Prevalence of syphilis among female sex workers and their clients in Togo in 2011

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Wemboo Afiwa Halatoko

2017-02-01

Full Text Available Abstract Background During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs, from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs and their clients in Togo. Methods We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing. Results In total, 1,836 participants (1,106 FSWs and 730 clients were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82. This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR =5.03; 95% CI [1.95-13.49]. Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]. Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]. Out of the 1,836 participants of the survey, 165 (8.9% were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]. Conclusion This study showed that: i the prevalence of syphilis among FSWs and their clients was high; ii syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.

Prevalence of syphilis among female sex workers and their clients in Togo in 2011.

Science.gov (United States)

Halatoko, Wemboo Afiwa; Landoh, Dadja Essoya; Saka, Bayaki; Akolly, Koffi; Layibo, Yao; Yaya, Issifou; Gbetoglo, Dodji; Banla, Abiba Kere; Pitché, Palokinam

2017-02-21

During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs), from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs) and their clients in Togo. We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing. In total, 1,836 participants (1,106 FSWs and 730 clients) were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82). This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR) =5.03; 95% CI [1.95-13.49]). Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]). Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]). Out of the 1,836 participants of the survey, 165 (8.9%) were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]). This study showed that: i) the prevalence of syphilis among FSWs and their clients was high; ii) syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.

Communicative principles among corporate clients and regional branches of commercial banks

OpenAIRE

Asie TSINTSADZE; Lela ONIANI

2014-01-01

The aim of this article is to discuss the share of consumption taken by the corporate clients in the autonomous republic of Adjara. It is remarkable that the most of the share of banks’ total incomes are formed exactly on the base of accumulated resource accounts of corporate clients. So in order to attract corporate clients in the region, there is a great and strong competition among the banks. According to the above mentioned information, we are discussing several principles concerning to t...

Discrimination against Obese Exercise Clients: An Experimental Study of Personal Trainers.

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

2018-01-01

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

Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

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

2015-03-01

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

Impact of food pantry donations on diet of a low-income population.

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Mousa, Tamara Y; Freeland-Graves, Jean H

2018-04-27

This cross-sectional study assessed the effect of food donations on total nutrient intake of clients of a food pantry in Central Texas. Nutrient intakes of total, base and food donation diets were estimated for 112 food pantry recipients using specific questionnaires; and then compared to the dietary reference intakes (DRI) and 2015-2020 US Dietary Guidelines. Food donations accounted for more than half of the client's daily intake of energy, carbohydrates, vitamin B 6 , phosphorus, copper and selenium. Yet, daily total intake remained less than their DRIs for carbohydrates, poly-unsaturated fats, dietary fiber, fat soluble vitamins and vitamin C, and was even lower for calcium, magnesium and potassium. Total food intake of clients almost met the US Dietary Guidelines for refined grains, fruits, vegetables, and meat; however, the amount of whole grains and dairy was inadequate. Supplemental foods offered at food pantries are an important resource for improving nutrient intake of low-income populations.

Sexual behaviours of clients of sex workers reported within phone calls at HIV/AIDS/STIs Italian Helpline

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Ilaria Mulieri

2013-06-01

Full Text Available BACKGROUND: Clients of sex workers represent a relevant target for interventions aimed at the prevention of HIV and sexually transmitted infections (STIs. Within prevention strategies, the AIDS and sexually transmitted infections helpline (Telefono Verde AIDS/ IST, TVA-IST of National Institute of Health in Italy has provided, since 1987, specific information and counselling interventions. AIM: The present study reports data on anagraphical characteristics and behaviours of clients of sex workers, anonymously reported at TVA-IST in the period 1987-2010. DISCUSSION: Among 95 149 phone calls (14% of the total considered 99.5% came from males, over 80% aged under 37 years and prevalently from Northern Italy. Among sexual behaviours, unprotected sexual intercourses were reported in the 26% of the calls. Subjects under 27 years reported a higher frequency of unprotected anal intercourse, while they used protection with oral and vaginal intercourses in a greater extent than older ones. Due to differential behaviours within clients of sex workers, specific informative strategies for this targeted population should adequately consider age-related differences.

Model-based estimation of finite population total in stratified sampling

African Journals Online (AJOL)

The work presented in this paper concerns the estimation of finite population total under model – based framework. Nonparametric regression approach as a method of estimating finite population total is explored. The asymptotic properties of the estimators based on nonparametric regression are also developed under ...

La contrainte client

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Guillaume Tiffon

2011-04-01

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

Clients of sex workers in Switzerland: it makes sense to counsel and propose rapid test for HIV on the street, a preliminary report.

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Diserens, Esther-Amélie; Bodenmann, Patrick; N'Garambe, Chantal; Ansermet-Pagot, Anne; Vannotti, Marco; Masserey, Eric; Cavassini, Matthias

2010-03-19

Clients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. For 5 evenings, clients in cars were stopped by trained field staff for face-to-face interviews focusing on sex-related HIV risk behaviors and HIV testing history. The clients were then offered a free anonymous rapid HIV test in a bus parked nearby. Rapid HIV testing and counselling were performed by experienced nurse practitioners. Clients with reactive tests were offered confirmatory testing, medical evaluation, and care in our HIV clinic. We intercepted 144 men, 112 (77.8%) agreed to be interviewed. Among them, 50 (46.6%) had never been tested for HIV. A total of 31 (27.7%) rapid HIV tests were performed, 16 (51.6%) in clients who had not previously been tested. None were reactive. Initially, 19 (16.9%) additional clients agreed to HIV testing but later declined due to the 40-minute queue for testing. This pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate. This setting seems particularly appropriate for targeted HIV screening, since more than 40% of the clients had not previously been tested for HIV even though they engaged in sex-related HIV risk behaviour.

Report on Provider-Client Interaction From 68 Methadone Maintenance Clinics in China.

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Li, Li; Comulada, W Scott; Lin, Chunqing; Lan, Chiao-Wen; Cao, Xiaobin; Wu, Zunyou

2017-11-01

Provider-client interaction is an integral of clinical practice and central to the delivery of high-quality medical care. This article examines factors related to the provider-client interaction in the context of methadone maintenance treatment (MMT). Data were collected from 68 MMT clinics in China. In total, 418 service providers participated in the survey. Linear mixed effects regression models were performed to identify factors associated with provider-client interaction. It was observed that negative attitude toward drug users was associated with lower level of provider-client interaction and less time spent with each client. Other factors associated with lower level of interaction included being female, being younger, being a nurse, and fewer years in medical field. Higher provider-client interaction was associated with provider reported job satisfaction. The findings of this study call for a need to address provider negative attitudes that can impact provider-client interaction and the effectiveness of MMT. Future intervention efforts targeting MMT providers should be tailored by gender, provider type, and medical experiences.

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

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Boghosian, Sara

2011-01-01

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

headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting?

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Rickwood, Debra J; Telford, Nic R; Parker, Alexandra G; Tanti, Chris J; McGorry, Patrick D

2014-02-03

To provide the first national profile of the characteristics of young people (aged 12-25 years) accessing headspace centre services - the Australian Government's innovation in youth mental health service delivery - and investigate whether headspace is providing early service access for adolescents and young adults with emerging mental health problems. Census of all young people accessing a headspace centre across the national network of 55 centres comprising a total of 21 274 headspace clients between 1 January and 30 June 2013. Reason for presentation, Kessler Psychological Distress Scale, stage of illness, diagnosis, functioning. Young people were most likely to present with mood and anxiety symptoms and disorders, self-reporting their reason for attendance as problems with how they felt. Client demographic characteristics tended to reflect population-level distributions, although clients from regional areas and of Aboriginal and Torres Strait Islander background were particularly well represented, whereas those who were born outside Australia were underrepresented. headspace centres are providing a point of service access for young Australians with high levels of psychological distress and need for care in the early stages of the development of mental disorder.

Counselor Responsiveness to Client Religiousness.

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Kelly, Eugene W., Jr.

1990-01-01

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

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

NARCIS (Netherlands)

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

2006-01-01

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

Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

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Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

2015-01-01

To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the

Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness.

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

2016-05-01

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

High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam.

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Nadol, Patrick; Hoang, Tran Vu; Le, Linh-Vi; Nguyen, Tuan Anh; Kaldor, John; Law, Matthew

2017-08-01

In Vietnam's concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a 'bridge' of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam's largest cities, in 2013-2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0-27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2-47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across 'bridging' categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87-7.56), current opioid use (OR 2.55; 95% CI 1.02-6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46-19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These

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

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Megan M McLaughlin

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

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

OpenAIRE

Zavadska Diana V.

2015-01-01

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

Open client/server computing and middleware

CERN Document Server

Simon, Alan R

2014-01-01

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

Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.

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Janse, Pauline D; De Jong, Kim; Van Dijk, Maarten K; Hutschemaekers, Giel J M; Verbraak, Marc J P M

2017-09-01

Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback. Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer. Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.

The Choice of Contraceptive Method among New Clients attending ...

African Journals Online (AJOL)

Background Nigeria is Africa's most populous state with a low rate of contraceptive use. Factors affecting the method of contraception chosen vary widely across different parts of the country. We studied the preferred methods and characteristics of new clients attending a family planning clinic in a teaching hospital in ...

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

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Bernat Gel Moreno

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

Development of a Nutrition Education Intervention for Food Bank Clients.

Science.gov (United States)

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

2017-03-01

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

The total satellite population of the Milky Way

Science.gov (United States)

Newton, Oliver; Cautun, Marius; Jenkins, Adrian; Frenk, Carlos S.; Helly, John C.

2018-05-01

The total number and luminosity function of the population of dwarf galaxies of the Milky Way (MW) provide important constraints on the nature of the dark matter and on the astrophysics of galaxy formation at low masses. However, only a partial census of this population exists because of the flux limits and restricted sky coverage of existing Galactic surveys. We combine the sample of satellites recently discovered by the Dark Energy Survey (DES) survey with the satellites found in Sloan Digital Sky Survey (SDSS) Data Release 9 (together these surveys cover nearly half the sky) to estimate the total luminosity function of satellites down to MV = 0. We apply a new Bayesian inference method in which we assume that the radial distribution of satellites independently of absolute magnitude follows that of subhaloes selected according to their peak maximum circular velocity. We find that there should be at least 124^{+40}_{-27}(68% CL, statistical error) satellites brighter than MV = 0 within 300kpc of the Sun. As a result of our use of new data and better simulations, and a more robust statistical method, we infer a much smaller population of satellites than reported in previous studies using earlier SDSS data only; we also address an underestimation of the uncertainties in earlier work by accounting for stochastic effects. We find that the inferred number of faint satellites depends only weakly on the assumed mass of the MW halo and we provide scaling relations to extend our results to different assumed halo masses and outer radii. We predict that half of our estimated total satellite population of the MW should be detected by the Large Synoptic Survey Telescope (LSST). The code implementing our estimation method is available online.†

The Competitive Advantage: Client Service.

Science.gov (United States)

Leffel, Linda G.; DeBord, Karen B.

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

Understanding the working alliance with clients diagnosed with anorexia nervosa.

Science.gov (United States)

Oyer, Laura; O'Halloran, Mary Sean; Christoe-Frazier, Liesel

2016-01-01

The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment.

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Science.gov (United States)

Boness, Cassandra L.

2016-01-01

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the APA’s Ethics Code and other relevant issues (e.g., ADA) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population. PMID:27917030

Medicare home health: a description of total episodes of care.

Science.gov (United States)

Branch, L G; Goldberg, H B; Cheh, V A; Williams, J

1993-01-01

The purpose of this study was to present descriptive information on the characteristics of 2,873 Medicare home health clients, to quantify systematically their patterns of service utilization and allowed charges during a total episode of care, and to clarify the bivariate associations between client characteristics and utilization. The model client was female, 75-84 years of age, living with a spouse, and frail based on a variety of indicators. The mean total episode was approximately 23 visits, with allowed charges of $1,238 (1986 dollars). Specific subgroups of clients, defined by their morbidities and frailties, used identifiable clusters of services. Implications for case-mix models and implications for capitation payments under health care reform are discussed.

Chaperone-client complexes: A dynamic liaison

Science.gov (United States)

Hiller, Sebastian; Burmann, Björn M.

2018-04-01

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

Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

Science.gov (United States)

Lloyd, Belinda; Zahnow, Renee; Barratt, Monica J; Best, David; Lubman, Dan I; Ferris, Jason

2017-11-01

Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site.

Science.gov (United States)

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

2015-10-01

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

Team-client Relationships And Extreme Programming

Directory of Open Access Journals (Sweden)

John Karn

2008-01-01

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

Anxiety in mammography: mammographers' and clients' perspectives

International Nuclear Information System (INIS)

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

2003-01-01

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

Population dynamics of active and total ciliate populations in arable soil amended with wheat

DEFF Research Database (Denmark)

Ekelund, F.; Frederiksen, Helle B.; Ronn, R.

2002-01-01

of the population may be encysted. The factors governing the dynamics of active and encysted cells in the soil are not well understood. Our objective was to determine the dynamics of active and encysted populations of ciliates during the decomposition of freshly added organic material. We monitored, in soil...... microcosms, the active and total populations of ciliates, their potential prey (bacteria and small protozoa), their potential competitors (amoebae, flagellates, and nematodes), and their potential predators (nematodes). We sampled with short time intervals (2 to 6 days) and generated a data set, suitable...

Prevalence and Predictors of Self-Reported Consistent Condom Usage among Male Clients of Female Sex Workers in Tamil Nadu, India

Science.gov (United States)

Charles, Bimal; Sam, Asirvatham Edwin

2014-01-01

Clients of female sex workers (FSWs) possess a high potential of transmitting HIV and other sexually transmitted infections from high risk FSWs to the general population. Promotion of safer sex practices among the clients is essential to limit the spread of HIV/AIDS epidemic. The aim of this study is to estimate the prevalence of consistent condom use (CCU) among clients of FSWs and to assess the factors associated with CCU in Tamil Nadu. 146 male respondents were recruited from the hotspots who reportedly had sex with FSWs in exchange for cash at least once in the past one month. Data were analyzed using bivariate and multivariate methods. Overall, 48.6 and 0.8 percent clients consistently used condoms in the past 12 months with FSWs and regular partners, respectively. Logistic regression showed that factors such as education, peers' use of condoms, and alcohol consumption significantly influenced clients' CCU with FSWs. Strategies for safe sex-behaviour are needed among clients of FSWs in order to limit the spread of HIV/AIDS epidemic in the general population. The role of peer-educators in experience sharing and awareness generation must also be emphasized. PMID:26316978

Call center. Centrados en el cliente

OpenAIRE

Leal-Alonso-de-Castañeda, José Enrique

2003-01-01

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

PATRON-CLIENT RELATIONSHIP PADA MASYARAKAT MADURA

OpenAIRE

Mohammad Hefni

2012-01-01

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

Developing a Culturally Appropriate HIV and Hepatitis C Prevention Intervention for Latino Criminal Justice Clients.

Science.gov (United States)

Ibañez, Gladys E; Whitt, Elaine; Rosa, Mario de la; Martin, Steve; O'Connell, Daniel; Castro, Jose

2016-07-01

The population within the criminal justice system suffers from various health disparities including HIV and hepatitis C virus (HCV). African American and Latino offenders represent the majority of the offender population. Evidence-based interventions to prevent HIV and HCV among criminal justice clients are scant and usually do not take cultural differences into account. Toward this end, this study describes the process of culturally adapting an HIV/HCV prevention intervention for Latino criminal justice clients in Miami, Florida, by using the ecological validity model. Recommendations for culturally adapting an intervention for Latinos include an emphasis on language and integrating cultural themes such as familism and machismo. © The Author(s) 2016.

How to reach clients of female sex workers: a survey by surprise in brothels in Dakar, Senegal.

Science.gov (United States)

Espirito Santo, M. E. Gomes do; Etheredge, G. D.

2002-01-01

OBJECTIVE: To describe the sampling techniques and survey procedures used in identifying male clients who frequent brothels to buy sexual services from female sex workers in Dakar, Senegal, with the aim of measuring the prevalence of human immunodeficiency virus (HIV) infection and investigating related risk behaviours. METHODS: Surveys were conducted in seven brothels in Dakar, Senegal. Clients were identified "by surprise" and interviewed and requested to donate saliva for HIV testing. RESULTS: Of the 1450 clients of prostitutes who were solicited to enter the study, 1140 (79.8%) agreed to be interviewed; 1083 (95%) of these clients provided saliva samples for testing. Of the samples tested, 47 were positive for HIV-1 or HIV-2, giving an HIV prevalence of 4.4%. CONCLUSION: The procedures adopted were successful in reaching the target population. Men present in the brothels could not deny being there, and it proved possible to explain the purpose of the study and to gain their confidence. Collection of saliva samples was shown to be an excellent method for performing HIV testing in difficult field conditions where it is hard to gain access to the population under study. The surveying of prostitution sites is recommended as a means of identifying core groups for HIV infection with a view to targeting education programmes more effectively. In countries such as Senegal, where the prevalence of HIV infection is still low, interventions among commercial sex workers and their clients may substantially delay the onset of a larger epidemic in the general population. PMID:12378288

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

International Nuclear Information System (INIS)

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

1983-01-01

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

Prioritizing the client trust factors in electronic banking using analytic hierarchy process

Directory of Open Access Journals (Sweden)

Hossein vazifedust

2014-04-01

Full Text Available This paper prioritizes the trust factors among electronic banking clients of an Iranian bank named Parsian Bank. The study first analyzes and reviews the literature and interviews with experts of electronic banking and academicians and determines client trust as the most important factor for development of electronic banking. The study also determines different factors associated with trust, which includes individual factors, banking factors and infrastructural factors. The sample populations consist of 25 experts who are academicians, managers and bank officers, clients of electronic banking. The necessary data was collected through conducting interviews and questionnaires and they are analyzed using analytic hierarchy process (AHP. The research findings indicate that the attitudinal factors, telecommunication infrastructure and cultural factors were the most influential factors accordingly and the customer orientation and ease of access were the least influential factors.

Negotiating the Client-Based Capstone Experience

Science.gov (United States)

Reifenberg, Steve; Long, Sean

2017-01-01

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

Four different types of client attitudes towards purchasing spectacles in optometric practice

Science.gov (United States)

Fylan, Fiona; Grunfeld, Elizabeth A; Turvey, Andrew; Desallais, Jacques

2005-01-01

Abstract Background  Unmet expectations are a major cause of client dissatisfaction, yet very little is known about the expectations and health values that clients in optometry practice hold about having an eye examination and purchasing spectacles. This study identified different attitudes and behaviours held by presbyope clients in optometric practices. Method  A total of 158 presbyope clients, recruited from 14 practices, completed a questionnaire which was developed from the theory of planned behaviour. The questionnaire examined attitudes towards spectacles and visiting the optician, motivation to visit the optician, perceptions of barriers to attending the opticians, information requirements, and preferences for shared decision‐making. Responses were analysed using principal components analysis. Results and Conclusions  Four factors were identified, which were labelled style, vision, avoiding and seeking. Style is concerned with the importance of appearing fashionable or stylish, and desiring approval from others. Vision relates to clients’ attitudes towards obtaining clear vision and to maintaining healthy eyesight. Avoiding describes the perceived difficulties associated with visiting the optician and purchasing new spectacles. Seeking corresponds to the desire for information on the technical details of lenses. Practitioners could use these characteristics to tailor information to meet the needs and address the expectations of individual clients. This may make the information provided more personally relevant, and could enhance client satisfaction. PMID:15713167

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

Directory of Open Access Journals (Sweden)

François Moors

2017-10-01

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

Smoking and its treatment in addiction services: clients' and staff behaviour and attitudes.

Science.gov (United States)

Cookson, Camilla; Strang, John; Ratschen, Elena; Sutherland, Gay; Finch, Emily; McNeill, Ann

2014-07-14

High smoking prevalence has been observed among those misusing other substances. This study aimed to establish smoking behaviours and attitudes towards nicotine dependence treatment among clients and staff in substance abuse treatment settings. Cross-sectional questionnaire survey of staff and clients in a convenience sample of seven community and residential addiction services in, or with links to, Europe's largest provider of mental health care, the South London and Maudsley NHS Foundation Trust. Survey items assessed smoking behaviour, motivation to quit, receipt of and attitudes towards nicotine dependence treatment. Eighty five percent (n = 163) and 97% (n = 145) response rates of clients and staff were achieved. A high smoking prevalence was observed in clients (88%) and staff (45%); of current smokers, nearly all clients were daily smokers, while 42% of staff were occasional smokers. Despite 79% of clients who smoked expressing a desire to quit and 46% interested in receiving advice, only 15% had been offered support to stop smoking during their current treatment episode with 56% reported never having been offered support. Staff rated smoking treatment significantly less important than treatment of other substances (p smoking cessation interventions to an extraordinarily high prevalence population of smokers in addiction services. This is despite the majority of smokers reporting motivation to quit. Staff smoking and attitudes may be a contributory factor in these findings.

Measuring participation of social-support clients: : validity and reliability of IPA-MO

NARCIS (Netherlands)

Berenschot, L.; Grift, Y.K.

2017-01-01

This study evaluates the reliability and validity of the Impact on Autonomy and Participation instrument (IPA) for heterogeneous populations of social support clients. Decentralisation of social support and accompanying budget cuts spurred interest in outcome-related payment systems to foster

14 CFR 1261.317 - Attorney-client privilege.

Science.gov (United States)

2010-01-01

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

Attitudes toward Substance Abuse Clients: An Empirical Study of Clinical Psychology Trainees.

Science.gov (United States)

Mundon, Chandra R; Anderson, Melissa L; Najavits, Lisa M

2015-01-01

Despite the high prevalence of substance use disorder (SUD) and its frequent comorbidity with mental illness, individuals with SUD are less likely to receive effective SUD treatment from mental health practitioners than SUD counselors. Limited competence and interest in treating this clinical population are likely influenced by a lack of formal training in SUD treatment. Using a factorial survey-vignette design that included three clinical vignettes and a supplementary survey instrument, we investigated whether clinical psychology doctoral students differ in their level of negative emotional reactions toward clients with SUD versus major depressive disorder (MDD); whether they differ in their attributions for SUD versus MDD; and how their negative emotional reactions and attributions impact their interest in pursuing SUD clinical work. Participants were 155 clinical psychology graduate-level doctoral students (72% female). Participants endorsed more negative emotional reactions toward clients with SUD than toward clients with MDD. They were also more likely to identify poor willpower as the cause for SUD than for MDD. More than a third reported interest in working with SUD populations. Highest levels of interest were associated with prior professional and personal experience with SUD, four to six years of clinical experience, and postmodern theoretical orientation.

32 CFR 776.4 - Attorney-client relationships.

Science.gov (United States)

2010-07-01

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

49 CFR 1103.23 - Confidences of a client.

Science.gov (United States)

2010-10-01

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

Characterizing fentanyl use in methadone-maintained clients.

Science.gov (United States)

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

2017-04-01

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

Interactive Effects of Counselor-Client Similarity and Client Self-Esteem on Termination Type and Number of Sessions.

Science.gov (United States)

Berry, G. William; Sipps, Gary J.

1991-01-01

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

The Client Risk and The Audit Planning: Influence of Acceptance of Audit Engagement

Directory of Open Access Journals (Sweden)

Deby Suryani

2018-03-01

Full Text Available This study briefly aims to extend the relationship between client risks with the audit planning by proposes the acceptance of audit engagement as a mediate variable to fill a gap research, furthermore to determine the effect of client risk toward the audit planning in Public Accounting Firm in Jakarta, Indonesia. This research is a quantitative causal with primary data obtained by questionnaires. The population of this study is the auditors of Public Accounting Firm registered in the Directory Indonesian Institute of Accountants (Certified 2016 in Jakarta and to obtain the sample used purposive sampling technique and obtained samples of 197 respondents from 45 Public Accounting Firms spread in Jakarta. The analysis of data is using Structural Equation Modeling. The results of this research shows; (1. The Client risks directly may affect the audit planning in a positive but not significantly, (2. The Client risk directly affects the acceptance of audit positively and significantly, (3. The acceptance of audit engagement has positively and significantly influence on audit planning. Therefore the acceptance of audit engagement perfectly can act as mediate variable between client's risks with the audit planning, whereas the acceptance of audit engagement indicated by Time Budget Pressure, Audit Fee. Letter of Auditing and all indicator have a high loading factor.

Client Involvement in Home Care Practice

DEFF Research Database (Denmark)

Glasdam, Stinne; Henriksen, Nina; Kjær, Lone

2013-01-01

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

31 CFR 10.28 - Return of client's records.

Science.gov (United States)

2010-07-01

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

A cross-sectional survey of attitudes to HIV risk and rapid HIV testing among clients of sex workers in Switzerland.

Science.gov (United States)

Darling, Katharine E A; Diserens, Esther-Amélie; N'garambe, Chantal; Ansermet-Pagot, Anne; Masserey, Eric; Cavassini, Matthias; Bodenmann, Patrick

2012-10-01

To assess attitudes to HIV risk and acceptability of rapid HIV testing among clients of street-based female sex workers (FSW) in Lausanne, Switzerland, where HIV prevalence in the general population is 0.4%. The authors conducted a cross-sectional study in the red light district of Lausanne for five nights in September of 2008, 2009 and 2010. Clients of FSW were invited to complete a questionnaire in the street assessing demographic characteristics, attitudes to HIV risk and HIV testing history. All clients interviewed were then offered anonymous finger stick rapid HIV testing in a van parked on-site. The authors interviewed 112, 127 and 79 clients in 2008, 2009 and 2010, respectively. All were men, average age 32-37 years old; 40-60% were in a stable relationship. History of unprotected sex was higher with non-commercial partners (33-50%) than with FSW (6-11%); 29-46% of clients had never undergone an HIV test. Anonymous rapid HIV testing was accepted by 45-50% of clients. Out of 109 HIV tests conducted during the three study periods, none was reactive. On-site HIV counselling and testing is acceptable among clients of FSW in this urban setting. These individuals represent an unquantified population, a proportion of which has an incomplete understanding of HIV risk in the face of high-risk behaviour, with implications for potential onward transmission to non-commercial sexual partners.

Podemos fidelizar clientes inicialmente insatisfechos

Directory of Open Access Journals (Sweden)

Jesús Cambra-Fierro

2011-01-01

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

Xerostomia among older home care clients.

Science.gov (United States)

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

2016-06-01

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

Client Motivation for Therapy Scale: a measure of intrinsic motivation, extrinsic motivation, and amotivation for therapy.

Science.gov (United States)

Pelletier, L G; Tuson, K M; Haddad, N K

1997-04-01

The purpose of this study was to examine the psychometric properties of a new measure of client motivation for therapy, the Client Motivation for Therapy Scale. This scale is designed to measure client's Intrinsic Motivation, four forms of regulation for Extrinsic Motivation (integrated, identified, introjected, and external regulation), and Amotivation for therapy. These subscales correspond to different forms of motivation identified by Deci and Ryan (1985) and fall along a self-determination continuum. An experimental version of the scale, along with related scales, was distributed to a total sample of 138 clients involved in therapy. The results supported the factor structure of the scale and revealed a satisfactory level of internal consistency. Correlations among the subscales revealed a simplex pattern that, in general, provides support for the self-determination continuum and the construct validity of the scale. Implications for research on client motivation for therapy are discussed.

Health service utilisation and investigations before diagnosis of cancer of unknown primary (CUP): A population-based nested case-control study in Australian Government Department of Veterans' Affairs clients.

Science.gov (United States)

Vajdic, Claire M; Schaffer, Andrea L; Dobbins, Timothy A; Ward, Robyn L; Er, Chuang C; Pearson, Sallie-Anne

2015-08-01

Population-based data on the use of health services and diagnostic investigations for patients with cancer of unknown primary (CUP) is scarce. It is uncertain whether the pathways to diagnosis are different for CUP compared to other cancers. We performed a population-based nested matched case-control study using linked routinely collected records for Australian Government Department of Veterans' Affairs clients, 2004-2007. We compared health care consultations, hospitalisations, emergency department visits, and diagnostic procedures in the three months prior and the month of diagnosis for 281 clients registered with a diagnosis of CUP (C809) and 1102 controls randomly selected from clients registered with a first diagnosis of metastatic cancer of known primary. Overall, the median age at cancer diagnosis was 83 years. CUP patients were slightly older and had significantly more comorbidities prior to diagnosis than those with known primary. Compared to known primary, a diagnosis of CUP was significantly more likely after an emergency department visit, less specialist input, fewer invasive diagnostic procedures such as resection or endoscopy, and more non-invasive procedures such as magnetic resonance imaging. There were no differences in primary care or allied health consultations and hospitalisations. This health care pathway suggests delayed recognition of cancer and scope for improvement in the medical management of high-risk individuals presenting to primary care. The pattern of diagnostic investigations reveals under-investigation in some CUP patients but this is likely to reflect recognition of limited treatment options and poor prognosis and is consistent with clinical guidelines. Copyright © 2015 Commonwealth of Australia. Published by Elsevier Ltd.. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Nedim Makarevic

2016-01-01

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

Clients' and therapists' stories about psychotherapy.

Science.gov (United States)

Adler, Jonathan M

2013-12-01

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

[On the clients of public health organizations].

Science.gov (United States)

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

2004-01-01

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

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

Directory of Open Access Journals (Sweden)

Dianne McGrath

2018-04-01

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

The network of corporate clients: customer attrition at commercial banks

Science.gov (United States)

Lublóy, Á.; Szenes, M.

2008-12-01

Commercial banks might profit from the adoption of methods widely used in network theory. A decision making process might become biased if one disregards network effects within the corporate client portfolio. This paper models the phenomenon of customer attrition by generating a weighted and directed network of corporate clients linked by financial transactions. During the numerical study of the agent-based toy model we demonstrate that multiple steady states may exist. The statistical properties of the distinct steady states show similarities. We show that most companies of the same community choose the same bank in the steady state. In contrast to the case for the steady state of the Barabási-Albert network, market shares in this model equalize by network size. When modeling customer attrition in the network of 3 × 105 corporate clients, none of the companies followed the behavior of the initial switcher in three quarters of the simulations. The number of switchers exceeded 20 in 1% of the cases. In the worst-case scenario a total of 688 companies chose a competitor bank. Significant network effects have been discovered; high correlation prevailed between the degree of the initial switcher and the severity of the avalanche effect. This suggests that the position of the corporate client in the network might be much more important than the underlying properties (industry, size, profitability, etc) of the company.

49 CFR 1103.22 - Restraining clients from improprieties.

Science.gov (United States)

2010-10-01

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

Disparities in HIV and syphilis prevalence and risk factors between older male clients with and without steady sex partners in southwestern rural China.

Science.gov (United States)

Chen, Li; His, Jenny H; Wu, Xinghua; Shen, Zhiyong; Lu, Huaxiang; Chen, Huanhuan; Huang, Hui; Zhang, Heng; Ruan, Yuhua; Shao, Yiming; Tang, Zhenzhu

2017-04-12

Heterosexual intercourse accounted for 93% of reported HIV cases in Guangxi, and Guangxi had 10% of China's total number of reported HIV cases. Older men are particularly vulnerable to STIs, for example, 46% of Guangxi's HIV cases were men over 50 years of age. As this is an under-studied population in China, effective prevention and control policies have yet to be developed. Thus, the aim of this study was to use a large-scale cross-sectional survey to understand the demographic and behavior factors associated with HIV and syphilis infections among older male clients of female sex workers (FSWs) in a high epidemic area of rural Guangxi, China. A large-scale cross-sectional survey was conducted in 2012 among older male clients of FSWs in low-cost commercial sex venues. Questionnaire interviews were administered to collect sociodemographic and sexual behavior information. Blood samples were collected for HIV and syphilis infection tests. Of the 3485 participants, 2509 (72.0%) clients had a steady sex partner and 976 (28.0%) clients had no steady sex partner. The overall prevalence of HIV and syphilis infection were 3.0% and 3.2%, respectively. Compared to those with a steady sex partner, clients with no steady partner had higher odds of HIV infection (AOR: 1.90, 95% CI: 1.27-2.86), syphilis infection (AOR: 1.53, 95% CI: 1.02-2.30), and having factors associated with HIV or syphilis infection, including non-commercial casual sex encounters in last month (AOR: 3.29, 95% CI: 2.42-4.46), >10 years of commercial sex history (AOR: 1.31, 95% CI: 1.12-1.53), >2 incidents of commercial sex in last month (AOR: 1.53, 95% CI: 1.19-1.96), and aphrodisiac use in last month (AOR: 1.40, 95% CI: 1.16-1.70). Clients with no steady partner had lower odds of having heterosexual intercourse (AOR: 0.66, 95% CI: 0.56-0.79), awareness and knowledge of HIV/AIDS (AOR: 0.75, 95% CI: 0.64-0.88), and having had HIV tests (AOR: 0.65, 95% CI: 0.44-0.98). Older male clients of low

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

Directory of Open Access Journals (Sweden)

Júlia Duran

2004-12-01

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

29 CFR 402.11 - Attorney-client communications exempted.

Science.gov (United States)

2010-07-01

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

29 CFR 403.9 - Attorney-client communications exempted.

Science.gov (United States)

2010-07-01

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

32 CFR 776.33 - Client under a disability.

Science.gov (United States)

2010-07-01

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

29 CFR 404.5 - Attorney-client communications exempted.

Science.gov (United States)

2010-07-01

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

42 CFR 483.420 - Condition of participation: Client protections.

Science.gov (United States)

2010-10-01

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

31 CFR 10.21 - Knowledge of client's omission.

Science.gov (United States)

2010-07-01

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

Uncovering client retention antecedents in service organizations

Directory of Open Access Journals (Sweden)

Mari Jansen van Rensburg

2014-01-01

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

Client Contacts Improve Quality of Copywriting.

Science.gov (United States)

McCann, Guy

1988-01-01

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

Group Work with Transgender Clients

Science.gov (United States)

Dickey, Lore M.; Loewy, Michael I.

2010-01-01

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

45 CFR 1608.7 - Attorney-client relationship.

Science.gov (United States)

2010-10-01

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

Can retail banking clients' attrition be managed?

Directory of Open Access Journals (Sweden)

Agaliotis Konstantinos

2015-01-01

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

HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China.

Science.gov (United States)

Zhu, Jing; Yuan, Rui; Hu, Dan; Zhu, Zhibin; Wang, Ning; Wang, Bei

2018-04-01

Female sex workers (FSWs) and their male clients are vulnerable to HIV infection and serve as a bridge in HIV transmission from the high-risk population to the general, low-risk population. To examine the factors of FSWs and male clients that correlate with the prevalence of HIV infection in the Chinese-Vietnamese border region, a cross-sectional survey was conducted in 2014 in the Hekou county of the Yunnan province of China. We performed a questionnaire survey to collect data on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections and drug use. We found that the prevalence of HIV infection among FSWs was 2.74%, and 15 male clients (2.62%) were HIV-positive. Multivariate logistic regression analysis revealed that herpes simplex virus type 2 infection was a risk factor for HIV infection in FSWs and male clients, suggesting the increased role of sexual transmission in the HIV epidemic in the Chinese-Vietnamese border region. Positive urinalysis result for amphetamine-type stimulants was observed in FSWs with HIV infection. History of drug use was correlated with HIV infection, which increased the HIV infection risk of male clients, confirming that drug use is an important target in future interventions for HIV prevention.

Prenatal screening for congenital anomalies: exploring midwives' perceptions of counseling clients with religious backgrounds.

Science.gov (United States)

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

2014-07-19

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

The meaning and experience of stress among supported employment clients with mental health problems.

Science.gov (United States)

Besse, Christine; Poremski, Daniel; Laliberté, Vincent; Latimer, Eric

2018-05-01

Many clinicians are concerned that competitive work may cause excessive stress for people with severe mental health problems. Individual Placement and Support (IPS) is acknowledged as the most effective model of supported employment for this population. The manner in which IPS clients define and experience employment-related stress is poorly understood. This qualitative study aims to explore how people with mental health problems receiving IPS services define and experience employment-related stress. We purposively sampled and interviewed 16 clients of an IPS programme, who had been competitively employed for more than 1 month. Data were collected between September 2014 and July 2015 in Montreal, Canada. Transcripts of semi-structured interviews were analysed using grounded theory methodology. IPS clients often defined stress similar to its common understanding: the result of experiencing prolonged or/and cumulative strains, or of an incongruence between efforts and rewards, hopes and reality. Stress experienced in this way could exacerbate psychiatric symptoms, especially depression or psychotic symptoms. However, when maintained at a more manageable level, stress stimulated learning and improved planning of tasks. Participants described different coping mechanisms, such as sharing their experiences and difficulties with others, focusing on problem resolution and avoidance. The first two of these helped IPS clients remain at work and bolstered their confidence. Work-related stress has potentially positive as well as negative consequences for IPS clients. In order to maximise the potential beneficial effects of stress, employment specialists can help clients anticipate potential stressors and plan how they might cope with them. Further research on the most effective ways of helping clients cope with stress is needed. © 2017 John Wiley & Sons Ltd.

17 CFR 205.3 - Issuer as client.

Science.gov (United States)

2010-04-01

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

19 CFR 111.39 - Advice to client.

Science.gov (United States)

2010-04-01

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

High Burden of Prevalent and Recently Acquired HIV among Female Sex Workers and Female HIV Voluntary Testing Center Clients in Kigali, Rwanda

NARCIS (Netherlands)

Braunstein, S.L.; Ingabire, C.M.; Geubbels, E.; Vyankandondera, J.; Umulisa, M.M.; Gahiro, E.; Uwineza, M.; Tuijn, C.J.; Nash, D.; van de Wijgert, J.H.H.M.

2011-01-01

Objectives: To estimate HIV prevalence and risk factors in population-based samples of female sex workers (FSW) and female voluntary counseling and testing (VCT) clients in Rwanda. Methods: We conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included

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

Directory of Open Access Journals (Sweden)

Laušević Dragan

2016-01-01

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

Análise da lucratividade dos clientes

OpenAIRE

Madeira, Paulo

2000-01-01

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

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

Directory of Open Access Journals (Sweden)

Omer Ozer

2017-03-01

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

Effects of an iodine-restricted food on client-owned cats with hyperthyroidism

NARCIS (Netherlands)

van der Kooij, M.; Becvárová, Iveta; Meyer, H.P.; Teske, E.; Kooistra, H.S.

The objective of this prospective, multicentre, non-controlled, open-label study was to evaluate the effects of an iodine-restricted food on circulating total thyroxine (TT4) concentrations and clinical parameters in client-owned cats with hyperthyroidism. Two hundred and twenty-five cats were

High burden of prevalent and recently acquired HIV among female sex workers and female HIV voluntary testing center clients in Kigali, Rwanda

NARCIS (Netherlands)

Braunstein, Sarah L.; Ingabire, Chantal M.; Geubbels, Eveline; Vyankandondera, Joseph; Umulisa, Marie-Michèle; Gahiro, Elysée; Uwineza, Mireille; Tuijn, Coosje J.; Nash, Denis; van de Wijgert, Janneke H. H. M.

2011-01-01

To estimate HIV prevalence and risk factors in population-based samples of female sex workers (FSW) and female voluntary counseling and testing (VCT) clients in Rwanda. We conducted a cross-sectional survey of 800 FSW and 1,250 female VCT clients in Rwanda, which included interviewing and testing

Improving UK client-contractor relations

International Nuclear Information System (INIS)

Brant, A.W.

1996-01-01

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

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

Science.gov (United States)

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

2016-08-01

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

Periodontal health of dental clients in a community health setting.

Science.gov (United States)

Darby, I; Phan, L; Post, M

2012-12-01

The aim of this study was to investigate the prevalence and severity of periodontal disease and possible risk factors in clients attending the Plenty Valley Community Health (PVCH) dental clinic. After ethics approval and calibration of examiners, all consenting patients attending PVCH were examined for periodontal status using the Community Periodontal Index (CPI) system and a World Health Organization (WHO) probe. A total of 2861 patients were screened, of which 1751 were female. The majority of patients were Australian born followed by Mediterranean birth. Just under 50% brushed their teeth twice a day and only 20% flossed regularly. It was found that 28.4% had CPI scores of 3 and 4 with only 3.1% recording 0 and a widespread presence of calculus. The severity of periodontal status increased with age, male gender, decreased frequency of brushing, lower level of education, diabetes and reflected country of birth. PVCH has a higher prevalence of periodontal disease than the most recent national survey which reflects the population studied. © 2012 Australian Dental Association.

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

Science.gov (United States)

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

2017-06-01

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

Managing Client Values in Construction Design

DEFF Research Database (Denmark)

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

2008-01-01

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

Client Involvement in Home Care Practice

DEFF Research Database (Denmark)

Glasdam, Stinne; Henriksen, Nina; Kjær, Lone

2013-01-01

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

RED ROSELLA TEA AND AVOCADO AS SIMVASTATIN THERAPY SUPPORT REDUCE TOTAL CHOLESTEROL

Directory of Open Access Journals (Sweden)

Budi Artini

2017-06-01

Full Text Available Introduction: Hypercholesterolemia is a condition characterized by high levels of total cholesterol in the blood. Many studies have proven that steeping tea rosella and flesh of an avocado can reduce total cholesterol levels. This study was conducted to determine the effectiveness of therapy companion rosella tea and  avocado in lowering total cholesterol levels in hypercholesterolemia clients. Method: This type of research is a quasi-experimental study with pre-post test control group design. The population study was a client with hypercholesterolemia in the working area of menganti health centers. First sample group consisted of nine respondents received the drug Simvastatin 10 mg and rosella tea consumed as much as 2 g 1x / day. The second group consisted of nine respondents received the drug Simvastatin 10 mg and avocado meat weighing 330 grams were consumed 1x / day. The control group consisted of 11 respondents have a drug Simvastatin 10 mg oral 1x daily at night before bed. All groups examined total cholesterol levels before treatment and after treatment on day 15. Result: The results of one-way ANOVA test showed a significant difference between before and after treatment in the first group (p=0,001 and second group (p= 0,005, and there is no significant difference before and after treatment in the control group (p= 0,248. The difference between the three groups showed p= 0.025. Conclusion: The conclusion of this study is giving rosella tea and avocado has the same effectiveness in lowering total cholesterol levels so that health workers can suggest the use of rosella tea and avocado as a companion therapy to reduce total cholesterol level.

Sex workers clients in Italy: results of a phone survey on HIV risk behaviour and perception

Directory of Open Access Journals (Sweden)

Ilaria Mulieri

2014-12-01

Full Text Available INTRODUCTION: Sex workers (SW clients represent a bridge population for HIV transmission from high risk to low risk general population. MATERIALS AND METHODS: A cross-sectional anonymous telephone survey was carried out at the AIDS and Sexually Transmitted Infections Helpline of National Institute of Health in Italy. The questionnaire was proposed on a voluntary basis to a sample of 119 subjects from helpline users. RESULTS: The 119 participants were all males, aged between 19 and 59 years and mostly accessed female prostitutes. Vaginal intercourses with SW were more frequently reported, followed by passive oral, active oral sex and active anal intercourses. Cumulatively, 86.6% and 84.6% of vaginal and anal intercourses were respectively reported as regularly protected by condom. DISCUSSION: The telephone interview allowed an eased access, a high response rate and a standardised evaluation of questions CONCLUSIONS: It is necessary a constant monitoring of the characteristics, behaviour, risk perception and testing of SW clients in Italian and other populations.

32 CFR 776.28 - Conflict of interest: Former client.

Science.gov (United States)

2010-07-01

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

Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities.

Directory of Open Access Journals (Sweden)

Shirley J Semple

Full Text Available Globally, client-perpetrated violence against female sex workers (FSWs has been associated with multiple health-related harms, including high-risk sexual behavior and increased exposure to HIV/STIs. This study examined correlates of client-perpetrated sexual, physical, and economic violence (e.g., robbery against FSWs in 13 cities throughout Mexico.FSWs (N = 1,089 who were enrolled in a brief, evidence-based, sexual risk reduction intervention for FSWs (Mujer Segura were interviewed about their work context, including experiences of violence perpetrated by clients, sexual risk and substance use practices, financial need, and social supports. Three broad categories of factors (sociodemographic, work context, behavioral and social characteristics of FSWs were examined as correlates of sexual, physical, and economic violence.The prevalence of different types of client-perpetrated violence against FSWs in the past 6 months was: sexual (11.7%, physical (11.8%, economic (16.9%, and any violence (22.6%. Greater financial need, self-identification as a street worker, and lower perceived emotional support were independently associated with all three types of violence. Alcohol use before or during sex with clients in the past month was associated with physical and sexual violence. Using drugs before or during sex with clients, injection drug use in the past month, and population size of city were associated with sexual violence only, and FSWs' alcohol use score (AUDIT-C was associated with economic violence only.Correlates of client-perpetrated violence encompassed sociodemographic, work context, and behavioral and social factors, suggesting that approaches to violence prevention for FSWs must be multi-dimensional. Prevention could involve teaching FSWs strategies for risk avoidance in the workplace (e.g., avoiding use of alcohol with clients, enhancement of FSWs' community-based supports, development of interventions that deliver an anti

Involvement of the Client in Home Care Practice

DEFF Research Database (Denmark)

Glasdam, Stinne; Kjær, Lone; Præstegaard, Jeanette

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

Play therapy and art therapy for substance abuse clients who have a history of incest victimization.

Science.gov (United States)

Glover, N M

1999-06-01

This article discusses the use of play therapy and art therapy treatment techniques for persons in substance abuse treatment who have a history of incest victimization. While substance abuse treatment focuses on substance abuse, neglecting to address issues related to past incest contact may increase the potential for relapse. This population displays unique characteristics that may prevent them from participating in, or benefitting from, traditional treatment modalities (which are highly dependent upon the verbal interactions between clients and therapists). Play therapy and art therapy are discussed in terms of history, rationale, and benefits to clients.

On Being "Attractive" With Resistant Clients.

Science.gov (United States)

Miller, Mark J.; Wells, Don

1990-01-01

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

37 CFR 10.84 - Representing a client zealously.

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

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

2014-10-01

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

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

NARCIS (Netherlands)

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

2012-01-01

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

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

African Journals Online (AJOL)

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

A "client perspective" helps improve services.

Science.gov (United States)

1998-01-01

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

31 CFR 8.34 - Knowledge of client's omission.

Science.gov (United States)

2010-07-01

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

Successful Vocational Rehabilitation of Clients with Retinitis Pigmentosa.

Science.gov (United States)

Taheri-Araghi, M.; Hendren, G.

1994-01-01

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

Mutual powerlessness in client participation practices in mental health care

Science.gov (United States)

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

2012-01-01

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

Asymmetry of Responsiveness in Client-Centered Therapy

Science.gov (United States)

Shapiro, David A.

1977-01-01

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

Initial validation of the Personality Assessment Inventory-Spanish version with clients from Mexican American communities.

Science.gov (United States)

Rogers, R; Flores, J; Ustad, K; Sewell, K W

1995-04-01

Psychological assessment of Hispanic populations are thwarted by the absence of clinical research on comparability of Spanish translations and the stability of their findings. In this study we examined the potential usefulness of the Spanish Personality Assessment Inventory (PAI; Morey, 1991) for Hispanic clients residing in Mexican American communities. We administered the Spanish version on two occasions to 48 monolingual clients and the Spanish and English versions to 21 bilingual clients. Results indicated that the clinical scales had a moderate to good correspondence for Spanish-English (M r = .72) and good test-retest reliability for Spanish-Spanish (M r = .79). Much more variation was observed for the validity scales and the treatment/interpersonal scales. Also more variability was observed in the convergence of elevations across administrations. Because of these mixed results, we discuss the potential usefulness of the PAI clinical scales to screen for major psychopathology.

Experimental Blind Quantum Computing for a Classical Client

Science.gov (United States)

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

2017-08-01

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

Experimental Blind Quantum Computing for a Classical Client.

Science.gov (United States)

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

2017-08-04

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

37 CFR 10.78 - Limiting liability to client.

Science.gov (United States)

2010-07-01

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

Who cares for involuntary clients?

Science.gov (United States)

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

2009-01-01

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

Factors Associated with the Intention of Registered Dietitians to Discuss Nutrigenetics with their Patients/Clients.

Science.gov (United States)

Bouchard-Mercier, Annie; Desroches, Sophie; Robitaille, Julie; Vohl, Marie-Claude

2016-12-01

The objective of this study was to investigate factors affecting the intention of Registered Dietitians (RDs) to discuss nutrigenetics with their patients/clients. A survey based on the theory of planned behaviour (TPB; attitude, subjective norm, and perceived behavioural control) was developed and sent by email to RD members of the Ordre professionnel des diététistes du Québec. Multiple regression analyses were performed to examine the determinants of intention and behaviour. A total of 141 RDs completed the questionnaire (5.8% response rate). On a scale from -2 to 2 (from strongly disagree to strongly agree), the intention of discussing nutrigenetics with patients/clients was neutral (mean of -0.07 ± 0.92). The TPB construct of attitude was the most strongly associated with intention (β = 0.66, P nutrigenetics with their patients/clients in the last 3 months. Only perceived behavioural control contributed to explain the behaviour (β = 0.17, P nutrigenetics with their patients/clients were determined. This knowledge will help inform the design of future educational content about nutrigenetics.

A Microfinance Program Targeting People Living with HIV in Uganda: Client Characteristics and Program Impact.

Science.gov (United States)

Linnemayr, Sebastian; Buzaalirwa, Lydia; Balya, James; Wagner, Glenn

HIV has disproportionately affected economically vulnerable populations. HIV medical care, including antiretroviral therapy, successfully restores physical health but can be insufficient to achieve social and economic health. It may therefore be necessary to offer innovative economic support programs such as providing business training and microcredit tailored to people living with HIV/AIDS. However, microfinance institutions have shown reluctance to reach out to HIV-infected individuals, resulting in nongovernment and HIV care organizations providing these services. The authors investigate the baseline characteristics of a sample of medically stable clients in HIV care who are eligible for microcredit loans and evaluate their business and financial needs; the authors also analyze their repayment pattern and how their socioeconomic status changes after receipt of the program. The authors find that there is a significant unmet need for business capital for the sample under investigation, pointing toward the potentially beneficial role of providing microfinance and business training for clients in HIV care. HIV clients participating in the loans show high rates of repayment, and significant increases in (disposable) income, as well as profits and savings. The authors therefore encourage other HIV care providers to consider providing their clients with such loans.

Relative efficacy of cash versus vouchers in engaging opioid substitution treatment clients in survey-based research.

Science.gov (United States)

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

2013-04-01

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

Assessment of health-related quality of life of clients in vocational rehabilitation: association with depressive symptoms and type of services.

Science.gov (United States)

Ferdiana, A; Post, M W; Finger, M; Bültmann, U; Escorpizo, R

2014-06-01

Health-related quality of life (HRQOL) has been frequently used as an outcome measure in disability-related studies, yet little is known about HRQOL in vocational rehabilitation (VR). To evaluate HRQOL in VR clients and identify factors associated with their HRQOL DESIGN, SETTING AND POPULATION: Cross-sectional study of 149 clients from 5 VR centers in Switzerland and Germany HRQOL was measured by 8 dimensions of the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and compared with sex-matched German population norms. Multiple regression analyses were conducted to identify whether VR-related variables (VR duration and type, sick leave duration) and depressive symptoms were associated with HRQOL dimensions independent of sociodemographics (age, sex, education) and clinical characteristics (type of disorders, number of comorbidities) HRQOL in VR clients was significantly lower in all dimensions measured by the SF-36 compared to the general population. Returning to the former workplace and being oriented to a new job were associated with less functional limitation due to physical problems, less pain and better mental health. Being oriented to a new job was also associated with better vitality. Presence of depressive symptoms was negatively related with all dimensions of HRQOL. Overall, the regression models explained 10%-25% variance of the physical HRQOL domain and 18%-27% variance of the mental HRQOL domain. Multiple dimensions of HRQOL were significantly decreased in VR clients. Depressive symptoms were prevalent and contributed significantly to poorer HRQOL, thus should be considered in the VR process. Further research is needed to ascertain the effect of different VR types to HRQOL and to elaborate the role of depressive symptoms in HRQOL over time. Rehabilitation professionals should be informed of the level of HRQOL in VR clients in order to tailor effective interventions to improve HRQOL by not only focusing on functional ability but also the

Client capital as a source of enterprise cost

Directory of Open Access Journals (Sweden)

Verba Veronika A.

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

van der Merwe Aletia

2011-10-01

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

Speech-rhythm characteristics of client-centered, Gestalt, and rational-emotive therapy interviews.

Science.gov (United States)

Chen, C L

1981-07-01

The aim of this study was to discover whether client-centered, Gestalt, and rational-emotive psychotherapy interviews could be described and differentiated on the basis of quantitative measurement of their speech rhythms. These measures were taken from the sound portion of a film showing interviews by Carl Rogers, Frederick Perls, and Albert Ellis. The variables used were total session and percentage of speaking times, speaking turns, vocalizations, interruptions, inside and switching pauses, and speaking rates. The three types of interview had very distinctive patterns of speech-rhythm variables. These patterns suggested that Rogers's Client-centered therapy interview was patient dominated, that Ellis's rational-emotive therapy interview was therapist dominated, and that Perls's Gestalt therapy interview was neither therapist nor patient dominated.

The offer to eligible clients and gas purchase

International Nuclear Information System (INIS)

Willson, G.; Brun, C.; Lautard, Ph.

2003-01-01

This article gathers 4 presentations given at the 2003 natural gas congress of Paris about the impacts of the deregulation of the natural gas market. The first presentation presents the impact of the UK gas market deregulation on the energy expenses of the French tire manufacturer Michelin. The second presentation treats of Gaz de France offer to eligible clients. The third presentation presents the operation of the gas hub of Zeebrugge and the arbitration of prices, and the last presentation deals with the gas trading activity of Total company. (J.S.)

Mutual construction and reconstruction in client-consultant interaction

DEFF Research Database (Denmark)

Smith, Irene Skovgaard

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

Multi-client quantum key distribution using wavelength division multiplexing

International Nuclear Information System (INIS)

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

2011-01-01

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

37 CFR 10.65 - Limiting business relations with a client.

Science.gov (United States)

2010-07-01

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

Empathy from the client's perspective: A grounded theory analysis.

Science.gov (United States)

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

2017-03-01

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

Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers

Science.gov (United States)

Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

2016-01-01

Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%). Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission

Social work - client relationship practice: exploring social worker perspectives

OpenAIRE

WENDY ELIZABETH ROLLINS

2018-01-01

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

49 CFR 1103.15 - The practitioner's duty to clients, generally.

Science.gov (United States)

2010-10-01

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

Assessment of ART centres in India: client perspectives.

Science.gov (United States)

Sogarwal, Ruchi; Bachani, Damodar

2009-05-01

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

Automated Detection of Client-State Manipulation Vulnerabilities

DEFF Research Database (Denmark)

Møller, Anders; Schwarz, Mathias

2012-01-01

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

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

OpenAIRE

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

2009-01-01

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

PATRON-CLIENT RELATIONSHIP PADA MASYARAKAT MADURA

Directory of Open Access Journals (Sweden)

Mohammad Hefni

2012-03-01

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

Laser Surgeon, Client Education, and Satisfaction with Tattoo Removal

DEFF Research Database (Denmark)

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

2017-01-01

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

User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya.

Science.gov (United States)

Sieverding, Maia; Briegleb, Christina; Montagu, Dominic

2015-02-01

Clinical social franchising is a rapidly growing delivery model in private healthcare markets in low- and middle-income countries. Despite this growth, little is known about providers' perceptions of the benefits and challenges of social franchising or clients' reasons for choosing franchised facilities over other healthcare options. We examine these questions in the context of three social franchise networks in Ghana and Kenya. We conducted in-depth interviews with a purposive sample of providers from the BlueStar Ghana, and Amua and Tunza networks in Kenya. We also conducted qualitative exit interviews with female clients who were leaving franchised facilities after a visit for a reproductive or child health reason. The total sample consists of 47 providers and 47 clients across the three networks. Providers perceived the main benefits of participation in a social franchise network to be training opportunities and access to a consistent supply of low-cost family planning commodities; few providers mentioned branding as a benefit of participation. Although most providers said that client flows for franchised services increased after joining the network, they did not associate this with improved finances for their facility. Clients overwhelmingly cited the quality of the client-provider relationship as their main motivation for attending the franchise facility. Recognition of the franchise brand was low among clients who were exiting a franchised facility. The most important benefit of social franchise programs to both providers and their clients may have more to do with training on business practices, patient counseling and customer service, than with subsidies, technical input, branding or clinical support. This finding may lead to a reconsideration of how franchise programs interact with both their member clinics and the larger health-seeking communities they serve.

32 CFR 776.32 - Department of the Navy as client.

Science.gov (United States)

2010-07-01

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

Qualidade de vida de clientes em hemodiálise e necessidades de orientação de enfermagem para o autocuidado Calidad de vida de clientes en hemodiálisis y necesidades de orientación de enfermería para el autocuidado Quality of life of clients on hemodialisys and needs of nursing guidance for self-care

Directory of Open Access Journals (Sweden)

Iraci dos Santos

2011-03-01

se encuentran en el Sistema de Autocuidado con total compensación de la enfermera. Se sugiere el desarrollo de la orientación de enfermería para el autocuidado, en consulta de enfermería, para promoción de la calidad de vida de los clientes.This work relates the needs of nursing guidance with quality of life of patients with chronic kidney disease on hemodialysis, considering conceptions of the Self-care of Orem. Descriptive search, through the interview held with 43 clients of the University Hospital of Rio de Janeiro, from 2008 to 2009. The Clients has arterial hypertension, being 83.72% on this treatment for less than a year. Applying the Kidney Disease Quality of Life Short Form obtained the lowest scores in the dimensions: physical emotional, work conditions, functional capacity. These results were related to the ones obtained with the needs of a guidance of nursing for nutrition, fluid intake, hemodialysis complications, anticoagulation, physical and leisure activities with membership associated groups. It was concluded that these clients are in this Totally Compensatory System of Self- care. Then It is suggested the development of the nursing guidance for the self-care through nursing consult, in order to promote the quality of life of the clients.

45 CFR 1639.4 - Permissible representation of eligible clients.

Science.gov (United States)

2010-10-01

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

37 CFR 10.33 - Direct contact with prospective clients.

Science.gov (United States)

2010-07-01

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

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

African Journals Online (AJOL)

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

Caring for Clients and Families With Anxiety

Directory of Open Access Journals (Sweden)

Noriko Yamamoto-Mitani

2016-08-01

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

Evaluating the Influence of the Client Behavior in Cloud Computing.

Science.gov (United States)

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

2016-01-01

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

Investigating the reliability and validity of the Dutch versions of the illness management and recovery scales among clients with mental disorders.

Science.gov (United States)

Goossens, Peter J J; Beentjes, Titus A A; Knol, Suzanne; Salyers, Michelle P; de Vries, Sjoerd J

2017-12-01

The Illness Management and Recovery scales (IMRS) can measure the progress of clients' illness self-management and recovery. Previous studies have examined the psychometric properties of the IMRS. This study examined the reliability and validity of the Dutch version of the IMRS. Clients (n = 111) and clinicians (n = 40) completed the client and clinician versions of the IMRS, respectively. The scales were administered again 2 weeks later to assess stability over time. Validity was assessed with the Utrecht Coping List (UCL), Dutch Empowerment Scale (DES), and Brief Symptom Inventory (BSI). The client and clinician versions of the IMRS had moderate internal reliability, with α = 0.69 and 0.71, respectively. The scales showed strong test-retest reliability, r = 0.79, for the client version and r = 0.86 for the clinician version. Correlations between client and clinician versions ranged from r = 0.37 to 0.69 for the total and subscales. We also found relationships in expected directions between the client IMRS and UCL, DES and BSI, which supports validity of the Dutch version of the IMRS. The Dutch version of the IMRS demonstrated good reliability and validity. The IMRS could be useful for Dutch-speaking programs interested in evaluating client progress on illness self-management and recovery.

Sociodemographic Differences in Clients Preferring Video-Call Over In-person Interview: A Pilot Study of HIV Tele-partner Services.

Science.gov (United States)

Udeagu, Chi-Chi N; Shah, Sharmila; Toussaint, Magalieta M; Pickett, Leonard

2017-11-01

The New York City Department of Health Disease Intervention Specialists (DIS) routinely contact newly HIV-diagnosed persons via telephone calls and in-person meetings to conduct partner services (PS) interviews in order to elicit the names and contact information of the HIV-exposed partners for notification and HIV-testing, and to assist clients with linkage to care. From October 2013 to December 2015, we offered PS interviews conducted via video-call alongside voice-call and in-person modes in a selected geographic area of NYC. PS interviews were conducted according to the clients' preferred mode (in-person, voice- or video-call) and location (health care facility, clients' residences, or other NYC locations). At the conclusion of the PS interviews, DIS elicited responses from persons interviewed via video-call on their perception, satisfaction and personal experiences using video-call for public health and personal purposes. Acceptance and satisfaction with PS interviews via video-call were high among clients aged interviews for specific populations.

Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia.

Science.gov (United States)

Haile, Demewoz; Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

2016-01-01

Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73)].Similarly, lower CD4 count (ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84).Bedridden [AHR = 5.02; 95% CI: (1.98-12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing treatment failure [AHR = 7.0, 95

75 FR 82236 - Principal Trades with Certain Advisory Clients

Science.gov (United States)

2010-12-30

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

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

Directory of Open Access Journals (Sweden)

Carly Steyn

2015-12-01

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

Organizational and Client Commitment among Contracted Employees

Science.gov (United States)

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

2006-01-01

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

Narrative Processes in Psychotherapy: differences between Good and Poor Outcome Clients

Directory of Open Access Journals (Sweden)

Luis Botella

2015-12-01

Full Text Available This paper compares 30 patients with good therapeutic outcome to 30 with poor therapeutic outcome in terms of the differential distribution of (1 Intake Variables (2 Outcome and Process Variables, and (3 Narrative Variables. Results indicated that psychosocial functioning, motivation, pre-therapy symptoms, Working Alliance, total number of therapy sessions, total pre-post symptom reduction, and mean scoring for total working alliance in sessions 3, 4, and 8 discriminated between both groups. Results also showed that almost all narrative variables except some of them discriminated good outcome clients from poor outcome ones from the beginning, midpoint and final stage of their therapeutic process. These results are discussed according to their relevance for clinical practice.

Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study

OpenAIRE

Shaw Souradet Y; Deering Kathleen N; Reza-Paul Sushena; Isac Shajy; Ramesh Banadakoppa M; Washington Reynold; Moses Stephen; Blanchard James F

2011-01-01

Abstract Background Studies have demonstrated the significance of commercial sex work in the ongoing transmission of HIV and other sexually transmitted infections (STIs) in India. Clients of female sex workers (FSWs) are thought to be an important bridging population for HIV/STIs. However, there is a lack of information on basic characteristics of sex work clients. This study sought to describe the prevalence of HIV and other STIs, as well as examine the determinants of these pathogens among ...

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

Directory of Open Access Journals (Sweden)

Dilip Kadam

2017-10-01

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

Factors associated with pretreatment and treatment dropouts: comparisons between Aboriginal and non-Aboriginal clients admitted to medical withdrawal management

Science.gov (United States)

2013-01-01

Background Addiction treatment faces high pretreatment and treatment dropout rates, especially among Aboriginals. In this study we examined characteristic differences between Aboriginal and non-Aboriginal clients accessing an inpatient medical withdrawal management program, and identified risk factors associated with the probabilities of pretreatment and treatment dropouts, respectively. Methods 2231 unique clients (Aboriginal = 451; 20%) referred to Vancouver Detox over a two-year period were assessed. For both Aboriginal and non-Aboriginal groups, multivariate logistic regression analyses were conducted with pretreatment dropout and treatment dropout as dependent variables, respectively. Results Aboriginal clients had higher pretreatment and treatment dropout rates compared to non-Aboriginal clients (41.0% vs. 32.7% and 25.9% vs. 20.0%, respectively). For Aboriginal people, no fixed address (NFA) was the only predictor of pretreatment dropout. For treatment dropout, significant predictors were: being female, having HCV infection, and being discharged on welfare check issue days or weekends. For non-Aboriginal clients, being male, NFA, alcohol as a preferred substance, and being on methadone maintenance treatment (MMT) at referral were associated with pretreatment dropout. Significant risk factors for treatment dropout were: being younger, having a preferred substance other than alcohol, having opiates as a preferred substance, and being discharged on weekends. Conclusions Our results highlight the importance of social factors for the Aboriginal population compared to substance-specific factors for the non-Aboriginal population. These findings should help clinicians and decision-makers to recognize the importance of social supports especially housing and initiate appropriate services to improve treatment intake and subsequent retention, physical and mental health outcomes and the cost-effectiveness of treatment. PMID:24325629

clientes surdos

Directory of Open Access Journals (Sweden)

Wiliam César Alves Machado

2015-01-01

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

37 CFR 10.67 - Settling similar claims of clients.

Science.gov (United States)

2010-07-01

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

Exploring the health visiting service from the view of South Asian clients in England: a grounded theory study.

Science.gov (United States)

Abdu, Lena; Stenner, Karen; Vydelingum, Vasso

2016-09-01

The fact that health inequalities disproportionately affect the minority ethnic population is not new and projections are that the minority ethnic population will continue to increase. The importance of early intervention and the key role that health visitors can play in attempting to reduce health inequalities is well documented as is the requirement for health providers to establish culturally sensitive services. To date, much of the research has focused on the perspectives of healthcare professionals caring for minority ethnic clients in hospital-based settings and little is known about the perspectives of minority ethnic clients regarding the health visiting service (HVS). The aim of this study was to explore the perspectives of South Asians regarding their experiences with the HVS. The study was conducted in a small town in the South of England between March and June 2013. A qualitative study using a grounded theory approach was used to capture the perspectives of this group regarding their interactions with the HVS. The sample consisted of 15 participants and data were collected through audio-recorded semi-structured interviews and analysed using constant comparative approach. Three key categories were identified: 'understanding the health visitor's role', 'sensitivity of services' and 'the significance of family'. While clients valued one-to-one support from health visitors, there was some evidence of poor communication and ethnocentric tendencies within the service. It was found that South Asian clients distinguish between health and parenting advice, being more likely to accept health advice from their health visitor and more likely to accept parenting advice from their family. The findings, although limited in their generalisability, offer important insights into how South Asians perceive the service and will equip health visitors with a better understanding of how best to improve the experience of South Asian clients accessing the health visiting. �

Psychometrics of the Personal Questionnaire: A client-generated outcome measure.

Science.gov (United States)

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

2016-03-01

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

Client contribution in negotiations on employability – categories revised?

DEFF Research Database (Denmark)

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

2010-01-01

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

Writing about Clients: Ethical Considerations and Options

Science.gov (United States)

Sperry, Len; Pies, Ronald

2010-01-01

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

Experiential Interventions for Clients with Genital Herpes.

Science.gov (United States)

Cummings, Anne L.

1999-01-01

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

Can Knowledge of Client Birth Order Bias Clinical Judgment?

Science.gov (United States)

Stewart, Allan E.

2004-01-01

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

A survey of smoking prevalence and interest in quitting among social and community service organisation clients in Australia: a unique opportunity for reaching the disadvantaged

Directory of Open Access Journals (Sweden)

Paul Christine

2011-10-01

Full Text Available Abstract Background Social and community service organisations (SCSOs are non-government, not-for-profit organisations that provide welfare services to disadvantaged individuals. SCSOs hold considerable potential for providing smoking cessation support to disadvantaged smokers. This study aimed to establish the prevalence of smoking, interest in quitting and interest in receiving cessation support amongst clients accessing SCSOs. Methods Clients seeking financial or material assistance from three SCSOs in NSW, Australia, between February and October 2010 were invited to complete a 60-item general health touch screen computer survey. This included questions about smoking status, past quit attempts and interest in receiving support to quit smoking from SCSO staff. Results A total of 552 clients were approached to participate during the study period, of which 383 provided consent and completed the survey (69% consent rate. Daily smoking was reported by 53.5% of participants. Occasional smoking (non-daily smoking was reported by a further 7.9% of participants. Most participants had tried to quit smoking in the past (77% and had made an average of two quit attempts (SD = 3.2 lasting longer than 24 hours in the previous 12 months. More than half of all participants (52.8% reported that they would like help from SCSO staff to quit smoking. For those interested in receiving help, the preferred types of help were access to free NRT (77%, cash rewards (52% and non-cash rewards (47% for quitting, and to receive support and encouragement from SCSO staff to quit (45%. Conclusions Smoking rates among clients accessing SCSO are substantially higher than the general population rate of 15.1%. A substantial proportion of clients are interested in quitting and want support from the SCSO to do so.

E-mail security: mail clients must use encrypted protocols

CERN Multimedia

2006-01-01

In the coming weeks, users of mail clients other than Outlook (e.g. Pine, Mozilla, Mac Mail, etc.) may receive an e-mail from Mail-service@cern.ch with instructions to update the security settings of their mail client. The aim of this campaign is to enforce the use of encrypted and authenticated mail protocols in order to prevent the propagation of viruses and protect passwords from theft. As a first step, from 6 June 2006 onwards, access to mail servers from outside CERN will require a securely configured mail client as described in the help page http://cern.ch/mmmservices/Help/?kbid=191040. On this page most users will also find tools that will update their mail client settings automatically. Note that Outlook clients and WebMail access are not affected. The Mail Team

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

Directory of Open Access Journals (Sweden)

Yellowlees Peter

2005-04-01

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

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

Science.gov (United States)

Coates, Dominiek

2016-12-01

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

The ARAC client system: network-based access to ARAC

International Nuclear Information System (INIS)

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

1999-01-01

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

Client/server models for transparent, distributed computational resources

International Nuclear Information System (INIS)

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

1991-01-01

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

Parallel Journeys: How a Music Therapist Can Travel with his Client

Directory of Open Access Journals (Sweden)

Henry Dunn

2009-01-01

Full Text Available This paper explores the nature of the client-therapist relationship through the presentation of a case study. In this case study I aim to show how our processes within the therapy had strong parallels and how through being personally affected by my client this enabled me to work therapeutically more effectively and help him on his journey. The case study demonstrates how I was prepared to try new techniques at the same time as my client became more experimental, and also reveals how the client’s experience was related to my own mental health history. I examine how this affected the way I worked and the way our therapeutic relationship developed. I ask the question of whether it is helpful for the therapist to be personally involved in the therapeutic process and how this can either aid or interfere with the work.Through reference to the work of Carl Jung in particular, I conclude that it is not only helpful, but essential for the therapist to be prepared to be part of the therapeutic process. By examining the nature of the wounded healer archetype and its relevance for the client-therapist relationship, it becomes clear that the therapist cannot help but be personally involved in some way, and that being conscious of this can be a very helpful part of our work. This is especially the case in music therapy, where the therapist usually participates in the co-creation of music, and therefore cannot stand totally outside it. It is this balance of being both outside and inside the process that is crucial to our work.

What Business Students Should Know about Attorney-Client Privilege

Science.gov (United States)

Draba, Robert; Marshall, Brent

2012-01-01

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

Enhancing Clients' Communication Regarding Goals for Using Psychiatric Medications.

Science.gov (United States)

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

2017-08-01

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

37 CFR 10.68 - Avoiding influence by others than the client.

Science.gov (United States)

2010-07-01

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

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

African Journals Online (AJOL)

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

Training Therapists about Client Expectations of Psychotherapy.

Science.gov (United States)

Soley, Georgia; Marshall, Renee; Chambliss, Catherine

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

Experience of Client-centered Practice amongst Danish Occupational Therapists

DEFF Research Database (Denmark)

Larsen, Anette Enemark

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

Client experiences of motivational interviewing: An interpersonal process recall study.

Science.gov (United States)

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

2016-03-01

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

Client capital as a source of enterprise cost

OpenAIRE

Verba Veronika A.; Tyshchenko Oleksandr O.

2014-01-01

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

Medicaid care management: description of high-cost addictions treatment clients.

Science.gov (United States)

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

2013-09-01

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

Characteristics of clients accessing HIV counseling and testing ...

African Journals Online (AJOL)

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

The Contribution of the Counselor-Client Working Alliance to Career Exploration

Science.gov (United States)

Elad-Strenger, Julia; Littman-Ovadia, Hadassah

2012-01-01

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

Seroprevalence of human immunodeficiency virus among voluntary counseling and testing clients at the University of Gondar Teaching Hospital, Northwest Ethiopia

Directory of Open Access Journals (Sweden)

Sinku Y

2016-08-01

Full Text Available Yohannes Sinku,1,2 Takele Gezahegn,1 Yalewayiker Gashaw,1 Meseret Workineh,1 Tekalign Deressa1 1School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, 2Diagnostic Laboratory Case Team, University of Gondar Teaching Hospital, Gondar, Ethiopia Background: The epidemiology of human immunodeficiency virus (HIV infection in Ethiopia varies with regions, study population, and time. Thus, timely information on HIV epidemiology is critical for the combat of the epidemic. In this study, we aim to update HIV prevalence and risk factors among voluntary counseling and testing (VCT clients at the University of Gondar Teaching Hospital, Northwest Ethiopia.Methods: A total of 2,120 VCT clients’ records from September 2007 to August 2010 were analyzed retrospectively. Bivariate logistic regression analysis was used to identify significant predictors. Odds ratio (OR and 95% confidence intervals (CIs were calculated. Statistical significance was set at P-value <0.05.Results: Of 2,120 VCT clients, 363 (17.1% were seropositive for HIV. A higher rate of HIV positivity was observed among female clients (20.4% than that in male clients (14.0% (OR 1.58, 95% CI 1.26–1.98, P=0.00. Widowed (95% CI 10.42–34.92, P=0.00, married (95% CI 3.42–5.94, P=0.00, divorced (95% CI 2.79–5.32, P=0.00, and illiterate (95% CI 2.33–5.47, P=0.00 clients were associated with HIV infection with the odds ratios of 19.07, 4.51, 3.85, and 3.57, respectively. Clients within the age category of 35–49 years (OR 5.03, 95% CI 3.56–7.12, P=0.00 and above the age of 50 years (OR 4.99, 95% CI 2.67–9.34, P=0.00 were more likely to be infected with HIV.Conclusion: HIV is still the major concern of public health in the Gondar area as evidenced by our data. Being female, widowed, married, illiterate, and older age were the identified risk factors for HIV infection. Thus, consideration of these factors in future intervention and

Emotional congruence between clients and therapists and its effect on treatment outcome.

Science.gov (United States)

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

2018-01-01

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

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

NARCIS (Netherlands)

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

2006-01-01

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

77 FR 17367 - Permissible Sharing of Client Records by Customs Brokers

Science.gov (United States)

2012-03-26

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

Clinical educators' experiences of facilitating learning when speaking a different language from both the student and client.

Science.gov (United States)

Keeton, Nicola; Kathard, Harsha; Singh, Shajila

2017-11-02

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

Dreaming of you: client and therapist dreams about each other during psychodynamic psychotherapy.

Science.gov (United States)

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

2014-01-01

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

THE CITIZEN CLIENT PROFILE

Directory of Open Access Journals (Sweden)

Ângela Cristina Bueno Vieira

2006-12-01

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

Examining challenging behaviors of clients with borderline personality disorder.

Science.gov (United States)

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

2015-12-01

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

Restating a Client-Centered Approach to Career Counseling.

Science.gov (United States)

Miller, Mark J.

1988-01-01

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

34 CFR 370.1 - What is the Client Assistance Program (CAP)?

Science.gov (United States)

2010-07-01

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

Clients' outcomes of home health nursing in Taiwan.

Science.gov (United States)

Yeh, L; Wen, M J

2001-09-01

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

13 CFR 113.3-3 - Structural accommodations for handicapped clients.

Science.gov (United States)

2010-01-01

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

Trust and Professional Skepticism in the Relationship between auditors and Clients

DEFF Research Database (Denmark)

Aschauer, Ewald; Fink, Matthias; Moro, Andrea

2017-01-01

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

Clients' satisfaction with HIV treatment services in Bamenda, Cameroon: a cross-sectional study.

Science.gov (United States)

Wung, Buh Amos; Peter, Nde Fon; Atashili, Julius

2016-07-19

Clients have explicit desires or requests for services when visiting hospitals; inadequate discovery of their needs may result in dissatisfaction. Patient satisfaction influences retention in HIV care, adherence to HAART and serves as determinant to HIV suppression. This study's objectives were to quantify clients' satisfaction with HIV services in Bamenda and determine relationship between satisfaction and clients' socio-demographic/structural characteristics. A cross-sectional study was conducted on HIV-positive patients followed-up, on treatment and who consulted in the Bamenda Regional Hospital treatment centre between July and August 2014. Participants consent was sought and data collected on client's level of satisfaction to staff-patient-communication, staff attitudes, privacy and confidentiality and staffing and amenities situations in the hospital. Data was collected using a structured questionnaire interviewer-administered by investigator and trained health personnel. Collected data was analyzed using Epi Info version 3.5.4 and clients' satisfaction measured using frequencies and percentages. A total of 384 participants took part in this study and their median age was 37 years (IQR: 29-46). Two hundred and seventy-four (71.4 %) participants were females. Overall satisfaction with HIV services was 91.2 % and participants reported less satisfaction with overall staffing and amenities situation of the centre (3.6 %). In the multivariate analysis, only being female, employed and perceiving high number of nurses working at the treatment centre remained significant predictors of overall satisfaction with HIV services. A high proportion of participants expressed satisfaction with HIV services. However, some dissatisfaction is masked in this high satisfaction level. This dissatisfaction underscores need to improve staff attitudes, staff-patient-communication, employ more staff and build better patient facilities. Future studies need to focus on assessing long

Mutual powerlessness in client participation practices in mental health care

NARCIS (Netherlands)

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

2014-01-01

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

Adapting Total Quality Management (TQM) to Government.

Science.gov (United States)

Swiss, James E.

1992-01-01

Total quality management will not work well in government agencies because of stress on products, not services; on well-defined consumer groups; on inputs/processes, not results; and on preoccupation with quality. An effective revised version emphasizes client feedback, performance monitoring, continuous improvement, and worker participation. (SK)

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

Directory of Open Access Journals (Sweden)

Joselany Afio Caetano

2007-03-01

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

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Suicidal behavior among delinquent former child welfare clients.

Science.gov (United States)

Björkenstam, C; Björkenstam, E; Ljung, R; Vinnerljung, B; Tuvblad, C

2013-06-01

Child welfare clients represent a high-risk group for delinquency and adult criminality, but also for future suicidal behavior. We examine associations between delinquency and suicidal behavior in a national child welfare population. This register-based cohort study is based on data for all Swedish former child welfare clients born between 1972 and 1981 that experienced interventions before their adolescent years. We followed 27,228 individuals from age 20 years until 31 December 2006. Juvenile delinquency was defined as being convicted of at least one crime between age 15 and 19. The risk of suicidal behavior was calculated as incidence rate ratios (IRRs). Fifteen percent of the women and 40% of the men had at least one conviction between the age 15 and 19. The adjusted risk of suicidal behavior among women with five or more convictions was 3.5 (95% CI 2.0-6.2); corresponding IRR for men was 3.9 (95% CI 3.1-4.9). Child welfare experience-specifically of out-of-home care-in combination with delinquency is a potent risk factor for suicidal behavior among young adults. However, we cannot exclude that some of this association is an epiphenomenon of uncontrolled confounders, such as impulsivity or severity of psychiatric disease. Despite this caveat, results should be disseminated to practitioners in the health and correction services.

Accessibility of long-term family planning methods: a comparison study between Output Based Approach (OBA) clients verses non-OBA clients in the voucher supported facilities in Kenya.

Science.gov (United States)

Oyugi, Boniface; Kioko, Urbanus; Kaboro, Stephen Mbugua; Gikonyo, Shadrack; Okumu, Clarice; Ogola-Munene, Sarah; Kalsi, Shaminder; Thiani, Simon; Korir, Julius; Odundo, Paul; Baltazaar, Billy; Ranji, Moses; Muraguri, Nicholas; Nzioka, Charles

2017-03-27

The study seeks to evaluate the difference in access of long-term family planning (LTFP) methods among the output based approach (OBA) and non-OBA clients within the OBA facility. The study utilises a quasi experimental design. A two tailed unpaired t-test with unequal variance is used to test for the significance variation in the mean access. The difference in difference (DiD) estimates of program effect on long term family planning methods is done to estimate the causal effect by exploiting the group level difference on two or more dimensions. The study also uses a linear regression model to evaluate the predictors of choice of long-term family planning methods. Data was analysed using SPSS version 17. All the methods (Bilateral tubal ligation-BTL, Vasectomy, intrauterine contraceptive device -IUCD, Implants, and Total or combined long-term family planning methods -LTFP) showed a statistical significant difference in the mean utilization between OBA versus non-OBA clients. The difference in difference estimates reveal that the difference in access between OBA and non OBA clients can significantly be attributed to the implementation of the OBA program for intrauterine contraceptive device (p = 0.002), Implants (p = 0.004), and total or combined long-term family planning methods (p = 0.001). The county of residence is a significant determinant of access to all long-term family planning methods except vasectomy and the year of registration is a significant determinant of access especially for implants and total or combined long-term family planning methods. The management level and facility type does not play a role in determining the type of long-term family planning method preferred; however, non-governmental organisations (NGOs) as management level influences the choice of all methods (Bilateral tubal ligation, intrauterine contraceptive device, Implants, and combined methods) except vasectomy. The adjusted R 2 value, representing the percentage of

Comparison and selection of client computer in nuclear instrument

International Nuclear Information System (INIS)

Ma Guizhen; Xie Yanhui; Peng Jing; Xu Feiyan

2012-01-01

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

Older Male Clients of Female Sex Workers in the United States.

Science.gov (United States)

Milrod, Christine; Monto, Martin

2017-08-01

Recent research has provided increased information about the clients of sex workers; however, little is known about the population of older male customers who contract for heterosexual services online. Clients (N = 208) between 60 and 84 years of age were obtained through sex work review sites and online discussion forums. Participants completed a 129-item questionnaire focusing on physical health, sexual and non-sexual behaviors with sex providers, and the qualities sought in the same. More than half reported having visited sex providers between 13 and 24 times or more during the past 12 months. Participants' advancing age was positively associated with frequency of paid sex. Most frequent sexual activities with providers were fellatio without a condom, followed by penile-vaginal sex with a condom. Analyses also examine the relationship between aging and buying sex. Those with higher incomes and without spouses or partners were more likely to report non-sexual activities with providers, and many participants sought a "GFE" or girlfriend experience, in which paid sexual exchanges are part of a relationship that mirrors conventional non-remunerative relationships.

Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India.

Science.gov (United States)

Bradley, Janet; Rajaram, Subramanian Potty; Isac, Shajy; Gurav, Kaveri; Ramesh, B M; Gowda, Chandrashekhar; Moses, Stephen; Alary, Michel

2016-05-01

Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8% reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions.

Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART Clients in Bale Zone Hospitals, South Eastern Ethiopia.

Directory of Open Access Journals (Sweden)

Demewoz Haile

Full Text Available Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia.Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure.The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30 per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73].Similarly, lower CD4 count (<100 m3/dl at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84.Bedridden [AHR = 5.02; 95% CI: (1.98-12.73] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of

Communication management between architects and clients

Science.gov (United States)

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

2017-10-01

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

Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

Science.gov (United States)

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2008-01-01

Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

Evaluation of a liaison librarian program: client and liaison perspectives.

Science.gov (United States)

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

2006-10-01

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

45 CFR 1609.5 - Acceptance of reimbursement from a client.

Science.gov (United States)

2010-10-01

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

Corruption of Client Advocacy in a Community Mental Health System.

Science.gov (United States)

Denner, Bruce

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

Acceptability and Receipt of Preventive Care for Chronic-Disease Health Risk Behaviors Reported by Clients of Community Mental Health Services.

Science.gov (United States)

Bartlem, Kate; Bowman, Jenny; Freund, Megan; Wye, Paula; Lecathelinais, Christophe; McElwaine, Kathleen; Wolfenden, Luke; Gillham, Karen; Wiggers, John

2015-08-01

Compared with the general population, people with a mental illness have a greater prevalence of behaviors that contribute to higher chronic disease rates. Mental health clinical guidelines recommend preventive care to address such behaviors; however, little information is available about whether clients consider preventive care acceptable or about the prevalence of such care in mental health services. This article describes acceptability and receipt of assessment, advice, and referral for smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and physical inactivity, as reported by community mental health service clients. The association between preventive care, diagnosis, and number of clinical appointments was examined. A cross-sectional telephone interview was conducted with clients (N=558) of community mental health services in Australia. Although preventive care was highly acceptable to clients (86%-97%), receipt of preventive care was low. Client receipt of risk assessment ranged from 26% (assessment of fruit or vegetable intake) to 76% (assessment of alcohol consumption). The proportion of clients at risk of and assessed for unhealthy behavior who then received brief advice ranged from 69% (fruit or vegetable intake) to 85% (physical activity), whereas only 38% (alcohol consumption) to 49% (smoking) received any referral. A greater number of mental health appointments were associated with higher prevalence of preventive care, as were diagnoses of diabetes or respiratory conditions and not having a schizophrenia diagnosis. Practice change strategies are required to increase the delivery of routine preventive care within mental health services if clients are to benefit from clinical guidelines.

Understanding the usage of the Helioviewer Project clients and services

Science.gov (United States)

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

2017-12-01

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

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

Directory of Open Access Journals (Sweden)

Hoch Jeffrey S

2011-08-01

Full Text Available Abstract Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention.

Science.gov (United States)

Markle-Reid, Maureen F; McAiney, Carrie; Forbes, Dorothy; Thabane, Lehana; Gibson, Maggie; Hoch, Jeffrey S; Browne, Gina; Peirce, Thomas; Busing, Barbara

2011-08-25

Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Data collection began in May 2010 and

Towards a framework in interaction training for staff working with clients with intellectual disabilities and challenging behaviour.

Science.gov (United States)

Willems, A; Embregts, P; Hendriks, L; Bosman, A

2016-02-01

Training support staff in dealing with challenging behaviour in clients with intellectual disabilities (ID) is needed. The goal of this study is to determine which elements need to be incorporated in a training on staff interactions with these clients, building upon a framework and an interpersonal model. As in functional analysis, this study tests the influence of client interpersonal behaviour, three types of staff reactions to challenging behaviour, two types of staff psychological resources and staff team climate on four styles of staff interpersonal behaviour. A total of 318 support staff members completed a questionnaire on staff interpersonal behaviour for 44 clients with ID and challenging behaviour, as well as seven questionnaires on client interpersonal behaviour, staff emotions, attributions, self-efficacy, self-reflection, coping styles and team climate. The influence of these seven factors on four staff interpersonal behaviours was examined using multilevel multiple regression analysis. Friendly-warm and dominant client interpersonal behaviour had a significant positive impact on friendly and assertive control staff behaviour, respectively. Also, there was a strong influence of staff negative and positive emotions, as well as their self-efficacy, on most of the staff interpersonal behaviours. Staff self-reflection, insight and avoidance-focused coping style had an impact on some staff interpersonal behaviours. Staff team climate only predicted higher support-seeking staff behaviour. In conducting a functional analysis of staff interpersonal behaviour, the results of this study can be used both as a framework in staff-client interaction training and in clinical practice for treating challenging behaviour. The emphasis in training and practice should not only be on the bidirectional dynamics of control and affiliation between staff and clients, but also - in order of importance - on the impact of staff emotions, self-efficacy, self-reflection and insight

Psychotherapy for Suicidal Clients.

Science.gov (United States)

Lester, David

1994-01-01

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

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

Science.gov (United States)

2010-04-01

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

Male nurses' experiences of providing intimate care for women clients.

Science.gov (United States)

Inoue, Madoka; Chapman, Rose; Wynaden, Dianne

2006-09-01

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

Institutional policy changes aimed at addressing obesity among mental health clients.

Science.gov (United States)

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

2010-05-01

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

37 CFR 10.57 - Preservation of confidences and secrets of a client.

Science.gov (United States)

2010-07-01

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

Reliability of the Client-Centeredness of Goal Setting (C-COGS) Scale in Acquired Brain Injury Rehabilitation.

Science.gov (United States)

Doig, Emmah; Prescott, Sarah; Fleming, Jennifer; Cornwell, Petrea; Kuipers, Pim

2016-01-01

To examine the internal reliability and test-retest reliability of the Client-Centeredness of Goal Setting (C-COGS) scale. The C-COGS scale was administered to 42 participants with acquired brain injury after completion of multidisciplinary goal planning. Internal reliability of scale items was examined using item-partial total correlations and Cronbach's α coefficient. The scale was readministered within a 1-mo period to a subsample of 12 participants to examine test-retest reliability by calculating exact and close percentage agreement for each item. After examination of item-partial total correlations, test items were revised. The revised items demonstrated stronger internal consistency than the original items. Preliminary evaluation of test-retest reliability was fair, with an average exact percent agreement across all test items of 67%. Findings support the preliminary reliability of the C-COGS scale as a tool to evaluate and promote client-centered goal planning in brain injury rehabilitation. Copyright © 2016 by the American Occupational Therapy Association, Inc.

An experimental study of client-side Spotify peering behaviour

OpenAIRE

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

2011-01-01

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

37 CFR 10.112 - Preserving identity of funds and property of client.

Science.gov (United States)

2010-07-01

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

49 CFR 1103.19 - Advising upon the merits of a client's cause.

Science.gov (United States)

2010-10-01

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

Meta-analysis of relationships between human offtake, total mortality and population dynamics of gray wolves (Canis lupus).

Science.gov (United States)

Creel, Scott; Rotella, Jay J

2010-09-29

Following the growth and geographic expansion of wolf (Canis lupus) populations reintroduced to Yellowstone National Park and central Idaho in 1995-1996, Rocky Mountain wolves were removed from the endangered species list in May 2009. Idaho and Montana immediately established hunting seasons with quotas equaling 20% of the regional wolf population. Combining hunting with predator control, 37.1% of Montana and Idaho wolves were killed in the year of delisting. Hunting and predator control are well-established methods to broaden societal acceptance of large carnivores, but it is unprecedented for a species to move so rapidly from protection under the Endangered Species Act to heavy direct harvest, and it is important to use all available data to assess the likely consequences of these changes in policy. For wolves, it is widely argued that human offtake has little effect on total mortality rates, so that a harvest of 28-50% per year can be sustained. Using previously published data from 21 North American wolf populations, we related total annual mortality and population growth to annual human offtake. Contrary to current conventional wisdom, there was a strong association between human offtake and total mortality rates across North American wolf populations. Human offtake was associated with a strongly additive or super-additive increase in total mortality. Population growth declined as human offtake increased, even at low rates of offtake. Finally, wolf populations declined with harvests substantially lower than the thresholds identified in current state and federal policies. These results should help to inform management of Rocky Mountain wolves.

Meta-analysis of relationships between human offtake, total mortality and population dynamics of gray wolves (Canis lupus.

Directory of Open Access Journals (Sweden)

Scott Creel

Full Text Available Following the growth and geographic expansion of wolf (Canis lupus populations reintroduced to Yellowstone National Park and central Idaho in 1995-1996, Rocky Mountain wolves were removed from the endangered species list in May 2009. Idaho and Montana immediately established hunting seasons with quotas equaling 20% of the regional wolf population. Combining hunting with predator control, 37.1% of Montana and Idaho wolves were killed in the year of delisting. Hunting and predator control are well-established methods to broaden societal acceptance of large carnivores, but it is unprecedented for a species to move so rapidly from protection under the Endangered Species Act to heavy direct harvest, and it is important to use all available data to assess the likely consequences of these changes in policy. For wolves, it is widely argued that human offtake has little effect on total mortality rates, so that a harvest of 28-50% per year can be sustained. Using previously published data from 21 North American wolf populations, we related total annual mortality and population growth to annual human offtake. Contrary to current conventional wisdom, there was a strong association between human offtake and total mortality rates across North American wolf populations. Human offtake was associated with a strongly additive or super-additive increase in total mortality. Population growth declined as human offtake increased, even at low rates of offtake. Finally, wolf populations declined with harvests substantially lower than the thresholds identified in current state and federal policies. These results should help to inform management of Rocky Mountain wolves.

Meeting the Needs of Clients with Dissociative Identity Disorder: Considerations for Psychotherapy

Science.gov (United States)

Ringrose, Jo L.

2011-01-01

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

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

Science.gov (United States)

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

2014-08-01

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

Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic

Science.gov (United States)

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

2014-01-01

Objectives To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. PMID:24695990

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

OpenAIRE

Benossi, Claudio

2010-01-01

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

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

Directory of Open Access Journals (Sweden)

B. M. H. Stöckigt

2015-01-01

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

Cleaner shrimp use a rocking dance to advertise cleaning service to clients.

Science.gov (United States)

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

2005-04-26

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

The Impact of Organizational Stress and Burnout on Client Engagement

Science.gov (United States)

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

2011-01-01

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

Efficient Mobile Client Caching Supporting Transaction Semantics

Directory of Open Access Journals (Sweden)

IlYoung Chung

2000-05-01

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

Counseling Older Japanese American Clients: An Overview and Observations.

Science.gov (United States)

Itai, Goro; McRae, Cynthia

1994-01-01

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

Dynamics of the HIV epidemic in southern China: sexual and drug-using behaviours among female sex workers and male clients in Yunnan.

Science.gov (United States)

Xu, J J; Smith, M K; Chu, J; Ding, G W; Chang, D F; Sharp, G B; Qian, H Z; Lu, L; Bi, A M; Wang, N

2012-09-01

To examine the HIV/sexually transmitted infection (STI)-related risk behaviours among community-based female sex workers (FSWs) and their clients in Yunnan Province, China, we performed a cross-sectional study of 705 FSWs and 100 male clients. We found that HIV seroprevalence among FSWs was 13.0% and the most prevalent STI was herpes simplex virus type 2 (HSV-2) (71.1%), followed by Chlamydia trachomatis (18.1%) and syphilis (8.8%). The 20% of FSWs who reported injection drug use also reported needle-sharing behaviours in the last three months. Drug-using FSWs had substantially higher HIV and HSV-2 prevalence, serviced more clients and had a longer history of sex work than non-using FSWs. In total, 57.0% of male clients did not consistently use condoms with FSWs, 2.0% reported illicit drug use and 17.0% had STI symptoms in the last year. The dual risk behaviours of drug-using FSWs and clients place them at greater risk of HIV infection. Intervention programmes must adopt comprehensive methods.

The Impact of Comprehensive Case Management on HIV Client Outcomes.

Directory of Open Access Journals (Sweden)

Mark Brennan-Ing

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

Visualization Software for VisIT Java Client

Energy Technology Data Exchange (ETDEWEB)

2017-01-01

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

75 FR 66050 - Permissible Sharing of Client Records by Customs Brokers

Science.gov (United States)

2010-10-27

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

Difficult Clients: Who Are They and How Do We Help Them?

Science.gov (United States)

Seligman, Linda; Gaaserud, Lynn

1994-01-01

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

A Client-Centered Review of Rogers with Gloria

Science.gov (United States)

Moon, Kathryn A.

2007-01-01

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

Client Views of TESOL Service: Expectations and Perceptions.

Science.gov (United States)

Walker, John

2001-01-01

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

Propuesta metodológica para la gestión del cliente

Directory of Open Access Journals (Sweden)

Luis Ignacio López Villegas

2016-03-01

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

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

African Journals Online (AJOL)

Abrham

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

Client Proteins and Small Molecule Inhibitors Display Distinct Binding Preferences for Constitutive and Stress-Induced HSP90 Isoforms and Their Conformationally Restricted Mutants.

Directory of Open Access Journals (Sweden)

Thomas L Prince

Full Text Available The two cytosolic/nuclear isoforms of the molecular chaperone HSP90, stress-inducible HSP90α and constitutively expressed HSP90β, fold, assemble and maintain the three-dimensional structure of numerous client proteins. Because many HSP90 clients are important in cancer, several HSP90 inhibitors have been evaluated in the clinic. However, little is known concerning possible unique isoform or conformational preferences of either individual HSP90 clients or inhibitors. In this report, we compare the relative interaction strength of both HSP90α and HSP90β with the transcription factors HSF1 and HIF1α, the kinases ERBB2 and MET, the E3-ubiquitin ligases KEAP1 and RHOBTB2, and the HSP90 inhibitors geldanamycin and ganetespib. We observed unexpected differences in relative client and drug preferences for the two HSP90 isoforms, with HSP90α binding each client protein with greater apparent affinity compared to HSP90β, while HSP90β bound each inhibitor with greater relative interaction strength compared to HSP90α. Stable HSP90 interaction was associated with reduced client activity. Using a defined set of HSP90 conformational mutants, we found that some clients interact strongly with a single, ATP-stabilized HSP90 conformation, only transiently populated during the dynamic HSP90 chaperone cycle, while other clients interact equally with multiple HSP90 conformations. These data suggest different functional requirements among HSP90 clientele that, for some clients, are likely to be ATP-independent. Lastly, the two inhibitors examined, although sharing the same binding site, were differentially able to access distinct HSP90 conformational states.

Clients' experiences of a community based lifestyle modification program: a qualitative study.

Science.gov (United States)

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

2009-10-01

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

Physical Attractiveness: Interactive Effects of Counselor and Client on Counseling Processes.

Science.gov (United States)

Vargas, Alice M.; Borkowski, John G.

1983-01-01

Assessed how the physical attractiveness of counselors and clients interacted to build rapport in two experiments involving college students (N=128 and N=64). Results showed the counselor's physical attractiveness had a major impact on her perceived effectiveness and the client's expectation of success irrespective of the client's attractiveness…

Clients' perception of service quality of care in health facilities in ...

African Journals Online (AJOL)

Introduction: Clients perception of service quality is important for utilization of health services. Clients with positive perception are more likely to comply with treatment and to continue to use health care services. Assessing clients' perception of services offered is crucial for improving delivery and organization of the services.

17 CFR 275.206(4)-3 - Cash payments for client solicitations.

Science.gov (United States)

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Cash payments for client... for client solicitations. (a) It shall be unlawful for any investment adviser required to be... client at the time of the solicitation or referral; or (iii) Other than a solicitor specified in...

Speaking for the Client

DEFF Research Database (Denmark)

Mik-Meyer, Nanna; Silverman, D.

. Nonetheless staff often assume that their clients were at the centre of the encounter, even when there is little indication that they understand the Danish language spoken. In order to analyze and explain dilemmas like these, we draw on symbolic interactionism and conversation analysis, placing linguistic...

Subjective Experiences of Clients in a Voluntary Money Management Program.

Science.gov (United States)

Serowik, Kristin L; Bellamy, Chyrell D; Rowe, Michael; Rosen, Marc I

2013-01-01

A large proportion of people diagnosed with mental illnesses have difficulty managing their money, and therefore many psychiatric treatments involve providing money management assistance. However, little is known about the subjective experience of having a money manager, and extant literature is restricted to people forced to work with a representative payee or conservator. In this study, fifteen people were interviewed about their experience receiving a voluntary money management intervention designed to minimize substance use. Clients emphasized the importance of trusting the money manager, financial mindfulness (an enhanced awareness of the financial transactions in clients' day-to-day lives), agency over their own affairs, and addiction. In contrast to evaluations of people assigned representative payees and/or conservators, there was little mention of feeling coerced. These findings suggest that money management programs can address client concerns by building trust, relating budgeting to clients' day-to-day lives, and encouraging clients' control over their own affairs.

Social networks and links to isolation and loneliness among elderly HCBS clients.

Science.gov (United States)

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

2016-01-01

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

Patient-Therapist Value Congruence and Ratings of Client Improvement

Science.gov (United States)

Martini, Janie L.

1978-01-01

It can be concluded from the results of the two studies described here that value similarity between client and therapist is related to therapists' ratings of client improvement. This phenomenon can be expected in therapies irrespective of theoretical orientation. (Author)

Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

Science.gov (United States)

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

2017-12-14

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

Seeking what matters: determinants of clients' satisfaction in obstetric care services in Pakistan.

Science.gov (United States)

Ali, Moazzam; Qazi, Muhammad Suleman; Seuc, Armando

2014-01-01

Aim of this study was to determine the dimensions of the service quality in the public hospitals and evaluate the determinants of client satisfaction in obstetric health in the context of Pakistan. The present research evaluates the application of an integrated client satisfaction model that draws mainly from the original SERVQUAL framework in obstetric health services. We conducted a cross-sectional study, in four public district hospitals in Pakistan, enrolling 1101 clients attending obstetric health care services. Measures of service quality and determinants of client satisfaction were factor-analysed and multiple regression analysis was used to test the hypothesis. The client satisfaction increased significantly with increases in respondent's age, number of children, number of visits and with decrease in educational status. Factor analysis revealed five service quality dimensions; and multiple regression analysis showed that all five dimensions of service quality in obstetric care were significant in explaining client satisfaction. The most powerful predictor for client satisfaction was provider communication with clients, followed by responsiveness and discipline. Interventions aimed at improving client provider interaction would not only advance the clinical provision of services, butwould also result in greater patient satisfaction with the services provided, leading to higher levels of facility utilization and continuity of care. Better client provider interaction can be accomplished at hospital's level through focused training of all cadre of service providers sensitizing them on clients' needs. Results also showed that the proposed framework is a valid and flexible instrument in assessing and monitoring service quality and enabling staff to identify where improvements are needed, from the clients' perspective.

What client?

DEFF Research Database (Denmark)

Unterrainer, Walter

2015-01-01

rising pressure for new approaches towards space, urbanization, environmental challenges, technological inventions, transformation of cities and buildings on one hand and the decline in impact, reputation, self-esteem and economy of ´conventional´architectural profession on the other hand. In Asia like...... engage architects, no matter how urgent the problems are. It is the architects who must reverse their understanding of ´clients´, for the sake of these challenges as well as for their own professional future. This started happen very much in contrast to predominant architectural education models: Young...

Client Centeredness and Health Reform: Key Issues for Occupational Therapy

Science.gov (United States)

Pitonyak, Jennifer S.; Fogelberg, Donald; Leland, Natalie E.

2015-01-01

Health reform promotes the delivery of patient-centered care. Occupational therapy’s rich history of client-centered theory and practice provides an opportunity for the profession to participate in the evolving discussion about how best to provide care that is truly patient centered. However, the growing emphasis on patient-centered care also poses challenges to occupational therapy’s perspectives on client-centered care. We compare the conceptualizations of client-centered and patient-centered care and describe the current state of measurement of client-centered and patient-centered care. We then discuss implications for occupational therapy’s research agenda, practice, and education within the context of patient-centered care, and propose next steps for the profession. PMID:26356651

El servicio al cliente: una necesidad imperante en la calidad de la industria. // The client service: a prevailing necessity in the quality of the industry.

Directory of Open Access Journals (Sweden)

E. Martínez Delgado

2006-05-01

Full Text Available A través de todos los sectores industriales la investigación por la excelencia en el servicio se ha convertido en unapreocupación creciente y los gerentes han reconocido que la ventaja sustancial competitiva puede ganarse a través de unservicio superior al cliente, e igualmente importante, el servicio al cliente se convierte en un medio poderoso de diferenciarlas compañías desde la competencia. La calidad equivale entonces no sólo al producto en sí mismo, sino combinado éstecon lo que le rodea; de hecho, en las normas ISO 9000: 2000 se define al producto como el resultado de un proceso,siendo los servicios una de las cuatro categorías genéricas de éste. Cada vez más se demanda la garantía de la capacidad deproducir establemente una calidad superior y de innovación del producto acorde con los deseos de los clientes; pasándosede la certificación del producto a la certificación de toda la cadena logística, debiendo brindarse servicios de alto valoragregado a los clientes en forma diferenciada. Así, en el mercado globalizado donde sólo es posible ubicar productos dealta calidad para satisfacer a los clientes y al mercado, lo primero que debe hacer el gerente de servicios es comprender lascalidades demandadas por los clientes, así como la información relacionada con la importancia relativa de lascaracterísticas de calidad.El presente trabajo expone los resultados favorables obtenidos en el sistema de producción-distribución a través de unmodelo conformado para la evaluación integral del desempeño de la organización. Éste considera al cliente, con suscriterios y preferencias, como un elemento clave en la planeación de la producción y en la proyección de las capacidadesproductivas, incorporándolo con su oferta de valor.Palabras claves: Calidad industrial, producción-distribución, ISO 9000, cliente._______________________________________________________________________________Abstract.The investigation for the

Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

Directory of Open Access Journals (Sweden)

N. Mlenzana

2012-12-01

Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction

On the Use of Client-Driven Projects in the Mathematics Classroom

Science.gov (United States)

Maki, Dan; Winston, Wayne; Shafii-Mousavi, Morteza; Kochanowski, Paul; Lang, Chris; Ernstberger, Kathy; Hodgson, Ted

2006-01-01

In this article, we discuss the use of client-driven projects--projects that are posed by business, government, and non-profit organizations and based upon real problems facing the organization. Although client-driven projects have long been used in business and engineering education, their use in the mathematics classroom is rare. Client-driven…

Client Mobile Software Design Principles for Mobile Learning Systems

Directory of Open Access Journals (Sweden)

Qing Tan

2009-01-01

Full Text Available In a client-server mobile learning system, client mobile software must run on the mobile phone to acquire, package, and send student’s interaction data via the mobile communications network to the connected mobile application server. The server will receive and process the client data in order to offer appropriate content and learning activities. To develop the mobile learning systems there are a number of very important issues that must be addressed. Mobile phones have scarce computing resources. They consist of heterogeneous devices and use various mobile operating systems, they have limitations with their user/device interaction capabilities, high data communications cost, and must provide for device mobility and portability. In this paper we propose five principles for designing Client mobile learning software. A location-based adaptive mobile learning system is presented as a proof of concept to demonstrate the applicability of these design principles.

Pharmacy clients' attitudes to expanded pharmacist prescribing and the role of agency theory on involved stakeholders.

Science.gov (United States)

Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

2011-02-01

To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

Cultural Psychiatry: A Spotlight on the Experience of Clinical Social Workers' Encounter with Jewish Ultra-Orthodox Mental Health Clients.

Science.gov (United States)

Freund, Anat; Band-Winterstein, Tova

2017-07-01

Community is a complex issue, especially in two particular populations overlap: Haredi society, which embraces cultural codes common to closed communities, and the mental health population characterized by its own unique needs. The present study explores the encounter experience of social workers with the cultural perceptions of mental health clients in the Haredi community in light of Community Cultural Psychiatry. A qualitative-phenomenological approach was adopted. In-depth semi-structured interviews were conducted with 27 social workers, mental health professionals, who are in contact with ultra-Orthodox Jewish clients. Three major themes emerged from the data analysis: (1) Exclusion vs. grace and compassion. (2) Mental health: A professional or cultural arena? (3) Mental health help-seeking changing processes. This study shows that the attitude in the Haredi community toward mental health therapy undergoes a process of change. It is important to strengthen this process, together with preserving existing community informal structures of help.

Tattoo removal by Q-switched yttrium aluminium garnet laser: client satisfaction.

Science.gov (United States)

Hutton Carlsen, K; Esmann, J; Serup, J

2017-05-01

Tattoo removal by Q-switched yttrium aluminium garnet (YAG) lasers is golden standard; however, clients' satisfaction with treatment is little known. To determine clients' satisfaction with tattoo removal. One hundred and fifty-four tattoo removal clients who had attended the private clinic 'Centre for Laser Surgery', Hellerup, Denmark, from 2001 to 2013 completed a questionnaire concerning outcome expectations, level of pain experiences and satisfaction with tattoo removal. The laser surgeon and his team were blinded from data handling. The study design included a minimum 2-year postlaser treatment observation period from 2013 to 2015. Overall, clients were satisfied with their laser treatment; 85% assessed their treatment and results to be acceptable to superb, while 15% assessed their treatment and results to be inferior to unacceptable. Effectiveness relative to colour of tattoo on a scale from 0 (no effect) to 10 (complete removal) scored a mean of blue 9.5, black 9.4, yellow 8.9, red 8.8 and green 6.5. Clients were dissatisfied with green pigment remnants, which could mimic bruising. One hundred and twenty-nine clients (84%) experienced moderate to extreme pain during treatment. Twenty-eight (20%) developed minor scarring. There were many reasons for tattoo removal; e.g. stigmatisation (33%), conspicuousness (29%) and poor artistic quality (22%). One hundred and two clients had expected complete removal of tattoos without a blemish, expectations that were only partly fulfilled. During the treatment period, clients adjusted expectations and adapted more realistic views of outcomes. The majority of clients were satisfied with Q-switched YAG laser removal of tattoos despite high pretreatment expectations which were only partly met. The study supports YAG lasers for tattoo removal as acceptable therapy of today, with room for new approaches. © 2017 European Academy of Dermatology and Venereology.

Workplace Responses and Psychologists' Needs Following Client Suicide.

Science.gov (United States)

Finlayson, Melissa; Simmonds, Janette

2017-01-01

This research aimed to explore the role of workplace responses in psychologists' adaptation to client suicides. Participants were 178 psychologists who completed an online self-report questionnaire which included both open and closed questions yielding qualitative and quantitative data. Fifty-six (31.5%) participants reported one or more client suicides. Mixed results were found in terms of perceived support from the workplace following a client suicide. Psychologists reported a need for more open communication in the workplace, peer supports, space to grieve, as well as opportunities to engage in a learning process. The findings have important implications for research and for understanding the role of the workplace postvention. It also raises the need for external support to be accessible for psychologists working in private practice.

Employment-related information for clients receiving mental health services and clinicians.

Science.gov (United States)

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

2011-01-01

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

Addressing clients' racism and racial prejudice in individual psychotherapy: Therapeutic considerations.

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Bartoli, Eleonora; Pyati, Aarti

2009-06-01

Psychotherapists lack clear guidelines regarding how to address clients' racist and prejudicial comments in clinical work. The authors explore the contributions of multicultural, social justice, feminist, and ethical theories to the field of psychotherapy and apply these theories to 2 clinical vignettes in which clients made racially charged statements. These clinical examples highlight the importance of using racial, in addition to traditional, theories to decipher the clinical meanings of racial comments and dynamics in clinical work. The article provides therapeutic conceptualizations regarding how to address clients' racist and prejudicial comments in psychotherapy and elaborates on the complex meanings that might arise from engaging in racially charged discussions with clients depending on the racial composition of the therapeutic dyad. In addition to highlighting how social justice, multicultural, and feminist lenses are necessary to fully understand the meaning of clients' comments, the argument is made that addressing clients' racist and prejudicial comments is at once a clinical and a social justice issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Performance of Distributed Query Optimization in Client/Server Systems

NARCIS (Netherlands)

Skowronek, J.; Blanken, Henk; Wilschut, A.N.

The design, implementation and performance of an optimizer for a nested query language is considered. The optimizer operates in a client/server environment, in particular an Intranet setting. The paper deals with the scalability challenge by tackling the load of many clients by allocating optimizer

Retención de clientes en agencias de eventos

Directory of Open Access Journals (Sweden)

Claudia Gómez-Ramírez

2011-01-01

Full Text Available Como componente de la mezcla de comunicación efectiva para las marcas se encuentran los "Eventos", que hoy en día exigen una gestión estratégica. Resulta clave, para las organizaciones especializadas en la prestación de este servicio, aplicar herramientas que les permitan ser competitivas a largo plazo gracias a la diferenciación. Para ello, el CESA ha estudiado la relación cliente-agencia de comunicación de marketing, fundamentalmente respecto a la importancia de la retención de clientes en relaciones B2B, como las que se llevan a cabo entre agencias de eventos y sus clientes. En el presente artículo se exponen los principales hallazgos de una investigación de tipo exploratorio acerca del tema de retención de clientes, que incluye perfiles, elementos claves para la satisfacción y factores relevantes de la relación clienteagencia de eventos como elementos fundamentales de la gestión empresarial. Al tener un mayor conocimiento del perfil de los clientes, las agencias podrán ser más productivas y competitivas, pues estarán en capacidad de ofrecer iniciativas de servicios con características particulares.

34 CFR 377.31 - What information must a grantee provide to eligible clients?

Science.gov (United States)

2010-07-01

... clients? 377.31 Section 377.31 Education Regulations of the Offices of the Department of Education... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM What Post-Award Conditions Must Be Met by a Grantee? § 377.31 What information must a grantee provide to eligible clients? Each grantee shall advise all clients and...

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

Science.gov (United States)

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

2018-02-01

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

Interactional patterns between staff and clients with borderline to mild intellectual disabilities

NARCIS (Netherlands)

Reuzel, E.; Embregts, P.J.C.M.; Bosman, A.M.T.; van Nieuwenhuizen, A.; Jahoda, A.

2013-01-01

Background Client-centred models of care imply that clients should have a collaborative relationship with staff providing support. This study investigates whether dialogues between staff and clients in naturally occurring contexts reflect this collaborative ideal. Methods Nineteen staff members

Speech Mannerisms: Games Clients Play

Science.gov (United States)

Morgan, Lewis B.

1978-01-01

This article focuses on speech mannerisms often employed by clients in a helping relationship. Eight mannerisms are presented and discussed, as well as possible interpretations. Suggestions are given to help counselors respond to them. (Author)

Feminist Therapy: A Comparative Study of Therapists and Clients.

Science.gov (United States)

Curtin, Catherine A.

Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical…

Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis

Science.gov (United States)

Prudden, Holly J.; Beattie, Tara S.; Bobrova, Natalia; Panovska-Griffiths, Jasmina; Mukandavire, Zindoga; Gorgens, Marelize; Wilson, David; Watts, Charlotte H.

2015-01-01

Background Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this. Methods National, urban and rural data on HIV prevalence, the percentage of younger (15–24) and older (25–49) women and men reporting multiple (2+) partners in the past year, HIV prevalence among female sex workers (FSWs), men who have bought sex in the past year (clients), and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other. Findings National population HIV prevalence varies between 0 4–2 9% for men and 0 4–5.6% for women. ART coverage ranges from 6–23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence. Interpretation In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners. PMID:26698854

Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis.

Directory of Open Access Journals (Sweden)

Holly J Prudden

Full Text Available Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this.National, urban and rural data on HIV prevalence, the percentage of younger (15-24 and older (25-49 women and men reporting multiple (2+ partners in the past year, HIV prevalence among female sex workers (FSWs, men who have bought sex in the past year (clients, and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other.National population HIV prevalence varies between 0 4-2 9% for men and 0 4-5.6% for women. ART coverage ranges from 6-23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence.In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners.

Alienation: A Concept for Understanding Low-Income, Urban Clients

Science.gov (United States)

Holcomb-McCoy, Cheryl

2004-01-01

The author examines the concept of alienation and how it can be used to understand low-income, urban clients. A description is presented of 4 dimensions of alienation: powerlessness, meaninglessness, normlessness, and social isolation. Case illustrations are provided, and recommendations are made for counseling alienated clients. This article…

A macro perspective for client-centred practice in curricula: Critique and teaching methods.

Science.gov (United States)

Fleming-Castaldy, Rita P

2015-07-01

Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients' goal attainment. The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students' abilities to address the complexities of client-centred practice. This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography. Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students' competencies for empowered client-centred practice are required. Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.

Exploring the field of public construction clients by a graphical network analysis

NARCIS (Netherlands)

Eisma, P.R.; Volker, L.

2014-01-01

Because public construction clients form the majority of construction clients and procure over 40% of the construction output in most countries, they are important actors in the construction industry. Yet, the field of research on clients is still underdeveloped. In order to identify the research

Do drug treatment facilities increase clients' exposure to potential neighborhood-level triggers for relapse? A small-area assessment of a large, public treatment system.

Science.gov (United States)

Jacobson, Jerry O

2006-03-01

Research on drug treatment facility locations has focused narrowly on the issue of geographic proximity to clients. We argue that neighborhood conditions should also enter into the facility location decision and illustrate a formal assessment of neighborhood conditions at facilities in a large, metropolitan area, taking into account conditions clients already face at home. We discuss choice and construction of small-area measures relevant to the drug treatment context, including drug activity, disadvantage, and violence as well as statistical comparisons of clients' home and treatment locations with respect to these measures. Analysis of 22,707 clients discharged from 494 community-based outpatient and residential treatment facilities that received public funds during 1998-2000 in Los Angeles County revealed no significant mean differences between home and treatment neighborhoods. However, up to 20% of clients are exposed to markedly higher levels of disadvantage, violence, or drug activity where they attend treatment than where they live, suggesting that it is not uncommon for treatment locations to increase clients' exposure to potential environmental triggers for relapse. Whereas on average both home and treatment locations exhibit higher levels of these measures than the household locations of the general population, substantial variability in public treatment clients' home neighborhoods calls into question the notion that they hail exclusively from poor, high drug activity areas. Shortcomings of measures available for neighborhood assessment of treatment locations and implications of the findings for other areas of treatment research are also discussed.

Client-Controlled Case Information: A General System Theory Perspective

Science.gov (United States)

Fitch, Dale

2004-01-01

The author proposes a model for client control of case information via the World Wide Web built on principles of general system theory. It incorporates the client into the design, resulting in an information structure that differs from traditional human services information-sharing practices. Referencing general system theory, the concepts of…

A Call for Feminist Research: A Limited Client Perspective

Science.gov (United States)

Murray, Kirsten

2006-01-01

Feminist approaches embrace a counselor stance that is both collaborative and supportive, seeking client empowerment. On review of feminist family and couple counseling literature of the past 20 years using several academic databases, no research was found that explored a clients experience of feminist-informed family and couple counseling. The…

Knowledge, Practices and Education of Clients on Cervical Cancer ...

African Journals Online (AJOL)

Background: Most patients with cancer of the cervix present late with poor prognosis. Health workers' knowledge and utilization of the screening services might influence their clients. The aim of this study was to determine the knowledge, practice and education of clients on cervical cancer and its screening among female ...

Clients' experiences of HIV positive status disclosure to sexual ...

African Journals Online (AJOL)

The purpose of the study was to describe the experiences of HIV positive clients as they disclose their HIV positive status to their sexual partners. A qualitative descriptive and phenomenological design was used. Purposive sampling was used to select 15 HIV positive clients to participate in the study. Semi-structured ...

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

Directory of Open Access Journals (Sweden)

Hj.Indirawaty

2015-08-01

Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

77 FR 62185 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients

Science.gov (United States)

2012-10-12

... 3235-AJ96 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... principal capacity in transactions with certain of their advisory clients. The amendment would extend the... Advisers Act when they act in a principal capacity in transactions with certain of their advisory clients...

75 FR 75650 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients

Science.gov (United States)

2010-12-06

... 3235-AJ96 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... principal capacity in transactions with certain of their advisory clients. The amendment would extend the... Advisers Act when they act in a principal capacity in transactions with certain of their advisory clients...

42 CFR 483.450 - Condition of participation: Client behavior and facility practices.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Client behavior and... Retarded § 483.450 Condition of participation: Client behavior and facility practices. (a) Standard: Facility practices—Conduct toward clients. (1) The facility must develop and implement written policies and...

Client Server design and implementation issues in the Accelerator Control System environment

International Nuclear Information System (INIS)

Sathe, S.; Hoff, L.; Clifford, T.

1995-01-01

In distributed system communication software design, the Client Server model has been widely used. This paper addresses the design and implementation issues of such a model, particularly when used in Accelerator Control Systems. in designing the Client Server model one needs to decide how the services will be defined for a server, what types of messages the server will respond to, which data formats will be used for the network transactions and how the server will be located by the client. Special consideration needs to be given to error handling both on the server and client side. Since the server usually is located on a machine other than the client, easy and informative server diagnostic capability is required. The higher level abstraction provided by the Client Server model simplifies the application writing, however fine control over network parameters is essential to improve the performance. Above mentioned design issues and implementation trade-offs are discussed in this paper

Epidemiology of HIV among female sex workers, their clients, men who have sex with men and people who inject drugs in West and Central Africa

Science.gov (United States)

Papworth, Erin; Ceesay, Nuha; An, Louis; Thiam-Niangoin, Marguerite; Ky-Zerbo, Odette; Holland, Claire; Dramé, Fatou Maria; Grosso, Ashley; Diouf, Daouda; Baral, Stefan D

2013-01-01

Introduction The West and Central Africa (WCA) sub-region is the most populous region of sub-Saharan Africa (SSA), with an estimated population of 356 million living in 24 countries. The HIV epidemic in WCA appears to have distinct dynamics compared to the rest of SSA, being more concentrated among key populations such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and clients of FSWs. To explore the epidemiology of HIV in the region, a systematic review of HIV literature among key populations in WCA was conducted since the onset of the HIV epidemic. Methods We searched the databases PubMed, CINAHL and others for peer-reviewed articles regarding FSWs, MSM and PWID in 24 countries with no date restriction. Inclusion criteria were sensitive and focused on inclusion of any HIV prevalence data among key populations. HIV prevalence was pooled, and in each country key themes were extracted from the literature. Results The search generated 885 titles, 214 abstracts and 122 full articles, of which 76 met inclusion and exclusion criteria providing HIV prevalence data. There were 60 articles characterizing the burden of disease among FSWs, eight for their clients, one for both, six for MSM and one for PWID. The pooled HIV prevalence among FSWs was 34.9% (n=14,388/41,270), among their clients was 7.3% (n=435/5986), among MSM was 17.7% (n=656/3714) and among PWID from one study in Nigeria was 3.8% (n=56/1459). Conclusions The disproportionate burden of HIV among FSWs appears to be consistent from the beginning of the HIV epidemic in WCA. While there are less data for other key populations such as clients of FSWs and MSM, the prevalence of HIV is higher among these men compared to other men in the region. There have been sporadic reports among PWID, but limited research on the burden of HIV among these men and women. These data affirm that the HIV epidemic in WCA appears to be far more concentrated among key populations than the

Male clients' behaviours with and perspectives about their last male escort encounter: comparing repeat versus first-time hires.

Science.gov (United States)

Wolff, Margaret M; Grov, Christian; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

2014-01-01

Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via daddysreviews.com completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, lifetime number of escorts hired and number hired in the past year were positively associated with the last encounter being a repeat encounter. Cuddling, sharing a meal, drinking alcohol, taking a walk, watching a show and shopping were also positively associated with repeat encounters. Conversely, none of the sexual behaviours were significantly associated with repeat encounters. Repeat encounters were significantly more likely to include non-sexual behaviours alongside sexual activities, but no more likely to involve condomless anal intercourse. Moreover, clients' knowledge of escorts' HIV status was not significantly associated with engaging in condomless anal intercourse with repeat encounters.

A brain-computer interface controlled mail client.

Science.gov (United States)

Yu, Tianyou; Li, Yuanqing; Long, Jinyi; Wang, Cong

2013-01-01

In this paper, we propose a brain-computer interface (BCI) based mail client. This system is controlled by hybrid features extracted from scalp-recorded electroencephalographic (EEG). We emulate the computer mouse by the motor imagery-based mu rhythm and the P300 potential. Furthermore, an adaptive P300 speller is included to provide text input function. With this BCI mail client, users can receive, read, write mails, as well as attach files in mail writing. The system has been tested on 3 subjects. Experimental results show that mail communication with this system is feasible.

Request queues for interactive clients in a shared file system of a parallel computing system

Science.gov (United States)

Bent, John M.; Faibish, Sorin

2015-08-18

Interactive requests are processed from users of log-in nodes. A metadata server node is provided for use in a file system shared by one or more interactive nodes and one or more batch nodes. The interactive nodes comprise interactive clients to execute interactive tasks and the batch nodes execute batch jobs for one or more batch clients. The metadata server node comprises a virtual machine monitor; an interactive client proxy to store metadata requests from the interactive clients in an interactive client queue; a batch client proxy to store metadata requests from the batch clients in a batch client queue; and a metadata server to store the metadata requests from the interactive client queue and the batch client queue in a metadata queue based on an allocation of resources by the virtual machine monitor. The metadata requests can be prioritized, for example, based on one or more of a predefined policy and predefined rules.

Daily total physical activity level and total cancer risk in men and women: results from a large-scale population-based cohort study in Japan.

Science.gov (United States)

Inoue, Manami; Yamamoto, Seiichiro; Kurahashi, Norie; Iwasaki, Motoki; Sasazuki, Shizuka; Tsugane, Shoichiro

2008-08-15

The impact of total physical activity level on cancer risk has not been fully clarified, particularly in non-Western, relatively lean populations. The authors prospectively examined the association between daily total physical activity (using a metabolic equivalents/day score) and subsequent cancer risk in the Japan Public Health Center-based Prospective Study. A total of 79,771 general-population Japanese men and women aged 45-74 years who responded to a questionnaire in 1995-1999 were followed for total cancer incidence (4,334 cases) through 2004. Compared with subjects in the lowest quartile, increased daily physical activity was associated with a significantly decreased risk of cancer in both sexes. In men, hazard ratios for the second, third, and highest quartiles were 1.00 (95% confidence interval (CI): 0.90, 1.11), 0.96 (95% CI: 0.86, 1.07), and 0.87 (95% CI: 0.78, 0.96), respectively (p for trend = 0.005); in women, hazard ratios were 0.93 (95% CI: 0.82, 1.05), 0.84 (95% CI: 0.73, 0.96), and 0.84 (95% CI: 0.73, 0.97), respectively (p for trend = 0.007). The decreased risk was more clearly observed in women than in men, especially among the elderly and those who regularly engaged in leisure-time sports or physical exercise. By site, decreased risks were observed for cancers of the colon, liver, and pancreas in men and for cancer of the stomach in women. Increased daily physical activity may be beneficial in preventing cancer in a relatively lean population.

77 FR 76854 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients

Science.gov (United States)

2012-12-31

... 3235-AL28 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... transactions with certain of their advisory clients. The amendment extends the date on which rule 206(3)- 3T... releases used RIN 3235-AJ96. (See Temporary Rule Regarding Principal Trades with Certain Advisory Clients...

Prevalence and risk factors of frailty among home care clients.

Science.gov (United States)

Miettinen, Minna; Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma

2017-11-17

Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. ClinicalTrials.gov: NCT02214758 .

Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.

Science.gov (United States)

Martin, Linda; Gitsels-van der Wal, Janneke T; Pereboom, Monique T R; Spelten, Evelien R; Hutton, Eileen K; van Dulmen, Sandra

2016-01-01

This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; pcommunication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The measurement of emotional reactions of bank clients

Directory of Open Access Journals (Sweden)

Marinković Veljko

2014-01-01

Full Text Available Focus on customers is an important factor in gaining sustainable competitive advantage of retail banks. Modern marketing-oriented banks have to be focused towards understanding and meeting the financial requirements of their clients. Attention of bank management should also be directed towards the study of quality of relationships between a bank and its clients. In this context, it is important to measure emotional reactions of clients. The aim of this paper is to identify the key drivers of emotional reactions. Specifically, two emotional reactions are observed in the paper: satisfaction and affective commitment. In the conducted study, two research models that include four independent variables (service quality, bank image, trust and social bonds are designed, wherein satisfaction is regarded as dependent variable in the first model, while affective commitment is given the role of dependent variable in the second model. The results indicate a moderate degree of satisfaction, but also a low level of affective commitment of the respondents. In addition, trust is stressed as the most important factor of emotional reactions. On the other hand, clients believe that banks provide a good quality service, where the quality stands out as an important driver of satisfaction, but not as a driver of affective commitment.

Assessment of Factors Affecting Quality of Life of Elderly Clients Coveraged Bye Health Centers of Southern of Tehran

Directory of Open Access Journals (Sweden)

Hasan Eftekhar Ardebili

2015-01-01

Full Text Available Objectives: The world population is aging rapidly because of rising life expectancy and deacrising fertility rate.with increasing longevity and special aging problems attention and evaluation the quality of life of elderly for health promotion would be significant importance Methods & Materials: this study is a descriptive and analytical study carried out to investigate the quality of life of elderly clients coveraged bye health centers of southern of tehran, in 2010-2011.132 elderly clients were selected by using the cluster randomised sampling from 5health centers. in this study a short form standard questionnaire (sf36was used for evaluation diverse domains of life quality scores. we also measured some other personal characteristics through demographic questionnaire. data were analyzed with descriptive and analytic statistics by spss software. Results: the mean score of physical domains of quality of life which was 54.42±24.42 and emotional domain of quality of life was 55.19±24.04. mean age was 67.97±6.86. research showed age had meaninful reverse relationship to quality of life (P=0.000, r=-0.4, men had higher quality of life scores than women.education level was directly related to all domains of life quality (P=0/000. married persons and who they lived with childerns or others had the higher quality of life scores than singles (divorced, widow (P<0.001. and physical activity was directly related to quality of life (P=0.000. but statistically significant differences were not found between the mean score of quality of life and BMI. (physical domain: P=0.59-emotional domain: P=0.127. notsmokers had higher quality of life scores than smokers. (P<0.05. Conclusion: total score of quality of life of elderly was moderate (54.81. therrefore attention and try to improving the quality of life of elderly clients is essential.

Cultural humility: measuring openness to culturally diverse clients.

Science.gov (United States)

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

2013-07-01

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

17 CFR 4.31 - Required delivery of Disclosure Document to prospective clients.

Science.gov (United States)

2010-04-01

... Disclosure Document to prospective clients. 4.31 Section 4.31 Commodity and Securities Exchanges COMMODITY... Advisors § 4.31 Required delivery of Disclosure Document to prospective clients. (a) Each commodity trading... prospective client a Disclosure Document containing the information set forth in §§ 4.34 and 4.35 for the...

A CONCEPTUAL TOOL FOR ASSESSING CLIENT PERFORMANCE IN THE CONSTRUCTION PROJECT COALITION

Directory of Open Access Journals (Sweden)

Gary D. Holt

2002-01-01

Full Text Available Due to the significant impact of client performance on overall project performance and the interdependence of participant%5C%27s performance in the construction project coalition %28i.e. clients%2C designers and constructors%29%2C there is a need to establish client performance measures. Based on data collected from in-depth interviews with nineteen UK architects and nine UK contractors%2C a generic tool for the on-going formal assessment of client performance is presented. It was found that this approach to performance assessment %28i.e. from the view point of other%2C non-client coalition participants%29 should lead to improved project relationships. Data analysis showed that in addition to %5C%27harder%5C%27 measures such as understanding of project requirements and finance%2C other%2C %5C%27softer%5C%27 measures of client performance %28e.g. attitude%29 were worthy of consideration since they determine the quality of participant relationships. It is recommended that the tool be used to promote more effective client performance and thus enhance coalition relationships%2C enabling continuous improvement. The ultimate aim is to develop similar tools for the assessment of all coalition participants based on a culture of openness and trust. Abstract in Bahasa Indonesia : assessment+tool%2C+coalition+participants%2C+client+performance%2C+perceptions%2C+performance+measures%2C+satisfaction.

Análise de Clientes de uma Distribuidora de Medicamentos

OpenAIRE

Sidney Lino Oliveira; Josmária Lima Ribeiro Oliveira

2004-01-01

Este artigo trata da análise de clientes por meio de uma pesquisa quantitativa para uma distribuidora farmacêutica. O interesse desta análise foi de identificar os principais clientes para estabelecer um relacionamento mais efetivo, e promo- ver a implantação de um sistema logístico que possibilite uma abordagem voltada para o cliente. O estudo de caso foi desenvolvido em uma distribuidora farmacêutica situada em Juiz de Fora/MG que atende à região da Zona da Mata/MG e o estado do Rio de Jane...

Community ambulation: influences on therapists and clients reasoning and decision making.

Science.gov (United States)

Corrigan, Rosemary; McBurney, Helen

2008-01-01

Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

An Evaluation of Treatment Outcomes in a Cohort of Clients on the DOTS Strategy, 2012-2016.

Science.gov (United States)

Tetteh, Ato Kwamena; Agyarko, Edward; Otchere, Joseph; Bimi, Langbong; Ayi, Irene

2018-01-01

We present, for the first time, an evaluation of treatment outcomes in a cohort at a TB referral centre in the Central Region of Ghana. Of the 213 clients placed on DOTS, 59.2% (126/213) were sputum smear-positive. An overall cure rate of 90.2% (51.6% cured + 37.6% completed) and a death rate of 8.5% (18/213) were estimated. Of the number of clients who died, 5.7% (12/213) were males ( χ 2 = 2.891, p = 0.699; LR = 3.004, p = 0.699). Deaths were only recorded among clients who were > 19 years old ( χ 2 = 40.319, p = 0.099; LR = 41.244, p = 0.083). Also, 0.9% (2/213) was lost to follow-up, while 1.4% (3/213) had treatment failure. In total, 13.6% (7.0%, 15/213 males, and 6.6%, 14/213 females) of clients who were placed on DOTS were HIV seropositive. Ages of 40-49 years had the highest number, 13/213 (6.1%), infected with HIV, though the difference among the remaining age groups was not statistically significant ( χ 2 = 9.621, p = 0.142). Furthermore, 7.0% (15/213) had TB/HIV coinfection. Out of them, 9 were cured and 5 died at home, while 1 had treatment failure. Tuberculosis/HIV infection prevention advocacy and interventions that address sociodemographic determinants of unfavourable treatment outcomes are urgently required to augment national efforts towards control.

Expectations and perceptions of clients concerning the quality of care provided at a Brazilian hospital facility.

Science.gov (United States)

Mendes, Isabel Amélia Costa; Trevizan, Maria Auxiliadora; de Godoy, Simone; Nogueira, Paula Cristina; Ventura, Carla Aparecida Arena; Furlan, Claudia Elizangela Bis

2018-02-01

To identify the expectations and perceptions of clients concerning the quality of hospital care provided to them and their respective companions at a private Brazilian hospital using SERVQUAL. The SERVQUAL questionnaire can provide information concerning expectations and perceptions of clients. In addition, it is able to identify the participation of frontline employees and how they contribute to the organization's end product (service delivery). In total, 172 inpatients for surgical reasons answered the SERVQUAL questionnaire. It consists of 23 pairs of statements, 22 of which are distributed into the dimensions of tangibles, reliability, responsiveness, assurance and empathy. Statement 23 refers to the overall quality of care. Exploratory analysis, internal consistency (Cronbach's alpha) and the kappa Coefficient were calculated using the Statistical Package for Social Sciences and SAS 9.2. Ethical approval was obtained from the Institutional Review Board at the Hospital das Clínicas at the University of São Paulo at Ribeirao Preto Medical School. Most participants had a bachelor's degree and were over than 60years old. Cronbach's alpha coefficients indicated good internal consistency (α=0.93) and high levels of agreement were observed (91.10%). The SERVQUAL questionnaire was sensitive to items in each dimension for which clients' perceptions surpassed their expectations. The continuous quality assessment of health services is mandatory for nursing leadership. The nursing leadership can further explore the SERVQUAL with a view to better attending to the clients' expectations. Copyright © 2017. Published by Elsevier Inc.

Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia.

Science.gov (United States)

Bell, Carolyn A; Ilomäki, Jenni; Pichenda, Koeut; Duncan, Gregory J; Saini, Bandana

2015-04-01

Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their closest public sector clinic for diagnosis and treatment. The study objective was to investigate factors associated with referral of TB symptomatic clients from pharmacies to public sector clinics in Phnom Penh, Cambodia. Face-to-face structured interviews were conducted with staff from a stratified random sample of 180 private pharmacies in Phnom Penh in 2012. Trained interviewers were Khmer speakers. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with self-reported referral during the previous 3 months. Fifty (29.6%) pharmacies reported that they had referred 125 clients (range 1-10) to public sector clinics during the previous 3 months. In total, 164 (96.5%) pharmacies reported that they always referred all TB symptomatic clients to DOTS (directly observed treatment, short course) clinics. More than 6-year participation in the programme (OR 5.23, 95% CI 1.93-14.18) and willingness to always continue referring (OR 12.24, 95% CI 11.61-93.10) were associated with referral of one or more clients in the previous 3 months. Referral to the client's closest clinic was negatively associated with referral (OR 0.45, 95% CI 0.23-0.99). Pharmacies' ongoing commitment to the Referral Programme was strongly associated with referral. Increased advocacy among the high number of non-referring pharmacies may improve programme performance. Factors negatively associated with referral may need investigation. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Montessori-based training makes a difference for home health workers & their clients.

Science.gov (United States)

Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

2003-01-01

Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.

Designing e-learning solutions with a client centred approach

DEFF Research Database (Denmark)

Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

2008-01-01

  This paper claims that the strategies applied in designing e-learning solutions tend to focus on how to proceed after the precondition, e.g., learners requirements, pedagogical choice, etc., have been decided upon. Investigating the HCI research field, we find that the methodological approaches...... as the organisation that has initiated the e-learning project and needs to manage the e-learning system after its development. Through the Client Centred Design and in close collaboration with the client, three strategic issues are uncovered and strategic models are presented for each. These models are complementary...... perspectives in a Client Centred framework that is useable as the starting point for others in developing large scale e-learning projects....

34 CFR 377.1 - What is the Demonstration Projects to Increase Client Choice Program?

Science.gov (United States)

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false What is the Demonstration Projects to Increase Client... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM General § 377.1 What is the Demonstration Projects to Increase Client Choice Program? The Demonstration Projects to Increase Client Choice Program is designed to...

Integrating Social and Traditional Media in the Client Project

Science.gov (United States)

Melton, James; Hicks, Nancy

2011-01-01

Based on a client project assigned to students in two undergraduate business classes, this article argues that social media learning is best done in a context that mixes social media with more traditional kinds of media. Ideally, this approach will involve teams of students who are working on different aspects of a larger client project. This…

Chilean geo client application for disasters

Science.gov (United States)

Suárez, Rodrigo F.; Lovison, Lucia; Potters, Martinus

2018-05-01

The global network of the Group on Earth Observation, GEO, connects all kinds of professionals from public and private institutions with data providers, sharing information to face the challenges of global changes and human development and they are creating a Global Earth Observation System of Systems (GEOSS) to connect existing data infrastructures. A GEOSS Architecture Implementation Pilot Project for Disasters in Chile (AIP-8) was created as part of a capacity building initiative and representatives of different national agencies in Chile, along with international experts, formed a GEOSS Capacity Building Working Group (Lovison et al, 2016). Consistent with the objectives of GEOSS AIP-8 Chile, we developed and implemented a prototype service based on web services, mobile applications and other communication channels, which allows connecting different sources of information, aiming to reduce population vulnerability to natural disasters such as: earthquakes, flooding, wild fires and tsunamis, which is presented here. The GEO Chile client application is a JavaScript application using GEODAB brokering services, GIS technology and disaster information provided by national and international disaster services, including public and private organizations, where cartography becomes fundamental as a tool to provide realism and ubiquity to the information. Seven hotpots are targeted: Calbuco, Copahue and Villarrica volcanoes areas, Valparaíso city, which is frequently a victim of wildfires in the zone where population meets forest and Iquique, Illapel and Talcahuano, areas frequently struck by earthquakes and tsunamis.

Prostitución en Galicia: clientes e imaginarios femeninos Prostitution in Galicia: clients and feminine imaginary

Directory of Open Access Journals (Sweden)

Agueda Gómez Suárez

2010-04-01

Full Text Available Hoy, la prostitución en nuestra sociedad resulta un indicador de la "cultura sexual" dominante en las sociedades patriarcales y capitalistas. Este artículo pretende aportar otro enfoque al análisis de la industria sexual en nuestro país, ajustándose, principalmente, a las experiencias de los hombres implicados en el fenómeno de la prostitución en Galicia. El dramatismo con que las mujeres en prostitución viven su realidad y la frivolidad y ociosidad en la que se recrean los clientes, muestra el controvertido e inquietante semblante de esta realidad. El análisis del discurso de los clientes a través del "Frame Analysis", y el estudio de los imaginarios femeninos dominantes entre ellos son retratados en este texto, junto con el discurso de las mujeres en prostitución y el de los hombres que ocupan espacios masculinizados. Este artículo pretende ser una contribución más al complejo estudio del fenómeno de la prostitución en nuestro país.Today, the prostitution in our society turns out to be an indicator of the dominant "sexual culture" in the patriarchal and capitalist societies. This article tries to contribute with another approach to the analysis of the sexual industry in our country, adjusting, principally, to the experiences of the men involved in the phenomenon of the prostitution in Galicia. The dramatic quality in which the women in prostitution live their reality and the levity and idleness, in which the clients enjoy themselves, show the controversial and worrying face of this reality. The analysis of the clients' speech across the "Frame Analysis", and the study of the feminine dominant imaginary among them are portrayed in this text, together with the speech of the women in prostitution and of the men who occupy masculinized spaces. This article tries to be a contribution to the complex study of the phenomenon of the prostitution in our country.

Estrategias de fidelización aplicadas a los clientes de la empresa Punto Exe del Canton Manta

Directory of Open Access Journals (Sweden)

Aarón Leonel Baduy Molina

2017-07-01

Full Text Available Las estrategias de fidelización en los clientes radican en ofrecer un servicio resaltando las cualidades del producto complementando una atención eficiente por parte de los colaboradores de una empresa. Es común observar que los técnicos en reparación de computadoras carecen de una atención personalizada, cumplir con eficiencia el plazo de entrega acordado. Esta investigación se realizó con el fin de desarrollar estrategias de marketing que permitan la captación y fidelización a corto plazo de nuevos clientes en la empresa Punto Exe de la ciudad de Manta. La misma describe las percepciones de los clientes sobre el servicio de atención que ellos reciben. Para ello se utilizó la encuesta basada al modelo Europeo de Gestión de la Calidad total, (EFQM de Joaquín Membrado Martínez a 313 clientes durante el último trimestre del año 2015, con la finalidad de conocer el nivel de posicionamiento de la empresa. Se aplicó el método descriptivo lo cual permitió conocer los resultados de la investigación, se pudo determinar que no todos los clientes conocen en totalidad los servicios que esta brinda mediante su página web, debido a la poca publicidad en redes sociales que ayudarían a mantener una relación e interacción con ellos teniendo como resultado la fidelización hacia la empresa.   Palabras clave: marketing, imagen, gestión de calidad

Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

Science.gov (United States)

1992-01-01

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

Encounters with unemployment in occupational health care: Nurses' constructions of clients without work.

Science.gov (United States)

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

2010-02-01

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

45 CFR 1621.4 - Complaints by clients about manner or quality of legal assistance.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Complaints by clients about manner or quality of...) LEGAL SERVICES CORPORATION CLIENT GRIEVANCE PROCEDURES § 1621.4 Complaints by clients about manner or... clients about the manner or quality of legal assistance that has been rendered by the recipient to the...

Bringing the client back in

DEFF Research Database (Denmark)

Danneris, Sophie; Nielsen, Mathias Herup

2018-01-01

Categorizing the job readiness of unemployed clients is a task of the utmost importance for active labor market policies. Scholarly attention on the topic has mostly focused either on questions of political legitimacy or on how categories are practically negotiated in meetings between the welfare...

Ulysses directives in The Netherlands: opinions of psychiatrists and clients

NARCIS (Netherlands)

Varekamp, I.

2004-01-01

In this article we present a study on the opinions of Dutch psychiatrists and clients on Ulysses directives. In-depth interviews were conducted with 18 clients and 17 psychiatrists. Most respondents were proponents of Ulysses directives. The most frequently mentioned objective of these directives

Client participation in moral case deliberation: a precarious relational balance

NARCIS (Netherlands)

Weidema, F.C.; Abma, T.A.; Widdershoven, G.A.M.; Molewijk, A.C.

2011-01-01

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client

Toward Healthy Family Breathing: client survey

National Research Council Canada - National Science Library

Kaloti, Jiti; Naylor, P.J

1997-01-01

.... A secondary purpose was to measure clients behaviours and attitudes to add to the knowledge about how different types of perinatal workers can best assist pregnant and parenting women who smoke...

Antecedent control in the treatment of brain-injured clients.

Science.gov (United States)

Zencius, A H; Wesolowski, M D; Burke, W H; McQuade, P

1989-01-01

Three brain-injured clients failed to respond significantly to consequence management programmes designed to increase attendance, use of a cane, and to reduce unauthorized breaks. When antecedent stimulus control procedures were applied, attendance and use of a cane increased and unauthorized breaks decreased. The study shows that antecedent control may be the treatment of choice when treating brain-injured clients with memory loss.

Meaning of dancing therapy in therapy of clients with psychological diseases

OpenAIRE

NĚMCOVÁ, Barbora

2010-01-01

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

UNDERSTANDING OF NON VERBAL BEHAVIOR CLIENTS AND TECHNIQUES IN COUNSELING SESSION

Directory of Open Access Journals (Sweden)

afdal afdal

2016-06-01

Full Text Available The practice of counseling by counselor not only need the skills to understand what is expressed by the client, but were further able to understand and have skills in giving meaning to the nonverbal communication, demonstrated by the behavior of a counseling session. During this time many of counselors who focus only on what is revealed by the client and using verbal techniques alone without seeing what goes on inside the client more deeply to understand the communication indicated by nonverbal behavior. The techniques used in the discussion of this article provides the inspiration that counseling is an art, not superficial, not skeptical and just focus on one technique alone, but many of the techniques that can be used to explore client issues. Furthermore, this paper supports the philosophical theory of Gestalt who believe that the client can feel the direct presence in the counseling sessions through the practices of the techniques used, to interpret the expression of various communications made, stationing themselves and find their own meaning.

BAG3 induces the sequestration of proteasomal clients into cytoplasmic puncta

Science.gov (United States)

Minoia, Melania; Boncoraglio, Alessandra; Vinet, Jonathan; Morelli, Federica F; Brunsting, Jeanette F; Poletti, Angelo; Krom, Sabine; Reits, Eric; Kampinga, Harm H; Carra, Serena

2014-01-01

Eukaryotic cells use autophagy and the ubiquitin–proteasome system as their major protein degradation pathways. Upon proteasomal impairment, cells switch to autophagy to ensure proper clearance of clients (the proteasome-to-autophagy switch). The HSPA8 and HSPA1A cochaperone BAG3 has been suggested to be involved in this switch. However, at present it is still unknown whether and to what extent BAG3 can indeed reroute proteasomal clients to the autophagosomal pathway. Here, we show that BAG3 induces the sequestration of ubiquitinated clients into cytoplasmic puncta colabeled with canonical autophagy linkers and markers. Following proteasome inhibition, BAG3 upregulation significantly contributes to the compensatory activation of autophagy and to the degradation of the (poly)ubiquitinated proteins. BAG3 binding to the ubiquitinated clients occurs through the BAG domain, in competition with BAG1, another BAG family member, that normally directs ubiquitinated clients to the proteasome. Therefore, we propose that following proteasome impairment, increasing the BAG3/BAG1 ratio ensures the “BAG-instructed proteasomal to autophagosomal switch and sorting” (BIPASS). PMID:25046115

Neurobiological response to EMDR therapy in clients with different psychological traumas

Directory of Open Access Journals (Sweden)

MARCO ePAGANI

2015-10-01

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

An Exploration of Supervisory and Therapeutic Relationships and Client Outcomes

Science.gov (United States)

Bell, Hope; Hagedorn, W. Bryce; Robinson, E. H. Mike

2016-01-01

The authors explored the connection between the facilitative conditions present within the supervisory relationship, the therapeutic relationship, and client outcomes. A correlational research design was used with a sample of 55 counselors-in-training and 88 clients. Results indicated a significant positive relationship between the therapeutic…

Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients

Science.gov (United States)

American Psychologist, 2012

2012-01-01

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

Ulysses directives in The Netherlands: opinions of psychiatrists and clients.

Science.gov (United States)

Varekamp, I

2004-12-01

In this article we present a study on the opinions of Dutch psychiatrists and clients on Ulysses directives. In-depth interviews were conducted with 18 clients and 17 psychiatrists. Most respondents were proponents of Ulysses directives. The most frequently mentioned objective of these directives was to secure timely admission to hospital, although a large minority was mainly interested in giving patients influence on treatment decisions. Psychiatrists differed on how much autonomy they preferred with regard to decisions about the moment of admission and kind of treatment. Clients also differed in this respect. Pressure from others to execute a Ulysses directive, and premature admission to the hospital were mentioned as risks of Ulysses directives. Crisis cards were seen as an alternative by many psychiatrists and some clients. Recommendations are made for a good functioning of Ulysses directives, and the appropriateness of crisis cards as an alternative for a number of patients is discussed.

Challenging the Courtesy Bias Interpretation of Favorable Clients' Perceptions of Family Planning Delivery

Science.gov (United States)

Len, Federico R.; Lundgren, Rebecka; Huapaya, Ana; Sinai, Irit; Jennings, Victoria

2007-01-01

Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three…

Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers

Directory of Open Access Journals (Sweden)

Marttila Anneli

2012-07-01

Full Text Available Abstract Background Long-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual´s own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions. Methods Interviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis. Results The main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities. Conclusions Overall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation

Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers.

Science.gov (United States)

Marttila, Anneli; Johansson, Eva; Whitehead, Margaret; Burström, Bo

2012-07-12

Long-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual's own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions. Interviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis. The main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities. Overall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation between different authorities.

Round-Trip Delay Estimation in OPC UA Server-Client Communication Channel

OpenAIRE

Nakutis, Zilvinas; Deksnys, Vytautas; Jarusevicius, Ignas; Dambrauskas, Vilius; Cincikas, Gediminas; Kriauceliunas, Alenas

2017-01-01

In this paper an estimation of round-trip delay (RTD) in OPC UA server-client channel was investigated in various data communication networks including Ethernet, WiFi, and 3G. Testing was carried out using the developed IoT gateway device running OPC UA server and remote computer running OPC UA client. The server and the client machines were configured to operate in Virtual Private Network powered by OpenVPN. Experimental analysis revealed that RTD values are distributed in the wide range exh...

Care coordinator views and experiences of physical health monitoring in clients with severe mental illness: A qualitative study.

Science.gov (United States)

Gronholm, Petra C; Onagbesan, Oluwadamilola; Gardner-Sood, Poonam

2017-11-01

Excess mortality among people with severe mental illness (SMI) is largely attributed to co-morbid physical illness. Improving the physical health of this population is critically important; however, physical health monitoring among people with SMI is often inadequate. This study aimed to facilitate an enhanced understanding of barriers to successfully attend to clients' physical health in mental health settings, through exploring care coordinators' views and experiences regarding their ability to monitor physical health in clients with SMI (specifically, psychosis). Semi-structured interviews were conducted with seven care coordinators from a South East London (UK) community mental health team. Data were analysed using thematic analysis principles. Three themes were identified in these data, capturing (1) how care coordinators viewed the professional roles of other clinical staff and themselves, (2) views on barriers to the provision of physical healthcare and (3) factors that motivated care coordinators to attend to clients' physical health. Our findings can inform efforts to implement physical healthcare interventions within mental health settings. Such insights are timely, as academic literature and guidelines regarding clinical practice increasingly promote the value of integrated provision of mental and physical healthcare.

Nonromantic/Nonsexual Relationships with Former Clients: Implications for Psychologists' Training.

Science.gov (United States)

Anderson, Sharon K.

The ethical principles and code of conduct of the American Psychological Association are clear: psychologists are to avoid sexual relationships with former clients. But guidelines offer scant guidance on nonromantic and nonsexual relationships with former clients; the ethical risks of such relationships are explored in this paper. The information…

The Challenge of Prejudice: Counsellors' Talk about Challenging Clients' Prejudices

Science.gov (United States)

Spong, Sheila J.

2012-01-01

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

Patent Medicine VendorsAND#8217; Clients: Medicine Use Behaviour

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Asa Auta

2012-12-01

Full Text Available AIM: To investigate some medicine use behaviour of Patent Medicine Vendors’ (PMVs clients including self medication practice and medication sharing behaviour. METHOD: A descriptive, cross-sectional survey was conducted in July 2011, on 361 undergraduate students of the University of Jos, Nigeria who visited PMVs within a month preceding the study. A pretested questionnaire was administered to participating students. Participants responded to questions on demography, and medicine use behaviour. Data were entered into the Statistical Package for Social Sciences (SPSS version 16 to generate descriptive statistics which were represented in percentages. RESULTS: The results showed that majority of the respondents (91.7% visited the PMVs for self-medication with the common classes of medicines procured by PMVs clients including analgesics (38.4%, antimalarials (22.2% and nutrition/blood preparations (14.1%. About 78.5% of the medicines sold to PMVs clients were in their original package and only 45.9% of clients reported checking the expiry date of their procured medicine prior to use. Medication sharing behaviour was common (60.2% among respondents. Although most respondents (70.2% said they had read a medicine information leaflet in the past, majority of them depended on unreliable sources such as friends/relatives (23.2%, media (10.8% and the internet (9.9% for medicine information. CONCLUSION: The study therefore demonstrated that PMV clients are those on self-medication practices and medication sharing behaviour is high among them. [TAF Prev Med Bull 2012; 11(6.000: 681-686

Experiences in occupational therapy with Afghan clients in Australia.

Science.gov (United States)

Maroney, Pamela; Potter, Marianne; Thacore, Vinod Rai

2014-02-01

With a steady increase of refugees arriving in Australia from Afghanistan coupled with reports that prevalence of mental illness amongst Afghan refugees in South-East Melbourne is particularly high, mental health providers will need to acquire cultural competence to provide effective treatment. There is a dearth of literature on the subject of rehabilitation of Afghan psychiatric clients in the Australian context, providing the impetus for this article. To illustrate the impact of Afghan socio-cultural beliefs and attitudes on the implementation of occupational therapy and rehabilitation programmes in a mental health facility and adaptations to accommodate the needs of the clients and their families. Two case vignettes of Afghan clients are presented to illustrate the variance in goals and expectations of the clients and their families to that of the occupational therapy and rehabilitation programmes offered. Family expectations and involvement, culture-specific factors and religion play significant roles in the presentation and treatment of clients from the Muslim culture and require modification in implementation of rehabilitation programmes. A need for developing family or community-based services is proposed coupled with culturally responsive practices. Culture sensitive models of occupational therapy will need to be developed as younger generations of refugee families acculturate and need psychological help to deal with conflicts with parents and elders who hold values different from those adopted by their children born and brought up in the Australian socio-cultural environment. These and other issues mentioned above provide fertile fields for research in this evolving area of occupational therapy. © 2014 Occupational Therapy Australia.

The insecure psychotherapy base: Using client and therapist attachment styles to understand the early alliance.

Science.gov (United States)

Marmarosh, Cheri L; Kivlighan, Dennis M; Bieri, Kathryn; LaFauci Schutt, Jean M; Barone, Carrie; Choi, Jaehwa

2014-09-01

The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Retaining clients in an outcome monitoring evaluation study: HIV prevention efforts in community settings.

Science.gov (United States)

Smith, Bryce D; Kalayil, Elizabeth J; Patel-Larson, Alpa; Chen, Brenda; Vaughan, Marla

2012-02-01

The Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) conducted outcome monitoring studies on evidence-based interventions (EBIs) provided by CDC-funded community-based organizations (CBOs). Critical to the success of outcome monitoring was the ability of CBOs to recruit and retain clients in evaluation studies. Two EBIs, Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) and Healthy Relationships, were evaluated using repeated measure studies, which require robust follow-up retention rates to increase the validity and usefulness of the findings. The retention rates were high for both VOICES/VOCES CBOs (95.8% at 30 days and 91.1% at 120 days), and Healthy Relationships CBOs (89.5% at 90 days and 83.5% at 180 days). This paper presents an overview of the retention of clients, challenges to follow-up, and strategies developed by CBOs to achieve high retention rates. These strategies and rates are discussed within the context of the CBOs' target populations and communities. Published by Elsevier Ltd.

Client-Centered Employee Assistance Services.

Science.gov (United States)

Bayer, Darryl Lee

This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

Hsp90: Friends, clients and natural foes.

Science.gov (United States)

Verma, Sharad; Goyal, Sukriti; Jamal, Salma; Singh, Aditi; Grover, Abhinav

2016-08-01

Hsp90, a homodimeric ATPase, is responsible for the correct folding of a number of newly synthesized polypeptides in addition to the correct folding of denatured/misfolded client proteins. It requires several co-chaperones and other partner proteins for chaperone activity. Due to the involvement of Hsp90-dependent client proteins in a variety of oncogenic signaling pathways, Hsp90 inhibition has emerged as one of the leading strategies for anticancer chemotherapeutics. Most of Hsp90 inhibitors blocks the N terminal ATP binding pocket and prevents the conformational changes which are essential for the loading of co-chaperones and client proteins. Several other inhibitors have also been reported which disrupt chaperone cycle in ways other than binding to N terminal ATP binding pocket. The Hsp90 inhibition is associated with heat shock response, mediated by HSF-1, to overcome the loss of Hsp90 and sustain cell survival. This review is an attempt to give an over view of all the important players of chaperone cycle. Copyright © 2016 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

A real time multi-server multi-client coherent database for a new high voltage system

International Nuclear Information System (INIS)

Gorbics, M.; Green, M.

1995-01-01

A high voltage system has been designed to allow multiple users (clients) access to the database of measured values and settings. This database is actively maintained in real time for a given mainframe containing multiple modules each having their own database. With limited CPU nd memory resources the mainframe system provides a data coherency scheme for multiple clients which (1) allows the client to determine when and what values need to be updated, (2) allows for changes from one client to be detected by another client, and (3) does not depend on the mainframe system tracking client accesses

Dinheiro, afeto, sexualidade: a relação de prostitutas com seus clientes Dinero, afecto y sexualidad: la relación de prostitutas com sus clientes Money, affection and sexuality: the prostitutes' relationship with clients

Directory of Open Access Journals (Sweden)

Fernanda Burbulhan

2012-12-01

Full Text Available A prostituição é alvo constante de diferentes olhares, e para desvelar alguns de seus significados, resolvemos estudar a relação estabelecida entre a prostituta e o seu cliente. Para tanto, elegemos a abordagem qualitativa de pesquisa, com informações obtidas através de entrevista semiestruturada. Nosso estudo contou com sete participantes mulheres, com idade mínima de dezoito anos e envolvimento com a prática da prostituição há pelo menos um ano. As participantes responderam um questionário socioeconômico e foram entrevistadas, sendo as entrevistas posteriormente submetidas à análise de conteúdo. Com base nas informações obtidas, concluímos que a relação estabelecida entre prostitutas e seus clientes fundamenta-se no dinheiro, tanto em relação ao que o cliente paga quanto em relação àquilo que ele não pode pagar, porque "não tem preço". Essa negociação serve de alicerce para o estabelecimento de condições de ser-estar dessas mulheres profissionais do sexo dentro e fora da prostituição.La prostitución es objetivo constante de diferentes puntos de vista y a fin de aclarar algunos de sus significados, se optó por estudiar la relación establecida entre la prostituta y su cliente. Así, elegimos un enfoque cualitativo de la investigación, con la información obtenida a través de entrevista semiestructurada. Nuestro estudio contó con la presencia de siete participantes del sexo femenino, con edad mínima de 18 años y su participación en el ejercicio de la prostitución en al menos un año. Las participantes respondieron a un cuestionario socioeconómico y fueron entrevistadas, y las entrevistas posteriormente objeto de análisis de contenido. Podemos concluir que la relación establecida entre las prostitutas y sus clientes se basa en el dinero, tanto en relación a lo que el cliente paga, así como en lo que respecta a lo que él no puede pagar porque "no tiene un precio". Este acuerdo sirve como base

The Performance and Compatibility of Thin Client Computing with Fleet Operations

National Research Council Canada - National Science Library

Landry, Kenneth J

2006-01-01

...) with a thin client/server-based computing (TCSBC) architecture. After becoming nearly extinct in the early 1990s, thin clients are emerging on the forefront of technology with numerous bandwidth improvements and cost reduction benefits...

An Evaluation of Treatment Outcomes in a Cohort of Clients on the DOTS Strategy, 2012–2016

Directory of Open Access Journals (Sweden)

Ato Kwamena Tetteh

2018-01-01

Full Text Available We present, for the first time, an evaluation of treatment outcomes in a cohort at a TB referral centre in the Central Region of Ghana. Of the 213 clients placed on DOTS, 59.2% (126/213 were sputum smear-positive. An overall cure rate of 90.2% (51.6% cured + 37.6% completed and a death rate of 8.5% (18/213 were estimated. Of the number of clients who died, 5.7% (12/213 were males (χ2 = 2.891, p=0.699; LR = 3.004, p=0.699. Deaths were only recorded among clients who were > 19 years old (χ2 = 40.319, p=0.099; LR = 41.244, p=0.083. Also, 0.9% (2/213 was lost to follow-up, while 1.4% (3/213 had treatment failure. In total, 13.6% (7.0%, 15/213 males, and 6.6%, 14/213 females of clients who were placed on DOTS were HIV seropositive. Ages of 40–49 years had the highest number, 13/213 (6.1%, infected with HIV, though the difference among the remaining age groups was not statistically significant (χ2 = 9.621, p=0.142. Furthermore, 7.0% (15/213 had TB/HIV coinfection. Out of them, 9 were cured and 5 died at home, while 1 had treatment failure. Tuberculosis/HIV infection prevention advocacy and interventions that address sociodemographic determinants of unfavourable treatment outcomes are urgently required to augment national efforts towards control.

Paying by the hour: The least appealing option for clients of lawyers

OpenAIRE

Seldeslachts, Jo

2016-01-01

In this study, we analyze a client's choice of contract in auctions where Dutch law firms compete for cases. The distinguishing feature is that lawyers may submit bids with any fee arrangement they wish. We find robust evidence that bids offering hourly rates are less attractive to clients. Our findings tentatively contradict lawyers' often-made argument that hourly rates are in a client's best interest.

Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective

OpenAIRE

Jati Utomo Dwi Hatmoko; Riqi Radian Khasania

2016-01-01

By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respo...

Channel Access Client Toolbox for Matlab

International Nuclear Information System (INIS)

2002-01-01

This paper reports on MATLAB Channel Access (MCA) Toolbox--MATLAB [1] interface to EPICS Channel Access (CA) client library. We are developing the toolbox for SPEAR3 accelerator controls, but it is of general use for accelerator and experimental physics applications programming. It is packaged as a MATLAB toolbox to allow easy development of complex CA client applications entirely in MATLAB. The benefits include: the ability to calculate and display parameters that use EPICS process variables as inputs, availability of MATLAB graphics tools for user interface design, and integration with the MATLABbased accelerator modeling software - Accelerator Toolbox [2-4]. Another purpose of this paper is to propose a feasible path to a synergy between accelerator control systems and accelerator simulation codes, the idea known as on-line accelerator model

Distribución comercial: Tema 14. El servicio al cliente en el comercio minorista

OpenAIRE

Juan Vigaray, María Dolores de

2010-01-01

El servicio al cliente tiene una importancia trascendente a la hora de mantener y recuperar clientes. Un mal servicio al cliente puede anular completamente un producto fantástico. Se debe de recordar al cliente la posibilidad y el interés de la empresa en que reclame y diga cualquier cosa que no le haya satisfecho, para que la empresa pueda corregir el error y compensarle.

Lightweight Tactical Client: A Capability-Based Approach to Command Post Computing

Science.gov (United States)

2015-12-01

bundles these capabilities together is proposed: a lightweight tactical client. In order to avoid miscommunication in the future, it is... solutions and almost definitely rules out most terminal-based thin clients. UNCLASSIFIED Approved for public release

The influence of clients' leadership in relation to construction health ...

African Journals Online (AJOL)

The South African Construction Regulations realise the contributions by each member of a project team to health and safety (H&S) improvement. These Regulations amplify the roles and contributions of clients to project realisation. The tenets of the Regulations conform with the observation that clients' H&S leadership and ...

Exploring Psychotherapy Clients' Independent Strategies for Change While in Therapy

Science.gov (United States)

Mackrill, Thomas

2008-01-01

Psychotherapy research usually describes how client change is caused by therapist interventions. This article describes how clients change by continuing to use and revising the strategies for change that they bring with them when they first enter therapy. This article presents data from a qualitative diary study of psychotherapy. Three cases…

Do Organizational Culture and Climate Matter for Successful Client Outcomes?

Science.gov (United States)

Silver Wolf, David A. Patterson; Dulmus, Catherine N.; Maguin, Eugene; Cristalli, Maria

2014-01-01

Objectives: The existing literature on the impact of workplace conditions on client care suggests that good cultures and climates provide the best outcomes for clients. The primary purpose of this study was to investigate the relationship between organizational culture and climate and the proportion of children and youth successfully discharged…

Client Participation in Managing Social Work Service--An Unfinished Quest

Science.gov (United States)

Leung, Terry T. F.

2011-01-01

"Client participation" is a popular ideal and object of rhetorical commitment in social work service. But the much-touted potential of this concept requires careful and critical scrutiny. This article reports on a study of client-participation initiatives in the Hong Kong welfare sector. The study identified significant differences in…

Parallel Journeys: How a Music Therapist Can Travel with his Client

OpenAIRE

Henry Dunn

2009-01-01

This paper explores the nature of the client-therapist relationship through the presentation of a case study. In this case study I aim to show how our processes within the therapy had strong parallels and how through being personally affected by my client this enabled me to work therapeutically more effectively and help him on his journey. The case study demonstrates how I was prepared to try new techniques at the same time as my client became more experimental, and also reveals how the clien...

A corporalidade do cliente segundo representações de estudantes de enfermagem La corporalidad del cliente según representaciones de estudiantes de enfermería The corporality of the client according to nursing students representations

Directory of Open Access Journals (Sweden)

Renata Campos de Lima

2006-12-01

Full Text Available É um estudo fundamentado na teoria da Representação Social que subsidiou a apreensão e análise de como as estudantes de enfermagem perceberam e representaram o corpo de seus clientes e as subjetividades emergentes do contato da relação do cuidar. Foi realizado junto a 20 estudantes do sexo feminino das quatro séries de graduação em Enfermagem da UNIFESP. Os dados foram obtidos utilizando a entrevista aberta e analisados pelo método Análise de Conteúdo (Análise Categorial, o qual desvelou as seguintes categorias: corpo objeto, estigmatização, relação estudante-cliente, comunicação corporal, invasão de privacidade e constrangimento.Es un estudio basado en la teoría de la Representación Social que subsidió la incautación y análisis de como las estudiantes de enfermería percibieron y representaron el cuerpo de sus clientes y las subjetividades emergentes del contacto de la relación del cuidar. Fue realizado junto la 20 estudiantes del sexo femenino de las cuatro series de graduación en Enfermería de la UNIFESP. Los datos fueron obtenidos utilizando la entrevista abierta y analizados por el método Análisis de Contenido (Análisis Categorial, lo cual desveló las siguientes categorías: cuerpo objeto, estigmatizacion, relación estudiante-cliente, comunicación corporal, invasión de privacidad y constreñimiento.This study based on the theory of the Social Representation that subsidized the apprehension and analysis of how nursing students had perceived and represented the body of their clients and the emergent subjectives of contact and relation of taking care. It was carried with 20 female students of four grades of the nursing faculty of the UNIFESP. The data were obtained using interview and analysed by content analysis method (Categorial Analysis that showed the following categories: body object, stigmatisation, student-client relationship, body communication, privacy's intrusion and embarrassing.

37 CFR 10.85 - Representing a client within the bounds of the law.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client within... OFFICE Patent and Trademark Office Code of Professional Responsibility § 10.85 Representing a client within the bounds of the law. (a) In representation of a client, a practitioner shall not: (1) Initiate...

Effects of Counselor Gender and Gender-Role Orientation on Client Career Choice Traditionality.

Science.gov (United States)

Barak, Azy; And Others

1988-01-01

Male (N=120) and female (N=120) clients were counseled by male or female counselor classified as masculine, feminine, or androgynous in sex-role orientation. Clients' career choice traditionality was measured during counseling, following counseling, and with respect to clients' career six months later. Counselor gender and gender-role orientation…

Counselors' attachment anxiety and avoidance and the congruence in clients' and therapists' working alliance ratings.

Science.gov (United States)

Kivlighan, Dennis M; Marmarosh, Cheri L

2018-07-01

To determine how counselors' attachment anxiety and avoidance related to congruence between counselors' and clients' Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients' WA ratings predicting counselors' WA ratings. Directional bias was defined as the difference in level between counselors' and clients' WA ratings. Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. As hypothesized counselors' WA ratings were significantly and positively related to clients' WA ratings. Also as hypothesized, counselors' WA ratings were significantly lower than their clients' WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors' attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Counselors' attachment anxiety is realted to their ability to accurately percieve their clients' WA.

Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective

Directory of Open Access Journals (Sweden)

Jati Utomo Dwi Hatmoko

2016-09-01

Full Text Available By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respondents. The results show that there is a significant difference between both types of client performance. Three variables related to financial indicators, i.e. timely payment, owner value estimate, and payment approval, rank in the bottom three of the government client performance, but in contrast rank in the top three of the private ones. These results suggest that the government clients’ performance is perceived inferior to the private ones. Establishing a clients’ forum for sharing knowledge and best practices would be a strategic solution to enhance clients’ capacities.

An Empirical Research on Bank Client Credit Assessments

Directory of Open Access Journals (Sweden)

Quan Chen

2018-05-01

Full Text Available Individual microcredit loans involve large quantities and small amounts and necessitate rapid approval, therefore making simple and fast application approvals rather critical. Creditors must evaluate clients’ credit status and default risk within the shortest time when determining whether to approve or decline their applications, preventing overdue responses that negatively impact bank profits and management practices, and could trigger domestic financial crises. This study investigates client credit quality criteria, focusing on the expert opinions of bank managers. The decision-making trial and evaluation laboratory method is adopted to enable a comparison and analysis of the similarities and differences in how banks evaluate their clients’ character, ability, financial capability, and collateral. Based on causality and correlations among the criteria, we also identify the core problems and key improvement criteria in the evaluation system. Through survey results of professional managers from Taiwanese banks, this study uses the DEMATEL method to compare the differences in bank evaluation methods based on the four dimensions of clients’ character, ability, pockets, and collateral, as well as the corresponding 14 criteria. In order to improve the reliability and usefulness in bank client credit risk assessment, the assessment dimensions and indicators of bank client credit risk assessment are first discussed; second, the causal relationship and degree of mutual influence between different dimensions and criteria are researched and assessed; in the end, the paper discusses how to improve the function and the benefits of bank client credit risk assessment.

Therapists' causal attributions of clients' problems and selection of intervention strategies.

Science.gov (United States)

Royce, W S; Muehlke, C V

1991-04-01

Therapists' choices of intervention strategies are influenced by many factors, including judgments about the bases of clients' problems. To assess the relationships between such causal attributions and the selection of intervention strategies, 196 counselors, psychologists, and social workers responded to the written transcript of a client's interview by answering two questionnaires, a 1982 scale (Causal Dimension Scale by Russell) which measured causal attribution of the client's problem, and another which measured preference for emotional, rational, and active intervention strategies in dealing with the client, based on the 1979 E-R-A taxonomy of Frey and Raming. A significant relationship was found between the two sets of variables, with internal attributions linked to rational intervention strategies and stable attributions linked to active strategies. The results support Halleck's 1978 hypothesis that theories of psychotherapy tie interventions to etiological considerations.

45 CFR 2551.81 - What type of clients are eligible to be served?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false What type of clients are eligible to be served... FOR NATIONAL AND COMMUNITY SERVICE SENIOR COMPANION PROGRAM Clients Served § 2551.81 What type of clients are eligible to be served? Senior Companions serve only adults, primarily older adults, who have...

Development and construct validation of the Client-Centredness of Goal Setting (C-COGS) scale.

Science.gov (United States)

Doig, Emmah; Prescott, Sarah; Fleming, Jennifer; Cornwell, Petrea; Kuipers, Pim

2015-07-01

Client-centred philosophy is integral to occupational therapy practice and client-centred goal planning is considered fundamental to rehabilitation. Evaluation of whether goal-planning practices are client-centred requires an understanding of the client's perspective about goal-planning processes and practices. The Client-Centredness of Goal Setting (C-COGS) was developed for use by practitioners who seek to be more client-centred and who require a scale to guide and evaluate individually orientated practice, especially with adults with cognitive impairment related to acquired brain injury. To describe development of the C-COGS scale and examine its construct validity. The C-COGS was administered to 42 participants with acquired brain injury after multidisciplinary goal planning. C-COGS scores were correlated with the Canadian Occupational Performance Measure (COPM) importance scores, and measures of therapeutic alliance, motivation, and global functioning to establish construct validity. The C-COGS scale has three subscales evaluating goal alignment, goal planning participation, and client-centredness of goals. The C-COGS subscale items demonstrated moderately significant correlations with scales measuring similar constructs. Findings provide preliminary evidence to support the construct validity of the C-COGS scale, which is intended to be used to evaluate and reflect on client-centred goal planning in clinical practice, and to highlight factors contributing to best practice rehabilitation.

Students: Customers, Clients or Pawns?

Science.gov (United States)

Tight, Malcolm

2013-01-01

The metaphor of the student as a consumer or customer is widely used within contemporary higher education, and impacts on the ways in which students, academics and institutions behave. These, and a number of alternative metaphors for the student, are critically reviewed. The alternatives considered include both contemporary (student as client or…

Usage of Thin-Client/Server Architecture in Computer Aided Education

Science.gov (United States)

Cimen, Caghan; Kavurucu, Yusuf; Aydin, Halit

2014-01-01

With the advances of technology, thin-client/server architecture has become popular in multi-user/single network environments. Thin-client is a user terminal in which the user can login to a domain and run programs by connecting to a remote server. Recent developments in network and hardware technologies (cloud computing, virtualization, etc.)…

Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China.

Science.gov (United States)

Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

2016-05-01

Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%).Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission.

Client and family engagement in rehabilitation research: a framework for health care organizations.

Science.gov (United States)

Anderson, James; Williams, Laura; Karmali, Amir; Beesley, Lori; Tanel, Nadia; Doyle-Thomas, Krissy; Sheps, Gideon; Chau, Tom

2018-04-01

To describe the development and implementation of an organizational framework for client and family-centered research. Case report. While patient-centered care is now well established, patient-centered research remains underdeveloped. This is particularly true at the organizational level (e.g., hospital based research institutes). In this paper we describe the development of an organizational framework for client and family centered research at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada. It is our hope that, by sharing our framework other research institutions can learn from our experience and develop their own research patient/client/family engagement programs. Implications for rehabilitation Family engagement in rehabilitation research •Rehabilitation research is crucial to the development and improvement of rehabilitative care. •The relevance, appropriateness, and accountability of research to patients, clients and families could be improved. •Engaging clients and families as partners in all aspects of the research process is one way to address this problem. •In this paper, we describe a framework for engaging clients and families in research at the organizational level.

Behavioral and Psychosocial Correlates of HIV Testing Among Male Clients of Female Sex Workers in Tijuana, Mexico.

Science.gov (United States)

Fleming, Paul J; Patterson, Thomas L; Chavarin, Claudia V; Semple, Shirley J; Magis-Rodriguez, Carlos; Pitpitan, Eileen V

2017-08-01

We use data collected from a sample of 400 male clients of female sex workers (FSW) to examine their HIV testing behavior. We present frequencies of HIV testing and used bivariate and multivariable analyses to assess its socio-demographic, behavioral, and psychosocial correlates. We found that the majority (55 %) of male clients of FSW in Tijuana, Mexico had never had an HIV test and the prevalence of HIV testing within the past year was low (9 %). In multivariable analyses, significant correlates of having ever tested for HIV were higher age, higher HIV knowledge score, lower sexual compulsiveness score, lower misogynistic attitudes score, having a condom break during sex with a FSW, and higher frequency of sex with a FSW while she was high. Our findings represent an important starting point for developing effective interventions to address the need to promote HIV testing among this population.

Certification. Tool for quality? Market and client for radiation experts

International Nuclear Information System (INIS)

Zwaard, W.

1999-01-01

The role and impact of certification in the advisory work of radiation experts is briefly outlined. Certification is a guarantee for quality of the advice or a product in case there is a client and a market. In cases where there is not a client or a market certification will lead to 'window-dressing and a bureaucratic system

Monitoring HIV Prevention Programme Outcomes among Key Populations in Kenya: Findings from a National Survey.

Directory of Open Access Journals (Sweden)

Parinita Bhattacharjee

Full Text Available In preparation for the implementation of the Kenya AIDS Strategic Framework 2014/15-2018/19, the Kenya National AIDS and STI Control Programme facilitated a national polling booth survey as part of a baseline assessment of HIV-related risk behaviours among FSWs, MSM, and PWID, and their utilization of existing preventive interventions, as well as structural factors that may influence KPs' vulnerability to HIV. The survey was conducted among "key populations" (female sex workers, men who have sex with men, and people who inject drugs to understand current HIV risk and prevention behaviours, utilization of existing programmes and services, and experiences of violence. In total, 3,448 female sex workers, 1,308 men who have sex with men, and 690 people who inject drugs were randomly selected to participate in polling booth survey sessions from seven priority sites. Survey responses were aggregated and descriptive statistics derived. In general, reported condom use among all key populations was quite high with paying clients, and lower with regular, non-paying partners. Many participants reported unavailability of condoms or clean injecting equipment within the past month. Exposure to, and utilization of, existing HIV prevention services varied significantly among the groups, and was reported least commonly by female sex workers. Encouragingly, approximately three-quarters of all key population members reported receiving an HIV test in the past three months. All key population groups reported experiencing high levels of physical and sexual violence from partners/clients, and/or arrest and violence by law enforcement officials. Although some of the findings are encouraging, there is room for improvement in HIV prevention programmes and services for key populations across Kenya.

77 FR 38766 - Proposed Information Collection; Comment Request; International Client Life-Cycle Multi-Purpose...

Science.gov (United States)

2012-06-29

... Request; International Client Life-Cycle Multi-Purpose Forms AGENCY: International Trade Administration...-0151, 0625-0215, 0625-0220, 0625-0228, and 0625- 0238. These collections include all client intake... trade events to U.S. organizations. The International Client Life-cycle Multi-Purpose Forms, previously...

Occupational Therapists’ Perceived Relevance of Nussbaum’s Central Capabilities to Client-centered Practice

Directory of Open Access Journals (Sweden)

Tahmineh Mousavi

2015-10-01

Full Text Available Background: Client-centered practice is highly valued in occupational therapy. Nussbaum’s Capabilities Approach focuses on the individual person and functional autonomy by encompassing 10 functional capabilities that could provide a framework for the systematic implementation of client-centered care. Method: To explore the perceived relevance of Nussbaum’s 10 capabilities with respect to client-centered practice, semi-structured interviews with 14 occupational therapists in British Columbia, Canada, were conducted and thematically analyzed. Results: Nussbaum’s Central Human Functional Capabilities approach provides a broad perspective, encompassing the range of settings of occupational therapy practice. Nussbaum’s 10 capabilities were viewed as being particularly aligned with the established tenets of client-centered practice. Conclusion: Nussbaum’s Capabilities Approach has several compelling attributes for consideration by occupational therapists that warrant further exploration as a novel basis for systematically implementing client-centered care.

Facilitating Client Value Creation in the Conceptual Design Phase of Construction Projects

DEFF Research Database (Denmark)

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

2009-01-01

If client values are not fully understood in a construction project it is likely to result in either low fulfilment of client expectations or multiple design alterations during the project process which lead to additional costs and frustration among the project participants. However...... by the fact that the delivery team, which is responsible for understanding and delivering client value, is made up of even more different parties. The paper reports the initial outcome of a joint research project between academics and practitioners, which aims to develop a practical workshop model...... that incorporates client values into the conceptual design of construction projects. The workshop model draws on value management and lean thinking as underlying principles in an attempt to address the ambiguous concept of ‘value’....

Exploring the field of public construction clients by a graphical network analysis

OpenAIRE

Eisma, P.R.; Volker, L.

2014-01-01

Because public construction clients form the majority of construction clients and procure over 40% of the construction output in most countries, they are important actors in the construction industry. Yet, the field of research on clients is still underdeveloped. In order to identify the research gaps in this field, a graphical network analysis of existing literature is performed. The analysis is based on a query executed in the scientific database Scopus resulting in around 3,300 publication...

Reconciling Spiritual Values Conflicts for Counselors and Lesbian and Gay Clients

Science.gov (United States)

Fallon, Kathleen M.; Dobmeier, Robert A.; Reiner, Summer M.; Casquarelli, Elaine J.; Giglia, Lauren A.; Goodwin, Eric

2013-01-01

Counselors and lesbian and gay clients experience parallel values conflicts between religious beliefs/spirituality and sexual orientation. This article uses critical thinking to assist counselors to integrate religious/spiritual beliefs with professional ethical codes. Clients are assisted to integrate religious/spiritual beliefs with sexual…

Evaluating the effectiveness of a healthy lifestyle clinician in addressing the chronic disease risk behaviours of community mental health clients: study protocol for a randomised controlled trial.

Science.gov (United States)

Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wye, Paula; Clancy, Richard; Castle, David; Wutzke, Sonia; Rissel, Chris; Wilson, Andrew; McCombie, Paul; Murphy, Fionna; Bowman, Jenny

2017-06-15

People with a mental illness experience a greater morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of modifiable health risk behaviours such as smoking, poor nutrition, physical inactivity and harmful alcohol consumption contribute substantially to this disparity. Despite clinical practice guidelines recommending that mental health services routinely provide care to address these risk behaviours, the provision of such care is consistently reported to be low internationally and in Australia. This protocol describes a randomised controlled trial that aims to assess the effectiveness of allocating a clinician within a community mental health service to the specific role of providing assessment, advice and referral for clients' chronic disease risk behaviours. Approximately 540 clients of one community mental health service will be randomised to receive either usual care for chronic disease risks provided in routine consultations or usual care plus an additional face-to-face consultation and follow-up telephone call with a 'healthy lifestyle clinician'. The clinician will assess clients' chronic disease risk behaviours, provide advice to change behaviours, and refer at-risk clients to free telephone coaching services (New South Wales (NSW) Quitline and NSW Get Healthy Information and Coaching Service) for specialist behaviour change care. The primary outcomes, regarding referral to and client uptake of the telephone services, will be obtained from the respective services. Telephone interviews of clients at baseline and at 1 and 6 months post baseline follow-ups will assess secondary outcomes: receipt of any assessment, advice and referral from the mental health service; satisfaction with the receipt of such care; satisfaction with the receipt of any care provided by the telephone services; interest and confidence in and perceived importance of changing risk behaviours; and risk behaviour status. This study will add

77 FR 24685 - Proposed Information Collection; Comment Request; Client Focus Groups and Qualitative Interviews

Science.gov (United States)

2012-04-25

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

Prototype for a generic thin-client remote analysis environment for CMS

International Nuclear Information System (INIS)

Steenberg, C.D.; Bunn, J.J.; Hickey, T.M.; Holtman, K.; Legrand, I.; Litvin, V.; Newman, H.B.; Samar, A.; Singh, S.; Wilkinson, R.

2001-01-01

The multi-tiered architecture of the highly-distributed CMS computing systems necessitates a flexible data distribution and analysis environment. The authors describe a prototype analysis environment which functions efficiently over wide area networks using a server installed at the Caltech/UCSD Tier 2 prototype to analyze CMS data stored at various locations using a thin client. The analysis environment is based on existing HEP (Anaphe) and CMS (CARF, ORCA, IGUANA) software technology on the server accessed from a variety of clients. A Java Analysis Studio (JAS, from SLAC) plug-in is being developed as a reference client. The server is operated as a 'black box' on the proto-Tier2 system. ORCA objectivity databases (e.g. an existing large CMS Muon sample) are hosted on the master and slave nodes, and remote clients can request processing of queries across the server nodes, and get the histogram results returned and rendered in the client. The server is implemented using pure C++, and use XML-RPC as a language-neutral transport. This has several benefits, including much better scalability, better integration with CARF-ORCA, and importantly, makes the work directly useful to other non-Java general-purpose analysis and presentation tools such as Hippodraw, Lizard, or ROOT

Assessing data quality for a federal environmental restoration project: Rationalizing the requirements of multiple clients

International Nuclear Information System (INIS)

Kiszka, V.R.; Carlsen, T.M.

1994-07-01

Most environmental restoration projects at federal facilities face the difficult task of melding the quality assurance (QA) requirements of multiple clients, as well as dealing with historical data that are often of unknown quality. At Lawrence Livermore National Laboratory (LLNL), we have successfully integrated the requirements of our multiple clients by carefully developing a QA program that efficiently meets our clients' needs. The Site 300 Experimental Test Site is operated by LLNL in support of its national defense program. The responsibility for conducting environmental contaminant investigations and restoration at Site 300 is vested in the Site 300 Environmental Restoration Project (Site 300 ERP) of LLNL's Environmental Restoration Division. LLNL Site 300 ERP must comply with the QA requirements of several clients, which include: the LLNL Environmental Protection Department, the DOE, the US Environmental Protection Agency-Region IX (EPA), the California Regional Water Quality Control Board -- Central Valley Region, and the California Department of Toxic Substances Control. This comprehensive QA program was used to determine the acceptability of historical data. The Site 300 ERP began soil and ground water investigations in 1982. However, we did not begin receiving analytical quality assurance/quality control (QA/QC) data until 1989; therefore, the pre-1989 data that were collected are of unknown quality. The US EPA QAMS-005/80 defines data quality as the totality of features and characteristics of data that bears on its ability to satisfy a given purpose. In the current context, the characteristics of major importance are accuracy, precision, completeness, representativeness, and comparability. Using our established QA program, we determined the quality of this historical data based on its comparability to the post-1989 data. By accepting this historical data, we were able to save a considerable amount of money in recharacterization costs

Working alliance, real relationship, session quality, and client improvement in psychodynamic psychotherapy: A longitudinal actor partner interdependence model.

Science.gov (United States)

Kivlighan, Dennis M; Hill, Clara E; Gelso, Charles J; Baumann, Ellen

2016-03-01

We used the Actor Partner Interdependence Model (APIM; Kashy & Kenny, 2000) to examine the dyadic associations of 74 clients and 23 therapists in their evaluations of working alliance, real relationship, session quality, and client improvement over time in ongoing psychodynamic or interpersonal psychotherapy. There were significant actor effects for both therapists and clients, with the participant's own ratings of working alliance and real relationship independently predicting their own evaluations of session quality. There were significant client partner effects, with clients' working alliance and real relationship independently predicting their therapists' evaluations of session quality. The client partner real relationship effect was stronger in later sessions than in earlier sessions. Therapists' real relationship ratings (partner effect) were a stronger predictor of clients' session quality ratings in later sessions than in earlier sessions. Therapists' working alliance ratings (partner effect) were a stronger predictor of clients' session quality ratings when clients made greater improvement than when clients made lesser improvement. For clients' session outcome ratings, there were complex three-way interactions, such that both Client real relationship and working alliance interacted with client improvement and time in treatment to predict clients' session quality. These findings strongly suggest both individual and partner effects when clients and therapists evaluate psychotherapy process and outcome. Implications for research and practice are discussed. (c) 2016 APA, all rights reserved).

Payeeship, financial leverage, and the client-provider relationship.

Science.gov (United States)

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

2007-03-01

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

[Client centered psychotherapy].

Science.gov (United States)

Werthmann, H V

1979-01-01

In the discussion concerning which psychotherapeutic methods should come under the auspices of the medical health system in West Germany, the question is raised regarding the client-centered therapy of Carl Rogers. Can it be considered a distinct psychotherapeutic method? A review of the scientific literature dealing with this method shows that it provides neither a theory of mental illness nor a theory of clinical application based on individual cases or specific neurotic disturbances, Therefore it should be categorized as a useful method of communication in the field of psychology and not as a therapeutic method for treating mental illness.

Modelling Client Satisfaction Levels: The Impact of Contractor Performance

Directory of Open Access Journals (Sweden)

Robby Soetanto

2012-11-01

Full Text Available The performance of contractors is known to be a key determinant of client satisfaction.Here, using factor analysis, clients’ satisfaction is defined in several dimensions. Based onclients’ assessment of contractor performance, a number of satisfaction models developedusing the multiple regression (MR technique are presented. The models identify arange of variables encompassing contractor performance, project performance and respondent(i.e. client attributes as useful predictors of satisfaction levels. Contractor performanceattributes were found to be of utmost importance indicating that clientsatisfaction levels are mainly dependent on the performance of the contractor. Furthermore,findings suggest that subjectivity is to some extent prevalent in clients’ performanceassessment. The models demonstrate accurate and reliable predictive power as confirmedby validation tests. Contractors could use the models to help improve their performanceleading to more satisfied clients. This would also promote the development ofharmonious working relationships within the construction project coalition.

Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.

Science.gov (United States)

Worku, Mesfin; Loha, Eskindir

2017-06-27

Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap. Cross-sectional study was conducted from March 13 to May 15/2014. Systematic sampling method was used to enroll study participants. The data was collected by trained data collectors using pre-structured questionnaire. A total 407 clients were enrolled under this study with respondent rate of 96.9%. Nearly two third of study participants were male, 270 (66.3%). 86.7% of study participants were satisfied by services provided in Emergency Out Patient Department (OPD). The percentage of study satisfaction with physical examination by Doctor, nursing, laboratory and pharmacy services were 95.6%, 89.9%, 84.7% and 67.6%, respectively. Only 31.9% were satisfied with availability of drugs in the pharmacy. Regarding to staff courtesy, 91.7% of study participants were satisfied by the manner shown by the staffs working in Emergency OPD. The vast majority of the participants (97%) were satisfied with the courtesy of Medical laboratory personnel and the least satisfaction (79.4%) was recorded for security guards. This study showed low level of patient satisfaction in pharmacy services specifically due to unavailability of drugs due to lack of sustained supply of drugs.

Attachment Patterns in the Psychotherapy Relationship: Development of the Client Attachment to Therapist Scale.

Science.gov (United States)

Mallinckrodt, Brent; And Others

1995-01-01

Describes development of an instrument, the Client Attachment to Therapist Scale (CATS). CATS factors correlated in expected directions with survey measures of object relations, client-rated working alliance, social self-efficacy, and adult attachment. Cluster analysis revealed four types of client attachment. Discusses implications of attachment…

77 FR 67804 - Agency Information Collection Activities; Comment Request; Application for Client Assistance Program

Science.gov (United States)

2012-11-14

...; Comment Request; Application for Client Assistance Program AGENCY: Department of Education (ED), Office of... of Collection: Application for Client Assistance Program. OMB Control Number: 1820-0520. Type of... Burden Hours: 9. Abstract: This form is used by states to request funds to establish and carry out Client...

Using Private Employment Agencies to Place Public Assistance Clients in Jobs.

Science.gov (United States)

Carcagno, George J.; And Others

1982-01-01

This paper presents the results of an experiment in which private employment agencies were used to place public assistance clients in jobs. Contains brief descriptions of the experiment and the AFDC clients who participated in it. Key experimental findings are outlined and policy implications are discussed. (CT)

On Non-Parallelizable Deterministic Client Puzzle Scheme with Batch Verification Modes

NARCIS (Netherlands)

Tang, Qiang; Jeckmans, Arjan

A (computational) client puzzle scheme enables a client to prove to a server that a certain amount of computing resources (CPU cycles and/or Memory look-ups) has been dedicated to solve a puzzle. Researchers have identified a number of potential applications, such as constructing timed cryptography,

Total Body Capacitance for Estimating Human Basal Metabolic Rate in an Egyptian Population

Science.gov (United States)

M. Abdel-Mageed, Samir; I. Mohamed, Ehab

2016-01-01

Determining basal metabolic rate (BMR) is important for estimating total energy needs in the human being yet, concerns have been raised regarding the suitability of sex-specific equations based on age and weight for its calculation on an individual or population basis. It has been shown that body cell mass (BCM) is the body compartment responsible for BMR. The objectives of this study were to investigate the relationship between total body capacitance (TBC), which is considered as an expression for BCM, and BMR and to develop a formula for calculating BMR in comparison with widely used equations. Fifty healthy nonsmoking male volunteers [mean age (± SD): 24.93 ± 4.15 year and body mass index (BMI): 25.63 ± 3.59 kg/m2] and an equal number of healthy nonsmoking females matched for age and BMI were recruited for the study. TBC and BMR were measured for all participants using octopolar bioelectric impedance analysis and indirect calorimetry techniques, respectively. A significant regressing equation based on the covariates: sex, weight, and TBC for estimating BMR was derived (R=0.96, SEE=48.59 kcal, and P<0.0001), which will be useful for nutritional and health status assessment for both individuals and populations. PMID:27127453

Indoor Location Fingerprinting with Heterogeneous Clients

DEFF Research Database (Denmark)

Kjærgaard, Mikkel Baun

2011-01-01

Heterogeneous wireless clients measure signal strength differently. This is a fundamental problem for indoor location fingerprinting, and it has a high impact on the positioning accuracy. Mapping-based solutions have been presented that require manual and error-prone calibration for each new clie...

Exploring Lawyer-Client Interaction: A Qualitative Study of Positive Lawyer Characteristics.

Science.gov (United States)

Elbers, Nieke A; van Wees, Kiliaan A P C; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

2012-03-01

Personal injury victims involved in compensation processes have a worse recovery than those not involved in compensation processes. One predictor for worse recovery is lawyer engagement. As some people argue that this negative relation between lawyer engagement and recovery may be explained by lawyers' attitude and communications to clients, it seems important to investigate lawyer-client interaction. Although procedural justice and therapeutic jurisprudence had previously discussed aspects relevant for lawyer-client interaction, the client's perspective has been rather ignored and only few empirical studies have been conducted. In this qualitative study, 21 traffic accident victims were interviewed about their experiences with their lawyer. Five desirable characteristics for lawyers were identified: communication, empathy, decisiveness, independence, and expertise. Communication and empathy corresponded with aspects already discussed in literature, whereas decisiveness, independence and expertise had been addressed only marginally. Further qualitative and quantitative research is necessary to establish preferable lawyer characteristics and to investigate what would improve the well-being of personal injury victims during the claims settlement process.

Gardening with Huntington's disease clients--creating a programme of winter activities.

Science.gov (United States)

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

2011-01-01

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

Beauty from the beast: Avoiding errors in responding to client questions.

Science.gov (United States)

Waehler, Charles A; Grandy, Natalie M

2016-09-01

Those rare moments when clients ask direct questions of their therapists likely represent a point when they are particularly open to new considerations, thereby representing an opportunity for substantial therapeutic gains. However, clinical errors abound in this area because clients' questions often engender apprehension in therapists, causing therapists to respond with too little or too much information or shutting down the discussion prematurely. These response types can damage the therapeutic relationship, the psychotherapy process, or both. We explore the nature of these clinical errors in response to client questions by providing examples from our own clinical work, suggesting potential reasons why clinicians may not make optimal use of client questions, and discussing how the mixed psychological literature further complicates the issue. We also present four guidelines designed to help therapists, trainers, and supervisors respond constructively to clinical questions in order to create constructive interactions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Comparative analysis of a client's verbal responses in counseling sessions: quantitative case study.

Science.gov (United States)

Lee, Han-Jong

2011-04-01

This study investigated how the in-session change in a client's verbal behavior might influence the effectiveness of counseling sessions. 10 sessions of counseling with a male undergraduate suffering from depressive mood were conducted by a humanistically oriented counselor. The two most effective and the two least effective sessions were identified according to the client's evaluation of the effectiveness of counseling sessions. Results indicated that over the three segments of the most effective sessions, the client gradually increased responses that indicated exploration of his own emotions, thoughts, and behaviors. By contrast, the client continued talking mainly about past events in a storytelling manner throughout the least effective sessions.

"Over here, it's just drugs, women and all the madness": The HIV risk environment of clients of female sex workers in Tijuana, Mexico.

Science.gov (United States)

Goldenberg, Shira M; Strathdee, Steffanie A; Gallardo, Manuel; Rhodes, Tim; Wagner, Karla D; Patterson, Thomas L

2011-04-01

HIV vulnerability depends upon social context. Based on broader debates in social epidemiology, political economy, and sociology of health, Rhodes' (2002) "risk environment" framework provides one heuristic for understanding how contextual features influence HIV risk, through different types of environmental factors (social, economic, policy, and physical) which interact at different levels of influence (micro, macro). Few data are available on the "risk environment" of male clients of female sex workers (FSWs); such men represent a potential "bridge" for transmission of HIV and other sexually transmitted infections from high- to low-prevalence populations. Using in-depth interviews (n = 30), we describe the HIV risk environment of male clients in Tijuana, Mexico, where disproportionately high HIV prevalence has been reported among FSWs and their clients. A number of environmental themes influence risky sex with FSWs and the interplay between individual agency and structural forces: social isolation and the search for intimacy; meanings and identities ascribed to Tijuana's Zona Roja (red light district) as a risky place; social relationships in the Zona Roja; and economic roles. Our findings suggest that clients' behaviors are deeply embedded in the local context. Using the HIV "risk environment" as our analytic lens, we illustrate how clients' HIV risks are shaped by physical, social, economic, and political factors. The linkages between these and the interplay between structural- and individual-level experiences support theories that view structure as both enabling as well as constraining. We discuss how the "embeddedness" of clients' experiences warrants the use of environmental interventions that address the circumstances contributing to HIV risk at multiple levels. Copyright © 2011 Elsevier Ltd. All rights reserved.

Advising Students or Practicing Law: The Formation of Implied Attorney-Client Relationships with Students

Science.gov (United States)

Sheridan, Patricia M.

2014-01-01

An attorney-client relationship is traditionally created when both parties formally enter into an express agreement regarding the terms of representation and the payment of fees. There are certain circumstances, however, where the attorney-client relationship can be implied from the parties' conduct. An implied attorney-client relationship may…

The prevalence and impact of depression in self-referred clients attending an employee assistance program.

Science.gov (United States)

Lam, Raymond W; Wolinsky, Debra; Kinsella, Cynthia; Woo, Cindy; Cayley, Paula M; Walker, Anne B

2012-11-01

To determine the prevalence and characteristics of clients with depression attending an employee assistance program (EAP). Anonymized data were obtained from 10,794 consecutive clients, including 9105 employees, self-referred to PPC Canada, a large, external EAP. Assessment measures included the self-rated nine-item Patient Health Questionnaire (PHQ-9). Clinical characteristics of depressed clients (PHQ-9 score ≥ 10) were compared with those of nondepressed clients. Thirty-seven percent of the employee sample met PHQ-9 criteria for clinically significant depression. Compared with clients without depression, they had significantly higher rates of anxiety, psychotropic medication use, problem substance use, global problems with functioning, absenteeism, impairment in work-related tasks, and low job satisfaction. A large proportion of EAP clients were clinically depressed with associated negative effects on personal and occupational functioning.

Effectively working with challenging clients who receive hunger service assistance: Case examples and eight recommended guidelines

Directory of Open Access Journals (Sweden)

Sharon E. Moore

2006-12-01

Full Text Available Those who provide services for people who experience food insecurity come into contact with people who do not always present themselves courteously and favorably. Using case examples from the food bank industry, the authors of this paper will: (1 discuss why people sometimes behave discourteously when seeking assistance from human services professionals; (2 give case examples of how social workers could properly respond to these situations and, (3 give recommendations for effectively working with this client population.

The Use of Narrative Therapy with Clients Diagnosed with Bipolar Disorder

Science.gov (United States)

Ngazimbi, Evadne E.; Lambie, Glenn W.; Shillingford, M. Ann

2008-01-01

Clients diagnosed with bipolar disorder often suffer from mood instability, and research suggests that these clients need both counseling services and pharmacotherapy. Narrative therapy is a social constructionist approach grounded on the premise that there is no single "truth"; individuals may create new meanings and retell their stories to…

Chair rise capacity and associated factors in older home-care clients.

Science.gov (United States)

Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma

2017-07-01

The aim of this study was to investigate the ability of older home-care clients to perform the five times chair rise test and associated personal characteristics, nutritional status and functioning. The study sample included 267 home-care clients aged ≥75 years living in Eastern and Central Finland. The home-care clients were interviewed at home by home-care nurses, nutritionists and pharmacists. The collected data contained sociodemographic factors, functional ability (Barthel Index, IADL), cognitive functioning (MMSE), nutritional status (MNA), depressive symptoms (GDS-15), medical diagnoses and drug use. The primary outcome was the ability to perform the five times chair rise test. Fifty-one per cent ( n=135) of the home-care clients were unable to complete the five times chair rise test. Twenty-three per cent ( n=64) of the home-care clients had good chair rise capacity (≤17 seconds). In a multivariate logistic regression analysis, fewer years of education (odds ratio [OR] = 1.11, 95% confidence interval [CI] 1.04-1.18), lower ADL (OR = 1.54, 95% CI 1.34-1.78) and low MNA scores (OR = 1.12, 95% CI 1.04-1.20) and a higher number of co-morbidities (OR = 1.21, 95% CI 1.02-1.43) were associated with inability to complete the five times chair rise test. Poor functional mobility, which was associated with less education, a high number of co-morbidities and poor nutritional status, was common among older home-care clients. To maintain and to prevent further decline in functional mobility, physical training and nutritional services are needed. (NutOrMed, ClinicalTrials.gov Identifier: NCT02214758).

Legibility of USP pictograms by clients of community pharmacies in Portugal.

Science.gov (United States)

Soares, Maria Augusta

2013-02-01

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

Care requirements for clients who present after rape and clients who presented after consensual sex as a minor at a clinic in Harare, Zimbabwe, from 2011 to 2014.

Directory of Open Access Journals (Sweden)

Rebecca E Harrison

Full Text Available To describe the differences between clients presenting after rape and clients who have consented to sex as a minor to an SGBV clinic in Harare, Zimbabwe, and how these differences affect their care requirements.Adolescents and adults presenting at the specialized Sexual and Gender Based Violence clinic in Harare are offered a standardised package of free medical and psychosocial care. Zimbabwe has an HIV prevalence of 14%, so prevention of HIV infection using PEP for those that present within 72 hours is a key part of the response. STI treatment, emergency contraceptive pills, referral for termination of pregnancy, psychological, social and legal support is also provided.This is a retrospective descriptive study of routine programmatic data collected at the Edith Opperman polyclinic in Mbare SGBV clinic from 2011 to 2014. Chi-square tests and logistic regression were used to describe the different experiences and the differences in uptake of care between clients presenting for rape compared to those who consented to sex as a minor.During the study period a total of 3617 clients presented to the clinic. 2242 (62% sought care after rape, 602 (17% for having consented to sex as a minor and 395 (11% for suspected sexual abuse. 1615 (45% of people presenting were 12-15 year olds. Minors who consented to sex compared to survivors of rape were less likely to report within 72 hours- 156 (26% vs 894 (40% p<0.001; less likely to report that they delayed due to fear- 68 (17% vs 472 (40% p<0.001, less likely to have experienced accompanying violence- 9 (1% vs 176 (8% p<0.001 or physical trauma-34 (6% vs 427 (19% p<0.001; and less likely to display psychological symptoms at presentation 51 (8% vs 411 (18% p<0.001. Minors who consented to sex compared to those who were raped were less likely to start PEP if eligible-123 (80% vs 751 (93% p<0.001, less likely to take emergency contraceptives if eligible-125 (81% vs 598 (88% p<0.001, more likely to be pregnant

The quality of integrated reproductive health services: perspectives of clients in KwaZulu-Natal, South Africa

Directory of Open Access Journals (Sweden)

P Maharaj

2005-09-01

Full Text Available The focus of family planning programmes has shifted away from an emphasis on controlling fertility towards helping individuals achieve their reproductive goals. This article seeks to expand knowledge about the quality of integrated services from the perspective of clients at health facilities in KwaZulu-Natal. The results from 300 structured interviews with clients visiting health facilities found that overall quality of services was relatively high. However, the quality of services varied somewhat between rural and urban areas. Clients visiting urban health facilities reported greater satisfaction with services than clients visiting rural health facilities. The interviews with clients suggests that existing efforts to integrate services has had limited success. Clients were rarely offered an expanded range of services during their visit. In most cases, clients only received services for which they presented at the health facility.

Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

Science.gov (United States)

Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

2004-12-01

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

MstApp, a rich client control applications framework at DESY

International Nuclear Information System (INIS)

Kirsten Hinsch, Winfried Schuette

2012-01-01

The control systems for PETRA 3 (a dedicated synchrotron machine) and its pre-accelerators extensively use rich clients for the control room and the servers. Most of them are written with the help of a rich client Java framework: MstApp. They totalize 106 different consoles and 158 individual server applications. MstApp takes care of many common control system application aspects beyond communication. MstApp provides a common look and feel: core menu items, a colour scheme for standard states of hardware components and predefined standardized screen sizes/locations. It interfaces our console application manager (CAM) and displays on demand our communication link diagnostics tools. MstApp supplies an accelerator context for each application; it handles printing, logging, re-sizing and unexpected application crashes. Due to our standardized deploy process MstApp applications know their individual developers and can even send them - on button press of the users - E-mails. Further a concept of different operation modes is implemented: view only, operating and expert use. Administration of the corresponding rights is done via web access of a database server. Initialization files on a web server are instantiated as JAVA objects with the help of the Java SE XML-Decoder. Data tables are read with the same mechanism. New MstApp applications can easily be created with in house wizards like the NewProjectWizard or the DeviceServerWizard. MstApp improves the operator experience, application developer productivity and delivered software quality. (authors)

El Servicio al cliente: ¡Más que un querer, un deber!

Directory of Open Access Journals (Sweden)

Gustavo Vargas Vargas

2013-02-01

Full Text Available Uno de los aspectos más importantes en la generaciónde diferenciación con respecto a la competencia loconstituye “el Servicio al Cliente”. El Servicio al Cliente presenta características, queconvierten su tratamiento en complejo de implementar:Por ejemplo se menciona que el Servicio es intangible;que el Servicio es variable; que el Servicio se producey se consume a la vez; y, que el Servicio no puede seralmacenado. Lo anterior es influido por la cultura del paísdonde se ubique la empresa. El tratar el tema del Servicio al Cliente es muyimportante en aras de poder mantener a nuestros clientes.En este sentido, varias investigaciones citadas evidencianel impacto de un mal manejo del Servicio al Cliente, asícomo cifras ligadas en general a su comportamiento. El Servicio al Cliente se puede definir como el conjuntode aspectos relacionados con los clientes, y no sólo setrata de atención al cliente, aspecto que es comúnmenteconfundido con el primero. La atención al cliente es partedel Servicio, pero no lo es todo! Es necesario escapar de seguir tratando este tema consuperficialidad, y más bien, aprovechar su implementacióncomo medio de generar ventajas competitivas ante lacompetencia.   ABSTRACT One of the most important aspects in the generationof a differentiation with your competition is constitutedby “Customer Service”. Customer Service presents several characteristicsthat make it complex to implement: For example itis mentioned that Service is intangible; that Serviceis variable; that Service is produced and consumedsimultaneously; and, that Service cannot be stored. Thisis influenced by the culture of the country where thecompany is located. Dealing with the subject of Customer Service is veryimportant for the sake of being able to maintain ourclients. In this sense several quoted investigations showthe impact of a badly handed Customer Service, as wellas financial figures related to its performance. Customer Service can be

A humanização no cuidado com o cliente cirúrgico

Directory of Open Access Journals (Sweden)

Rosemari Ferigolo Medina

2002-10-01

Full Text Available A compreensão e o respeito ao ser humano na sua individualidade, a preocupação com seus sentimentos, desejos e direitos e a busca pela melhora no cuidado com vistas à humanização na assistência ao cliente e familiar, orientou este trabalho respaldado na Teoria Humanística de Paterson & Zderad (1988, desenvolvido com quinze clientes cirúrgicos internados num Hospital de Santa Maria. O acompanhamento no pré-operatório procurou identificar e reduzir os fatores causadores de ansiedade, medo e desconfortos ocasionados frente à iminência do ato cirúrgico. Os elementos-chave utilizados, neste processo de humanização ao cliente e seu familiar, foram a capacidade de empatia e a comunicação, sendo esta, verbal ou não-verbal. A interação vivida junto aos clientes propiciou-nos unir o saber técnico (racionalidade instrumental à subjetividade (intuição e afeto, desenvolvendo, desse modo, uma assistência de enfermagem diferenciada, com maior apoio e presença, orientação e reflexão e, segurança e conforto ao cliente (ser humano assistido.

Population, environment dynamics, poverty and quality of life in China.

Science.gov (United States)

Gu, B

1996-12-01

This article focuses on the growth in poverty, environmental concerns, and Chinese government efforts to eliminate poverty with integrated programs. China had 1.2 billion people in February 1995, or 20% of total world population on 7% of the world's arable land. The rate of natural increase was 1.1% in 1996. China's population could double to 2.4 billion by 2060. About 14 million people are added every year. China has about 300 million women of childbearing age. Even with 1 child per woman, population would grow by 300 million. 18 provinces have population growth over the national average of 1.49%. Many of these provinces are also provinces with high population density, high poverty ratios, and higher than 2 birth orders. The highest growth is in western China. Poor households have a lower quality of life, more disabled members, high rates of endemic disease, and illiteracy. Among the very poor without adequate food or clothing, environmental protection is a meaningless concept. Poverty alleviation strategies have shifted from relief to economic development. State support combined with local resources in a pooling approach pays for poverty alleviation programs. The central government's share will increase until the year 2000. The number of poor was 80 million in 1994 (9% of total population) living in 592 poor counties in remote and mountainous areas. The number of poor was reduced to 65 million in 1996. An integrated approach of family planning and poverty alleviation operates in Jinzhai County of Anhui province. China is determined to reorient to a "service-oriented, client- centered, woman-sensitive, and rural-emphasized approach."

Using Web-Based Peer Benchmarking to Manage the Client-Based Project

Science.gov (United States)

Raska, David; Keller, Eileen Weisenbach; Shaw, Doris

2013-01-01

The complexities of integrating client-based projects into marketing courses provide challenges for the instructor but produce richness of context and active learning for the student. This paper explains the integration of Web-based peer benchmarking as a means of improving student performance on client-based projects within a single semester in…

Trainees' use of supervision for therapy with sexual minority clients: A qualitative study.

Science.gov (United States)

Chui, Harold; McGann, Kevin J; Ziemer, Kathryn S; Hoffman, Mary Ann; Stahl, Jessica

2018-01-01

In the supervision literature, research on sexual orientation considerations often focuses on sexual minority supervisees and less often on their work with sexual minority clients. Yet both heterosexual and sexual minority supervisees serve sexual minority clients and may have different supervision needs. Twelve predoctoral interns from 12 APA-accredited counseling center internships were interviewed about how they made use of supervision for their work with a sexual minority client. The sample consisted of 6 heterosexual-identified supervisees and 6 supervisees who identified as lesbian, gay, or queer (LGQ). Data were analyzed using consensual qualitative research. All participants reported positive gains from supervision that carried over to their work with heterosexual and sexual minority clients, even when not all supervisors disclosed or discussed their own sexual orientation. Heterosexual supervisees used supervision to ensure that their heterosexuality does not interfere with an affirmative experience for their sexual minority client, whereas LGQ supervisees used supervision to explore differences in sexual identity development between themselves and their client to minimize the negative impact of overidentification. Thus, affirmative supervision may unfold with different foci depending on supervisees' sexual identity. Implications for training and supervision are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Use of Dialectical Behavior Therapy and Prolonged Exposure to Treat Comorbid Dissociation and Self-Harm: The Case of a Client With Borderline Personality Disorder and Posttraumatic Stress Disorder.

Science.gov (United States)

Granato, Hollie F; Wilks, Chelsey R; Miga, Erin M; Korslund, Kathryn E; Linehan, Marsha M

2015-08-01

There is a high rate of comorbidity between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD; Pagura et al., 2010). Preliminary studies have evaluated the treatment of PTSD in a BPD population and found positive outcomes for the integration of dialectical behavior therapy (DBT) and prolonged exposure (PE). This case study illustrates the implementation of a PE protocol into standard DBT treatment, specifically focusing on the management of self-harm and severe dissociation for a client with co-occurring PTSD and BPD. The client entered into treatment with severe and persistent dissociation and a recent history of self-harm, and the case includes consideration of two separate pauses in PTSD treatment related to elevated dissociation and self-harm behaviors. The client successfully completed the DBT PE protocol and results indicate significant improvements in PTSD symptoms as well as outcomes related to self-harm and dissociation. These findings demonstrate the efficacy of combining DBT with PE for clients with comorbid BPD and PTSD and exemplify how complex clients with BPD who present with severe dissociation and self-harm behavior can safely and successfully receive treatment for PTSD. © 2015 Wiley Periodicals, Inc.

Coerced addiction treatment: Client perspectives and the implications of their neglect

Directory of Open Access Journals (Sweden)

Urbanoski Karen A

2010-06-01

Full Text Available Abstract Recent work has criticized the evidence base for the effectiveness of addiction treatment under social controls and coercion, suggesting that the development of sound policies and treatment practices has been hampered by numerous limitations of the research conducted to date. Implicit assumptions of the effectiveness of coerced treatment are evident in the organization and evolution of treatment, legal, and social service systems, as well as in related legislative practices. This review builds upon previous work by focusing in greater detail on the potential value of incorporating client perspectives on coercion and the implications for interpreting and applying existing research findings. Reviewing the existing empirical and theoretical literature, a case is made for greater accuracy in representing coercive experiences and events in research, so as to better align the measured concepts with actual processes of treatment entry and admission. Attention is given to studies of the effectiveness of treatment under social controls or pressures, the connections to coercion and decision-making, and theoretical perspectives on motivation and behaviour change, including Self-Determination Theory in particular. This synthesis of the available research on coerced addiction treatment suggests that it remains largely unclear to what extent many of the commonly employed methods for getting people into treatment may be detrimental to the treatment process and longer-term outcomes. The impact of coercion upon individual clients, treatment systems, and population health has not been adequately dealt with by addiction researchers to date.

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

Science.gov (United States)

2010-10-29

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

77 FR 38582 - Proposed Information Collection; Comment Request; Domestic Client Life-Cycle Multi-Purpose Forms

Science.gov (United States)

2012-06-28

... Request; Domestic Client Life-Cycle Multi-Purpose Forms AGENCY: International Trade Administration. ACTION..., 0625-0237, and 0625-0238. These collections include all client intake, events/activities and export... Client Life-cycle Multi-Purpose Forms, previously titled Export Information Services Order Forms, are...

The Role of Reflection on Clients' Change in the Coaching Process

Science.gov (United States)

Kristal, Zuno

2010-01-01

This study explored the role of reflection in the personal life-coaching process and the ways it affects clients' change, as perceived by both coach and client. Underlying this study is that coaching is currently recognized as a learning process, yet how reflection is understood or used is currently unspecified. Insights gained from the adult…

Effects of Client Violence on Social Work Students: A National Study

Science.gov (United States)

Criss, Pam

2010-01-01

This study uses a work stress theoretical framework to examine the effects of direct and indirect client violence on a randomly selected national sample of MSW and BSW social work students from the National Association of Social Workers (N=595). Client violence variables were analyzed in relationship to fear of future violence and occupational…

Social-Cognitive Factors Affecting Clients' Career and Life Satisfaction after Counseling

Science.gov (United States)

Verbruggen, Marijke; Sels, Luc

2010-01-01

This study examines factors affecting clients' career and life satisfaction in the first 6 months after having participated in career counseling. In particular, we tested a large subset of the recent social-cognitive model of work satisfaction of Lent and Brown using a longitudinal data set of 195 former counseling clients. Our results showed that…

When psychologists work with religious clients: applications of the general principles of ethical conduct.

Science.gov (United States)

Yarhouse, M A; VanOrman, B T

1999-12-01

Psychologists become more effective and relevant when they appreciate that many clients hold religious values and commitments. Greater awareness of religion and religious values in the lives of clients may aid clinicians' efforts to provide more accurate assessments and effective treatment plans. The authors use the American Psychological Association's (1992) "Ethical Principles of Psychologists and Code of Conduct" as a framework to examine many of the ethical issues relevant when psychologists work with religious clients. This article also provides suggestions for ways in which clinicians may obtain the skills needed to offer competent assessments and interventions with religiously committed clients.

Client/Server Architecture Promises Radical Changes.

Science.gov (United States)

Freeman, Grey; York, Jerry

1991-01-01

This article discusses the emergence of the client/server paradigm for the delivery of computer applications, its emergence in response to the proliferation of microcomputers and local area networks, the applicability of the model in academic institutions, and its implications for college campus information technology organizations. (Author/DB)

Estimating Client Out-of-Pocket Costs for Accessing Voluntary Medical Male Circumcision in South Africa.

Directory of Open Access Journals (Sweden)

Michel Tchuenche

Full Text Available In 2010, South Africa launched a countrywide effort to scale up its voluntary medical male circumcision (VMMC program on the basis of compelling evidence that circumcision reduces men's risk of acquiring HIV through heterosexual intercourse. Even though VMMC is free there, clients can incur indirect out-of-pocket costs (for example transportation cost or foregone income. Because these costs can be barriers to increasing the uptake of VMMC services, we assessed them from a client perspective, to inform VMMC demand creation policies. Costs (calculated using a bottom-up approach and demographic data were systematically collected through 190 interviews conducted in 2015 with VMMC clients or (for minors their caregivers at 25 VMMC facilities supported by the government and the President's Emergency Plan for AIDS Relief in eight of South Africa's nine provinces. The average age of VMMC clients was 22 years and nearly 92% were under 35 years of age. The largest reported out-of-pocket expenditure was transportation, at an average of US$9.20 (R 100. Only eight clients (4% reported lost days of work. Indirect expenditures were childcare costs (one client and miscellaneous items such as food or medicine (20 clients. Given competing household expense priorities, spending US$9.20 (R100 per person on transportation to access VMMC services could be a significant burden on clients and households, and a barrier to South Africa's efforts to create demand for VMMC. Thus, we recommend a more focused analysis of clients' transportation costs to access VMMC services.

Risk Factors for Hip Fracture in Older Home Care Clients

Science.gov (United States)

Poss, Jeff; Cook, Richard J.; Byrne, Kerry; Hirdes, John P.

2009-01-01

Background Little information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. Methods This was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set–Home Care assessment instrument. Results In all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65–74, relative risk [95% confidence interval]: 0.52 [0.43–0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51–0.70)]. Other risk factors include osteoporosis (1.19 [1.03–1.36]), falls (1.31 [1.15–1.49]), unsteady gait (1.18 [1.03–1.36]), use of ambulation aide (1.39 [1.21–1.59]), tobacco use (1.42, [1.13–1.80]), severe malnutrition (2.61 [1.67–4.08]), and cognitive impairment (1.30 [1.12–1.51]). Arthritis (0.86 [0.76–0.98]) and morbid obesity (0.34 [0.16–0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. Conclusions Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies [22]. PMID:19196903

Democracia, clientes y calidad total en la Administración Pública

OpenAIRE

Losada, Antón

2008-01-01

Este artículo considera las dinamicas de evolución más recientes en el ámbito de la gestión pública. Su objetivo es dar un repaso al estado de la cuestión en torno a la Nueva Gestión Pública y la emergencia del paradigma de la calidad total. También pretende plantear algunas preguntas para la reflexión. Tanto en lo que se refiere a las aportaciones de la ciencia política a la mejora de la gestión de los asuntos públicos, como a la reflexión en torno a soluciones emergentes como...

Veterinary students' views on animal patiens and human clients, using Q methodology

NARCIS (Netherlands)

de Graaf, G.

2007-01-01

Veterinarians serve two masters: animal patients and human clients. Both animal patients and human clients have legitimate interests, and conflicting moral claims may flow from these interests. Earlier research concludes that veterinary students are very much aware of the complex and often

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews.

Science.gov (United States)

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-Ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

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

DEFF Research Database (Denmark)

Johnsen, Helle

2014-01-01

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

What client?

DEFF Research Database (Denmark)

Unterrainer, Walter

2015-01-01

Urbanization is growing exponentially, global streams of refugees are at an all-time high, 10 million people found their homes destroyed by one typhoon on the Philippines, 2,000,000,000 people have no access to basic sanitation. The building sector produces a gigantic 60% of global waste. 40...... has been a popular art and that the clients were the rich and powerful, documented by a legacy of palaces, churches, villas, office blocs and alienated ´property developments´. Slum dwellers, climate victims, war refugees, the urban poor but also endangered species as well as tormented spaces cannot......% of (non-renewable) energy is consumed by buildings (without calculating energy used in construction). Growing amounts of buildings become abandoned and derelict, infrastructural failures and junk spaces surge and whole urban quarters decline socially and physically. Any more challenges needed? Looking...

OHS consultants as facilitators of learning processes in client enterprises

DEFF Research Database (Denmark)

Broberg, Ole

2004-01-01

emphasis on initiating learning processes in the client enter-prise in a way that will develop the OHS management capabilities of that enterprise. This presentation is based on a research program focussing on how OHS consultants go about when they are involved in consultancy on technological change...... processes in client enter-prises. Specifically the learning perspective will be touched upon. The research programme included four cases in different client enterprises: 1) New tech-nology in a logistic department of a brewery, 2) new pharmaceutical process facility, 3) design of a new catering centre...... in another institution than pre-sent the users to blueprints and then ask them to put forward technical suggestions to im-prove the workplace design. In conclusion, the study pointed out that the OHS consultants had different work practices on learning aspects of their consultancy. Several constraining...

Implementation of news module for news client based on ApiCloud

OpenAIRE

Fu Xin; Liang Yu; Cao Sanxing; Gu Hongbo

2017-01-01

With the development of new media technology, news client has become the main battlefield of news browsing. Based on the ApiCloud hybrid development platform, this paper uses HTML, JavaScript and other technologies to develop the mobile client news module, and uses WAMP integrated development environment to build a news publishing system on the server side.

Risk-Coping through Sexual Networks: Evidence from Client Transfers in Kenya

Science.gov (United States)

Robinson, Jonathan; Yeh, Ethan

2012-01-01

Why do women engage in transactional sex? While much of the explanation is that sex-for-money pays more than other jobs, we use a unique panel data set constructed from 192 self-reported diaries of sex workers in Western Kenya to show that women who supply transactional sex develop relationships with regular clients, and that these clients send…

Effect of Pre-Construction on Construction Schedule and Client Loyalty

OpenAIRE

Jong Hoon Kim; Hyun-Soo Lee; Moonseo Park; Min Jeong; Inbeom Lee

2016-01-01

Pre-construction is essential in achieving the success of a construction project. Due to the early involvement of project participants in the construction phase, project managers are able to plan ahead and solve issues well in advance leading to the success of the project and the satisfaction of the client. This research utilizes quantitative data derived from construction management projects in order to identify the relationship between pre-construction, construction schedule, and client sat...

Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

Science.gov (United States)

Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

2015-01-01

The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

49 CFR 1103.21 - How far a practitioner may go in supporting a client's cause.

Science.gov (United States)

2010-10-01

... client's cause. 1103.21 Section 1103.21 Transportation Other Regulations Relating to Transportation... of Ethics The Practitioner's Duties and Responsibilities Toward A Client § 1103.21 How far a practitioner may go in supporting a client's cause. A practitioner shall put forth his best effort to maintain...

34 CFR 379.42 - What are the special requirements pertaining to the Client Assistance Program?

Science.gov (United States)

2010-07-01

... Client Assistance Program? 379.42 Section 379.42 Education Regulations of the Offices of the Department... requirements pertaining to the Client Assistance Program? Each grantee under a program covered by this part... availability and purposes of the State's Client Assistance Program, including information on seeking assistance...

Genome-wide association study for levels of total serum IgE identifies HLA-C in a Japanese population.

Directory of Open Access Journals (Sweden)

Yohei Yatagai

Full Text Available Most of the previously reported loci for total immunoglobulin E (IgE levels are related to Th2 cell-dependent pathways. We undertook a genome-wide association study (GWAS to identify genetic loci responsible for IgE regulation. A total of 479,940 single nucleotide polymorphisms (SNPs were tested for association with total serum IgE levels in 1180 Japanese adults. Fine-mapping with SNP imputation demonstrated 6 candidate regions: the PYHIN1/IFI16, MHC classes I and II, LEMD2, GRAMD1B, and chr13∶60576338 regions. Replication of these candidate loci in each region was assessed in 2 independent Japanese cohorts (n = 1110 and 1364, respectively. SNP rs3130941 in the HLA-C region was consistently associated with total IgE levels in 3 independent populations, and the meta-analysis yielded genome-wide significance (P = 1.07×10(-10. Using our GWAS results, we also assessed the reproducibility of previously reported gene associations with total IgE levels. Nine of 32 candidate genes identified by a literature search were associated with total IgE levels after correction for multiple testing. Our findings demonstrate that SNPs in the HLA-C region are strongly associated with total serum IgE levels in the Japanese population and that some of the previously reported genetic associations are replicated across ethnic groups.

Training in Rational-Behavior Problem Solving and Employability Enhancement of Rehabilitation Clients.

Science.gov (United States)

Farley, Roy C.

1984-01-01

Examined the effects of a psychoeducational program on employability enhancement of 23 rehabilitation clients. The program had a significant, positive impact on clients' thinking, feeling, acting, and vocational outcome and reduced task-interfering beliefs, thoughts, emotions, and problem behavior. Participants had a lower vocational training…

Design and Build: Views from some Major Public Clients in Hong Kong

Directory of Open Access Journals (Sweden)

Albert P C Chan

2001-09-01

Full Text Available This paper presents the views of clients in public sector on design and build(D&B procurement method. Specifically, their reasons of adopting D&B and refusing to adopt it were explored. Data were collected through face-to-face interviews with ten senior staff from four major public organisations in Hong Kong. The findings indicate that public clients held different views on D&B methods based on different grounds. Apart from functional requirements such as project completion time, cost certainty, etc., internal resources and political force would also influence client's adoption of D&B method in the public sector.

Counselling and Psychological Services for Clients at the Shelter Home

Directory of Open Access Journals (Sweden)

Ľudmila Fonferová

2014-07-01

Full Text Available Problem: The paper is dealing with a psychological approach to the work with families and their children at a shelter home. It describes the circumstances and conditions for the work in the specific socio-therapeutic environment of the Horni Pocernice Shelter Home. The main research question - 'What are the options of psychological intervention and psychotherapeutic work with clients in the scope of services offered by the shelter home in Horni Pocernice'- works with the hypopaper that psychology and psychotherapy have their place within and next to social services. For clients who use services of this shelter home is this work essential and contributes to better understanding of their life situation and their social relations. Effectivity of psychological work in the environment of a shelter home is in a great deal connected to its acceptance, inner belief and understanding of its real possibilities by every single social worker. Lack of understanding, distorted expectations both on the side of social workers and psychologists complicate or even prevent psychotherapeutic work with clients for whom the requirements and demands of social workers are determining during their stay. Methods: This paper is based on the design of ethnographic field research. Empirical design of this research is defined by the premises of the shelter home and the time period from 2007 to 2012. Therapeutic possibilities of clients are examined from the position of psychologist and psychotherapist of this centre who offers his/her services once a week for about 5 to 7 hours. The research sample was being created during the collection of data in the examined period and its analysis when it was early established with respect to the research question that all available cases typical for full collection will be included (there were 646 clients in the examined period. Results: The answer to the main research question concerns two variables which are related to each other. The

Client's Constraining Factors to Construction Project Management

African Journals Online (AJOL)

factors as a significant system that constrains project management success of public and ... finance for the project and prompt payment for work executed; clients .... consideration of the loading patterns of these variables, the major factor is ...

Using machine learning algorithms to guide rehabilitation planning for home care clients.

Science.gov (United States)

Zhu, Mu; Zhang, Zhanyang; Hirdes, John P; Stolee, Paul

2007-12-20

Targeting older clients for rehabilitation is a clinical challenge and a research priority. We investigate the potential of machine learning algorithms - Support Vector Machine (SVM) and K-Nearest Neighbors (KNN) - to guide rehabilitation planning for home care clients. This study is a secondary analysis of data on 24,724 longer-term clients from eight home care programs in Ontario. Data were collected with the RAI-HC assessment system, in which the Activities of Daily Living Clinical Assessment Protocol (ADLCAP) is used to identify clients with rehabilitation potential. For study purposes, a client is defined as having rehabilitation potential if there was: i) improvement in ADL functioning, or ii) discharge home. SVM and KNN results are compared with those obtained using the ADLCAP. For comparison, the machine learning algorithms use the same functional and health status indicators as the ADLCAP. The KNN and SVM algorithms achieved similar substantially improved performance over the ADLCAP, although false positive and false negative rates were still fairly high (FP > .18, FN > .34 versus FP > .29, FN. > .58 for ADLCAP). Results are used to suggest potential revisions to the ADLCAP. Machine learning algorithms achieved superior predictions than the current protocol. Machine learning results are less readily interpretable, but can also be used to guide development of improved clinical protocols.

The impact of worker values on client outcomes within a drug treatment service.

Science.gov (United States)

Phillips, Rosie; Bourne, Humphrey

2008-02-01

Little attention has been paid to understanding the impact of values, attributes and characteristics of drugs workers on therapeutic relationships and treatment outcomes. Interaction of values with other variables is considered to be of importance since values play a role in determining attitudes and behaviours. This exploratory study investigates the impact of drug workers' personal values on client outcomes within a drug treatment service. Eight drug workers and 58 clients were recruited at a UK charity working with problematic drug users who are also socially excluded. Drug workers completed a validated questionnaire to elicit their personal values. Client outcomes were assessed using the Christo Inventory for Substance Misuse Services. The relationship between client outcomes and worker values were analysed using Spearman's rank test of association. Drug workers prioritising stimulation, self-direction and hedonism value types experienced more positive client outcomes compared with those prioritising security, conformity, benevolence, tradition and universalism types. The value types associated with positive outcomes fall within Schwartz's 'openness to change' superordinate dimension, whereas those related to more negative outcomes fall within the 'conservation' dimension. The study suggests that drug workers' personal values may have a significant impact upon client outcomes in the treatment of substance misuse. Reasons for this finding are explored, as are limitations of this study and suggestions for future research.

17 CFR 275.206(4)-4 - Financial and disciplinary information that investment advisers must disclose to clients.

Science.gov (United States)

2010-04-01

... information that investment advisers must disclose to clients. 275.206(4)-4 Section 275.206(4)-4 Commodity and... disclose to clients. (a) It shall constitute a fraudulent, deceptive, or manipulative act, practice, or... fail to disclose to any client or prospective client all material facts with respect to: (1) A...

Reproductive Health Needs Among Substance Use Disorder Treatment Clients.

Science.gov (United States)

Terplan, Mishka; Lawental, Maayan; Connah, Melanie Bryant; Martin, Caitlin Eileen

2016-01-01

Individuals with substance use disorders (SUDs) have unique reproductive health needs. The aim of this study was to evaluate these needs and assess the acceptability of family planning service delivery of SUD treatment clients. Reproductive health needs of drug treatment clients were assessed using a cross-sectional anonymous survey in 4 treatment sites in Baltimore City, MD. Surveys were distributed by staff. Contraceptives assessed included sterilization, intrauterine devices, implants, injections, pills, patches, rings, condoms, spermicide, withdrawal, and the rhythm method. Results are stratified by sex and between those using and not using highly effective contraceptive methods. A total of 115 women and 95 men completed the survey (80% younger than 50 years), with 39% of women and 54% of men reporting using condoms, but only 24% of women and 26% of men reporting consistent use. All other methods were used by less than 12% of the sample. Only 20% of sexually active women reported using a highly reliable form of contraception and only 53% were using any form of contraception at all. Contraceptive use correlated inversely with age, but did not correlate with having had sexually transmitted infection testing or other preventive health services. Although more than 90% of participants had access to health care services in the past 3 years, 25% of women and 33% of men reported difficulty accessing health care providers. The majority of respondents said they would likely use family planning services if available at their SUD treatment (83% of women and 58% of men). Men and women in SUD treatment have unmet reproductive health needs. As SUD treatment moves toward greater integration, the programmatic inclusion of family planning services should be considered.

Knowledge about feet care of the diabetic client

OpenAIRE