77 FR 65898 - Agency Information Collection Activities: InfoPass System, No Form Number; Extension, Without...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

...-0113] Agency Information Collection Activities: InfoPass System, No Form Number; Extension, Without...) Title of the Form/Collection: InfoPass System. (3) Agency form number, if any, and the applicable... InfoPass system allows an applicant or petitioner to schedule an interview appointment with USCIS...

Therapist adherence is associated with outcome in cognitive-behavioral therapy for bulimia nervosa.

PubMed

Folke, Sofie; Daniel, Sarah I F; Gondan, Matthias; Lunn, Susanne; Tækker, Louise; Poulsen, Stig

2017-06-01

Studies of therapist adherence in relation to treatment outcome have produced mixed results. The aim of the present study was to investigate change in therapist adherence to cognitive-behavioral therapy (CBT) for bulimia nervosa over time, and to investigate the relationship between adherence and client outcome in early, middle, and late phases of treatment. Thirty-six clients received the focused form of "enhanced" CBT (CBT-E) for bulimia nervosa. Trained observers rated audiotapes of 92 full-length therapy sessions from early (Session 3), middle (Session 11), and late phases (Session 20) of treatment using the Cognitive-Behavioral Therapy Treatment Protocol Adherence Scale. Change in adherence across the 3 treatment phases was examined using multilevel analysis. The relationship between early, middle, and late adherence levels and end-of-treatment binging frequency was examined using multilevel Poisson regression analysis. Adherence decreased significantly over the course of treatment. Higher levels of therapist adherence in early and middle phases of treatment were associated with reduced binging frequency, whereas higher levels of adherence measured late in treatment was not. Results indicate that therapists' adherence to the CBT-E treatment protocol decreases over time and that high levels of protocol adherence in early and middle phases of treatment are more important for positive client outcomes than high levels of adherence in the end of treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

INFO RELEASE. National Information Network for Recreation, Leisure and Sport.

ERIC Educational Resources Information Center

Sharma, Vidya S.

A study by the Northern Territories Department of Community Development systematically and specifically identified information needs and categories of clients through a set of intellectual concepts in the fields of sport, recreation, and leisure. A survey of Australia's serials holdings was conducted to assess the country's existing information…

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

PubMed

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.

78 FR 5477 - Agency Information Collection Activities: InfoPass System, No Form Number; Extension, Without...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

...-0113] Agency Information Collection Activities: InfoPass System, No Form Number; Extension, Without... Change, of a Currently Approved Collection. (2) Title of the Form/Collection: InfoPass System. (3) Agency...: Primary: Individuals or households. The InfoPass system allows an applicant or petitioner to schedule an...

Moving from affirmation to liberation in psychological practice with transgender and gender nonconforming clients.

PubMed

Singh, Anneliese A

2016-11-01

While affirmative approaches with transgender and gender nonconforming (TGNC) clients are gaining momentum within psychological practice (American Counseling Association, 2010; American Psychological Association, 2015), there is a simultaneous and pressing need to move beyond TGNC-affirmative to TGNC-liberatory approaches to more fully address how societal gender binaries influence both psychologist and client. Psychologists may use the lens of liberation psychology (Martín-Baró, 1996) to transform the ways they work with TGNC clients. Using this perspective, psychologists can reflect on their own gender journey and experiences, identify how cisgender privilege influences counseling and psychological practice, and advocate for TGNC people to be better served in the settings in which they work. Psychologists are then able to engage in social change on behalf of, and in collaboration with, TGNC people in ways that simultaneously liberate psychologists from their own gender oppression experiences. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Becoming psychotherapists: Experiences of novice trainees in a beginning graduate class.

PubMed

Hill, Clara E; Sullivan, Catherine; Knox, Sarah; Schlosser, Lewis Z

2007-12-01

The authors investigated the experiences related to becoming psychotherapists for 5 counseling psychology doctoral trainees in their first prepracticum course. Qualitative analyses of weekly journals indicated that trainees discussed challenges related to becoming psychotherapists (e.g., being self-critical, having troubling reactions to clients, learning to use helping skills), gains made during the semester related to becoming psychotherapists (e.g., using helping skills more effectively, becoming less self-critical, being able to connect with clients), as well as experiences in supervision and activities that helped them cope with their anxieties. Results are discussed in 5 broad areas: feelings about self in role of psychotherapist, awareness of reactions to clients, learning and using helping skills, reactions to supervision, and experiences that fostered growth. Implications for training and research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Internet Patient Records: new techniques

PubMed Central

Moehrs, Sascha; Anedda, Paolo; Tuveri, Massimiliano; Zanetti, Gianluigi

2001-01-01

Background The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article - XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans - may significantly reduce the complexity of the development of distributed healthcare systems. Objective The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists. Methods We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is achieved using standard HTML forms and thus may conceivably be authored by clinical specialists. A generic JavaScript library has been written that allows the seamless incorporation of such contributions into the InfoDOM client. In conjunction with another JavaBean, that library renders graphically-enhanced reporting tools that read and write content to and from the XML data-structure, ready for resubmission to the EPR server. Results We demonstrate the InfoDOM experimental EPR system that is currently being adapted for test-bed use in three hospitals in Cagliari, Italy. For this we are working with specialists in neurology, radiology, and epilepsy. Conclusions Early indications are that the rapid prototyping of reports afforded by our EPR system can assist communication between clinical specialists and our system developers. We are now experimenting with new technologies that may provide services to the kind of XML EPR client described here. PMID:11720950

A qualitative meta-analysis examining clients' experiences of psychotherapy: A new agenda.

PubMed

Levitt, Heidi M; Pomerville, Andrew; Surace, Francisco I

2016-08-01

This article argues that psychotherapy practitioners and researchers should be informed by the substantive body of qualitative evidence that has been gathered to represent clients' own experiences of therapy. The current meta-analysis examined qualitative research studies analyzing clients' experiences within adult individual psychotherapy that appeared in English-language journals. This omnibus review integrates research from across psychotherapy approaches and qualitative methods, focusing on the cross-cutting question of how clients experience therapy. It utilized an innovative method in which 67 studies were subjected to a grounded theory meta-analysis in order to develop a hierarchy of data and then 42 additional studies were added into this hierarchy using a content meta-analytic method-summing to 109 studies in total. Findings highlight the critical psychotherapy experiences for clients, based upon robust findings across these research studies. Process-focused principles for practice are generated that can enrich therapists' understanding of their clients in key clinical decision-making moments. Based upon these findings, an agenda is suggested in which research is directed toward heightening therapists' understanding of clients and recognizing them as agents of change within sessions, supporting the client as self-healer paradigm. This research aims to improve therapists' sensitivity to clients' experiences and thus can expand therapists' attunement and intentionality in shaping interventions in accordance with whichever theoretical orientation is in use. The article advocates for the full integration of the qualitative literature in psychotherapy research in which variables are conceptualized in reference to an understanding of clients' experiences in sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Treatment refusal and premature termination in psychotherapy, pharmacotherapy, and their combination: A meta-analysis of head-to-head comparisons.

PubMed

Swift, Joshua K; Greenberg, Roger P; Tompkins, Kelley A; Parkin, Susannah R

2017-03-01

The purpose of this meta-analysis was to examine rates of treatment refusal and premature termination for pharmacotherapy alone, psychotherapy alone, pharmacotherapy plus psychotherapy, and psychotherapy plus pill placebo treatments. A systematic review of the literature resulted in 186 comparative trials that included a report of treatment refusal and/or premature termination for at least 2 of the 4 treatment conditions. The data from these studies were pooled using a random-effects analysis. Odds Ratio effect sizes were then calculated to compare the rates between treatment conditions, once across all studies and then again for specific client disorder categories. An average treatment refusal rate of 8.2% was found across studies. Clients who were assigned to pharmacotherapy were 1.76 times more likely to refuse treatment compared with clients who were assigned psychotherapy. Differences in refusal rates for pharmacotherapy and psychotherapy were particularly evident for depressive disorders, panic disorder, and social anxiety disorder. On average, 21.9% of clients prematurely terminated their treatment. Across studies, clients who were assigned to pharmacotherapy were 1.20 times more likely to drop out compared with clients who were assigned to psychotherapy. Pharmacotherapy clients with anorexia/bulimia and depressive disorders dropped out at higher rates compared with psychotherapy clients with these disorders. Treatment refusal and dropout are significant problems in both psychotherapy and pharmacotherapy and providers of these treatments should seek to employ strategies to reduce their occurrence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Identifying and integrating helpful and harmful religious beliefs into psychotherapy.

PubMed

Rosenfield, George W

2010-12-01

The 2 main roles of the psychotherapist involve identifying and understanding the client's problems/strengths and treating problems. Suggestions are offered to guide addressing or avoiding religious beliefs in both roles. Types of religious beliefs that contribute to distress, particularly for youth, are identified and treatment options are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

"A qualitative meta-analysis examining clients' experiences of psychotherapy: A new agenda": Correction to Levitt, Pomerville, and Surace (2016).

PubMed

2016-10-01

Reports an error in "A qualitative meta-analysis examining clients’ experiences of psychotherapy: A new agenda" by Heidi M. Levitt, Andrew Pomerville and Francisco I. Surace ( Psychological Bulletin , 2016[Aug], Vol 142[8], 801-830). In the article, the 2nd sentence in the Broadening the Forms of Power When Considering Client–Therapist Differences section, “Indeed, most of the studies (55/66, 83.3%) in these categories focused either on the power differential within the therapeutic relationship (37) or culturally based power differences between therapists and clients (29).” should read: “Indeed, most of the studies (49/59, 83.1%) in these categories focused either on the power differential within the therapeutic relationship (38) or culturally based power differences between therapists and clients (31).” (The following abstract of the original article appeared in record 2016-21269-001.) This article argues that psychotherapy practitioners and researchers should be informed by the substantive body of qualitative evidence that has been gathered to represent clients’ own experiences of therapy. The current meta-analysis examined qualitative research studies analyzing clients’ experiences within adult individual psychotherapy that appeared in English-language journals. This omnibus review integrates research from across psychotherapy approaches and qualitative methods, focusing on the cross-cutting question of how clients experience therapy. It utilized an innovative method in which 67 studies were subjected to a grounded theory meta-analysis in order to develop a hierarchy of data and then 42 additional studies were added into this hierarchy using a content meta-analytic method—summing to 109 studies in total. Findings highlight the critical psychotherapy experiences for clients, based upon robust findings across these research studies. Process-focused principles for practice are generated that can enrich therapists’ understanding of their clients in key clinical decision-making moments. Based upon these findings, an agenda is suggested in which research is directed toward heightening therapists’ understanding of clients and recognizing them as agents of change within sessions, supporting the client as self-healer paradigm. This research aims to improve therapists’ sensitivity to clients’ experiences and thus can expand therapists’ attunement and intentionality in shaping interventions in accordance with whichever theoretical orientation is in use. The article advocates for the full integration of the qualitative literature in psychotherapy research in which variables are conceptualized in reference to an understanding of clients’ experiences in sessions. PsycINFO Database Record (c) 2016 APA, all rights reserved

Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review.

PubMed

Lee, Windy W M; Choi, K C; Yum, Royce W Y; Yu, Doris S F; Chair, S Y

2016-01-01

Clinically, there is an increasing trend in using motivational interviewing as a counseling method to help clients with cardiovascular diseases to modify their unhealthy lifestyle in order to decrease the risk of disease occurrence. As motivational interviewing has gained increased attention, research has been conducted to examine its effectiveness. This review attempts to identify the best available evidence related to the effectiveness of motivational interviewing on lifestyle modification, physiological and psychological outcomes for clients at risk of developing or with established cardiovascular diseases. Systematic review of studies incorporating motivational interviewing in modifying lifestyles, improving physiological and psychological outcomes for clients at risk of or diagnosed with cardiovascular diseases. Major English and Chinese electronic databases were searched to identify citations that reported the effectiveness of motivational interviewing. The searched databases included MEDLINE, British Nursing Index, CINAHL Plus, PsycINFO, SCOPUS, CJN, CBM, HyRead, WanFang Data, Digital Dissertation Consortium, and so on. Two reviewers independently assessed the relevance of citations based on the inclusion criteria. Full texts of potential citations were retrieved for more detailed review. Critical appraisal was conducted by using the standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute - Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStaRI). After eligibility screening, 14 articles describing 9 studies satisfied the inclusion criteria and were included in the analysis. Only certain outcomes in certain studies were pooled for meta-analysis because of the large variability of the studies included, other findings were presented in narrative form. For lifestyle modification, the review showed that motivational interviewing could be more effective than usual care on altering smoking habits. For physiological outcomes, the review showed that motivational interviewing positively improved client's systolic and diastolic blood pressures but the result was not significant. For psychological outcomes, the review showed that motivational interviewing might have favorable effect on improving clients' depression. For other outcomes, the review showed that motivational interviewing did not differ from usual care or usual care was even more effective. The review showed that motivational interviewing might have favorable effects on changing clients' smoking habits, depression, and three SF-36 domains. For the other outcomes, most of the results were inconclusive. Further studies should be performed to identify the optimal format and frequency of motivational interviewing. Primary research on the effectiveness of motivational interviewing on increasing clients' motivation and their actual changes in healthy behavior is also recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

The relationship between clients' depression etiological beliefs and psychotherapy orientation preferences, expectations, and credibility beliefs.

PubMed

Tompkins, Kelley A; Swift, Joshua K; Rousmaniere, Tony G; Whipple, Jason L

2017-06-01

The purpose of this study was to examine the relationship between clients' etiological beliefs for depression and treatment preferences, credibility beliefs, and outcome expectations for five different depression treatments-behavioral activation, cognitive therapy, interpersonal psychotherapy, pharmacotherapy, and psychodynamic psychotherapy. Adult psychotherapy clients (N = 98) were asked to complete an online survey that included the Reasons for Depression Questionnaire, a brief description of each of the five treatment options, and credibility, expectancy, and preference questions for each option. On average, the participating clients rated pharmacotherapy as significantly less credible, having a lower likelihood of success, and being less preferred than the four types of psychotherapy. In general, interpersonal psychotherapy was also rated more negatively than the other types of psychotherapy. However, these findings depended somewhat on whether the participating client was personally experiencing depression. Credibility beliefs, outcome expectations, and preferences for pharmacotherapy were positively associated with biological beliefs for depression; however, the other hypothesized relationships between etiological beliefs and treatment attitudes were not supported. Although the study is limited based on the specific sample and treatment descriptions that were used, the results may still have implications for psychotherapy research, training, and practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Diversity within African American, female therapists: variability in clients' expectations and assumptions about the therapist.

PubMed

Kelly, Jennifer F; Greene, Beverly

2010-06-01

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

77 FR 38582 - Proposed Information Collection; Comment Request; Domestic Client Life-Cycle Multi-Purpose Forms

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

... Request; Domestic Client Life-Cycle Multi-Purpose Forms AGENCY: International Trade Administration. ACTION... life-cycle with CS. CS is mandated by Congress to help U.S. organizations, particularly small and... Client Life-cycle Multi-Purpose Forms, previously titled Export Information Services Order Forms, are...

Meeting the mental health needs of today's college student: Reinventing services through Stepped Care 2.0.

PubMed

Cornish, Peter A; Berry, Gillian; Benton, Sherry; Barros-Gomes, Patricia; Johnson, Dawn; Ginsburg, Rebecca; Whelan, Beth; Fawcett, Emily; Romano, Vera

2017-11-01

A new stepped care model developed in North America reimagines the original United Kingdom model for the modern university campus environment. It integrates a range of established and emerging online mental health programs systematically along dimensions of treatment intensity and associated student autonomy. Program intensity can be either stepped up or down depending on level of client need. Because monitoring is configured to give both provider and client feedback on progress, the model empowers clients to participate actively in care options, decisions, and delivery. Not only is stepped care designed to be more efficient than traditional counseling services, early observations suggest it improves outcomes and access, including the elimination of service waitlists. This paper describes the new model in detail and outlines implementation experiences at 3 North American universities. While the experiences implementing the model have been positive, there is a need for development of technology that would facilitate more thorough evaluation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Correction to hill (2005).

PubMed

Hill, Clara E

2006-01-01

Reports an error in "Therapist Techniques, Client Involvement, and the Therapeutic Relationship: Inextricably Intertwined in the Therapy Process" by Clara E. Hill (Psychotherapy: Theory, Research, Practice, Training, 2005 Win, Vol 42(4), 431-442). An author's name was incorrectly spelled in a reference. The correct reference is presented. (The following abstract of the original article appeared in record 2006-03309-003.) I propose that therapist techniques, client involvement, and the therapeutic relationship are inextricably intertwined and need to be considered together in any discussion of the therapy process. Furthermore, I present a pantheoretical model of how these three variables evolve over four stages of successful therapy: initial impression formation, beginning the therapy (involves the components of facilitating client exploration and developing case conceptualization and treatment strategies), the core work of therapy (involves the components of theory-relevant tasks and overcoming obstacles), and termination. Theoretical propositions as well as implications for training and research are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Reassessing Rogers' necessary and sufficient conditions of change.

PubMed

Watson, Jeanne C

2007-09-01

This article reviews the impact of Carl Rogers' postulate about the necessary and sufficient conditions of therapeutic change on the field of psychotherapy. It is proposed that his article (see record 2007-14630-002) made an impact in two ways; first, by acting as a spur to researchers to identify the active ingredients of therapeutic change; and, second, by providing guidelines for therapeutic practice. The role of the necessary and sufficient conditions in process-experiential therapy, an emotion-focused therapy for individuals, and their limitations in terms of research and practice are discussed. It is proposed that although the conditions are necessary and important in promoting clients' affect regulation, they do not take sufficient account of other moderating variables that affect clients' response to treatment and may need to be balanced with more structured interventions. Notwithstanding, Rogers highlighted a way of interacting with clients that is generally acknowledged as essential to effective psychotherapy practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Perceived sources of change in trainees' self-efficacy beliefs.

PubMed

Lent, Robert W; Cinamon, Rachel Gali; Bryan, Nicole A; Jezzi, Matthew M; Martin, Helena M; Lim, Robert

2009-09-01

Thought-listing procedures were used to examine the perceived incidence, size, direction, and bases of change in the session-level self-efficacy of therapists in training. Ninety-eight Master's-level trainees completed a cognitive assessment task immediately after each session with a client in their first practicum. Participants typically reported modest-sized, positive changes in their therapeutic self-efficacy at each session. Seven perceived sources of change in self-efficacy were identified. Some of these sources (e.g., trainees' performance evaluations, affective reactions) were consistent with general self-efficacy theory; others reflected the interpersonal performance context of therapy (e.g., perceptions of the therapeutic relationship and client behavior). Implications of the findings for training and future research on therapist development are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Is low therapist empathy toxic?

PubMed

Moyers, Theresa B; Miller, William R

2013-09-01

One of the largest determinants of client outcomes is the counselor who provides treatment. Therapists often vary widely in effectiveness, even when delivering standardized manual-guided treatment. In particular, the therapeutic skill of accurate empathy originally described by Carl Rogers has been found to account for a meaningful proportion of variance in therapeutic alliance and in addiction treatment outcomes. High-empathy counselors appear to have higher success rates regardless of theoretical orientation. Low-empathy and confrontational counseling, in contrast, has been associated with higher drop-out and relapse rates, weaker therapeutic alliance, and less client change. The authors propose emphasis on empathic listening skills as an evidence-based practice in the hiring and training of counselors to improve outcomes and prevent harm in addiction treatment. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Client-therapist agreement in the termination process and its association with therapeutic relationship.

PubMed

Olivera, Julieta; Challú, Laura; Gómez Penedo, Juan Martín; Roussos, Andrés

2017-03-01

There is no consensus among different therapeutic approaches on the process of termination when therapy does not have a prefixed duration. Moreover, both clinicians and researchers are still exploring decision making in the termination of treatment. The present study assessed former client's perspective of therapy termination in a nonprobabilistic sample from Buenos Aires, Argentina. Seventy-three semistructured interviews, lasting ∼60 min each, were conducted with participants that had finished a therapeutic treatment or dropped out. They were asked about several aspects of therapy, including their experience of termination, specifically who decided to terminate, if there was agreement on termination or not, and their thoughts on the termination process. All interviews were transcribed and analyzed using an adaptation of Consensual Qualitative Research (CQR). Quantitative analyses were also conducted to examine associations between variables. Two main factors emerged from the analysis: client/therapist initiative on termination; and level of agreement between client and therapist regarding termination. Whereas nearly all (95%) of therapist-initiated termination cases agreed on termination, client-initiated termination cases could be sorted in agreed (49%) and disagreed (51%) terminations. Both therapist-initiated terminations and agreed upon terminations presented more categories of positive termination motives, better therapeutic bond, and higher overall satisfaction with treatment. Implications for research and clinical practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Significant events in psychotherapy: An update of research findings.

PubMed

Timulak, Ladislav

2010-11-01

Significant events research represents a specific approach to studying client-identified important moments in the therapy process. The current study provides an overview of the significant events research conducted, the methodology used together with findings and implications. PsychInfo database was searched with keywords such as significant events, important events, significant moments, important moments, and counselling or psychotherapy. The references of the selected studies were also searched. This process led to the identification of 41 primary studies that used client-identified significant event(s) as a main or secondary focus of the study. These were consequently reviewed with regard to their methodology and findings. The findings are presented according to type of study conducted. The impacts of helpful events reported by clients are focused on contributions to therapeutic relationship and to in-session outcomes. Hindering events focus on some client disappointment with the therapist or therapy. The group therapy modality highlighted additional helpful impacts (like learning from others). Perspectives on what is significant in therapy differ between clients and therapists. The intensive qualitative studies reviewed confirm that the processes involved in significant events are complex and ambiguous. Studies show that the helpful events may also contain many hindering elements and that specific events are deeply contextually embedded in the preceding events of therapy. Some studies suggest that helpful significant events are therapeutically productive although this may need to be established further. Specific intensive studies show that the clients' perceptions in therapy may differ dramatically from that of the therapist. Furthermore, the relational and emotional aspects of significant moments may be more important for the clients than the cognitive aspects of therapy which are frequently stressed by therapists. 2010 The British Psychological Society.

Improving completion rates for client intake forms through Audio Computer-Assisted Self-Interview (ACASI): results from a pilot study with the Avon Breast Health Outreach Program.

PubMed

Hallum-Montes, Rachel; Senter, Lindsay; D'Souza, Rohan; Gates-Ferris, Kathryn; Hurlbert, Marc; Anastario, Michael

2014-01-01

This study compares rates of completion of client intake forms (CIFs) collected via three interview modes: audio computer-assisted self-interview (ACASI), face-to-face interview (FFI), and self-administered paper-based interview (SAPI). A total of 303 clients served through the Avon Breast Health Outreach Program (BHOP) were sampled from three U.S. sites. Clients were randomly assigned to complete a standard CIF via one of the three interview modes. Logistic regression analyses demonstrated that clients were significantly more likely to complete the entire CIF via ACASI than either FFI or SAPI. The greatest observed differences were between ACASI and SAPI; clients were almost six times more likely to complete the CIF via ACASI as opposed to SAPI (AOR = 5.8, p < .001). We recommend that where feasible, ACASI be utilized as an effective means of collecting client-level data in healthcare settings. Adoption of ACASI in health centers may translate into higher completion rates of intake forms by clients, as well as reduced burden on clinic staff to enter data and review intake forms for completion. © 2013 National Association for Healthcare Quality.

Key competencies of the psychodynamic psychotherapist and how to teach them in supervision.

PubMed

Sarnat, Joan

2010-03-01

Four of Rodolfa et al.'s (2005) competencies in professional psychology-relationship, self-reflection, assessment-case conceptualization, and intervention-are key for the psychodynamic psychotherapist. Relationship lies at the heart of what is understood to be curative about psychodynamic psychotherapy. Self-reflection implies a complex and highly developed process that includes but goes beyond Rodolfa et al.'s and Kaslow, Dunn, and Smith's (2008) definitions. Competent assessment, diagnosis, and case conceptualization entails making inferences about unconscious processes by observing the client and also one's own experience, and integrating these inferences with theory. Effective psychodynamic intervention is derived from what the psychotherapist has experienced, processed, and conceptualized about the relationship with the client and about the client's internal object world. An extended vignette shows these competencies emerging in a psychotherapist-in-training, facilitated by an intense interaction with a supervisor. Although the supervisory and clinical tasks are different, the supervisor provides a relationship experience that models these same competencies for the supervisee and catalyzes their development in the supervisee. PsycINFO Database Record (c) 2010 APA, all rights reserved

Qualitative psychotherapy research: the journey so far and future directions.

PubMed

Levitt, Heidi M

2015-03-01

This article documents the evolution of qualitative psychotherapy research over the past 3 decades. Clients' and therapists' accounts of their experiences in psychotherapy provide a window into the psychotherapy relationship and its mechanisms of change. A sizable body of literature has been generated that uses qualitative methods to collect and analyze these accounts and to shed light on the psychotherapy process. It notes changes in the field such as growing numbers of dissertations and publications using qualitative methods as well as a strengthening emphasis on qualitative research within graduate education and research funding bodies. Future recommendations include developing principles for practice from qualitative methods and conducting qualitative meta-analyses. Other recommendations include forming journal review policies that support the publication of qualitative research and that focus on coherence in adapting methods to meet research goals, in light of a study's characteristics and epistemological framework, rather than focusing on sets of procedures. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Client attachment in a randomized clinical trial of psychoanalytic and cognitive-behavioral psychotherapy for bulimia nervosa: Outcome moderation and change.

PubMed

Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig; Lunn, Susanne

2016-06-01

In the context of a randomized clinical trial of psychoanalytic psychotherapy (PPT) versus cognitive behavior therapy (CBT) for bulimia nervosa (BN), this study performed secondary analyses of (a) the relation between attachment and pretreatment symptom levels, (b) whether client pretreatment attachment moderated treatment outcome, (c) whether change in client attachment was associated with symptomatic change, and (d) whether client attachment changed differently in the 2 treatments. Sixty-nine women and 1 man of a mean age of 25.8 years diagnosed with BN were randomly assigned to either 2 years of weekly PPT or 5 months of CBT. Assessments at intake, after 5 months, and after 2 years included the Eating Disorder Examination to assess eating disorder symptoms, the Adult Attachment Interview to assess client attachment, and the Symptom Checklist 90-R to assess general psychiatric distress. Repeated measures were analyzed using multilevel analysis. Higher scores on attachment insecurity and attachment preoccupation were associated with more frequent binging pretreatment. Pretreatment attachment did not predict treatment outcome. In PPT, but not in CBT, reduction of binging was associated with an increase in attachment security. The 2 treatment types were not associated with significantly different patterns of attachment-related change. Degree and type of attachment insecurity is related to the frequency of binging in BN. Increase in attachment security may be a treatment-specific mechanism of change in PPT for BN. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Request; International Client Life-Cycle Multi-Purpose Forms AGENCY: International Trade Administration... aspects of an international organization's life-cycle with CS. CS is mandated by Congress to help U.S... trade events to U.S. organizations. The International Client Life-cycle Multi-Purpose Forms, previously...

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.

PubMed

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.

Comparative study of group treatments for posttraumatic stress disorder.

PubMed

Maxwell, Kendal; Callahan, Jennifer L; Holtz, Pamela; Janis, Beth M; Gerber, Monica M; Connor, Dana R

2016-12-01

Presented herein is a comparative study of group treatments for posttraumatic stress disorder (PTSD). In this study, an emerging intervention, memory specificity training (MeST), was compared with cognitive processing therapy (CPT) using standardized outcome measures of target symptoms (i.e., anxiety and depression from client perspective; memory specificity from independent rater perspective) and global functioning (independent rater perspective), as well as a process measure of expectancy (client perspective). Clients were assessed on 3 separate occasions: at baseline, posttreatment, and 3 months posttreatment. Adherence and treatment fidelity (independent rater perspective) were monitored throughout the course of both treatment conditions. Improvement in PTSD symptoms, depressive symptoms, and global functioning were similar between MeST and CPT; an increase in ability to specify memories upon retrieval was also similar between MeST and CPT. Positive reliable change was observed in both groups on all outcome measures. With respect to the primary target of PTSD symptoms, 88% of participants in both treatment groups moved into the functional distribution by posttreatment and maintained these gains at follow-up. Notably, compared with CPT, MeST required only half the dosage (i.e., number of sessions) to accomplish these gains. Illustrative vignettes from client-therapist exchanges are provided, and results are discussed in terms of the potential mechanisms of action. Implications for both clinical practice and clinical research are also included. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

University Counseling Center Clients' Expressed Preferences for Counselors: A Four Year Archival Exploration

ERIC Educational Resources Information Center

Speight, Suzette L.; Vera, Elizabeth M.

2005-01-01

This archival study explored patterns of client preferences from a randomized sample of 881 clients at a Midwestern university counseling center. Information from client intake forms was collected for a four year time frame. Results showed that 61% of the clients did not express preferences for particular types of counselors when asked on intake…

Interventions to improve cultural competency in healthcare: a systematic review of reviews

PubMed Central

2014-01-01

Background Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area. Methods A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong. Results Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes. Conclusion This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs. PMID:24589335

The Info Commons Concept: Assessing User Needs

ERIC Educational Resources Information Center

Cataldo, Tara Tobin; Freund, LeiLani; Ocha, Marilyn N.; Salcedo, Marina

2006-01-01

The University of Florida Libraries took the opportunity of remodeling its Humanities and Social Sciences library to conceptualize the design of an info commons area for the new building. An Info Commons Concept Team was formed and charged with this task. The team used site visits, surveys, focus groups, and interviews to determine the needs of…

45 CFR 1608.7 - Attorney-client relationship.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 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...

45 CFR 1608.7 - Attorney-client relationship.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 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...

45 CFR 1608.7 - Attorney-client relationship.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 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...

45 CFR 1608.7 - Attorney-client relationship.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 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...

45 CFR 1608.7 - Attorney-client relationship.

Code of Federal Regulations, 2010 CFR

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...

77 FR 59373 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

...: International Trade Administration. Title: Domestic Client Life-cycle Multi-Purpose Forms. OMB Control Number... customized for each CS client, and will cover all aspects of a client's life-cycle with CS, involves merging...

Reputation management promotes strategic adjustment of service quality in cleaner wrasse.

PubMed

Binning, Sandra A; Rey, Olivia; Wismer, Sharon; Triki, Zegni; Glauser, Gaétan; Soares, Marta C; Bshary, Redouan

2017-08-21

Adjusting one's behaviour in response to eavesdropping bystanders is considered a sophisticated social strategy, yet the underlying mechanisms are not well studied. Cleaner wrasse, Labroides dimidiatus, cooperate by eating ectoparasites off "client" fishes, or cheat (i.e. bite) and eat client mucus. Image scoring by bystander clients generally causes cleaners from socially-complex (i.e. high cleaner and client abundance; high client species richness) habitats to increase levels of cooperation. However, some individuals may periodically provide tactile stimulation to small resident clients, which attract bystanders close that are bitten, a form of tactical deception. Cortisol injection can reproduce this pattern. Here, we tested whether cleaners from socially-complex versus simple habitats respond differently to cortisol injections in terms of their cleaning interactions with clients. We found that only cleaners from the socially-complex habitat respond to cortisol injection with strategies functioning as tactical deception: i.e. increased tactile stimulation to small clients and increased cheating of large clients relative to small ones. At the socially-simple site, where reputation management is less important, cortisol-treated fish increased their overall levels of cheating, especially of small clients. Thus, strategic adjustments to cooperative behaviour and tactical deception are likely context-dependent, forming part of general reputation management abilities in cleaner wrasse.

A scoping review of Australian allied health research in ehealth.

PubMed

Iacono, Teresa; Stagg, Kellie; Pearce, Natalie; Hulme Chambers, Alana

2016-10-04

Uptake of e-health, the use of information communication technologies (ICT) for health service delivery, in allied health appears to be lagging behind other health care areas, despite offering the potential to address problems with service access by rural and remote Australians. The aim of the study was to conduct a scoping review of studies into the application of or attitudes towards ehealth amongst allied health professionals conducted in Australia. Studies meeting inclusion criteria published from January 2004 to June 2015 were reviewed. Professions included were audiology, dietetics, exercise physiology, occupational therapy, physiotherapy, podiatry, social work, and speech pathology. Terms for these professions and forms of ehealth were combined in databases of CINAHL (EBSCO), Cochrane Library, PsycINFO (1806 - Ovid), MEDLINE (Ovid) and AMED (Ovid). Forty-four studies meeting inclusion criteria were summarised. They were either trials of aspects of ehealth service delivery, or clinician and/or client use of and attitudes towards ehealth. Trials of ehealth were largely from two research groups located at the Universities of Sydney and Queensland; most involved speech pathology and physiotherapy. Assessments through ehealth and intervention outcomes through ehealth were comparable with face-to-face delivery. Clinicians used ICT mostly for managing their work and for professional development, but were reticent about its use in service delivery, which contrasted with the more positive attitudes and experiences of clients. The potential of ehealth to address allied health needs of Australians living in rural and remote Australia appears unrealised. Clinicians may need to embrace ehealth as a means to radicalise practice, rather than replicate existing practices through a different mode of delivery.

Metamethod study of qualitative psychotherapy research on clients' experiences: Review and recommendations.

PubMed

Levitt, Heidi M; Pomerville, Andrew; Surace, Francisco I; Grabowski, Lauren M

2017-11-01

A metamethod study is a qualitative meta-analysis focused upon the methods and procedures used in a given research domain. These studies are rare in psychological research. They permit both the documentation of the informal standards within a field of research and recommendations for future work in that area. This paper presents a metamethod analysis of a substantial body of qualitative research that focused on clients' experiences in psychotherapy (109 studies). This review examined the ways that methodological integrity has been established across qualitative research methods. It identified the numbers of participants recruited and the form of data collection used (e.g., semistructured interviews, diaries). As well, it examined the types of checks employed to increase methodological integrity, such as participant counts, saturation, reflexivity techniques, participant feedback, or consensus and auditing processes. Central findings indicated that the researchers quite flexibly integrated procedures associated with one method into studies using other methods in order to strengthen their rigor. It appeared normative to adjust procedures to advance methodological integrity. These findings encourage manuscript reviewers to assess the function of procedures within a study rather than to require researchers to adhere to the set of procedures associated with a method. In addition, when epistemological approaches were mentioned they were overwhelmingly constructivist in nature, despite the increasing use of procedures traditionally associated with objectivist perspectives. It is recommended that future researchers do more to explicitly describe the functions of their procedures so that they are coherently situated within the epistemological approaches in use. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

PubMed

Magill, Molly; Apodaca, Timothy R; Borsari, Brian; Gaume, Jacques; Hoadley, Ariel; Gordon, Rebecca E F; Tonigan, J Scott; Moyers, Theresa

2018-02-01

In the present meta-analysis, we test the technical and relational hypotheses of Motivational Interviewing (MI) efficacy. We also propose an a priori conditional process model where heterogeneity of technical path effect sizes should be explained by interpersonal/relational (i.e., empathy, MI Spirit) and intrapersonal (i.e., client treatment seeking status) moderators. A systematic review identified k = 58 reports, describing 36 primary studies and 40 effect sizes (N = 3,025 participants). Statistical methods calculated the inverse variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple target behaviors (i.e., alcohol use, other drug use, other behavior change). Therapist MI-consistent skills were correlated with more client change talk (r = .55, p < .001) as well as more sustain talk (r = .40, p < .001). MI-inconsistent skills were correlated with more sustain talk (r = .16, p < .001), but not change talk. When these indicators were combined into proportions, as recommended in the Motivational Interviewing Skill Code, the overall technical hypothesis was supported. Specifically, proportion MI consistency was related to higher proportion change talk (r = .11, p = .004) and higher proportion change talk was related to reductions in risk behavior at follow up (r = -.16, p < .001). When tested as two independent effects, client change talk was not significant, but sustain talk was positively associated with worse outcome (r = .19, p < .001). Finally, the relational hypothesis was not supported, but heterogeneity in technical hypothesis path effect sizes was partially explained by inter- and intrapersonal moderators. This meta-analysis provides additional support for the technical hypothesis of MI efficacy; future research on the relational hypothesis should occur in the field rather than in the context of clinical trials. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

PubMed

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.

Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies

PubMed Central

2012-01-01

Background Case management has been applied in community aged care to meet frail older people’s holistic needs and promote cost-effectiveness. This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes. Methods We searched Web of Science, Scopus, Medline, CINAHL (EBSCO) and PsycINFO (CSA) from inception to 2011 July. Inclusion criteria were: no restriction on date, English language, community-dwelling older people and/or carers, case management in community aged care, published in refereed journals, randomized control trials (RCTs) or comparative observational studies, examining client or carer outcomes. Quality of studies was assessed by using such indicators as quality control, randomization, comparability, follow-up rate, dropout, blinding assessors, and intention-to-treat analysis. Two reviewers independently screened potentially relevant studies, extracted information and assessed study quality. A narrative summary of findings were presented. Results Ten RCTs and five comparative observational studies were identified. One RCT was rated high quality. Client outcomes included mortality (7 studies), physical or cognitive functioning (6 studies), medical conditions (2 studies), behavioral problems (2 studies) , unmet service needs (3 studies), psychological health or well-being (7 studies) , and satisfaction with care (4 studies), while carer outcomes included stress or burden (6 studies), satisfaction with care (2 studies), psychological health or well-being (5 studies), and social consequences (such as social support and relationships with clients) (2 studies). Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group, while all the three studies consistently reported fewer unmet service needs among the intervention participants. In contrast, available studies reported mixed results regarding client physical or cognitive functioning and carer stress or burden. There was also limited evidence indicating significant effects of the interventions on the other client and carer outcomes as described above. Conclusions Available evidence showed that case management in community aged care can improve client psychological health or well-being and unmet service needs. Future studies should investigate what specific components of case management are crucial in improving clients and their carers’ outcomes. PMID:23151143

IDD Info: a software to manage surveillance data of Iodine Deficiency Disorders.

PubMed

Liu, Peng; Teng, Bai-Jun; Zhang, Shu-Bin; Su, Xiao-Hui; Yu, Jun; Liu, Shou-Jun

2011-08-01

IDD info, a new software for managing survey data of Iodine Deficiency Disorders (IDD), is presented in this paper. IDD Info aims to create IDD project databases, process, analyze various national or regional surveillance data and form final report. It has series measures of choosing database from existing ones, revising it, choosing indicators from pool to establish database and adding indicators to pool. It also provides simple tools to scan one database and compare two databases, to set IDD standard parameters, to analyze data by single indicator and multi-indicators, and finally to form typeset report with content customized. IDD Info was developed using Chinese national IDD surveillance data of 2005. Its validity was evaluated by comparing with survey report given by China CDC. The IDD Info is a professional analysis tool, which succeeds in speeding IDD data analysis up to about 14.28% with respect to standard reference routines. It consequently enhances analysis performance and user compliance. IDD Info is a practical and accurate means of managing the multifarious IDD surveillance data that can be widely used by non-statisticians in national and regional IDD surveillance. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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-term progression of satisfaction levels with services and determinants of satisfaction involving larger samples in many treatment centres.

Personal risk factors associated with burnout among psychotherapists: A systematic review of the literature.

PubMed

Simionato, Gabrielle K; Simpson, Susan

2018-03-24

Emotionally taxing job demands place psychotherapists at risk for burnout, often to the detriment of the therapist, clients, and the profession of psychotherapy (Maslach, 2007). The aim of the present systematic review was to (a) explore the levels of both burnout and job stress in psychotherapists, (b) identify tools used to measure work-related stress and burnout, and (c) identify personal risk factors for developing burnout among psychotherapists. Databases PsycINFO, Medline, EMBASE, ASSIA, and CINHAL were searched. Forty articles met inclusion criteria. Over half of sampled psychotherapists reported moderate-high levels of burnout, with the majority of results based on quantitative cross-sectional self-report surveys. Younger age, having less work experience, and being overinvolved in client problems were the most common personal risk factors for moderate-high levels of stress and burnout among psychotherapists. It appears that psychotherapists commonly experience some burnout, and personal factors influence burnout development. © 2018 Wiley Periodicals, Inc.

Therapist effects on dropout from a college counseling center practice research network.

PubMed

Xiao, Henry; Castonguay, Louis G; Janis, Rebecca A; Youn, Soo Jeong; Hayes, Jeffrey A; Locke, Benjamin D

2017-07-01

Dropout has been a pervasive and costly problem in psychotherapy, particularly for college counseling centers. The present study examined potential predictors of dropout using a large data set (N = 10,147 clients, 481 therapists) that was gathered through a college counseling center practice research network as a replication and extension of recent findings regarding therapist effects on dropout. The final model resulted in a dropout rate of 15.9% and a therapist effect of 9.51% on dropout variance. Therapist demographic variables were investigated, though none were found to be significant. Variables found to be predictive of increased likelihood of dropping out included higher levels of general presenting concerns, alcohol-related distress, and current financial stress. Ultimately, this study showed that therapists may play an important role in the likelihood of client dropout, and that additional research should be conducted to identify additional predictors, particularly at the therapist and center level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

On the enduring and substantial influence of Carl Rogers' not-quite necessary nor sufficient conditions.

PubMed

Farber, Barry A

2007-09-01

Carl Rogers' 1957 paper (see record 2007-14639-002) is arguably the most successful of his many attempts to clarify and render testable the ideas behind client-centered therapy. While each of the conditions that Rogers postulated has been linked to positive therapeutic outcome, taken together they have never been conclusively proved (nor disproved) to be either necessary or sufficient for positive outcome. Nevertheless, the overriding "take-home" message in this classic paper--that the therapist's attitude and caring presence is critical for therapeutic success--is one that has had virtually unparalleled influence in every segment of the psychotherapeutic community. Clinical and theoretical innovations in the psychoanalytic community serve as examples of the following proposition: that Rogers' concepts, while accepted more than ever by a remarkably wide variety of psychotherapists, remain essentially unacknowledged as originating with him or in the tradition of humanistic and client-centered therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Systematic review and meta-analysis of dropout rates in individual psychotherapy for generalized anxiety disorder.

PubMed

Gersh, Elon; Hallford, David J; Rice, Simon M; Kazantzis, Nikolaos; Gersh, Hannah; Gersh, Benji; McCarty, Carolyn A

2017-12-01

Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates. A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD. Forty-five studies, involving 2224 participants, were identified for meta-analysis. The weighted mean dropout rate was 16.99% (95% confidence interval 14.42%-19.91%). The Q-statistic indicated significant heterogeneity among studies. Moderator analysis and meta-regressions indicated no statistically significant effect of client age, sex, symptom severity, comorbidity, treatment type, study type (randomized trial or not), study quality, number of sessions or therapist experience. In research investigating psychotherapy for GAD, approximately one in six clients can be expected to drop out of treatment. Dropout rate was not significantly moderated by the client, therapist or treatment variables investigated. Future research should specify the definition of dropout, reasons for dropout and associated correlates to assist the field's progression. Copyright © 2017 Elsevier Ltd. All rights reserved.

Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

ERIC Educational Resources Information Center

Simpson, D. Dwayne; Joe, George W.; Knight, Kevin; Rowan-Szal, Grace A.; Gray, Julie S.

2012-01-01

The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (one-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for…

Satisfaction with emergency obstetric and new born care services among clients using public health facilities in Jimma Zone, Oromia Regional State, Ethiopia; a cross sectional study.

PubMed

Kumsa, Alemayehu; Tura, Gurmessa; Nigusse, Aderajew; Kebede, Getahun

2016-04-25

The 2005 report of United Nations Millennium Project of Transforming Health Systems for women and children concluded that universal access to Emergency Obstetric and New born Care could reduce maternal deaths by 74%. Even though some studies investigated quality of Emergency Obstetric and New born Care in different parts of the world, there is scarcity of data regarding this issue in Ethiopia, particularly in Jimma zone. Therefore, the aim of this study was to assess satisfaction with Emergency Obstetric and new born Care services among clients using public health facilities in Jimma zone, Southwest Ethiopia. A facility-based cross sectional study was conducted in Jimma Zone from April 01-30, 2014. The data were collected by interviewing 403 clients, who gave birth in the past 12 months prior to data collection in 34 randomly selected public health facilities. The collected data were entered by using Epi-info version 3.5.4 and analysed using SPSS version 20.0. Linear regression analysis was done to ascertain the association between covariates and the outcome variable, and finally the results were presented using frequency distribution tables, graphs and texts. The overall mean client satisfaction with Emergency Obstetric and New born Care services in this study was 79.4%; 95% CI (75%, 83%). The result of linear regression analysis revealed that a unit decrease in satisfaction to availability of drugs and equipment, decreased overall clients' satisfaction by 0.23 unit 95% CI (0.15, 0.31). The level of clients' satisfaction with Emergency Obstetric and New born Care services was low in the study area. Factors such as availability of essential equipment and drugs, health workers' communication, health care provided, and attitude of health workers had positive association with client satisfaction with Emergency Obstetric and New born Care services. This in turn could affect utilization of Emergency Obstetric and New born Care services and play a role in contribution to maternal and new born mortality. Therefore, the efforts of health facilities leaders and health care providers towards improvement of quality of care could contribute more for better maternal satisfaction.

CES4Health.info: A Web-Based Mechanism for Disseminating Peer-Reviewed Products of Community-Engaged Scholarship--Reflections on Year One

ERIC Educational Resources Information Center

Jordan, Catherine; Gelmon, Sherril; Ryan, Katharine; Seifer, Sarena D.

2012-01-01

CES4Health.info was launched in November 2009 as an online mechanism for peer reviewing and disseminating products of community-engaged scholarship in forms other than journal articles. One year after its launch, the authors conducted an online survey of CES4Health.info contributing authors, reviewers, and users of published products. Early…

Hsp70 Forms Antiparallel Dimers Stabilized by Post-translational Modifications to Position Clients for Transfer to Hsp90

PubMed Central

Morgner, Nina; Schmidt, Carla; Beilsten-Edmands, Victoria; Ebong, Ima-obong; Patel, Nisha A.; Clerico, Eugenia M.; Kirschke, Elaine; Daturpalli, Soumya; Jackson, Sophie E.; Agard, David; Robinson, Carol V.

2015-01-01

Summary Protein folding in cells is regulated by networks of chaperones, including the heat shock protein 70 (Hsp70) system, which consists of the Hsp40 cochaperone and a nucleotide exchange factor. Hsp40 mediates complex formation between Hsp70 and client proteins prior to interaction with Hsp90. We used mass spectrometry (MS) to monitor assemblies formed between eukaryotic Hsp90/Hsp70/Hsp40, Hop, p23, and a client protein, a fragment of the glucocorticoid receptor (GR). We found that Hsp40 promotes interactions between the client and Hsp70, and facilitates dimerization of monomeric Hsp70. This dimerization is antiparallel, stabilized by post-translational modifications (PTMs), and maintained in the stable heterohexameric client-loading complex Hsp902Hsp702HopGR identified here. Addition of p23 to this client-loading complex induces transfer of GR onto Hsp90 and leads to expulsion of Hop and Hsp70. Based on these results, we propose that Hsp70 antiparallel dimerization, stabilized by PTMs, positions the client for transfer from Hsp70 to Hsp90. PMID:25921532

Retiree benefit mailing dates | Alaska Division of Retirement and Benefits

Science.gov Websites

Employee Retiring Retiree Disabled Survivor Features Empower Retirement Account Info Online myRnB Member Scheduler Empower Retirement Account Info Online myRnB Member Services Seminars AlaskaCare Wellness Forms

45 CFR 1611.7 - Manner of determining financial eligibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... forms and procedures to obtain information from applicants and groups to determine financial eligibility in a manner that promotes the development of trust between attorney and client. The forms shall be... verify the information, in a manner consistent with the attorney-client relationship. (d) When one...

45 CFR 1611.7 - Manner of determining financial eligibility.

Code of Federal Regulations, 2012 CFR

2012-10-01

... forms and procedures to obtain information from applicants and groups to determine financial eligibility in a manner that promotes the development of trust between attorney and client. The forms shall be... verify the information, in a manner consistent with the attorney-client relationship. (d) When one...

45 CFR 1611.7 - Manner of determining financial eligibility.

Code of Federal Regulations, 2013 CFR

2013-10-01

... forms and procedures to obtain information from applicants and groups to determine financial eligibility in a manner that promotes the development of trust between attorney and client. The forms shall be... verify the information, in a manner consistent with the attorney-client relationship. (d) When one...

Personality and mental health treatment: Traits as predictors of presentation, usage, and outcome.

PubMed

Thalmayer, Amber Gayle

2018-03-08

Self-report scores on personality inventories predict important life outcomes, including health and longevity, marital outcomes, career success, and mental health problems, but the ways they predict mental health treatment have not been widely explored. Psychotherapy is sought for diverse problems, but about half of those who begin therapy drop out, and only about half who complete therapy experience lasting improvements. Several authors have argued that understanding how personality traits relate to treatment could lead to better targeted, more successful services. Here self-report scores on Big Five and Big Six personality dimensions are explored as predictors of therapy presentation, usage, and outcomes in a sample of community clinic clients (N = 306). Participants received evidence-based treatments in the context of individual-, couples-, or family-therapy sessions. One measure of initial functioning and three indicators of outcome were used. All personality trait scores except Openness associated with initial psychological functioning. Higher Conscientiousness scores predicted more sessions attended for family therapy but fewer for couples-therapy clients. Higher Honesty-Propriety and Extraversion scores predicted fewer sessions attended for family-therapy clients. Better termination outcome was predicted by higher Conscientiousness scores for family- and higher Extraversion scores for individual-therapy clients. Higher Honesty-Propriety and Neuroticism scores predicted more improvement in psychological functioning in terms of successive Outcome Questionnaire-45 administrations. Taken together, the results provide some support for the role of personality traits in predicting treatment usage and outcome and for the utility of a 6-factor model in this context. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Momentary assessment of interpersonal process in psychotherapy.

PubMed

Thomas, Katherine M; Hopwood, Christopher J; Woody, Erik; Ethier, Nicole; Sadler, Pamela

2014-01-01

To demonstrate how a novel computer joystick coding method can illuminate the study of interpersonal processes in psychotherapy sessions, we applied it to Shostrom's (1966) well-known films in which a client, Gloria, had sessions with 3 prominent psychotherapists. The joystick method, which records interpersonal behavior as nearly continuous flows on the plane defined by the interpersonal dimensions of control and affiliation, provides an excellent sampling of variability in each person's interpersonal behavior across the session. More important, it yields extensive information about the temporal dynamics that interrelate clients' and therapists' behaviors. Gloria's 3 psychotherapy sessions were characterized using time-series statistical indices and graphical representations. Results demonstrated that patterns of within-person variability tended to be markedly asymmetric, with a predominant, set-point-like interpersonal style from which deviations mostly occurred in just 1 direction (e.g., occasional submissive departures from a modal dominant style). In addition, across each session, the therapist and client showed strongly cyclical variations in both control and affiliation, and these oscillations were entrained to different extents depending on the therapist. We interpreted different patterns of moment-to-moment complementarity of interpersonal behavior in terms of different therapeutic goals, such as fostering a positive alliance versus disconfirming the client's interpersonal expectations. We also showed how this method can be used to provide a more detailed analysis of specific shorter segments from each of the sessions. Finally, we compared our approach to alternative techniques, such as act-to-act lagged relations and dynamic systems and pointed to a variety of possible research and training applications. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

"Everything that I thought that they would be, they weren't:" family systems as support and impediment to recovery.

PubMed

EnglandKennedy, Elizabeth Sara; Horton, Sarah

2011-10-01

Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA, these were collected as part of a larger, long-term study. We examine the latter's concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members' actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees' perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery. Copyright © 2011 Elsevier Ltd. All rights reserved.

“Everything that I thought that they would be, they weren’t:” Family systems as support and impediment to recovery

PubMed Central

Kennedy, Elizabeth Sara England; Horton, Sarah

2011-01-01

Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA these were collected as part of a larger, long-term study. We examine the latter’s concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members’ actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees’ perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery. PMID:21880408

Lifetime Alcoholics Anonymous attendance as a predictor of spiritual gains in the Relapse Replication and Extension Project (RREP).

PubMed

Tonigan, J Scott; McCallion, Elizabeth A; Frohe, Tessa; Pearson, Matthew R

2017-02-01

This study investigated the association between extent of lifetime attendance in Alcoholics Anonymous (AA) and spiritual gains among treatment seeking adults for alcohol use disorder. Participants included 246 individuals from 2 of the 3 sites in the Relapse Replication and Extension Project (Lowman, Allen, Stout, & The Relapse Research Group, 1996). Baseline characteristics included 63% male, 39.9% single, and the average age was 34 years (SD = 8.2). The Alcoholics Anonymous Involvement questionnaire (Tonigan, Connors, & Miller, 1996) was used to assess lifetime AA attendance. The Religious Beliefs & Behaviors Questionnaire (Connors, Tonigan, & Miller, 1996) was used to assess spirituality. Percent days abstinent (PDA) and drinks per drinking day (DPDD) were measured using the Form 90. At baseline, adults with more extensive AA histories were more severely alcohol impaired although they were no older relative to adults with less past AA exposure. Clear patterns of AA engagement were found between the high-low AA history groups over follow-up, with adults with less AA experience reporting less AA participation across a swath of AA-specific measures. Gains in spiritual practices significantly mediated AA-related benefit as measured by PDA and DPDD. Tests for moderated-mediation indicated that the magnitude of the mediational effect of spiritual gains did not differ between high-low AA history groups. Having an extensive AA history did not advantage (or disadvantage) adults in mobilizing future spiritual practices that are prescribed in AA. Clinical assessment of client AA history is important, however, because it predicts both the nature and extent that clients may participate in AA. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Sexual Orientation Microaggressions: The Experience of Lesbian, Gay, Bisexual, and Queer Clients in Psychotherapy

ERIC Educational Resources Information Center

Shelton, Kimber; Delgado-Romero, Edward A.

2011-01-01

Psychological research has shown the detrimental effects that overt heterosexism have on lesbian, gay, bisexual, and queer (LGBQ) clients and on the psychotherapeutic relationship. However, the effects of subtle forms of discrimination, specifically sexual orientation microaggressions, have on LGBQ clients and the therapeutic relationship have not…

Fostering Experiential Learning and Service through Client Projects in Graduate Business Courses Offered Online

ERIC Educational Resources Information Center

Hagan, Linda M.

2012-01-01

Undergraduate marketing and public relations capstone courses utilize client projects to allow students to apply their knowledge and encourage collaboration. Yet, at the graduate level, especially with courses offered in an online modality, experiential service learning in the form of client project assignments presents unique challenges. However,…

Response to Patterson's "Winds of Change for Client-Centered Counseling."

ERIC Educational Resources Information Center

Brodley, Barbara Temaner

1993-01-01

Responds to previous article by Patterson in which Patterson defends Rogers' theory of psychotherapy and the traditional form in which it is practiced by many client-centered counselors. Shares Patterson's concern about the changes being advocated for client-centered counseling on the grounds that the approach is inadequate. Attempts to clarify…

ORBIT: an integrated environment for user-customized bioinformatics tools.

PubMed

Bellgard, M I; Hiew, H L; Hunter, A; Wiebrands, M

1999-10-01

There are a large number of computational programs freely available to bioinformaticians via a client/server, web-based environment. However, the client interface to these tools (typically an html form page) cannot be customized from the client side as it is created by the service provider. The form page is usually generic enough to cater for a wide range of users. However, this implies that a user cannot set as 'default' advanced program parameters on the form or even customize the interface to his/her specific requirements or preferences. Currently, there is a lack of end-user interface environments that can be modified by the user when accessing computer programs available on a remote server running on an intranet or over the Internet. We have implemented a client/server system called ORBIT (Online Researcher's Bioinformatics Interface Tools) where individual clients can have interfaces created and customized to command-line-driven, server-side programs. Thus, Internet-based interfaces can be tailored to a user's specific bioinformatic needs. As interfaces are created on the client machine independent of the server, there can be different interfaces to the same server-side program to cater for different parameter settings. The interface customization is relatively quick (between 10 and 60 min) and all client interfaces are integrated into a single modular environment which will run on any computer platform supporting Java. The system has been developed to allow for a number of future enhancements and features. ORBIT represents an important advance in the way researchers gain access to bioinformatics tools on the Internet.

77 FR 65665 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

...: International Trade Administration. Title: International Client Life-cycle Multi-Purpose Forms. OMB Control... of an international client's life-cycle with CS, involves merging with other information collections...

Driver rehabilitation: a systematic review of the types and effectiveness of interventions used by occupational therapists to improve on-road fitness-to-drive.

PubMed

Unsworth, Carolyn A; Baker, Anne

2014-10-01

Driver rehabilitation has the potential to improve on-road safety and is commonly recommended to clients. The aim of this systematic review was to identify what intervention approaches are used by occupational therapists as part of driver rehabilitation programmes, and to determine the effectiveness of these interventions. Six electronic databases (MEDLINE, CINAHL, PsycInfo, Embase, The Cochrane Library, and OTDBase) were searched. Two authors independently reviewed studies reporting all types of research designs and for all patient populations, provided the interventions could be administered by occupational therapists. The methodological quality of studies was assessed using the 'Downs and Black Instrument', and the level of evidence for each intervention approach was established using 'Centre for Evidence Based Medicine' criteria. Sixteen studies were included in the review. The most common type of intervention approach used was computer-based driving simulator training (n=8), followed by off-road skill-specific training (n=4), and off-road education programmes (n=3). Car adaptations/modifications were used in one of the included studies. There was significant variability between studies with regards to frequency, duration, and total number of intervention sessions, and the diagnoses of the participants. Of the four intervention approaches, there is evidence to support the effectiveness of off-road skill-specific training (with older clients), and computer-based driving simulator training (with both older clients and participants with acquired brain injury). Three types of intervention approaches are commonly reported, however, there is limited evidence to determine to effectiveness of these in improving fitness-to-drive. Further research is required, with clients from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving these clients' on-road fitness-to-drive. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

75 FR 71488 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... compliance with the notice rules and to document that clients have been informed of the clients' retained tax... review and clearance under the Paperwork Reduction Act of 1995, Public Law 104-13 on or after the date of... approved collection. Title: U.S. Departing Alien Income Tax Return. Form: 1040-C. Abstract: Form 1040-C is...

Integration of treatment innovation planning and implementation: strategic process models and organizational challenges.

PubMed

Lehman, Wayne E K; Simpson, D Dwayne; Knight, Danica K; Flynn, Patrick M

2011-06-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A two-phase procedural approach is therefore presented based on the integration of Texas Christian University (TCU) models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Clinical errors that can occur in the treatment decision-making process in psychotherapy.

PubMed

Park, Jake; Goode, Jonathan; Tompkins, Kelley A; Swift, Joshua K

2016-09-01

Clinical errors occur in the psychotherapy decision-making process whenever a less-than-optimal treatment or approach is chosen when working with clients. A less-than-optimal approach may be one that a client is unwilling to try or fully invest in based on his/her expectations and preferences, or one that may have little chance of success based on contraindications and/or limited research support. The doctor knows best and the independent choice models are two decision-making models that are frequently used within psychology, but both are associated with an increased likelihood of errors in the treatment decision-making process. In particular, these models fail to integrate all three components of the definition of evidence-based practice in psychology (American Psychological Association, 2006). In this article we describe both models and provide examples of clinical errors that can occur in each. We then introduce the shared decision-making model as an alternative that is less prone to clinical errors. PsycINFO Database Record (c) 2016 APA, all rights reserved

Supportive psychotherapy or client education alongside surgical procedures to correct complications of female genital mutilation: A systematic review.

PubMed

Abayomi, Olukayode; Chibuzor, Moriam T; Okusanya, Babasola O; Esu, Ekpereonne; Odey, Edward; Meremikwu, Martin M

2017-02-01

Supportive psychotherapy, in individual or group settings, may help improve surgical outcomes for women and girls living with female genital mutilation (FGM). To assess whether supportive psychotherapy given alongside surgical procedures to correct complications of FGM improves clinical outcomes. We searched major databases including CENTRAL, Medline, African Index Medicus, SCOPUS, PsycINFO, and others. There were no language restrictions. We checked the reference lists of retrieved studies for additional reports of relevant studies. We included studies of girls and women living with any type of FGM who received supportive psychotherapy or client education sessions alongside any surgical procedure to correct health complications from FGM. Two team members independently screened studies for eligibility. There were no eligible studies identified. There is no direct evidence for the benefits or harms of supportive psychotherapy alongside surgical procedures for women and girls living with FGM. Research evidence is urgently needed to guide clinical practice. 42015024639. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

"No-Show": Therapist Racial/Ethnic Disparities in Client Unilateral Termination

ERIC Educational Resources Information Center

Owen, Jesse; Imel, Zac; Adelson, Jill; Rodolfa, Emil

2012-01-01

In the present study, the authors examined the source of racial/ethnic minority (REM) disparities in unilateral termination (i.e., the client ending therapy without informing the therapist)--a form of dropout that is associated with poor alliance and outcome. First, the authors tested whether some therapists were more likely to have clients who…

Mitigating delay and non-payment in the Malaysian construction industry

NASA Astrophysics Data System (ADS)

Mohamad, N.; Suman, A. S.; Harun, H.; Hashim, H.

2018-02-01

Construction industry is one of the industries that have contributed towards the rapid growth of development and economics in Malaysia. However, the industry is inundated with delay and non-payment issues between the two parties in contract that is the clients and contractors Even though there are contractual and administrative provisions in the standard forms of contract in Malaysia regarding payments, delay and non-payment issues still occur between them. The aim of the study is to develop measures to mitigate delay and non-payment issues between contractors and clients in the Malaysian construction industry. Questionnaire survey was conducted with clients and contractors in Klang Valley. Results from data analysis identified significant measures to mitigate delay and non-payment issues between contractors and clients which include contractors should submit their progress work invoicing with adequate documents; contractors should follow up constantly with client regarding payment; proper understanding of requirements with regards to payment; mutual discussion of problems with client to address problems in a timely manner and proper use of payment provisions in the standard form of contract. This study is significant to contractors and clients and to other construction players in order to reduce and minimise delay and non-payment issues for the growth of economy in the Malaysian construction industry.

SQLGEN: a framework for rapid client-server database application development.

PubMed

Nadkarni, P M; Cheung, K H

1995-12-01

SQLGEN is a framework for rapid client-server relational database application development. It relies on an active data dictionary on the client machine that stores metadata on one or more database servers to which the client may be connected. The dictionary generates dynamic Structured Query Language (SQL) to perform common database operations; it also stores information about the access rights of the user at log-in time, which is used to partially self-configure the behavior of the client to disable inappropriate user actions. SQLGEN uses a microcomputer database as the client to store metadata in relational form, to transiently capture server data in tables, and to allow rapid application prototyping followed by porting to client-server mode with modest effort. SQLGEN is currently used in several production biomedical databases.

Interpersonal relations between health care workers and young clients: barriers to accessing sexual and reproductive health care.

PubMed

Alli, Farzana; Maharaj, Pranitha; Vawda, Mohammed Yacoob

2013-02-01

Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent interpersonal relations form a barrier to young peoples access to and satisfaction of health services. The study draws on data from 200 client exit interviews and four in-depth interviews conducted with university students and university health care staff in Kwazulu-Natal, South Africa. While young people are aware of the importance of utilising STI, HIV and family planning services they experienced barriers in their relationship with providers. This served as a deterrent to their use of the health facility. Adequate training in interpersonal relations for youth-friendly service provision is essential in helping overcome communication problems and enabling providers to interact with young clients at a more personal level.

A novel application in the study of client language: Alcohol and marijuana-related statements in substance-using adolescents during a simulation task.

PubMed

Ladd, Benjamin O; Garcia, Tracey A; Anderson, Kristen G

2016-09-01

The current study explored whether laboratory-based techniques can provide a strategy for studying client language as a mechanism of behavior change. Specifically, this study examined the potential of a simulation task to elicit healthy talk, or self-motivational statements in favor of healthy behavior, related to marijuana and alcohol use. Participants (N = 84) were adolescents reporting at least 10 lifetime substance use episodes recruited from various community settings in an urban Pacific Northwest setting. Participants completed the Adolescent Simulated Intoxication Digital Elicitation (A-SIDE), a validated paradigm for assessing substance use decision making in peer contexts. Participants responded to 4 types of offers in the A-SIDE: (a) marijuana, (b) food (marijuana control), (c) alcohol, and (d) soda (alcohol control). Using a validated coding scheme adapted for the current study, client language during a structured interview assessing participants' response to the simulated offers was evaluated. Associations between percent healthy talk (PHT, calculated by dividing the number of healthy statements by the sum of all substance-related statements) and cross-sectional outcomes of interest (previous substance use, substance use expectancies, and behavioral willingness) were explored. The frequency of substance-related statements differed in response to offer type; rate of PHT did not. PHT was associated with behavioral willingness to accept the offer. However, PHT was not associated with decontextualized measures of substance use. Associations between PHT and global expectancies were limited. Simulation methods may be useful in investigating the impact of context on self-talk and to systematically explore client language as a mechanism of change. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Evaluating the Influence of the Client Behavior in Cloud Computing.

PubMed

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.

Evaluating the Influence of the Client Behavior in Cloud Computing

PubMed Central

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. PMID:27441559

75 FR 68040 - Proposed Information Collection Activity: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0663 (Pay Now Enter Info Page)] Proposed... of automated collection techniques or the use of other forms of information technology. Title: Pay... make online payments through VA's Pay Now Enter Info Page Web site. Data entered on the Pay Now Enter...

Cross-sectional research into counselling for non-physician assisted suicide: who asks for it and what happens?

PubMed

Hagens, Martijn; Pasman, H Roeline W; Onwuteaka-Philipsen, Bregje D

2014-10-02

In the Netherlands, people with a wish to die can request physician assistance in dying. However, almost two thirds of the explicit requests do not result in physician assistance in dying. Some people with a wish to end life seek counselling outside the medical context to end their own life. The aim of this cross-sectional research was to obtain information about clients receiving counselling for non-physician assisted suicide, and the characteristics and outcome of the counselling itself. All counsellors working with foundation De Einder (an organisation that offers professional counselling for people with a wish to end life) (N=12) filled in registration forms about all clients they counselled in 2011 and/or 2012. Only client registration data forms with at least one face-to-face contact with the counsellor were selected for analysis (n=595). More than half of the clients were over 65 years old. More than one third of the clients had no wish to end life and 16% had an urgent wish to end life. Almost two thirds of the clients had not requested physician assistance in dying. Half of the clients had others involved in the counselling. More than half of the clients received explicit practical information concerning non-physician assisted suicide, while 13% of all clients actually ended their own life through non-physician assisted suicide. Clients without a (severe) disease were older than clients with a severe disease. They also had more problems of old age and existential suffering and more often wanted to be prepared for self-determination. The clients without a (severe) disease more often had no wish to end life and requested physician assistance in dying less often than clients with a severe disease. While some of the clients receiving counselling for non-physician assisted suicide seem to be looking for a peaceful death to escape from current suffering, others have no wish to end life and seem to be looking for reassurance in anticipation of prospective suffering. If non-physician assisted suicide is be distinguished from 'mutilating' suicide, this asks for a different approach than suicide crisis intervention, for example suicide-attempt prevention.

"Gender aware therapy" for professional men in a day treatment center.

PubMed

Robertson, John M; Williams, Betsy White

2010-09-01

High accountability men in the medical, legal, corporate, and mental health professions sometimes engage in behavior that violates their fiduciary responsibilities. These highly skilled men may engage in disruptive or explosive behavior, cross sexual boundaries with clients or patients, abuse substances, or have other psychiatric problems that compromise their workplace performance. When this occurs, licensing boards, professional societies, or supervising executives often require the dysregulated man to seek assistance. This article reports on ways the Professional Renewal Center incorporates recommendations from "Gender Aware Therapy" in developing a male-friendly approach to conducting comprehensive multidisciplinary psychological assessments, and to providing intensive, multimodal, weeks-long treatment services. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Novel low-risk commercial sex practices in the parks of Vietnam.

PubMed

Walters, I

2003-06-01

This is a paper about a novel form of commercial sex practice recorded in Vietnam, and its implications for HIV/AIDS prevention strategies. Female commercial sex workers occupy urban parks in the evenings, offering on-site masturbation services to clients at cheap prices even by local standards. All sex acts are performed in public by workers who sit on benches, path edges or stools,often behind bicycles or open umbrellas in the quest for some semblance of privacy. Clients are local men, with only an occasional foreigner involved Many sex workers were involved, some having 15 to 20 or more clients a night. Sex workers and clients in Vietnam, a s elsewhere, operate at high risk of HIV/AIDS infection. As a service which minimizes risks, this form of commercial sex practice should perhaps be given serious consideration by policy makers and authorities for formal deployment in the fight against AIDS.

Chaperone-client complexes: A dynamic liaison

NASA Astrophysics Data System (ADS)

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.

Using feminist, emotion-focused, and developmental approaches to enhance cognitive-behavioral therapies for posttraumatic stress disorder related to childhood sexual abuse.

PubMed

Cohen, Jacqueline N

2008-06-01

A body of research indicates the efficacy of cognitive-behavioral interventions for the treatment of posttraumatic stress disorder (PTSD) subsequent to sexual assault in adulthood. The generalizability of these treatments to women who present with trauma symptoms associated with childhood sexual abuse (CSA) has yet to be shown, however. A number of characteristics and dynamics of CSA that make it unique from sexual assault in adulthood are described, specifically its disruption of normal childhood development, its impact on attachment style and interpersonal relationships, its inescapability, and the stigma attached to it. Then, drawing on the developmental, emotion-focused, and feminist literatures, a number of considerations that would enhance the application of cognitive- behavioral trauma therapies to the treatment of women with PTSD related to CSA are delineated. These considerations relate to providing clients with corrective interpersonal experiences, creating new relationship events, enhancing affect regulation skills before initiating exposure therapy, considering the time elapsed since the abuse, addressing themes of power, betrayal, self-blame, stigma, and sex-related cognitions and emotions, and helping clients develop a feminist consciousness. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Clients' and workers' perceptions on clients' functional ability and need for help: home care in municipalities.

PubMed

Hammar, Teija; Perälä, Marja-Leena; Rissanen, Pekka

2009-03-01

The aim of the study was to compare clients' and named home care (HC) workers' perceptions of clients' functional ability (FA) and need for help and to analyse which client- and municipality-related factors are associated with perceptions of client's FA. The total of 686 Finnish HC clients was interviewed in 2001. Further, the questionnaire was sent to 686 HC workers. FA was assessed by activities of daily living (ADL), which included both basic/physical (PADL) and instrumental (IADL) activities. The association between client's FA and municipality-related variables was analysed by using hierarchical logistic regression models. The findings indicated that clients' and HC-workers' perceptions about what the clients were able to do were similar in the PADL functions, but perceptions differed when it comes to the IADL functions for mobility and in climbing stairs. A smaller proportion of clients compared with HC workers assessed themselves to be in need of help in all ADL functions. Use of home help and bathing services increased the probability of belonging to the 'poor' FA class while living alone and small size of municipality decreased the probability. The study indicates that although clients and workers assessed client's FA fairly similarly, there were major differences in perceptions concerning clients' needs for help in ADL functions. Clients' and workers' shared view of need for help forms a basis for high-quality care. Therefore, the perception of both the clients and workers must be taken into account when planning care and services. There was also variation in clients' FA between municipalities, although only the size of municipality had some association with the variation. The probability that clients with a lower FA are cared for in HC is higher if the clients live in large- rather than small-sized municipalities. This may reflect a better mix of services and resources in large-sized municipalities.

The realities of risk, the nature of hope, and the role of science: A response to Cook and VandeCreek.

PubMed

Rudd, M David; Joiner, Thomas; Brown, Gregory K; Cukrowicz, Kelly; Jobes, David A; Silverman, Morton

2009-12-01

A response is offered to the critiques of both Cook and VandeCreek. Among the points emphasized are the simple realities of risk with suicidal patients, existing empirical research with informed consent in both clinical psychology and other health care areas, as well as the persistence of common myths in clinical practice with suicidal patients. Although empirical science provides a firm foundation to much of what is proposed, it is critical for practitioners to recognize and respond to the ethical demands for openness and transparency with high-risk clients in an effort to achieve shared responsibility in care. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Client value models provide a framework for rational library planning (or, phrasing the answer in the form of a question).

PubMed

Van Moorsel, Guillaume

2005-01-01

Libraries often do not know how clients value their product/ service offerings. Yet at a time when the mounting costs for library support are increasingly difficult to justify to the parent institution, the library's ability to gauge the value of its offerings to clients has never been more critical. Client Value Models (CVMs) establish a common definition of value elements-or a "value vocabulary"-for libraries and their clients, thereby providing a basis upon which to make rational planning decisions regarding product/service acquisition and development. The CVM concept is borrowed from business and industry, but its application has a natural fit in libraries. This article offers a theoretical consideration and practical illustration of CVM application in libraries.

Resource assessment in Western Australia using a geographic information system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jackson, A.

1991-03-01

Three study areas in Western Australia covering from 77,000 to 425,000 mi{sup 2} were examined for oil and gas potential using a geographic information system (GIS). A data base of source rock thickness, source richness, maturity, and expulsion efficiency was created for each interval. The GIS (Arc/Info) was used to create, manage, and analyze data for each interval in each study area. Source rock thickness and source richness data were added to the data base from digitized data. Maturity information was generated with Arc/Info by combining geochemical and depth to structure data. Expulsion efficiency data was created by a systemmore » level Arc/Info program. After the data base for each interval was built, the GIS was used to analyze the geologic data. The analysis consisted of converting each data layer into a lattice (grid) and using the lattice operation in Arc/Infor (addition, multiplication, division, and subtraction) to combine the data layers. Additional techniques for combining and selecting data were developed using Arc/Info system level programs. The procedure for performing the analyses was written as macros in Arc/Info's macro programming language (AML). The results of the analysis were estimates of oil and gas volumes for each interval. The resultant volumes were produced in tabular form for reports and cartographic form for presentation. The geographic information system provided several clear advantages over traditional methods of resource assessment including simplified management, updating, and editing of geologic data.« less

Development of the Vicarious Resilience Scale (VRS): A measure of positive effects of working with trauma survivors.

PubMed

Killian, Kyle; Hernandez-Wolfe, Pilar; Engstrom, David; Gangsei, David

2017-01-01

Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors' resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Exploratory factor analysis yielded 7 factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients' spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self-awareness and self-care practices, increased consciousness about power and privilege relative to clients' social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach's alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating discriminant validity and that vicarious resilience is a unique construct that is not merely "the opposite" of CF or burnout. The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Federal Emergency Management Information System (FEMIS) system administration guide, version 1.4.5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arp, J.A.; Burnett, R.A.; Carter, R.J.

The Federal Emergency Management Information Systems (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local areamore » network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication, data distribution, and notification functionality necessary to operate FEMIS in a networked, client/server environment. The UNIX server provides an Oracle relational database management system (RDBMS) services, ARC/INFO GIS (optional) capabilities, and basic file management services. PNNL developed utilities that reside on the server include the Notification Service, the Command Service that executes the evacuation model, and AutoRecovery. To operate FEMIS, the Application Software must have access to a site specific FEMIS emergency management database. Data that pertains to an individual EOC`s jurisdiction is stored on the EOC`s local server. Information that needs to be accessible to all EOCs is automatically distributed by the FEMIS database to the other EOCs at the site.« less

Perceptions of Counselor Source Characteristics by Premature and Successful Terminators.

ERIC Educational Resources Information Center

McNeill, Brian W.; And Others

1987-01-01

University counseling center clients who terminated prematurely were less satisfied with counseling services and viewed their counselors as less expert, attractive, and trustworthy than did clients who terminated successfully. Subjects who responded anonymously to the evaluation form also viewed their counselors as less attractive and trustworthy…

Negotiating: experiences of community nurses when contracting with clients.

PubMed

Duiveman, Trudie; Bonner, Ann

2012-04-01

A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: 'assessment of needs', 'education towards enablement', and 'negotiation'. 'Assessment of needs' identified that community nurses assess both the client's requirements for health care as well as the ability of the nurse to provide that care. 'Education towards enablement' described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, 'negotiation', involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs.

The data model for social welfare in Finland.

PubMed

Kärki, Jarmo; Ailio, Erja

2014-01-01

A client data model for social welfare was gradually developed in the National Project of IT in Social Services in Finland. The client data model describes the nationally uniformed data structures and relationships between the data elements needed in production of social services. It contains the structures of social care client records, unique core components and distinct classifications. The modeling method guaranteed the coverage, integrity, flexibility and device independency of the model. The model is maintained and developed by the National Institute for Health and Welfare (THL) together with the social workers and other experts of social welfare. It forms the basis of the electronic information management of the social services. Implementation of the data model in information systems enables the availability of the client data where and when ever a client has to be helped.

Heart rate variability and the anxious client: cardiac autonomic and behavioral associations with therapeutic alliance.

PubMed

Stratford, Trisha; Meara, Alan; Psychotherapy, M Gestalt; Lal, Sara

2014-08-01

This exploratory study was designed to investigate the link between a client's heart rate variability (HRV) and the forming of a therapeutic alliance (TA) during psychotherapy. Change in HRV is associated with many psychological and physiological situations, including cardiac mortality. Cardiac effects were evaluated during therapy in 30 symptomatically anxious clients using HRV during six weekly 1-hour therapy sessions (S1-S6). Therapeutic index (TI), a measure of TA, was evaluated using skin conductance resonance between client and therapist. The Working Alliance Inventory provides a subjective measure of TA. State and trait anxiety and mood states were also assessed. Most HRV parameters were highest during S4. The sympathovagal balance was highest in S1 but stabilized after S2. In S4, TI was linked to high HRV parameters. Overall higher anxiety levels seem to be associated to lower HRV parameters. Conversely, in S4, high HRV parameters were linked to higher mood scores. This study found that a subjective measure of TA contradicted the physiological outcome. Results suggest that physiological data collected during therapy are a more accurate barometer of TA forming. These research findings suggest a need for further research identifying physiological markers in clients with a variety of mental health disorders over long-term therapy.

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

PubMed

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%; p<.01) and less likely to report planning to purchase food/drinks/groceries (62% vs 76%; p=0.02). Just three out of 155 cash participants reported planning to purchase illicit drugs with their payment. 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.

The Role of the African Media in Patron-Client Relations: A Preliminary Look.

ERIC Educational Resources Information Center

Fair, Jo Ellen

Noting the many difficulties in conceptualizing and analyzing development communication, this paper enriches the concept by linking it with a particular form of political, economic, and social organization common to many developing nations--the patron-client network. After a brief review of relevant communication and political science literature…

Brief Christian and Non-Christian Rational-Emotive Therapy with Depressed Christian Clients: An Exploratory Study.

ERIC Educational Resources Information Center

Johnson, W. Brad; Ridley, Charles R.

1992-01-01

Operationalized brief "Christian" form of rational-emotive therapy (CRET) and compared therapeutic efficacy of CRET with standard version of brief rational-emotive therapy (RET). Findings from depressed Christian clients (n=10) indicated that both treatments were effective in reducing depression and automatic negative thoughts whereas only CRET…

Ellenore Flood's Kuder Occupational Interest Survey and Career Search Schedule.

ERIC Educational Resources Information Center

Zytowski, Donald G.

1998-01-01

The Kuder Occupational Interest Survey (KOIS) and Kuder Career Search Survey (KCSS) are interpreted for a 29-year-old female client in the form of a letter addressed to her. Technique, the author's reasoning, and suggestions for interventions are discussed. Includes job profiles of people whose scores were similar to the client's. (MKA)

76 FR 51984 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-19

... promotional activities and permission to extract de-identified QL call volume data from the National Quitline Data Warehouse (NQDW, OMB No. 0920-0856, exp. 7/31/2012). Information will be transmitted to CDC on a... client intake data, i.e., information obtained from clients when they request tobacco cessation services...

Paul B. Pedersen (1936-2017).

PubMed

Lonner, Walter J; Draguns, Juris G

2018-01-01

Presents an obituary for Paul B. Pedersen, who passed away on January 11, 2017, in a Minnetonka, Minnesota hospital. In 1973 Pedersen convened a pathfinding APA (Division 9) symposium in Montreal that resulted in the publication in 1976 of Counseling Across Cultures (Pedersen, Lonner, and Draguns, Eds.). The first book of its kind, it became the "Granddaddy" of all subsequent books in that area. The seventh edition, published in 2016 (with Trimble and Scharron-del Rio, co-eds), benefitted from his steadfast encouragement, but his deteriorating health prevented a more active role. His epitaph may well be one of his wisest and oft-quoted sayings: "All interviewing and counseling is multicultural. Each client comes to the session embodying multiple voices from the past." (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Knowing what we do not know about sexual orientation change efforts.

PubMed

Rosik, Christopher H; Jones, Stanton L; Byrd, A Dean

2012-09-01

Comments on the original article, "Guidelines for psychological practice with lesbian, gay, and bisexual clients," by the American Psychological Association (see record 2011-19419-001). The present authors notes that the APA has provided a very helpful document for those who do clinical work with individuals experiencing same-sex attractions. Psychologists no doubt need to be familiar with the literature described in these guidelines as a part of ethical practice. However, the present authors register concern regarding how the guidelines address sexual orientation change efforts (SOCE). They focus their critique on how the guidelines portray two issues pertaining to SOCE-effectiveness and harm-and conclude with a proposal to move the discussion forward via science. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

The necessary and sufficient conditions of therapeutic personality change: Reactions to Rogers' 1957 article.

PubMed

Samstag, Lisa Wallner

2007-09-01

Carl Rogers' article (see record 2007-14639-002) on the necessary and sufficient conditions for personality change has had a significant impact on the field of psychotherapy and psychotherapy research. He emphasized the client as arbiter of his or her own subjective experience and tested his hypothesized therapist-offered conditions of change using recorded sessions. This aided in demystifying the therapeutic process and led to a radical shift in the listening stance of the therapist. I briefly outline my views regarding the influence of the ideas presented in this work, describe the intellectual and cultural context of the times, and discuss a number of ways in which the therapist-offered conditions for psychological transformation are neither necessary nor sufficient. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The role of evidence-based therapy relationships on treatment outcome for adults with trauma: A systematic review.

PubMed

Ellis, Amy E; Simiola, Vanessa; Brown, Laura; Courtois, Christine; Cook, Joan M

2018-01-01

The purpose of this paper was to systematically review and synthesize the empirical literature on the effects of evidence-based therapy relationship (EBR) variables in the psychological treatment for adults who experienced trauma-related distress. Studies were identified using comprehensive searches of PsycINFO, Medline, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between 1980 and 2015, in English that reported on the impact of EBRs on treatment outcome in clinical samples of adult trauma survivors. Nineteen unique studies met inclusion criteria. The bulk of the studies were on therapeutic alliance and the vast majority found that alliance was predictive of or associated with a reduction in various symptomotology. Methodological concerns included the use of small sample sizes, little information on EBRs beyond alliance as well as variability in its measurement, and non-randomized assignment to treatment conditions or the lack of a comparison group. More research is needed on the roles of client feedback, managing countertransference, and other therapist characteristics on treatment outcome with trauma survivors. Understanding the role of EBRs in the treatment of trauma survivors may assist researchers, clinicians, and psychotherapy educators to improve therapist training as well as client engagement and retention in treatment.

Design and Development of a Web-Based Self-Monitoring System to Support Wellness Coaching.

PubMed

Zarei, Reza; Kuo, Alex

2017-01-01

We analyzed, designed and deployed a web-based, self-monitoring system to support wellness coaching. A wellness coach can plan for clients' exercise and diet through the system and is able to monitor the changes in body dimensions and body composition that the client reports. The system can also visualize the client's data in form of graphs for both the client and the coach. Both parties can also communicate through the messaging feature embedded in the application. A reminder system is also incorporated into the system and sends reminder messages to the clients when their reporting is due. The web-based self-monitoring application uses Oracle 11g XE as the backend database and Application Express 4.2 as user interface development tool. The system allowed users to access, update and modify data through web browser anytime, anywhere, and on any device.

Knowledge displays: Soliciting clients to fill knowledge gaps and to reconcile knowledge discrepancies in therapeutic interaction.

PubMed

Pino, Marco

2016-06-01

To examine knowledge displays (KDs), a practice by which Therapeutic Community (TC) professionals exhibit previous knowledge about their clients' circumstances and experiences. Conversation analysis is used to examine 12 staff-led meetings recorded in Italy (8 in a drug addiction TC; 4 in a mental health TC). The TC professionals use KDs within broader sequences of talk where they solicit their clients to share personal information and where the clients provide insufficient or inconsistent responses. In these circumstances, the staff members employ KDs to pursue responses that redress emerging knowledge gaps and discrepancies regarding the clients' experiences or circumstances. KDs allow the staff members to achieve a balance between respecting their clients' right to report their own experiences and influencing the ways in which they report them. KDs help to reinforce the culture of openness that is central to many forms of therapeutic interaction, to forward the therapeutic agenda and to expand the staff members' knowledge of the clients' experiences and circumstances. KDs can be used to solicit clients to share personal information. This paper illustrates core features that underlie the function of KDs (where they are used and how they are constructed). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sequences of emotional distress expressed by clients and acknowledged by therapists: are they associated more with some therapists than others?

PubMed

Viney, L L

1994-11-01

When clients come to psychotherapy they are distressed, this distress usually being expressed in the form of anxiety, hostility, depression and helplessness. This study explored the sequences of emotional distress expressed by clients and acknowledged by therapists, and examined their associations with other factors. The transcripts of five therapists (two single sessions each) were content-analysed: they used personal construct, client centered, rational-emotive, Gestalt and transactional analysis therapy. Log-linear analyses of appropriate contingency table cell frequencies were conducted to test associations between identified sequences and the two variables of therapist and timing of completion of the sequence. Therapist-client sequences of Anxiety-Anxiety, Anxiety-Hostility and Helplessness-Hostility were found to be associated more with the personal construct and client centred therapists than with the rational-emotive therapist. Client-therapist sequences of Anxiety-Anxiety, Helplessness-Anxiety and Helplessness-Helplessness were more often found with the client centred therapist than the other therapists. For most of these sequences timing had an effect, yet timing rarely interacted with the therapist variable. The findings are discussed in terms of their relevance to the theoretical positions represented, the shortcomings of the research and the value of this methodology in studies linking therapy process with outcome.

Policing the epidemic: High burden of workplace violence among female sex workers in conflict-affected northern Uganda.

PubMed

Muldoon, Katherine A; Akello, Monica; Muzaaya, Godfrey; Simo, Annick; Shoveller, Jean; Shannon, Kate

2017-01-01

Sex workers in sub-Saharan Africa experience a high burden of HIV with a paucity of data on violence and links to HIV risk among sex workers, and even less within conflict-affected environments. Data are from a cross-sectional survey of female sex workers in Gulu, northern Uganda (n = 400). Logistic regression was used to determine the specific association between policing and recent physical/sexual violence from clients. A total of 196 (49.0%) sex workers experienced physical/sexual violence by a client. From those who experienced client violence the most common forms included physical assault (58.7%), rape (38.3%), and gang rape (15.8%) Police harassment was very common, a total of 149 (37.3%) reported rushing negotiations with clients because of police presence, a practice that was significantly associated with increased odds of client violence (adjusted odds ratio: 1.61, 95% confidence intervals: 1.03-2.52). Inconsistent condom use with clients, servicing clients in a bar, and working for a manager/pimp were also independently associated with recent client violence. Structural and community-led responses, including decriminalisation, and engagement with police and policy stakeholders, remain critical to addressing violence, both a human rights and public health imperative.

Allo-Centered Psychotherapy and Counseling: An Approach Particularly Suitable in a Pluralistic Society.

ERIC Educational Resources Information Center

Motet, Dan

This paper describes the development of Allo-Centered (altruistic other-centered) Psychotherapy, an other-centered form of counseling which aims to redirect the client's orientation from self to others. It is noted that this approach is also suitable for clients from group-oriented cultures such as Asians, Pacific Islanders, or Latin Americans.…

Personality Measurement with Mentally Retarded and Other Sub-Cultural Adults. Final Report.

ERIC Educational Resources Information Center

Eber, Herbert W.

Two 160-item experimental forms of multidimensional personality test to assess vocational potential of clients of limited literacy (third grade reading level) were developed and administered to clients at rehabilitation centers and at centers for the retarded. Using the 16 Personality Factors Test as a model, items were constructed to do the…

The Relation of Secondary Traumatization to Therapists' Perceptions of the Working Alliance with Clients Who Commit Sexual Abuse

ERIC Educational Resources Information Center

Carmel, Melissa J. Sheehy; Friedlander, Myrna L.

2009-01-01

The authors assessed burnout, compassion fatigue, secondary trauma symptoms, and compassion satisfaction in relation to experienced therapists' perceptions of the working alliance. Participants, 106 specialists in the treatment of clients who commit sexual abuse, completed the Working Alliance Inventory-Short Form (T. J. Tracey & A. M.…

Case of the Drunken Holon: An Integral Performative Co-Inquiry

ERIC Educational Resources Information Center

Fisher, R. Michael; Davis, Tess

2012-01-01

A postmodern and integral co-inquiry led by the authors, with Lucinda as "client," offered a unique unconventional and postconventional perspective on a client's case review. Utilizing integral theory (Wilber) as a guideline for a theory of holons and change, the co-investigators reflect upon and trans(per)form a learning experiment around the…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-12

... a.m. and 3:00 p.m. All comments received will be posted without change; we do not edit personal... became subject to the Advisers Act with respect to those accounts, and the client relationship became... directed the Comptroller General of the United States to study the feasibility of forming an self...

Romancing the boundary: client masculinities in the Chinese sex industry.

PubMed

Kong, Travis S K

2015-01-01

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

A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder.

PubMed

Hayes-Skelton, Sarah A; Roemer, Lizabeth; Orsillo, Susan M

2013-10-01

To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment. This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, and number of comorbid diagnoses. Mixed effect regression models showed significant, large effects for time for all primary outcome measures (ds = 1.27 to 1.61) but nonsignificant, small effects for condition and Condition × Time (ds = 0.002 to 0.20), indicating that clients in the 2 treatments improved comparably over treatment. For secondary outcomes, time was significant (ds = 0.74 to 1.38), but condition and Condition × Time effects were not (ds = 0.004 to 0.31). No significant differences emerged over follow-up (ds = 0.03 to 0.39), indicating maintenance of gains. Between 63.3 and 80.0% of clients in ABBT and 60.6 and 78.8% of clients in AR experienced clinically significant change across 5 calculations of change at posttreatment and follow-up. ABBT is a viable alternative for treating GAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Factors affecting acceptance of provider-initiated HIV testing and counseling services among outpatient clients in selected health facilities in Harar Town, Eastern Ethiopia.

PubMed

Abdurahman, Sami; Seyoum, Berhanu; Oljira, Lemessa; Weldegebreal, Fitsum

2015-01-01

To improve the slow uptake of HIV counseling and testing, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have developed draft guidelines on provider-initiated testing and counseling (PITC). Both in low- and high-income countries, mainly from outpatient clinics and tuberculosis settings, indicates that the direct offer of HIV testing by health providers can result in significant improvements in test uptake. In Ethiopia, there were limited numbers of studies conducted regarding PITC in outpatient clinics. Therefore, in this study, we have assessed the factors affecting the acceptance of PITC among outpatient clients in selected health facilities in Harar, Harari Region State, Ethiopia. Institutional-based, cross-sectional quantitative and qualitative studies were conducted from February 12-30, 2011 in selected health facilities in Harar town, Harari Region State, Ethiopia. The study participants were recruited from the selected health facilities of Harar using a systematic random sampling technique. The collected data were double entered into a data entry file using Epi Info version 3.5.1. The data were transferred to SPSS software version 16 and analyzed according to the different variables. A total of 362 (70.6%) clients accepted PITC, and only 39.4% of clients had heard of PITC in the outpatient department service. Age, occupation, marital status, anyone who wanted to check their HIV status, and the importance of PITC were the variables that showed significant associations with the acceptance of PITC upon bivariate and multivariate analyses. The main reasons given for not accepting the tests were self-trust, not being at risk for HIV, not being ready, needing to consult their partners, a fear of the results, a shortage of staff, a busy work environment, a lack of private rooms, and a lack of refresher training, which were identified as the main barriers for PITC. There is evidence of the relatively increased acceptability of PITC services by outpatient department clients. A program needs to be strengthened to enhance the use of PITC; the Ministry of Health, Regional Health Bureau, and other responsible bodies - including health facilities - should design and strengthen information education and communication/behavioral change and communication interventions and promote activities related to PITC and HIV counseling and testing in both health facilities and the community at large.

The Effectiveness of Challenging Skills in Work With Young Offenders.

PubMed

Trotter, Chris; Evans, Phillipa; Baidawi, Susan

2017-03-01

Probation officers and others who work with young offenders often challenge or confront their clients in relation to pro-criminal comments and criminal behaviour. There is, however, very little research that can inform practitioners about which forms of challenging most effectively engage young people. This study examines the use of challenging by youth justice workers in New South Wales, Australia. Researchers observed and audiotaped 116 interviews between youth justice workers and their clients with a view to examining the nature of challenging used by workers and the response of young people to different forms of challenging. Qualitative and quantitative findings indicate that the clients were more positively engaged by, and responsive to, challenging that was exploratory, non-blaming, and accompanied by positive reinforcement of their strengths. Excerpts taken from the interviews provide examples of high- and low-level use of the skill of challenging.

Moving toward mainstream: perspectives on enhancing therapy with men.

PubMed

Wade, Jay C; Good, Glenn E

2010-09-01

Psychotherapists began sharing their clinical experiences with men's gender-related psychological issues and the challenges of addressing them in therapy during the late 1970s and early 1980s (e.g., O'Neil, 1981; Scher, 1979; Skovholt, 1978). However, it has taken several decades for these messages and the accompanying research to yield advances that are being adopted into more mainstream psychotherapeutic practices. Over the recent three decades, the theory, research, and clinical wisdom about psychotherapy with men can be viewed as falling into several main clusters. Specifically, there is literature and research providing: - General information on masculine socialization and the psychology of men. - Information about specific issues that men and male clients bring to therapy. - Information about the expectations and experiences of specific groups of men (e.g., men of differing racial/ethnic backgrounds, geographical regions, age cohorts, spiritual/religious beliefs, differing physical ability statuses). - Suggestions for addressing men's reluctance to seek psychotherapy and the challenges associated with forming therapeutic working alliances with men when they do come to therapy. - Suggestions regarding adjustments to psychotherapeutic processes for conducting effective psychotherapy with men. - Development and assessment of instruments to assess endorsement of various male norms and of aspects of men's gender role conflict and stress. Reviewing the earliest writings, some of these pioneering therapists' initial clinical observations remain highly relevant today. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

CES4Health.info: an online tool for peer reviewed publication and dissemination of diverse products of community-engaged scholarship.

PubMed

Jordan, Catherine; Seifer, Sarena D; Gelmon, Sherril B; Ryan, Katharine; McGinley, Piper

2011-01-01

Community-engaged scholarship (CES)-research, teaching, programmatic and other scholarly activities conducted through partnerships between academic and community partners-may result in innovative applied products such as manuals, policy briefs, curricula, videos, toolkits, and websites. Without accepted mechanisms for peer-reviewed publication and dissemination, these products often do not "count" toward faculty promotion and tenure (P&T) and have limited opportunities for broad impact. This paper reports on CES4Health.info, a unique online tool for peer-reviewed publication and dissemination of products of CES in forms other than journal articles. In its first year, CES4Health.info has published 24 products and documented the satisfaction of users, authors, and reviewers.

77 FR 12096 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... dealt with quickly and do not cause any client outages or connectivity issues. Due to the continuous... issues are dealt with quickly and do not cause any client outages or connectivity issues. Due to the... the Commission's Internet comment form ( http://www.sec.gov/rules/sro.shtml ); or Send an email to...

Atheists, agnostics and Alcoholics Anonymous.

PubMed

Tonigan, J Scott; Miller, W R; Schermer, Carol

2002-09-01

In spite of the strong emphasis in AA on spiritual beliefs and practices, findings are mixed about the importance of such beliefs in predicting AA affiliation. This study of the Project MATCH outpatient (N = 952) and aftercare (N = 774) samples tested three hypotheses about the role of client God belief and subsequent AA attendance and benefit, taking into account that some individuals may, in fact, deny the existence of a God. Longitudinal analyses were conducted (N = 1,526) investigating client God beliefs, AA attendance, patterns of AA attendance and alcohol use. Assessments were conducted at intake and in 3-month intervals using the Form 90, Religious Behaviors and Background, and the Alcoholics Anonymous Inventory. 12-Step treatment was significantly more likely to promote pre-post shifts in client God beliefs, and atheist and agnostic clients attended AA significantly less often throughout follow-up relative to clients self-labeled as spiritual and religious. AA attendance, however, was significantly associated with increased abstinence and reductions in drinking intensity regardless of God belief. Finally, no differences in percent days abstinence and drinking intensity were found between atheist and agnostic versus spiritual and religious clients, but clients unsure about their God belief reported significantly higher drinking frequency relative to the other groups. God belief appears to be relatively unimportant in deriving AA-related benefit, but atheist and agnostic clients are less likely to initiate and sustain AA attendance relative to spiritual and religious clients. This apparent reticence to affiliate with AA ought to be clinically recognized when encouraging AA participation.

A Reasoned Action Model of Male Client Involvement in Commercial Sex Work in Kibera, A Large Informal Settlement in Nairobi, Kenya.

PubMed

Roth, Eric Abella; Ngugi, Elizabeth; Benoit, Cecilia; Jansson, Mikael; Hallgrimsdottir, Helga

2014-01-01

Male clients of female sex workers (FSWs) are epidemiologically important because they can form bridge groups linking high- and low-risk subpopulations. However, because male clients are hard to locate, they are not frequently studied. Recent research emphasizes searching for high-risk behavior groups in locales where new sexual partnerships form and the threat of HIV transmission is high. Sub-Saharan Africa public drinking venues satisfy these criteria. Accordingly, this study developed and implemented a rapid assessment methodology to survey men in bars throughout the large informal settlement of Kibera, Nairobi, Kenya, with the goal of delineating cultural and economic rationales associated with male participation in commercial sex. The study sample consisted of 220 male patrons of 110 bars located throughout Kibera's 11 communities. Logistic regression analysis incorporating a modified Reasoned Action Model indicated that a social norm condoning commercial sex among male peers and the cultural belief that men should practice sex before marriage support commercial sex involvement. Conversely, lacking money to drink and/or pay for sexual services were barriers to male commercial sex involvement. Results are interpreted in light of possible harm reduction programs focusing on FSWs' male clients.

The function of home visits in maternal and child welfare as evaluated by service providers and users.

PubMed

Vehviläinen-Julkunen, K

1994-10-01

This study looks at how public health nurses and clients of maternal and child welfare clinics evaluate the function and meaning of home visits. Another concern is with the options available to the service user. The data were collected during November and December 1992 from a total of 203 health centres across Finland; responses were obtained from 263 public health nurses and 323 clients. The results are presented in the form of frequencies, percentages and cross tabulations. According to the results, the clients felt that the most important function of home visits was to have a competent professional examination of the newborn. They also attached much importance to the information function, i.e. learning about the growth and care of small children. The public health nurses, on the other hand, felt that the most important function of home visits was to support and encourage parents and to ensure the continuity of care. The advantages of meeting in the client's home environment were equally stressed by both sides. By contrast, clients and public health nurses had very different views on the options available to the client. Almost all nurses said that the client can freely choose between home visits and visiting the clinic; however, only about half the clients felt they could choose the service they best preferred.

Reinforced Concrete Wall Form Design Program

DTIC Science & Technology

1992-08-01

criteria is an absolute limit. You have the choice of 1/8 or 1/16 of an inch total deflection in a span. Once these limits are set here, then they are...Calls GET-INFO-TEXT - Calls ZERO -PLY - If the response to GET-INFO-TEXT is "Values retrieved by computer", then the following procedures are executed...like to enter their own values. ZERO -PLY - Re-initializes all PLY-VEC values to"?". GET-PLY-CLASS - Retrieves from the user the grade of plyform to be

[A documentation procedure for community social psychiatry services--a pilot project in Bielefeld and Minden].

PubMed

Hellmeier, W; Genin, G; Klewe-Niemann, S

1996-04-01

The status of health reporting (on community levels) has improved considerably during recent years. It is being increasingly used as an instrument for planning, controlling and evaluating political processes. In addition to individual studies the statistics within the departments of the health authorities are an important factor for meaningful health reporting on a local level. The IDIS (from Jan. 1st, 1995 LOGD) and the social psychiatric services on the Minden-Lübbecke district and the city of Bielefeld have developed a programme for automation-aided management of the statistics for social psychiatric services on a local level. Details on the personal situation and illnesses of the clients as well as on the activities of the services staff are recorded and analysed. Based on the WHO programme EPI-info 6.01 the documentation programme SPD-STAT was developed. This programme is menudriven and, in addition to the functions for the statistical data input and retrieval of fixed table sets, also offers the possibility of processing data with the full functionality of the ANALYSIS-module of EPI-Info. Thus interactive ad-hoc evaluations for current questions are made possible. Using SPD-STAT in as many local regions in NRW as possible may be a big step forward for health reporting on local levels as well as for health reporting on a state level.

Safer Conception Methods and Counseling: Psychometric Evaluation of New Measures of Attitudes and Beliefs Among HIV Clients and Providers.

PubMed

Woldetsadik, Mahlet Atakilt; Goggin, Kathy; Staggs, Vincent S; Wanyenze, Rhoda K; Beyeza-Kashesya, Jolly; Mindry, Deborah; Finocchario-Kessler, Sarah; Khanakwa, Sarah; Wagner, Glenn J

2016-06-01

With data from 400 HIV clients with fertility intentions and 57 HIV providers in Uganda, we evaluated the psychometrics of new client and provider scales measuring constructs related to safer conception methods (SCM) and safer conception counselling (SCC). Several forms of validity (i.e., content, face, and construct validity) were examined using standard methods including exploratory and confirmatory factor analysis. Internal consistency was established using Cronbach's alpha correlation coefficient. The final scales consisted of measures of attitudes towards use of SCM and delivery of SCC, including measures of self-efficacy and motivation to use SCM, and perceived community stigma towards childbearing. Most client and all provider measures had moderate to high internal consistency (alphas 0.60-0.94), most had convergent validity (associations with other SCM or SCC-related measures), and client measures had divergent validity (poor associations with depression). These findings establish preliminary psychometric properties of these scales and should facilitate future studies of SCM and SCC.

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

PubMed

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.

76 FR 9330 - Notice of Proposed Information Collection Requests

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... Number: 1820-0528. Agency Form Number(s): Form RSA-227. Frequency of Responses: Annually. Affected Public... Estimated Number of Annual Burden Hours: 896. Abstract: Form RSA-227 is used to meet specific data.... In addition, Form RSA-227 will be used to analyze and evaluate the effectiveness of individual Client...

Effects of self reflection on engagement in a 12-step addiction treatment programme: a linguistic analysis of diary entries.

PubMed

Stephenson, Geoffrey M; Zygouris, Nikolaos

2007-02-01

Thirty clients receiving Twelve-Step Facilitation Therapy in a rehabilitation setting formed the intervention group. They were asked to complete in third person a weekly evaluation of progress based on reading personal "Feelings" diaries they had written on a daily basis over a period of one week, starting 3weeks previously. The diaries of the clients and of a further 60 clients in two matched control groups were compared. One control group consisted of clients receiving treatment before the intervention was introduced, and clients in the second control group received treatment after the intervention was terminated. Clients in the control groups were matched to the intervention group according to presenting disorder (alcohol, drugs or food), gender and age. Analysis of the number of words written and diaries produced suggested that the experimental group's productivity was enhanced. Linguistic and cluster analyses indicated that the clients in the Intervention group referred more frequently to key elements of the programme (steps and spirituality) and responded in a more integrated way to the major aspects of their treatment regime. The study supported the expectation that by promoting self-reflection on progress in therapeutic settings, an increase in programme engagement can be expected.

Religion and suicide: Buddhism, Native American and African religions, Atheism, and Agnosticism.

PubMed

Lizardi, D; Gearing, R E

2010-09-01

Research has repeatedly demonstrated that religiosity can potentially serve as a protective factor against suicidal behavior. A clear understanding of the influence of religion on suicidality is required to more fully assess for the risk of suicide. The databases PsycINFO and MEDLINE were used to search peer-reviewed journals prior to 2008 focusing on religion and suicide. Articles focusing on suicidality across Buddhism, Native American and African religions, as well as on the relationship among Atheism, Agnosticism, and suicide were utilized for this review. Practice recommendations are offered for conducting accurate assessment of religiosity as it relates to suicidality in these populations. Given the influence of religious beliefs on suicide, it is important to examine each major religious group for its unique conceptualization and position on suicide to accurately identify a client's suicide risk.

In the public interest: intellectual disability, the Supreme Court, and the death penalty.

PubMed

Abeles, Norman

2010-11-01

This article deals with a case that recently came before the U.S. Supreme Court. The issues involved whether attorneys provided effective assistance to a person convicted of murder when no mitigating evidence was presented (either strategically or by neglect) to the jury concerning the intellectual disabilities of their client during the death penalty phase of the trial. The Supreme Court had previously ruled that the death penalty for intellectually disabled individuals (mentally retarded) constituted cruel and unusual punishment. In this case the attorneys made a strategic decision not to present possibly mitigating evidence for the death penalty phase. The Supreme Court considered whether the appeals court abdicated its judicial review responsibilities. The results of psychological evaluations are presented, and the decisions of the Supreme Court are discussed. PsycINFO Database Record (c) 2010 APA, all rights reserved.

A Study of Some Effects of Early Change Agent Behavior on a Group Client System.

ERIC Educational Resources Information Center

Darden, Douglas Wylie

A study was conducted to explore some of the relationships existing between the early behavior of a change agent with a group client system and its subsequent effects on the helping relationship established between them. A review of related literature was made. The model of helping relationship which formed the basis for the design of the study…

Use of geographic information system to display water-quality data from San Juan basin

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thorn, C.R.; Dam, W.L.

1989-09-01

The ARC/INFO geographic information system is creating thematic maps of the San Juan basin as part of the USGS Regional Aquifer-System Analysis program. (Use of trade names is for descriptive purposes only and does not constitute endorsement by the US Geological Survey.) Maps created by a Prime version of ARC/INFO, to be published in a series of Hydrologic Investigations Atlas reports for selected geologic units, will include outcrop patters, water-well locations, and water-quality data. The San Juan basin study area, encompassing about 19,400 mi{sup 2}, can be displayed with ARC/INFO at various scales; on the same scale, generated water-quality mapsmore » can be compared and overlain with other maps such as potentiometric surface and depth to top of a geologic or hydrologic unit. Selected water-quality and well data (including latitude and longitude) are retrieved from the USGS National Water Information System data base for a specified geologic unit. Data are formatted by Fortran programs and read into an INFO data base. Two parallel files - an INFO file containing water-quality data and well data and an ARC file containing the site coordinates - are joined to form the ARC/INFO data base. A file containing a series of commands using Prime's Command Procedure language is used to select coverage, display, and position data on the map. Data interpretation is enhanced by displaying water-quality data throughout the basin in combination with other hydrologic and geologic data.« less

Conflict and user involvement in drug misuse treatment decision-making: a qualitative study

PubMed Central

Fischer, Jan; Neale, Joanne; Bloor, Michael; Jenkins, Nicholas

2008-01-01

Background This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making. Methods Seventy-nine in-depth interviews were conducted with new treatment clients in two residential and two community drug treatment agencies. Fifty-nine of these clients were interviewed again after twelve weeks. Twenty-seven interviews were also conducted with staff, who were the keyworkers for the interviewed clients. Results Drug users did not expect, desire or prepare for conflict at treatment entry. They reported few actual conflicts within the treatment setting, but routinely discussed latent conflicts – that is, negative experiences and problematic aspects of current or previous treatment that could potentially escalate into overt disputes. Conflict resulted in a number of possible outcomes, including the premature termination of treatment; staff deciding on the appropriate outcome; the client appealing to the governance structure of the agency; brokered compromise; and staff skilfully eliciting client consent for staff decisions. Conclusion Although the implementation of user involvement in drug treatment decision-making has the potential to trigger high levels of staff-client conflict, latent conflict is more common than overt conflict and not all conflict is negative. Drug users generally want to be co-operative at treatment entry and often adopt non-confrontational forms of covert resistance to decisions about which they disagree. Staff sometimes deploy user involvement as a strategy for managing conflict and soliciting client compliance to treatment protocols. Suggestions for minimising and avoiding harmful conflict in treatment settings are given. PMID:18837989

Qualitative analysis of bibliotherapy as a tool for adults who stutter and graduate students.

PubMed

Gerlach, Hope; Subramanian, Anu

2016-03-01

The purpose of this study was to investigate the use of bibliotherapy as a therapeutic tool for adults who stutter (AWS) and as an educational tool for graduate students in speech-language pathology. Bibliotherapy refers to the process of reading, reflecting upon, and discussing literature, often first person illness or disability narratives, to promote cognitive shifts in the way clients and clinicians conceptualize the experience of disability. Five AWS and six graduate students participated in supervised bibliotherapy using a stuttering memoir during therapy sessions. An inductive, qualitative analysis was utilized to analyze data collected from questionnaires and interviews. An additional deductive qualitative approach was utilized to explore how client data fit into an existing five-outcome model of bibliotherapy from the psychology literature. Graduate students reported developing essential clinical skills for working with clients who stutter, including an improved understanding of the experience of people who stutter and an increased ability to form and strengthen the therapeutic alliance. Clients reported experiencing shifts in the cognitive and affective components of the disorder. Imposing the five-outcome model on client data indicates that at least two clients in the current study experienced all five outcomes of bibliotherapy. These include client experiences of involvement, identification, catharsis, insight and universalism. Both graduate students and clients reported benefits from reading and discussing a memoir about stuttering. Bibliotherapy can be an effective tool in therapy and clinical education when used appropriately. Copyright © 2015 Elsevier Inc. All rights reserved.

Privacy preserving, real-time and location secured biometrics for mCommerce authentication

NASA Astrophysics Data System (ADS)

Kuseler, Torben; Al-Assam, Hisham; Jassim, Sabah; Lami, Ihsan A.

2011-06-01

Secure wireless connectivity between mobile devices and financial/commercial establishments is mature, and so is the security of remote authentication for mCommerce. However, the current techniques are open for hacking, false misrepresentation, replay and other attacks. This is because of the lack of real-time and current-precise-location in the authentication process. This paper proposes a new technique that includes freshly-generated real-time personal biometric data of the client and present-position of the mobile device used by the client to perform the mCommerce so to form a real-time biometric representation to authenticate any remote transaction. A fresh GPS fix generates the "time and location" to stamp the biometric data freshly captured to produce a single, real-time biometric representation on the mobile device. A trusted Certification Authority (CA) acts as an independent authenticator of such client's claimed realtime location and his/her provided fresh biometric data. Thus eliminates the necessity of user enrolment with many mCommerce services and application providers. This CA can also "independently from the client" and "at that instant of time" collect the client's mobile device "time and location" from the cellular network operator so to compare with the received information, together with the client's stored biometric information. Finally, to preserve the client's location privacy and to eliminate the possibility of cross-application client tracking, this paper proposes shielding the real location of the mobile device used prior to submission to the CA or authenticators.

What is “Support” in Supportive Housing: Client and Service Providers’ Perspectives

PubMed Central

Owczarzak, Jill; Dickson-Gomez, Julia; Convey, Mark; Weeks, Margaret

2014-01-01

Supportive housing programs are proposed as a way of increasing housing access and stability for the chronically homeless, improving access to needed services, and decreasing vulnerability to HIV and other diseases. Little is known about residents’ understandings of and experiences with different models of supportive housing and how they fit within residents’ broader strategies to maintain housing. We conducted semi-structured interviews with 23 residents and 10 service providers from nine different supportive housing programs in Hartford, Connecticut. Data analysis explored residents’ perceptions of and experiences with supportive housing programs in the context of strategies to access resources and receive emotional, financial, and other forms of support. Themes of independence, coercion, and choice pervaded participants’ narratives of their experiences accessing services. Concerns with privacy influenced the types of relationships residents formed with program staff and clients. Findings illustrate the need for more ethnographic studies of how supportive housing services are delivered by community agencies and accessed by clients. PMID:25477620

Grand Rounds: A Method for Improving Student Learning and Client Care Continuity in a Student-Run Physical Therapy Pro Bono Clinic

ERIC Educational Resources Information Center

Black, Jill D.; Bauer, Kyle N.; Spano, Georgia E.; Voelkel, Sarah A.; Palombaro, Kerstin M.

2017-01-01

Background and Purpose: Grand Rounds is a teaching methodology that has existed in various forms in medical education for centuries. When a student-run pro bono clinic identified a growing challenge of providing continuity of care for clients and a lack of preparedness in students, they implemented a Grand Rounds model of case presentation within…

Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

PubMed Central

SIMPSON, D. DWAYNE; JOE, GEORGE W.; KNIGHT, KEVIN; ROWAN-SZAL, GRACE A.; GRAY, JULIE S.

2012-01-01

The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (1-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for treatment (MOTForm), psychological functioning (PSYForm), social relations and functioning (SOCForm), and therapeutic participation and engagement (ENGForm). These instruments facilitate optically-scanned data entry, computerized scoring, and rapid graphical feedback for clinical decisions. The present study (based on 5,022 inmates from eight residential prison treatment programs) examines evidence on scale reliabilities and measurement structures of these tools. Results confirmed their integrity and usefulness as indicators of individual and group-level therapeutic dynamics. PMID:22505795

Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine

PubMed Central

2011-01-01

Background The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice. Results Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap. Conclusions Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills. PMID:21777495

Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine.

PubMed

Kleen, Joachim L; Atkinson, Owen; Noordhuizen, Jos Ptm

2011-07-20

The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice. Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap. Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills.

A Reasoned Action Model of Male Client Involvement in Commercial Sex Work in Kibera, A Large Informal Settlement in Nairobi, Kenya

PubMed Central

Roth, Eric Abella; Ngugi, Elizabeth; Benoit, Cecilia; Jansson, Mikael; Hallgrimsdottir, Helga

2015-01-01

Male clients of female sex workers (FSWs) are epidemiologically important because they can form bridge groups linking high- and low-risk subpopulations. However, because male clients are hard to locate, they are not frequently studied. Recent research emphasizes searching for high-risk behavior groups in locales where new sexual partnerships form and the threat of HIV transmission is high. Sub-Saharan Africa public drinking venues satisfy these criteria. Accordingly, this study developed and implemented a rapid assessment methodology to survey men in bars throughout the large informal settlement of Kibera, Nairobi, Kenya, with the goal of delineating cultural and economic rationales associated with male participation in commercial sex. The study sample consisted of 220 male patrons of 110 bars located throughout Kibera’s 11 communities. Logistic regression analysis incorporating a modified Reasoned Action Model indicated that a social norm condoning commercial sex among male peers and the cultural belief that men should practice sex before marriage support commercial sex involvement. Conversely, lacking money to drink and/or pay for sexual services were barriers to male commercial sex involvement. Results are interpreted in light of possible harm reduction programs focusing on FSWs’ male clients. PMID:26778847

GénoPlante-Info (GPI): a collection of databases and bioinformatics resources for plant genomics

PubMed Central

Samson, Delphine; Legeai, Fabrice; Karsenty, Emmanuelle; Reboux, Sébastien; Veyrieras, Jean-Baptiste; Just, Jeremy; Barillot, Emmanuel

2003-01-01

Génoplante is a partnership program between public French institutes (INRA, CIRAD, IRD and CNRS) and private companies (Biogemma, Bayer CropScience and Bioplante) that aims at developing genome analysis programs for crop species (corn, wheat, rapeseed, sunflower and pea) and model plants (Arabidopsis and rice). The outputs of these programs form a wealth of information (genomic sequence, transcriptome, proteome, allelic variability, mapping and synteny, and mutation data) and tools (databases, interfaces, analysis software), that are being integrated and made public at the public bioinformatics resource centre of Génoplante: GénoPlante-Info (GPI). This continuous flood of data and tools is regularly updated and will grow continuously during the coming two years. Access to the GPI databases and tools is available at http://genoplante-info.infobiogen.fr/. PMID:12519976

Treatment of cannabis use among people with psychotic or depressive disorders: a systematic review.

PubMed

Baker, Amanda L; Hides, Leanne; Lubman, Dan I

2010-03-01

This article systematically reviews the evidence from randomized controlled trials (RCTs) for pharmacologic and psychological approaches to the treatment of cannabis use among individuals with psychotic or depressive disorders. A systematic literature search was conducted using the PubMed and PsychINFO databases from inception to December 2008. Individual searches in cannabis use (search terms: marijuana, cannabis, marijuana abuse, cannabis abuse, marijuana usage, cannabis usage), mental disorders (search terms: mood disorders, affective disorders, anxiety disorders, anxiety, depressive disorder, depression, psychotic disorders, psychosis, mental disorders), and pharmacotherapy (search terms: medication, drug therapy, pharmacotherapy, psychopharmacology, clinical trials, drug trial, treatment trial) were conducted and limited to humans, adolescents and adults. A search combining the individual cannabis use, mental disorder and pharmacotherapy searches produced 1,713 articles (PubMed = 1,398; PsychINFO = 315). Combining the cannabis use and mental disorder searches while limiting them to English articles and RCTs produced a total of 286 articles (PubMed = 228; PsychINFO = 58). From this literature, there were 7 RCTs conducted among mental health clients that reported cannabis use outcomes using pharmacologic or psychological interventions. While few RCTs have been conducted, there is evidence that pharmacologic and psychological interventions are effective for reducing cannabis use in the short-term among people with psychotic disorders or depression. Although it is difficult to make evidence-based treatment recommendations due to the paucity of research in this area, available studies indicate that effectively treating the mental health disorder with standard pharmacotherapy may be associated with a reduction in cannabis use and that longer or more intensive psychological interventions rather than brief interventions may be required, particularly among heavier users of cannabis and those with more chronic mental disorders. Specific recommendations regarding the type and length of specific psychological treatments cannot be made at this time, although motivational interviewing and cognitive-behavioral therapy approaches appear most promising. (c) 2010 Physicians Postgraduate Press, Inc.

Internet calculations of thermodynamic properties of substances: Some problems and results

NASA Astrophysics Data System (ADS)

Ustyuzhanin, E. E.; Ochkov, V. F.; Shishakov, V. V.; Rykov, S. V.

2016-11-01

Internet resources (databases, web sites and others) on thermodynamic properties R = (p,T,s,...) of technologically important substances are analyzed. These databases put online by a number of organizations (the Joint Institute for High Temperatures of the Russian Academy of Sciences, Standartinform, the National Institute of Standards and Technology USA, the Institute for Thermal Physics of the Siberian Branch of the Russian Academy of Sciences, etc) are investigated. Software codes are elaborated in the work in forms of “client functions” those have such characteristics: (i) they are placed on a remote server, (ii) they serve as open interactive Internet resources. A client can use them for a calculation of R properties of substances. “Complex client functions” are considered. They are focused on sharing (i) software codes elaborated to design of power plants (PP) and (ii) client functions those can calculate R properties of working fluids for PP.

A preliminary case-mix classification system for Medicare home health clients.

PubMed

Branch, L G; Goldberg, H B

1993-04-01

In this study, a hierarchical case-mix model was developed for grouping Medicare home health beneficiaries homogeneously, based on the allowed charges for their home care. Based on information from a two-page form from 2,830 clients from ten states and using the classification and regression trees method, a four-component model was developed that yielded 11 case-mix groups and explained 22% of the variance for the test sample of 1,929 clients. The four components are rehabilitation, special care, skilled-nurse monitoring, and paralysis; each are categorized as present or absent. The range of mean-allowed charges for the 11 groups in the total sample was $473 to $2,562 with a mean of $847. Of the six groups with mean charges above $1,000, none exceeded 5.2% of clients; thus, the high-cost groups are relatively rare.

Confirming, Validating, and Norming the Factor Structure of Systemic Therapy Inventory of Change Initial and Intersession.

PubMed

Pinsof, William M; Zinbarg, Richard E; Shimokawa, Kenichi; Latta, Tara A; Goldsmith, Jacob Z; Knobloch-Fedders, Lynne M; Chambers, Anthony L; Lebow, Jay L

2015-09-01

Progress or feedback research tracks and feeds back client progress data throughout the course of psychotherapy. In the effort to empirically ground psychotherapeutic practice, feedback research is both a complement and alternative to empirically supported manualized treatments. Evidence suggests that tracking and feeding back progress data with individual or nonsystemic feedback systems improves outcomes in individual and couple therapy. The research reported in this article pertains to the STIC(®) (Systemic Therapy Inventory of Change)-the first client-report feedback system designed to empirically assess and track change within client systems from multisystemic and multidimensional perspectives in individual, couple, and family therapy. Clients complete the STIC Initial before the first session and the shorter STIC Intersession before every subsequent session. This study tested and its results supported the hypothesized factor structure of the six scales that comprise both STIC forms in a clinical outpatient sample and in a normal, random representative sample of the U.S. This study also tested the STIC's concurrent validity and found that its 6 scales and 40 of its 41 subscales differentiated the clinical and normal samples. Lastly, the study derived clinical cut-offs for each scale and subscale to determine whether and how much a client's score falls in the normal or clinical range. Beyond supporting the factorial and concurrent validity of both STIC forms, this research supported the reliabilities of the six scales (Omegahierarchical ) as well as the reliabilities of most subscales (alpha and rate-rerate). This article delineates clinical implications and directions for future research. © 2015 Family Process Institute.

Guidance Documents and Sample Forms for Central Data Exchange (CDX) Registration and e-PMN Software (Thin Client)

EPA Pesticide Factsheets

For users submitting electronic notices through CDX, this page contains guidance documents and sample forms to help you, submit Premanufacture Notices (PMN), Bona Fide and biotechnology notices, among others.

A starting point for delivery reform. Catholic healthcare providers can receive guidance from "A Time to Be Old, a Time to Flourish".

PubMed

1992-03-01

The ideal healthcare delivery system is client focused and ensures that the individual and the family receive the appropriate mix of services to meet their needs. Healthcare delivery should be presented as a coordinated continuum of care. Key integrating elements are essential to provide healthcare services on a day-by-day basis as a continuum of care. Integrating elements that form the bridge between clients and services include planning, care management, a management information system, financing, and an appropriate administrative structure. Many Catholic healthcare providers are expanding by acquiring a variety of services. However, many of these acquisitions are in response to today's competitive environment, whereas a true continuum of care must focus on the client's range of functional needs. Catholic providers must keep in mind that not all services they provide will be profitable. Although Catholic healthcare providers will be pressured to focus on fiscal strength and market position, they must put the client's holistic needs first. By doing so, they can help create a client-centered healthcare system in their communities.

An Adaptive Priority Tuning System for Optimized Local CPU Scheduling using BOINC Clients

NASA Astrophysics Data System (ADS)

Mnaouer, Adel B.; Ragoonath, Colin

2010-11-01

Volunteer Computing (VC) is a Distributed Computing model which utilizes idle CPU cycles from computing resources donated by volunteers who are connected through the Internet to form a very large-scale, loosely coupled High Performance Computing environment. Distributed Volunteer Computing environments such as the BOINC framework is concerned mainly with the efficient scheduling of the available resources to the applications which require them. The BOINC framework thus contains a number of scheduling policies/algorithms both on the server-side and on the client which work together to maximize the available resources and to provide a degree of QoS in an environment which is highly volatile. This paper focuses on the BOINC client and introduces an adaptive priority tuning client side middleware application which improves the execution times of Work Units (WUs) while maintaining an acceptable Maximum Response Time (MRT) for the end user. We have conducted extensive experimentation of the proposed system and the results show clear speedup of BOINC applications using our optimized middleware as opposed to running using the original BOINC client.

A neuroscience agenda for counseling psychology research.

PubMed

Gonçalves, Oscar F; Perrone-McGovern, Kristin M

2014-10-01

Recent advances in the field of neuroscience have dramatically changed our understanding of brain-behavior relationships. In this article, we illustrate how neuroscience can provide a conceptual and methodological framework to understand our clients within a transdiagnostic developmental perspective. We provide directions for integrating neuroscience into future process and outcome research. We present examples on how neuroscience can be integrated into researching the effects of contextual counseling interventions. We posit that interpersonal and environmental factors, such as neurotoxic factors (e.g., emotional neglect, stress), positive neurodevelopmental factors (e.g., nurturing and caring, environmental enrichment), and therapeutic interventions influence psychological processes (executive control, behavioral flexibility, reinforcement learning and approach motivation, emotional expression and regulation, self-representation and theory of mind). These psychological processes influence brain networks (attention, motivational, emotional regulation, social cognition), which influence cognitive, social, emotional, identity, and vocational development. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Recovery and money management.

PubMed

Rowe, Michael; Serowik, Kristin L; Ablondi, Karen; Wilber, Charles; Rosen, Marc I

2013-06-01

Social recovery and external money management are important approaches in contemporary mental health care, but little research has been done on the relationship between the two or on application of recovery principles to money management for people at risk of being assigned a representative payee or conservator. Out of 49 total qualitative interviews, 25 transcripts with persons receiving Social Security insurance or Social Security disability insurance who were at risk of being assigned a money manager were analyzed to assess the presence of recognized recovery themes. The recovery principles of self-direction and responsibility were strong themes in participant comments related to money management. Money management interventions should incorporate peoples' recovery-related motivations to acquire financial management skills as a means to direct and assume responsibility for one's finances. Staff involved in money management should receive training to support client's recovery-related goals. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Sandra L. Shullman: Award for Distinguished Professional Contributions to Independent Practice.

PubMed

2012-11-01

Presents a short biography of the winner of the American psychological Association's Award for Distinguished Professional Contributions to Independent Practice. The 2012 winner is Sandra L. Shullman for her outstanding contributions and leadership as an independent practitioner in the fields of counseling and consulting psychology. Through her national scholarship on sexual harassment in the workplace, her development of the practice of organizational counseling psychology, her management of a leading behavioral health care practice, and her pioneering leadership development initiatives for national and international clients, Shullman has greatly enhanced the public's recognition of psychology. In addition, her involvement and leadership as a representative of independent practitioners in professional associations at the state and national levels have benefited the profession in immeasurable ways. Shullman's Award citation and a selected bibliography are also presented here. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Application of adult attachment theory to group member transference and the group therapy process.

PubMed

Markin, Rayna D; Marmarosh, Cheri

2010-03-01

Although clinical researchers have applied attachment theory to client conceptualization and treatment in individual therapy, few researchers have applied this theory to group therapy. The purpose of this article is to begin to apply theory and research on adult dyadic and group attachment styles to our understanding of group dynamics and processes in adult therapy groups. In particular, we set forth theoretical propositions on how group members' attachment styles affect relationships within the group. Specifically, this article offers some predictions on how identifying group member dyadic and group attachment styles could help leaders predict member transference within the therapy group. Implications of group member attachment for the selection and composition of a group and the different group stages are discussed. Recommendations for group clinicians and researchers are offered. PsycINFO Database Record (c) 2010 APA, all rights reserved

Using service data: tools for taking action.

PubMed

1992-01-01

Program performance can be improved through use of a simple information system. The focus of the discussion is on analysis of service data, decision making, and program improvement. Clinic managers must collect and analyze their own data and not wait for supervisors from central or district offices to conduct thorough examination. Local decision making has the advantage of providing monitoring and modification of services in a timely way and in a way responsive to client needs. Information can be shared throughout all levels of local and central administration. The model for decision making is based on data collection, data analysis, decision making, action, evaluation, information dissemination, and feedback. Data need to be collected on types of clients (new acceptor or continuing user), type of contraceptive method and quantity dispensed, and how the client learned about the clinic. Supply data also needs to be collected on methods of contraceptives on hand, number dispensed by method to clients, and projected supplies; requests for additional supplies can thus be made in a timely and appropriate way. The basic clinic forms are the family planning (FP), client record, the client referral card, an appointment card, a complication card, a daily FP activity register, a FP activities worksheet, a monthly summary of FP activities, and a commodities request/receipt form. A suggestion sheet from users addresses issues about performance targets, continuing users, dropouts, staff motivation, and setting up a system. Suggestions are also provided on the importance of staff training in data collection and analysis and in creating awareness of the program's objectives. Discussion is directed to how to interpret new acceptor data and to look for patterns. A sample chart is provided of a summary of FP activities, possible interpretations, and possible actions to take. Analysis is given for new acceptor trends, contraceptive method mix, and sources of information. A short example illustrates how client card data and bar graphs of method mix by desire for no more children or for more children revealed that couples childbearing desires did not affect method choice.

Cucurbitacin D Is a Disruptor of the HSP90 Chaperone Machinery.

PubMed

Hall, Jessica A; Seedarala, Sahithi; Rice, Nichole; Kopel, Lucas; Halaweish, Fathi; Blagg, Brian S J

2015-04-24

Heat shock protein 90 (Hsp90) facilitates the maturation of many newly synthesized and unfolded proteins (clients) via the Hsp90 chaperone cycle, in which Hsp90 forms a heteroprotein complex and relies upon cochaperones, immunophilins, etc., for assistance in client folding. Hsp90 inhibition has emerged as a strategy for anticancer therapies due to the involvement of clients in many oncogenic pathways. Inhibition of chaperone function results in client ubiquitinylation and degradation via the proteasome, ultimately leading to tumor digression. Small molecule inhibitors perturb ATPase activity at the N-terminus and include derivatives of the natural product geldanamycin. However, N-terminal inhibition also leads to induction of the pro-survival heat shock response (HSR), in which displacement of the Hsp90-bound transcription factor, heat shock factor-1, translocates to the nucleus and induces transcription of heat shock proteins, including Hsp90. An alternative strategy for Hsp90 inhibition is disruption of the Hsp90 heteroprotein complex. Disruption of the Hsp90 heteroprotein complex is an effective strategy to prevent client maturation without induction of the HSR. Cucurbitacin D, isolated from Cucurbita texana, and 3-epi-isocucurbitacin D prevented client maturation without induction of the HSR. Cucurbitacin D also disrupted interactions between Hsp90 and two cochaperones, Cdc37 and p23.

A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions.

PubMed

Froján-Parga, María Xesús; Ruiz-Sancho, Elena M; Calero-Elvira, Ana

2016-01-01

The goal of this study is to show the development of a strategy for a descriptive assessment of the therapeutic interaction. In this study, we develop an observational methodology to analyze the dialogues that took place during 92 sessions conducted in a psychological center in Madrid, Spain, in which 19 adults were treated for various psychological problems by 9 behavioral therapists. A system was developed to codify vocal behavior of both the therapists and the clients; the software The Observer XT was used for recording. Therapeutic interactions were analyzed using sequential analysis. There are three main sequences that synthesize the therapist-client interaction: first, an utterance by the client preceded by a therapist's verbalization, specifically a question (discriminative morphology) and followed by an expression of approval (reinforcement morphology); second, verbalizations of failure or discomfort uttered by the client, followed most often by verbalizations of disapproval (punishing morphology) uttered by the therapist; and third, verbalizations uttered by the client that are discriminated by the therapist after an in-depth explanation and followed by different therapist's utterances (expressions of approval, technical information, etc.). Depending on how the client responds the results in this study present a starting point for the study of the functional sequences that form the basis of therapeutic change.

CUCURBITACIN D IS A DISRUPTOR OF THE HSP90 CHAPERONE MACHINERY

PubMed Central

Hall, Jessica A.; Seedarala, Sahithi; Rice, Nichole; Kopel, Lucas; Halaweish, Fathi; Blagg, Brian S. J.

2018-01-01

Heat shock protein 90 (Hsp90) facilitates the maturation of many newly synthesized and unfolded proteins (clients) via the Hsp90 chaperone cycle, in which Hsp90 forms a heteroprotein complex and relies upon co-chaperones, immunophilins, etc. for assistance in client folding. Hsp90 inhibition has emerged as a strategy for anticancer therapies due to the involvement of clients in many oncogenic pathways. Inhibition of chaperone function results in client ubiquitinylation and degradation via the proteasome, ultimately leading to tumor digression. Small molecule inhibitors perturb ATPase activity at the N-terminus and include derivatives of the natural product geldanamycin. However, N-terminal inhibition also leads to induction of the pro-survival heat shock response (HSR), in which displacement of the Hsp90-bound transcription factor, Heat Shock Factor-1 translocates to the nucleus and induces transcription of heat shock proteins, including Hsp90. An alternative strategy for Hsp90 inhibition is disruption of the Hsp90 heteroprotein complex. Disruption of the Hsp90 heteroprotein complex is an effective strategy to prevent client maturation without induction of the HSR. Cucurbitacin D, isolated from Cucurbita texana, and 3-epi-isocucurbitacin D prevented client maturation without induction of the HSR. Cucurbitacin D also disrupted interactions between Hsp90 and two co-chaperones, Cdc37 and p23. PMID:25756299

75 FR 49233 - Amendments to Form ADV

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

...The Securities and Exchange Commission is adopting amendments to Part 2 of Form ADV, and related rules under the Investment Advisers Act, to require investment advisers registered with us to provide new and prospective clients with a brochure and brochure supplements written in plain English. These amendments are designed to provide new and prospective advisory clients with clearly written, meaningful, current disclosure of the business practices, conflicts of interest and background of the investment adviser and its advisory personnel. Advisers must file their brochures with us electronically and we will make them available to the public through our Web site. The Commission also is withdrawing the Advisers Act rule requiring advisers to disclose certain disciplinary and financial information.

Using artwork to understand the experience of mental illness: Mainstream artists and Outsider artists

PubMed Central

Rustin, Terry A.

2008-01-01

Objective: Artwork and psychiatric disorders are often linked. Accomplished artists with psychiatric disorders express themselves and their emotional distress through their works, and art therapists use the visual arts to help clients understand their problems and cope with them. There have been a number of psychiatric patients with no previous art training who produced artwork that many consider museum-worthy (Art Brut, or Outsider Art.) For the past two years, I have used artwork in another way: to better understand my clients and their psychiatric disorders. Methods: Presented here are paintings I have made about the mental illness experience of some of my clients, all well known to me through their therapy. It is a form of visual psychodrama, in which I reverse roles with the client through the paintings. My goal has been to experience the stresses felt by my clients so that I can understand them better. Results: The paintings have served as a point of embarkation for therapy sessions, as a means of clarifying a client’s experience, and as a way to show clients that their therapist is attending to what they say. Countertransference undoubtedly plays a role in my choice of clients and their portrayals, but the intent is to help me better understand the clients’ experiences. Included here are images of some of these paintings with a short psychiatric history of the client about whom they were made. Accompanying each one are responses from the clients upon viewing “their” paintings, and a discussion of the client’s psychiatric disorder. Conclusions: Making these paintings has helped me understand better the feelings of isolation, rejection, loss, and alienation that many of my clients experience every day. In turn, they tell me that viewing the paintings is an intense experience for them as well. As an outsider artist, I must leave it to the viewer to determine whether or not these paintings qualify as “art.” PMID:19742284

77 FR 26413 - Promoting International Regulatory Cooperation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... engage in various forms of collaboration and communication with respect to regulations, in particular a... as such in the Unified Agenda of Federal Regulatory and Deregulatory Actions, on RegInfo.gov , and on...

The ALICE DAQ infoLogger

NASA Astrophysics Data System (ADS)

Chapeland, S.; Carena, F.; Carena, W.; Chibante Barroso, V.; Costa, F.; Dénes, E.; Divià, R.; Fuchs, U.; Grigore, A.; Ionita, C.; Delort, C.; Simonetti, G.; Soós, C.; Telesca, A.; Vande Vyvre, P.; Von Haller, B.; Alice Collaboration

2014-04-01

ALICE (A Large Ion Collider Experiment) is a heavy-ion experiment studying the physics of strongly interacting matter and the quark-gluon plasma at the CERN LHC (Large Hadron Collider). The ALICE DAQ (Data Acquisition System) is based on a large farm of commodity hardware consisting of more than 600 devices (Linux PCs, storage, network switches). The DAQ reads the data transferred from the detectors through 500 dedicated optical links at an aggregated and sustained rate of up to 10 Gigabytes per second and stores at up to 2.5 Gigabytes per second. The infoLogger is the log system which collects centrally the messages issued by the thousands of processes running on the DAQ machines. It allows to report errors on the fly, and to keep a trace of runtime execution for later investigation. More than 500000 messages are stored every day in a MySQL database, in a structured table keeping track for each message of 16 indexing fields (e.g. time, host, user, ...). The total amount of logs for 2012 exceeds 75GB of data and 150 million rows. We present in this paper the architecture and implementation of this distributed logging system, consisting of a client programming API, local data collector processes, a central server, and interactive human interfaces. We review the operational experience during the 2012 run, in particular the actions taken to ensure shifters receive manageable and relevant content from the main log stream. Finally, we present the performance of this log system, and future evolutions.

Atomistic simulations and network-based modeling of the Hsp90-Cdc37 chaperone binding with Cdk4 client protein: A mechanism of chaperoning kinase clients by exploiting weak spots of intrinsically dynamic kinase domains

PubMed Central

Czemeres, Josh; Buse, Kurt

2017-01-01

A fundamental role of the Hsp90 and Cdc37 chaperones in mediating conformational development and activation of diverse protein kinase clients is essential in signal transduction. There has been increasing evidence that the Hsp90-Cdc37 system executes its chaperoning duties by recognizing conformational instability of kinase clients and modulating their folding landscapes. The recent cryo-electron microscopy structure of the Hsp90-Cdc37-Cdk4 kinase complex has provided a framework for dissecting regulatory principles underlying differentiation and recruitment of protein kinase clients to the chaperone machinery. In this work, we have combined atomistic simulations with protein stability and network-based rigidity decomposition analyses to characterize dynamic factors underlying allosteric mechanism of the chaperone-kinase cycle and identify regulatory hotspots that control client recognition. Through comprehensive characterization of conformational dynamics and systematic identification of stabilization centers in the unbound and client- bound Hsp90 forms, we have simulated key stages of the allosteric mechanism, in which Hsp90 binding can induce instability and partial unfolding of Cdk4 client. Conformational landscapes of the Hsp90 and Cdk4 structures suggested that client binding can trigger coordinated dynamic changes and induce global rigidification of the Hsp90 inter-domain regions that is coupled with a concomitant increase in conformational flexibility of the kinase client. This process is allosteric in nature and can involve reciprocal dynamic exchanges that exert global effect on stability of the Hsp90 dimer, while promoting client instability. The network-based rigidity analysis and emulation of thermal unfolding of the Cdk4-cyclin D complex and Hsp90-Cdc37-Cdk4 complex revealed weak spots of kinase instability that are present in the native Cdk4 structure and are targeted by the chaperone during client recruitment. Our findings suggested that this mechanism may be exploited by the Hsp90-Cdc37 chaperone to recruit and protect intrinsically dynamic kinase clients from degradation. The results of this investigation are discussed and interpreted in the context of diverse experimental data, offering new insights into mechanisms of chaperone regulation and binding. PMID:29267381

Info-disruption: pollution and the transfer of chemical information between organisms.

PubMed

Lürling, Miquel; Scheffer, Marten

2007-07-01

Many organisms use subtle chemical cues not only to find partners and food, but also to sense the presence of natural enemies and to avoid predation. As we discuss here, an increasing number of studies now show that low, non-toxic concentrations of chemicals, ranging from heavy metals and pesticides to seemingly harmless substances such as surfactants, can disrupt the transfer of chemical information, inducing maladaptive responses in both the signaller and the receiver. Similar to endocrine disruptors, these 'info disruptors' form a new class of chemical threats, which could have far-reaching implications for ecosystem functioning and conservation management.

Disaster-related injuries and illnesses treated by American Red Cross disaster health services during Hurricanes Gustav and Ike.

PubMed

Noe, Rebecca S; Schnall, Amy H; Wolkin, Amy F; Podgornik, Michelle N; Wood, April D; Spears, Jeanne; Stanley, Sharon A R

2013-01-01

To describe the injuries and illnesses treated by the American Red Cross (Red Cross) during Hurricanes Gustav and Ike disaster relief operations reported on a new Aggregate Morbidity Report Form. From August 28 to October 18, 2008, 119 Red Cross field service locations in Louisiana, Mississippi, Tennessee, and Texas addressed the healthcare needs of people affected by the hurricanes. From these locations, individual client visit data were retrospectively collated per site onto new 24-hour Aggregate Morbidity Report Forms. A total of 3863 clients were treated. Of the clients, 48% were girls and women and 44% were boys and men; 61% were 19 to 64 years old. Ninety-eight percent of the visits occurred in shelters. The reasons for half of the visits were acute illness and symptoms (eg, pain) and 16% were for routine follow-up care. The majority (65%) of the 2516 visits required treatment at a field location, although 34%, or 1296 visits, required a referral, including 543 healthcare facility transfers. During the hurricanes, a substantial number of displaced evacuees sought care for acute and routine healthcare needs. The capacity of the Red Cross to address the immediate and ongoing health needs of sheltered clients for an extended period of time is a critical resource for local public health agencies, which are often overwhelmed during a disaster. This article highlights the important role that this humanitarian organization fills, to decrease surge to local healthcare systems and to monitor health effects following a disaster. The Aggregate Morbidity Report Form has the potential to assist greatly in this role, and thus its utility for real-time reporting should be evaluated further.

Sexual health-related information delivery - are patient information leaflets still relevant?

PubMed

Varma, Rick; Chung, Charles; Townsend, Amanda; Power, Melissa

2016-06-01

Background Patient information leaflets (PILs) are widely utilised within publically funded sexual health clinics to deliver sexual health-related information (SHRI); however, their continued value to clients in the era of social media is unclear. This study aimed to evaluate clients' opinions on three newly developed PILs and examine client views on other forms of SHRI delivery. An anonymous self-administered questionnaire was completed by clients attending the Western Sydney Sexual Health Centre (WSSHC) in 2012. High-risk population (HRP) vs non-high-risk population (non-HRP) views on PILs vs alternative methods of SHRI delivery were analysed by using Mann-Whitney U, Wilcoxon, McNemar and χ(2) tests. Over half (210/315; (67%)) of the consecutive clients from a culturally diverse population completed the survey. Sex workers (SW) and young people (YP) were significantly likely to have a high school education than non-HRP (P<0.039 and P<0.032). Overall, PILs, a clinic website and the Sexual Health Information Link (SHIL), a state-wide website and telephone line, were ranked significantly higher as a means of SHRI delivery on a Likert scale than newer technologies including Facebook (P<0.001), email (P<0.001), mobile phone applications (P<0.001), TVs in waiting rooms (P<0.001) and business cards (P<0.001). There was no significant difference in opinion between HRP and non-HRP. This study provides evidence for the ongoing use of PILs to deliver SHRI to clinic attendees, in conjunction with other forms of SHRI delivery such as websites and SHIL. Novel methods may require additional consumer engagement and a greater understanding of specific population's needs.

Entrepreneurial Earth Science.

ERIC Educational Resources Information Center

Lacy, Carol

1997-01-01

Presents an activity in which groups of students form land-use companies that work for a client who is seeking land suitable for an all-season resort. Involves students working together and drawing on their knowledge of contour lines, topography, land forms, climate, natural disasters, geology, and hydrology. (JRH)

Gender and nutrition management in type 2 diabetes.

PubMed

Wong, Mildred; Gucciardi, Enza; Li, Louisa; Grace, Sherry L

2005-01-01

The literature suggests that adherence to dietary recommendations may differ between women and men with type 2 diabetes due to family obligations and spousal support. To assess division of household labour between spouses, retrospective chart review of 561 individuals who attended the Diabetes Education Centre at the Toronto Western Hospital was performed. Qualitative interviews were also performed with 12 married clients (six female and six male) and seven spouses of clients (three female, four male) to understand how the sharing of household labour influences adherence to nutrition guidelines in type 2 diabetes. Results indicate a significant gender difference in responsibility for meal preparation (chi2(3)=140.64, p<.001) and grocery shopping (chi2(3)=88.24, p<0.001), with women more often engaging in these household activities than men. Male clients are more likely to be actively supported by their wives in the form of meal preparation and verbal encouragement, while female clients are only passively supported by their husbands. The results suggest that diabetes educators should recognize gender differences in household labour and support when counselling their clients to ensure that both men and women have the help they need to successfully manage their diabetes.

Employee assistance programs: a workplace resource to address intimate partner violence.

PubMed

Pollack, Keshia M; Austin, Whitney; Grisso, Jeane Ann

2010-04-01

Intimate partner violence (IPV) is a major public health problem with significant impact on the workplace. Employee assistance programs (EAPs) are a confidential benefit to assist employees and their families with a variety of problems that may negatively affect their job performance. The purpose of this systematic review is to study the extant literature to identify articles that have explored the role of EAPs in addressing IPV. We searched Medline, PsychINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) for English-language papers that have explored how EAPs can address IPV. Articles published through 2008 were included. Our review yielded nine articles, mostly from EAP-centered journals. Nearly all of the studies were published before the year 2000 and primarily describe the need for EAPs to be more engaged in preventing violence against women. Most of the studies were commentaries, often using case reports to support recommendations on how EAPs could address IPV. Results from the two intervention studies revealed close connections between EAP clients being treated for alcoholism and IPV perpetration and the effectiveness of a standardized tool to identify EAP clients experiencing IPV. Research in this area is in its infancy, and more studies are needed to inform the formulation of evidence-based policies and programs that guide the role of EAPs in addressing IPV. The lack of research on how EAPs address IPV is alarming, as many employers state that they often refer employees affected by IPV to the EAP for assistance.

Privacy versus care--The shifting balance in mental health.

PubMed

Mork, Mary Jean; Price, Steven; Best, Kathryn

2016-03-01

Mental health professionals are now debating client confidentiality and its relationship to care coordination. History tells us there is a need to protect the privacy of people who are diagnosed with mental health issues in a world filled with stigma and misperceptions. People with mental illness and substance use problems may be legitimately concerned that employers, insurance companies, financial institutions, medical practices, and educational institutions could use their health information to discriminate against them, often without their knowledge. The protection of jobs and health information is a real, justifiable benefit of privacy legislation. However, there are also a host of negative consequences, including fragmented health care, lack of prevention, uninformed families, and even early death, because of a lack of coordination with medical treatment. The legal situation can be very confusing, but the upshot is that we are shifting from an environment of strict confidentiality to one of better care coordination. In short, we are moving toward a system that allows for better coordination because it improves the quality of care for our clients. At the policy level, we must lead the change process and actively support the revision and reinterpretation of existing laws and regulations. These changes will require earning the trust of the people being served. Many are wary, and some even scared, of their perceived loss of privacy. Health-care professionals must commit to the concept of coordinating care, making communication about shared care plans a priority. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services.

PubMed

Ogloff, James R P; Talevski, Diana; Lemphers, Anthea; Wood, Melisa; Simmons, Melanie

2015-03-01

Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Motivational interviewing and the clinical science of Carl Rogers.

PubMed

Miller, William R; Moyers, Theresa B

2017-08-01

The clinical method of motivational interviewing (MI) evolved from the person-centered approach of Carl Rogers, maintaining his pioneering commitment to the scientific study of therapeutic processes and outcomes. The development of MI pertains to all 3 of the 125th anniversary themes explored in this special issue. Applications of MI have spread far beyond clinical psychology into fields including health care, rehabilitation, public health, social work, dentistry, corrections, coaching, and education, directly impacting the lives of many people. The public relevance and impact of clinical psychology are illustrated in the similarity of MI processes and outcomes across such diverse fields and the inseparability of human services from the person who provides them, in that both relational and technical elements of MI predict client outcomes. Within the history of clinical psychology MI is a clear product of clinical science, arising from the seminal work of Carl Rogers whose own research grounded clinical practice in empirical science. As with Rogers' work 70 years ago, MI began as an inductive empirical approach, observing clinical practice to develop and test hypotheses about what actually promotes change. Research on MI bridges the current divide between evidence-based practice and the well-established importance of therapeutic relationship. Research on training and learning of MI further questions the current model of continuing professional education through self-study and workshops as a way of improving practice behavior and client outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Wheelchair Procurement Process: Perspectives of Clients and Prescribers

PubMed Central

Mortenson, William B; Miller, William C

2014-01-01

Back ground Increasing choices in assistive technology has made the process of procuring a wheelchair more complex and challenging. Purpose To explore the intricacies of the procurement process from the perspectives of clients and therapists. Methods Thirty-four participants were interviewed, including 13 wheelchair prescribers, 14 wheelchair users, and 7 wheelchair associates (family members and caregivers). Findings Analysis revealed five main themes. 1) “Who decides?” described varying degrees of client involvement in the procurement process. 2) “Expert knowledge” reflected the expert knowledge that all parties possessed. 3) “Form versus function” captured the primary and, at times, conflicting outcomes that participants wanted to achieve. 4) “Fitting in” depicted the environmental factors that affected wheelchair procurement. 5) “(Re)solutions” illustrated strategies that participants felt improved the process. Implications This study reveals clients’ experiences with wheelchair procurement, identifies potential issues therapists may encounter, and suggests possible remedies they might consider when prescribing wheelchairs within a client-centred framework. PMID:18615928

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

PubMed

Hodge, David R; Lietz, Cynthia A

2014-11-01

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

Elder law and Alzheimer's disease.

PubMed

Overman, W H; McCormick, W A

1998-04-27

The elder-law practice focuses on the particular needs of older individuals and their families. Thus, elder law is truly "family" law because the needs of older clients are inextricably interwoven with the needs of their families. This is particularly true for the client who is chronically ill or has some form of dementia, such as Alzheimer's disease. Elder-law attorneys may now be certified to identify to the public those lawyers who demonstrate enhanced knowledge, skills, experience, and proficiency in elder law. Elder law draws from many substantive areas, such as trust, real property, agency, health care, tax, guardianship, will and probate, Social Security, Medicare, and Medicaid law. Together, the client and family are educated on legal options and are assisted in making decisions, formalized through legal documentation. The emphasis is on advance planning. Among legal practitioners, elder-law attorneys understand most clearly that the client's needs must be understood in the context of cultural and family dynamics, and addressed through a team approach involving other professions.

Unraveling the CHIP:Hsp70 complex as an information processor for protein quality control.

PubMed

VanPelt, Jamie; Page, Richard C

2017-02-01

The CHIP:Hsp70 complex stands at the crossroads of the cellular protein quality control system. Hsp70 facilitates active refolding of misfolded client proteins, while CHIP directs ubiquitination of misfolded client proteins bound to Hsp70. The direct competition between CHIP and Hsp70 for the fate of misfolded proteins leads to the question: how does the CHIP:Hsp70 complex execute triage decisions that direct misfolded proteins for either refolding or degradation? The current body of literature points toward action of the CHIP:Hsp70 complex as an information processor that takes inputs in the form of client folding state, dynamics, and posttranslational modifications, then outputs either refolded or ubiquitinated client proteins. Herein we examine the CHIP:Hsp70 complex beginning with the structure and function of CHIP and Hsp70, followed by an examination of recent studies of the interactions and dynamics of the CHIP:Hsp70 complex. Copyright © 2016 Elsevier B.V. All rights reserved.

Genetics Home Reference: paroxysmal extreme pain disorder

MedlinePlus

... extreme pain disorder is considered a form of peripheral neuropathy because it affects the peripheral nervous system, which ... Page National Institute of Neurological Disorders and Stroke: Peripheral Neuropathy Information Page Educational Resources (6 links) Disease InfoSearch: ...

Genetics Home Reference: congenital insensitivity to pain

MedlinePlus

... insensitivity to pain is considered a form of peripheral neuropathy because it affects the peripheral nervous system, which ... link) National Institute of Neurological Disorders and Stroke: Peripheral Neuropathy Information Page Educational Resources (5 links) Disease InfoSearch: ...

Enrollment in HIV Care Two Years after HIV Diagnosis in the Kingdom of Swaziland: An Evaluation of a National Program of New Linkage Procedures.

PubMed

MacKellar, Duncan A; Williams, Daniel; Storer, Nosipho; Okello, Velephi; Azih, Charles; Drummond, Jennifer; Nuwagaba-Biribonwoha, Harriet; Preko, Peter; Morgan, Rebecca L; Dlamini, Makhosazana; Byrd, Johnita; Agolory, Simon; Baughman, Andrew L; McNairy, Margaret L; Sahabo, Ruben; Ehrenkranz, Peter

2016-01-01

To improve early enrollment in HIV care, the Swaziland Ministry of Health implemented new linkage procedures for persons HIV diagnosed during the Soka Uncobe male circumcision campaign (SOKA, 2011-2012) and the Swaziland HIV Incidence Measurement Survey (SHIMS, 2011). Abstraction of clinical records and telephone interviews of a retrospective cohort of HIV-diagnosed SOKA and SHIMS clients were conducted in 2013-2014 to evaluate compliance with new linkage procedures and enrollment in HIV care at 92 facilities throughout Swaziland. Of 1,105 clients evaluated, within 3, 12, and 24 months of diagnosis, an estimated 14.0%, 24.3%, and 37.0% enrolled in HIV care, respectively, after adjusting for lost to follow-up and non-response. Kaplan-Meier functions indicated lower enrollment probability among clients 14-24 (P = 0.0001) and 25-29 (P = 0.001) years of age compared with clients >35 years of age. At 69 facilities to which clients were referred for HIV care, compliance with new linkage procedures was low: referral forms were located for less than half (46.8%) of the clients, and few (9.6%) were recorded in the appointment register or called either before (0.3%) or after (4.9%) their appointment. Of over one thousand clients newly HIV diagnosed in Swaziland in 2011 and 2012, few received linkage services in accordance with national procedures and most had not enrolled in HIV care two years after their diagnosis. Our findings are a call to action to improve linkage services and early enrollment in HIV care in Swaziland.

[Relapse prevention in drug addicts].

PubMed

Rácz, József

2013-12-01

The literature review deals with methods of relapse prevention. Relapse prevention is the key in the treatment of clients with drug addictions according to the transtheoretical model of change. If relapse prevention is more effective then not only the relapse would be prevented, but the client would leave the circulus vitiosus of relapses. Among psychotherapies cognitive behavioural methods are proven effective. Shorter forms of cognitive therapies are also available: for example, cognitive bias modification. Pharmacotherapy partly decreases craving of the clients or ceases the effects of psychoactive substances. Specific pharmacotherapeutic methods prevent relapses in a non-abstinent treatment design. Here the goal is not the abstinence in a short time, but the reduction of harms associated with drug use. In this way, a new target group of drug users can be involved in treatment.

Responsive persistence part I: therapist influence in postmodern practice.

PubMed

Sutherland, Olga; Turner, Jean; Dienhart, Anna

2013-10-01

Feminist and social constructionist developments in family therapy highlighted the importance of attending to therapist-client power relations and incorporating clients' understandings and preferences as a part of therapy. Significantly, less attention has been given to how postmodern therapists do use their power and influence. This is an important topic because it is therapists who have the major responsibility for guiding the interaction with clients and persisting in this so that change is facilitated. Therapist persistence in various forms and across dimensions of therapy process is examined to expand understanding of therapist influence in postmodern and collaborative work. An analysis of responsive persistence in a session with Karl Tomm as the therapist is presented to illustrate this conceptual framing. © 2013 American Association for Marriage and Family Therapy.

Collaborative Approach in Software Engineering Education: An Interdisciplinary Case

ERIC Educational Resources Information Center

Vicente, Aileen Joan; Tan, Tiffany Adelaine; Yu, Alvin Ray

2018-01-01

Aim/Purpose: This study was aimed at enhancing students' learning of software engineering methods. A collaboration between the Computer Science, Business Management, and Product Design programs was formed to work on actual projects with real clients. This interdisciplinary form of collaboration simulates the realities of a diverse Software…

3 CFR 13609 - Executive Order 13609 of May 1, 2012. Promoting International Regulatory Cooperation

Code of Federal Regulations, 2013 CFR

2013-01-01

... engage in various forms of collaboration and communication with respect to regulations, in particular a... as such in the Unified Agenda of Federal Regulatory and Deregulatory Actions, on RegInfo.gov, and on...

Find a Massage Therapist

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Building a secure internal attachment: an intra-relational approach to ego strengthening and emotional processing with chronically traumatized clients.

PubMed

Lamagna, Jerry; Gleiser, Kari A

2007-01-01

In this paper, we introduce Intra-Relational AEDP (I-R) as an attachment-based experiential approach to trauma treatment. Integrating Accelerated Experiential Dynamic Psychotherapy (AEDP) (Fosha, 2000a,b, 2002, 2003) with ego-state methodology, intra-relational interventions specifically seeks to help clients by (1) fostering capacities for self-regulation through shared states of affective resonance between therapist, client, and dissociated self-states; (2) facilitating authentic, open internal dialogue between self-states which can alter engrained patterns of intra-psychic conflict and self-punishment; (3) developing abilities for self-reflection and emotional processing by co-mingling previously disowned affect and emotional memories with here and now experience; and (4) attending to positive affects evoked through experiences of transformation, self-compassion, and self-affirmation. Drawing from object relations and attachment theory, intra-relational interventions places particular emphasis on internal attachment relationships formed through interactions between the client's subjective selves (internal subjects) and reflective selves (internal objects). Through visual imagery, internal dialogue, and explicit relational techniques, intra-relational interventions aims to develop this subjective-reflective dyad's capacity for reciprocal attunement, resonance, and responsiveness. Such clinical strategies aim to foster healing and psychological integration between the client and heretofore disavowed aspects of self.

Staff's attitudes and reactions towards aggressive behaviour of clients with intellectual disabilities: a multi-level study.

PubMed

Knotter, Maartje H; Wissink, Inge B; Moonen, Xavier M H; Stams, Geert-Jan J M; Jansen, Gerard J

2013-05-01

Data were collected from 121 staff members (20 direct support staff teams) on background characteristics of the individual staff members and their teams (gender, age, years of work experience, position and education), the frequency and form of aggression of clients with an intellectual disability (verbal or physical), staff members' attitudes towards aggression, and the types of behavioural interventions they executed (providing personal space and behavioural boundary-setting, restricting freedom and the use of coercive measures). Additionally, client group characteristics (age of clients, type of care and client's level of intellectual disability) were assessed. Multilevel analyses (individual and contextual level) were performed to examine the relations between all studied variables and the behavioural interventions. The results showed that for providing personal space and behavioural boundary-setting as well as for restricting freedom, the proportion of variance explained by the context (staff team and client group characteristics) was three times larger than the proportion of variance explained by individual staff member characteristics. For using coercive measures, the context even accounted for 66% of the variance, whereas only 8% was explained by individual staff member characteristics. A negative attitude towards aggression of the direct support team as a whole proved to be an especially strong predictor of using coercive measures. To diminish the use of coercive measures, interventions should therefore be directed towards influencing the attitude of direct support teams instead of individual staff members. Copyright © 2013 Elsevier Ltd. All rights reserved.

Intimate Partner Violence Is As Important As Client violence in Increasing Street-based Female Sex Workers’ Vulnerability to HIV in India

PubMed Central

Panchanadeswaran, Subadra; Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Latkin, Carl; Bentley, Margaret E.; Solomon, Suniti; Go, Vivian F.; Celentano, David

2008-01-01

Objectives There are no studies that examine street-based female sex workers’ vulnerability to HIV from both clients and intimate partners. This study documents street-based female sex workers’ experiences of client and intimate partners, examines the intersections of violence, alcohol use in condom use, and highlights survival strategies used to avert harm. Methods Ethnographic data were collected from 49 female sex workers though focus group discussions and in-depth interviews. Results Female sex workers experienced multifarious forms of severe client and intimate partner violence. Sexual coercion and forced group sex in the context of alcohol use posed formidable barriers for condom use negotiation. Further, traditional gender norms dictated women’s inabilities to negotiate condom-use with intimate partners. However, there was evidence of adoption of successful survival strategies in the face of danger and women’s positive evaluations of the benefits of sex work and their contributions to family well-being. Conclusions Harm reduction efforts with female sex workers need to account for their vulnerability to HIV from intimate partners in addition to clients. HIV prevention programmes need to include male clients in order to reduce harm among street-based female sex workers. There is an urgent need to build on sex workers’ strengths and involve them in designing individual level, community, and structural interventions that could help in reducing women’s vulnerability to intimate partner violence and HIV in India. PMID:18187314

Measuring smoking knowledge, attitudes and services (S-KAS) among clients in addiction treatment

PubMed Central

Guydish, Joseph; Tajima, Barbara; Chan, Mable; Delucchi, Kevin L.; Ziedonis, Douglas

2010-01-01

Background Addiction treatment programs are increasingly working to address prevalent and comorbid tobacco dependence in their service populations. However at present there are few published measurement tools, with known psychometric properties, that can be used to assess client-level constructs related to tobacco dependence in addiction treatment settings. Following on previous work that developed a staff-level survey instrument, this report describes the development and measurement characteristics of the Smoking Knowledge, Attitudes and Services (S-KAS) for use with clients in addiction treatment settings. Method 250 clients enrolled in residential drug abuse treatment programs were surveyed. Summary statistics were used to characterize both the participants and their responses, and exploratory factor analysis (EFA) was used to examine the underlying factor structure. Results Examination of the rotated factor pattern indicated that the latent structure was formed by one Knowledge factor, one Attitude factor, and two “service” factors reflecting Program Services and Clinician Services related to tobacco dependence. Standardized Cronbach’s alpha coefficients for the four scales were, respectively, .57, .75, .82 and .82. Conclusions The proposed scales have reasonably good psychometric characteristics, although the knowledge scale leaves room for improvement, and will allow researchers to quantify client knowledge, attitudes and services regarding tobacco dependence treatment. Researchers, program administrators, and clinicians may find the S-KAS useful in changing organizational culture and clinical practices related to tobacco addiction, help in program evaluation studies, and in tracking and improving client motivation. PMID:21055884

A Study Examining Compliance with the Anti-Tobacco Law Nb. 4207 Inside Taxis

PubMed Central

Öztürk, Burcu; Kosku, Hakan; Güven, İbrahim; Erdoğan, Beyza; Sarıtaş, Özge; Şanver, Tuğçe; Aslan, Dilek

2017-01-01

OBJECTIVES This observational study assessed compliance with the anti-tobacco Law Nb 4207 with regard to taxis in Çankaya district, Ankara. MATERIAL AND METHODS This descriptive study was conducted in Kızılay, Kuğulu, and Tandoğan intersections on January 18–23, 2016 between 9.00–11.00 and 14.00–16.00 hours in Ankara. Data regarding the status of the taxi (either cruising or not), smoking inside taxis, smoking status of the taxi drivers and/or clients, location of the clients in the taxi, presence of a child in the taxi, and status of the windows (open or not) were recorded using a data-gathering form. RESULTS Three thousand six hundred fifty-six taxis were evaluated, of which 79 (2.2%) taxi drivers were observed smoking. Clients were observed smoking in 17 taxis (1.3%). Ninety-four taxi drivers and/or clients (2.6%) were observed smoking. Taxi drivers smoked more frequently in the absence of a client. In addition, a smoking client influenced the taxi driver’s smoking status (p<0.001). CONCLUSION Violation of the anti-tobacco Law Nb 4207 was observed. In this regard, the number of inspections needs to be increased. Systematic training programs for the taxi drivers regarding the risks of tobacco should be a priority. Preventive studies concerning the hazards of passive smoking should be also conducted at a community level. PMID:29404168

Therapeutic alliance in psychological therapy for people with recent onset psychosis who use cannabis.

PubMed

Berry, Katherine; Gregg, Lynsey; Lobban, Fiona; Barrowclough, Christine

2016-05-01

This paper examines the role of therapeutic alliance in predicting outcomes in a Randomized Controlled Trial of Motivational Interviewing and Cognitive Behavioral Therapy (MICBT) for problematic cannabis use in recent onset psychosis. All clients were participating in a three arm pragmatic rater-blind randomized controlled trial of brief MICBT plus standard care compared with longer term MICBT plus standard care and standard care alone. Participants completed measures to assess clinical symptoms, global functioning and substance misuse at baseline, 4.5months, 9months and 18months. Clients and therapists completed the Working Alliance Inventory approximately one month into therapy. Client alliance data was available for 35 participants randomized to therapy and therapist alliance data was available for 52 participants randomized to therapy. At baseline, poorer client-rated alliance was associated with more negative symptoms, poorer insight and greater cannabis use, whereas poorer therapist-rated alliance was only associated with amount of cannabis used per cannabis using day. Alliance ratings were also positively associated with amount of therapy: client-rated alliance was higher in the longer compared to the briefer therapy; therapist-rated alliance was associated with greater number of sessions attended (controlling for type of therapy) and therapy completion. In predicting outcome, client-rated alliance predicted total symptom scores and global functioning scores at follow-up. Neither client nor therapist alliance predicted changes in substance misuse at any time point. Findings demonstrate that individuals with psychosis and substance misuse who form better alliances with their therapists gain greater benefits from therapy, at least in terms of improvements in global functioning. Copyright © 2016 Elsevier Inc. All rights reserved.

The Expressive Arts in Counseling. ERIC Digest.

ERIC Educational Resources Information Center

Gladding, Samuel T.

Art has played a part in the helping professions since ancient times. In recent times, there has been renewed interest in the use of the arts in counseling, especially art forms that are considered "expressive." Counselors can help their clients develop their potential through concrete and abstract verbal and nonverbal art forms. To do…

New Technology and Changing Organisational Forms: Implications for Managerial Control and Skills.

ERIC Educational Resources Information Center

Grimshaw, Damian; Cooke, Fang-Lee; Grugulis, Irena; Vincent, Steve

2002-01-01

Case studies of client relations in a call center and an information technology company's partnership with a government agency examined how new technology affects organizational structures and managerial control. Evidence suggests that new structures arise in tandem with technological changes and technology's use as a form of control differs in…

Journeys through the valley of death: multimethod psychological assessment and personality transformation in long-term psychotherapy.

PubMed

Finn, Stephen E

2011-03-01

The Psychodynamic Diagnostic Manual (PDM Task Force, 2006) is based on the assumption that an in-depth understanding of clients' underlying emotional, personality, and interpersonal patterns will facilitate their treatment. In this article I show how such an understanding can be achieved through multimethod psychological assessment, and how useful such information can be in long-term psychotherapy with high-achieving, successful clients who struggle with forming and maintaining intimate relationships. Such treatments are extremely difficult, because when these clients attach to their psychotherapists, many of them temporarily become more symptomatic. I illustrate these points with a detailed account of my long-term therapy with a resilient but highly traumatized young man. Repeated use of the Minnesota Multiphasic Personality Disorder-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and Rorschach with my client helped guide us in our work, and also helped create an important therapeutic "opening" into the underlying traumatic material. This and other experiences have convinced me that it is extremely useful for psychologists to have training in both assessment and psychotherapy.

Pedophilia-Themed Obsessive-Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention.

PubMed

Bruce, Simone Leavell; Ching, Terence H W; Williams, Monnica T

2018-02-01

Fears of sexually harming children are fairly common among clients suffering from obsessive-compulsive disorder (OCD), yet these symptoms are largely unrecognized and frequently misdiagnosed by mental health professionals. Specifically, clients with pedophilia-themed OCD (P-OCD) experience excessive worries and distressing intrusive thoughts about being sexually attracted to, and sexually violating, children. Expressing these concerns may provoke misjudgments from uninformed mental health professionals that a client is presenting instead with pedophilic disorder. This misdiagnosis and subsequent improper interventions can then contribute to increased fear, anxiety, and in many cases, depression, in affected clients. Therefore, it is imperative that mental health professionals first possess a good understanding of this common manifestation of OCD. As such, in this article, we described obsessions and compulsions typical of P-OCD, in order to inform the reader of the distinctive differences between P-OCD and pedophilic disorder. Information about how to assess for P-OCD symptoms is then provided, followed by suggestions on how to tailor aspects of exposure and response prevention to treat this specific form of OCD.

Access and accounting schemes of wireless broadband

NASA Astrophysics Data System (ADS)

Zhang, Jian; Huang, Benxiong; Wang, Yan; Yu, Xing

2004-04-01

In this paper, two wireless broadband access and accounting schemes were introduced. There are some differences in the client and the access router module between them. In one scheme, Secure Shell (SSH) protocol is used in the access system. The SSH server makes the authentication based on private key cryptography. The advantage of this scheme is the security of the user's information, and we have sophisticated access control. In the other scheme, Secure Sockets Layer (SSL) protocol is used the access system. It uses the technology of public privacy key. Nowadays, web browser generally combines HTTP and SSL protocol and we use the SSL protocol to implement the encryption of the data between the clients and the access route. The schemes are same in the radius sever part. Remote Authentication Dial in User Service (RADIUS), as a security protocol in the form of Client/Sever, is becoming an authentication/accounting protocol for standard access to the Internet. It will be explained in a flow chart. In our scheme, the access router serves as the client to the radius server.

Marketing and design of residential energy conservation programs for the elderly

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berry, L.; Schweitzer, M.; Freeman, E.

1988-02-01

This report describes barriers to energy conservation by the elderly. Because of these barriers, they have a greater need for programs that assist with the installation of energy-efficiency improvements. In response to this need, a number of specialized programs are operated for the elderly. This report contains descriptions of 39 energy conservation programs for the elderly. Telephone interviews were conducted with the managers of these programs to identify marketing techniques and organizational structures. Interagency networking, presentations and referrals are the most common methods of recruiting clients. Other marketing techniques in order of the frequency of use are: direct mail, billmore » inserts, television, radio, printed materials, and telemarketing. Many managers consider word-of-mouth advertising from satisfied clients the most effective form of marketing. Interagency networking and support (financial, structural and in-kind) can offer real advantages in the operation of conservation programs for the elderly. The use of specific marketing techniques is probably less important to success in recruiting clients than the degree of trust potential clients have in the sponsoring organization(s). 4 figs., 10 tabs.« less

Questions for Your Prospective Massage Therapist

MedlinePlus

... tools to market your massage practice, expand your business and improve your professional growth. Explore Career Guidance » Take Care of Your Practice Marketing Tools Client Experience/Intake Forms Self-Care Tips ...

Allosteric Regulation of the Hsp90 Dynamics and Stability by Client Recruiter Cochaperones: Protein Structure Network Modeling

PubMed Central

Blacklock, Kristin; Verkhivker, Gennady M.

2014-01-01

The fundamental role of the Hsp90 chaperone in supporting functional activity of diverse protein clients is anchored by specific cochaperones. A family of immune sensing client proteins is delivered to the Hsp90 system with the aid of cochaperones Sgt1 and Rar1 that act cooperatively with Hsp90 to form allosterically regulated dynamic complexes. In this work, functional dynamics and protein structure network modeling are combined to dissect molecular mechanisms of Hsp90 regulation by the client recruiter cochaperones. Dynamic signatures of the Hsp90-cochaperone complexes are manifested in differential modulation of the conformational mobility in the Hsp90 lid motif. Consistent with the experiments, we have determined that targeted reorganization of the lid dynamics is a unifying characteristic of the client recruiter cochaperones. Protein network analysis of the essential conformational space of the Hsp90-cochaperone motions has identified structurally stable interaction communities, interfacial hubs and key mediating residues of allosteric communication pathways that act concertedly with the shifts in conformational equilibrium. The results have shown that client recruiter cochaperones can orchestrate global changes in the dynamics and stability of the interaction networks that could enhance the ATPase activity and assist in the client recruitment. The network analysis has recapitulated a broad range of structural and mutagenesis experiments, particularly clarifying the elusive role of Rar1 as a regulator of the Hsp90 interactions and a stability enhancer of the Hsp90-cochaperone complexes. Small-world organization of the interaction networks in the Hsp90 regulatory complexes gives rise to a strong correspondence between highly connected local interfacial hubs, global mediator residues of allosteric interactions and key functional hot spots of the Hsp90 activity. We have found that cochaperone-induced conformational changes in Hsp90 may be determined by specific interaction networks that can inhibit or promote progression of the ATPase cycle and thus control the recruitment of client proteins. PMID:24466147

Allosteric regulation of the Hsp90 dynamics and stability by client recruiter cochaperones: protein structure network modeling.

PubMed

Blacklock, Kristin; Verkhivker, Gennady M

2014-01-01

The fundamental role of the Hsp90 chaperone in supporting functional activity of diverse protein clients is anchored by specific cochaperones. A family of immune sensing client proteins is delivered to the Hsp90 system with the aid of cochaperones Sgt1 and Rar1 that act cooperatively with Hsp90 to form allosterically regulated dynamic complexes. In this work, functional dynamics and protein structure network modeling are combined to dissect molecular mechanisms of Hsp90 regulation by the client recruiter cochaperones. Dynamic signatures of the Hsp90-cochaperone complexes are manifested in differential modulation of the conformational mobility in the Hsp90 lid motif. Consistent with the experiments, we have determined that targeted reorganization of the lid dynamics is a unifying characteristic of the client recruiter cochaperones. Protein network analysis of the essential conformational space of the Hsp90-cochaperone motions has identified structurally stable interaction communities, interfacial hubs and key mediating residues of allosteric communication pathways that act concertedly with the shifts in conformational equilibrium. The results have shown that client recruiter cochaperones can orchestrate global changes in the dynamics and stability of the interaction networks that could enhance the ATPase activity and assist in the client recruitment. The network analysis has recapitulated a broad range of structural and mutagenesis experiments, particularly clarifying the elusive role of Rar1 as a regulator of the Hsp90 interactions and a stability enhancer of the Hsp90-cochaperone complexes. Small-world organization of the interaction networks in the Hsp90 regulatory complexes gives rise to a strong correspondence between highly connected local interfacial hubs, global mediator residues of allosteric interactions and key functional hot spots of the Hsp90 activity. We have found that cochaperone-induced conformational changes in Hsp90 may be determined by specific interaction networks that can inhibit or promote progression of the ATPase cycle and thus control the recruitment of client proteins.

Neurosciences, empathy, and healthy interpersonal relationships: recent findings and implications for counseling psychology.

PubMed

Coutinho, Joana Fernandes; Silva, Patrícia Oliveira; Decety, Jean

2014-10-01

In this article, we define the construct of empathy and its relevance for counseling psychology. The importance of deficits in empathic processes for most of the psychological disorders is presented within the context of the social brain hypothesis (Frith, 2007). We provide a review of empirical research about the neural correlates of empathy in terms of both the central and peripheral nervous system. We present recent evidence on the cortical and subcortical regions involved in different dimensions of empathy-emotional contagion, cognitive and emotional empathy, and self-regulation. Regarding the autonomic correlates of empathy, we present evidence about the correlates of sympathetic arousal associated with empathic processes and review data supporting the idea of the physiological linkage or synchrony as indicator of empathy in interpersonal relationships. The implications of these findings for counseling psychology, particularly for the psychotherapist-client relationship and for context of intimate relationships or couples therapy, are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Therapist qualities preferred by sexual-minority individuals.

PubMed

Burckell, Lisa A; Goldfried, Marvin R

2006-01-01

Psychotherapy research concerning lesbian, gay, and bisexual (LGB) individuals has focused on matching clients on gender and sexual orientation, yet has not considered how factors such as therapeutic skill, presenting problem, and cohort membership may influence preference for therapists. This study was designed to identify those therapist qualities that sexual-minority individuals prefer and to determine how the presenting problem influences therapist choice. Forty-two nonheterosexual adults between 18 and 29 years old ranked 63 therapist characteristics from "Extremely Uncharacteristic" to "Extremely Characteristic" when seeking treatment for a problem in which their sexual orientation was salient and one in which it was not. The analyses of both conditions yielded clusters of items reflecting therapist characteristics that participants considered unfavorable, neutral, beneficial, and essential. Participants valued therapists who had LGB-specific knowledge as well as general therapeutic skills, whereas they indicated that they would avoid therapists who held heterocentric views. Application of these findings to clinical practice and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Outcome expectancy as a predictor of treatment response in cognitive behavioral therapy for public speaking fears within social anxiety disorder.

PubMed

Price, Matthew; Anderson, Page L

2012-06-01

Outcome expectancy, the extent that clients anticipate benefiting from therapy, is theorized to be an important predictor of treatment response for cognitive-behavioral therapy. However, there is a relatively small body of empirical research on outcome expectancy and the treatment of social anxiety disorder. This literature, which has examined the association mostly in group-based interventions, has yielded mixed findings. The current study sought to further evaluate the effect of outcome expectancy as a predictor of treatment response for public-speaking fears across both individual virtual reality and group-based cognitive-behavioral therapies. The findings supported outcome expectancy as a predictor of the rate of change in public-speaking anxiety during both individual virtual reality exposure therapy and group cognitive-behavioral therapy. Furthermore, there was no evidence to suggest that the impact of outcome expectancy differed across virtual reality or group treatments. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Another missed opportunity? Recognition of alcohol use problems by mental health providers.

PubMed

Freimuth, Marilyn

2008-09-01

Alcohol use problems (AUPs) are prevalent among people seeking psychotherapy. Despite mandates from managed care companies to routinely screen for AUPs, little is known about the screening practices of providers or their ability to identify AUPs based on presenting symptoms. Participants (N = 117) read two case vignettes and suggested initial diagnoses and questions they would ask in order to clarify a diagnosis. Participants were more likely to ask about substance use and diagnose an AUP when the vignette contained explicit reference to the client's substance use as compared to a vignette where the signs of an AUP were more subtle. In both vignettes, a mental health problem was a more likely diagnosis than an AUP. Neither participant attributes nor personal or professional experiences with AUPs reliably shaped responses to the vignettes. The findings are discussed in light of their implications for future research and improved training in addictions for mental health providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

What has psychotherapy inherited from Carl Rogers?

PubMed

Goldfried, Marvin R

2007-09-01

Rogers' classic article (see record 2007-14639-002) on the necessary and sufficient conditions for therapeutic change--now 50 years old--has made an indelible impact on the field. In his brief article, Rogers broke with the past, making a compelling case for the importance of subjecting our hypotheses about how therapy works to empirical test. Moreover, his emphasis on the importance of the therapy relationship is now routinely accepted as necessary, even if not sufficient for change to occur. Having moved beyond Rogers' necessary and sufficient conditions, the field of therapy now recognizes that as important as the therapy relationship might be, there are certain clinical problems that require the use of specific techniques to bring about change. Still, it is currently recognized that therapist acceptance is essential, that nondirective methods can be effective in improving client motivation, and perhaps most important, that the therapist needs to work toward the development of evidence-based interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Intrinsic motivation and organizational identification among on-demand workers.

PubMed

Rockmann, Kevin W; Ballinger, Gary A

2017-09-01

On-demand firms provide services for clients through a network of on-demand workers ready to complete specific tasks for a set contractual price. Given such on-demand work is defined by payment on short-term contracts with no obligation for continued employment, there is little reason to believe on-demand workers experience more than extrinsic motivation and a transactional relationship with the on-demand firm. However, using self-determination theory, we argue that to the degree that on-demand work fulfills innate psychological needs individual on-demand workers will develop intrinsic motivation, which further leads to organizational identification with the on-demand firm. Across 2 survey-based studies we find support for this path to organizational identification. This adds to the literature on motivation and identification by strengthening the link between individual needs and the individual-organizational relationship. Implications for theory and for the management of on-demand workers are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Facilitating congruence between religious beliefs and sexual identity with mindfulness.

PubMed

Tan, Erica S N; Yarhouse, Mark A

2010-12-01

With the increasing relevance of sexual minority concerns, including the process of navigating sexual and religious identities, clinical practice has focused on helping sexual minorities address methods of self-expression that are most congruent with the client's values. Sexual Identity Therapy (SIT), (Throckmorton & Yarhouse, 2006) has been developed to assist individuals who are seeking to address potential conflicts between religious and sexual identities by focusing on personal congruence. To facilitate this process, the practice of mindfulness is applied. As an adaptation from its spiritual origins, mindfulness is used to facilitate the treatment of various disorders, such as chronic pain, substance abuse, and depression. It has also been the crux of several different third-wave cognitive and behavioral therapies that consider the "… context and functions of psychological phenomena" (Hayes, 2004, p. 5) for the purpose of helping clients to develop "… broad, flexible and effective repertoires" (p. 6). In this instance, mindfulness is applied to SIT to assist individuals with same-sex attraction to become nonjudgmentally aware of their thoughts and feelings related to same-sex attraction such that they are able to experience their attractions in an open and honest manner without feeling compelled to either dismiss or augment these attractions. Mindful awareness of same-sex attraction facilitates congruence because there is less emphasis on changing behaviors, thoughts or feelings, but rather, changing the relationship the individual has to their experiences of same-sex attraction so that they are experienced as neutral, as opposed to aversive. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Condom utilization and sexual behavior of female sex workers in Northwest Ethiopia: A cross-sectional study.

PubMed

Tamene, Masresha Molla; Tessema, Gizachew Assefa; Beyera, Getahun Kebede

2015-01-01

Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers.

Coping, adapting or self-managing - what is the difference? A concept review based on the neurological literature.

PubMed

Audulv, Åsa; Packer, Tanya; Hutchinson, Susan; Roger, Kerstin S; Kephart, George

2016-11-01

The aim of this study was to report: (1) an analysis of the concepts of coping, adaptation and self-management in the context of managing a neurological condition; and (2) the overlap between the concepts. The three concepts are often confused or used interchangeably. Understanding similarities and differences between concepts will avoid misunderstandings in care. The varied and often unpredictable symptoms and degenerative nature of neurological conditions make this an ideal population in which to examine the concepts. Concept analysis. Articles were extracted from a large literature review about living with a neurological condition. The original searches were conducted using SCOPUS, EMBASE, CINAHL and Psych INFO. Seventy-seven articles met the inclusion criteria of: (1) original article concerning coping, adaptation or self-management of a neurological condition; (2) written in English; and (3) published between 1999-2011. The concepts were examined according to Morse's concept analysis method; structural elements were then compared. Coping and adaptation to a neurological condition showed statistically significant overlap with a common focus on internal management. In contrast, self-management appears to focus on disease-controlling and health-related management strategies. Coping appears to be the most mature concept, whereas self-management is least coherent in definition and application. All three concepts are relevant for people with neurological conditions. Healthcare teams need to be cautious when using these terms to avoid miscommunication and to ensure clients have access to all needed interventions. Viewing the three concepts as a complex whole may be more aligned with client experience. © 2016 John Wiley & Sons Ltd.

Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

PubMed

Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

2015-01-01

Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

Detection and Assessment of Ecosystem Regime Shifts from Fisher Information

EPA Science Inventory

Ecosystem regime shifts, which are long-term system reorganizations, have profound implications for sustainability. There is a great need for indicators of regime shifts, particularly methods that are applicable to data from real systems. We have developed a form of Fisher info...

Underweight and malnutrition in home care: A multicenter study.

PubMed

Lahmann, Nils A; Tannen, Antje; Suhr, Ralf

2016-10-01

This study aimed to provide representative figures about the prevalence of underweight and malnutrition among home care clients, and to determine the associated risk factors and the provided nutritional nursing interventions. In 2012, a multicenter point prevalence study was conducted among 878 randomly selected clients from 100 randomly selected home care services across Germany. Following a standardized study protocol, demographics, nutritional assessments (Body Mass Index, Malnutrition Universal Screening Tool (MUST), Mini nutritional Assessment - short form (MNA-sf), nurses' clinical judgment on nutritional status) and interventions were assessed. Common nutritional risk factors for underweight and malnutrition were analyzed in a logistic regression model. Malnutrition figures varied between 4.8% (MNA-sf) and 6.8% (MUST), underweight between 8.7% (BMI < 20 kg/m(2)) and 10.2% (clinical judgment). Missing values were high in both malnutrition assessments (MNA-sf 48.8%, MUST 39.1%) due to a lack of information on many clients' loss of weight within the past 3-6 months. Regular weighing was performed in 33.6-57.3% of all clients, depending on weight and nutritional status. Mental overload (OR 8.1/4.4), needs help with feeding (OR 5.0/2.8) and loss of appetite (OR 3.6/3.9) were highly associated with malnutrition/underweight. Malnutrition and underweight are important issues in home care clients. Regular weighing should be performed in all home care clients so that a potential weight loss can be detected in time. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

PubMed Central

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.

The taboo of politics in pastoral counseling.

PubMed

LaMothe, Ryan

2010-01-01

The political realities of society are present in counseling in subtle and overt ways. In this article, I argue that the client's (and counselor's) political experiences, beliefs, and commitments can be and, in many cases, should be explored. The idea of the political self or subjectivity and its identifying features and sources are described. I posit that political subjectivity forms through the processes of internalization, identification, and idealization. In identifying several reasons for the taboo of political discourse in pastoral counseling, I suggest a number of ways pastoral counselors may manage the political self in the counseling relationship. The three goals for exploring a client's political subjectivity for the client are: (1) to have a deeper and broader understanding of one's political beliefs, values, and commitments; (2) develop a more empathic understanding of the beliefs and experiences of Others; and (3) be able to take responsibility for the harm that results from one's political commitments.

Illness and the disruption of autobiography: accounting for the complex effect of awareness in schizophrenia.

PubMed

Lysaker, Paul H; Buck, Kelly D

2007-09-01

Interventions for individuals with schizophrenia often involve helping clients become more aware of their condition so they can make informed decisions about their treatment and recovery. Yet the effect of awareness or admission of schizophrenia has remained elusive. Empirical research has found that awareness of illness is essential for people to make informed decisions about the future, to free themselves from blame for difficulties linked with illness, and to form and sustain bonds with others. However, this awareness has also been linked to depressed mood, lower self-esteem, and a diminished sense of well-being. In this article, we review the evidence and suggest that the effect of awareness on well-being may be mitigated by the meaning clients assign to their illness and whether it disrupts their life story. Evidence linking clients' internalized, stigmatizing beliefs about illness with demoralization is presented, and clinical implications are discussed.

Astrological counseling in contemporary India.

PubMed

Pugh, J F

1983-09-01

Astrological counseling constitutes an important but relatively unexplored sector of India's medical and psychiatric traditions. The present paper provides a critique of studies of divination-as-therapy and presents a symbolic or phenomenological approach to the analysis of astrology as a form of situation-focused counseling. Three arts of medicine--the art of dialogue, the art of prediction, and the art of remedy--organize the therapeutic effectiveness of the counseling session. In analyzing these arts, the discussion extends the idea of performative efficacy by developing the concept of "therapeutic space," defining it as the topographical framework which encompasses both the scene of the advisory session and the scene of the client's everyday life. The experiential continuities which are established in this space are constituted through imaginal activity, which is indigenously understood as "picturing" the client's situation. The discussion focuses on the text of an advisory session between an astrologer and his politician-client in the city of Banaras.

The nexus between OSH and subcontracting.

PubMed

Nunes, Isabel L

2012-01-01

Subcontracting of specialized functions to external companies (e.g. cleaning or maintenance) is actually very common within several industries. These external companies' are called contractors and their contracting is often designated as outsourcing. Frequently contractors involve other companies (the sub-contractors) to assist them in fulfilling the contract, resulting in a complex chain of organizations focused on interchange of work - the contracting chain. Therefore in the same work site can coexist workers form the client-company and workers from the contractors and/or subcontractors. Since contractors perform their job in client's facilities, they can be exposed to hazards that are unknown to them. On other hand, workers of the client company can also be exposed to hazardous situations derived from the work performed by the contractors. The paper discusses how adequate occupational safety and health conditions can be assured when dealing with this kind of dynamic labor networks. Two case-studies and several examples coming from international literature will be presented.

A comprehensive and efficient process for counseling patients desiring sterilization.

PubMed

Haws, J M; Butta, P G; Girvin, S

1997-06-01

To optimize the time spent counseling a sterilization patient, this article presents a 10-step process that includes all steps necessary to ensure a comprehensive counseling session: (1) Discuss current contraception use and all available methods; (2) assess the client's interest in/readiness for sterilization; (3) emphasize that the procedure is meant to be permanent, but there is a possibility of failure; (4) explain the surgical procedure using visuals, and include a discussion of benefits and risks; (5) explain privately to the client the need to use condoms if engaging in risky sexual activity; (6) have the client read and sign an informed consent form; (7) schedule an appointment for the procedure and provide the patient with a copy of all necessary paperwork; (8) discuss cost and payment method; (9) provide written preoperative and postoperative instructions; and (10) schedule a postoperation visit, or a postoperation semen analysis.

Is ownership the decisive factor in collaborations between occupational health services and client companies?

PubMed

Schmidt, Lisa; Sjöström, John; Antonsson, Ann-Beth

2017-01-01

Swedish employers are required to use external resources such as Occupational Health Services (OHS providers) if their own knowledge of occupational health and safety is insufficient. Some large employers have their own in-house OHS units but it is more common to engage the services of an external provider. However, no studies have been carried out from a critical perspective regarding how ownership of the OHS provider is related to a successful collaboration with client companies. This study explores the extent to which the six key factors for a successful collaboration are related to ownership and seeks to identify the challenges that the different models of ownership pose. Interviews with 15 client companies and their OHS providers were conducted in order to identify key factors in achieving a successful collaboration with an OHS provider. This study utilizes existing data to identify challenges related to ownership. Two key factors were identified with challenges related to ownership of the OHS provider: The importance of having a long-term perspective when building a relationship; and ensuring that collaboration extends beyond the client's HR Department to the various organisational levels of the company. Whatever form the ownership of an OHS provider may take, each comes with its own specific set of challenges that must be managed in order to achieve a successful collaboration with the client company.

Sex workers in Kenya, numbers of clients and associated risks: an exploratory survey.

PubMed

Elmore-Meegan, Michael; Conroy, Ronán M; Agala, C Bernard

2004-05-01

In Kenya in 1999, an estimated 6.9% of women nationally said they had exchanged sex for money, gifts or favours in the previous year. In 2000 and 2001, in collaboration with sex workers who had formed a network of self-help groups, we conducted an exploratory survey among 475 sex workers in four rural towns and three Nairobi townships, regarding where they worked, the number of clients they had and the risks they were exposed to. Participants were identified by a network of social contacts in the seven centres. Most of the women (88%) worked from bars, hotels, bus stages and discos; 57% lived with a stable partner and almost 90% had dependent children. In the previous month, 17% had been assaulted and 35% raped by clients. Unwanted pregnancy was common; 86% had had at least one abortion. Compared with women in rural towns, township sex workers were younger (median age 22 vs. 26), saw more clients (median 9 vs. 4 per week) and earned more from sex work (up to 63-90 euros vs. 12 euros per week). Issues of alternative sources of income, safety for sex workers and the conditions which create the necessity for sex work are vital to address. The question of number of clients and the nature of sex work have obvious implications for HIV/STI prevention policy.

Cooperative processing data bases

NASA Technical Reports Server (NTRS)

Hasta, Juzar

1991-01-01

Cooperative processing for the 1990's using client-server technology is addressed. The main theme is concepts of downsizing from mainframes and minicomputers to workstations on a local area network (LAN). This document is presented in view graph form.

The Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client version and hypnotizability.

PubMed

Green, Joseph P

2012-01-01

Abstract The present study examined responses on the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client (VSABTH-C) version among a sample of American college students (N = 448) and explored the relationship between VSABTH-C factor scores and measures of hypnotizability, fantasy proneness, and absorption. Scores across three factors (i.e., help, interest, and marginal factors) accounted for 12% of the variance in responsiveness to suggestions administered from the Harvard Group Scale of Hypnotic Susceptibility, Form A. Normative data on the VSABTH-C factors by hypnotizability level and individual VSABTH-C item factor loadings are provided.

Storm Warning Service

NASA Technical Reports Server (NTRS)

1993-01-01

A Huntsville meteorologist of Baron Services, Inc. has formed a commercial weather advisory service. Weather information is based on data from Marshall Space Flight Center (MSFC) collected from antennas in Alabama and Tennessee. Bob Baron refines and enhances MSFC's real time display software. Computer data is changed to audio data for radio transmission, received by clients through an antenna and decoded by computer for display. Using his service, clients can monitor the approach of significant storms and schedule operations accordingly. Utilities and emergency management officials are able to plot a storm's path. A recent agreement with two other companies will promote continued development and marketing.

Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: a systematic review of the literature.

PubMed

Wafula, Francis N; Miriti, Eric M; Goodman, Catherine A

2012-07-27

Specialized drug shops such as pharmacies and drug shops are increasingly becoming important sources of treatment. However, knowledge on their regulatory performance is scarce. We set out to systematically review literature on the characteristics, knowledge and practices of specialized drug shops in Sub-Saharan Africa. We searched PubMed, EMBASE, WEB of Science, CAB Abstracts, PsycINFO and websites for organizations that support medicine policies and usage. We also conducted open searches using Google Scholar, and searched manually through references of retrieved articles. Our search included studies of all designs that described characteristics, knowledge and practices of specialized drug shops. Information was abstracted on authors, publication year, country and location, study design, sample size, outcomes investigated, and primary findings using a uniform checklist. Finally, we conducted a structured narrative synthesis of the main findings. We obtained 61 studies, mostly from Eastern Africa, majority of which were conducted between 2006 and 2011. Outcome measures were heterogeneous and included knowledge, characteristics, and dispensing and regulatory practices. Shop location and client demand were found to strongly influence dispensing practices. Whereas shops located in urban and affluent areas were more likely to provide correct treatments, those in rural areas provided credit facilities more readily. However, the latter also charged higher prices for medicines. A vast majority of shops simply sold whatever medicines clients requested, with little history taking and counseling. Most shops also stocked popular medicines at the expense of policy recommended treatments. Treatment policies were poorly communicated overall, which partly explained why staff had poor knowledge on key aspects of treatment such as medicine dosage and side effects. Overall, very little is known on the link between regulatory enforcement and practices of specialized drug shops. Evidence suggests that characteristics and practices of specialized drug shops differ across rural and urban locations, and that these providers are highly responsive to client demand. However, there is a dearth in knowledge on how regulatory enforcement influences their characteristics and practices, and what strategies can be employed to strengthen the governance of the retail pharmaceutical sector.

Geosciences Information Network (GIN): A modular, distributed, interoperable data network for the geosciences

NASA Astrophysics Data System (ADS)

Allison, M.; Gundersen, L. C.; Richard, S. M.; Dickinson, T. L.

2008-12-01

A coalition of the state geological surveys (AASG), the U.S. Geological Survey (USGS), and partners will receive NSF funding over 3 years under the INTEROP solicitation to start building the Geoscience Information Network (www.geoinformatics.info/gin) a distributed, interoperable data network. The GIN project will develop standardized services to link existing and in-progress components using a few standards and protocols, and work with data providers to implement these services. The key components of this network are 1) catalog system(s) for data discovery; 2) service definitions for interfaces for searching catalogs and accessing resources; 3) shared interchange formats to encode information for transmission (e.g. various XML markup languages); 4) data providers that publish information using standardized services defined by the network; and 5) client applications adapted to use information resources provided by the network. The GIN will integrate and use catalog resources that currently exist or are in development. We are working with the USGS National Geologic Map Database's existing map catalog, with the USGS National Geological and Geophysical Data Preservation Program, which is developing a metadata catalog (National Digital Catalog) for geoscience information resource discovery, and with the GEON catalog. Existing interchange formats will be used, such as GeoSciML, ChemML, and Open Geospatial Consortium sensor, observation and measurement MLs. Client application development will be fostered by collaboration with industry and academic partners. The GIN project will focus on the remaining aspects of the system -- service definitions and assistance to data providers to implement the services and bring content online - and on system integration of the modules. Initial formal collaborators include the OneGeology-Europe consortium of 27 nations that is building a comparable network under the EU INSPIRE initiative, GEON, Earthchem, and GIS software company ESRI. OneGeology-Europe and GIN have agreed to integrate their networks, effectively adopting global standards among geological surveys that are available across the entire field. ESRI is creating a Geology Data Model for ArcGIS software to be compatible with GIN, and other companies are expressing interest in adapting their services, applications, and clients to take advantage of the large data resources planned to become available through GIN.

SSWAP: A Simple Semantic Web Architecture and Protocol for semantic web services

PubMed Central

Gessler, Damian DG; Schiltz, Gary S; May, Greg D; Avraham, Shulamit; Town, Christopher D; Grant, David; Nelson, Rex T

2009-01-01

Background SSWAP (Simple Semantic Web Architecture and Protocol; pronounced "swap") is an architecture, protocol, and platform for using reasoning to semantically integrate heterogeneous disparate data and services on the web. SSWAP was developed as a hybrid semantic web services technology to overcome limitations found in both pure web service technologies and pure semantic web technologies. Results There are currently over 2400 resources published in SSWAP. Approximately two dozen are custom-written services for QTL (Quantitative Trait Loci) and mapping data for legumes and grasses (grains). The remaining are wrappers to Nucleic Acids Research Database and Web Server entries. As an architecture, SSWAP establishes how clients (users of data, services, and ontologies), providers (suppliers of data, services, and ontologies), and discovery servers (semantic search engines) interact to allow for the description, querying, discovery, invocation, and response of semantic web services. As a protocol, SSWAP provides the vocabulary and semantics to allow clients, providers, and discovery servers to engage in semantic web services. The protocol is based on the W3C-sanctioned first-order description logic language OWL DL. As an open source platform, a discovery server running at (as in to "swap info") uses the description logic reasoner Pellet to integrate semantic resources. The platform hosts an interactive guide to the protocol at , developer tools at , and a portal to third-party ontologies at (a "swap meet"). Conclusion SSWAP addresses the three basic requirements of a semantic web services architecture (i.e., a common syntax, shared semantic, and semantic discovery) while addressing three technology limitations common in distributed service systems: i.e., i) the fatal mutability of traditional interfaces, ii) the rigidity and fragility of static subsumption hierarchies, and iii) the confounding of content, structure, and presentation. SSWAP is novel by establishing the concept of a canonical yet mutable OWL DL graph that allows data and service providers to describe their resources, to allow discovery servers to offer semantically rich search engines, to allow clients to discover and invoke those resources, and to allow providers to respond with semantically tagged data. SSWAP allows for a mix-and-match of terms from both new and legacy third-party ontologies in these graphs. PMID:19775460

Systematic review of interventions to increase the provision of care for chronic disease risk behaviours in mental health settings: review protocol.

PubMed

Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wolfenden, Luke; Regan, Timothy; Dray, Julia; Bailey, Jacqueline; Bowman, Jenny

2018-04-30

People with a mental illness experience a higher morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of risk behaviours, including tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity, is a substantial contributor to this health inequity. Clinical practice guidelines recommend that mental health services routinely provide care to their clients to address these risk behaviours. Such care may include the following elements: ask, assess, advise, assist and arrange (the '5As'), which has been demonstrated to be effective in reducing risk behaviours. Despite this potential, the provision of such care is reported to be low internationally and in Australia, and there is a need to identify effective strategies to increase care provision. The proposed review will examine the effectiveness of interventions which aimed to increase care provision (i.e. increase the proportion of clients receiving or clinicians providing the 5As) for the chronic disease risk behaviours of clients within the context of mental health service delivery. Eligible studies will be any quantitative study designs with a comparison group and which report on the effectiveness of an intervention strategy (including delivery arrangements, financial arrangements, governance arrangements and implementation strategies) to increase care provision specifically for chronic disease risk behaviours (tobacco smoking, poor nutrition, harmful alcohol consumption and physical inactivity). Screening for studies will be conducted across seven electronic databases: PsycINFO, MEDLINE, Excerpta Medica database (EMBASE), Psychology and Behavioural Sciences Collection, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Two authors will independently screen studies for eligibility and extract data from included studies. Where studies are sufficiently homogenous, meta-analysis will be performed. Where considerable heterogeneity exists (I 2  ≥ 75), narrative synthesis will be used. This review will be the first to synthesise evidence for the effectiveness of intervention approaches to facilitate care provision for chronic disease risk behaviours in the context of mental health service delivery. The results have the potential to inform the development of evidenced-based approaches to address the health inequities experienced by this population group. PROSPERO CRD42017074360 .

'Meatball searching' - The adversarial approach to online information retrieval

NASA Technical Reports Server (NTRS)

Jack, R. F.

1985-01-01

It is proposed that the different styles of online searching can be described as either formal (highly precise) or informal with the needs of the client dictating which is most applicable at a particular moment. The background and personality of the searcher also come into play. Particular attention is focused on meatball searching which is a form of online searching characterized by deliberate vagueness. It requires generally comprehensive searches, often on unusual topics and with tight deadlines. It is most likely to occur in search centers serving many different disciplines and levels of client information sophistication. Various information needs are outlined as well as the laws of meatball searching and the adversarial approach. Traits and characteristics important to sucessful searching include: (1) concept analysis, (2) flexibility of thinking, (3) ability to think in synonyms and (4) anticipation of variant word forms and spellings.

An Assessment Instrument for Identifying Counseling Needs of Elementary-Aged Students: The Multimodal Sentence Completion Form for Children (MSCF-C).

ERIC Educational Resources Information Center

Gamble, Charles W.; Hamblin, Arthur G.

1986-01-01

Discusses the use of a sentence completion instrument predicated on Lazarus' multimodal system. The instrument, entitled The Multimodal Sentence Completion Form for Children (MSCF-C), is designed to systematically assess client needs and assist in identifying intervention strategies. Presents a case study of a 12-year-old, sixth-grade student.…

Poker Flats Mine - Div. of Mining, Land, and Water

Science.gov Websites

Lands Coal Regulatory Program Large Mine Permits Mineral Property and Rights Mining Index Land Fishery Water Resources Factsheets Forms banner image of landscape Poker Flats Mine Home Mining Coal Regulatory Program Poker Flats Mine Mining Coal Regulatory Program Info Chickaloon Chuit Watershed Chuitna

Employee Health Plan Details | Alaska Division of Retirement and Benefits

Science.gov Websites

Health Information Life Disability DCAP Forms/Publications Features Empower Retirement Account Info Home Retirement Benefits Employer Services AlaskaCare Easy Navigation Employee Health Gym Discount Health Plan FAQs Overview What Plan am I in? Information Enrollment Information FAQs Premiums Qualified

Retiree Health and Optional Benefits | Alaska Division of Retirement and

Science.gov Websites

Categories Health Long-Term Care Life Forms Publications FAQs Features Empower Retirement Account Info Online Retirement Benefits Employer Services AlaskaCare Easy Navigation Retiree Health AlaskaCare Retiree Health Retiree Tax Implications FAQs Administration > Division of Retirement and Benefits > Health and

78 FR 46256 - Adoption of Updated EDGAR Filer Manual

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... (202) 551-3600; in the Division of Trading and Markets for questions concerning Form 13H contact...://www.sec.gov/info/edgar.shtml . You can also inspect the document at the National Archives and Records...: http://www.archives.gov/federal_register/code_of_federal_regulations/ibr_locations.html . By the...

Clients with chronic conditions: community nurse role in a multidisciplinary team.

PubMed

Wilkes, Lesley; Cioffi, Jane; Cummings, Joanne; Warne, Bronwyn; Harrison, Kathleen

2014-03-01

To define and validate the role of the community nurse in a multidisciplinary team caring for clients with chronic and complex needs. A key factor in optimising care for clients with chronic and complex conditions in the community is the use of multidisciplinary teams. A team approach is more effective as it enables better integration of services. The role of the community nurse in the multidisciplinary team has as yet not been delineated. A modified Delphi technique was used in this study. A group of 17 volunteer registered nurses who were experienced in the care of clients with chronic conditions and complex care needs in the community formed a panel of experts. Experts were emailed a series of three questionnaires. Main findings show that the role of the community nurse in a multidisciplinary team for clients with chronic conditions has six main domains - advocate, supporter, coordinator, educator, team member and assessor. A consensus on the role of the community nurse in the multidisciplinary team is described. The six key role domains reaffirm the generic role of the nurse and the validation of the role clarifies and reinforces the centrality of the community nurse in the team. Further refinement of the community nurse role is indicated to increase comprehensiveness of role descriptors particularly for the role domain, advocate. Community nurses working in multidisciplinary teams caring for clients with chronic conditions can define their role as a team member. The working relationship of the community nurse with other health professionals in the multidisciplinary team as a key approach to more integrated care for clients and carers enables the use of this approach to be better understood by all team members. With this increased understanding, community nurses are in a position to build stronger and more effective care teams. © 2013 John Wiley & Sons Ltd.

An evaluation of a family planning mobile job aid for community health workers in Tanzania.

PubMed

Braun, Rebecca; Lasway, Christine; Agarwal, Smisha; L'Engle, Kelly; Layer, Erica; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa

2016-07-01

The global rapid growth in mobile technology provides unique opportunities to support community health workers (CHWs) in providing family planning (FP) services. FHI 360, Pathfinder International and D-tree International developed an evidence-based mobile job aid to support CHW counseling, screening, service provision and referrals, with mobile forms for client and service data, and text-message reporting and reminders. The purpose of this study is to evaluate the acceptability and potential benefits to service quality from the perspective of CHWs and their clients. The mobile job aid was piloted in Dar es Salaam, Tanzania. Data collection tools included a demographic survey of all 25 CHWs trained to use the mobile job aid, in-depth interviews with 20 of the CHWs after 3 months and a survey of 176 clients who received FP services from a CHW using the mobile job aid after 6 months. Both CHWs and their clients reported that the mobile job aid was a highly acceptable FP support tool. CHWs perceived benefits to service quality, including timelier and more convenient care; better quality of information; increased method choice; and improved privacy, confidentiality and trust with clients. Most clients discussed multiple FP methods with CHWs; only 1 in 10 clients reported discussion of all 9 methods. This research suggests that mobile phones can be effective tools to support CHWs with FP counseling, screening and referrals, data collection and reporting, and communication. Challenges remain to support informed contraceptive choice. Future research should focus on implementation, including scale-up and sustainability. Mobile job aids can uniquely enhance FP service provision at the community level through adherence to standard protocols, real-time feedback and technical assistance, and provision of confidential care. This study can inform future efforts to support and expand the role of CHWs in increasing FP access and informed contraceptive choice. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of a tinnitus management programme: a 2-year follow-up study

PubMed Central

Gudex, Claire; Skellgaard, Preben H; West, Torben; Sørensen, Jan

2009-01-01

Background Tinnitus impairs the possibility of leading a normal life in 0.5–1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC) in southern Denmark. The aims of this exploratory study were to examine i) the characteristics of CHC's clients and their tinnitus, ii) the effectiveness of the treatment, and iii) whether particular client groups benefit more than others. Methods One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI) three times – before their first consultation, after one month and after 1–2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points). Results At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5–34.2) vs. 37.2 (CI 33.1–37.2), p < 0.01. The programme achieved a clinically important difference for 27% and 24% of the clients one month and 1–2 years after the first consultation, respectively. It appeared that greater improvement in THI score was related to higher baseline THI score and possibly also to treatment by a particular CHC therapist. The absolute reduction in mean THI score after 1–2 years for clients with moderate and severe handicap was 14 and 20 points, respectively, i.e. similar to that previously reported for TRT (14–28 points). The cost of the current programme was approximately 200 EUR per client. Conclusion The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches. PMID:19558680

The rehabilitation plan can support clients' active engagement and facilitate the process of change - experiences from people with late effects of polio participating in a rehabilitation programme.

PubMed

Lexell, Eva Månsson; Lexell, Jan; Larsson-Lund, Maria

2016-01-01

To explore how the rehabilitation plan influences the rehabilitation process and its outcome in people with late effects of polio participating in an individualised goal-oriented interdisciplinary rehabilitation programme. Four women and two men with late effects of polio were interviewed before rehabilitation, at discharge, and at follow-up. Data were analysed according to the constant comparative method of grounded theory. The participants' experiences formed one core category: "The same starting point but different rehabilitation processes". Before rehabilitation, all participants experienced a similar starting point: Naïve understanding of rehabilitation. During rehabilitation, two separate processes followed. Four participants experienced their rehabilitation as being a mutually shared process that led to a process of change. They were actively engaged, using the rehabilitation plan, and working towards goals targeting a broad perspective of daily activities. The remaining two participants experienced their rehabilitation as a staff-directed process, with limited use of the rehabilitation plan, focusing on goals mainly related to body functions and self-care, not leading to any substantial changes. When clients experience that they develop a mutually shared rehabilitation process, based on a rehabilitation plan, they became more engaged in their rehabilitation and gained a better understanding of their participation during the process. Knowledge of the differences in how clients use the rehabilitation plan during the rehabilitation process can support their active engagement during rehabilitation. This, in turn, can promote a more holistic view among clients and professionals during the rehabilitation for people with late effects of polio. Implications for Rehabilitation Clients who experience a rehabilitation that is mutually shared with professionals, have a better understanding of their engagement during the rehabilitation process. When clients and professionals use the rehabilitation plan as a mutual tool, clients become more actively engaged in their rehabilitation process. A structured rehabilitation plan can serve as a map, and support clients' process of change during the rehabilitation process, also after the rehabilitation period is completed.

Tanning salons in Santiago, Chile: the knowledge of the staff in charge and the quality of information provided to potential clients before and after a new regulatory law.

PubMed

Salomone, Claudia; Majerson, Daniela; Molgó, Montserrat; de Santa María, Mariá Luisa Sáenz; Romero, William

2009-04-01

In recent years, the use of artificial tanning devices has become very popular in Chile. In April, 2007, a new law was established to regulate the non-medical use of tanning beds and tanning booths. The aim of this study was to evaluate the level and quality of information provided by tanning salon staff to clients before deciding on using the services. This information was collected before and 6 months after the law was enacted by researchers visiting tanning salons posing as potential clients. Using a previously designed questionnaire, 24 tanning salons in Santiago, Chile, were evaluated by researchers acting as potential customers without experience with artificial tanning devices. Employees were questioned using a hidden questionnaire before and 6 months after enactment of the law. Before the law, 25% of the establishments gave spontaneous information about the risks of using tanning beds, which increased to 45.8% after enactment of the law. Clients never received written information, either before or after enactment of the law. On both evaluations, more than 1/3 of the employees affirmed that there were no risks in using tanning beds. Before enactment of the law, only 12.5% of the tanning salons required the use of goggles, while after the law, this increased to 25% (P=NS). Only two establishments required that clients sign an informed consent form after enactment of the law. The level of knowledge among employees in tanning salons was very low and the quality of the information they provided to the clients was very poor. It was important to legislate on ultraviolet tanning services, but at present, the impact of the law has been very limited.

Youth Top Problems: using idiographic, consumer-guided assessment to identify treatment needs and to track change during psychotherapy.

PubMed

Weisz, John R; Chorpita, Bruce F; Frye, Alice; Ng, Mei Yi; Lau, Nancy; Bearman, Sarah Kate; Ugueto, Ana M; Langer, David A; Hoagwood, Kimberly E

2011-06-01

To complement standardized measurement of symptoms, we developed and tested an efficient strategy for identifying (before treatment) and repeatedly assessing (during treatment) the problems identified as most important by caregivers and youths in psychotherapy. A total of 178 outpatient-referred youths, 7-13 years of age, and their caregivers separately identified the 3 problems of greatest concern to them at pretreatment and then rated the severity of those problems weekly during treatment. The Top Problems measure thus formed was evaluated for (a) whether it added to the information obtained through empirically derived standardized measures (e.g., the Child Behavior Checklist [CBCL; Achenbach & Rescorla, 2001] and the Youth Self-Report [YSR; Achenbach & Rescorla, 2001]) and (b) whether it met conventional psychometric standards. The problems identified were significant and clinically relevant; most matched CBCL/YSR items while adding specificity. The top problems also complemented the information yield of the CBCL/YSR; for example, for 41% of caregivers and 79% of youths, the identified top problems did not correspond to any items of any narrowband scales in the clinical range. Evidence on test-retest reliability, convergent and discriminant validity, sensitivity to change, slope reliability, and the association of Top Problems slopes with standardized measure slopes supported the psychometric strength of the measure. The Top Problems measure appears to be a psychometrically sound, client-guided approach that complements empirically derived standardized assessment; the approach can help focus attention and treatment planning on the problems that youths and caregivers consider most important and can generate evidence on trajectories of change in those problems during treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

WFRC patrners: our extended family

USGS Publications Warehouse

Connolly, P.; Elliot, D.; Parsley, M.; Winton, J.

2007-01-01

For more than five decades the Western Fisheries Research Center (WFRC) has worked with partners to provide research findings to managers of aquatic resources. Those partners form an extended family, a network of clients, colleagues, co-investigators, and customers. Our partners include numerous clients in other Department of Interior bureaus such as the U.S. Fish and Wildlife Service, the U.S. Bureau of Reclamation, and the National Park Service. But there is much more--we have partners in other federal agencies, state agencies, and universities. The extended family includes tribal governments, and non-government organizations such as the Nature Conservancy and the Lower Columbia River Estuary Program.

Fulfillment of HTTP Authentication Based on Alcatel OmniSwitch 9700

NASA Astrophysics Data System (ADS)

Liu, Hefu

This paper provides a way of HTTP authentication On Alcatel OmniSwitch 9700. Authenticated VLANs control user access to network resources based on VLAN assignment and user authentication. The user can be authenticated through the switch via any standard Web browser software. Web browser client displays the username and password prompts. Then a way for HTML forms can be given to pass HTTP authentication data when it's submitted. A radius server will provide a database of user information that the switch checks whenever it tries to authenticate through the switch. Before or after authentication, the client can get an address from a Dhcp server.

A Study Investigating the Feasibility of Creating a Short Form of the WISC-R for Disabled Readers.

ERIC Educational Resources Information Center

Brown, David M.; Otts, David A.

The purpose of this study was to investigate the feasibility of creating a short form of the Wechsler Intelligence Scale for Children-Revised (WISC-R) for use in a clinical setting with disabled readers. The subjects were 100 clients ages six to sixteen of the Belser-Parton Reading Center at the University of Alabama whose files contained scores…

Patients satisfaction with laboratory services at antiretroviral therapy clinics in public hospitals, Addis Ababa, Ethiopia.

PubMed

Mindaye, Tedla; Taye, Bineyam

2012-07-04

Despite the fact that Ethiopia has scale up antiretroviral treatment (ART) program, little is known about the patient satisfaction with ART monitoring laboratory services in health facilities. We therefore aimed to assess patient satisfaction with laboratory services at ART clinics in public hospitals. Hospital based, descriptive cross sectional study was conducted from October to November 2010 among clients attending in nine public hospitals ART clinics in Addis Ababa Ethiopia. Patients' satisfaction towards laboratory services was assessed using exit interview structured questionnaire. Data were coded and entered using EPI info 2002 (Centers for Disease Control and Prevention Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC, Chicago, IL, USA). A total of 406 clients were involved in the study. Of these 255(62.8%) were females. The overall satisfaction rate for ART monitoring laboratory services was (85.5%). Patients were satisfied with measures taken by health care providers to keep confidentiality and ability of the person drawing blood to answer question (98.3% and 96.3% respectively). Moreover, the finding of this study revealed, statistical significant associations between the overall patients' satisfaction with waiting time to get blood drawing service, availability of ordered laboratory tests and waiting time to get laboratory result with (p < 0.05). Patients receiving blood drawing service less than 30 minute were 7.59 times (95% CI AOR: 3.92-14.70) to be more satisfied with ART monitoring laboratory services compared to those who underwent for more than 30 minutes. Overall, the satisfaction survey showed, most respondents were satisfied with ART monitoring laboratory services. However, factors such as improving accessibility and availability of latrines should be taken into consideration in order to improve the overall satisfaction.

Housing first on a large scale: Fidelity strengths and challenges in the VA's HUD-VASH program.

PubMed

Kertesz, Stefan G; Austin, Erika L; Holmes, Sally K; DeRussy, Aerin J; Van Deusen Lukas, Carol; Pollio, David E

2017-05-01

Housing First (HF) combines permanent supportive housing and supportive services for homeless individuals and removes traditional treatment-related preconditions for housing entry. There has been little research describing strengths and shortfalls of HF implementation outside of research demonstration projects. The U.S. Department of Veterans Affairs (VA) has transitioned to an HF approach in a supportive housing program serving over 85,000 persons. This offers a naturalistic window to study fidelity when HF is adopted on a large scale. We operationalized HF into 20 criteria grouped into 5 domains. We assessed 8 VA medical centers twice (1 year apart), scoring each criterion using a scale ranging from 1 ( low fidelity ) to 4 ( high fidelity ). There were 2 HF domains (no preconditions and rapidly offering permanent housing) for which high fidelity was readily attained. There was uneven progress in prioritizing the most vulnerable clients for housing support. Two HF domains (sufficient supportive services and a modern recovery philosophy) had considerably lower fidelity. Interviews suggested that operational issues such as shortfalls in staffing and training likely hindered performance in these 2 domains. In this ambitious national HF program, the largest to date, we found substantial fidelity in focusing on permanent housing and removal of preconditions to housing entry. Areas of concern included the adequacy of supportive services and adequacy in deployment of a modern recovery philosophy. Under real-world conditions, large-scale implementation of HF is likely to require significant additional investment in client service supports to assure that results are concordant with those found in research studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Measuring Patients' Experience of Rehabilitation Services Across the Care Continuum. Part II: Key Dimensions.

PubMed

McMurray, Josephine; McNeil, Heather; Lafortune, Claire; Black, Samantha; Prorok, Jeanette; Stolee, Paul

2016-01-01

To identify key dimensions of patients' experience across the rehabilitative care system and to recommend a framework to develop survey items that measure the rehabilitative care experience. Data were sourced from a literature review that searched MEDLINE (PubMed), CINAHL (Ebsco), and PsycINFO (APA PsycNET) databases from 2004 to 2014, the reference lists of the final accepted articles, and hand searches of relevant journals. Four reviewers performed the screening process on 2472 articles; 33 were included for analysis. Interrater reliability was confirmed through 2 rounds of title review and 1 round of abstract review, with an average κ score of .69. The final sample of 33 accepted articles was imported into a qualitative data analysis software application. Multiple levels of coding and a constant comparative methodology generated 6 themes. There were 502 discreet survey questions measuring patient experience that were categorized using the following dimensions: rehabilitative care ecosystem, client and informal caregiver engagement, patient and health care provider relation, pain and functional status, group and individual identity, and open ended. The most common survey questions examine the care delivery ecosystem (37%), the engagement of clients and their informal caregivers (24.9%), and the quality of relations between providers and patients (21.7%). Examination of patient's functional status and management of pain yielded (15.3%) of the instruments' questions. Currently available instruments and questions that measure patients' experience in rehabilitative care are unable to assess the performance of rehabilitative delivery systems that aspire to integrate care across the continuum. However, question panels derived from our 6 key themes may measure the key concepts that define rehabilitative care and facilitate measurement of patient experience at the system level. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Consumer-providers of care for adult clients of statutory mental health services.

PubMed

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

2013-03-28

In mental health services, the past several decades has seen a slow but steady trend towards employment of past or present consumers of the service to work alongside mental health professionals in providing services. However the effects of this employment on clients (service recipients) and services has remained unclear.We conducted a systematic review of randomised trials assessing the effects of employing consumers of mental health services as providers of statutory mental health services to clients. In this review this role is called 'consumer-provider' and the term 'statutory mental health services' refers to public services, those required by statute or law, or public services involving statutory duties. The consumer-provider's role can encompass peer support, coaching, advocacy, case management or outreach, crisis worker or assertive community treatment worker, or providing social support programmes. To assess the effects of employing current or past adult consumers of mental health services as providers of statutory mental health services. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2012, Issue 3), MEDLINE (OvidSP) (1950 to March 2012), EMBASE (OvidSP) (1988 to March 2012), PsycINFO (OvidSP) (1806 to March 2012), CINAHL (EBSCOhost) (1981 to March 2009), Current Contents (OvidSP) (1993 to March 2012), and reference lists of relevant articles. Randomised controlled trials of current or past consumers of mental health services employed as providers ('consumer-providers') in statutory mental health services, comparing either: 1) consumers versus professionals employed to do the same role within a mental health service, or 2) mental health services with and without consumer-providers as an adjunct to the service. Two review authors independently selected studies and extracted data. We contacted trialists for additional information. We conducted analyses using a random-effects model, pooling studies that measured the same outcome to provide a summary estimate of the effect across studies. We describe findings for each outcome in the text of the review with considerations of the potential impact of bias and the clinical importance of results, with input from a clinical expert. We included 11 randomised controlled trials involving 2796 people. The quality of these studies was moderate to low, with most of the studies at unclear risk of bias in terms of random sequence generation and allocation concealment, and high risk of bias for blinded outcome assessment and selective outcome reporting.Five trials involving 581 people compared consumer-providers to professionals in similar roles within mental health services (case management roles (4 trials), facilitating group therapy (1 trial)). There were no significant differences in client quality of life (mean difference (MD) -0.30, 95% confidence interval (CI) -0.80 to 0.20); depression (data not pooled), general mental health symptoms (standardised mean difference (SMD) -0.24, 95% CI -0.52 to 0.05); client satisfaction with treatment (SMD -0.22, 95% CI -0.69 to 0.25), client or professional ratings of client-manager relationship; use of mental health services, hospital admissions and length of stay; or attrition (risk ratio 0.80, 95% CI 0.58 to 1.09) between mental health teams involving consumer-providers or professional staff in similar roles.There was a small reduction in crisis and emergency service use for clients receiving care involving consumer-providers (SMD -0.34 (95%CI -0.60 to -0.07). Past or present consumers who provided mental health services did so differently than professionals; they spent more time face-to-face with clients, and less time in the office, on the telephone, with clients' friends and family, or at provider agencies.Six trials involving 2215 people compared mental health services with or without the addition of consumer-providers. There were no significant differences in psychosocial outcomes (quality of life, empowerment, function, social relations), client satisfaction with service provision (SMD 0.76, 95% CI -0.59 to 2.10) and with staff (SMD 0.18, 95% CI -0.43 to 0.79), attendance rates (SMD 0.52 (95% CI -0.07 to 1.11), hospital admissions and length of stay, or attrition (risk ratio 1.29, 95% CI 0.72 to 2.31) between groups with consumer-providers as an adjunct to professional-led care and those receiving usual care from health professionals alone. One study found a small difference favouring the intervention group for both client and staff ratings of clients' needs having been met, although detection bias may have affected the latter. None of the six studies in this comparison reported client mental health outcomes.No studies in either comparison group reported data on adverse outcomes for clients, or the financial costs of service provision. Involving consumer-providers in mental health teams results in psychosocial, mental health symptom and service use outcomes for clients that were no better or worse than those achieved by professionals employed in similar roles, particularly for case management services.There is low quality evidence that involving consumer-providers in mental health teams results in a small reduction in clients' use of crisis or emergency services. The nature of the consumer-providers' involvement differs compared to professionals, as do the resources required to support their involvement. The overall quality of the evidence is moderate to low. There is no evidence of harm associated with involving consumer-providers in mental health teams.Future randomised controlled trials of consumer-providers in mental health services should minimise bias through the use of adequate randomisation and concealment of allocation, blinding of outcome assessment where possible, the comprehensive reporting of outcome data, and the avoidance of contamination between treatment groups. Researchers should adhere to SPIRIT and CONSORT reporting standards for clinical trials.Future trials should further evaluate standardised measures of clients' mental health, adverse outcomes for clients, the potential benefits and harms to the consumer-providers themselves (including need to return to treatment), and the financial costs of the intervention. They should utilise consistent, validated measurement tools and include a clear description of the consumer-provider role (eg specific tasks, responsibilities and expected deliverables of the role) and relevant training for the role so that it can be readily implemented. The weight of evidence being strongly based in the United States, future research should be located in diverse settings including in low- and middle-income countries.

DNR Recorder's Office

Science.gov Websites

Department of Natural Resources logo, color scheme Alaska Department of Natural Resources UCC Central Search Search DNR's site DNR State of Alaska RO Home UCC Home Filing Info Fees Forms Online Filing Searches RO Search Menu UCC Search Menu *NEW* Online Copy Request FAQs Notices Contact Us State of Alaska / Natural

The Facebook Papers

ERIC Educational Resources Information Center

Balzhiser, Deborah; Grover, Mandy; Lauer, Evelyn; McNeely, Sarah; Polk, Jonathan D.; Zmikly, Jon; Holmes, Cade; Porter, Ellen; Saucier, Corey; Swearingen, Tiffany

2011-01-01

The purpose of this project was to explore and document one approach for integrating social media--Facebook, really--into freshman writing. The assignment using Facebook was first given in 2006 and twice more through 2009. Our report on the project takes the form of a network; the content is distributed across the wall, info, and notes sections of…

Cultural concepts of the person and mental health in Africa.

PubMed

Kpanake, Lonzozou

2018-04-01

People in different cultures have different concepts of the person that underlie self-understanding and self-representation. These concepts influence many aspects of individuals' life experience, including illness and expectations toward recovery. Psychotherapies aim to promote adaptive change in experience and behavior. This goal is embedded in a social and cultural context that promotes or sanctions a particular notion of personhood. If every system of psychotherapy depends on implicit models of personhood, which varies cross-culturally, then the goals and methods of therapeutic change must consider the cultural concept of the person. This paper reviews cultural concepts of the person in relation to communal values, practices, and systems of thought observed across many African cultural contexts. It presents a practical framework that can inform therapists working with African clients. Many African cultures promote a relational-oriented personhood, in which an individual manifests his or her personhood through connections to three distinct forms of agency: (a) spiritual agency, including God, ancestors, and spirits that influence the person; (b) social agency, including the family, the clan, and the community, with extension to humanity; and (c) self-agency, which is responsible for the person's inner experience. This distinctive form of personhood underlies concepts of the "normal" person, understandings of mental illness, help-seeking behavior, and clients' needs and expectations. Implications of this cultural concept of the person for psychotherapy with African clients are discussed.

Families, markets, and medicalization: the role of paid support for childbirth and breastfeeding.

PubMed

Torres, Jennifer M C

2015-07-01

Much attention has been given to the commercialization of care and its relationship to the outsourcing of family life, as well as larger social and cultural processes that can change the nature of caring. I engage with this question of why certain aspects of care are provided by the market, using 72 interviews with lactation consultants, doulas, clients, and clinicians, as well as 150 hours of ethnographic observation in the USA. Examining how participants understood the role of these services in the maternity care system and the reasons why clients turned to these services, I found that, in several ways, these forms of care work reflected outsourcing trends. However, lactation consultants and doulas were also acting as advocates and guides, helping their clients navigate the complex medical maternity system. This reflects a fundamental transformation in the nature of maternity support, attributed to the impact of medicalization, both historically and currently. © The Author(s) 2014.

Improvements to Autoplot's HAPI Support

NASA Astrophysics Data System (ADS)

Faden, J.; Vandegriff, J. D.; Weigel, R. S.

2017-12-01

Autoplot handles data from a variety of data servers. These servers communicate data in different forms, each somewhat different in capabilities and each needing new software to interface. The Heliophysics Application Programmer's Interface (HAPI) attempts to ease this by providing a standard target for clients and servers to meet. Autoplot fully supports reading data from HAPI servers, and support continues to improve as the HAPI server spec matures. This collaboration has already produced robust clients and documentation which would be expensive for groups creating their own protocol. For example, client-side data caching is introduced where Autoplot maintains a cache of data for performance and off-line use. This is a feature we considered for previous data systems, but we could never afford the time to study and implement this carefully. Also, Autoplot itself can be used as a server, making the data it can read and the results of its processing available to other data systems. Autoplot use with other data transmission systems is reviewed as well, outlining features of each system.

Conserved conformational selection mechanism of Hsp70 chaperone-substrate interactions

PubMed Central

Velyvis, Algirdas; Zoltsman, Guy; Rosenzweig, Rina; Bouvignies, Guillaume

2018-01-01

Molecular recognition is integral to biological function and frequently involves preferred binding of a molecule to one of several exchanging ligand conformations in solution. In such a process the bound structure can be selected from the ensemble of interconverting ligands a priori (conformational selection, CS) or may form once the ligand is bound (induced fit, IF). Here we focus on the ubiquitous and conserved Hsp70 chaperone which oversees the integrity of the cellular proteome through its ATP-dependent interaction with client proteins. We directly quantify the flux along CS and IF pathways using solution NMR spectroscopy that exploits a methyl TROSY effect and selective isotope-labeling methodologies. Our measurements establish that both bacterial and human Hsp70 chaperones interact with clients by selecting the unfolded state from a pre-existing array of interconverting structures, suggesting a conserved mode of client recognition among Hsp70s and highlighting the importance of molecular dynamics in this recognition event. PMID:29460778

SE Requirements Development Tool User Guide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benson, Faith Ann

2016-05-13

The LANL Systems Engineering Requirements Development Tool (SERDT) is a data collection tool created in InfoPath for use with the Los Alamos National Laboratory’s (LANL) SharePoint sites. Projects can fail if a clear definition of the final product requirements is not performed. For projects to be successful requirements must be defined early in the project and those requirements must be tracked during execution of the project to ensure the goals of the project are met. Therefore, the focus of this tool is requirements definition. The content of this form is based on International Council on Systems Engineering (INCOSE) and Departmentmore » of Defense (DoD) process standards and allows for single or collaborative input. The “Scoping” section is where project information is entered by the project team prior to requirements development, and includes definitions and examples to assist the user in completing the forms. The data entered will be used to define the requirements and once the form is filled out, a “Requirements List” is automatically generated and a Word document is created and saved to a SharePoint document library. SharePoint also includes the ability to download the requirements data defined in the InfoPath from into an Excel spreadsheet. This User Guide will assist you in navigating through the data entry process.« less

Computer based interpretation of infrared spectra-structure of the knowledge-base, automatic rule generation and interpretation

NASA Astrophysics Data System (ADS)

Ehrentreich, F.; Dietze, U.; Meyer, U.; Abbas, S.; Schulz, H.

1995-04-01

It is a main task within the SpecInfo-Project to develop interpretation tools that can handle a great deal more of the complicated, more specific spectrum-structure-correlations. In the first step the empirical knowledge about the assignment of structural groups and their characteristic IR-bands has been collected from literature and represented in a computer readable well-structured form. Vague, verbal rules are managed by introduction of linguistic variables. The next step was the development of automatic rule generating procedures. We had combined and enlarged the IDIOTS algorithm with the algorithm by Blaffert relying on set theory. The procedures were successfully applied to the SpecInfo database. The realization of the preceding items is a prerequisite for the improvement of the computerized structure elucidation procedure.

Phenomenological Inquiry into Phoenix Rising Yoga Therapy.

PubMed

Sneed, Jenilee; Hammer, Tonya

2018-04-26

There is growing recognition within psychology and other disciplines that body experience may be as important as cognitive and emotional experience. However, psychology has few psychotherapeutic interventions to support the integration of mind and body within therapy. Phoenix Rising Yoga Therapy (PRYT) is a form of mind-body therapy that uses yoga posture, touch, and psychotherapeutic dialogue to facilitate growth and healing. The current study explored the phenomenological experience of four women who each received five PRYT sessions. Research questions posed were: (1) What are the clients' experiences of the phenomena of PRYT? and (2) How does receiving PRYT sessions impact the clients' lives? The following themes emerged from the data as the essence of PRYT sessions: mindfulness, self-awareness, mind-body connection, in vivo experience of new behaviors, client-directed, empowerment, and life changes. These themes show significance in the mind-body connection and that it is important to consider alternative modalities such as PRYT for clients. Each participant noted greater insight into mind-body connection. They noticed the effect of cognition and emotion on the body, observed how the body can be used to improve coping through movement and breathing, and experienced different thoughts and emotions associated with different areas of their bodies. Although these results are not necessarily generalizable, they offer interesting theoretical implications for embodied interventions.

The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers.

PubMed

Polachek, Alicia J; Wallace, Jean E

2018-03-01

Compassionate work appears paradoxical as it may provide great rewards, but may also come at great costs to care providers. This paper explores the paradox of compassionate work by examining what interactions contribute to compassion satisfaction and what interactions contribute to compassion fatigue. This mixed-methods, cross-sectional study uses qualitative interview data from animal health care providers (N = 20) to identify work interactions that they find satisfying or stressful. Quantitative survey data (N = 572) are used to test hypotheses generated from the interviews regarding predictors of compassion satisfaction and compassion fatigue. Interview transcripts were analyzed using a directed content analysis approach. Survey data were analyzed using ordinary least squares regression. The results highlight the complex nature of compassionate work. As hypothesized, making a difference to animals and building relationships with animal patients and human clients relate to greater compassion satisfaction. Human client barriers to animal care and witnessing client grief relate to greater compassion fatigue, as predicted. None of the predictors relate to less compassion fatigue, but forming relationships with animal patients relates to both greater compassion satisfaction and compassion fatigue. This paper enhances our understanding of provider-client-patient interactions and highlights the paradox of compassionate work.

Referrals for pediatric weight management: the importance of proximity.

PubMed

Ambler, Kathryn A; Hagedorn, Douglas W J; Ball, Geoff D C

2010-11-01

Limited access to weight management care can have a negative impact on the health and well-being of obese children and youth. Our objectives were to describe the characteristics of clients referred to a pediatric weight management centre and explore potential differences according to proximity. All demographic and anthropometric data were abstracted from standardized, one-page referral forms, which were received by a pediatric weight management centre in Edmonton, AB (Canada) between April, 2005 and April, 2009. Referrals (n = 555; 52% male; age [mean +/- standard deviation]: 12.4 +/- 2.6 y; BMI: 32.3 +/- 6.8 kg/m2; BMI percentile: 98.4 +/- 1.7; BMI z-score: 2.3 +/- 0.4) were received from 311 physicians. Approximately 95% of referrals were for boys and girls classified as obese or very obese. Based on postal code data, individuals were dichotomized as either living within (local; n = 455) or beyond (distant; n = 100) the Edmonton Census Metropolitan Area. Numerous families resided several hundred kilometres away from our centre. Overall, distant clients were taller, weighed more, and were more overweight than their local counterparts. For distant clients, the degree of overweight was higher in youth versus children. Pediatric weight management services must be designed to optimize access to health services, especially for distant clients who may be at increased obesity-related health risk.

Epi info - present and future.

PubMed

Su, Y; Yoon, S S

2003-01-01

Epi Info is a suite of public domain computer programs for public health professionals developed by the Centers for Disease Control and Prevention (CDC). Epi Info is used for rapid questionnaire design, data entry and validation, data analysis including mapping and graphing, and creation of reports. Epi Info was originally created in 1985 using Turbo Pascal. In 1998, the last version of Epi Info for DOS, version 6, was released. Epi Info for DOS is currently supported by CDC but is no longer updated. The current version, Epi Info 2002, is Windows-based software developed using Microsoft Visual Basic. Approximately 300,000 downloads of Epi Info software occurred in 2002 from approximately 130 countries. These numbers make Epi Info probably one of the most widely distributed and used public domain programs in the world. The DOS version of Epi Info was translated into 13 languages, and efforts are underway to translate the Windows version into other major languages. Versions already exist for Spanish, French, Portuguese, Chinese, Japanese, and Arabic.

78 FR 72932 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... protections when advisers engage in principal trades. Clients of advisers will primarily use the information... information on respondents, including through the use of automated collection techniques or other forms of..., Copies Available From: Securities and Exchange Commission, Office of Investor Education and Advocacy...

Mediator Deathwork

ERIC Educational Resources Information Center

Walter, Tony

2005-01-01

The most discussed and analyzed form of deathwork is the dyadic "therapist" [double arrow] "client" relationship, but this far from exhausts the various types of professional work involving the dead. Mediator deathwork is where the professional gleans or constructs information about the dead, edits and polishes it, and publicly…

Counseling Women for Responsibilities

ERIC Educational Resources Information Center

Koontz, Elizabeth Duncan

1970-01-01

This article stresses the need for those counseling young women today to be aware of thechanges taking place in career possibilities. Counselors must combine their insights with client potential to form a solid combination which will serve as a guide for a young woman's future. (Author/CJ)

Decision analysis. Clinical art or Clinical Science

DTIC Science & Technology

1977-05-01

having helped some clients. Over the past half century, psychotherapy has faced a series of crises concerned with its transformation from an art to a...clinical science . These include validation of the effectiveness of various forms of therapy, validating elements of treatment programs and

Culturally competent evidence-based behavioral health services for the transgender community: Progress and challenges.

PubMed

Hope, Debra A; Mocarski, Richard; Bautista, Chandra L; Holt, Natalie R

2016-01-01

The presence of individuals who identify as transgender has emerged into public awareness in the United States in recent years. Celebrities who publicly transition have expanded the national conversation about gender variation beyond gender and women's studies classrooms and certain specialty health and mental health services. This increased public visibility has been accompanied by increased visibility in the mental health literature, including the publishing of competencies or guidelines for working with clients who identify as transgender by various professional organizations. However, rapid societal changes and increased understanding of the experience of being transgender in our society means literature can rapidly become dated. This commentary identifies key points that will move forward professional competency, both of the field and of individual practitioners, in the provision of psychological services. Topics discussed include (1) how mental health has contributed to trans stigma, (2) why more than good intentions are needed, (3) a research agenda for the development of high-quality evidence-based behavioral health care for the trans community, and (4) clinician recommendations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A cultural accommodation model for cross-cultural psychotherapy: Illustrated with the case of Asian Americans.

PubMed

Leong, Frederick T; Lee, Szu-Hui

2006-01-01

As an extension of F. T. L. Leong's (1996) integrative model, this article presents the cultural accommodation model (CAM), an enhanced theoretical guide to effective cross-cultural clinical practice and research. Whereas F. T. L. Leong's model identifies the importance of integrating the universal, group, and individual dimensions, the CAM takes the next step by providing a theoretical guide to effective psychotherapy with culturally different clients by means of a cultural accommodation process. This model argues for the importance of selecting and applying culture-specific constructs when working with culturally diverse groups. The first step of the CAM is to identify cultural disparities that are often ignored and then accommodate them by using current culturally specific concepts. In this article, several different cultural "gaps" or culture-specific constructs of relevance to Asian Americans with strong scientific foundations are selected and discussed as they pertain to providing effective psychotherapy to this ethnic minority group. Finally, a case study is incorporated to illustrate application of the CAM. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol.

PubMed

Pepping, Christopher A; Lyons, Anthony; Morris, Eric M J

2018-03-01

Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from <1 year to 37 years (M = 6.54 years). Across all outcomes, therapists reported increased knowledge and skills related to working with LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Case conceptualization research in cognitive behavior therapy: A state of the science review.

PubMed

Easden, Michael H; Kazantzis, Nikolaos

2018-03-01

Prominent models of cognitive behavior therapy (CBT) assert that case conceptualization is crucial for tailoring interventions to adequately address the needs of the individual client. We aimed to review the research on case conceptualization in CBT. We conducted a systematic search of PsychINFO, MEDLINE, Psychology and Behavioral Science Collection, and CINAHL databases to February 2016. A total of 24 studies that met inclusion criteria were identified. It was notable that studies (a) focused on the assessment function of case conceptualization, (b) employed diverse methodologies, and, overall, (c) there remains a paucity of studies examining the in-session process of using case conceptualization or examining relations with outcome. Results from the existing studies suggest that experienced therapists can reliably construct some elements of case conceptualizations, but importance for the efficacy of case conceptualization in CBT has yet to be demonstrated. Research that involves direct observation of therapist competence in case conceptualization as a predictor of CBT outcomes is recommended as a focus for future hypothesis testing. © 2017 Wiley Periodicals, Inc.

Modular architectures for quantum networks

NASA Astrophysics Data System (ADS)

Pirker, A.; Wallnöfer, J.; Dür, W.

2018-05-01

We consider the problem of generating multipartite entangled states in a quantum network upon request. We follow a top-down approach, where the required entanglement is initially present in the network in form of network states shared between network devices, and then manipulated in such a way that the desired target state is generated. This minimizes generation times, and allows for network structures that are in principle independent of physical links. We present a modular and flexible architecture, where a multi-layer network consists of devices of varying complexity, including quantum network routers, switches and clients, that share certain resource states. We concentrate on the generation of graph states among clients, which are resources for numerous distributed quantum tasks. We assume minimal functionality for clients, i.e. they do not participate in the complex and distributed generation process of the target state. We present architectures based on shared multipartite entangled Greenberger–Horne–Zeilinger states of different size, and fully connected decorated graph states, respectively. We compare the features of these architectures to an approach that is based on bipartite entanglement, and identify advantages of the multipartite approach in terms of memory requirements and complexity of state manipulation. The architectures can handle parallel requests, and are designed in such a way that the network state can be dynamically extended if new clients or devices join the network. For generation or dynamical extension of the network states, we propose a quantum network configuration protocol, where entanglement purification is used to establish high fidelity states. The latter also allows one to show that the entanglement generated among clients is private, i.e. the network is secure.

The use of data for process and quality improvement in long term care and home care: a systematic review of the literature.

PubMed

Sales, Anne E; Bostrom, Anne-Marie; Bucknall, Tracey; Draper, Kellie; Fraser, Kimberly; Schalm, Corinne; Warren, Sharon

2012-02-01

Standardized resident or client assessments, including the Resident Assessment Instrument (RAI), have been available in long term care and home care settings (continuing care sector) in many jurisdictions for a number of years. Although using these data can make quality improvement activities more efficient and less costly, there has not been a review of the literature reporting quality improvement interventions using standardized data. To address 2 questions: (1) How have RAI and other standardized data been used in process or quality improvement activities in the continuing care sector? and (2) Has the use of RAI and similar data resulted in improvements to resident or other outcomes? Searches using a combination of keyword and controlled vocabulary term searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, and PsychINFO. ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: English language publications from database inception to October 2008 were included. Eligibility criteria included the following: (1) set in continuing care (long-term care facility or home care), (2) involved some form of intervention designed to improve quality or process of care, and (3) used standardized data in the quality or process improvement intervention. After reviewing the articles, we grouped the studies according to the type of intervention used to initiate process improvement. Four different intervention types were identified. We organized the results and discussion by these 4 intervention types. Key word searches identified 713 articles, of which we excluded 639 on abstract review because they did not meet inclusion criteria. A further 50 articles were excluded on full-text review, leaving a total of 24 articles. Of the 24 studies, 10 used a defined process improvement model, 8 used a combination of interventions (multimodal), 5 implemented new guidelines or protocols, and 1 used an education intervention. The most frequently cited issues contributing to unsuccessful quality improvement interventions were lack of staff, high staff turnover, and limited time available to train staff in ways that would improve client care. Innovative strategies and supporting research are required to determine how to intervene successfully to improve quality in these settings characterized by low staffing levels and predominantly nonprofessional staff. Research on how to effectively enable practitioners to use data to improve quality of care, and ultimately quality of life, needs to be a priority. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

[The interpreter in an intercultural clinical milieu].

PubMed

Vissandjée, B; Ntetu, A L; Courville, F; Breton, E R; Bourdeau, M

1998-05-01

The public's diversified language profile means that nursing practice must adjust to provide the same quality of care to all clients, no matter what language they speak. To improve quality and quantity of information exchanged in the nurse-client-interpreter triangle, the authors have investigated the type of information likely to be filtered and studied the various factors underlying the interpreter's choice to filter information. The authors also analyzed the values interpreters assign to information and the factors that form the background for filtering, including mistrust. The authors suggest adequately preparing interpreters; using interpreters' expertise; and developing an appropriate training program for intercultural interpreters to enable them to better function within health care institutions.

Reflections on Fritz Perls's Gestalt Prayer.

ERIC Educational Resources Information Center

Dolliver, Robert H.

1981-01-01

Reviews the alternative forms of Fritz Perls' Gestalt Prayer, which was highly influential in the 1970s when individuality and personal rights were being explored. The prayer is subject to interpretation. Counselors should clarify for clients that ongoing relationships require a great deal of work. (JAC)

Teacher Professionalism: The Wrong Conversation.

ERIC Educational Resources Information Center

Coulter, David; Orme, Liz

2000-01-01

Defining teachers as professionals in the same way that doctors or engineers are professionals is reductionist because such definition generally distorts the moral dimensions of teaching by using the wrong language (clients, customers), focusing on limited forms of knowledge, and ignoring the fundamental democratic character of education.…

Black Oral Art Forms: Guided Group Interaction Techniques.

ERIC Educational Resources Information Center

Toldson, Ivory L.; Pasteur, Alfred B.

1981-01-01

Describes how oral art can positively influence the development of Black people through therapeutic guidance. Group techniques are suggested to stimulate the counselor's creative potential and enhance clients' self-worth Presents guidelines to enhance educational achievement and school retention, and develop determination and persistence. (JAC)

Gestalt and Other Strategies for Exploring Dreams through a Step-by-Step Approach.

ERIC Educational Resources Information Center

France, M. Honore; Allen, G. Edward

1993-01-01

The Gestalt dream approach is a practical way to explore personal issues. This article demonstrates how dream work can be adapted by counselors to focus clients to direct forms of personal exploration. A four-step strategy is described. (Authors)

Assessing the effectiveness of massage therapy for bilateral cleft lip reconstruction scars.

PubMed

McKay, Emilie

2014-06-01

Bilateral cleft lips occur when the bones that form the upper lip fail to fuse at birth. Surgical reconstruction creates scars, which may lead to the following impairments: adhesions, decreased oral range of motion, decreased strength of orbicularis oris muscle, and asymmetry of oral region leading to poor self-esteem. The purpose of this case study is to determine the effectiveness of massage therapy in its ability to improve these impairments. A five-week treatment plan consisting of fascial release, kneading, and intraoral techniques. Subjective information was assessed on two scales: restriction of scar and clients attitudes and acceptance of scar. Objective information was cataloged through photographs, a palpatory chart, and a self-created "Pen Test". Results included increase range of motion and strength, decrease restrictions (palpable and subjective), and increase of symmetry. Client's perceived confidence of scar and its appearance increased. The evidence suggests that massage therapy helped with the impairments associated with scars formed by bilateral cleft lip reconstruction.

Pluralism, public choice, and the state in the emerging paradigm in health systems.

PubMed

Chernichovsky, Dov

2002-01-01

Today in developed nations, the public pays for most medical care, with the state and the medical profession or providers determining its nature, form, and level. But there is no well-defined institutional framework for revealing consumer preferences and enabling client choice about the nature and form of public entitlement. This thwarts the efforts of health system reformers to satisfy their clients and consequently promote equity and control costs--the raison d'être of publicly supported care. Consumers can be empowered in the emerging paradigm, however, in which the publicly financed system also contains competing fund-holding institutions that organize and manage the consumption of care (OMCC), such as HMOs and sickness funds. In a system in which individuals are entitled to health coverage, OMCC institutions can play an essential role in both shaping the entitlement and in expressing members' preferences. To do this, the OMCCs need to be financed through capitation and endowed with appropriate constitutional rights on how to use the funds.

Crystal Structure of the ERp44-Peroxiredoxin 4 Complex Reveals the Molecular Mechanisms of Thiol-Mediated Protein Retention.

PubMed

Yang, Kai; Li, De-Feng; Wang, Xi'e; Liang, Jinzhao; Sitia, Roberto; Wang, Chih-Chen; Wang, Xi

2016-10-04

ERp44 controls the localization and transport of diverse proteins in the early secretory pathway. The mechanisms that allow client recognition and the source of the oxidative power for forming intermolecular disulfides are as yet unknown. Here we present the structure of ERp44 bound to a client, peroxiredoxin 4. Our data reveal that ERp44 binds the oxidized form of peroxiredoxin 4 via thiol-disulfide interchange reactions. The structure explains the redox-dependent recognition and characterizes the essential non-covalent interactions at the interface. The ERp44-Prx4 covalent complexes can be reduced by glutathione and protein disulfide isomerase family members in the ER, allowing the two components to recycle. This work provides insights into the mechanisms of thiol-mediated protein retention and indicates the key roles of ERp44 in this biochemical cycle to optimize oxidative folding and redox homeostasis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Update on Bullying at School: Science Forgotten?

ERIC Educational Resources Information Center

Berger, Kathleen Stassen

2007-01-01

Research on bullying has increased dramatically worldwide, from only 62 citations in PsycINFO from 1900-1990, to 289 in the 1990s, to 562 from 2000-2004. Much has been learned, including that bullying takes many forms (physical, verbal, relational), is prevalent in every school, with long-lasting consequences. It is not known how genes, parents,…

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

PubMed

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 psychological well-being.

Ethical tensions associated with the promotion of public health policy in health visiting: a qualitative investigation of health visitors' views.

PubMed

Greenway, Julie Catherine; Entwistle, Vikki Ann; terMeulen, Ruud

2013-04-01

To explore whether and how health visitors experience ethical tensions between the public health agenda and the need to be responsive to individual clients. Current health policy in England gives health visitors a key role in implementing the government's public health agenda. Health visitors are also required by their Professional Code to respond to the health-related concerns and preferences of their individual clients. This may generate tensions. A total of 17 semi-structured individual interviews covering participants' experiences of implementing public health interventions and perceptions of the ethical tensions involved were conducted. Interviews were audio-recorded, transcribed and analysed thematically using a Framework approach. Health visitors raised a number of ethical concerns, which they attributed to organisational resource allocation and the introduction of protocols and targets relating to public health goals. They did not always regard it as appropriate to raise topics that employing organisations had identified as public health priorities with particular clients for whom they were not priorities, or who had other more pressing needs. They noted that resources that were allocated towards reaching public health targets were unavailable for clients who needed support in other areas. Organisational protocols designed to monitor performance put pressure on health visitors to prioritise achieving targets and undermined their ability to exercise professional judgement when supporting individual clients. This had implications for health visitors' sense of professionalism. Health visitors saw trusting relationships as key to effective health visiting practice, but the requirement to implement public health priorities, combined with a lack of resources in health visiting, eroded their ability to form these. Policies need to be evaluated with regard to their impact upon a broader range of processes and outcomes than public health goals. The erosion of health visitors' professional values and ability to develop relationships with clients could have numerous adverse implications.

76 FR 46326 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Understanding...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... Trends in Hate Crimes Against Immigrants and Hispanic Americans ACTION: 60-Day Notice of Information...) Title of the Form/Collection: Understanding Trends in Hate Crimes Against Immigrants and Hispanic... immigrants, and clients of immigration advocacy organizations. While there has been great progress in...

External Communities of Practice and Relational Capital

ERIC Educational Resources Information Center

Dewhurst, Frank W.; Navarro, Juan G. Cegarra

2004-01-01

External communities of practice are groups formed by company clients and employees based on common interests, commitment, mutual trust and collaboration whose members regularly share knowledge and learning. This paper examines how external communities of practice contribute to the creation of relational capital through an empirical investigation…

[Observing migration and deficiencies in health care - STD center at the Cologne Municipal Health Department].

PubMed

Nitschke, H; Oliveira, F; Knappik, A; Bunte, A

2011-11-01

In spite of the compulsory health insurance in Germany, many people only have limited access to medical services. This has serious consequences, especially in the field of sexual health. The affected people are not only undocumented migrants, but also many people from the new European Union countries who are temporarily living in Germany. Many of these people, especially in larger cities, frequent STD counselling centers. Since 2002, in addition to basic socio-demographic data, other anonymous data have been recorded for all consultations in the STD offices of the Cologne Health Department. These data include the patients' country of origin, rea-son for consultation, whether the patients are medically insured, as well as the medical services provided and the diagnoses. The data is evaluated with the help of EpiInfo. During the study period, between 608 and 883 people visited the STD Counselling Centre per year. During this period, 4 235 people received in total medical help. The proportion of patients with a migration history rose from 65% in 2002 to 83% in 2010. The proportion of patients without health insurance rose from 45% (2002) to 67% (2010).About half of the counselled migrants were, at least for a short time, involved in professional sexwork. The number of counselled patients from the sub-Saharan region decreased from 123 (2002) to 72 (2010). The number of patients from Central Europe increased from 112 to 364 in this period.Migrants were over-represented in the group of patients who were diagnosed with gonorrhea and trichomoniasis, as well as among women with a conspicuous cytological swab. Chlamydia infections were, in contrast, more frequent among German clients.Gender, sexual orientation, age and the proportion of people involved in sexwork are, however, more important predictive factors than having an immigration status. The client spectrum has changed considerably during the study period.These changes are related to economic and political developments, as well as to the consequences of immigration laws. For the majority of patients with a migration history, the STD centre is the primary means of access to medical care in Germany. The rapid change in the client spectrum, the patients' limited access to information and to medical care and the resulting changes in epidemiology represent a major challenge for the public health services. © Georg Thieme Verlag KG Stuttgart · New York.

Effectiveness of hsp90 inhibitors as anti-cancer drugs.

PubMed

Xiao, Li; Lu, Xiangyi; Ruden, Douglas M

2006-10-01

Hsp90 is a chaperone with over 100 identified client proteins. What makes Hsp90 especially promising as a target for anti-cancer drugs is that many of its client proteins are in signaling and chromatin-remodeling pathways, and these pathways are often disrupted in many types of cancers. Recently, it was determined that Hsp90 bound to a client protein in a co-chaperone complex has a higher ATPase activity and binds to the geldanamycin inhibitor with over 100-fold higher affinity than the low-ATPase form. Consequently, despite Hsp90 being an abundant protein in most cell types, Hsp90 inhibitors accumulate at high levels primarily in tumor cells because tumor cells are "oncogene addicted" and require especially high levels of the high-ATPase form of Hsp90. Numerous classes of Hsp90 inhibitors have recently been developed, such as the anasamysin geldanamycin and derivatives 17-AAG and 17-DMAG; the macrolide radicicol and derivatives; purine-scaffold derivatives; pyrazoles; and shepherdins that bind to the N-terminal high-affinity ATP-binding domain of Hsp90. Other inhibitors have recently been shown to bind to the C-terminal dimerization domain of Hsp90, such as cisplatin and novobiocin, or modify Hsp90 postranslationally, such as histone deacetylase or proteasome inhibitors. In this mini-review, we present hypothetical mechanisms for Hsp90 inhibitors in treating cancers, preliminary studies in early clinical trials, and potential tumor-killing and tumor-promoting activities of Hsp90 inhibitors.

Exploring the impact of music concerts in promoting well-being in dementia care.

PubMed

Shibazaki, Kagari; Marshall, Nigel A

2017-05-01

This study explores the specific effects of live music concerts on the clients with dementia, their families and nursing staff/caregivers. Researchers attended 22 concerts in care facilities in England and Japan. Interviews were carried out with clients with dementia, nursing staff and family members. Observations were also carried out before, during and after the concerts. All observations were recorded in field notes. The effect of the concerts in both countries was seen to be beneficial to all clients and nursing staff, whether or not they attended the concert. Interviews with clients with mild to mid-stage dementia noted increased levels of cooperation, interaction and conversation. Those with more advanced forms of dementia exhibited decreased levels of agitation and anti-social behaviour. Staff members reported increased levels of care, cooperation and opportunities for assessment. Family members noted an increase in the levels of well-being in their partner/parent as well as in themselves. The study also suggested that the knowledge of musical components, an awareness of the rules of music and specific musical preferences appear to remain well beyond the time when other cognitive skills and abilities have disappeared. This initial study provided some further indication in terms of the uses of music as a non-pharmacological intervention for those living with all stages of dementia. These included opportunities for assessment of physical abilities as well as facilitating an increasing level of care.

Unraveling the concept of race in Brazil: issues for the Rio de Janeiro Cooperative Agreement site.

PubMed

Surratt, H L; Inciardi, J A

1998-01-01

Scholars throughout the Americas have spent much of the 20th century studying race and its meaning in Brazil. Racial identities in Brazil are dynamic concepts which can only be understood if situated and explored within the appropriate cultural context. Empirical evidence of the fluidity of racial identification quickly came to the authors' attention within the context of a prevention initiative targeting segments of the Rio de Janeiro population at high risk for HIV/AIDS. Because the main objective of this program was to slow the spread of AIDS through an intervention designed to promote behavioral change, comparisons of client data at the baseline and follow-up assessments form the core of the analyses. Through quality control procedures used to link client information collected at different points in time, it was revealed that 106 clients, or 12.5% of the follow-up sample, had changed their racial self-identification. The authors' attempts to engage project staff in a dialogue about the fluidity of racial identity among these clients have provided some insight into what might be called the "contextual redefinition" of race in Brazil. Within the framework of this study, the ramifications of this phenomenon are clear. Racial comparisons of HIV risk, sexual activity, drug use, and behavioral change, which are part and parcel of U.S.-based research, would appear to be of little utility in this setting.

Cross-Cultural Validation of the Career Maturity Inventory: A Korean Form

ERIC Educational Resources Information Center

Bang, Na Mi

2016-01-01

As counselors become aware of the importance of providing culturally sensitive counseling, they can use evaluation and assessment to support client career development (Swanson & Fouad, 2014). For culturally sensitive career assessment, counselors should understand cultural factors, including the values and level of acculturation that may…

Renewing Occupational Cultures--Bridging Boundaries in Learning Spaces

ERIC Educational Resources Information Center

Kalliola, Satu; Nakari, Risto

2007-01-01

Professional bureaucracies of the Finnish municipal services are challenged by many modernization pressures manifested currently in the form of New Public Management. Along with efficiency demands the new emphasis is on the provision of client-oriented services by the means of multi-professional teamwork crossing the traditional sector boundaries.…

76 FR 17869 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... complexity to respond to changes in the epidemic, including the diffusion and implementation of Effective... interventions by monitoring changes in clients' self-reported HIV transmission risk behaviors after... project. Each agency will recruit 400 men who are 18 years of age and older, report having had anal sex...

Professional Characteristics Communicated by Formal versus Casual Workplace Attire

ERIC Educational Resources Information Center

Cardon, Peter W.; Okoro, Ephraim A.

2009-01-01

Employees are frequently advised to dress for success to build their careers. From the corporate perspective, employees who are well dressed are believed to form better impressions with colleagues, clients, and customers. Many companies create dress codes in order to gain the benefits of a professionally appearing workforce. Developing effective…

Palmistry, tarot cards, and psychotherapy.

PubMed

Pejic, Nicholas G

2008-01-01

The author summarizes his experience with palm and Tarot card readers in New Orleans. The history, practice, and psychodynamics of palmistry and Tarot are explored. It's postulated that these practices are forms of archaic psychotherapy, which employ supportive treatment and placebo. These tactics are used to elicit hope for its clients.

Wireless Security Within Hastily Formed Networks

DTIC Science & Technology

2006-09-01

WLAN DEVICES (STEP ONE) ............34 1. Personal Firewalls..............................................................................34 2. Anti ...includes client devices , access points, network infrastructure, network management, and delivery of mobility services to maintain network security and...Technology Special Publication 800-48, Wireless Network Security, 802.11, Bluetooth , and Handheld Devices . Available at http://csrc.nist.gov

A Process Model for Assessing Adolescent Risk for Suicide.

ERIC Educational Resources Information Center

Stoelb, Matt; Chiriboga, Jennifer

1998-01-01

This comprehensive assessment process model includes primary, secondary, and situational risk factors and their combined implications and significance in determining an adolescent's level or risk for suicide. Empirical data and clinical intuition are integrated to form a working client model that guides the professional in continuously reassessing…

Educational Interventions in Counseling: The Need to Avoid Pronouncements

ERIC Educational Resources Information Center

Mawson, Carol Dienhardt

1978-01-01

Pronouncements are unqualified statements of, or declarations of, expertise. It is suggested that pronouncements are generally an unethical form of language for the counselor-teacher to use, and that although they serve a number of persuasive functions for the counselor, they mystify knowledge and authority relationships for the client. (Author)

Distributed Agent-Based Networks in Support of Advanced Marine Corps Command and Control Concept

DTIC Science & Technology

2012-09-01

clusters of managers and clients that form a hierarchical management framework (Figure 14). However, since it is SNMP-based, due to the size and...that are much less computationally intensive than other proposed approaches such as multivariate calculations of Pareto boundaries (Bordetsky and

78 FR 76310 - Agency Information Collection Activities: Submission to OMB for Review and Approval; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... collecting qualitative and quantitative information. To support the qualitative analysis, HRSA will conduct... sites in order to gain a deeper understanding of the program's implementation. Finally, quantitative... forms; and 3. Client satisfaction surveys. ORHP is seeking approval from OMB for the three methods of...

76 FR 62149 - Proposed Collection; Comment Request; Renewal With Changes to a Currently Approved Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... , again with a caption, in the body of the text, ``Attention: PRA Comments--MSB Registration--Form 107... box to indicate a foreign country, adds a box to indicate the type of taxpayer identification number... entry expansion, TIN and TIN type as in part II. E-mail address and Web site info is added and removes...

Transforming Insecurity into a Commodity: Using the Digital Tools Unikum and InfoMentor as an Example in Swedish Education

ERIC Educational Resources Information Center

Andreasson, Ingela; Dovemark, Marianne

2013-01-01

New forms of activities now shape and govern the Swedish education system, based on governance through comparison. The focus on comparison can be regarded as soft governance and different types of (self-) evaluations and valuations are, at present, deeply embedded keystones in the decentralised education system. Recently this has, together with…

Internet Distribution of Spacecraft Telemetry Data

NASA Technical Reports Server (NTRS)

Specht, Ted; Noble, David

2006-01-01

Remote Access Multi-mission Processing and Analysis Ground Environment (RAMPAGE) is a Java-language server computer program that enables near-real-time display of spacecraft telemetry data on any authorized client computer that has access to the Internet and is equipped with Web-browser software. In addition to providing a variety of displays of the latest available telemetry data, RAMPAGE can deliver notification of an alarm by electronic mail. Subscribers can then use RAMPAGE displays to determine the state of the spacecraft and formulate a response to the alarm, if necessary. A user can query spacecraft mission data in either binary or comma-separated-value format by use of a Web form or a Practical Extraction and Reporting Language (PERL) script to automate the query process. RAMPAGE runs on Linux and Solaris server computers in the Ground Data System (GDS) of NASA's Jet Propulsion Laboratory and includes components designed specifically to make it compatible with legacy GDS software. The client/server architecture of RAMPAGE and the use of the Java programming language make it possible to utilize a variety of competitive server and client computers, thereby also helping to minimize costs.

BossPro: a biometrics-based obfuscation scheme for software protection

NASA Astrophysics Data System (ADS)

Kuseler, Torben; Lami, Ihsan A.; Al-Assam, Hisham

2013-05-01

This paper proposes to integrate biometric-based key generation into an obfuscated interpretation algorithm to protect authentication application software from illegitimate use or reverse-engineering. This is especially necessary for mCommerce because application programmes on mobile devices, such as Smartphones and Tablet-PCs are typically open for misuse by hackers. Therefore, the scheme proposed in this paper ensures that a correct interpretation / execution of the obfuscated program code of the authentication application requires a valid biometric generated key of the actual person to be authenticated, in real-time. Without this key, the real semantics of the program cannot be understood by an attacker even if he/she gains access to this application code. Furthermore, the security provided by this scheme can be a vital aspect in protecting any application running on mobile devices that are increasingly used to perform business/financial or other security related applications, but are easily lost or stolen. The scheme starts by creating a personalised copy of any application based on the biometric key generated during an enrolment process with the authenticator as well as a nuance created at the time of communication between the client and the authenticator. The obfuscated code is then shipped to the client's mobile devise and integrated with real-time biometric extracted data of the client to form the unlocking key during execution. The novelty of this scheme is achieved by the close binding of this application program to the biometric key of the client, thus making this application unusable for others. Trials and experimental results on biometric key generation, based on client's faces, and an implemented scheme prototype, based on the Android emulator, prove the concept and novelty of this proposed scheme.

Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study

PubMed Central

Brabin, Loretta; Thomas, Grace; Hopkins, Mark; O'Brien, Karen; Roberts, Stephen A

2009-01-01

Background More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group. PMID:19323804

[Ethical issues concerning surrogate assisted sex therapy].

PubMed

Aloni, Ronit; Heruti, Rafi J

2009-09-01

Sex therapy, by definition, is a couple therapy as well as behavioral therapy by origin. As such, practicing a series of exercises is an essential part of the therapy. Masters and Johnson, in their book "Human Sexual Inadequacy", wrote that "one cannot learn about sexuality in any practical way without actually experiencing intimate behavior with a partner". This ethical approach directed them to develop the therapeutic method of working with surrogate partners, as they thought all people are entitled to receive therapy, if they so wish, including people without partners. Surrogate is a form of mentoring; this is a one-on-one relationship that allows practicing classic behavioral methods such as gradual progress, breaking the task into small goals, onsite feedback, rehearsals, role-play, modifying the environment, etc. The content and the skills that are practiced are related to sexual dysfunction as well as social, couple and intimate skills. The lack of those critical skills prevents the clients from fulfilling their wish to develop social or intimate relationships in which they will be able to accomplish their sexuality. Ethical procedures should be strictly kept in order to protect the clients and the surrogates, in a three-way therapeutic team, working together to reach the goals of the therapy. During the therapy process a weekly meeting is held between the therapist and the client, between the therapist and the surrogate and, only then, between the surrogate and the client. At the end of the therapy process the relationship between the client and the surrogate is terminated, completely. In this article, the authors illuminate the complexity of this therapy process, as well as dealing with some of the ethical issues that are raised. The article also identifies types of patients who can benefit from surrogate therapy.

Matching therapists' predicates: an in vivo test of effectiveness.

PubMed

Dowd, E T; Hingst, A G

1983-08-01

The theory of neurolinguistic programming predicts that a therapist's matching of a client's primary representational system, as expressed in the client's predicates, should result in increased therapist's rapport and social influence. This hypothesis was tested in an actual interview situation. Six relatively inexperienced therapists, two each in predicate matching, predicate mismatching, and predicate no-matching conditions, conducted a 30-min. interview with nine undergraduate student volunteers each, for a total of 54 subjects. After the appropriate interview condition was completed, subjects rated ther therapists on the Counselor Rating Form and the Counseling Evaluation Inventory. No significant differences among the three conditions on any of the measures were found. Results are compared with those of previous research on assessment and primary representational matching in analogue situations.

Enrollment in mental health courts: voluntariness, knowingness, and adjudicative competence.

PubMed

Redlich, Allison D; Hoover, Steven; Summers, Alicia; Steadman, Henry J

2010-04-01

Mental health courts (MHCs) are rapidly expanding as a form of diversion from jails and prisons for persons with mental illness charged with crimes. Although intended to be voluntary, little is known about this aspect of the courts. We examined perceptions of voluntariness, and levels of knowingness and legal competence among 200 newly enrolled clients of MHCs at two courts. Although most clients claimed to have chosen to enroll, at the same time, most claimed not to have been told the court was voluntary or told of the requirements prior to entering. The majority knew the "basics" of the courts, but fewer knew more nuanced information. A minority also were found to have impairments in legal competence. Implications are discussed.

Volume 51, Issue 7-8Copyright © 2003 WILEY-VCH Verlag GmbH & Co. KGaA, WeinheimSave Title to My Profile

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