expect from commissioning new and existing California houses (Matson et al. 2002), and an assessment of 107 diagnostic tools for evaluating residential commissioning metrics (Wray et al. 2002). In this guide, we describe the issues that non-experts should consider in developing a commissioning program to achieve the benefits we have identified. We do this by providing specific recommendations about: how to structure the commissioning process, which diagnostics to use, and how to use them to commission new and existing houses. Using examples, we also demonstrate the potential benefits of applying the recommended whole-house commissioning approach to
... Extension: Sickle Cell Disease Treatment Demonstration Program (U1E) Awards to Three Currently Funded... the Sickle Cell Disease Treatment Demonstration Program. Three of these awards will end on August 31.... Justification: The Sickle Cell Disease Treatment Demonstration Program provides grants to evaluate the use of...
Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Borgeson, Merrian Goggio [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Zimring, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
With the proliferation of statewide energy savings targets and other policies favorable to energy efficiency, savings from utility customer-funded energy efficiency programs could rise to offset much of annual load growth by 2025 (Barbose et al 2013). For these increased savings to occur, however, nearly all of these programs must pass screening for cost effectiveness. Some program administrators and state regulators are finding that conventional analyses, which only consider a narrow set of energy-savings related efficiency program benefits, are now resulting in some natural gas efficiency programs failing their cost-effectiveness criteria in the new low natural gas price environment. Regulators are considering whether to scale back or terminate gas portfolios in at least four states (WA, OR, ID, NM) because of cost-effectiveness concerns. Stakeholders in several regions of the country have asked LBNL to help assess alternatives to reducing the pursuit of energy savings in their regions. We address these requests by producing two working papers: one exploring cost-effectiveness screening policy implications of low to moderate natural gas prices, and a second assessing some of the values that policymakers may take into account in weighing the pros and cons of ending natural gas efficiency programs. In this policy brief, we lay out the challenges that low gas prices pose for cost effectiveness of an electric-gas efficiency program and portfolio. We then quantify options available to regulators and administrators who want to evaluate the tradeoffs among multiple policy objectives. A multi-measure, residential energy upgrade program in the Midwest is used as a lens to explore the implications of common and emerging cost-effectiveness policies in the context of low prices for natural gas. We illustrate the results across a range of cost-effectiveness screening options, including different discount rates, levels of test application, various benefit-cost tests, and the
Fan, Lijun; Hou, Xiang-Yu; Zhao, Jingzhou; Sun, Jiandong; Dingle, Kaeleen; Purtill, Rhonda; Tapp, Sam; Lukin, Bill
There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67-0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50-0.76); p Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.
Lv, Ming; Li, Yi; Kou, Bo; Zhou, Zhili
Patients received by radiotherapy departments are diverse and may be diagnosed with different cancers. Therefore, they need different radiotherapy treatment plans and thus have different needs for medical resources. This research aims to explore the best method of scheduling the admission of patients receiving radiotherapy so as to reduce patient loss and maximize the usage efficiency of service resources. A mix integer programming (MIP) model integrated with special features of radiotherapy is constructed. The data used here is based on the historical data collected and we propose an exact method to solve the MIP model. Compared with the traditional First Come First Served (FCFS) method, the new method has boosted patient admission as well as the usage of linear accelerators (LINAC) and beds. The integer programming model can be used to describe the complex problem of scheduling radio-receiving patients, to identify the bottleneck resources that hinder patient admission, and to obtain the optimal LINAC-bed radio under the current data conditions. Different management strategies can be implemented by adjusting the settings of the MIP model. The computational results can serve as a reference for the policy-makers in decision making.
Lv, Ming; Kou, Bo; Zhou, Zhili
Background and purpose Patients received by radiotherapy departments are diverse and may be diagnosed with different cancers. Therefore, they need different radiotherapy treatment plans and thus have different needs for medical resources. This research aims to explore the best method of scheduling the admission of patients receiving radiotherapy so as to reduce patient loss and maximize the usage efficiency of service resources. Materials and methods A mix integer programming (MIP) model integrated with special features of radiotherapy is constructed. The data used here is based on the historical data collected and we propose an exact method to solve the MIP model. Results Compared with the traditional First Come First Served (FCFS) method, the new method has boosted patient admission as well as the usage of linear accelerators (LINAC) and beds. Conclusions The integer programming model can be used to describe the complex problem of scheduling radio-receiving patients, to identify the bottleneck resources that hinder patient admission, and to obtain the optimal LINAC-bed radio under the current data conditions. Different management strategies can be implemented by adjusting the settings of the MIP model. The computational results can serve as a reference for the policy-makers in decision making. PMID:28700726
Li, Jianan; Cheng, Weixiao; Xu, Like; Strong, P J; Chen, Hong
In this study, we determined the abundance of 8 antibiotics (3 tetracyclines, 4 sulfonamides, and 1 trimethoprim), 12 antibiotic-resistant genes (10 tet, 2 sul), 4 antibiotic-resistant bacteria (tetracycline, sulfamethoxazole, and combined resistance), and class 1 integron integrase gene (intI1) in the effluent of residential areas, hospitals, and municipal wastewater treatment plant (WWTP) systems. The concentrations of total/individual targets (antibiotics, genes, and bacteria) varied remarkably among different samples, but the hospital samples generally had a lower abundance than the residential area samples. The WWTP demonstrated removal efficiencies of 50.8% tetracyclines, 66.8% sulfonamides, 0.5 logs to 2.5 logs tet genes, and less than 1 log of sul and intI1 genes, as well as 0.5 log to 1 log removal for target bacteria. Except for the total tetracycline concentration and the proportion of tetracycline-resistant bacteria (R (2) = 0.330, P antibiotics and the corresponding resistant bacteria (P > 0.05). In contrast, various relationships were identified between antibiotics and antibiotic resistance genes (P antibiotic-resistant bacteria (P < 0.01).
KP, R. M. Bambang Setyohadi; Wicaksono, Dimas
The poverty is one of the prevailing problems in Indonesia until now. Even a change of the era of governance has not succeeded in eradicating the problem of poverty. The program of poverty alleviation program has always been a focus in the budget allocation in all era of leadership in Indonesia. Those programs were strategic because it prepared the foundation of community self-reliance in the form of representative, entrenched and conducive community leadership institutions to develop of social capital of society in the future. Developing an area of the village requires an integrated planning (Grand Design) to figure out the potential and the problems existing in the rural area as well as the integration of the rural area surrounding. In addition, the grand design needs to be synchronized to the more comprehensive spatial plan with a hierarchical structure such as RTBL, RDTRK / RRTRK, RTRK, and RTRW. This rural area management plan can be oriented or refer to the pattern developed from neighborhood Development program which is part of the PNPM Mandiri program. The neighborhood development program is known as residential area development plan whose process involves of the entire community. Therefore, the regional development up to the scale of the environment requires the planning phase. Particularly, spatial planning which emphasizes the efforts to optimize sectorial development targets to be integrated into an integrated development process must be conducted, in addition to taking into consideration the opportunities, potentials and limitations of the resources, the level of interconnection with the central government within the district and between sub-districts and rural areas.
Full Text Available Analyzed multi residential house renovation investment projects efficiency evaluation methods: economic-social, and environmental, as well as key financial valuation methods: simple pay-back period, the energy cost savings, the net present value, internal rate of return. Building walls condition regenerative rate which is used to evaluate investments in energy-saving measures is also discussed. According to reconstruction investments of multi residential house, three government financing programs of multi residential house are evaluated and selected the most effective program by comparing financial valuation methods taking and without taking into account building walls condition regenerative rate. Article in Lithuanian
Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.
Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048
Fullen, Mark D.
The numbers of workers in the residential construction industry are on the rise. Falls have continually been the largest contributor to residential construction worker deaths and injuries. These workers are largely self-employed or working for small companies. These individuals are difficult to reach through traditional methods. This research…
Barbose, Galen; Wiser, Ryan; Bolinger, Mark
In this paper, we review experiences with programs to support the deployment of photovoltaics (PV) in new, market-rate homes, drawing upon interviews with program managers around the country, project data, and publicly-available documentation on program design, impacts, and experiences. We focus on state clean energy funds, which have been established in 14 U.S. states to build markets for clean energy resources, as well as a select number of other state or local organizations whose activities are particularly noteworthy. We describe the types of programs implemented and their impacts to date, and discuss key issues and lessons learned for initiatives aimed at growing the new home market for PV.
Macintosh, Andrew; Wilkinson, Deb
The Australian Government ran a renewable energy program in the 2000s that provided rebates to householders who acquired solar Photovoltaic (PV) energy systems. Originally called the Photovoltaic Rebate Program (PVRP), it was rebranded the Solar Homes and Communities Plan (SHCP) in November 2007. This paper evaluates both the PVRP and SHCP using measures of cost-effectiveness and fairness. It finds that the program was a major driver of a more than six-fold increase in PV generation capacity in the 2000s, albeit off a low base. In 2010, solar PV's share of the Australian electricity market was still only 0.1%. The program was also environmentally ineffective and costly, reducing emissions by 0.09 MtCO 2 -e/yr over the life of the rebated PV systems at an average cost of between AU$238 and AU$282/tCO 2 -e. In addition, the data suggest there were equity issues associated with the program, with 66% of all successful applicants residing in postal areas that were rated as medium-high or high on a Socio-economic Status (SES) scale. - Research highlights: → We evaluated a solar photovoltaic (PV) rebate program. → The program was ineffective, reducing emissions by 0.09 MtCO 2 -e/yr. → The average abatement cost was ∼AU$250/tCO 2 -e. → The program had a relatively minor impact as an industry assistance measure. → The distribution of rebates was skewed toward higher SES areas.
Bolliger, Doris U.; Shepherd, Craig E.
As more adults frequent wilderness areas, they bring Internet-enabled devices (e.g., smart phones, tablets) with them. This study focuses on adults' perceptions of these devices in relation to desired outdoor learning experiences. Specifically, researchers examined the perspectives of naturalists who taught outdoor education programs and park…
Pelletier, Luc R; Hoffman, Jeffrey A
As a result of new federal regulations released in early 2001 that move the monitoring and evaluation of opioid treatment programs from a government regulation to an accreditation model, program staff members are now being challenged to develop performance measurement systems that improve care and service. Using measurement selection criteria is the first step in developing a performance measurement system as a component of an overall quality management (QM) strategy. Opioid treatment programs can "leapfrog" the development of such systems by using lessons learned from the healthcare quality industry. This article reviews performance measurement definitions, proposes performance measurement selection criteria, and makes a business case for Internet automation and accessibility. Performance measurement sets that are appropriate for opioid treatment programs are proposed, followed by a discussion on how performance measurement can be used within a comprehensive QM program. It is hoped that through development, adoption, and implementation of such a performance measurement program, treatment for clients and their families will continuously improve.
Wisdom, Jennifer P; Ford, James H; Wise, Meg; Mackey, Deirdre; Green, Carla A
Despite treatment improvement and performance management imperatives, little research describes the data management capacity of substance abuse treatment programs, and useful metrics are not available to gauge capacity. This exploratory study evaluates clinical and administrative data management at eight substance abuse treatment programs in four US states to identify factors for developing an appropriate metric. Findings indicate that programs tend to manage data inefficiently and have few protocols guiding information management. Barriers to better data management included lack of integrated information technology (IT) systems; limited funding, time, and staff for developing and implementing IT-related changes; and divergent staff skills in and attitudes toward IT. This snapshot of substance abuse treatment programs' data management capabilities suggests a need for a metric to examine data management capability in these settings. Infusion of expertise, training, and funding are needed to improve substance abuse treatment programs' IT-related systems and data management processes.
Full Text Available Techniques for residential energy monitoring are an emerging field that is currently drawing significant attention. This paper is a description of the current efforts to monitor and compare the performance of three solar powered homes built at Missouri University of Science and Technology. The homes are outfitted with an array of sensors and a data logger system to measure and record electricity production, system energy use, internal home temperature and humidity, hot water production, and exterior ambient conditions the houses are experiencing. Data is being collected to measure the performance of the houses, compare to energy modeling programs, design and develop cost effective sensor systems for energy monitoring, and produce a cost effective home control system.
Carey, K B
Drug and alcohol abuse represents a major obstacle to the successful rehabilitation of psychiatrically-disabled persons. Prevalence estimates for current chemical abuse among individuals in psychiatric treatment range from 24% to 49%. Although specialized treatment programs for mentally ill chemical abusers (MICAs) have recently been developed, few of these innovative programs are described in the literature. This paper presents main features of the MICA Day Treatment Program at the Richard H. Hutchings Psychiatric Center, including staffing, schedule, maintenance of a drug-free treatment environment, and therapeutic programming. Recommendations are offered for treatment providers who are developing their own services for MICAs.
Stewart, James [Cadmus Group, Waltham, MA (United States); Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
Residential behavior-based (BB) programs use strategies grounded in the behavioral social sciences to influence household energy use. Strategies may include providing households with real-time or delayed feedback about their energy use; supplying energy-efficiency education and tips; rewarding households for reducing their energy use; comparing households to their peers; and establishing games, tournaments, and competitions. BB programs often target multiple energy end uses and encourage energy savings, demand savings, or both. Savings from BB programs are usually a small percentage of energy use, typically less than 5%.
Friedmann, P D; Lemon, S C; Stein, M D
To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.
Johnson, K. R.; Polequaptewa, N.; Leon, Y.
Native Americans remain severely underrepresented in the geosciences, despite a clear need for qualified geoscience professionals within Tribal communities to address critical issues such as natural resource and land management, water and air pollution, and climate change. In addition to the need for geoscience professionals within Tribal communities, increased participation of Native Americans in the geosciences would enhance the overall diversity of perspectives represented within the Earth science community and lead to improved Earth science literacy within Native communities. To address this need, the Department of Earth System Science and the American Indian Resource Program at the University California have organized a two-week residential American Indian Summer Institute in Earth System Science (AISESS) for high-school students (grades 9-12) from throughout the nation. The format of the AISESS program is based on the highly-successful framework of a previous NSF Funded American Indian Summer Institute in Computer Science (AISICS) at UC Irvine and involves key senior personnel from the AISICS program. The AISESS program, however, incorporates a week of camping on the La Jolla Band of Luiseño Indians reservation in Northern San Diego County, California. Following the week of camping and field projects, the students spend a week on the campus of UC Irvine participating in Earth System Science lectures, laboratory activities, and tours. The science curriculum is closely woven together with cultural activities, native studies, and communication skills programs The program culminates with a closing ceremony during which students present poster projects on environmental issues relevant to their tribal communities. The inaugural AISESS program took place from July 15th-28th, 2012. We received over 100 applications from Native American high school students from across the nation. We accepted 40 students for the first year, of which 34 attended the program. The
Magid, Kenneth M.
The children facing divorce program began last year and was built on the talents of an interdisciplinary staff. Included are experts in client-centered counseling, sociometry and psychodrama, Gestalt and TA, behavior modification, and various eclectic approaches to family therapy. (Author)
Full Text Available Jennifer Hewitt,1 Kathryn M Refshauge,1 Stephen Goodall,2 Timothy Henwood,3 Lindy Clemson1 1Faculty of Health Sciences, University of Sydney, 2Centre for Health Economic Research and Evaluation, University of Technology, Sydney, NSW, 3University of Queensland/Blue Care Research and Practice Development Centre, The University of Queensland, Brisbane, QLD, Australia Introduction: Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care reduces falls in residents of aged care facilities. Research question: Is the program more effective and cost-effective than usual care for the prevention of falls? Design: Single-blinded, two group, cluster randomized trial. Participants and setting: 300 residents, living in 20 aged care facilities. Intervention: Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Control: Usual care. Measurements: Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. Analysis: The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. Discussion: This study addresses a significant shortcoming in aged care research, and has potential to impact
Adkins, Brian [Bishop Paiute Tribe; Castilone, Lisa
The objective of the project was to provide affordable renewable energy to 22 low income reservation homeowners; provide job training to tribal members and reduce air pollution by equivalent carbon offsets. The project exceeded grant objectives installing 66kW of rooftop solar on 22 low income single family homes and providing hands-on PV rooftop solar installation training to 24 tribal individuals (four more than planned). The project was a phased installment of an on-going partnership between the Tribe and GRID that was initiated in 2013 whereby 62 rooftop solar units were installed prior to this funded effort. The reported work in this report describes the funded effort where US Department of Energy provided partial funding through grant award IE0006949 and marks the first phase of an effort matching California Solar SASH Initiative funding with DOE Office of Indian Energy Funding and brings the total for the program to 84 installed systems (running total of 271 Kw installed) and the end of the project. Tribal workforce development was a key aspect of the project and trained 24tribal members for a total 1168 cumulative on-job training hours. The solar installations and training efforts were fully completed by September of 2016 with 66.6 kW installed - 8 kW more than the original estimate stated in the grant application.
Background The subject site (Ian George Court) caters for clients from a socially disadvantaged background. All clients have been homeless or at risk of homelessness and have a history of alcohol and substance abuse often linked to mental health issues. This project was developed to examine if the site provided best practice in the promotion of smoking cessation. Objectives The first objective of this project was to improve client knowledge to make informed choice about smoking cessation, ensuring that client advice was given in line with best available evidence and assist the client in accessing community programs. The second objective was to fully review the current assessment tool used in relation to gathering baseline data about smoking habits and act on the information provided. Search strategy The search strategy sought to find published studies and papers. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract. A second extensive search was then undertaken using all identified keywords. Conclusion A smoking assessment tool was developed and is now in use across all Anglicare sites in South Australia. This provides staff with consistent baseline information and offers evidence-based health care in a package format to aid clients in smoking cessation. © 2008 The Author.
from community life.1 One type of community care that relies largely on making contact ... Objective: This study aims to evaluate an Intensive Home Based Program (IHBP) in terms of effects on admissions and length of stay. Method: The ... residential accommodation options if the home environment is un- suitable. The GP ...
Reynolds, Elizabeth K; Magidson, Jessica F; Bornovalova, Marina A; Gwadz, Marya; Ewart, Craig K; Daughters, Stacey B; Lejuez, C W
Risky sexual behavior (RSB) is a leading cause of HIV/AIDS, particularly among urban substance users. Using the social action theory, an integrative systems model of sociocognitive, motivational, and environmental influences, as a guiding framework, the current study examined (1) environmental influences, (2) psychopathology and affect, (3) HIV-related attitudes and knowledge, and (4) self-regulatory skills/deficits as factors associated with event-level condom use (CU) among a sample of 156 substance users residing at a residential substance abuse treatment center (M age = 41.85; SD = 8.59; 75% male). RSB was assessed using event-level measurement of CU given its advantages for improved accuracy of recall and ability for an examination of situational variables. A logistic regression predicting event-level CU indicated the significant contribution of partner type (environmental influences), less favorable attitudes towards condoms (HIV-related attitudes and knowledge), and higher levels of risk-taking propensity (self-regulatory skills/deficits) in predicting greater likelihood of not having used a condom at one's most recent sexual encounter. This study contributes to the literature examining HIV risk behaviors among substance users within a theory-driven model of risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Burkholder, H.C.; Brouns, R.A.; Powell, J.A.
To support DOE's attainment of its goals, Nuclear Waste Treatment Program (NWTP) is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting. This annual report describes progress during FY 1986 toward meeting these two objectives. 29 refs., 59 figs., 25 tabs
Burkholder, H.C.; Brouns, R.A. (comps.); Powell, J.A. (ed.)
To support DOE's attainment of its goals, Nuclear Waste Treatment Program (NWTP) is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting. This annual report describes progress during FY 1986 toward meeting these two objectives. 29 refs., 59 figs., 25 tabs.
Jansson, Irene; Hesse, Morten; Fridell, Mats
Background Personality disorders (PD) are related to negative outcome in substance abuse treatment, and in the general population, personality disorders are related to negative outcome in overall functioning. Little is known about the impact of PD on adjustment following substance abuse treatment...... associated with unemployment. Dependent PD and obsessive-compulsive personality disorder features were positively associated with employment. Borderline PD features were associated with hospital admissions. Discussion We discuss how strategies associated with various PDs may foster or hinder social...... status over the years, and linked with hospital and criminal justice registers. Results The impact of PD on functioning varied substantially between disorders and outcome domains. Conduct disorder alone was associated with criminal justice involvement, and conduct disorder and avoidant PD features were...
Implementation of a bowel management program in the treatment of incontinence in children for primary healthcare providers. Mahmoud M.A. Elfiky, Mostafa A. Gad, Mohamed M. El Barbary, Sherif N. Kaddah, Gamal H. El Tagy ...
Kolton, Marilyn S.
This article presents a philosophy perceived by young professionals, often members of the counterculture, who completed a series of questions concerning innovative programs with a humanistic orientation to drug treatment. (Author/RK)
Sideroff, Stephen I.
Presents a Gestalt therapeutic approach that has shown promise within a drug treatment program. The major issues discussed include the acquisition of self-support, taking responsibility, dealing with anxiety, contact, and the expression of pent-up feelings. (Author)
Birmingham, C L; Hlynsky, J; Russell, B; Gritzner, S
There are no established treatment programs for shoplifting in eating disorder patients. Our objective was to observe the effect of an established behavioural treatment program in a series of eating disorder patients. Patients with eating disorders who shoplift voluntarily took part in an 8-week behavioral treatment program at the Elizabeth Fry Society of Greater Vancouver, British Columbia. They completed assessments at the first session, last session, and at 1 and 6 months post intervention. Six patients enrolled in the study and three patients completed the treatment program. Only one patient reported a decrease in shoplifting frequency. All subjects reported an increase in self-esteem and ability to control shoplifting impulses. Our findings suggest that behavioral therapy may be effective in treating shoplifting in eating disorders, but that longer sessions and follow-up may be necessary to show benefit. A randomized control trial with longer-term follow-up is needed to determine whether there is a benefit.
Radon concentrations have been studied extensively in single-family residential buildings, but relatively little work has been done in large buildings, including multistory residential buildings. The phenomena of radon transport in multistory residential buildings is made more complicated by the multizone nature of the airflow system and the numerous interzone airflow paths that must be characterized in such a system. This paper presents the results of a computer simulation of airflow and radon transport in a twelve-story residential building. Interzone airflow rates and radon concentrations were predicted using the multizone airflow and contaminant dispersal program (CON-TAM88). Limited simulations were conducted to study the influence of two different radon source terms, indoor-outdoor temperature difference and exterior wall leakage values on radon transport and radon concentration distributions
Trust Territory of the Pacific Islands Dept. of Education, Saipan.
This curriculum guide on residential wiring for secondary students is one of six developed for inservice teachers at Marianas High School in Saipan. The guide provides the rationale, description, goals, and objectives of the program; the program of studies and performance objectives by levels; samples of lesson plans for effective delivery of…
Dementiev N. P.
Full Text Available The article presents a comparative analysis of residential mortgages in Russia and the United States. The primary ways of mortgage refinancing are outlined. Predominance of the elements of two-level refinancing system of residential mortgage in Russia and the United States is shown. The activity of the Agency for Housing Mortgage Lending (AHML, the basic tool of the Russian government’s mortgage policy, is described in detail. In its objectives and functions the AHML is similar to the American mortgage agencies Ginnie Mae, Fannie Mae and Freddie Mac. Similarities were identified in the Russian and US residential mortgages in the pre-crisis period (high rates of mortgage growth, favourable economic conjuncture, low interest rates, large increase in house prices, speculative housing demand. During the mortgage crisis, the policies of the Russian and US governments and monetary authorities had also much in common (monetary policy easing, cheap central banks loans, extended facilities of mortgage refinancing on the part of state agencies, mortgage rescue scheme, social mortgage programs. But the scope of mortgage in Russia is enormously narrow as compared to the US mortgage. The most important reason for that - low incomes of the Russian population.
This report provides an overview of the U.S. Department of Energy Building America program's Summer 2011 Residential Energy Efficiency Technical Update Meeting. This meeting was held on August 9-11, 2011, in Denver, Colorado, and brought together more than 290 professionals representing organizations with a vested interest in energy efficiency improvements in residential buildings.
Kalet, I.J.; Jacky, J.P.
The function of a treatment planning program is to graphically simulate radiation dose distributions from proposed radiation therapy treatments. While many such programs are available which provide this much-needed service, none addresses the question of how to intercompare calculation and display techniques. This paper describes a program system designed for support of research efforts, particularly development and testing of new calculation algorithms. The system emphasizes a modular flexible structure, enabling programs to be developed somewhat as interchangeable parts. Thus multiple variants of a calculation algorithm can be compared without undue software overhead or additional data management. Unusual features of the system include extensive use of command procedures, logical names and a structured language (PASCAL). These features are described along with other implementation details. Obstacles, limitations and future applications are also discussed. (Auth.)
Lehmann, Lauren P; Detweiler, Jonna G; Detweiler, Mark B
To assess the experiences of a veteran initiated horticultural therapy garden during their 28-day inpatient Substance Abuse Residential Rehabilitation Treatment Program (SARRTP). Retrospective study. Veterans Affairs Medical Center (VAMC), Salem, Virginia, USA INTERVENTIONS: Group interviews with veterans from the last SARRTP classes and individual interviews with VAMC greenhouse staff in summer of 2016. Time spent in garden, frequency of garden visits, types of passive and active garden activities, words describing the veterans' emotional reactions to utilizing the garden. In 3 summer months of 2016, 50 percent of the 56 veterans interviewed visited and interacted with the gardens during their free time. Frequency of visits generally varied from 3 times weekly to 1-2 times a day. Amount of time in the garden varied from 10min to 2h. The veterans engaged in active and/or passive gardening activities during their garden visits. The veterans reported feeling "calm", "serene", and "refreshed" during garden visitation and after leaving the garden. Although data was secured only at the end of the 2016 growing season, interviews of the inpatient veterans revealed that they used their own initiative and resources to continue the horticulture therapy program for 2 successive growing years after the original pilot project ended in 2014. These non-interventionist, therapeutic garden projects suggest the role of autonomy and patient initiative in recovery programs for veterans attending VAMC treatment programs and they also suggest the value of horticulture therapy as a meaningful evidence- based therapeutic modality for veterans. Published by Elsevier Ltd.
Watkins, Laura E; Sippel, Lauren M; Pietrzak, Robert H; Hoff, Rani; Harpaz-Rotem, Ilan
Aggression and suicidality are two serious public health concerns among U.S. veterans that can co-occur and share many overlapping risk factors. The current study aims to elucidate the contribution of posttraumatic stress disorder (PTSD) symptom clusters defined by a five-factor model and alcohol misuse in predicting aggression and suicide attempts among veterans entering residential treatment for PTSD. Participants were 2570 U.S. veterans across 35 Veterans Health Administration sites. Multinomial logistic regression models were used to identify correlates of aggression only (n = 1471; 57.2%), suicide attempts only (n = 41; 1.6%), co-occurring aggression and suicide attempts (n = 202; 7.9%), and neither behavior (n = 856; 33.3%) over the past four months. When compared to veterans endorsing neither behavior, greater PTSD re-experiencing symptoms were related to suicide attempts (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.09-2.30), aggression (OR = 1.13, 95% CI = 1.02-1.26), and co-occurring aggression and suicide (OR = 1.38, 95% CI = 1.13-1.68), and higher PTSD dysphoric arousal symptoms and alcohol misuse symptoms were related to aggression (OR = 1.54, 95% CI = 1.38-1.71; OR = 1.30, 95% CI = 1.18-1.44, respectively) and co-occurring aggression and suicide (OR = 1.66, 95% CI = 1.35-2.04; OR = 1.50, 95% CI = 1.28-1.75, respectively). Our findings suggest that assessment of PTSD symptom clusters and alcohol misuse can potentially help to identify veterans who endorse suicide attempts, aggression, or both concurrently. These results have important implications for risk assessment and treatment planning with U.S. veterans seeking care for PTSD. Published by Elsevier Ltd.
Griebenow, M.L.; Dorn, R.V. III; Gavin, P.R.; Spickard, J.H.
The United States (US) Department of Energy (DOE) recently initiated a focused, multidisciplined program to evaluate Boron Neutron Capture Therapy (BNCT) for the treatment of brain tumors. The program, centered at the DOE/endash/Idaho National Engineering Laboratory (INEL), will develop the analytical, diagnostic and treatment tools, and the database required for BNCT technical assessment. The integrated technology will be evaluated in a spontaneously-occurring canine brain-tumor model. Successful animal studies are expected to lead to human clinical trials within four to five years. 2 refs., 3 figs
MacDonald, P; Stanton, M E
The cornerstone of the US Agency for International Development (USAID) fistula program is to support and strengthen local capacity for fistula repair. The USAID program includes support to upgrade facilities, enhance local surgical repair capability, allocate equipment and supplies to operating rooms, implement quality improvement systems, and cover the women's transportation costs to and from the treatment facilities. The program also offers training in clinical and counseling skills; transferring skills South-to-South; and monitoring and evaluating the program's effectiveness. As new fistula cases continually increase the backlog of untreated cases, its efforts are also directed toward the prevention of fistula and the reintegration of treated women into their communities. Furthermore, the program challenges the culture of sexual violence against women that leads to traumatic gynecologic fistulas.
This study examined differences in two residential care giving models (houseparent vs. child care worker) in providing continuity of care for youth in residential placement, and the effect that a care giving model had on selected program outcomes. Data for this research were collected in a residential facility that used both models. Youth with…
... 25 Indians 1 2010-04-01 2010-04-01 false Are there different formulas for different levels of residential services? 39.218 Section 39.218 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR... Verifications Residential Programs § 39.218 Are there different formulas for different levels of residential...
Kateeb, Elham; Warren, John; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim
The purpose of this study was to investigate the extent of clinical training on atraumatic restorative treatment (ART) among pediatric dentistry residency programs and assess program directors' attitudes toward ART. All U.S. Pediatric Dentistry residency programs' directors were asked to complete a web-based survey. Sixty-one of the 76 directors (80 percent) completed the survey, with no significant response bias. Eighty-nine percent of the responding programs provided clinical instruction on ART. Of these, 30 percent provided ART training often/very often. ART was used mostly in single-surface cavities (43 percent) and as an interim treatment in primary teeth (57 percent). Factors associated with ART clinical training included not placing amalgams in primary teeth (Ppediatric dentistry residency programs in the United States. Residency directors' attitudes were highly predictive of the amount of clinical training provided, suggesting that directors need to be better informed about the use of ART.
Libby, Daniel J; Reddy, Felice; Pilver, Corey E; Desai, Rani A
Posttraumatic stress disorder (PTSD) is a chronic, debilitating anxiety disorder that is highly prevalent among U.S. military veterans. Yoga, defined to include physical postures (asana) and mindfulness and meditation, is being increasingly used as an adjunctive treatment for PTSD and other psychological disorders. No research or administrative data have detailed the use of these services in Department of Veterans Affairs' (VA) 170 PTSD treatment programs. One hundred twenty-five program coordinators or designated staff completed an 81-item survey of their program's use of complementary and alternative medicine modalities in the past year. This report describes data from a subset of 30 questions used to assess the prevalence, nature, and context of the use of yoga, mindfulness, and meditation other than mindfulness practices. Results revealed that these practices are widely offered in VA specialized PTSD treatment programs and that there is great variability in the context and nature of how they are delivered. Understanding how yoga is used by these programs may inform ongoing efforts to define and distinguish yoga therapy as a respected therapeutic discipline and to create patient-centered care models that mindfully fulfill the unmet needs of individuals with mental health issues, including veterans with PTSD.
Mckay, James R.; Gutman, Marjorie; Mclellan, A. Thomas; Lynch, Kevin G.; Ketterlinus, Robert
This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients…
Tatiana Rehder Gonçalves
Full Text Available Objective: To evaluate the dropout of a multidisciplinary treatment program in fibromyalgia (FM. Methods: An observational study conducted during the period of April 2000 to December 2005, including 133 women with fibromyalgia, participating in a multidisciplinary treatment program. Those who had left the treatment for two weeks or more were classified as inactive and contacted by telephone to record the reasons for their noncompliance, which were divided into four groups: 1 Family; 2 Occupations; 3 Medical; 4 Other Reasons. Results: When collecting data, 92 (69.4% women were considered inactive. There was no significant difference between noncompliance before and after six months of treatment. Of the total number of inactive women, 54 (40.8% participants left for medical reasons, 30 (22.6% for other reasons, 26 (19.4% for family reasons and 23 (17.2% due to occupation. There was no statistical difference between the motives of dropout according to the length of stay in the program (p> 0.05. Conclusion: We conclude that the multidisciplinary program for women with fibromyalgia had high levels of noncompliance, half of them occurred in the first six months. Among the main reasons reported for dropout, the medical reasons were more frequent.
Influence of different heat treatment programs on properties of sol–gel synthesized (Na0·5K0·5)NbO3 (KNN) thin films. S WIEGAND. ∗. , S FLEGE, O BAAKE and W ENSINGER. Department of Materials and Geosciences, Materials Analysis Group, Technische Universität Darmstadt, Petersenstrasse. 23, 64287 Darmstadt ...
McElroy, J.L.; Burkholder, H.C. (comps.)
This annual report describes progress during FY 1983 relating to technologies under development by the Commercial Waste Treatment Program, including: development of glass waste form and vitrification equipment for high-level wastes (HLW); waste form development and process selection for transuranic (TRU) wastes; pilot-scale operation of a radioactive liquid-fed ceramic melter (LFCM) system for verifying the reliability of the reference HLW treatment proces technology; evaluation of treatment requirements for spent fuel as a waste form; second-generation waste form development for HLW; and vitrification process control and product quality assurance technologies.
Huefner, Jonathan C.; Ringle, Jay L.
There has been ongoing concern about the negative impact of residential treatment on youth in care. Research examining the impact of negative peer influence in juvenile justice, education, and residential care settings is reviewed. A study was conducted to examine the impact of negative peer contagion on the level of problem behavior in a…
Friedman, A S; Glickman, N W
The relationship to treatment outcome, as measured by reduction in drug use, of specific characteristics and elements of 30 drug-free outpatient programs for adolescents is reported. Admission and discharge data were obtained from National Institute on Drug Abuse-Client Oriented Data Acquisition Process on 5789 adolescents in the 30 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual clients, was the unit of analysis. While controlling for differences between programs on their client populations, multiple regression analysis indicated that the following characteristics of programs were found to predict the outcome criterion variable, to a statistically significant degree: treat a large number of adolescent clients; have a special school for school dropouts; have a relatively large budget; employ counselors or therapists who have at least 2 years' experience in working with adolescent drug abusers; provide special services such as vocational counseling, recreational services, and birth control services; use such therapy methods as crisis intervention, gestalt therapy, music/art therapy, and group confrontation; and be perceived by the clients as allowing and encouraging free expression and spontaneous action by clients. There was a high degree of replication of these findings across the two annual subsamples of clients; and the amount of variance in the treatment outcome criterion variable accounted for by the above-listed program characteristics was quite impressive.
Walsh, Stephanie M; Palmer, Wendy; Welsh, Jean A; Vos, Miriam B
Despite the well-documented need for multidisciplinary pediatric obesity treatment programs, few programs exist and best practices are not clearly defined. We describe the design and initial quality-related outcomes of the Strong4Life multidisciplinary pediatric obesity treatment program along with some challenges and solutions implemented over the first 2 years. The purpose of this report is to inform others interested in designing similar programs. The Strong4Life Clinic obesity program was designed to provide children with the medical care, as well as the behavior change guidance and support needed to reverse their obesity and/or minimize the related health risks. This low-intensity program is designed to provide approximately 6 hours of care over 12 months from a medical provider, psychologist, registered dietitian nutritionist, exercise physiologist, and nurse. Between August 2011 and February 2014, the Strong4Life clinic served 781 high-risk (mean sex- and age-adjusted body mass index [BMI] percentile 98.8) and racially/ethnically diverse (45% non-Hispanic black and 24% Hispanic) patients. Of the 781 patients seen, 66% returned for at least 1 visit. Nearly all returning Strong4Life patients stabilized or improved their BMI (90% of those who participated 6 months, but longer follow-up and assessment of comorbidities are needed. © 2014 American Society for Parenteral and Enteral Nutrition.
Full Text Available This work considers a two-stage stochastic integer programming (SIP approach for optimizing fuel treatment planning under uncertainty in weather and fire occurrence for rural forests. Given a set of areas for potentially performing fuel treatment, the problem is to decide the best treatment option for each area under uncertainty in future weather and fire occurrence. A two-stage SIP model is devised whose objective is to minimize the here-and-now cost of fuel treatment in the first-stage, plus the expected future costs due to uncertain impact from potential fires in the second-stage calculated as ecosystem services losses. The model considers four fuel treatment options: no treatment, mechanical thinning, prescribed fire, and grazing. Several constraints such as budgetary and labor constraints are included in the model and a standard fire behavior model is used to estimate some of the parameters of the model such as fuel levels at the beginning of the fire season. The SIP model was applied to data for a study area in East Texas with 15 treatment areas under different weather scenarios. The results of the study show, for example, that unless the expected ecosystem services values for an area outweigh fuel treatment costs, no treatment is the best choice for the area. Thus the valuation of the area together with the probability of fire occurrence and behavior strongly drive fuel treatment choices.
Maimunah; Aldila, Dipo
In this article, using a deterministic approach in a seven-dimensional nonlinear ordinary differential equation, we establish a mathematical model for the spread of HIV with an ART treatment intervention. In a simplified model, when no ART treatment is implemented, disease-free and the endemic equilibrium points were established analytically along with the basic reproduction number. The local stability criteria of disease-free equilibrium and the existing criteria of endemic equilibrium were analyzed. We find that endemic equilibrium exists when the basic reproduction number is larger than one. From the sensitivity analysis of the basic reproduction number of the complete model (with ART treatment), we find that the increased number of infected humans who follow the ART treatment program will reduce the basic reproduction number. We simulate this result also in the numerical experiment of the autonomous system to show how treatment intervention impacts the reduction of the infected population during the intervention time period.
Moggi, Franz; Giovanoli, Anna; Buri, Caroline; Moos, Bernice S; Moos, Rudolf H
Cross-cultural comparisons may increase our understanding of different models of substance use treatment and help identify consistent associations between patients' characteristics, treatment conditions, and outcomes. The aim of the study was to compare matched samples of substance use disorder (SUD) patients with personality disorders (PD) in Swiss and the United States (U.S.) residential SUD treatment programs and examine the relationship of program characteristics to 1-year outcomes. A prospective, naturalistic design was used to compare 132 demographically matched Swiss and U.S. male patients drawn from a sample of 10 Swiss and 15 U.S. public treatment programs. Patients completed comparable inventories at admission, discharge, and 1-year follow-up. Compared to Swiss SUD-PD patients, U.S. SUD-PD patients had more severe substance use and psychosocial problems at admission and follow-up. More intensive treatment and a stronger emphasis on patients' involvement were related to better outcomes for both Swiss and U.S. SUD-PD patients. There may be some cross-cultural consistency in the associations between treatment characteristics and SUD-PD patients' outcomes. Treatment evaluation findings from representative programs in one country may apply elsewhere and contribute to our overall knowledge about how to improve SUD-PD patients' outcomes.
This Risk Management (RM) Program covers the 283-W Water Treatment Facility (283W Facility), located in the 200 West Area of the Hanford Site. A RM Program is necessary for this facility because it stores chlorine, a listed substance, in excess of or has the potential to exceed the threshold quantities defined in Title 40 of the Code of Federal Regulations (CFR) Part 68 (EPA, 1998). The RM Program contains data that will be used to prepare a RM Plan, which is required by 40 CFR 68. The RM Plan is a summary of the RM Program information, contained within this document, and will be submitted to the U.S. Environmental Protection Agency (EPA) ultimately for distribution to the public. The RM Plan will be prepared and submitted separately from this document
Bray, Jeremy W; Mallonee, Erin; Dowd, William; Aldridge, Arnie; Cowell, Alexander J; Vendetti, Janice
This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist) and service delivery setting (emergency department, hospital inpatient, outpatient). Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service provision for some settings and implementation models.
Full Text Available When selecting a chemical treatment program for wastewater to achieve an effective flocculation and coagulation is crucial to understand how individual colloids interact. The coagulation process requires a rapid mixing while flocculation process needs a slow mixing. The behavior of colloids in water is strongly influenced by the electrokinetic charge, where each colloidal particle carries its own charge, which in its nature is usually negative. Polymers, which are long chains of high molecular weight and high charge, when added to water begin to form longer chains, allowing removing numerous particles of suspended matter. A study of physico-chemical treatment by addition of coagulant and flocculant was carried out in order to determine a chemical program for oily wastewater coming from the gravity separation process in a crude oil refinery. The tests were carried out in a Jar Test equipment, where commercial products: aluminum polychloride (PAC, aluminum sulfate and Sintec D50 were evaluated with five different flocculants. The selected chemical program was evaluated with fluids at three temperatures to know its sensitivity to this parameter and the mixing energy in the coagulation and flocculation. The chemical program and operational characteristics for physico-chemical treatment with PAC were determined, obtaining a removal of more than 93% for suspended matter and 96% for total hydrocarbons for the selected coagulant / flocculant combination.
Coughlin, J.; Cory, K.
This report presents the information that homeowners and policy makers need to facilitate PV financing at the residential level. The full range of cash payments, bill savings, and tax incentives is covered, as well as potentially available solar attribute payments. Traditional financing is also compared to innovative solutions, many of which are borrowed from the commercial sector. Together, these mechanisms are critical for making the economic case for a residential PV installation, given its high upfront costs. Unfortunately, these programs are presently limited to select locations around the country. By calling attention to these innovative initiatives, this report aims to help policy makers consider greater adoption of these models to benefit homeowners interested installing a residential PV system.
Two techniques for restraining the use of the automobile have recently become popular in the United States: residential parking permit programs and traffic restraint devices. While both the these approaches are aimed at restraining the use of the aut...
A comparison of multidisciplinary team residential rehabilitation with conventional outpatient care for the treatment of non-arthritic intra-articular hip pain in UK Military personnel - a protocol for a randomised controlled trial.
Coppack, Russell J; Bilzon, James L; Wills, Andrew K; McCurdie, Ian M; Partridge, Laura; Nicol, Alastair M; Bennett, Alexander N
Non-arthritic hip disorders are defined as abnormalities of the articulating surfaces of the acetabulum and femur before the onset of osteoarthritis, including intra-articular structures such as the acetabular labrum and chondral surfaces. Abnormal femoroacetabular morphology is commonly seen in young men who constitute much of the UK military population. Residential multidisciplinary team (MDT) rehabilitation for patients with musculoskeletal injuries has a long tradition in the UK military, however, there are no studies presenting empirical data on the efficacy of a residential MDT approach compared with individualised conventional outpatient treatment. With no available data, the sustainability of this care pathway has been questioned. The purpose of this randomised controlled trial is to compare the effects of a residential multidisciplinary intervention, to usual outpatient care, on the clinical outcomes of young active adults undergoing treatment for non-arthritic intra-articular hip pain. The trial will be conducted at the Defence Medical Rehabilitation Centre, Headley Court, UK. One hundred military male participants with clinical indicators of non-arthritic intra-articular hip pain will be randomly allocated to either: (1) 7-day residential multidisciplinary team intervention, n = 50; (2) 6-week physiotherapist-led outpatient intervention (conventional care), n = 50. Measurements will be taken at baseline, post-treatment (1-week MDT group; 6-weeks physiotherapy group), and 12-weeks. The primary outcome measures are the function in daily living sub-scale of the Copenhagen Hip and Groin Outcome Score (HAGOS), the physical function subscale of the Non-arthritic Hip Score (NAHS), and VAS pain scale. Secondary outcomes include objective measures of physical capacity and general health. An intention-to-treat analysis will be performed using linear and mixed models. This study will be the first to assess the efficacy of intensive MDT rehabilitation
Full Text Available Jeremy W Bray,1 Erin Mallonee,2 William Dowd,2 Arnie Aldridge,2 Alexander J Cowell,2 Janice Vendetti31Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA; 2RTI International, Research Triangle Park, NC, USA; 3Department of Community Medicine and Health Care, School of Medicine, UCONN Health, Farmington, CT, USAAbstract: This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist and service delivery setting (emergency department, hospital inpatient, outpatient. Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service
Phobias are a prevalent and often debilitating mental health problem all over the world. This article aims to explore what is known about the use of Neuro-linguistic Programming (NLP) as a treatment for this condition. Whilst there is abundant experiential evidence from NLP practitioners attesting to the efficacy of this method as a treatment for phobias, experimental research in this area is somewhat limited. This paper reviews evidence available in literature produced in the UK and US and reveals that NLP is a successful treatment for phobias as well as being particularly efficient due to the relatively brief time period it takes to effect an improvement. Copyright © 2010 Elsevier Ltd. All rights reserved.
McKone, Thomas E.; Sherman, Max H.
The goals of this scoping study are to identify research needed to develop improved ventilation standards for California's Title 24 Building Energy Efficiency Standards. The 2008 Title 24 Standards are the primary target for the outcome of this research, but this scoping study is not limited to that timeframe. We prepared this scoping study to provide the California Energy Commission with broad and flexible options for developing a research plan to advance the standards. This document presents the findings of a scoping study commissioned by the Public Interest Energy Research (PIER) program of the California Energy Commission to determine what research is necessary to develop new residential ventilation requirements for California. This study is one of three companion efforts needed to complete the job of determining the ventilation needs of California residences, determining the bases for setting residential ventilation requirements, and determining appropriate ventilation technologies to meet these needs and requirements in an energy efficient manner. Rather than providing research results, this scoping study identifies important research questions along with the level of effort necessary to address these questions and the costs, risks, and benefits of pursuing alternative research questions. In approaching these questions and corresponding levels of effort, feasibility and timing were important considerations. The Commission has specified Summer 2005 as the latest date for completing this research in time to update the 2008 version of California's Energy Code (Title 24).
German, a. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Hoeschele, M. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)
This research conducted by the Alliance for Residential Building Innovation team evaluated mechanical air conditioner pre-cooling strategies in homes throughout the United States. EnergyPlus modeling evaluated two homes with different performance characteristics in seven climates. Results are applicable to new construction homes and most existing homes built in the last 10 years, as well as fairly efficient retrofitted homes.
This publication contains student and teacher instructional materials for a course in residential solar systems. The text is designed either as a basic solar course or as a supplement to extend student skills in areas such as architectural drafting, air conditioning and refrigeration, and plumbing. The materials are presented in four units…
The characteristics of electric heat pumps are described. Options are defined and assessed for utilizing gas heating in conjunction with existing residential electric heat pumps. These options include gas heat introduced into the refrigeration circuit, a flue gas-heated tube bank in the air supply duct, and a hot-water-to-air coil in the supply duct. Economics are presented for conversion of a residence's total space and water heating from electric to gas in New York City and Atlanta. Potential marketing strategies are discussed, and potential gas sales volumes from conversions are estimated. The study concludes that the use of gas water heating coupled with a hydronic coil in the supply ductwork from the air handler is the most advantageous option for the gas industry
Palepu, Anita; Patterson, Michelle L; Moniruzzaman, Akm; Frankish, C James; Somers, Julian
We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study). The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence. We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness. People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence.
Full Text Available Background: Type 2 diabetes mellitus (T2DM is a highly prevalent disease characterized by chronic hyperglycemia. Yoga is a form of mind-body intervention shown to have a positive impact on several health conditions in both healthy and diseased patients. The present study is intended to assess the effects of the Residential Integrated Yoga Program (RIYP on blood glucose levels in patients with T2DM. Material and Methods: Data of 598 (186 females T2DM patients from a holistic health center in Bengaluru, India, who attended a 15-day RIYP between January 2013 and December 2015 was obtained retrospectively. Average age of the participants was 56.45 ± 11.02 years. All subjects underwent a 15-day RIYP which involved yoga-based lifestyle changes with components of regulated sleep, balanced diet, asanas, pranayama, relaxation techniques, meditations, yogic cleaning procedures, and tuning to the nature. Fasting and post-prandial blood sugar, medication score, symptom score, systolic and diastolic blood pressure, pulse rate, and respiratory rate were assessed before and after intervention. Result: There was a significant decrease in fasting (p < 0.001 and post-prandial blood sugar levels (p < 0.001 along with a significant reduction in medication and symptom scores after 15 days of RIYP compared to baseline. Conclusion: The present study indicates that 2 weeks of a yoga-based residential program improves blood glucose levels, blood pressure, and medication score in patients with T2DM. However, further randomized controlled studies need to be performed in order to confirm the present findings.
Field, Clinton E; Nash, Heather M; Handwerk, Michael L; Friman, Patrick C
Out-of-home treatment for youth with conduct problems is increasing rapidly in this country. Most programs for these youth deliver treatment in a group format and commonly employ some version of a token economy. Despite widespread evidence of effectiveness, a substantial minority of treated youth fail to respond. Participants for this study were 3 youth who were nonresponsive to treatment provided in a family-style residential care program with a comprehensive token economy. Our approach to the "nonresponse" of these youth involved modifications of the frequency and immediacy of their access to the backup rewards earned with tokens. We evaluated the effects of the modifications with a treatment-withdrawal experimental design. Dependent measures included two indices of youth response to treatment: intense behavioral episodes and backup rewards earned. Results showed substantial improvement among these indices during treatment conditions.
Dixon, L; Hackman, A; Lehman, A
The last decade has witnessed the increasing importance of consumers as providers of mental health services. Assertive Community Treatment (ACT) teams and ACT variants, with their emphasis on rehabilitation and support in the client's natural environment, have hosted consumer-professional collaborations. The authors discuss one such program in which an ACT program for homeless mentally ill adults employed consumer advocates (CAs). Consumer advocates were found to have a service profile similar to other staff. Further, there is suggestive evidence that the employment of CAs created a more positive attitude toward persons with mental illness. Issues of role definition, boundaries, support with supervision and the importance of CAs' experiences with mental illness are discussed.
Lineberry, M.J.; McFarlane, H.F.
Argonne National Laboratory has refurbished and equipped an existing hot cell facility for demonstrating a high-temperature electrometallurgical process for treating spent nuclear fuel from the Experimental Breeder Reactor-11. Two waste forms will be produced and qualified for geologic disposal of the fission and activation products. Relatively pure uranium will be separated for storage. Following additional development, transuranium elements will be blended into one of the high-level waste streams. The spent fuel treatment program will help assess the viability of electrometallurgical technology as a spent fuel management option
Mulatu, Mesfin S; Leonard, Kimberly Jeffries; Godette, Dionne C; Fulmore, Darren
Black youth are disproportionately affected by the HIV/AIDS epidemic. This study examined disparities in patterns and determinants of sexual risk behaviors among black and white adolescents in substance abuse treatment programs. We used pooled clinical data collected from 4,565 sexually active 12-17-year-old black (29.7%) and white (70.3%) adolescents entering outpatient and residential substance abuse treatment programs nationally. Multivariate logistic regression analyses were used to examine racial differences in patterns of sexual risk behaviors and the associations of these behaviors with demographic, socioenvironmental and psychosocial risk factors, including substance use and abuse, symptoms of mental disorders and criminal behaviors. Blacks were significantly more likely than whites to have had sex with multiple partners, purchased or traded sex and used substances to enhance their sexual experiences, even after adjusting for demographic, socioenvironmental and psychosocial risk factors. Substance use and abuse, internalizing symptoms and drug-related crimes were significantly associated with engaging in > or =2 sexual risk behaviors in both groups. Disparities in determinants of HIV risk were also found. For instance, male gender, single-parent custody and history of criminal justice involvement were associated with having had sex with multiple partners among blacks but not among whites. Demographic, socioenvironmental and psychosocial risk factors accounted for up to 30% of the variance in sexual risk in both groups. Black adolescents with substance use problems are at greater risk for HIV infection than their white peers because of their higher rates of sexual risk behaviors. Differences in co-occurring psychosocial problems did not fully explain racial disparities in sexual risk behaviors. HIV prevention programs for black adolescents in treatment should consider both individual and broader contextual factors that co-occur with sexual risk behaviors.
Brouns, R.A.; Powell, J.A. (comps.)
Two of the US Department of Energy's (DOE) nuclear waste management-related goals are to ensure that waste management is not an obstacle to the further development of light-water reactors and the closure of the nuclear fuel cycle and to fulfill its institutional responsibility for providing safe storage and disposal of existing and future nuclear wastes. As part of its approach to achieving these goals, the Office of Remedial Action and Waste Technology of DOE established what is now called the Nuclear Waste Treatment Program (NWTP) at the Pacific Northwest Laboratory during the second half of FY 1982. To support DOE's attainment of its goals, the NWTP is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting assistance, as required to treat existing wastes. This annual report describes progress during FY 1987 towards meeting these two objectives. 24 refs., 59 figs., 24 tabs.
Browne, Julia; Penn, David L; Bauer, Daniel J; Meyer-Kalos, Piper; Mueser, Kim T; Robinson, Delbert G; Addington, Jean; Schooler, Nina R; Glynn, Shirley M; Gingerich, Susan; Marcy, Patricia; Kane, John M
This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.
Load curve modelling of the residential segment electric power consumption applying a demand side energy management program; Modelagem da curva de carga das faixas de consumo de energia eletrica residencial a partir da aplicacao de um programa de gerenciamento de energia pelo lado da demanda
Rahde, Sergio Barbosa [Pontificia Univ. Catolica do Rio Grande do Sul, Porto Alegre (Brazil). Dept. de Engenharia Mecanica e Mecatronica]. E-mail: email@example.com; Kaehler, Jose Wagner [Pontificia Univ. Catolica do Rio Grande do Sul, Porto Alegre (Brazil). Faculdade de Engenharia]. E-mail: firstname.lastname@example.org
The dissertation aims to offer a current vision on the use of electrical energy inside CEEE's newly defined area of operation. It also intends to propose different alternatives to set up a Demand Side Management (DSM) project to be carried out on the same market segment, through a Residential Load Management program. Starting from studies developed by DNAEE (the Brazilian federal government's agency for electrical energy), to establish the load curve characteristics, as well as from a research on electrical equipment ownership and electricity consumption habits, along with the contribution supplied by other utilities, especially in the US, an evaluation is offered, concerning several approaches to residential energy management, setting up conditions that simulate the residential segment's scenarios and their influence on the general system's load. (author)
Data on residential loads has been collected from four residences in real time. The data, measured at 5-second intervals for 53 days of continuous operation, were statistically characterized. An algorithm was developed and incorporated into the modeling code SOLCEL. Performance simulations with SOLCEL using these data as well as previous data collected over longer time intervals indicate that no significant errors in system value are introduced through the use of long-term average data.
Murphy, Christopher J.; Siv, Alexander M.
This case study is to evaluate the effectiveness of Mode Deactivation Therapy (MDT) implementation in a child and adolescent residential treatment unit and provide preliminary effectiveness data on MDT versus treatment as usual (TAU). This case study compared the efficacy of two treatment methodologies for adolescent males in residential treatment…
McKetin, Rebecca; Dunlop, Adrian J; Holland, Rohan M; Sutherland, Rachel A; Baker, Amanda L; Salmon, Allison M; Hudson, Susan L
The purpose of this study was to document treatment outcomes for methamphetamine users receiving outpatient counselling from the Stimulant Treatment Program (STP) in Australia. Clients attending the STP for methamphetamine use (n = 105) were assessed on entry to the service and at 3 (n = 86) and 6 months (n = 83) after starting treatment. At each interview methamphetamine use (days of use, severity of dependence), other drug use and health and social functioning (HIV risk behaviour, crime, disability, psychotic symptoms and hostility) were assessed for the past month. Participants received a median of six counselling sessions (interquartile range 1-11) over a period of 89 days (interquartile range 41-148 days). Past month methamphetamine use fell from 79% at treatment entry to 53% at the 3-month follow-up (P methamphetamine were more common among younger participants, those who had no history of drug treatment and those without concurrent heroin use. Methamphetamine users entering the STP showed reductions in methamphetamine use and improvements in their mental health after treatment. Improved treatment responses are needed to address polydrug use and other harms within in this population. © 2012 Australasian Professional Society on Alcohol and other Drugs.
Moretti, M. M.; Emmrys, C.; Grizenko, N.; Holland, R.; Moore, K.; Shamsie, J.; Hamilton, H.
Provides a synopsis of treatment programs for conduct-disordered children in Canada. Five groups of authors from British Columbia, Ontario, Quebec, and New Brunswick describe their approaches to the treatment of children with conduct disorder. All programs emphasize the need to use multimodal treatment schemes, including day and short-term residential care, as well as the need to base programs on identified factors associated with the development of conduct disorder.
Lanhers, Charlotte; Walther, Guillaume; Chapier, Robert; Lesourd, Bruno; Naughton, Geraldine; Pereira, Bruno; Duclos, Martine; Vinet, Agnès; Obert, Philippe; Courteix, Daniel; Dutheil, Frédéric
To demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control. A within-trial cost-medication analysis with a 1-year time horizon. Controlled environment within the spa resort of Chatel-Guyon, France. Twenty-nine participants (aged 50-70 years) with T2D. A 1-year follow-up intervention, beginning with a 3-week residential programme combining high exercise volume (15-20 hours/week), restrictive diet (-500 kcal/day) and education. Participants continued their routine medication, independently managed by their general practitioner. Number of medications, number of pills, cost of medications and health-related outcomes. Twenty-six participants completed the 1-year intervention. At 1 year, 14 patients out of 26 (54%) stopped/decreased their medications whereas only 5 (19%) increased or introduced new drugs (χ 2 =6.3, p=0.02). The number of pills per day decreased by 1.3±0.3 at 12 months (pDiabetics patients with HbA1c >6.5% in the highest (last) quartile doubled their routine medication costs (66% vs 33%, p=0.037). Individuals with T2D reduced routine medication costs following a long-term lifestyle intervention that started with a 3-week residential programme. Combining high exercise volume, restrictive diet and education effectively supported the health of T2D. The main factor explaining reduced medication costs was better glycaemic control, independent of weight changes. Despite limitations precluding generalisability, cost-effective results of reduced medication should contribute to the evidence base required to promote lifestyle interventions for individuals with T2D. NCT00917917; Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
van Ham, Maarten; Findlay, Allan M.
While researchers are increasingly re-conceptualizing international migration, far less attention has been devoted to re-thinking short-distance residential mobility and immobility. In this paper we harness the life course approach to propose a new conceptual framework for residential mobility research. We contend that residential mobility and immobility should be re-conceptualized as relational practices that link lives through time and space while connecting people to structural conditions. Re-thinking and re-assessing residential mobility by exploiting new developments in longitudinal analysis will allow geographers to understand, critique and address pressing societal challenges. PMID:27330243
The EPA provides resources for handling residential demolitions or renovations. This includes planning, handling harmful materials, recycling, funding, compliance assistance, good practices and regulations.
... detoxification and maintenance treatment programs. 2.34 Section 2.34 Public Health PUBLIC HEALTH SERVICE... detoxification and maintenance treatment programs. (a) Definitions. For purposes of this section: Central... information about individuals applying for maintenance treatment or detoxification treatment for the purpose...
Turley, Alan; Thornton, Tim; Johnson, Craig; Azzolino, Sue
Substance abuse treatment has become the new fashion for reducing recidivism among inmates. But the question is, does this work? Various studies have been done tracking the same cohort of inmates over time to assess the validity of treatment. This study assesses one treatment program's success over 5 years to determine if drug and alcohol treatment reduces recidivism among nonviolent, short-term (sentence of less than a year) inmates. Monroe County's drug treatment program demonstrates that for 1 year after receiving the treatment, three different cohorts of nonviolent, short-term inmates (1995, 1998, and 2000) were found to be substantially less likely to be recidivists than control group inmates.
Sherman, Max H.
In the last quarter of a century, the western world has become increasingly aware of environmental threats to health and safety. During this period, people psychologically retreated away from outdoors hazards such as pesticides, smog, lead, oil spills, and dioxin to the seeming security of their homes. However, the indoor environment may not be healthier than the outdoor environment, as has become more apparent over the past few years with issues such as mold, formaldehyde, and sick-building syndrome. While the built human environment has changed substantially over the past 10,000 years, human biology has not; poor indoor air quality creates health risks and can be uncomfortable. The human race has found, over time, that it is essential to manage the indoor environments of their homes. ASHRAE has long been in the business of ventilation, but most of the focus of that effort has been in the area of commercial and institutional buildings. Residential ventilation was traditionally not a major concern because it was felt that, between operable windows and envelope leakage, people were getting enough outside air in their homes. In the quarter of a century since the first oil shock, houses have gotten much more energy efficient. At the same time, the kinds of materials and functions in houses changed in character in response to people's needs. People became more environmentally conscious and aware not only about the resources they were consuming but about the environment in which they lived. All of these factors contributed to an increasing level of public concern about residential indoor air quality and ventilation. Where once there was an easy feeling about the residential indoor environment, there is now a desire to define levels of acceptability and performance. Many institutions--both public and private--have interests in Indoor Air Quality (IAQ), but ASHRAE, as the professional society that has had ventilation as part of its mission for over 100 years, is the
Full Text Available Abstract Background The roll-out of antiretroviral therapy (ART in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. Methods This paper describes healthcare utilization from program entry by treatment-naïve patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count Results 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO, excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. Conclusion Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.
Lee, A.D.; Englin, J.E.; Harkreader, S.A.
In 1983, the Northwest Power Planning Council (Council) issued Model Conservation Standards (MCS) designed to improve the efficiency of electrically heated buildings. Since then, the standards have been adopted by numerous local governments and utilities. The Bonneville Power Administration (Bonneville) has played an active role in marketing residential energy efficiency improvements through the Super Good Cents Program (SGCP) and encouraging the adoption and implementation of the MCS as local codes through the Early Adopter Program (EAP). Since the inception of the MCS, however, questions have arisen about the effect of the code and programs on the selection of heating fuels for new homes. Recently, Bonneville has proposed a gradual reduction in the incentive levels under these two programs prior to 1995 based on several assumptions about the market for MCS homes: builder costs will decline as builders gain experience building them; buyers will seek out MCS homes as their appreciation for their lower energy costs and greater comfort increases; and the resale market will increasingly reflect the greater quality of MCS homes. The growing availability of data from several jurisdictions where the MCS have been implemented has recently made it possible to begin assessing the effect of the MCS programs on residential fuel choice and evaluating assumptions underlying the programs and Bonneville's plans to revise them. This study is the first such assessment conducted for Bonneville.
... the Buildings Technologies Program-Building Energy Codes Program Manager, U.S. Department of Energy... hotel, motel, and other transient residential building types of any height as commercial buildings for... insulation and length requirements Skylight definition change Penalizing electric resistance heating in the...
Liddicoat, Kendra R.; Krasny, Marianne E.
Residential outdoor environmental education (ROEE) programs for youth have been shown to yield lasting autobiographical episodic memories. This article explores how past program participants have used such memories, and draws on the memory psychology literature to offer a new perspective on the long-term impacts of environmental education.…
German, Alea [Davis Energy Group, Davis, CA (United States). Alliance for Residential Building Innovation (ARBI); Hoeschele, Marc [Davis Energy Group, Davis, CA (United States). Alliance for Residential Building Innovation (ARBI)
Residential air conditioning (AC) represents a challenging load for many electric utilities with poor load factors. Mechanical precooling improves the load factor by shifting cooling operation from on-peak to off-peak hours. This provides benefits to utilities and the electricity grid, as well as to occupants who can take advantage of time-of-use (TOU) electricity rates. Performance benefits stem from reduced compressor cycling, and shifting condensing unit operation to earlier periods of the day when outdoor temperatures are more favorable to operational efficiency. Finding solutions that save energy and reduce demand on the electricity grid is an important national objective and supports key Building America goals. The Alliance for Residential Building Innovation team evaluated mechanical AC precooling strategies in homes throughout the United States. EnergyPlus modeling was used to evaluate two homes with different performance characteristics in seven climates. Results are applicable to new construction homes and most existing homes built in the last 10 years, as well as fairly efficient retrofitted homes. A successful off-peak AC strategy offers the potential for increased efficiency and improved occupant comfort, and promotes a more reliable and robust electricity grid. Demand response capabilities and further integration with photovoltaic TOU generation patterns provide additional opportunities to flatten loads and optimize grid impacts.
McMahon, Catherine M.; Ibrahim, Ronny K.; Mathur, Ankit
Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i) compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii) investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG) recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants) showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants’ 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual’s objective (source strength and anterior-posterior source location) and subjective measures (using tinnitus reaction questionnaire, TRQ). The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by the
Catherine M McMahon
Full Text Available Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants' 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual's objective (source strength and anterior-posterior source location and subjective measures (using tinnitus reaction questionnaire, TRQ. The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...
This study combines principles of energy systems engineering and statistics to develop integrated models of residential energy use in the United States, to include residential recharging of electric vehicles. These models can be used by government, policymakers, and the utility industry to provide answers and guidance regarding the future of the U.S. energy system. Currently, electric power generation must match the total demand at each instant, following seasonal patterns and instantaneous fluctuations. Thus, one of the biggest drivers of costs and capacity requirement is the electricity demand that occurs during peak periods. These peak periods require utility companies to maintain operational capacity that often is underutilized, outdated, expensive, and inefficient. In light of this, flattening the demand curve has long been recognized as an effective way of cutting the cost of producing electricity and increasing overall efficiency. The problem is exacerbated by expected widespread adoption of non-dispatchable renewable power generation. The intermittent nature of renewable resources and their non-dispatchability substantially limit the ability of electric power generation of adapting to the fluctuating demand. Smart grid technologies and demand response programs are proposed as a technical solution to make the electric power demand more flexible and able to adapt to power generation. Residential demand response programs offer different incentives and benefits to consumers in response to their flexibility in the timing of their electricity consumption. Understanding interactions between new and existing energy technologies, and policy impacts therein, is key to driving sustainable energy use and economic growth. Comprehensive and accurate models of the next-generation power system allow for understanding the effects of new energy technologies on the power system infrastructure, and can be used to guide policy, technology, and economic decisions. This
Seyyed Jalal Sadrosadat
Full Text Available Adaptive behavior is defined as the manner in which people cope with the natural and social demands of their environments. Impairments in adaptive behavior are described as significant limitations in an individual's effectiveness in meeting the standards of maturation, learning, personal independence, and/or social responsibility that are expected for one's age level and cultural group, as determined by clinical assessment, and usually, standardized scales. The definitions of adaptive deficiencies imply an individual's ability to cope with demands of his or her environment. Some scholars support this notion when describing adaptive behavior's relationship to mental retardation. Despite the fact that adaptive behavior scales are the necessary tools in diagnosing training: treatment. Rehabilitation of people (Particularly with developmental disorders and the assessment of programs, those are not available to professionals. This article tries to explain the necessity of producing/normalizing such scales, and introduces one of the most famous scales named as "Adaptive Behavior Scale-Residential and Community".
Libretto, Salvatore; Nemes, Susanna; Namur, Jenny; Garrett, Gerald; Hess, Lauren; Kaplan, Linda
In a study to evaluate the drug treatment and aftercare efforts sponsored by the State Department's International Narcotics and Law Enforcement Affairs Bureau, residential Therapeutic Community (TC) treatment programs in three countries in Southeast Asia--Malaysia, Singapore, and Thailand--were examined to identify promising practices and to…
Brouns, R.A.; Powell, J.A. (comps.)
Much emphasis continues to be on the transfer of remote design technology for components integral to the West Valley Demonstration Project's (WVDP) vitrification process. In addition to preparing equipment specifications and drawings, Pacific Northwest Laboratory (PNL) staff also participated in numerous design coordination meetings and reviews of drawings prepared by other WVDP contractors. Nearly 200 jumper drawings for the vitrification cell were prepared by this program in FY 1988. The remote jumpers connect vessels in the cell to each other for the transfer of solutions and provide for the flow of materials, instrumentation signals, and power from outside the cell. Analysis required in preparing the jumper designs involved balance, thermal stress, seismic, set-down stress, and displacement calculations. Design efforts were begun on the canister decontamination and swipe station and on the remote maintenance station. Equipment selection and layouts of the vitrification off-gas treatment system, including a reamer to remotely clean the melter off-gas line, were finalized. Also finalized were the designs for the high-efficiency particulate air (HEPA) filter assemblies for heating, cooling and air conditioning of the vitrification cell.
Weeland, Martine M; Nijhof, Karin S; Vermaes, Ignace; Engels, Rutger C M E; Buitelaar, Jan K
Although adolescents are often referred to residential treatment centres because of severe externalizing behaviours, a vast majority demonstrated comorbid symptoms of depression and anxiety. Covert internalizing symptoms in these adolescents might be easily unrecognized and therefore untreated. Adolescents with mild intellectual disability (MID) are overrepresented among youth with both externalizing and internalizing problems. There are yet few treatment programs available for adolescents with both externalizing and internalizing problems. The CBT-based resiliency program, Op Volle Kracht (OVK), which is based on the US Penn Resiliency Program (PRP), was adapted to suit the needs of adolescents with both externalizing and internalizing problems, either with or without MID, in Dutch residential treatment centres. The effectiveness of this group intervention program of eight sessions will be tested in a randomised controlled trial (RCT) with N = 182 adolescents aged 12-16, allocated to either the target intervention plus treatment as usual (OVK + TAU) or treatment as usual only (TAU). The main outcome variables include depressive symptoms (primary), anxiety, behavioural problems, and group therapeutic climate. Cognitive styles and coping styles will be included as possible mediators. Assessments take place at baseline (T1), one week before the start of the program (T2), immediately after the program (T3), and at three months follow-up (T4). The program assets include its wide implementation possibilities due to low costs, the short duration of the program and the delivery by group care workers, and its suitability for adolescents with MID. Further strengths of the present study design include its robust method (RCT), the ecological validity, and the inclusion of possible mediators of treatment effect. The program emphasizes individual risk factors for depression rather than social and family factors. Implications for practice and future research are
Lishness, Alan [Gulf Of Maine Research Inst., Portland, ME (United States); Peake, Leigh [Gulf Of Maine Research Inst., Portland, ME (United States)
Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling, and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.
Sexton-Radek, Kathy; Hartley, Andrew
College students regularly report increased sleep disturbances as well as concomitant reductions in performance (e.g., academic grades) upon entering college. Sleep hygiene refers to healthy sleep practices that are commonly used as first interventions in sleep disturbances. One widely used practice of this sort involves arranging the sleep environment to minimize disturbances from excessive noise and light at bedtime. Communal sleep situations such as those in college residence halls do not easily support this intervention. Following several focus groups, a questionnaire was designed to gather self-reported information on sleep disturbances in a college population. The present study used The Young Adult Sleep Environment Inventory (YASEI) and sleep logs to investigate the sleep environment of college students living in residential halls. A summary of responses indicated that noise and light are significant sleep disturbances in these environments. Recommendations are presented related to these findings.
Blom, Björn; Dukes, Kimberly A; Lundgren, Lena; Sullivan, Lisa M
Data from large-scale registers is often underutilized when evaluating addiction treatment programs. Since many programs collect register data regarding clients and interventions, there is a potential to make greater use of such records for program evaluation. The purpose of this article is to discuss the value of using large-scale registers in the evaluation and program planning of addiction treatment systems and programs. Sweden is used as an example of a country where register data is both available and is starting to be used in national evaluation and program planning efforts. The article focuses on possibilities, limitations and practicalities when using large-scale register data to conduct evaluations and program planning of addiction treatment programs. Main conclusions are that using register data for evaluation provides large amounts of data at low cost, limitations associated to the use of register data may be handled statistically, register data can answer important questions in planning of addiction treatment programs, and more accurate measures are needed to account for the diversity of client populations. Copyright © 2014 Elsevier Ltd. All rights reserved.
Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.
Lancaster, Ross; lutzenhiser, Loren; Moezzi, Mithra; Widder, Sarah H.; Chandra, Subrato; Baechler, Michael C.
This study examined a range of factors influencing energy consumption in households that had participated in residential energy-efficiency upgrades. The study was funded by a grant from the U.S. Department of Energy’s Pacific Northwest National Laboratory and was conducted by faculty and staff of Portland State University Center for Urban Studies and Department of Economics. This work was made possible through the assistance and support of the Energy Trust of Oregon (ETO), whose residential energy-efficiency programs provided the population from which the sample cases were drawn. All households in the study had participated in the ETO Home Performance with Energy Star (HPwES) program. A number of these had concurrently pursued measures through other ETO programs. Post-retrofit energy outcomes are rarely investigated on a house-by-house basis. Rather, aggregate changes are ordinarily the focus of program impact evaluations, with deviation from aggregate expectations chalked up to measurement error, the vagaries of weather and idiosyncrasies of occupants. However, understanding how homes perform post-retrofit on an individual basis can give important insights to increase energy savings at the participant and the programmatic level. Taking a more disaggregated approach, this study analyzed energy consumption data from before and after the retrofit activity and made comparisons with engineering estimates for the upgrades, to identify households that performed differently from what may have been expected based on the estimates. A statistical analysis using hierarchal linear models, which accounted for weather variations, was performed looking separately at gas and electrical use during the periods before and after upgrades took place. A more straightforward comparison of billing data for 12-month periods before and after the intervention was also performed, yielding the majority of the cases examined. The later approach allowed total energy use and costs to be
Chi Nguyen Thuy Lan
Full Text Available In accordance with Decision 99/TTg dated 9/2/1996 and Decision 173/TTg dated 6/11/2001 of the Prime Minister regarding the construction program of residential clusters (residential flood free areas, these residential areas as constructed would be fully equipped with critical infrastructures and services such as water supply and drainage works, toilets with sanitary appropriateness, etc. to ensure environmental sanitary conditions in the residential clusters. However, the actual surveys done in residential clusters in the Mekong Delta show that many arising problems must be addressed to enable the local communities to have better living conditions and ensure the sanitary conditions and environmental safety.
Winkler, Jon [National Renewable Energy Lab. (NREL), Golden, CO (United States); Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States)
Residential building codes and voluntary labeling programs are continually increasing the energy efficiency requirements of residential buildings. Improving a building's thermal enclosure and installing energy-efficient appliances and lighting can result in significant reductions in sensible cooling loads leading to smaller air conditioners and shorter cooling seasons. However due to fresh air ventilation requirements and internal gains, latent cooling loads are not reduced by the same proportion. Thus, it's becoming more challenging for conventional cooling equipment to control indoor humidity at part-load cooling conditions and using conventional cooling equipment in a non-conventional building poses the potential risk of high indoor humidity. The objective of this project was to investigate the impact the chosen design condition has on the calculated part-load cooling moisture load, and compare calculated moisture loads and the required dehumidification capacity to whole-building simulations. Procedures for sizing whole-house supplemental dehumidification equipment have yet to be formalized; however minor modifications to current Air-Conditioner Contractors of America (ACCA) Manual J load calculation procedures are appropriate for calculating residential part-load cooling moisture loads. Though ASHRAE 1% DP design conditions are commonly used to determine the dehumidification requirements for commercial buildings, an appropriate DP design condition for residential buildings has not been investigated. Two methods for sizing supplemental dehumidification equipment were developed and tested. The first method closely followed Manual J cooling load calculations; whereas the second method made more conservative assumptions impacting both sensible and latent loads.
Choi, Sang D; Carlson, Kathryn
Residential construction is a high-risk industry in the U.S. due to the exposure to work-related safety hazards and fall injuries. This study aimed to examine the safety training and safe work practices of construction workers within the small residential construction industry. In order to achieve the study objectives, a survey was designed and sent to approximately 200 Wisconsin based residential construction contractors. About one third of the respondents stated that they did not have any form of safety programs. The study indicated that the most common types of work-related injuries in residential construction were slips/trips/falls and cuts/lacerations. The survey findings also suggested that the residential construction contractors needed to increase the utilization of fall protection safety equipment. Further education and subject matter expert training could provide benefits to improve occupational safety and health of the small business workforce in the residential construction industry.
This report provides an overview of the U.S. Department of Energy Building America program's Summer 2011 Residential Energy Efficiency Technical Update Meeting. This meeting was held on August 9-11, 2011, in Denver, Colorado, and brought together more than 290 professionals representing organizations with a vested interest in energy efficiency improvements in residential buildings.
Smith, B.A.; Uhlaner, R.T.; Cason, T.N.; Courteau, S. (Quantum Consulting, Inc., Berkeley, CA (United States))
This report presents the research methods and results from the Residential Energy Usage Comparison (REUC) project, a joint effort by Southern California Edison Company (SCE) and the Electric Power Research Institute (EPRI). The REUC project design activities began in early 1986. The REUC project is an innovative demand-site project designed to measure and compare typical energy consumption patterns of energy efficient residential electric and gas appliances. 95 figs., 33 tabs.
Walakira, Eddy J; Ochen, Eric A; Bukuluki, Paul; Alllan, Sue
This article describes a model of care for abandoned and neglected infants in need of urgent physical, social, and medical support as implemented by the Child's i Foundation, an international, nongovernmental organization operating in Uganda. The model discounts the need for long-term care of young children within institutions and challenges the basis for intercountry adoption. Underpinned by the essentials of care continuum provided under the Uganda National Alternative Care Framework (Ministry of Gender, Labour and Social Development, 2012), the model emphasizes the need to effect the reintegration of the separated child within the family of his or her birth, or locally organize foster care or adoption. Highlighting policy and programming lessons, the model showcases a holistic approach to the problem and puts emphasis on interventions that are protective, promotional, and transformational and the use of a community-oriented approach. The model offers guidance to both government and nongovernment actors in addressing the problems of child neglect and abandonment through the implementation of the alternative care framework. © 2014 Michigan Association for Infant Mental Health.
Whittaker, James K; Holmes, Lisa; Del Valle, Jorge F; Ainsworth, Frank; Andreassen, Tore; Anglin, James; Bellonci, Christopher; Berridge, David; Bravo, Amaia; Canali, Cinzia; Courtney, Mark; Currey, Laurah; Daly, Daniel; Gilligan, Robbie; Grietens, Hans; Harder, Annemiek; Holden, Martha; James, Sigrid; Kendrick, Andrew; Knorth, Erick; Lausten, Mette; Lyons, John; Martin, Eduardo; McDermid, Samantha; McNamara, Patricia; Palareti, Laura; Ramsey, Susan; Sisson, Kari; Small, Richard; Thoburn, June; Thompson, Ronald; Zeira, Anat
Therapeutic Residential Care for Children and Youth: A Consensus Statement of the International Work Group on Therapeutic Residential Care. In many developed countries around the world residential care interventions for children and adolescents have come under increasing scrutiny. Against this background an international summit was organised in England (spring 2016) with experts from 13 countries to reflect on therapeutic residential care (TRC). The following working definition of TRC was leading: “Therapeutic residential care involves the planful use of a purposefully constructed, multi-dimensional living environment designed to enhance or provide treatment, education, socialization, support, and protection to children and youth with identified mental health or behavioral needs in partnership with their families and in collaboration with a full spectrum of community based formal and informal helping resources”. The meeting was characterised by exchange of information and evidence, and by preparing an international research agenda. In addition, the outlines of a consensus statement on TRC were discussed. This statement, originally published in English and now reproduced in a Spanish translation, comprises inter alia five basic principles of care that according to the Work Group on Therapeutic Residental Care should be guiding for residential youth care provided at any time.
Frimpong, Jemima A; Shiu-Yee, Karen; D'Aunno, Thomas
To describe changes in characteristics of directors of outpatient opioid agonist treatment (OAT) programs, and to examine the association between directors' characteristics and low methadone dosage. Repeated cross-sectional surveys of OAT programs in the United States from 1995 to 2011. We used generalized linear regression models to examine associations between directors' characteristics and methadone dose, adjusting for program and patient factors. Data were collected through telephone surveys of program directors. The proportion of OAT programs with an African American director declined over time, from 29 percent in 1995 to 16 percent in 2011. The median percentage of patients in each program receiving methadone doses than other programs. This association was even stronger in programs with an African American director who served populations with higher percentages of African American patients. Demographic characteristics of OAT program directors (e.g., their race) may play a key role in explaining variations in methadone dosage across programs and patients. Further research should investigate the causal pathways through which directors' characteristics affect treatment practices. This may lead to new, multifaceted managerial interventions to improve patient outcomes. © Health Research and Educational Trust.
Stevens, Laura; Verdejo-García, Antonio; Roeyers, Herbert; Goudriaan, Anna E.; Vanderplasschen, Wouter
Recent studies consistently indicate high rates of delay discounting in drug users, which refers to a strong tendency to devaluate delayed rewards. Many addiction treatment programs however, place high demands on the ability to postpone immediate gratification. Therefore, these programs may be
Swisher, Joel; Wang, Kitty; Stewart, Stewart
This paper reviews the performance of two recent automated load management programs for residential customers of electric utilities in two American states. Both pilot programs have been run with about 200 participant houses each, and both programs have control populations of similar customers without the technology or program treatment. In both cases, the technology used in the pilot is GoodWatts, an advanced, two-way, real-time, comprehensive home energy management system. The purpose of each pilot is to determine the household kW reduction in coincident peak electric load from the energy management technology. Nevada Power has conducted a pilot program for Air-Conditioning Load Management (ACLM), in which customers are sent an electronic curtailment signal for three-hour intervals during times of maximum peak demand. The participating customers receive an annual incentive payment, but otherwise they are on a conventional utility tariff. In California, three major utilities are jointly conducting a pilot demonstration of an Automated Demand Response System (ADRS). Customers are on a time-of-use (ToU) tariff, which includes a critical peak pricing (CPP) element. During times of maximum peak demand, customers are sent an electronic price signal that is three times higher than the normal on-peak price. Houses with the automated GoodWatts technology reduced their demand in both the ACLM and the ADRS programs by about 50% consistently across the summer curtailment or super peak events, relative to homes without the technology or any load management program or tariff in place. The absolute savings were greater in the ACLM program, due to the higher baseline air conditioning loads in the hotter Las Vegas climate. The results suggest that either automated technology or dynamic pricing can deliver significant demand response in low-consumption houses. However, for high-consumption houses, automated technology can reduce load by a greater absolute kWh difference. Targeting
Bosma, Anouk Q; Kunst, Maarten J J; Dirkzwager, Anja J E; Nieuwbeerta, Paul
The current study had three aims. First, it measured treatment readiness among offenders who entered the Prevention of Recidivism program. This is a prison-based rehabilitation program in the Netherlands that aims to lower re-offending rates among offenders with a prison sentence of at least for months and that is carried out during the final months of incarceration. Second, the study evaluated whether treatment readiness was associated with treatment participation. Third, the study examined whether treatment readiness measured with a validated instrument predicted treatment participation above and beyond a clinical assessment of treatment readiness, currently used as a criterion to include offenders in rehabilitation programs. To address these aims, data were used from the fourth wave of a research project studying the effects of imprisonment on the life of detainees in the Netherlands. Results indicated that treatment readiness as measured with a validated instrument was a significant predictor of treatment participation. Also, the current study showed that treatment readiness measured with a validated instrument improved the prediction of treatment participation above and beyond a clinical assessment of treatment readiness. Outcomes were discussed in light of study limitations and implications.
Marlowe, Stephanie L.
The present study investigated within a substance abuse treatment center the influence of family therapy on flexibility and cohesion among family members. Past studies have suggested adolescents who abuse substances exist in families who have a lack of balance of flexibility and cohesion. Unfortunately, few studies have examined the influence of…
Sarna, Linda; Bialous, Stella Aguinaga
To discuss strategies for implementing tobacco dependence treatment in cancer care and the role of oncology nurses. Evidence-based clinical practice guidelines for tobacco dependence treatment, published literature and Web sites. There are many benefits of quitting smoking after a diagnosis of cancer. Implementation of tobacco dependence treatment can improve patient outcomes but requires system changes. The electronic health care record, access to telephone quit lines for smoking cessation, resources for providers, and changes in insurance coverage all facilitate the delivery of treatment. Oncology nurses can play an important role in championing tobacco dependence treatment in cancer care. Copyright © 2016 Elsevier Inc. All rights reserved.
Trudeau, Kimberlee J.; Black, Ryan A.; Kamon, Jody L.; Sussman, Steve
Background: An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base is lacking. Objective: To assess the efficacy of the online Navigating my Journey (NmJ) program. Methods: 129 adolescent-aged…
Yorty, Jack S.; Brown, K. Birgitta
A survey of 42 U.S. dental schools was conducted to identify the number and characteristics of caries risk- assessment/treatment programs. Findings address lectures about caries risk, use of variable recall programs, categorization of risk level, early detection and treatment of lesions, and restoration of radiographically visible lesions. (DB)
Zimmer, Andrea; Bläuer, Cornelia; Coslovsky, Michael; Kappos, Ludwig; Derfuss, Tobias
Satisfaction with information on medication is linked to adherence, but patients are often dissatisfied with information about medication. Information about treatment with fingolimod is important for MS patients since an active role in managing treatment is required from them. To facilitate optimal treatment initiation, a nurse-led patient education program on fingolimod was implemented in a Swiss MS center. To evaluate the impact of the evidence-based comprehensive patient education program on knowledge, self-efficacy and patient satisfaction. Knowledge gain, subjective perception of being informed about the new treatment, self-efficacy in handling it and satisfaction with the program were evaluated in a pretest-posttest design. Patient reported outcomes were collected before and after an educational session on the first-dose day at the MS Center in a consecutive sample of 98 people with MS. Data was analyzed descriptively, score comparisons were done by Wilcoxon tests, and associations were estimated with Spearman's correlation coefficient. Knowledge increased significantly from pre- to posttest. Similarly, perception of being informed and self-efficacy increased significantly. Satisfaction with the program was high. Pretest-differences in knowledge concerning gender and marital status were balanced after the educational session. Results did not differ between patients with fingolimod as first treatment and those switching from other MS treatments. At posttest perception of being informed and self-efficacy were significantly related to satisfaction. An evidence-based comprehensive treatment education program is suitable to satisfy MS patients' information needs at treatment initiation. It enhances short-term treatment knowledge and self-efficacy in handling a new treatment in daily life. MS Nurses can thus contribute to effective treatment education and potentially to medication safety and adherence. Copyright © 2015 Elsevier B.V. All rights reserved.
Callaway, J.W.; Brenchley, D.L.; Davis, L.J.; Ivey, D.L.; Smith, S.A.; Westergard, E.J.
The purpose of the handbook is to provide technical assistance to state grantees participating in the Partnerships in Low-Income Residential Retrofit (PILIRR) Program. PILIRR is a demonstration program aimed at identifying innovative, successful approaches to developing public and private support for weatherization of low-income households. The program reflects the basic concept that responsibility for financial support for conservation activities such as low-income residential retrofitting is likely to gradually shift from the DOE to the states and the private sector. In preparing the handbook, PNL staff surveyed over 50 programs that provide assistance to low-income residents. The survey provided information on factors that contribute to successful programs. PNL also studied the winning PILIRR proposals (from the states of Florida, Iowa, Kentucky, Oklahoma and Washington) and identified the approaches proposed and the type of information that would be most helpful in implementing these approaches.
Handwerk, Michael L.; Huefner, Jonathan C.; Ringle, Jay L.; Howard, Brigid K.; Soper, Stephen H.; Almquist, Julie K.; Chmelka, M. Beth
This study examined the impact of therapeutic alliance (TA) on therapy outcomes for youth with behavioral and emotional problems residing in residential care. Study participants were 71 youth in an out-of-home family-style residential treatment facility who were referred to an onsite psychotherapy clinic. A therapeutic alliance scale was completed…
Leipoldt, Jonathan David; Kayed, Nanna; Harder, A.T.; Grietens, Hans; Rimehaug, Tormod
Background Previous studies have shown that social climate in therapeutic residential youth care (TRC) is important to the welfare of residents, staff, and assessing treatment outcomes. The most influential theory on social climate in residential settings is the theory of Moos. The measurement of
Fuchs, P.S.; Lele, A.; Venkatesha-Prasad, R.R.
The Indian Energy grid is growing rapidly and there is a large simulation to improve not only the grid reliability, but also provide power for all by 2027. To this aim the Government of India has launched the Restructured Accelerated Power Development Program (RAPDRP). In India, residential loads
Full Text Available A simulation program describing the performance of solar ejector refrigerant system for air conditioning of China’s residential buildings was established. Hourly performance of the system under different operate conditions, the collector efficiency, coefficient of performance, cooling capacity and cooling load were analyzed. It is found that the collector efficiency and the overall coefficient of performance increase first and then decline, and it can be concluded that the application of solar ejector refrigerant system will have a better developmental prospect in China’s residential buildings.
Cutler, D L
We have discussed the problems of the new young chronic patients, deinstitutionalized old chronic patients now living in the community, and some of the groups of hard to place patients. We have talked about problems with community barriers, staff training, a spectrum of facilities, and we have looked at what new sorts of facilities may need to be developed. It seems clear that we have not yet developed a spectrum which can deal with all varieties of the chronically mentally ill. Pepper (1985) has suggested a different, more ideal spectrum of housing particularly suited to the young adult chronic patient. These include crisis residences, supervised 14-bed residences, growth house for 14 beds; support house for 14 beds; supervised apartments (satellite apartments), 14 beds; supportive apartments, 14 beds; (these have less intensive staffing than supervised ones); open community living; and residential congregate care for adults (RCCAs). These RCCAs are large facilities located either in old state hospitals or nursing homes which are primarily oriented towards the homeless mentally ill. According to Pepper, if a program can plan a spectrum of housing situations in the immediate catchment area, it can then actually meet the specific needs of each patient with a specific sort of residential facility. The challenge for community residences is certainly much greater than a decade ago and, with the homeless mentally ill population continuing to grow (Bachrach, 1985), one might be tempted to regard our present situation as one of crisis proportions. Clearly, there is little doubt that a need exists for a wide spectrum of living situations to be made available to the deinstitutionalized or never institutionalized young adult chronic patient. Yet very few incentives exist for those who would try to meet this challenge. To do this effectively will undoubtedly require the development of sizeable amounts of public funding through existing and new channels to provide support for
Albert, A; Rajagopal, R
This work describes a methodology for informing targeted demand-response (DR) and marketing programs that focus on the temperature-sensitive part of residential electricity demand. Our methodology uses data that is becoming readily available at utility companies-hourly energy consumption readings collected from "smart" electricity meters, as well as hourly temperature readings. To decompose individual consumption into a thermal-sensitive part and a base load (non-thermally-sensitive), we propose a model of temperature response that is based on thermal regimes, i.e., unobserved decisions of consumers to use their heating or cooling appliances. We use this model to extract useful benchmarks that compose thermal profiles of individual users, i.e., terse characterizations of the statistics of these users' temperature-sensitive consumption. We present example profiles generated using our model on real consumers, and show its performance on a large sample of residential users. This knowledge may, in turn, inform the DR program by allowing scarce operational and marketing budgets to be spent on the right users-those whose influencing will yield highest energy reductions-at the right time. We show that such segmentation and targeting of users may offer savings exceeding 100% of a random strategy.
Bridgman, Kate; Onslow, Mark; O'Brian, Susan; Jones, Mark; Block, Susan
Purpose: Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early…
Busche, S.; Hockett, S.
This analysis is an update to the 2005 Energy Efficiency Potential Study completed by KEMA for the Kauai Island Utility Cooperative (KIUC) and identifies potential energy efficiency opportunities in the residential sector on Kauai (KEMA 2005). The Total Resource Cost (TRC) test is used to determine which of the energy efficiency measures analyzed in the KEMA report are cost effective for KIUC to include in a residential energy efficiency program. This report finds that there remains potential energy efficiency savings that could be cost-effectively incentivized through a utility residential demand-side management program on Kauai if implemented in such a way that the program costs per measure are consistent with the current residential program costs.
Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E
Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.
Teater, Barbra; Hammond, Gretchen Clark
Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…
Danis, D; D'Epagnier, C; Udry, C
This study evaluates the kind of pressure put on 136 chemically dependent patients to enter treatment in a specialized chemical dependency residential program at the Clinique La Métairie. The results show that patients' motivation to enter treatment is directly linked to the pressure significant others exerce on them.
Rash, Carla J; Alessi, Sheila M; Petry, Nancy M
Use of homeless and transitional housing (e.g., recovery homes) programs can be associated with success in substance abuse treatment, perhaps because many of these programs encourage or mandate sobriety. In this study, we examined whether contingency management (CM) protocols that use tangible incentives for submission of drug-free specimens or other specific behaviors are effective for treatment-seeking substance abusers whose behavior may also be shaped by housing programs. Of 355 participants in randomized trials of CM, 56 (16%) reported using transitional housing during the 12-week treatment period. Main and interaction effects of housing status and treatment condition were evaluated for the primary substance abuse treatment outcomes: a) longest duration of abstinence from alcohol, cocaine, and opioids, b) percentage of samples submitted that were negative for these substances, and c) treatment retention. After controlling for demographic and clinical characteristics, those who accessed housing programs submitted a higher percentage of negative samples (75%) compared to those who did not access housing programs (67%). Housing status groups did not differ in terms of longest duration of abstinence (accessed housing: M=3.1 weeks, SE=0.6; did not access housing: M=3.9 weeks, SE=0.3) or retention in substance abuse treatment (accessed housing: M=6.4 weeks, SE=0.6; did not access housing: M=6.6 weeks, SE=0.3). Regardless of housing status, CM was associated with longer durations of abstinence and treatment retention. No interactive effects of housing and treatment condition were observed (p>.05). Results suggest that those who accessed housing programs during substance abuse treatment benefit from CM to a comparable degree as their peers who did not use such programs. These effects suggest that CM remains appropriate for those accessing housing in community-based programs. Copyright © 2016 Elsevier Inc. All rights reserved.
Snowden, Lonnie R; McClellan, Sean R
We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.
McClellan, Sean R.
Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663
Anselmo Alexandre MENDES
Full Text Available ABSTRACT This study aimed to conduct a systematic review of publications addressing the multidisciplinary treatment of obesity in Brazil and analyze their main results. A search was conducted in the databases SciELO, Lilacs, and Pubmed/Medline using the following search terms: 'obesidade', 'intervenção', 'tratamento', 'Brasil', for the search in Portuguese, and 'obesity', 'intervention', 'treatment', 'Brazil', for the search in English. Based on these terms, the following combination of words was used: 'Intervenção multiprofissional da obesidade', 'tratamento multidisciplinar da obesidade, tratamento multiprofissional da obesidade' and 'multidisciplinary obesity intervention', 'multidisciplinary obesity treatment', 'Multiprofessional obesity treatment'. Inclusion criteria were as follows: original studies carried out in Brazil involving human beings and that reported an intervention including two or more health care professionals. Articles published between January 2005 and July 2015 were analyzed independently by two reviewers. At the end of the analysis, out of 355 articles initially selected, 26 met all inclusion criteria. The following results were found: 23 studies involved children and adolescents and 03 involved adults 20-60 years of age. It was also found that the 26 studies analyzed had an impact on anthropometric parameters, 10 on physical fitness parameters, 16 on biochemical parameters, 10 on the reduction in comorbidities, 6 on nutritional parameters, and 4 on the psychological/social aspects. Based on evidence presented in the studies reviewed, it can be said that the multidisciplinary treatment for obesity greatly contributed to the reduction in the anthropometric indicators, especially BMI and the biochemical, social, and psychological parameters. Thus, these findings demonstrate that there is a need to expand the range of this type of treatment since it has proven to be effective in the fight against obesity and its
Residential exposure to drinking water arsenic in Inner Mongolia, ChinaZhixiong Ning1, Richard K. Kwok2, Zhiyi Liu1, Shiying Zhang1, Chenglong Ma1, Danelle T. Lobdell2, Michael Riediker3 and Judy L. Mumford21) Institute of Endemic Disease for Prevention and Treatment in I...
This paper explores the nature and consequences of residential decision-making for women on treatment for AIDS illness in a poor urban settlement in South Africa. Drawing on ethnographic data collected over a two-year period, it points to the subtle shifts in 'householding' practices and kinship relationships prompted by ...
Increasing self-consumption of photovoltaic electricity by storing energy in electric vehicle using smart grid technology in the residential sector. A model for simulating different smart grid programs
Kam, M. van der; Sark, W.G.J.H.M. van
In this paper a model has been developed which intends to simulate the increase of self-consumption of photovoltaic (PV)-power by storing energy in electric vehicle (EV) using smart grid technology in the residential sector. Three different possible smart grid control algorithms for a micro-grid
Full Text Available The subjects of analysis were the multi-layered expressions applied by the author in designing the residential building in Banjaluka. These are foremost the site, the location, and the corner motif, as the building’s outstanding formal accents. Next is the analysis of the applied materials their treatment and the accomplished effects. The craftsmanship has been emphasised since it demanded a close cooperation of the architect and the craftsman. Furthermore, the interior organisation of this non-standard residential building has been elucidated.
Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci
Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Snowden, Lonnie R; Wallace, Neal; Cordell, Kate; Graaf, Genevieve
Latino child populations are large and growing, and they present considerable unmet need for mental health treatment. Poverty, lack of health insurance, limited English proficiency, stigma, undocumented status, and inhospitable programming are among many factors that contribute to Latino-White mental health treatment disparities. Lower treatment expenditures serve as an important marker of Latino children's low rates of mental health treatment and limited participation once enrolled in services. We investigated whether total Latino-White expenditure disparities declined when autonomous, county-level mental health plans receive funds free of customary cost-sharing charges, especially when they capitalized on cultural and language-sensitive mental health treatment programs as vehicles to receive and spend treatment funds. Using Whites as benchmark, we considered expenditure pattern disparities favoring Whites over Latinos and, in a smaller number of counties, Latinos over Whites. Using segmented regression for interrupted time series on county level treatment systems observed over 64 quarters, we analyzed Medi-Cal paid claims for per-user total expenditures for mental health services delivered to children and youth (under 18 years of age) during a study period covering July 1, 1991 through June 30, 2007. Settlement-mandated Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) expenditure increases began in the third quarter of 1995. Terms were introduced to assess immediate and long term inequality reduction as well as the role of culture and language-sensitive community-based programs. Settlement-mandated increased EPSDT treatment funding was associated with more spending on Whites relative to Latinos unless plans arranged for cultural and language-sensitive mental health treatment programs. However, having programs served more to prevent expenditure disparities from growing than to reduce disparities. EPSDT expanded funding increased proportional
Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.
While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689
Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States); Robertson, Joseph [National Renewable Energy Lab. (NREL), Golden, CO (United States); Christensen, Dane [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heaney, Mike [Arrow Electronics, Centennial, CO (United States); Brown, David [Univ. of Virginia, Charlottesville, VA (United States); Norton, Paul [Norton Energy Research and Development, Boulder, CO (United States); Smith, Chris [Ingersoll-Rand Corp., Dublin (Ireland)
In this study, we are adding to the body of knowledge around answering the question: What are good assumptions for HVAC set points in U.S. homes? We collected and analyzed indoor temperature data from US homes using funding from the U.S. Department of Energy's Building America (BA) program, due to the program's reliance on accurate energy simulation of homes. Simulations are used to set Building America goals, predict the impact of new building techniques and technologies, inform research objectives, evaluate home performance, optimize efficiency packages to meet savings goals, customize savings approaches to specific climate zones, and myriad other uses.
... provide needed treatment services by telemental health (using technology to communicate) or by referral to Vet Centers ... Minority Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration ...
... relating to sickle cell anemia or infection with the human immunodeficiency virus. 1.478 Section 1.478... treatment programs; not applicable to records relating to sickle cell anemia or infection with the human...
Hendriks, L.; Kleine, R.A. de; Hendriks, G.J.; Minnen, A. van; Martin, C.; Preedy, V.; Patel, V.
Cognitive-behavioral treatment usually lasts several months with sessions being delivered on a weekly basis. However, despite its status as highly effective first-line treatment for PTSD, given the relatively low remission, high dropout, and low accessibility of cognitive-behavioral treatment, there
Full Text Available The present article is a position paper aiming to initiate a professional debate related to the aspects related to the urban dysfunctions leading to the wear of the residential areas. The paper proposes a definition of the wear process, identify the main causes leading to its occurrence and propose a number of solutions to neutralise the dysfunctions. The three wearing phases of residential areas components are emphasized, exploring their lifecycle. In order to perform the study of urban wear, the status of the residential areas components can be established and monitored, and also the variables of the function that can mathematically model the specific wear process may be considered. The paper is considered a first step for the model adjustment, to be tested and validated in the following steps. Based on the mathematical method and model, there can be created, in a potential future research, the possibility of determining the precarity degree for residential areas/neighbourhoods and cities, by minimising the subjective component of the analyses preceding the decision for renovation or regeneration.
The article is based on Master’s research conducted during Scottish Housing Expo 2010. The aim of the research was to determine the prevailing trends in sustainable residential architecture. Each trend can be described by features detected during visual and technical observation of project data. Based on that architects may predict possible problems related to a specific trend.
Nowogońska, Beata; Cibis, Jerzy
Beauty, utility, durability - these are the features of good architecture and should also be the distinguishing qualities of every residential building. But do beauty and utility remain along with the passing of time? Performance characteristics are an indicator of both, the technical as well as aesthetic state of buildings. Aesthetic needs are in disagreement with the merciless aging process. The beauty of a city is formed not only by the original forms of new residential buildings, but also by existing tenement housing; thus preserving their aesthetics becomes a necessity. Time is continuously passing and along with it, aging intensifies. The aging process is a natural phenomenon for every material. The life expectancy of building materials is also limited. Along with the passing of time, the technical state of residential buildings continuously deteriorates. With the passing of time, the aesthetic values and preferences of users of flats change and the usability of the building decreases. The permanence of buildings, including residential buildings, is shaped not only by the forces of nature but also by activities of humans. A long lifespan is ensured by carrying out ongoing, systematic renovation-repair works. It is thanks to them that buildings derived from past centuries are still being used, and their market attractiveness is not decreasing.
Larsen, Morten Marott; Pilegaard, Ninette; Van Ommeren, Jos
we study how congestion and residential moving behaviour are interrelated, using a two-region job search model. Workers choose between interregional commuting and residential moving, in order to live closer to their place of work. This choice affects the external costs of commuting, due to conges......we study how congestion and residential moving behaviour are interrelated, using a two-region job search model. Workers choose between interregional commuting and residential moving, in order to live closer to their place of work. This choice affects the external costs of commuting, due...... to congestion. We focus on the equilibrium in which some workers currently living in one region accept jobs in the other, with a fraction of them choosing to commute from their current residence to the new job in the other region and the remainder choosing to move to the region in which the new job is located....... The welfare-maximising road tax is derived, which is essentially the Pigouvian tax, given the absence of a tax on moving. Given the presence of moving taxes, which are substantial in Europe, the optimal road tax for commuters is the Pigouvian tax plus the amortised value of the moving tax, evaluated...
Hartog, F.T.H. den; Balm, M.; Jong, C.M. de; Kwaaitaal, J.J.B.
A new OSI-based model is described that can be used for the classification of residential gateways. It is applied to analyze current gateway solutions and draw evolutionary paths for the medium to long term. From this it is concluded that particularly set-top boxes and broadband modems, as opposed
Theurer, Gregory; Lovell, David
An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…
Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.
The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.
Jeffrey P. Prestemon; Karen L. Abt; Robert J. Jr. Huggett
We describe a two-stage model of global log and chip markets that evaluates the spatial and temporal economic effects of government- subsidized fire-related mechanical fuel treatment programs in the U.S.West and South. The first stage is a goal program that allocates subsidies according to fire risk and location priorities, given a budget and a feasible, market-...
Rook, Elisabeth J.; Huitema, Alwin D. R.; van den Brink, Wim; Hillebrand, Michel J. X.; van Ree, Jan M.; Beijnen, Jos H.
The aim of this study was to investigate the use of illicit heroin among patients in a heroin-assisted treatment program. In this program, pharmaceutical-grade heroin was administered to heroin-addicted patients. Monitoring of illicit heroin use was considered important for the evaluation of this
Levitt, John L.; Sansone, Randy A.
Outlines a multi-faceted treatment approach to eating disorders within a partial hospital program that is affiliated with a community mental health hospital. Although empirical confirmation is not currently available, initial clinical impressions indicate that the program is facilitating the recovery of these difficult-to-treat individuals.…
Hudson, Patricia E.
A treatment program that integrates spirituality and therapy for sex abusers who are Roman Catholic priests or brothers is described. Selections from an interview with the program director cover definitions, philosophy, women as therapists, daily activity, candidates, and the spiritual dimension. Measures of success and after-care are discussed.…
De La Mata, Nicole L; Kumarasamy, Nagalingeswaran; Khol, Vohith; Ng, Oon Tek; Van Nguyen, Kinh; Merati, Tuti Parwati; Pham, Thuy Thanh; Lee, Man Po; Durier, Nicolas; Law, Matthew
Background Antiretroviral treatment (ART) for HIV-positive patients has expanded rapidly in Asia over the last ten years. Our study aimed to describe the time trends and risk factors for overall survival in patients receiving first-line ART in Asia. Methods We included HIV-positive adult patients who initiated ART between 2003–2013 (n=16 546), from seven sites across six Asia-Pacific countries. Patient follow-up was to May 2014. We compared survival for each country and overall by time period of ART initiation using Kaplan-Meier curves. Factors associated with mortality were assessed using Cox regression, stratified by site. We also summarized first-line ART regimens, CD4 count at ART initiation, and CD4 and HIV viral load testing frequencies. Results There were 880 deaths observed over 54 532 person-years of follow-up, a crude rate of 1.61 (1.51, 1.72) per 100 person-years. Survival significantly improved in more recent years of ART initiation. The survival probabilities at 4 years follow-up for those initiating ART in 2003–05 was 92.1%, 2006–09 was 94.3% and 2010–2013 was 94.5% (pAsia have improved survival in more recent years of ART initiation. This is likely a consequence of improvements in treatment and, patient management and monitoring over time. PMID:26961354
Building Technologies Program Multi-Year Program Plan 2008 for research and development, including residential and commercial integration, lighting, HVAC and water heating, envelope, windows, and analysis tools.
In early 2002, the National Association of Home Builders completed a census of residential green building programs across the United States to assess differences and similarities among programs. This report catalogs different ways that builders participate in residential green building programs.
Blackman, Sheldon; And Others
The Gamblers Treatment Clinic (GTC) opened in 1982 as a New York State Office of Mental Health Demonstration Program. The basic premise of the GTC is that excessive gambling is a disorder of impulse control. Treatment, conducted in the community in a time-limited fashion, attempts to uncover the underlying dynamics that precipitate disorders of…
Todahl, Jeff; Linville, Deanna; Tuttle Shamblin, Abby F.; Ball, David
A handful of clinical trials have concluded that conjoint couples treatment for intimate partner violence is safe and at least as effective as conventional batterer intervention programs, yet very few researchers have explored couples' perspectives on conjoint treatment. Using qualitative narrative analysis methodology, the researchers conducted…
... 42 Public Health 1 2010-10-01 2010-10-01 false Educational requirements for personnel in drug... TREATMENT BLOCK GRANTS AND/OR PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS GRANTS § 54.13 Educational requirements for personnel in drug treatment programs. In determining whether personnel of a...
... [CMS-1350-ANPRM] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act... Emergency Medical Treatment and Labor Act (EMTALA). Specifically, this document serves as a request for... available to persons without Federal government identification, commenters are encouraged to leave their...
... [CMS-1350-NC] RIN 0938-AQ51 Medicare Program; Emergency Medical Treatment and Labor Act (EMTALA... the applicability of the Emergency Medical Treatment and Labor Act (EMTALA) to hospital inpatients... available to persons without Federal government identification, commenters are encouraged to leave their...
California State Univ., Sacramento. School of Engineering.
The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…
California State Univ., Sacramento. School of Engineering.
The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…
California State Univ., Sacramento. School of Engineering.
The purpose of this water treatment field study training program is to: (1) develop new qualified water treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…
California State Univ., Sacramento. Dept. of Civil Engineering.
The purpose of this wastewater treatment field study training program is to: (1) develop new qualified wastewater treatment plant operators; (2) expand the abilities of existing operators, permitting better service both to employers and public; and (3) prepare operators for civil service and certification examinations (examinations administered by…
Methodology and assumptions for evaluating heating and cooling energy requirements in new single-family residential buildings: Technical support document for the PEAR (Program for Energy Analysis of Residences) microcomputer program
Huang, Y.J.; Ritschard, R.; Bull, J.; Byrne, S.; Turiel, I.; Wilson, D.; Hsui, C.; Foley, D.
This report provides technical documentation for a software package called PEAR (Program for Energy Analysis of Residences) developed by LBL. PEAR offers an easy-to-use and accurate method of estimating the energy savings associated with various energy conservation measures used in site-built, single-family homes. This program was designed for use by non-technical groups such as home builders, home buyers or others in the buildings industry, and developed as an integral part of a set of voluntary guidelines entitled Affordable Housing Through Energy Conservation: A Guide to Designing and Constructing Energy Efficient Homes. These guidelines provide a method for selecting and evaluating cost-effective energy conservation measures based on the energy savings estimated by PEAR. This work is part of a Department of Energy program aimed at conducting research that will improve the energy efficiency of the nation's stock of conventionally-built and manufactured homes, and presenting the results to the public in a simplified format.
Full Text Available Objective: The aim of present study was to investigate the effectiveness of stress management program on quality of life among methadone maintenance treatment members. Method: In this pre-test, post-test experimental study, 30 individual who referred to Saba MMT center in Pakdasht were randomly divided into experimental group (n=15 participants and control group (n=15 participants. The experimental group was undergone ten 90 minutes sessions of stress management program and the control group didn’t receive any treatment program. Quality of life questionnaire (SF-36 was administered. Result: The results showed that the mean sf-36 score in the experimental group had significant higher increased in comparison of control group. Conclusion: It can be concluded stress management program is effective on increasing of quality of life among methadone maintenance treatment members.
Two deterministic models (US EPA’s Ofﬁce of Pesticide Programs Residential Standard Operating Procedures (OPP Residential SOPs) and Draft Protocol for Measuring Children’s Non-Occupational Exposure to Pesticides by all Relevant Pathways (Draft Protocol)) and four probabilistic mo...
Dominick, Gregory M.; Tudose, Alina; Pohlig, Ryan T.; Saunders, Ruth P.
Research examining sustainability of health promotion programs within organizational settings is limited. The Environmental Interventions in Residential Children's Homes (ENRICH) was a structural intervention that trained Wellness Teams (WTs) within residential children's homes (RCH) to target environmental changes that promote physical activity…
Burke, Edmund K.; Leite-Rocha, Pedro; Petrovic, Sanja
Radiotherapy represents an important phase of treatment for a large number of cancer patients. It is essential that resources used to deliver this treatment are employed effectively. This paper presents a new integer linear programming model for real-world radiotherapy treatment scheduling and analyses the effectiveness of using this model on a daily basis in a hospital. Experiments are conducted varying the days on which schedules can be created. Results obtained using real-world data from t...
Ross, W.A.; Powell, J.A.
The Western New York Nuclear Services Center reprocessed nuclear fuel for five years until operations were terminated in 1972. Underground tanks at the site contain high-level waste (HLW) generated during the reprocessing operations. Based on original agreements, the state of New York has assumed responsibility for the wastes and the site. The Department of Energy (DOE) is assisting New York State, through the West Valley Demonstration Project (WVDP), in processing and solidifying the HLW. The site contractor for the WVDP is West Valley Nuclear Services Co., Inc. (WVNS). The Pacific Northwest Laboratory (PNL), through the West Valley Support Project, has been supporting WVNS and DOE in establishing vitrification and waste processing technology and capability at the West Valley Site. The specific objective of the West Valley Support Project during FY 1989 were to complete designs of remote equipment, assist in characterizing the WVNS feed, sampling, ceramic melter and off-gas systems, provide chemical analysis of the radioactive wastes and testing of future processes with actual radioactive wastes, provide testing and modeling studies of the reference WV waste product, and conduct special studies, such as evaluating corrosion of the waste tanks and supporting operation of the supernatant treatment system. 13 refs., 13 figs., 5 tabs
Craig, Christopher A.; Feng, Song
Highlights: • Study examined impact of electricity fuel sources and consumption on emissions. • 97.2% of variability in emissions explained by coal and residential electricity use. • Increasing cooling degree days significantly related to increased electricity use. • Effectiveness of state-level energy efficiency programs showed mixed results. - Abstract: This study examined the impact of electricity generation by fuel source type and electricity consumption on carbon emissions to assess the role of climatic variability and energy efficiency (EE) in the United States. Despite high levels of greenhouse gas emissions, residential electricity consumption continues to increase in the United States and fossil fuels are the primary fuel source of electricity generation. 97.2% of the variability in carbon emissions in the electricity industry was explained by electricity generation from coal and residential electricity consumption. The relationships between residential electricity consumption, short-term climatic variability, long-term climatic trends, short-term reduction in electricity from EE programs, and long-term trends in EE programs was examined. This is the first study of its nature to examine these relationships across the 48 contiguous United States. Inter-year and long-term trends in cooling degree days, or days above a baseline temperature, were the primary climatic drivers of residential electricity consumption. Cooling degree days increased across the majority of the United States during the study period, and shared a positive relationship with residential electricity consumption when findings were significant. The majority of electricity reduction from EE programs was negatively related to residential electricity consumption where findings were significant. However, the trend across the majority of states was a decrease in electricity reduction from EE while residential electricity consumption increased. States that successfully reduced consumption
Thylstrup, Birgitte; Hesse, Morten
Antisocial behavior is associated with low quality of life for the patient and with adverse effects on society and those close to the antisocial patient. However, most patients with antisocial behavior are not seen in treatment settings that focus on their personality but rather in criminal justice settings, substance-abuse treatment, and social welfare settings. This article describes the adaptation and implementation of a highly structured manualized treatment, Impulsive Lifestyle Counseling (ILC), based on the Lifestyle Issues program, a 10-week psychoeducation program studied in prison settings. ILC consists of four sessions over 4 weeks and a booster session 8 weeks later. The goal of treatment is described to patients as "to help people identify their impulsive thoughts and lifestyle leading to problems with drug use, other people, and the police." Two clinical examples and reflections on our experiences with the training and implementation of the ILC program are presented. © The Author(s) 2011.
Han, Benjamin; Polydorou, Soteri; Ferris, Rosie; Blaum, Caroline S; Ross, Stephen; McNeely, Jennifer
The population of adults accessing opioid treatment is growing older, but exact estimates vary widely, and little is known about the characteristics of the aging treatment population. Further, there has been little research regarding the epidemiology, healt h status, and functional impairments in this population. To determine the utilization of opioid treatment services by older adults in New York City. This study used administrative data from New York State licensed drug treatment programs to examine overall age trends and characteristics of older adults in opioid treatment programs in New York City from 1996 to 2012. We found significant increases in utilization of opioid treatment programs by older adults in New York City. By 2012, those aged 50-59 made up the largest age group in opioid treatment programs. Among older adults there were notable shifts in demographic background including gender and ethnicity, and an increase in self-reported impairments. More research is needed to fully understand the specific characteristics and needs of older adults with opioid dependence.
Sigrin, Benjamin O [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
High customer acquisition costs remain a persistent challenge in the U.S. residential solar industry. Effective customer acquisition in the residential solar market is increasingly achieved with the help of data analysis and machine learning, whether that means more targeted advertising, understanding customer motivations, or responding to competitors. New research by the National Renewable Energy Laboratory, Sandia National Laboratories, Vanderbilt University, University of Pennsylvania, and the California Center for Sustainable Energy and funded through the U.S. Department of Energy's Solar Energy Evolution and Diffusion (SEEDS) program demonstrates novel computational methods that can help drive down costs in the residential solar industry.
Cristina Raluca POPESCU
Full Text Available In order to comply with the quality standards and with the best practices, the execution of the professional programs must be rigorously controlled so that to avoid occurrence of unpredictable situations that might generate anomalies and could lead to computer blockage, forced termination of the execution and data loss. In traditional programming languages, including Visual Basic 6, the concept of error is extremely evolved. It is considered as error any situation in which the program fails to execute correctly, regardless if such anomaly is generated by a software or hardware cause. Nowadays the modern platforms, including VB.NET have introduced a new concept: exception. Unfortunately, perhaps by mistake, exception is assimilated by many IT specialists as an exceptional (extraordinary situation or a rare situation.We agree with the opinion of those IT specialists asserting that error is strictly dependant on the programmer, when he/she fails in correctly generating the applicationÃ¢Â€Â™s structures, whilst exception is a situation not fitting in the usual natural execution or as desired by the programmer or user, without meaning that it occurs more often or more rarely.Designing robust programs implies for such not to terminate abnormally or block, not even upon receiving improper parameters. Two aspects are referred to: the behavior regarding low level errors (caused by the operation system, memory allocation, reading/writing in files or hardware malfunctions and the reaction to the userÃ¢Â€Â™s errors, such as providing incorrect input data or incorrect use of operations in respect with their sequences. Notwithstanding what platform is used in designing the programs and regardless the controversy between the specialists, in order for the execution to be terminated under the programÃ¢Â€Â™s control, the commands that might generate anomalies and interruptions should be strictly monitored. Implicitly, the execution control
Full Text Available Residential polymer electrolyte fuel cells cogeneration systems (residential PEFC systems produce hydrogen from city gas by internal gas-reformer, and generate electricity, the hot water at the same time. From the viewpoint of the operation, it is known that residential PEFC systems do not continuously work but stop for long time, because the systems generate enough hot water for short operation time. In other words, currently residential PEFC systems are dominated by the amount of hot water demand. This study focuses on the idle time of residential PEFC systems. Since their gas-reformers are free, the systems have potential to produce hydrogen during the partial load operations. The authors expect that residential PEFC systems can take a role to supply hydrogen for fuel cell vehicles (FCVs before hydrogen fueling stations are distributed enough. From this perspective, the objective of this study is to evaluate the hydrogen production potential of residential PEFC systems. A residential PEFC system was modeled by the mixed integer linear programming to optimize the operation including hydrogen supply for FCV. The objective function represents annual system cost to be minimized with the constraints of energy balance. It should be noted that the partial load characteristics of the gas-reformer and the fuel cell stack are taken into account to derive the optimal operation. The model was employed to estimate the possible amount of hydrogen supply by a residential PEFC system. The results indicated that the system could satisfy at least hydrogen demand for transportation of 8000 km which is as far as the average annual mileage of a passenger car in Japan. Furthermore, hydrogen production by sharing a residential PEFC system with two households is more effective to reduce primary energy consumption with hydrogen supply for FCV than the case of introducing PEFC in each household.
Li, Dan; Yuan, Yuan; Sun, Li-Ping; Fang, Xue; Zhou, Bao-Sen
To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. RESULTS from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. RESULTS from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.
Dwyer, Stephen F.; Sanchez, Alfred; Campos, Ivan A.; Gerstle, Walter H.
Engineering certification for the installation of solar photovoltaic (PV) modules on wood roofs is often denied because existing wood roofs do not meet structural design codes. This work is intended to show that many roofs are actually sufficiently strong given the conservatism in codes, documented allowable strengths, roof structure system effects, and beam composite action produced by joist-sheathing interaction. This report provides results from a testing program to provide actual load carrying capacity of residential rooftops. The results reveal that the actual load carrying capacity of structural members and systems tested are significantly stronger than allowable loads provided by the International Residential Code (IRC 2009) and the national structural code found in Minimum Design Loads for Buildings and Other Structures (ASCE 7-10). Engineering analysis of residential rooftops typically ignores the system affects and beam composite action in determining rooftop stresses given a potential PV installation. This extreme conservatism combined with conservatism in codes and published allowable stress values for roof building materials (NDS 2012) lead to the perception that well built homes may not have adequate load bearing capacity to enable a rooftop PV installation. However, based on the test results presented in this report of residential rooftop structural systems, the actual load bearing capacity is several times higher than published values (NDS 2012).
Wu, Yunna; Wang, Zhen
Green residential buildings are concerned by more and more people. However, the development of green residential buildings has been limited due to the single-standard requirements and lack of the multi-objective performance. At same time, the evaluation criteria system of green residential building is not comprehensive enough. So first of all, using SPSS software, residents questionnaire surveys are figured and found that the judge of experts and residents about the green elements is inconsistent, so the owners’ satisfaction is included in the post-evaluation criterial systems of green residential building from five aspects-the preliminary work of construction, construction process, economic, social benefits and owners satisfaction in Ningxia area, combined with expert interviews. Secondly, in the post-evaluation, it is difficult for many experts judgment matrix to meet the requirement of consistency, in this paper using MATLAB program, judgment matrix consistency is adjusted. And the weights of the criteria and sub-criteria and experts weights using group AHP method are determined. Finally, the grey clustering method is used to establish the post-evaluation model and the real case of Sai-shang project is carried out. It shows that the result obtained by using the improved criteria system and method in this paper is in a high degree of agreement with the actual result.
Amoon, A T; Oksuzyan, S; Crespi, C M; Arah, O A; Cockburn, M; Vergara, X; Kheifets, L
Studies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the effect of mobility. We analyzed data from a population-based case-control study of childhood leukemia using cases who were born in California and diagnosed between 1988 and 2008 and birth certificate controls. We used stratified logistic regression, case-only analysis, and propensity-score adjustments to assess predictors of residential mobility between birth and diagnosis, and account for potential confounding due to residential mobility. Children who moved tended to be older, lived in housing other than single-family homes, had younger mothers and fewer siblings, and were of lower socioeconomic status. Odds ratios for leukemia among non-movers living mobility, including dwelling type, increased odds ratios for leukemia to 2.61 (95% CI: 1.76-3.86) for living mobility of childhood leukemia cases varied by several sociodemographic characteristics, but not by the distance to the nearest power line or calculated magnetic fields. Mobility appears to be an unlikely explanation for the associations observed between power lines exposure and childhood leukemia. Copyright © 2018 Elsevier Inc. All rights reserved.
Heaney, M. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Polly, B. [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
This report presents an analysis of data for residential single-family projects reported by 37 organizations that were awarded federal financial assistance (cooperative agreements or grants) by the U.S. Department of Energy’s Better Buildings Neighborhood Program.1 The report characterizes the energy-efficiency measures installed for single-family residential projects and analyzes energy savings and savings prediction accuracy for measures installed in a subset of those projects.
Nerín, I; Crucelaegui, A; Más, A; Villalba, J A; Guillén, D; Gracia, A
To assess a comprehensive smoking prevention and treatment program in an electrical appliances company with 1600 employees. The program included smoking restrictions with the designation of smoking areas and the offer of smoking cessation treatment for the smokers affected. Study variables were age, sex, nicotine dependence (Fagerström Test), carbon monoxide in expired air, adherence to therapy, and smoking abstinence at 1 week, 1 month, 3 months (end of treatment), and 6 months. Successful smoking abstinence was defined as continuous abstinence from the beginning of treatment. Smoking prevalence was 34.8% and 19.5% of smokers requested treatment (77.4% men and 22.6% women). Mean (SD) age was 41.3 (10.3) years. Mean score of nicotine dependence was 5.3 (2.6) and the mean quantity of carbon monoxide in expired air was 35.6 (23.7) ppm. Adherence to therapy was good in 80% of patients. Rate of abstinence was 57.5% at 6 months, signifying a 4% reduction in prevalence. Workplace smoking cessation programs reduce prevalence and facilitate the establishment of smoking restrictions at the worksite. Companies are convenient settings for the implementation of programs aimed at smoking prevention and treatment.
The initial objective of the program was the optimization (in terms of cost and performance) of a Rankine cycle mechanical refrigeration system which utilizes thermal energy from a flat solar collector for air conditioning residential buildings. However, feasibility investigations of the adsorption process revealed that a dessicant-type air conditioner offers many significant advantages. As a result, limited efforts were expended toward the optimization of such a system.
Based on a previous empirical study of the effect of a residential demand response program in Sala, Sweden, this project investigated the economic consequences of consumer behaviour change after a demand-based time of use distribution tariff was employed. The economic consequences of consumers were proven to be disadvantageous in terms of unit electricity price. Consumers could achieve more electricity bill saving through stabilising their electricity consumption during peak hours, and this ...
Barbose, Galen L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Darghouth, Naïm R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Spears, Mike [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Buckley, Michael [Exeter Associates, Columbia, MD (United States); Widiss, Rebecca [Exeter Associates, Columbia, MD (United States); Grue, Nick [National Renewable Energy Lab. (NREL), Golden, CO (United States)
Now in its eighth edition, Lawrence Berkeley National Laboratory (LBNL)’s Tracking the Sun report series is dedicated to summarizing trends in the installed price of grid-connected solar photovoltaic (PV) systems in the United States. The present report focuses on residential and nonresidential systems installed through year-end 2014, with preliminary trends for the first half of 2015. As noted in the text box below, this year’s report incorporates a number of important changes and enhancements. Among those changes, this year's report focuses solely on residential and nonresidential PV systems; data on utility-scale PV are reported in LBNL’s companion Utility-Scale Solar report series. Installed pricing trends presented within this report derive primarily from project-level data reported to state agencies and utilities that administer PV incentive programs, solar renewable energy credit (SREC) registration systems, or interconnection processes. In total, data were collected for roughly 400,000 individual PV systems, representing 81% of all U.S. residential and non-residential PV capacity installed through 2014 and 62% of capacity installed in 2014, though a smaller subset of this data were used in analysis.
Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area; Darghouth, Naïm [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Technologies Area; Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cates, Sarah [Exeter Associates, Columbia, MD (United States); DiSanti, Nicholas [Exeter Associates, Columbia, MD (United States); Widiss, Rebecca [Exeter Associates, Columbia, MD (United States)
Now in its ninth edition, Lawrence Berkeley National Laboratory (LBNL)’s Tracking the Sun report series is dedicated to summarizing trends in the installed price of grid-connected solar photovoltaic (PV) systems in the United States. The present report focuses on residential and non-residential systems installed through year-end 2015, with preliminary trends for the first half of 2016. An accompanying LBNL report, Utility-Scale Solar, addresses trends in the utility-scale sector. This year’s report incorporates a number of important changes and enhancements from prior editions. Among those changes, LBNL has made available a public data file containing all non-confidential project-level data underlying the analysis in this report. Installed pricing trends presented within this report derive primarily from project-level data reported to state agencies and utilities that administer PV incentive programs, solar renewable energy credit (SREC) registration systems, or interconnection processes. Refer to the text box to the right for several key notes about these data. In total, data were collected and cleaned for more than 820,000 individual PV systems, representing 85% of U.S. residential and non-residential PV systems installed cumulatively through 2015 and 82% of systems installed in 2015. The analysis in this report is based on a subset of this sample, consisting of roughly 450,000 systems with available installed price data.
Al-Asadi, Ali M; Klein, Britt; Meyer, Denny
Although relatively new, the field of e-mental health is becoming more popular with more attention given to researching its various aspects. However, there are many areas that still need further research, especially identifying attrition predictors at various phases of assessment and treatment delivery. The present study identified the predictors of posttreatment assessment completers based on 24 pre- and posttreatment demographic and personal variables and 1 treatment variable, their impact on attrition bias, and the efficacy of the 5 fully automated self-help anxiety treatment programs for generalized anxiety disorder (GAD), social anxiety disorder (SAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). A complex algorithm was used to diagnose participants' mental disorders based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR). Those who received a primary or secondary diagnosis of 1 of 5 anxiety disorders were offered an online 12-week disorder-specific treatment program. A total of 3199 individuals did not formally drop out of the 12-week treatment cycle, whereas 142 individuals formally dropped out. However, only 347 participants who completed their treatment cycle also completed the posttreatment assessment measures. Based on these measures, predictors of attrition were identified and attrition bias was examined. The efficacy of the 5 treatment programs was assessed based on anxiety-specific severity scores and 5 additional treatment outcome measures. On average, completers of posttreatment assessment measures were more likely to be seeking self-help online programs; have heard about the program from traditional media or from family and friends; were receiving mental health assistance; were more likely to learn best by reading, hearing and doing; had a lower pretreatment Kessler-6 total score; and were older
FY 1997 report on the survey on the current residential waste treatment and integrated utilization of waste including heat supply in Shanghai city; 1997 nendo chosa hokokusho (Shanghai shi ni okeru seikatsu gomi shori no genjo narabini kyonetsunado wo fukumu sogo riyo ni kansuru chosa)
Survey was made on residential waste treatment in Shanghai city. Shanghai city with nearly 13 million registered residents produces on average 10,000-11,000 tons/day residential solid wastes. Such wastes are basically disposed by land filling. A landfill site has a current disposal capacity of 7,500 tons/day, and is scheduled to be expanded up to 9,000 tons/day. Problems of waste disposal in Shanghai city are as follows: transportation of wastes collected in the city by trucks, transportation through transit stations to the landfill site by ships, and high disposal cost. Shanghai Environmental Sanitation Bureau is pursuing researches on recycling of wastes, reduction of wastes and harmless treatment in place of conventional land filling. As the survey result, adoption of complete separate collection of wastes is basically important, and application of the latest technologies such as combustion treatment for every waste, heat use, gasification fusion furnace, and RDF (refuse derived fuel) for coal-firing boilers should be considered. 86 figs., 18 tabs.
Gillins, R.L.; DeWitt, L.M.; Wollerman, A.L.
The Mixed Waste Integrated Program (MWIP) is one of several US Department of Energy (DOE) integrated programs established to organize and coordinate throughout the DOE complex the development of technologies for treatment of specific waste categories. The goal of the MWIP is to develop and deploy appropriate technologies for -the treatment of DOE mixed low-level and alpha-contaminated wastes in order to bring all affected DOE installations and projects into compliance with environmental laws. Evaluation of treatment technologies by the MWIP will focus on meeting waste form performance requirements for disposal. Thermal treatment technologies were an early emphasis for the MWIP because thermal treatment is indicated (or mandated) for many of the hazardous constituents in DOE mixed waste and because these technologies have been widely investigated for these applications. An advisory group, the Thermal Treatment Working Group (TTWG), was formed during the program's infancy to assist the MWIP in evaluating and prioritizing thermal treatment technologies suitable for development. The results of the overall evaluation scoring indicate that the four highest-rated technologies were rotary kilns, slagging kilns, electric-arc furnaces, and plasma-arc furnaces. The four highest-rated technologies were all judged to be applicable on five of the six waste streams and are the only technologies in the evaluation with this distinction. Conclusions as to the superiority of one technology over others are not valid based on this preliminary study, although some general conclusions can be drawn
Washton, A M
This chapter describes the rationale, indications, design, and use of a structured outpatient treatment approach as an effective alternative to residential treatment for alcohol and drug dependencies. An increasing demand for outpatient treatment services is being created by a combination of clinical and economic factors, including the influx of employed drug abusers who do not need or desire residential care and mounting financial pressures to contain health care costs. To be effective as a primary treatment modality, outpatient programs must be highly structured and intensive and able to deal with the full spectrum of alcohol and drug addictions. Perpetuating the historical separation between alcoholism and drug abuse treatment programs is unnecessary and counterproductive, although certain modifications in treatment approaches are needed to accommodate the distinctive characteristics of particular classes of drugs and the people who use them. The "outpatient rehab," a treatment model that approximates the intensity of inpatient treatment on an outpatient basis, may help to maximize the clinical efficacy and cost-effectiveness of outpatient treatment as a viable alternative to residential care. Initial treatment results with this model are encouraging.
decreases in alcohol and tobacco use. Conclusion: Acupuncture treatment may help veterans engage in positive health behaviors and feel more supported in...Investigators.(2009). The impact of cognitive behavioral group training on event-free survival in patients with myocardial infarction : the ENRICHD
de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk
Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their
Park, Y. C.; Woo, J. S.; Ryu, J. S.; Cho, Y. K.; Jeon, B. J.
The secondary cooling water in HANARO had been treated with a low ca-hardness treatment program. The program has now been altered to a high ca-hardness treatment program to reduce the consumption of service water and the maintenance cost. After the alteration of the water treatment method, the water quality of the secondary cooling system is maintained below the limit of water quality control as same as before the alteration. This means indirectly that the secondary cooling system is not much affected by the water quality. To confirm this fact, it is necessary to analyze the effects of corrosion, scale, sludgy and slime that the water qualities are directly interfered with the secondary cooling system. We analyzed the deteriorating effects with a water monitoring equipment connected to the secondary cooling system to measure the monitoring parameters every 6 months. As a result, it is confirmed through this examination that the effects are maintained below the control limits and the high ca-hardness treatment program is applicable to treatment of the water quality of the secondary cooling system in HANARO
Suzuki, Joji; Ellison, Tatyana V; Connery, Hilary S; Surber, Charles; Renner, John A
Psychiatrists are well suited to provide office-based opioid treatment (OBOT), but the extent to which psychiatry residents are exposed to buprenorphine training and OBOT during residency remains unknown. Psychiatry residency programs in the USA were recruited to complete a survey. Forty-one programs were included in the analysis for a response rate of 23.7 %. In total, 75.6 % of the programs currently offered buprenorphine waiver training and 78.1 % provided opportunities to treat opioid dependence with buprenorphine under supervision. Programs generally not only reported favorable beliefs about OBOT and buprenorphine waiver training but also reported numerous barriers. The majority of psychiatry residency training programs responding to this survey offer buprenorphine waiver training and opportunities to treat opioid-dependent patients, but numerous barriers continue to be cited. More research is needed to understand the role residency training plays in impacting future practice of psychiatrists.
Wendel, Jeanne; Dumitras, Diana
This paper describes an analytical methodology for obtaining statistically unbiased outcomes estimates for programs in which participation decisions may be correlated with variables that impact outcomes. This methodology is particularly useful for intraorganizational program evaluations conducted for business purposes. In this situation, data is likely to be available for a population of managed care members who are eligible to participate in a disease management (DM) program, with some electing to participate while others eschew the opportunity. The most pragmatic analytical strategy for in-house evaluation of such programs is likely to be the pre-intervention/post-intervention design in which the control group consists of people who were invited to participate in the DM program, but declined the invitation. Regression estimates of program impacts may be statistically biased if factors that impact participation decisions are correlated with outcomes measures. This paper describes an econometric procedure, the Treatment Effects model, developed to produce statistically unbiased estimates of program impacts in this type of situation. Two equations are estimated to (a) estimate the impacts of patient characteristics on decisions to participate in the program, and then (b) use this information to produce a statistically unbiased estimate of the impact of program participation on outcomes. This methodology is well-established in economics and econometrics, but has not been widely applied in the DM outcomes measurement literature; hence, this paper focuses on one illustrative application.
Carmichael, Suzan L; Yang, Wei; Roberts, Eric M; Kegley, Susan E; Wolff, Craig; Guo, Liang; Lammer, Edward J; English, Paul; Shaw, Gary M
Experimental evidence suggests pesticides may be associated with hypospadias. Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications. The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother's residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year. Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9. Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations.
Bozkurt, Hande; Quaglia, Alberto; Gernaey, Krist
The increasing number of alternative wastewater treatment technologies and stricter effluent requirements make the optimal treatment process selection for wastewater treatment plant design a complicated problem. This task, defined as wastewater treatment process synthesis, is currently based...... on expert decisions and previous experiences. This paper proposes a new approach based on mathematical programming to manage the complexity of the problem. The approach generates/identifies novel and optimal wastewater treatment process selection, and the interconnection between unit operations to create...... a process flow diagram. Towards this end, a superstructure approach is used to represent the treatment alternatives for reaction and separation. A generic process interval model is used to describe each alternative in terms of inputeoutput mass balances including conversion and separation factors. Next...
Song, Langui; Wu, Xiaoying; Zhang, Beibei; Liu, Jiahua; Ning, An; Wu, Zhongdao
The prevalence and intensity of schistosomiasis has dropped dramatically in China due to an effective integrated control program. However, advanced schistosomiasis is becoming a key challenge on the road to elimination. The aims of this study were to compare the disease condition between advanced cases under the general assistance program (GAP) and free treatment program (FTP) and to determine whether the FTP should be popularized to provide an objective reference for policymakers in China's advanced schistosomiasis control program. One hundred and ninety-four patients with schistosomiasis japonica who were enrolled in the GAP or FTP participated in this study. Little significant difference was observed in the potential confounders, including general characteristics, comorbidities, and lifestyle, indicating a similar effect on the pathology of liver damage caused by schistosome infection. There was no apparent difference in the incidence of common clinical symptoms. Furthermore, no significant difference was observed in the ultrasound findings, implying that the GAP and FTP groups shared a similar degree of liver lesion. With the exception of the abnormal rates of aspartate aminotransferase (AST), alkaline phosphatase (ALP), and hyaluronic acid (HA), the other serological indicators were comparable between the groups. Overall, the FTP is not a better option for controlling advanced schistosomiasis in China. It is important to reveal the precise mechanism underlying the pathogenesis of advanced schistosomiasis so that specific approaches to treating and preventing the development of advanced schistosomiasis can be developed and schistosomiasis can be eliminated in China.
Kleit, Andrew N.; Shcherbakova, Anastasia V.; Chen Xu
In January 2010 electricity retail residential rate caps expired in a large part of Pennsylvania, allowing consumers to shop for electricity in the retail market. In this paper we employ customer-level data from the relevant territory to analyze what residential customer and community characteristics impacted the decision of whether or not to switch to an alternative electricity provider, and when to make the switch. Results show that customers with higher usage levels (especially around the time of the program's introduction), electric heating, and those living in more urban and more educated communities with lower unemployment rates and higher median household incomes were both more likely to switch, and more likely to do so faster. Lower switching rates and a slower switching response was observed from customers with more variable month to month usage (perhaps this made them unsure of future benefits from switching), those on alternative residential electricity rates (time-of-day and thermal storage programs), and those new to the relevant area (perhaps due to lack of information about the residential choice program). Critics of retail electricity competition have suggested that it disadvantages poor and elderly ratepayers. Our results do not support this contention. Customers living in communities with higher poverty rates were actually more likely to switch (and do so faster) than middle-income consumers. Communities with higher shares of senior population were not found to have lower switching rates from younger communities. - Highlights: ► We analyze introduction of retail competition in Pennsylvania's electricity sector. ► We evaluate what characteristics influence consumers to switch electric providers. ► Higher usage and electric heat influence customers to switch and to do so faster. ► More variable usage and being new to service area deter switching. ► High poverty rates induce switching; older communities no less likely to switch.
Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M
Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.
Klimas, Jan; Muench, John; Wiest, Katharina; Croff, Raina; Rieckman, Traci; McCarty, Dennis
Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention, and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n = 208) and in an opioid treatment program (n = 204) over a two-year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. In the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counselors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested that organizational, structural, provider, patient, and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow.
Beitel, Mark; Oberleitner, Lindsay; Muthulingam, Dharushana; Oberleitner, David; Madden, Lynn M; Marcus, Ruthanne; Eller, Anthony; Bono, Madeline H; Barry, Declan T
Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory. Rates of reported burnout (in response to an open-ended question) were lower than expected, with approximately 26% of participants reporting burnout. Counselor descriptions of burnout included cognitive, affective, behavioral, and physiological symptoms; and job-related demands were identified as a frequent cause. Participants described both self-initiated (e.g., engaging in pleasurable activities, exercising, taking breaks during workday) and system-supported strategies for managing or preventing burnout (e.g., availing of supervision and paid time off). Counselors provided recommendations for system-level changes to attenuate counselor risk of burnout (e.g., increased staff-wide encounters, improved communication, accessible paid time off, and increased clinical supervision). Findings suggest that drug counselor burnout is not inevitable, even in opioid treatment program settings whose treatment capacities are expanding. Organizations might benefit from routinely assessing counselor feedback about burnout and implementing feasible recommendations to attenuate burnout and promote work engagement.
Van Den Houte, Maaike; Luyckx, Koen; Van Oudenhove, Lukas; Bogaerts, Katleen; Van Diest, Ilse; De Bie, Jozef; Van den Bergh, Omer
Treatments including multiple nonpharmacological components have beneficial effects on the key symptoms of fibromyalgia, although effects are limited and often do not persist. In this study, we examined different patterns of clinical progress and the dynamic interplay between predictors and outcomes over time. Fibromyalgia patients (N=153; 135 women) followed a multidisciplinary group program spanning 12weeks, aimed at "regaining control over daily functioning". Anxiety, depression, pain coping and kinesiophobia were used as predictor variables. Outcome variables were pain severity, pain-related disability, physical functioning and functional interference. All variables were assessed at 3 moments: on the first and last day of treatment, and 12weeks after the last day of treatment. Overall treatment effects were analyzed using mixed model analyses. Latent class growth analysis identifying different treatment trajectory classes was used to investigate individual differences in treatment effects. Finally, cross-lagged structural equation models were used to investigate the dynamic interplay between predictors and outcomes over time. Only a fourth to a third of the total group showed improvement on the outcome variables. These patients had lower baseline anxiety, depression and kinesiophobia, and improved more on anxiety, depression and kinesiophobia. Physical well-being had a stronger effect on anxiety and depression than vice versa. Physical functioning predicted relative changes in kinesiophobia, while kinesiophobia predicted relative changes in pain-related disability. The results emphasize the importance of tailoring treatments to individual needs in order to improve overall effectiveness of treatment programs. Copyright © 2017. Published by Elsevier Inc.
Full Text Available Objectives: The main aim of this study was to investigate and to compare elderly happiness and self-esteem among residential and non-residential. Methods & Materials: This research was designed as descriptive. Two groups were selected in convenience method. Member of residential elderly (416 elderly were chosen based on Morgan Table. Hundred-twenty elderly, 60 residential (30 men and 30 women and 60 non-residential (30 men and 30 women were chosen for study. Data used the three questionnaires, like Demographic questionnaires, Oxford Happiness Inventory and Self-esteem Scale’s Rozenberg. Data were gathered and analyzed with Pearson test, t-student test. Results: The results were indicated that a significant relationship between happiness and self-esteem, among residential and non- residential old people. The findings showed significant difference in happiness, self-esteem among residential and home participants in both groups (P<0.01. Conclusion: The results were showed that a significant relationship between social support and self-esteem, among residential and non-residential old people. Also, the results were indicated that significant difference between social support. In general, residential participants had lower social support and self-esteem than non-residential participants.
Perreault, Michel; Bouchard, Stéphane; Lapalme, Micheline; Laverdure, Anick; Audet, Denis; Cusson, Jean-Claude; Zacchia, Camillo; Milton, Diana; Sam Tion, Michaël; Chartier-Otis, Mariko; Marchand, André; Bélanger, Claude
Support groups can help to reach individuals with anxiety disorders who are not or are only partly obtaining health services. The present study is based on a program that involves peer helpers as animators of a self-treatment group (Zéro-ATAQ). Their perspective has been documented in order to identify the aspects of the program which can be improved. Eleven peer helpers led the 12 sessions of the program, which was dispensed in four regions of Quebec for 32 persons having panic disorders with agoraphobia. The perspectives of ten peer animators were documented based on a semi-structured interview that took place at the end of the program, and a focus group that was held over six months later with peer animators from each of the groups. Their comments were transcribed and a thematic content analysis was conducted. All of the peer helper animators reported that they enjoyed participating in the program, that they appreciated being able to help others having an anxiety disorder, and that the program helped them in their role as animators of these types of activities. Nearly all of the peer helpers emphasized the importance of being able to count on the supervision of a professional when needed. This study revealed (1) the feasibility of implementing a program of this kind in partnership with peers, (2) the qualifications necessary to lead this type of program, (3) the requirements in terms of training and available material, and (4) the importance of supervision.
Zimmermann, Peter; Kowalski, Jens; Niggemeier-Groben, Angelika; Sauer, Melanie; Leonhardt, Robert; Ströhle, Andreas
Since 1999, the German Armed Forces (Bundeswehr) have been conducting 3-weeks preventive treatment programs aimed at psychological resource-strengthening in soldiers returning from deployment. Five hundred participants of these programs received the Posttraumatic Stress Scale 10 (PTSS-10) before and after treatment and the rehabilitation assessment questionnaire of the German statutory pension insurance body. Sixty control group subjects received the PTSS-10 twice in an interval of 4-5 months without therapeutic interventions. Comparison of pre- and post-treatment PTSS-10 results in the covariance analysis showed an effect of the initial PTSS-10-stress-levels and rank category, not of the intervention. On average, the treatment program received 'very good' to 'excellent' overall ratings in the rehabilitation questionnaire. The acceptance of sports and movement therapy was significantly above average, whereas that of individual and group counselling was below. The results of this pilot study suggest a high acceptance of the post-deployment preventive program. Effectiveness in terms of psychometric improvement cannot be proven at this point.
of renal function) Dipstick urinalysis (Routine screening for proteinuria and urinary glucose) AST, ALT (Screening for non - alcoholic fatty liver ...method of pediatric obesity treatment and chronic disease prevention. Pediatrics Diabetes Prevention and Weight Management Programs...developing type 2 diabetes (T2D) as well as cardiovascular disease (CVD) . Moreover, approximately 65% of US adults are overweight or obese . [2
Objective: To report the expansion of HIV-1 screening, enrollment in an ART program, and treatment outcomes over twelve months among HIV-positive patients at a nonprofit, non-governmental faith-based clinic providing free and holistic care in Jos City, Plateau State, Nigeria. Design: This was a retrospective analysis of ...
Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J
To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behavior therapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sleep. The brief group-administered CBT-I program produced improvements in the timing and quality of sleep including later bedtimes, earlier out-of-bed times, reduced wake after sleep onset, and improved sleep efficiency. Participants also reported a reduction of the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. The treatment program used in the current study has demonstrated potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population.
Huntington, Dorothy S.; And Others
Reported are the recommendations resulting from a review of the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT). The concept of developmental assessment, as used in the EPSDT, is explained. The introduction provides a summary of the recommendations. Areas covered and for which recommendations are discussed include the role…
Calsyn, Donald A.; And Others
Studies sexual behavior and condom use in 103 men attending an urban outpatient drug abuse treatment center in Seattle (Washington) before and after initiation of a condom giveaway program. Results indicate that male clients will take and use condoms when they are readily available. (SLD)
Van Hasselt, Vincent B.; Schlessinger, Kari M.; DiCicco, Tina M.; Anzalone, William F.; Leslie, Tricia L.; George, John A.; Werder, Edward J.; Massey, Larry L.
The present study provides preliminary data concerning the efficacy of the Adolescent Drug Abuse Prevention and Treatment (ADAPT) Program, a collaborative effort involving mental health and law enforcement. ADAPT is a multi-component, cognitive-behavioral outpatient intervention serving children and youth referred directly from local police…
Karniski, Walt; And Others
Analysis of treatment of infants suffering from Failure to Thrive placed in foster medical placement homes (MPH, N=17) or admitted to hospitals (N=18) revealed that the MPH infants grew more than hospitalized infants and parents of MPH children had advantages of education and support. The MPH program cost less than 25 percent of hospital care.…
Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.
Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…
Full Text Available This paper introduces Jasper, a web programming framework which allows web applications to be developed in an essentially platform indepedent manner and which is also suited to a formal treatment. It outlines Jasper conceptually and shows how Jasper is implemented on several commonplace platforms. It also introduces the Jasper Music Store, a web application powered by Jasper and implemented on each of these platforms. And it briefly describes a formal treatment and outlines the tools and languages planned that will allow this treatment to be automated.
Maka, Erika; Imre, László; Somogyvári, Zsolt; Németh, János
Retinopathy of prematurity is a leading cause of childhood blindness around the world. The Department of Ophthalmology at the Semmelweis University and the Peter Cerny Neonatal Emergency and Ambulance Service started an innovative Premature Eye Rescue Program to reduce the non-essential transport of premature babies suffering from retinopathy of prematurity. During the first 5 years 186 eyes of 93 premature babies were treated at the bedside with stage 3 retinopathy of prematurity in the primary hospitals. In this first 5-years period the authors reduced the number of transports of premature babies for laser treatment; 93 children avoided the unnecessary transport, saving altogether a distance of 21,930 kilometers for children, as well as the ambulance service. The Premature Eye Rescue Program offers a good and effective alternative for treatment of retinopathy in the primary hospitals. The authors propose the national extension of this program.
Dancyger, I; Fornari, V; Schneider, M; Fisher, M; Frank, S; Goodman, B; Sison, C; Wisotsky, W
In this study, we report on our day treatment program (DTP) for adolescents and young adults with eating disorders (EDs). Data for the 82 female patients in DTP were examined, compared across ED diagnosis and by age (adolescents vs. young adults). At admission, patients completed the Eating Disorder Inventory-2 (EDI-2) and the Beck Depression Inventory (BDI) and the Family Adaptability and Cohesion Evaluation Scale- II (FACES-II). Forty-nine percent of patients successfully completed the day program and 13% required hospitalization following day treatment. Overall, there were no significant differences between the adolescents and adults at discharge of the day program. With shortened inpatient (IP) hospitalizations, DTPs can provide the long-term care required by many adolescent patients for psychological and physical recovery. This may be particularly important for the development of children and adolescents.
Simonovska, Natasa; Chibishev, Andon; Babulovska, Aleksandra; Pereska, Zanina; Jurukov, Irena; Glasnovic, Marija
The program of our Clinic includes, not only treatment of acute intoxication with opioids and other drugs, but also comprehends clinical investigations and treatment of the somatic complications of this population. For the first time in our country our Clinic offers to this population the alternative way of treatment with Buprenorfin. The Clinic started with this protocol on August 1, 2009. During a period of two years, the treatment with Buprenorfine has been initiated in 353 patients, of which 211 regularly attend the medical check ups. This model is used according to the national clinical guidelines and procedures for the use of buprenorfine in the treatment of opioid dependence The dose of this medicament depends on the evolution of the withdrawal symptoms. We have used the objective and subjective opioid withdrawal scale for the observation of these symptoms (OOWS ; SOWS – Handelsman et al 1987). This protocol starts with a complete clinical investigations, (i.e. where all patients undergo the inclusion and exclusion criteria with a written consent). Afterwards, the patients are hospitalized and start with a Buprenorfin teratment. After period of 7-10 days hospitalization they come to our Clinic, like outpatients for a regular controls. We have precise evidence for every patient who comes for control (e.g. medical record with all biochemical and toxicological screenings). All patients are recommended a tight cooperation with psychiatrists who are specialized to treat the problematic drug addictions. PMID:23678303
Washington State's law for sexually violent predators was enacted in 1990; since then, 14 other states have passed similar laws authorizing civil commitment for dangerous sexual offenders following their prison terms. Although the law has survived constitutional challenges at both the state and in the U.S. Supreme Court, a related set of court actions has addressed whether the treatment program is adequate. In 1994, the federal district court placed Washington's program under injunction and appointed a special master to ensure that the state improve deficiencies in the program. As of 2003, the federal court continues to oversee the state's program, with a threat of fines totaling several million dollars if the injunction terms are not met. Over an eight-year period, the special master delivered 19 reports to the court, documenting the program's deficiencies as well as its successes in meeting the court's orders. This article reviews these reports and court orders, detailing the court's requirements for an adequate treatment program.
Matthews, Alicia K; Li, Chien-Ching; Kuhns, Lisa M; Tasker, Timothy B; Cesario, John A
Little is known about lesbian, gay, bisexual, and transgender (LGBT) people's response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. A total of N = 198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association's "Freedom from Smoking Program" (ALA-FFS) and were tailored to LGBT smokers' needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Participants (M age = 40.5) were mostly White (70.4%) and male (60.5%) and had at least a college degree (58.4%). Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions). Higher educational attainment and use of nicotine replacement therapy (NRT) were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45), use of NRT (OR = 4.24), and lower nicotine dependency (OR = 0.73) were positively associated with quitting smoking. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.
Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9 13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.
Hardy, Louise L; Mihrshahi, Seema; Gale, Joanne; Nguyen, Binh; Baur, Louise A; O'Hara, Blythe J
Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions. Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables. Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.
Starke, Michael R [ORNL; Onar, Omer C [ORNL; DeVault, Robert C [ORNL
Electrical energy consumption of the residential sector is a crucial area of research that has in the past primarily focused on increasing the efficiency of household devices such as water heaters, dishwashers, air conditioners, and clothes washer and dryer units. However, the focus of this research is shifting as objectives such as developing the smart grid and ensuring that the power system remains reliable come to the fore, along with the increasing need to reduce energy use and costs. Load research has started to focus on mechanisms to support the power system through demand reduction and/or reliability services. The power system relies on matching generation and load, and day-ahead and real-time energy markets capture most of this need. However, a separate set of grid services exist to address the discrepancies in load and generation arising from contingencies and operational mismatches, and to ensure that the transmission system is available for delivery of power from generation to load. Currently, these grid services are mostly provided by generation resources. The addition of renewable resources with their inherent variability can complicate the issue of power system reliability and lead to the increased need for grid services. Using load as a resource, through demand response programs, can fill the additional need for flexible resources and even reduce costly energy peaks. Loads have been shown to have response that is equal to or better than generation in some cases. Furthermore, price-incentivized demand response programs have been shown to reduce the peak energy requirements, thereby affecting the wholesale market efficiency and overall energy prices. The residential sector is not only the largest consumer of electrical energy in the United States, but also has the highest potential to provide demand reduction and power system support, as technological advancements in load control, sensor technologies, and communication are made. The prevailing loads
Lara A. Roman; John J. Battles; Joe R. McBride
Urban forests can provide ecosystem services that motivate tree planting campaigns, and tree survival is a key element of program success and projected benefits. We studied survival in a shade tree give-away program in Sacramento, CA, monitoring a cohort of young trees for five years on single-family residential properties. We used conditional inference trees to...
Full Text Available Key factors influencing electricity consumption in the residential sector in Poland have been identified. A fixed-effects model was used, which includes time effects, and a set of covariates, based on the model developed by Houthakker et al. This model estimates electricity demand by using lagged values of the dependent variable along with current and lagged values of electricity prices, and other variables that affect electricity demand such as: population, economic growth, income per capita, price of related goods, etc. The model has been identified according to the research results of the authors and those obtained by Bentzen and Engsted. The set of covariates was extended to the lagged electricity price given by a tariff (taken from two years previous to the time of interest and heating degree days index, a very important factor in European Union countries, where the climate is temperate. The authors propose four models of residential electricity demand, for which a confidence interval of 95% has been assumed. Estimation was based on Polish quarterly data for the years 2003-2013. (original abstract
Appleby, Lawrence; Desai, Prakash
In an exploration of residential instability and recidivism in chronic mental patients, 215 psychiatric admissions were followed for a year after the initial episode. In addition to an unusually high incidence of residential mobility, a relationship between mobility and number of hospitalizations was evident, as were isolation, disruptive family situations, and homelessness. The needed response of the mental health system is discussed.
Nelson, Ashlyn Aiko
Credit scores have a profound impact on home purchasing power and mortgage pricing, yet little is known about how credit scores influence households' residential location decisions. This study estimates the effects of credit scores on residential sorting behavior using a novel mortgage industry data set combining household demographic, credit, and…
the extent to which heightened levels of residential crowding might reflect “hidden homelessness.” I find mixed evidence to support this link, and, if anything, find some evidence to suggest that the link between residential crowding and hidden homelessness, if one exists, is strongest for the Canadian-born.
Daigre, Constanza; Comín, Marina; Rodríguez-Cintas, Laia; Voltes, Nuria; Alvarez, Alba; Roncero, Carlos; Gonzalvo, Begoña; Casas, Miguel
We analyzed the perspective of users enrolled in a harm reduction program that provides syringe exchange, an educational room for «warmth and coffee», a methadone maintenance program, a room for supervised drug consumption, a place for personal hygiene, and medical and psychosocial follow-up. The particularity of this program lies in its integration within an outpatient drug treatment center forming part of a general hospital. We performed a descriptive study using qualitative methods. Theoretical sampling was conducted. Twelve in-depth interviews and one focus group composed of eight users were carried out. Information analysis was based on grounded theory. Literal transcriptions were coded and subsequently sorted into broad categories. Three researchers participated in this process and finally a fourth researcher triangulated the results. Five dimensions were identified in the users' discourse: accessibility, service, relationship, localization, and identity. Each consisted of several topics that were evaluated based on the participants' experiences and expectations. The dimension of identity emerged as a distinctive element in patient-program bonding. The users' overall evaluation of the program was positive. Facilitators and barriers influencing patient-program bonding were identified and participants suggested ways to remove barriers. The coexistence among users of the harm reduction program and patients treated conventionally provoked ambivalence but the team's management was deemed helpful in easing the difficulties arising from this situation. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.
Abraham Amanda J
Full Text Available Abstract Background Buprenorphine was approved for use in the treatment of opioid dependence in 2002, but its diffusion into everyday clinical practice in community-based treatment programs has been slow. This study examines the net impact of efforts by state agencies, including provision of Medicaid coverage, on program-level adoption of buprenorphine as of 2006. Methods Interviews were conducted with key informants in 49 of the 50 state agencies with oversight responsibility for addiction treatment services. Information from these interviews was integrated with organizational data from the 2006 National Survey of Substance Abuse Treatment Services. A multivariate logistic regression model was estimated to identify the effects of state efforts to promote the use of this medication, net of a host of organizational characteristics. Results The availability of Medicaid coverage for buprenorphine was a significant predictor of its adoption by treatment organizations. Conclusion Inclusion of buprenorphine on state Medicaid formularies appears to be a key element in ensuring that patients have access to this state-of-the-art treatment option. Other potential barriers to the diffusion of buprenorphine require identification, and the value of additional state-level policies to promote its use should be evaluated.
Feng, Yan; Xu, Hao; Liu, Kai; Zhou, Xue-Zhong; Chen, Ke-Ji
To initially optimize comprehensive treatment program for treating and preventing unstable angina (UA) by integrative medicine (IM). Based on partially observable Markov decision process model (POMDP), we chose 3 syndrome elements, i.e., qi deficiency, blood stasis, and phlegm turbidity from UA inpatients. The efficacy of treating UA by IM was objectively assessed by in-depth data mining and analyses. The treatment programs for UA patients of qi deficiency syndrome, blood stasis syndrome, and phlegm turbidity syndrome were recommended as follows: nitrates +statins +clopidogrel +angiotensin II receptor blockers +heparins +Astragalus membranaceus +Condonopsis + poria and large-head atractylodes rhizome (ADR = 0.85077869); nitrates + aspirin + clopidogrel + statins + heparins + Astragalus membranaceus + safflower + peach seed + red peony root (ADR = 0.70773000); nitrates + aspirin + statins + angiotensin-converting inhibitors + snakegourd fruit + onion bulb + ternate pinellia + tangerine peel (ADR = 0.72509600). As a POMDP based optimized treatment programs for UA, it can be used as a reference for further standardization and formulation of UA program by integrative medicine.
Legha, Rupinder Kaur; Novins, Douglas
Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.
Segan, Catherine Jane; Maddox, Sarah; Borland, Ron
Few homeless programs offer smoking cessation treatment. This study examined the feasibility, acceptability, and effectiveness of a smoking cessation treatment model delivered by staff of a homeless persons' program. Fourteen nurses from Melbourne's Royal District Nursing Service Homeless Persons' Program recruited 49 clients into a 12-week program offering weekly nurse-delivered smoking cessation appointments with intermittent carbon monoxide measurements, doctor-prescribed free nicotine patch, bupropion or varenicline, and Quitline phone support. Surveys were completed at program enrolment, end of program (EoP, 3 months) and 6 months post-enrolment. Clients attended on average 6.7 nurse-delivered appointments. Most used pharmacotherapy (69%, n = 34) and Quitline (61%, n = 30, average 8.4 calls among users). Using all-cases analyses 29% had made a quit attempt by EoP; 24-hour point prevalence abstinence rates were 6% at EoP and 4% at 6 months (no participants achieved sustained cessation), and 29% reported 50% consumption reduction at 6 months, the latter positively associated with increased Quitline use. Tobacco consumption and money spent on tobacco halved by EoP with similar levels maintained at 6 months. Discarded butt smoking reduced. Using within-subjects analyses, all participants reported either the same or less symptoms of anxiety at EoP compared to baseline and 92% reported the same or less depressive symptoms. Integrating nurse support with readily accessible cessation interventions (government subsidized pharmacotherapy plus Quitline) was feasible and acceptable. While quit rates were low, treatment benefits included harm-reduction (reduced consumption and butt smoking), significant financial savings, and psychological benefits (improved or stable mood). © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
Full Text Available Context: A module-based training program for medical interns using World Health Organization guide for good prescription along with the individual feedback on their prescription was developed and implemented. Objective: The objective of the study was to obtain the medical interns' reactions to newly developed skill-based training program on rational treatment. Study Setting: This study was conducted at the Department of Community Medicine. Participants: A total of 96 medical interns were included in the study. Study Design: A cross-sectional study consisting of retro-prefeedback and open-ended questions about self-assessment of perceived skill on rational treatment. Analysis: Collected data were entered in Epi Info (3.5.4 and analyzed. Results: After training, there was a significant increase in self-perceived posttest scores of setting up the therapeutic objective for the treatment (2.9–4.9, ability to select the correct drug (2.8–5.1, ability to select right dose, schedule, and duration of drugs (2.5–4.9. and overall prescription skill (2.9–4.9. There is a significant decrease in self-perceived scores in the skill of practicing polypharmacy (4.1–2.5. Conclusions: Overall, the training program was taken well and interns perceived their skill on rational treatment was improved as shown by the feedback.
Zeng, Wei; Lian, Xiaotian; Chen, Gang; Ju, Rui; Tian, Weidong; Tang, Wei
The purpose of this study was to evaluate the accuracy of the digital diagnosis and treatment program for maxillofacial fractures. The data of 626 patients with maxillofacial fractures were analyzed retrospectively from January 2010 to August 2016. These patients were divided into 2 groups. In the experimental group, preoperative planning was conducted and transferred to patients with guiding templates and navigation according to the digital diagnosis and treatment program for maxillofacial fractures. In the control group, postsurgical planning was performed instead of preoperative planning. To assess the accuracy of the digital diagnosis and treatment program for maxillofacial fractures, preoperative planning and postoperative computed tomographic models were superimposed and imported to dedicated software (Geomagic Studio 13.0, Geomagic, Inc, Research Triangle Park, NC) to calculate the difference between the 2 models in the 2 groups. Results of the experimental set showed that the mean error between the preoperative planning model and the postoperative model ranged from 0.65 to 0.97 mm (average, 0.89 mm). For the control group, the mean error was 0.78 to 1.45 mm (average, 1.01 mm). Thus, the mean error of the experimental group was statistically lower than that of the control group (P maxillofacial fractures was more accurate. Aided by the digital diagnosis and treatment program, the accuracy for maxillofacial fractures was notably improved. To facilitate the application and promotion of digital technology, further modification of the complete digital diagnosis and treatment pathway for maxillofacial fractures is highly desired. Copyright © 2017. Published by Elsevier Inc.
Arriaga, M A; Eavy, R; Stool, S E; Guerrero, J; Odio, C N; Santos, J I
Otitis media in Latin America is an important cause of hearing impairment and infectious complications which can be prevented without an inordinate effort or investment of resources. The Latin American Otitis Media Research and Training Program is a multidisciplinary, international project designed to improve the detection an treatment of otitis media in Latin America. Over 200 health care providers have already participated in pilot seminars presented in Brazil, Costa Rica, and Mexico. These sessions were highlighted by audiovisual presentations emphasizing pneumatic otoscopy. We conclude that this focused program of medical education can significantly contribute to improve primary health care in the region.
Edwards, Jennifer R.; Knight, Danica K.; Broome, Kirk M.; Flynn, Patrick M.
Directors in substance use treatment programs are increasingly required to respond to external economic and socio-political pressures. Leadership practices that promote innovation can help offset these challenges. Using focus groups, factor analysis, and validation instruments, the current study developed and established psychometrics for the Survey of Transformational Leadership. In 2008, clinical directors were evaluated on leadership practices by 214 counselors within 57 programs in four U.S. regions. Nine themes emerged: integrity, sensible risk, demonstrates innovation, encourages innovation, inspirational motivation, supports others, develops others, delegates tasks, and expects excellence. Study implications, limitations and suggested future directions are discussed. Funding from NIDA. PMID:20509734
Tho, Poh Chi; Ang, Emily
Advancements in technology and medical treatment have made cancer care treatment more complex. With the current trend of sub-specialization in health care, cancer patients commonly receive care from multiple specialists and have wider treatment options. In view of this, there is a need to coordinate care and integrate information to enhance care and quality of outcomes for patients. Since the successful implementation of programs for increasing the survival rate of breast cancer patients at Harlem Hospital Center, New York, USA, patient navigation programs have been widely introduced in healthcare settings. Some literature has identified nurses as a primary candidate in assuming the role of a navigator. However, there is a need to further explore the effectiveness of patient navigation programs for their effectiveness in improving quality of life, and patient satisfaction and outcomes during the commencement of cancer treatment. The objective of this review was to synthesize the best available evidence on the effectiveness of patient navigation programs in adult cancer patients undergoing treatments such as radiotherapy and/or chemotherapy. This review considered studies that included adults aged 18 years and over, diagnosed with any type of cancer and undergoing treatment in an acute care hospital setting, including inpatient and outpatient/ambulatory care.This review considered studies that evaluated nurse-led patient navigation programs versus no patient navigation program or non-structured care coordination.A patient navigation program includes patient education, psychosocial support, and care coordination.This review considered randomized controlled trials and quasi-experimental studies.The review focused on the effects of patient navigator program clinical/patient outcomes. The review included studies on patient wellbeing and clinical outcomes, but excluded studies that had examined the impact of these programs on efficiency-related outcomes, such as length
A program to help accelerate the adoption and implementation of new and innovative remediation technologies has been initiated by the Department of Energy's (DOE) Environmental Restoration Program Office (EM40). Developed as a Public-Private Partnership program in cooperation with the US Environmental Protection Agency's (EPA) Technology Innovation Office (TIO) and coordinated by Sandia National Laboratories, the Innovative Treatment Remediation Demonstration (ITRD) Program attempts to reduce many of the classic barriers to the use of new technologies by involving government, industry, and regulatory agencies in the assessment, implementation, and validation of innovative technologies. In this program, DOE facilities work cooperatively with EPA, industry, national laboratories, and state and federal regulatory agencies to establish remediation demonstrations using applicable innovative technologies at their sites. Selected innovative technologies are used to remediate small, one to two acre, sites to generate the full-scale and real-world operating, treatment performance, and cost data needed to validate these technologies and gain acceptance by industry and regulatory agencies, thus accelerating their use nationwide. Each ITRD project developed at a DOE site is designed to address a typical soil or groundwater contamination issue facing both DOE and industry. This includes sites with volatile organic compound (VOC), semi-VOC, heavy metal, explosive residue, and complex or multiple constituent contamination. Projects are presently underway at three DOE facilities, while additional projects are under consideration for initiation in FY96 at several additional DOE sites. A brief overview of the ITRD Program, program plans, and the status and progress of existing ITRD projects are reviewed in this paper
Keshen, Aaron; Helson, Thomas; Town, Joel; Warren, Karly
This prospective pilot study examined the relationship between self-efficacy and treatment outcome in an adult outpatient eating disorder program. Data from 59 eating disorder outpatients were collected, including measures of self-efficacy, eating disorder symptom severity, negative emotions (depression, anxiety, and stress), body mass index, and duration of illness. Hierarchical regression was used to examine the impact of baseline self-efficacy, and early treatment changes in self-efficacy (i.e., baseline to 6 weeks), on end-of-treatment (EoT) eating disorder symptom severity and treatment dropout. Early change in self-efficacy during the course of treatment was found to predict EoT symptom severity when controlling for confounding variables. Furthermore, baseline self-efficacy was found to predict treatment dropout, but not end-of-treatment symptom severity. This is the first study (using a validated scale) to show that self-efficacy, and early changes in self-efficacy, may be an important predictor of treatment outcome for eating disorder outpatients. Implications and suggestions for future research are discussed.
Jeo, H. S.; Son, J. S.; Kim, T. K.; Kang, I. S.; Lee, Y. H
As for the generated radioactive waste, a nuclide and a form are various, and by small quantity occurs the irregular times in KAERI. Record management of a radioactive waste personal history is an important element in disposal. A data collection of a liquid / solid radioactive waste treatment process of a research organization became necessary while developing the RAWMIS which it can generate personal history management for efficient management of a waste, documents, all kinds of statistics. This paper introduces an input and output application program design to do to database with data in the results and a stream process of a treatment that analyzed the waste occurrence present situation and data by treatment process. Data on the actual treatment process that is not limited experiment improve by a document, human traces, saving of material resources and improve with efficiency of tracking about a radioactive waste and a process and give help to radioactive waste material valance and inventory study
Lee, Y. H.; Ann, S. J.; Jo, H. S.; Son, J. S.
A data collection of a liquid radioactive waste treatment process of a research organization became necessary while developing the RAWMIS(Radioactive Waste Management Integration System) which it can generate personal history management for efficient management of a waste, documents, all kinds of statistics. This paper introduces an input and output application program design to do to database with data in the results and a stream process of a treatment that analyzed the waste occurrence present situation and data by treatment process. Data on the actual treatment process that is not limited experiment improve by a document, human traces, saving of material resources and improve with efficiency of tracking about a radioactive waste and a process and give help to radioactive waste material valance and inventory study
Schwarzkopf, Kathleen; Conrad, Nathalie; Straus, Doris; Porschke, Hildburg; von Känel, Roland
We studied the clinical course and long-term effects of inpatient treatment in 723 patients with job burnout referred with an ICD-10 F diagnosis and Z73.0 code («overwhelming exhaustion») to a Swiss hospital specialized in the treatment of job stress-related disorders. Patients were characterized in terms of age, gender, socioeconomic status. Self-rated psychological measures related to general and burnout-specific symptoms (i. e., emotional exhaustion, depersonalization, and diminished personal accomplishments) were applied before and after a six-week treatment program, as well as at 15 months after hospital discharge in 232 patients. The results show that the multimodal inpatient psychiatric-psychotherapeutic treatment was successful with a sustainable effect on psychological well-being (>90 %), including improvements regarding emotional exhaustion, depersonalization and personal accomplishments as well as professional reintegration in 71 % of cases.
Needham, Marie; Gummerum, Michaela; Mandeville-Norden, Rebecca; Rakestrow-Dickens, Janine; Mewse, Avril; Barnes, Andrew; Hanoch, Yaniv
Cognitive behavioral therapy-based alcohol treatment programs have been widely used to break the link between alcohol and crime. While evidence exists on the connection between alcohol and crime, there is little data that demonstrate the effectiveness of different alcohol treatment programs in reducing criminal behavior. We tested whether male offenders who participate in alcohol treatment programs show lower rates of recidivism than a matched offender group who did not participate in an alcohol prevention program. This is an observational matched case-control study. Participants were 564 male offenders with an alcohol problem related to offending. Participants were assigned by the courts to 1 of 3 alcohol treatment programs (141 offenders per treatment): Low Intensity Alcohol Program (LIAP), Alcohol Specified Activity Requirement, and Addressing Substance-Related Offending. A fourth matched group (n = 141) was not assigned to a program and served as a control group. Survival analysis was used to calculate participants' charged and reconviction rates over 4 time periods (0 to 3, 4 to 6, 7 to 9, and 10 to 12 months after completion of program or order). Offenders who did not participate in a program were more than twice as likely to be charged compared to offenders who participated in a program. Furthermore, offenders who did not participate in a program were over 2.5 times more likely to be reconvicted. Among the 3 alcohol treatment programs evaluated, the LIAP was the most cost-effective. Offenders enrolled in an alcohol treatment program showed a significant reduction in being charged with or reconvicted of a crime. With costs of keeping offenders in prison per year reaching close to £40,000 per offender per year (Mulheirn et al., 2010, www.smf.co.uk), assigning offenders to alcohol preventive programs-such as LIAP-are a promising way to reduce recidivism and reduce cost. Copyright © 2015 by the Research Society on Alcoholism.
Arvela, H.; Maekelaeinen, I.; Castren, O.
The study measured the indoor radon concentration in the dwellings of 3074 persons, selected randomly from the central population register of Finland. Alpha track detectors and two consecutive half year measuring periods were used. The national mean of indoor radon concentration for persons living in low-rise residential buildings as well as blocks of flats was 145 and 82 Bq/m 3 , respectively. The mean for the total population was 123 Bq/m 3 . Based on the decision of the Ministry of Social Affairs and Health in 1992, the indoor radon concentration should not exceed 400 Bq/m 3 in already existing houses, the target for new construction being less than 200 Bq/m 3 . According to the study, the percentage of the Finnish population living in houses with an indoor radon concentration exceeding 200, 400 and 800 Bq/m 3 was 12.3 %, 3.6 % and 1.0 %
Brown, Franklin C; Buboltz, Walter C; Soper, Barlow
University students report significantly worse sleep quality than the general population. Sleep problems are related to increased health concerns, irritability, depression, fatigue, and attention and concentration difficulties, along with poor academic performance. Clinical research indicates that psychoeducational interventions are among the most effective methods for improving sleep quality in the general population. Similar studies for university students are lacking. In this study, the authors describe the development of the Sleep Treatment and Education Program for Students (STEPS) and evaluate its effectiveness with a double blind, experimental design. Students in the treatment group reported significantly improved sleep quality and sleep hygiene behaviors at 6 weeks posttreatment.
...; compounders for narcotic treatment programs; manufacturing and compounding areas. 1301.73 Section 1301.73 Food... controls for non-practitioners; compounders for narcotic treatment programs; manufacturing and compounding... unauthorized persons may not enter or leave the area without his knowledge. (c) During the production of...
Lamers, A.; Delsing, M.J.M.H.; Van Widenfelt, B.M.; Vermeiren, R.R.J.M.
Background: The therapeutic alliance between multidisciplinary teams and parents within youth (semi) residential psychiatry is essential for the treatment process and forms a promising process variable for Routine Outcome Monitoring (ROM). No short evaluative instrument, however, is currently
Weeland, M.M.; Nijhof, K.S.; Vermaes, I.; Engels, R.C.M.E.; Buitelaar, J.K.
BACKGROUND: Although adolescents are often referred to residential treatment centres because of severe externalizing behaviours, a vast majority demonstrated comorbid symptoms of depression and anxiety. Covert internalizing symptoms in these adolescents might be easily unrecognized and therefore
Russo, A M; Taber, J I; McCormick, R A; Ramirez, L F
In 1972 the Brecksville Unit of the Cleveland Veterans Administration Medical Center began the first inpatient treatment program for pathological gambling in the United States. The 30-day, highly structured gambling treatment program aims for abstinence from gambling, reduction of the urge to gamble, and restoration of a maximum level of social functioning. The authors report the results of a preliminary outcome study of 60 former patients who completed a survey form rating various aspects of their lives one year postdischarge. Fifty-five percent of the respondents reported complete abstinence from gambling since discharge. Chi-square analyses demonstrated significant relationships between abstinence from gambling and improved interpersonal relationships, better financial status, decreased depression, and participation in professional aftercare and Gamblers Anonymous. The authors believe that their initial results support the contention that pathological gambling is a treatable disorder.
Andrews, Christina M; D'Aunno, Thomas A; Pollack, Harold A; Friedmann, Peter D
This article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations' technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs' decisions to adopt evidence-based clinical innovations such as buprenorphine use.
Evans, Steven W; Langberg, Joshua; Raggi, Veronica; Allen, Jessica; Buvinger, Elizabeth C
The authors conduct an evaluation of a middle school-based treatment program for youth with ADHD during early stages of treatment development. The studies focus on interpreting outcome trends in preliminary data and identifying assessment issues that will be important to consider when conducting a clinical trial. Parent reports indicate that the majority of students benefit from improvements in academic, social, and overall functioning. Although teachers report beneficial effects for the majority of the participants in the program, there is little agreement about individual students. Measurement problems are associated with understanding normal change during a school year, accounting for normal behavior changes in December and May, and considerable disagreement between teachers. Suggestions to guide future work in this area are provided.
The study's purpose was to examine the effects of providing a partnership support program. It was designed to improve Japanese couples' partnership, maintain quality of life, decrease psychological distress, and improve marital relationship satisfaction while they underwent infertility treatment that included the possibility of using assisted reproductive technology. This quasi-experimental study with a two-group pretest-post-test design used purposive sampling and non-random assignment of 318 consenting Japanese patients from previous phases of assisted reproductive technology fertility treatment who were patients from a fertility clinic in Tokyo, Japan. The intervention group of 152 patients (76 couples) participated in the partnership support program. The comparison group of 166 patients (83 couples) received usual care. Recruitment was age matched. The program provided information and used a participatory-interactive approach to enhance understanding and cooperation in couples undergoing fertility treatment. The main outcome measures were: "partnership", FertiQoL, Quality Marriage Index, and "psychological distress". There were 311 participants (intervention group n = 148; comparison group, n = 163). The intervention group showed significant improvement in the couples' partnerships and a significant decrease in women's psychological distress using subgroup analysis. The partnership support program provided effective improvement in partnership for the couples, and reduced psychological distress for the women; however, it had less impact for the men. The program was not effective in improving couples' overall quality of life (QOL); however, it was effective in improving the "mind-body" aspects of the QOL subscale. © 2015 The Author. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.
Gray, Jane Simpson; Spear Filigno, Stephanie; Santos, Melissa; Ward, Wendy L; Davis, Ann M
Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service.
Gray, Jane Simpson; Filigno, Stephanie Spear; Santos, Melissa; Ward, Wendy L.; Davis, Ann M.
Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service. PMID:23224661
van der Palen, Jacobus Adrianus Maria; Klein, Jakob J.; Seydel, E.R.; Zielhuis, Gerhard A.; van Herwaarden, Cees L.A.; Klein, J.J.; van der Palen, J.
To assess the efficacy of self-management programs it is important to know what behavioural changes take place. This paper assesses whether including self-treatment guidelines (action plans) in a self-management program for adult asthmatics, leads to greater behavioural changes than a program
Hartzler, Bryan; Jackson, T. Ron; Jones, Brinn E.; Beadnell, Blair; Calsyn, Donald A.
Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (interventio...
José Luis Jiménez López; Jesús Arenas Osuna
High demand of care and the academic burden of courses of specialization in medicine affect the mental health of medical residents with events ranging from simple emotional discomfort to development of affective disorders in susceptible individuals. The suicide of physicians has produced programs for their attention in some countries. We present the first mental health clinic for residents of a high specialty hospital in Mexico, focused on the prevention of suicide and depression, treatment o...
MAGNO, Fernanda Cristina Carvalho Mattos; da SILVA, Monique Silveira; COHEN, Larissa; SARMENTO, Luciana d'Abreu; ROSADO, Eliane Lopes; CARNEIRO, Jo?o R?gis Ivar
BACKGROUND: Along with the augmentation in obesity rates in recent years, the demand for bariatric surgery has startlingly increased. Nutritional counseling in the preoperative period is very important because it contributes to higher success rate in the post-operative period. AIM: To assess the nutritional status of patients in a multidisciplinary program for the treatment of severe obesity and pre-operatively for bariatric surgery, characterizing the consumption of healthy nutrients. METHOD...
Boles, Richard E.; Scharf, Cynthia; Stark, Lori J.
We developed and tested the feasibility of a behavioral intervention that utilizes clinic and home visitations to reduce overweight in preschool children above the 95th BMI percentile. Five families of preschool children ages 2 to 5 years with a BMI above the 95th percentile and one overweight parent were enrolled in a 24-week behavioral weight management program. Phase I, Intensive Treatment included 12 weekly sessions, alternating group-based clinic sessions and home settings. Phase II, Mai...
Grigoreva, Larisa; Grigoryev, Vladimir
For the formation of programs for housing construction and planning of capital investments, when developing the strategic planning companies by construction companies, the norms or calculated indicators of the duration of the construction of high-rise residential buildings and multifunctional complexes are mandatory. Determination of stable values of the parameters for the high-rise construction residential buildings provides an opportunity to establish a reasonable duration of construction at the planning and design stages of residential complexes, taking into account the influence of market conditions factors. The concept of the formation of enlarged models for the high-rise construction residential buildings is based on a real mapping in time and space of the most significant redistribution with their organizational and technological interconnection - the preparatory period, the underground part, the above-ground part, external engineering networks, landscaping. The total duration of the construction of a residential building, depending on the duration of each redistribution and the degree of their overlapping, can be determined by one of the proposed four options. At the same time, a unified approach to determining the overall duration of construction on the basis of the provisions of a streamlined construction organization with the testing of results on the example of high-rise residential buildings of the typical I-155B series was developed, and the coefficients for combining the work and the main redevelopment of the building were determined.
Full Text Available For the formation of programs for housing construction and planning of capital investments, when developing the strategic planning companies by construction companies, the norms or calculated indicators of the duration of the construction of high-rise residential buildings and multifunctional complexes are mandatory. Determination of stable values of the parameters for the high-rise construction residential buildings provides an opportunity to establish a reasonable duration of construction at the planning and design stages of residential complexes, taking into account the influence of market conditions factors. The concept of the formation of enlarged models for the high-rise construction residential buildings is based on a real mapping in time and space of the most significant redistribution with their organizational and technological interconnection - the preparatory period, the underground part, the above-ground part, external engineering networks, landscaping. The total duration of the construction of a residential building, depending on the duration of each redistribution and the degree of their overlapping, can be determined by one of the proposed four options. At the same time, a unified approach to determining the overall duration of construction on the basis of the provisions of a streamlined construction organization with the testing of results on the example of high-rise residential buildings of the typical I-155B series was developed, and the coefficients for combining the work and the main redevelopment of the building were determined.
Full Text Available The increasingly complex residential microgrids (r-microgrid consisting of renewable generation, energy storage systems, and residential buildings require a more intelligent scheduling method. Firstly, aiming at the radiant floor heating/cooling system widely utilized in residential buildings, the mathematical relationship between the operative temperature and heating/cooling demand is established based on the equivalent thermodynamic parameters (ETP model, by which the thermal storage capacity is analyzed. Secondly, the radiant floor heating/cooling system is treated as virtual energy storage system (VESS, and an optimization model based on mixed-integer nonlinear programming (MINLP for r-microgrid scheduling is established which takes thermal comfort level and economy as the optimization objectives. Finally, the optimal scheduling results of two typical r-microgrids are analyzed. Case studies demonstrate that the proposed scheduling method can effectively employ the thermal storage capacity of radiant floor heating/cooling system, thus lowering the operating cost of the r-microgrid effectively while ensuring the thermal comfort level of users.
Hayanga, Awori J; Zeliadt, Steve B; Backhus, Leah M
To examine the relationship between race and lung cancer mortality and the effect of residential segregation in the United States. A retrospective, population-based study using data obtained from the 2009 Area Resource File and Surveillance, Epidemiology and End Results program. Each county in the United States. Black and white populations per US county. A generalized linear model with a Poisson distribution and log link was used to examine the association between residential segregation and lung cancer mortality from 2003 to 2007 for black and white populations. Our primary independent variable was the racial index of dissimilarity. The index is a demographic measure that assesses the evenness with which whites and blacks are distributed across census tracts within each county. The score ranges from 0 to 100 in increasing degrees of residential segregation. RESULTS The overall lung cancer mortality rate was higher for blacks than whites (58.9% vs 52.4% per 100 000 population). Each additional level of segregation was associated with a 0.5% increase in lung cancer mortality for blacks (P segregation) and the highest levels of segregation (≥60% segregation), respectively. In contrast, the adjusted lung cancer mortality rates for whites decreased with increasing levels of segregation. Lung cancer mortality is higher in blacks and highest in blacks living in the most segregated counties, regardless of socioeconomic status.
Huefner, Jonathan C; Smith, Gail L; Stevens, Amy L
The potential for negative peer influence has been well established in research, and there is a growing interest in how positive peer influence also impacts youth. No research, however, has concurrently examined positive and negative peer influence in the context of residential care. Clinical records for 886 residential care youth were used in a Hierarchical Linear Model analysis to examine the impact of negative and positive peer influence on naturally occurring patterns of serious problem behavior over time. Negative peer influence, where the majority of youth in a home manifested above the average number of serious behavior problems, occurred 13.7% of the time. Positive peer influence, where the majority of youth manifested no serious problem behaviors for the month, occurred 47.7% of the time. Overall, youth problem behavior improved over time. There were significantly lower rates of serious problem behavior in target youth during positive peer influence months. Conversely, there were significantly higher rates of serious problem behaviors in target youth during negative peer influence months. Negative peer influence had a relatively greater impact on target peers' serious behavior problems than did positive peer influence. Caregiver experience significantly reduced the impact of negative peer influence, but did not significantly augment positive peer influence. Months where negative peer influence was combined with inexperienced caregivers produced the highest rates of serious problem behavior. Our results support the view that residential programs for troubled youth need to create circumstances that promote positive and control for negative peer influence.
Scott, Melanie C; Easton, Caroline J
It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.
Alicia K. Matthews
Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.
Joe, George W; Becan, Jennifer E; Knight, Danica K; Flynn, Patrick M
A number of program-level and counselor-level factors are known to impact the adoption of treatment innovations. While program leadership is considered a primary factor, the importance of leadership among clinical staff to innovation transfer is less known. Objectives included explore (1) the influence of two leadership roles, program director and individual counselor, on recent training activity and (2) the relationship of counselor attributes on training endorsement. The sample included 301 clinical staff in 49 treatment programs. A structural equation model was evaluated for key hypothesized relationships between exogenous and endogenous variables related to the two leadership roles. The importance of organizational leadership, climate, and counselor attributes (particularly counseling innovation interest and influence) to recent training activity was supported. In a subset of 68 counselors who attended a developer-led training on a new intervention, it was found that training endorsement was higher among those with high innovation interest and influence. The findings suggest that each leadership level impacts the organization in different ways, yet both can promote or impede technology transfer.
An onsite treatment planning computer has become state of the art in the care of radiation therapy patients, but in most installations the computer is used for therapy planning a diminutive amount of the day. At St. Mary's Hospital, arrangements have been negotiated for part time use of the treatment planning computer for health physics purposes. Computerized Medical Systems, Inc. (CMS) produces the Modulex radiotherapy planning system which is programmed in MUMPS, a user oriented language specially adapted for handling text string information. St. Mary's Hospital's CMS computer has currently been programmed to assist in data collection and write-up of diagnostic x-ray surveys, meter calibrations, and wipe/leak tests. The computer is setup to provide timely reminders of tests and surveys, and billing for consultation work. Programs are currently being developed for radionuclide inventories. Use of a therapy planning computer for health physics purposes can enhance the radiation safety program and provide additional grounds for the acquisition of such a computer system
Branham, Douglas Keith
Prescription drug abuse has become a major issue in the United States in recent years. Prescription drug monitoring programs (PDMPs) are designed to help health care providers to prevent such abuses. There may be unintended effects of these programs. Specifically, PDMPs may move prescription opioid users to begin use of heroin. This article aims to evaluate the impact of PDMPs on heroin abuse across several different states through use of treatment admissions records obtained from the Treatment Episode Data Set. Operational dates and other characteristics of state PDMPs were obtained from the Prescription Drug Monitoring Program Training and Technical Assistance Center. Data for the dependent variable were collected from the Treatment Episodes Data Set from 1992 to 2012. Interrupted time-series analyses using autoregressive integrated moving average modeling were used to estimate the effect of presence of an operational PDMP on the number of admissions reporting heroin as their primary drug being used. The relationship between heroin admissions and prescription opioid admissions was significant for the average data (β = 0.41, p = 0.0017) and the 5-year data (β = 0.5, p = 0.036), both showing positive associations between heroin and prescription drug admissions in states in the post PDMP implementation period. Conclusions/Importance: The study found a positive relationship that between heroin and prescription opioid admissions post PDMP implementation. Future research should attempt to identify what this relationship means and how this information can be used to improve opioid policy.
Avalos, Lyndsay A; Raine-Bennett, Tina; Chen, Hong; Adams, Alyce S; Flanagan, Tracy
To evaluate whether universal prenatal and early postnatal screening for depression leads to increased detection, subsequent intervention, and improved depressive symptom outcomes. We conducted a population-based retrospective cohort study of 97,678 pregnant Kaiser Permanente Northern California members during three phases of the Universal Perinatal Depression Screening Program (preimplementation, rollout, fully implemented) from 2007 through 2014. Depression screening scores (Patient Health Questionnaire-9), depression diagnoses, individual counseling visits, demographic characteristics, and medication dispensings were extracted from electronic health records and pharmacy databases. The percentage of women screened, new depression diagnoses, and women receiving treatment were compared among the three phases (tests of trend). Changes in depressive symptom scores up to 6 months postpartum were assessed (rollout and fully implemented phases). A significant increase emerged in the percentage of women screened over the three phases ranging from less than 1% (n=122) (preimplementation) to 98% (n=41,124) (fully implemented) (PHealth Questionnaire-9 scores of 15 or greater (greater severity), highlighting an increase in expected percentage of women receiving treatment (5.9% [preimplementation] to 81.9% [fully implemented]; Puniversal perinatal depression screening programs regarding depression identification and treatment receipt and suggest improvement in symptom outcomes for women in screening programs, especially among integrated health care systems.